Dentosphere : World of Dentistry: October 2017

MCQs on Local and General Anesthetic Agents - Oral and Maxillofacial Surgery

# Which of the following local anesthetic agent would be preferred in prolonged surgical procedure?
A. Bupivacaine
B. Cocaine
C. Lignocaine
D. Prilocaine

# Which of the following is not a theory for local anesthetic action?
A. Membrane expansion theory
B. Calcium displacement theory
C. Electrical potential theory
D. Specific receptor theory
E. None of the above

Equality, Justice and Equity - World Bioethics Day 2017 Theme Essay Competition - First Position

Equality, Justice and Equity

The worst form of inequality is to try to make unequal things equal.

(Aristotle)

Justice cannot be for one side alone but must be for both.

(Eleanor Roosevelt)

Ethics and equity and the principles of justice do not change with the calendar.

(DH Lawrence)

The genesis of equality and equity as a concept of social justice arose from a history of evolving philosophies of societal organization and distribution of human rights, responsibilities and services. The principles of equity and equality are always relevant in the context of distributive justice as well as variety of social justice issues. These principles all appeal the idea that fair treatment is a matter of giving people what they deserve. In general, people deserve to be rewarded for their effort and productivity, punished for their transgressions, treated as equal persons, and have their basic needs met. However, because these principles may come into conflict, it is often difficult to achieve these goals simultaneously. The central theories underlying the equity paradigm follow, providing a theoretical background for the concept of equality and justice and its relevance in today’s highly unequal world.

MCQs on Oral Pathology - Tongue Disorders

# A blue nodular mass on the lateral border of the tongue is soft, smooth and blanches upon pressure. It is most likely to be:
A. Lymphoma
B. Hemangioma
C. Epulis Fissuratum
D. Epithelioma

# Leutic glossitis can occur in connection with:
A. Vitamin B deficiency
B. Vitamin C deficiency
C. Iron deficiency
D. Syphilis

CNS Questions Pathology - Yearwise Sorted

2016
1. Enumerate the CSF findings and morphological changes in the brain in case of Tuberculosis meningitis. (2.5+2.5=5)

2. Write brief about diffusely infiltrating astrocytoma. (5)

2015
1. Enlist the indication and contraindication of lumbar puncture. (3+2=5)

2. Describe the microscopic features of astrocytoma in a child. (2)

3. Describe the brain abscess under following heading: (1.5x2=3)
a. Gross and microscopic feature
b. Complication

2014
1. Enumerate the degenerative disease of basal ganglia and brain stem. Write about the microscopy changes seen in Alzheimer’s disease. (1+4=5)

2. Mention the most important cause and age of occurrence of subarachnoid hemorrhage. Describe its location with the help of a well-labeled diagram. (1+1+3=5)

2013
1. Write briefly on sub-arachnoid hemorrhage with a labeled diagram of major vessels involved. (3+2=5)
2. Describe the morphologic features of Alzheimer’s disease. (5)

2012
1. Describe the microscopic picture of Alzheimer’s disease. (5)

2. Draw a well labeled diagram of anatomical location of Berry aneurysm. Write its gross description. (3+2=5)

2011
1. Classify Astrocytoma. Describe Diffuse Astrocytoma in detail. (5)

2. Compare and contrast CSF findings of normal from Tuberculous Meningitis. (5)

2010
1. Write CSF findings in different types of meningitis in tabulated form. (3)

2. Classify CNS tumors. (2)

3. Write briefly about Multiple Sclerosis. (5)

CNS Questions Biochemistry - Yearwise sorted

2016
1. Explain the biochemical basis of myasthenia gravis. (2)

2. What are the indications of CSF analysis? Explain the utility of measuring some biochemical parameters in CSF. (3)

2015
1. Mention the role of neurotransmitter in development of Schizophrenia. (5)

2014
1. Write the biochemical basis of myasthenia gravis. (2)

2. Explain how biochemical examination of CSF helps in differential diagnosis of meningeal diseases. (3)

2013
1. Mention the possible biochemical events involved in Alzheimer disease. (3)

