RQs: Most Recent: (1)Patient with hypertension and diabetes what is the most dental chair problem associated with this patient? And they give high blood pressure reading in the case Th choice was: 1-Hypertension 2-Hyperglycemia 3-Syncope I chose (1)→Syncope (2) what is the treatment for patient want replace missing teeth with least price? 1- rpd 2-complete denture 3-implant I chose (1) least expensive one-→ RPD (3)what is the long term treatment for patient with missing teeth on both side ? 1-rpd 2-complete denture 3-implant The choice was all can fit the question but l chose (3) cause long term treatment the key -→ Implant (4) X-ray show chronic sclerotic osteomyelitis (CSO)and the choice was include melkersson Rosenthal syndrome and 2 other not related to question but I think it was (CSO) common in Mn M1,Carious lesion, non-vital tooth.
(5)x-ray show cementoblastoma Cementoblastoma, or benign cementoblastoma, is a relatively rare benign neoplasm of the cementum of the teeth.
(6) questions the answer contain geriatric dentistry (7) patient take pralidoxime contraindicated with ? →atropine When atropine and pralidoxime are used together, the signs of atropinization (flushing, mydriasis, tachycardia, dryness of the mouth and nose) may occur earlier than might be expected when atropine is used alone. Pralidoxime is typically used in cases of organophosphate poisoning. (8) many question about antidote know it all they came all in my exam Organophosphate poisoning =pralidoxime Acetaminophen = N acetylcysteine TCA overdose =physostigmine Opioids =naloxane Benzodiazepine=flumazenil (9) too many questions about xerostomia One of the question was patient with xerostomia which drug contraindicated to use ? The answer is pralidoxime -→?? (10) many questions about when to give antibiotics to patient before treatment and many of answer was no need for preoprative ABC prophylaxis, needed only for
pulmonary shunt and myocardial endocarditis and prosthetic heart valve and in case perio and implant and exodontia. (11)patient with liver disease and has history of drug addiction what analgesic can give? The choice was (A) acetaminophen (B) acetaminophen with one of opioid drug I don't remember exactly (C)naproxen ( I chose this one cause with liver disease not give acetaminophen and also he has history of abuse so we can't give something contain opioids→ Naproxen In my opinion Acetaminophen is the answer. Paracetamol is safe in patients with chronic liver disease but a reduced dose of 2-3 g/d is recommended for long-term use. Non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided because of risk of renal impairment, hepatorenal syndrome, and gastrointestinal hemorrhage. Most opioids can have deleterious effects in patients with cirrhosis. They have an increased risk of toxicity and hepatic encephalopathy. They should be administrated with lower and less frequent dosing in these patients and be avoided in patients with a history of encephalopathy or addiction to any substance. (12)The supraspinal receptors for morphine analgesic? The answer is -→ mu receptor The supraspinal analgesic properties of the opioid agonist morphine are mediated by activation of the μ1 receptor; respiratory depression and physical dependence by the μ2 receptor; and sedation and spinal analgesia by the κ receptor. (13)questions about meperidine : Meperidine- synthetic opioid agonist (14)patient with hyperthyroidism? The answer was give him propylthiouracil and methmazole .
Propylthiouracil (PTU) or 6-n-propylthiouracil (PROP) is a thiouracil-derived drug used to treat hyperthyroidism (including Graves' disease) by decreasing the amount of thyroid hormone produced by the thyroid gland.Its notable side effects include a risk of agranulocytosis and aplastic anemia. PTU is preferred over methimazole (which is also a class D) only in the first trimester of pregnancy and in woman who may become pregnant because of the increased risk of teratogenicity of methimazole during critical organogenesis. In the second and third trimester, this risk is diminished and methimazole is preferred to avoid the risk of liver complications from PTU in the mother. (15)what will see in patient with hyperthyroidism? The answer will have tachycardia The most common presenting symptoms are: rapid weight loss, tachycardia (rapid heart rate), vomiting, diarrhea, increased consumption of fluids (polydipsia) and food, and increased urine production (polyuria). (14)many questions about hyperthyroidism and hypothyroidism Which endocrine system does thick hair become thin hair thyroid - hypothyroidism (cretinism in kids and myxoedema in adults) Hyperthyroidism : restless/irritable , heat intolerance, weight loss, muscle wasting, tremor , diarrhea, sweaty, fine hair Causes: Graves, Thyroid adenoma, Pituitary adenoma (2˚ hyper), Hashimoto’s thyroiditis (early) Hypothyroidism : mental slowing, cold intolerance, weight gain, deep voice, constipation, edema, dry (15)question about anthralin/dithranol drug? for psoriasis (I don't remember)
