Condition which may lead to Noma

 # Which of the following conditions if not treated properly may lead to Noma?

A. Diphtheria

B. Herpangina

C. Herpetic gingivostomatitis

D. ANUG

The correct answer is D. ANUG

Clinical course of ANUG (Acute Necrotizing Ulcerative Gingivitis)  is indefinite. If untreated, NUG (Necrotizing Ulcerative Gingivitis) may lead to NUP (Necrotizing Ulcerative Periodontitis) with a progressive destruction of the periodontium and denudation of roots, accompanied by an increase in severity of toxic systemic complication. 

Horning and Cohen Staging of Oral Necrotizing Diseases

Necrotizing Ulcerative Gingivitis --> Periodontitis --> Stomatitis -->Noma

Stage 1: Necrosis of the tip of interdental papilla

Stage 2: Necrosis of entire interdental papilla or marginal gingiva or attached gingiva

Stage 3: Necrosis extending to gingival margin

Stage 4: Necrosis extending also to attached gingiva

Stage 5: Necrosis extending into buccal or labial mucosa

Stage 6: Necrosis exposing alveolar bone

Stage 7: Necrosis perforating skin of cheek

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Drug of choice in pneumocystis carinii pneumonia:

 # Drug of choice in pneumocystis carinii pneumonia:

a) Pentamidine

b) Zidovudine

c) Ciprofloxacin

d) Cotrimoxazole

The correct answer is D. Cotrimoxazole.

Legionnaire's pneumonia -Pneumonia in association with high fever, confusion and diarrhea suggests

Cotrimoxazole, Clindamycin - Drug of choice for atypical pneumonia caused by pneumocystis carini

Clarithromycin, Flucloxacillin - Drug of choice for community acquired pneumonia

Gram negative bacilli - Most common micro organisms isolated from the patients with nosocomial pneumonias

Mycoplasma, Chlamydia, pneumocystis carinii and viral infections -Causes of atypical pneumonia

Streptococcus pneumonia (or) Pneumococcus pneumonia - Most common cause of community acquired pneumonia is

Doxycycline, Erythromycin - Drugs used for treatment of atypical pneumonia caused by Chlamydia

Erythromycin, Clarithromycin - Drug of choice for atypical pneumonia caused by mycoplasma

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Cyanosis is seen if:

 # Cyanosis is seen if:

a) Meth Hb 1.5gm%

b) Sulf Hb 0.5gm%

c) Reduced Hb 5gm%

d) All of the above

The correct answer is D. All of the above.

Types of cyanosis

- Central 

- Peripheral

- Cyanosis due to abnormal pigments (methemoglobin, sulfhemoglobin)

- Mixed

CENTRAL CYANOSIS

Mechanism:

Diminished arterial oxygen saturation

Sites:

On skin & mucous membranes

Eg.: Tongue, lips, cheeks

Temperature of the Limb

Warm

PERIPHERAL CYANOSIS

Mechanism:

Diminished flow of blood to the local part

Sites:

On skin only

Temperature of the Limb

Cold

Thin bluish line around the gingival margin

 # A thin bluish line around the gingival margin is due to the absorption of :

 A. Silver

 B. Mercury

 C. Drugs like tetracycline

 D. Lead

The correct answer is D. lead.

Heavy metals cause gingival pigmentation in areas of inflammation only, where the increased permeability permits the seepage of metal into the surrounding tissue.

Lead Line (Burtonian Line) --- Bluish red or deep blue linear pigmentation in marginal gingiva

Silver (argyria) --- Violet marginal line

Bismuth, arsenic and mercury --- Black marginal line

Mesenteric line --- Delicate, brown or black pigmented non cariogenic plaque found on the enamel at the cervical margin of the tooth

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Plasma cell gingivitis

 # Plasma cell gingivitis is seen in individuals having the habit of chewing of the following types of flavored chewing gum?

A. Peppermint flavored

B. Clove flavored

C. Cinnamon flavored

D. Banana flavored

The correct answer is  C. Cinnamon flavored.

PLASMA CELL GINGIVITIS

- The gingiva appears red, friable, granular, and bleeds easily. 

- It may be associated with cheilitis and glossitis.

- Plasma cell gingivitis is a contact hypersensitivity reaction most frequently attributed to Cinnamon flavored chewing gum. 

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Gingival manifestation is seen maximum with:

 # Gingival manifestation is seen maximum with:

 A. AML

B. CLL

C. CML

D. ALL

The correct answer is A. AML.

Gum hypertrophy due to leukemic infiltration of the gingiva is a frequent finding in:

- M4: Acute myelomonocytic leukemia (Naegeli type)

- M5: Acute monocytic leukemia (Schilling type)

Incidence of gingival enlargement is highest in acute monocytic leukemia (66.7%), followed by acute myelocytic monocytic leukemia (18.7%) and myelocytic leukemia (3.7%). Leukemic gingival enlargements are not found in edentulous patients or in chronic leukemia.

Leukemic gingival enlargement occurs only in acute type and not in chronic leukemia. It occurs mostly in acute monocytic leukemia. The gingival connective tissue is infiltrated with immature leukocytes.

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AIIMS MDS Entrance Exam MCQS - May 2016

# Which of the following cannot be used to block undercuts intraorally?
A. Addition silicon
B. Plaster of Paris
C. Irreversible hydrocolloid
D. Temporary restorative material

# Inability of a material to sustain plastic deformation before the fracture occur:
A. Toughness
B. Hardness
C. Brittleness
D. Critical Stress