2. List four properties of acetylcholine receptor. (2)

2012
1. List the genetic culprit proteins leading to alzheimer’s disease. (3)

2. Write the biochemical pathway of epinephrine neurotransmitter synthesis in the brain. (2)

2011
1. Explain with a diagram the role of acetylcholine at the neuromuscular junction and the biochemical basis of myasthenia gravis. (5)

2010
1. Mention the steps of epinephrine synthesis and breakdown. (2)

2. Explain the biochemical basis of myasthenia gravis. (3)

CNS Questions Physiology - Yearwise sorted

2016
1. Describe three basic functions of cerebrospinal fluid. (6)

2. Write about the spatial and temporal summation of postsynaptic potentials. (1.5+1.5=3)

3. How is a generator potential similar and different from a receptor potential? (1.5+1.5=3)

4. What is referred pain? How is it useful in diagnosing internal disorder? (1+2=3)

5. List and explain the pathways that control the motor activity of distal muscles. (4)

6. What is dysdiadochokinesia? It is observed in lesions of which part of the brain and why? (2+1+2=5)

7. What is muscle spindle? Draw a well labeled diagram of it. Explain briefly the role of gamma motor neuron on it. (1+3+2=6)

8. List the centers in the categorical hemisphere that are concerned with language comprehension and explain their functions. (4)

9. What is a conditional reflex? Explain operant conditioning with its physiological significance. (2+4=6)

2015
1. Define adequate stimulus. Describe briefly the “Law of Specific Nerve Energies”. (5)

2. Tabulate the differences between electrical and chemical synapse. (5)

3. Compare and contrast between excitatory postsynaptic potential (EPSP) and inhibitory postsynaptic potential (IPSP). (5)

4. Draw a well labeled diagram of a muscle spindle. Explain the role of gamma fiber on stretch reflex. (5)

5. Explain the mechanism how semicircular canals detect person’s head is rotating or stopped. (4)

6. Tabulate and list the following:
a. Name of the medial and lateral descending pathways.
b. Muscles they control and
c. Their functions

7. Define Habituation. Explain the mechanism involved for Habituation. (6)

8. Describe pathways of speech activated through perceived written language. (4)

2014
1. Explain the mechanism of CSF formation. Mention any two functions of CSF. (3+2=5)

2. State the law of projection. Elaborate this law with a suitable example. (2+3=5)

3. Define receptor. Write down its any three properties. (2+3=5)

4. Describe the decerebrate rigidity. (5)

5. Tabulate and list the principal postural reflexes integrated at the level of the midbrain, their stimulus, response and receptors. (5)

6. Tabulate & compare between habituation and sensitization. (5)

7. List any two functions of parieto-occipitotemporal association area and describe any one of them. (1+4=5)

8. Define circadian rhythm. State its relationship with sleep-wakefulness with reference to melatonin. (5)

2013
1. Describe the stages of non-rapid eye movement (Non-REM) sleep based on EEG findings. (6)

2. Explain the mechanism of long-term potentiation involved for long-term memory. (4)

3. Briefly describe the muscle spindle with diagram and analyze their function that controls muscle length. (5)

4. Briefly describe how the receptors in the vestibular apparatus detect angular and linear acceleration. (5)

5. Describe the neural circuitry of basal ganglia with the help of the diagram. (5)

6. With the help of a flow diagram, explain the neuronal descending pain inhibiting system. (5)

7. Explain synaptic inhibition with the help of suitable examples. (5)

8. Explain the adaptation of sensory receptors with the help of suitable examples. (5)

2012
1. Describe cross extensor reflex with its reflex arc. Mention its termination. (4+2=6)

2. Mention any two functions of each of the following. (2+2=4)
a. Vestibulo-cerebellum
b. Cerebro-cerebellum

3. Draw a well labeled diagram of putamen circuit through basal ganglia and mention its one important function. (4+1=5)

4. Tabulate and compare the spatial and temporal summation of synaptic transmission with schematic diagram. (5)

5. Define sensory unit and receptive field of sensory unit. Explain importance of lateral inhibition with a suitable diagram. (2+3=5)