Dithranol (INN) or anthralin is a Hydroxyanthrone, anthracene derivative, medicine applied to the skin of people with psoriasis. (16) trigaminal neuralgia ? Carbamazepine (17)the drug that cause gingival hyperplasia? Anticonvulsant, ca channel blocker, immune suppression (cyclosporine) (18)what is the roll action of carpidopa? Inhibit the peripheral decarboxylation of levodopa (19)action of beta blocker drug in angina? Reduce cardiac rate and force (20)succinylcholine should used with caution in patient with low level of pseudocholinestrase (21)tetracycline have ability to chelate calcium ion (22) kanamycin cause ototoxicity (23) there was case patient take cetirizine which is antihistamine and the is many questions in this case related to this drug Read Hydroxyzine (24)phentolamine mesylate reverse the local anesthesia (25)questions mention intrinsic activities? The answer is efficacy (26)distraction osteogenesis These techniques are now extensively used by maxillofacial surgeons for the correction of micrognathia, midface, and frontoorbital hypoplasia in patients with craniofacial deformities (27) small size antral communication? Answer leave it no treatment
(28) most common complication after extracted molar? Dead tract ? No antibiotics required ?? Dry socket (29)vesicles in pemphigus vulgaris and in benign mucous membranes pemphigoid (30)sialolith is most common in-→ submandibular gland (31) ranula (32)necrotizing sialometaplasia ? Lesion of minor slivary gland (33)picture of pigmentation in tongue laterally like many very small dot ? I chose Addison disease The was amalgam tattoo but there is no amalgam filling in the picture besides the pigment also the was Peutz- jegher syndrome but it's not the choice according To the picture Addison’s ds pigmentation-tongue Peutz jehger syndrome pigmentation-tongue & lips I think it is Racial Pigmentation if patient is AfricanAmerican or Asian. (34)x-Ray of periapical cemental dysplasia
(35) the question was giving the characters features of gardner syndrome so it was clear the answer is gardner multiple facial osteoma, Odontomas, hyperdontia, GI polyps w/ potential for colon carcinoma
(36)keratocysts (37)traumatic cyst (38)most common disease that will become malignant? There was paget disease and fibrous dysplasia The answer is paget
(39) x-Ray of odontoma
(40)question was mention low level of alkaline phosphate? The answer was clear ,it is hypophosphatasia (early loss of teeth). (41)know that widening periodontal ligament space associated with osteosarcoma and scleroderma so it is not the choice the other one is the answer in the X-ray ( I don't remember exactly)
PDL widening: Hyperparathyoid, osteosarcoma and scleroderma (Trismus, widened PDL spaces, mask-like face, Excess type I & III collagen) (42)most common cause of xerostomia? Medications (43)with cerebral palsy? Attrition of the teeth (44)x-Ray show dentinal dysplasia
(45)internal resorption in the x Ray (46) most common impacted? Canine (47) u shape in X-ray? Zygomatic process of maxillary (48)X-ray show RO area in the jaw ? The answer was reflection of the opposite jaw ( I'm not sure about the answer I pick it by exclusion ) ??? I didn’t understand the question. (49)many questions about aspirin, it was direct the answer (50) pregnant position in dental chair (51) the distance from the top of the implant to adjacent CEJ ? 2-3 mm (51)sensitivity after composite restoration? Shrinkage
(52) questions about t-test and bundling they are straight forward from remembered and patient management important file (53) For day 2 also there was cases about asthma,psoriasis, bisphosphonate Drugs, antibiotics,xerostomia, bimaxillary protrusion black boy treatment modality (54)polyether disadvantage (55)specific plaque hypothesis
(56)questions about bone morphology D1 D2 D3 D4 Type I thick cortical, dense cancellous. Anterior mandible Type II thick cortical cancellous mostly dense. Type III thin cortical, cancellous dense Type IV thin cortical, low density cancellous. Posterior maxilla (57) how much Fluoride give to patient ?( know the table for Florid supplementation) it was direct question (58) when do you indicate sinus left surgery : increase height, best graft is autograft (59)most common benign epithelial tumor? Papilloma (60)most common salivary gland tumor? Pleomorphic adenoma (61) pyogenic granuloma (62)inform consent ? Consider autonomy (63)distance between 2 implants? Answer is 3mm (64) the drug that have the most anticholinergic side effect? TCA (65) if dentist change shade of tooth he's changing? Hue ( I think) Value I think (66) questions about spreading infection from maxillary molar teeth is effected by? Massetric muscle attachment or Massetric space and there was buccinator ( I don't remember exactly) Which muscle separates 2 potential infection spaces from a maxillary 2nd molar? Buccinator Infection from Mandibular premolar spreads to – Sublingual (not submandibular) Molar submaxillary (67)do dental treatment the day after renal dialysis (68) the use of posterior palatal seal to compensate shrinkage ( known the advantage of pps) (69) different between arcon and non arcon ARCON ARTICULATOR - An instrument following anatomic guidelines such that the ball of the condyle analogs are carried on the mandibular element, and the fossa assemblies
