Oral Medicine and Radiology COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up

Subject: Oral Medicine                                                                                                              Time: 2 hr. 30 mins.
Date 4/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with a well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]

1.A 40 year old male patient visited the department with a chief complaint of pain and swelling in right side below the ear and behind the angle of the mandible. Patient gives a history of increased pain while eating food which subsides after meals. On clinical examination, there is pus discharge from a point in right buccal mucosa opposite to maxillary 2nd molar. 

Give the provisional diagnosis and discuss it in detail.               [2+4=6]

2. Define pain. Discuss in-detail about gate control theory.        [1+4=5]

3. Discuss in detail about radiotherapy. Mention the advantages and disadvantages of radiotherapy when compared with a surgical option.                                           [3+2=5]

4. Write short notes on: [3*3=9]

• Oral thrush
• Treatment of aphthous ulcers
• Corticosteroids in dentistry

SECTION "C" [25 Marks]

5. Discuss the image characteristics in detail.                              [6]
6. What is a bitewing radiograph? Give the advantages, disadvantages, indications, and uses of bitewing radiographs.      [1+4 =5]

7. Describe in detail the methods to reduce x-ray hazards.    [5]

8. Write short notes on :               [3x3=9]

• PA skull view
• Braking radiation
• Composition of fixing solution

Most common bone cancer:

# The most common bone cancer is (AlIMS 94, AIPG 99)
a) Osteosarcoma
b) Metastatic bone cancer
c) Multiple myeloma
d) Squamous cell carcinoma

The correct answer is: B. Metastatic bone cancer.

Metastatic cancers are most common cancers in bone. Multiple myeloma is the common primary bone tumor, whereas the common inherent bone cell tumor is osteogenic sarcoma or osteosarcoma.

Bifid ribs and Falx Cerebri Calcification

# Bifid ribs, multiple radiolucent lesions of the jaws, multiple basal cell nevi and falx ceribri calcification are found in (Man 98, 97)
a) Basal cell nevus syndrome
b) Sturge weber syndrome
c) Horner syndrome
d) Hereditary internal polyposis

The correct answer is A. Basal cell nevus syndrome.

Basal cell nevus syndrome is also called as Gorlin Goltz syndrome.

Horner's syndrome is characterized by miosis, ptosis and anhidrosis over face due to interruption of sudomotor and vasomotor control.

Hereditary intestinal polyposis is seen in Peutz-Jeghers syndrome.

Most aggresive odontogenic tumor

# Which of the following tumors is most aggressive? (AIPG 91, AIIMS2004)
a) Ameloblastoma
b) Odontoma
c) Odontogenic myxoma
d) Fibrocarcinoma

The answer is C. Odontogenic myxoma

ODONTOGENIC MYXOMAS

Aggressive, intraosseous neoplasms derived from embryonic odontogenic mesenchyme probably arise from the dental papilla or follicular mesenchyme. Nearly all lesions are found in the tooth bearing areas of maxillary and mandibular bone.

Mandibular lesions are commonly found in the premolar-molar area. The lesions often produce multilocular radiolucency with a "soap bubble' or "honey comb" appearance in the bone.

Thin and extremely delicate septa of bone are often seen to course through the radiolucent area and produce a "spider- web" like or "tennis racket" like appearance.

 (Ref: Shafer's Textbook of oral pathology 7h ed., p 299)