6. Explain endogenous pain relief system of the body. (5)

7. Describe paradoxical sleep. (5)

8. Diagrammatically show the neural pathway involved for spelling heard word in a blind person. (5)

2011
1. Define receptor potential. Mention any two mechanisms of fast adaptation of Pacinian corpuscles. (1+2+2=5)

2. Describe spatial summation with diagram. (3)

3. Describe referred pain with an example and mention underlying mechanism with suitable diagram. (2+3=5)

4. A 43-year-old woman is brought to her primary care physician by her family because of concerns about her forgetfulness. Over the last year, she has become more forgetful. Once easy tasks (such as placing a telephone call, following directions, and housekeeping) are now becoming difficult. She has become lost, walking around the grounds and has difficulty naming objects and telling time. She often does not recognize old friends and forgets previous conversations. Physical examination confirms many of the memory and cognitive deficits. After a thorough workup, no specific etiology can be found, and the patient is diagnosed with Alzheimer disease. Now, answer the following questions:
a. What type of memory is available for conscious retrieval?
b. Which part of the brain stores semantic (factual) memories?
c. What is long-term synaptic potentiation (LTP)?

5. Write short notes on: (4+4=8)
a. Alpha waves in EEG
b. NREM sleep

6. Tabulate the differences in context to speech, comprehension, and repetition of various forms of aphasia. (4)

7. Describe the role of muscle spindle in stretch reflex. (4)

8. Describe in brief the functions of different functional divisions of the cerebellum. (4)

9. List the functional differences between autonomic and somatic motor systems. (4)

2010
1. Enumerate the relationship between circadian rhythm and sleep wake cycle. (5)

2. Name the brain areas involved in language and describe their functions in it. (1+4=5)

3. Explain motivation and addiction in terms of brain area and pathway involved in it. (5)

4. Describe the acute effects of spinal shock. (5)

5. Describe pathophysiology of pain. (5)

6. Describe the function of cerebellum. (5)

7. Describe how a written word is interpreted by brain. (5)

8. State the brain areas for learning with their functions. (5)

Unit 5 Central Nervous System paper IIIB - Anatomy Questions

2016
1. Draw a well labeled diagram of transverse section of midbrain at the level of superior colliculus. (5)

2. Write down the blood supply of internal capsule with suitable diagram. (5)

3. Mention the blood vessels forming the Circle of Willis along with diagram. (5)

4. Name the lobes of cerebral cortex. Name the functional areas & the functions related to any one lobe of cerebral cortex. (5)

1st year MBBS - Basic Sciences - paper IB - Internal Assessment January 2011

Numbers in the brackets indicate marks allocated.

SHORT ANSWER QUESTIONS

SECTION - A

1. Define shock. Enumerate types of shock. Describe briefly the stages of Septic shock. (1+1+3=5)

2. Define Neoplasia. What are the modes of spread of malignant tumors? Give one example each. (1.5+2+1.5=5)

3. Define Edema. Mention the pathophysiologic causes of edema. (2+3=5)

4. Define thrombus. What are the predisposing factors of thrombus formation? Enumerate the fates of a thrombus. (1+2+2=5)

5. Differentiate between dystrophic and metastatic calcification. (5)

6. Write short notes on: (5+5=10)
a. Type I hypersensitivity reaction
b. Autosomal dominant disease

SECTION - B

7. Write briefly on: (5*4=20)
a. Gram's Staining
b. Cultivation of Viruses
c. Genetic transfer of antimicrobial resistance among bacterial population
d. Common disinfectants used in hospital

8. Draw a schematic diagram of Bacteriophage and mention its medical importance. (2.5+2.5=5)

9. Define nosocomial infection and briefly outline the approach to prevent this infection. (5)

10. Tabulate the differences between gram-positive and gram-negative bacteria. (5)

SECTION - C

11. Write briefly on the following with suitable examples: (5*6=30)
a. First pass metabolism
b. Topical routes of administration
c. Redistribution
d. Receptors antagonism
e. Tolerance
f. Cell cycle Kinetics

12. Define adverse drug reaction. Classify adverse drug reaction with examples. (5)

13. Write the mechanism of action, uses and adverse drug effects of the following: (5*4=20)
a. Amantadine
b. Amphotericin
c. Cloxacillin
d. Doxycycline