on the maxillary element. CONDYLAR ARTICULATOR - A non-arcon articulator. Advantage of Arcon over Condylar Articulator o When using an occlusal record to relate opposing casts, the thickness of the record increases the VDO upon articulation. o When the record is removed the condylar guidance inclination would be decreased in the non-arcon articulator creating a potential negative error in excursive movements. (70) white sponge Nevus (71)prilocaine cause methemoglobinemia (72) turner tooth : Infection and trauma (73)contraindications of gingivectomy (74)gracy curette (75)primary and secondary trauma from occlusion (76)asthma ? Answer expiratory wheezing (77) which structure that fragile and can be perforated in new born head ? I think the answer fontanelles Or the question in other way is cranial distortion is possible because? Fontanelles (78)what is the complementary color ? There was gray , violet and 2 other I chose violet ( not sure) ??? (79)fluoride varnish (80)medication in GERD= cemitidine (81)if patient has ketone breath and fainting this is due to ? Hyperglycemia (82) there was case anxiety in the second day (83)-‐ recurent aphthus ulcers is mostly associated with what cell? T lymphocyte (84) Diazepam works on which chanels? chloride (85)questions about sensitivity and specificity (86) all can be done to a dry socket except? Curettage (87)questions . About how to differentiate b/t periodontal and periapical abscesses?vitality test Acute apical periodontitis pain to percussion Chronic apical periodontitis Radiolucency
Acute apical abscess pain to palpation Chronic apical abscess drainage and sinus tract All apical periodontitis and abscess have radiographic RL except acute apical periodontitis- it doesn’t. With vitality = apexogensis With non-vitality = pulpectomy then apexification EPT (Electronic Pulp Testing) least use for primary tooth and least reliable about pulp status Cold test for primary tooth with open apex and for tooth with crown especially metal crown Reversible pulpitis sharp pain for 2-5 sec. Irreversible pulpitis lingering pain to cold > 10 sec and pain spontaneous and referral (88)most important factor in shade selection? Value (81)question about panoramic view with reverse smile and the hard palate shows above apices of upper teeth… Which tech. Error is this? Chin position too upward (82)we convince the patient to replace present Amg by composite? veracity (83)MOD composite , causes of postoperative pain is ? ? cfactor , leakage , large increment , dentin trauma , other options-- the answer is leakage (84)function of HEX?? anti rotation device. (85)there were so many questions about herpetic gingivostomatitis?The answer was obvious Herpetic gingivostomatitis – within 3 days of onset: treat with Acyclovir 15mg/kg 5 times per day for 7 days All patients: palliative care: plaque removal, systemic NSAIDS, and topical anesthetics Contagious when vesicles are present (86)treatment of type 2 &3 furcation Tx for ClassII furcation involvement (called cul-desac)? guided tissue regeneration
Note:2nd maxillary molar has the worst prognosis in furcation involvement hemisection mand molar Mandibular molars to treat Class II or III furcation invasions (87) the natural tooth provide more force on the arch than anything else (88)after maxilla resorption? It became narrow and flat (89)thiazides drug? We give k+ supplement (90)leeway space approx. 2 mm in maxilla and 4mm in mandible (91)contraindications of diazepam for narrow angle glaucoma (92)list the order of perio therapy Phases of Perio Treatment - Preliminary phase--- all types of emergencies irrespective of origin Phase 1:Initial therapy: Extraction, caries control, scaling and root planing, OHI, occlusal adjustments, splinting This is followed by Re-evaluation where you check BOP etc. Phase 2:Periodontal Surgery Phase 3:Restorative Phase 4:Maintenance Tx order in general: emergency, disease control, reeval, definitive, maintenance (93) Women allergic to penicillin and needs extractions, what to give before? (600mg clinda 1 hr before…the other choices were the right drugs but wrong doses) (94)the main effect that cause osteoradionecrosis? Something about blood supply (95)- Which structure is involved in a Leforte I fracture? Maxillary sinus Lefort I associated with- what fracture-nasoethmoidal air cell, frontal sinus, max sinus, mastoid air cell Le Fort II - separation of the maxilla, attached nasal
complex from the orbital and zygomatic fractures Le Fort III - Nasoethmoidal complex, the zygomas, and the maxilla from the cranial base which results in craniofacial separation (96)- What structure is similar to an epiphyseal plate? Synchondroses (97) leathery brown caries: diagnosis : acute or chronic ?? chronic (arrested ) (98) more blades in carbide bur?? less cutting and more smooth surface (99)burning mouth can cause from candida Candidiasis Pt has both burning sensation of tongue and altered taste sensation. Sjogren’s syndrome does NOT have burning sensation of tongue but has altered taste sensation.Pt complains of difficulty wearing the denture and shows cervical caries.Tx of sicca (dry mouth, eye) in Sjogren syn is pilocarpine (100)Radiograph for diagnosis of mesiodens? The answer occlusal Panoramic, maxillary occlusal and periapical radiographs are indicated to assist in the diagnosis of mesiodens. (101)zygomatic arch integrity by radio?? CT The was no other choice same that mention in X-ray dental decks so I chose Ct