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Equality, Justice and Equity - World Bioethics Day 2017 Theme Essay Competition - Second Position

Equilibrium is the fundamental law of nature. Irrespective of the size and operating mechanism of any particular system of consideration, it is amazing to notice that it is in or at least it tries to be in equilibrium. In accordance with this simple rule, the stars stay at their specified place within a galaxy, planets stay on their orbits, the population of wild animals in an environment free from human interference remains nearly constant, the rivers flow, days and night occur, and the gases move from their higher concentration zones to those with their lower concentration, which is fundamental for our survival as it is well known now that it is that simple process of diffusion of gases in alveoli which makes our life possible. Even within the cells and across them, the molecules diffuse from higher to lower concentration zones. From the smallest possible microcosm to the unimaginably vast universe, equilibrium tends to occur. As human beings realized, during the course of evolution, that equality is the ultimate state of stability, the concept of human rights, democracy, equality, and justice have emerged.

Equality, Justice and Equity, all these seemingly alike terms perplex almost everyone the first time they hear it. “I think they are similar, don’t they mean the same?”, even the purported pundits of our society gave this answer to me when they were asked about the subtle difference between these terms. Though they all are directed towards creating a better society and environment to live for everyone, ethical values, circumstances, and relativity may make these things a bit confusing, a bit paradoxical, and in some cases completely unreasonable.

Equality is the concept of providing the equal opportunity to everyone or distributing the available resources to each individual equally, irrespective of the backgrounds, needs, or any other special circumstances. From the time of the 14th-century English hero, Robin Hood, who supposedly used to steal from the rich and distribute to the poor, to modern-day communism, the concept of equality is implemented in various ways. However, equality doesn't always ensure justice and equity. Equality is like the blindfolded lady that is depicted in the symbol of justice. That blindfold has to be taken off and judgment should be done by seeing perspicaciously through the eyes of wisdom and compassion. Then only the justice is done and a state of equity is attained.

Let's make this more intelligible with some real-life situations. Implementing a rule that everyone should wait for their turns in a queue in a bill counter is equality. No matter whether someone is rich or poor, strong or weak, black or white, has to wait for their turns in a queue. This system for equality sounds perfect and desirable for each and every aspect of life. But, will it be justifiable to make a handicapped person who had already struggled so much just to reach the place wait for long hours in a queue along with other persons? Will it be a justice to make a pregnant lady in her third trimester of pregnancy wait in the queue? Who should be given more priority, the pregnant lady or the handicapped person? Now, there we seem to have reached an impasse of an ethical dilemma. The perfect system of equality suddenly seemed like a system where there is no place for compassion and empathy. Equality should always be tested for its accordance with justice. Equity is only attained when justice is considered for along with equality.

Similarly, in a classroom, a teacher should focus and give his attention differently to different students based on their individual needs. If on the premise of providing equality, the teacher gives equal focus to all students, the slightly slow learning student might never catch up with the speed of the class and the fast learning fellow may get bored. Also, what happens if every patient in the emergency unit of a hospital was given equal attention, time and resources? This will be a terrible mistake because it seems that we have practiced equality but the life of a critically injured patient may not be saved because unnecessary time and resources were wasted for a patient whose state was not as critical.

This insight into equality, justice and equity has to be implemented into every aspect of our lives be it social, economic or political. The act of budget planning and distribution, providing relief and compensation for the calamity struck population, providing healthcare facilities in a hospital, providing seats for the needy in public vehicles, providing reservation quotas for admission in a college or for a job, etc. all should have a consideration for justice whenever practicing equality. All the individuals should be well aware of the nuance between equality and equity and should be empathetic to incorporate in their own lives. Then only, we can make the society, the country and the world we live, a place where there is equality, justice and equity.

- Raman Dhungel
BDS 2014
BPKIHS

BDS Second Year CNS, MSK and Special Senses OSPE and VIVA Questions - Anatomy - July 2015

1. Key: Spinal cord
a. Identify the displayed specimen. (2)
b. Draw a well-labeled diagram showing the blood supply of it. (5)
c. Name the branches of typical spinal nerve. (2)

2. Key: Medulla Oblongata
a. Identify the displayed specimen. (2)
b. Name the cranial nerve arising from it. (4)
c. Write about the formation of facial colliculus. (4)

3. Key: Fourth Ventricle

a. Identify the flagged cavity. (2)

b. Draw a well-labeled diagram showing the floor of it. (5)

c. Write the three features of increased intracranial pressure. (3)

4. Key: Foramen Transversarium

a. Identify the flagged foramen. (2)

b. Name three structures passing from it. (3)

c. Write about the ossification of typical cervical vertebra. (5)

5. Key: Superior Orbital Fissure

a. Identify the flagged foramen. (2)

b. Name three nerves passing through its middle part. (3)

c. Define diploic vein and name any three of it. (5)

6. Key: Hypoglossal Canal

a. Identify the flagged foramen. (2)

b. Name four muscles supplied by cranial nerve passing through it. (4)

c. List 4 unpaired bones of skull. (4)

7. Key: Temporal Bone

a. Identify the displayed bone. (2)

b. Name different parts of it. (4)

c. List the boundaries and importance of suprameatal triangle. (4)

8. Key: Orbicularis Oculi

a. Identify the flagged muscle. (2)

b. Name the different parts of this muscle and the nerve supplying it. (4)

c. Name any four other muscles of facial expression. (4)

9. Key: Parotid Gland

a. Identify the displayed specimen. (2)

b. List the structures within it. (4)

c. Give the anatomical explanation for Frey's syndrome. (4)

10. Key: Sternocleidomastoid muscle

a. Identify the flagged muscle. (2)

b. Write the functions and nerve supply of it. (4)

c. List the muscle forming the floor of posterior triangle. (4)

11. Key: Tentorium Cerebelli

a. Identify the flagged part of the displayed specimen. (2)

b. Name three dural venous sinuses related to it. (3)

c. List the structure lying in the lateral wall of the cavernous sinus. (5)

12. Key: tongue

a. Identify the flagged specimen. (2)

b. List any four muscles of it. (4)

c. List any four parts of the cervical fascia. (4)

13. Key: Masseter

a. Identify the flagged muscle. (2)

b. Write the function and nerve supply of it. (4)

c. List any four contents of infratemporal fossa. (4)

14. Key: facial artery

a. Identify the tied vessel. (2)

b. List any four branches of it. (4)

c. List posterior and terminal branches of external carotid artery. (4)

15. Key: Hyoid bone

a. Identify the displayed bone. (2)

b. Name the parts and developmental source of it. (5)

c. List any three content of carotid sheath. (3)

16. Key: Thyroid gland

a. Identify the displayed specimen. (2)

b. List five structures related with medial surface of it. (5)

c. Name any three subarachnoid cisterns. (3)

17. Key: Eyeball

a. Identify the displayed specimen. (2)

b. Name six muscles attached to it. (6)

c. List two structures found within cavernous sinus. (2)

18. Key: Middle meatus

a. Identify the flagged region. (2)

b. List the Paranasal air sinuses opening to this region. (4)

c. List four structures forming the nasal septum. (3)

19. Key: Lateral Rectus

a. Identify the flagged muscle. (2)

b. Write its action and nerve supply. (4)

c. Write the parts of internal ear containing endolymph. (4)

20. Key: Vagus Nerve

a. Identify the tied structure. (2)

b. Name any four branches of it arising in the neck. (4)

c. List the nuclei of facial nerve. (4)

21. Key: Anterior cerebral artery

a. Identify the tied vessel. (2)

b. List the branches of basilar artery. (5)

c. List three characteristic features of cerebral veins. (3)

22. Key: Stylomastoid foramen

a. Identify the flagged foramen. (2)

b. List two structures passing through it. (2)

c. With the help of diagram show the branches of the ophthalmic artery. (6)

VIVA Questions

1. What is Bell’s palsy? (2)

2. Why the infection behind the prevertebral fascia cannot extend below the superior mediastinum? (2)

3. What is the most common cause of subarachnoid hemorrhage? (2)

4. What is Argyl-Robertson pupil? (2)

5. Tell two features of medial medullary syndrome. (2)

MCQs on Viral Infections - Oral Pathology

# The feature that distinguishes Herpes Zoster from other Vesiculobullous eruptions is :
A. Unilateral occurence
B. Severe burning pain
C. Prominent crusting vesicles
D. Subepidermal bullous formation

# A 3 year old child has a fever of 102 degrees F ; and following upper respiratory tract infection discrete vesicles and ulcers on the soft palate and pharynx are noted. The most probable diagnosis is :
A. Herpangina
B. Scarlet fever
C.Rubella
D. Herpetic gingivostomatitis

Regressive changes in Tooth : Attrition, Abrasion, Erosion and Abfraction

Regressive alterations are the group of degradative changes in the teeth which occur due to non-bacterial causes and result in wear and tear of the tooth structure with some impairment of function. Let's see some of the commonest regressive alterations of teeth one by one.

Firstly, Attrition. Attrition is a form of regressive change in teeth characterized by wear of tooth substance or restoration as a result of the tooth to tooth contact during occlusion, mastication or parafunction. Mostly, attrition is an age-related physiological process whose rate and severity depends on several factors like diet quality, dentition, masticatory force and chewing habits. So, older individuals often exhibit more attrition than the younger ones.

Attrition may also be pathological which may be caused either due to:
a. Abnormal occlusion - leading to traumatic contact during chewing which causes more tooth wear
b. Premature extraction of teeth - which causes attrition of remaining teeth as the occlusal load on these teeth increase after the extraction of teeth because the masticatory force of an individual remains constant.

Also, pathological attrition may be due to parafunctional chewing habits like bruxism and habitual chewing of coarse and abrasive foods or other substances like tobacco and betel nut.

Abrasion: It is the pathological wearing of tooth structure or dental restorations by friction with foreign substances independent of occlusion. Toothbrush abrasion is the commonest type of abrasion caused by faulty toothbrushing technique, excessive force during tooth brushing and a dentrifice with strong abrasive. Abrasion may also be caused by habitual chewing of betel nut. tobacco and Pan (betel quid), and also by faulty clasp design in removable partial denture prosthesis. Tailors, carpenters, hairdressers, and shoemakers who use their teeth to hold nails and pins also develop abrasion.

Erosion: It is the progressive irreversible loss of hard dental tissues by some chemical process that doesn't involve bacterial action. It may be caused due to extrinsic factors such as acidic foods and beverages, medications ( Vitamin C and Hydrochloric acid preparations) and occupational exposure to acidic vapors. Intrinsic factors causing erosions are systemic diseases like Bulimia, GERD (Gastroesophageal reflux disease), etc. which cause increased vomiting and regurgitation of bowel contents into the mouth.

Abfraction: It is the pathological loss of tooth structure caused by biochemical loading forces. Excessive force during chewing or clenching cause repeated flexure of tooth and cause ultimate material fatigue and wearing off of tooth away from the point of loading.

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MCQs on Local and General Anesthetic Agents - Oral and Maxillofacial Surgery

Equality, Justice and Equity - World Bioethics Day 2017 Theme Essay Competition - First Position

Equality, Justice and Equity

MCQs on Oral Pathology - Tongue Disorders

MBBS / BDS Medical Entrance Examination - Endocrine System MCQs

MBBS / BDS Medical Entrance Examination - Cardiovascular System MCQs

Periodontics MCQs - Periodontal Microbiology

CNS Questions Pathology - Yearwise Sorted

CNS Questions Biochemistry - Yearwise sorted

CNS Questions Physiology - Yearwise sorted

Unit 5 Central Nervous System paper IIIB - Anatomy Questions

1st year MBBS - Basic Sciences - paper IB - Internal Assessment January 2011

Equality, Justice and Equity - World Bioethics Day 2017 Theme Essay Competition - Second Position

BDS Second Year CNS, MSK and Special Senses OSPE and VIVA Questions - Anatomy - July 2015

VIVA Questions

MCQs on Viral Infections - Oral Pathology

Regressive changes in Tooth : Attrition, Abrasion, Erosion and Abfraction