Generalized Anxiety Disorder Treatment

 # A young man of 24 years is suffering from Generalized Anxiety Disorder; which drug may be preferred for his problem?

a. Zolpidem

b. Buspirone

c. Midazolam

d. Triazolam

e. Phenobarbital

The correct answer is B. Buspirone.

Buspirone is the first azapirone, a new class of antianxiety drugs, distinctly different from

Benzodiazepines. 

Buspirone: 

• Does not produce significant sedation or cognitive/functional impairment.

• Does not interact with BZD receptor or modify GABAergic transmission.

• Does not produce tolerance or physical dependence.

• Does not suppress BZD or barbiturate withdrawal syndrome.

• Has no muscle relaxant or anticonvulsant activity.

Buspirone relieves mild-to-moderate generalized anxiety, but is ineffective in severe cases, in those showing panic reaction and in OCD.

Though most patients on buspirone remain alert, those operating machinery/motor vehicles should be cautioned.

Dose: 5–15 mg OD–TDS:

Anemia of chronic disease

# Which of the following is a feature of anemia of chronic disease ?

A.Increased red cell protoporphyrin

B.Hypoproliferative marrow

C.Normal or increased serum ferritin

D.All of the above

The correct answer is D. All of the above. 

Features of anemia of chronic disease are a low serum iron, increased red cell protoporphyrin, hypoproliferative marrow, transferrin saturation of 15 - 20%, & normal or increased serum ferritin.

Ref: Harrison’s 18th edition, Page 849.

Pediatric Dentistry MCQs - Child Behavior Management

# The main areas of concern in diagnosis and treatment planning for the child are:
A. Oral medical problems
B. Dental caries and restorative dentistry
C. Occlusion and craniofacial growth and development
D. All of the above

# Pedodontic triangle is given by:
A. Mischer
B. McDonanld
C. Finn
D. Wright

# Place of the child in the pedodontic treatment triangle is:
A. At the base
B. In the centre
C. At the apex
D. None of the above 

Paradoxical excitement in children

 # Which of the following can result in paradoxical excitement in children?

 A. Morphine

 B. Phenobarbitone

 C. Nitrous oxide

 D. Amphetamine

The correct answer is B. Phenobarbitone.

A paradoxical reaction or paradoxical effect is an effect of medical treatment,usually a drug, opposite to the effect which would normally be expected. Paradoxical excitement is caused by barbiturates which also includes secobarbital. 

Reported to occur in approximately 3% of patients. In susceptible individuals,benzodiazepine treatment might increase anxiety,aggressiveness, agitation, loss of  impulse control, talkativeness, violent behavior, and even convulsions. 

Before sedating a child

 # Before sedating a child:

A. Not essential to take the consent

B. Essential to take the written consent

C. Needed to consult the pediatrician

D. Essential for the parents to be present

The correct answer is D. Essential for the parents to be present.

Before sedating a normal child it is important to take informed consent, and have the parents present during procedure.

A child with previous medical history however requires consulting with the child's physician.

Altered state of consciousness

 # Altered state of consciousness characterized by a heightened suggestibility to produce desirable behavioral and psychological changes is called:

A. Coping

B. Hypnosis

C. Biofeedback

D. Implosion therapy

The correct answer is B. Hypnosis.

It is also called psychomatic or suggestion therapy. 

Hypnosis is a state of  human consciousness involving focused attention and reduced peripheral awareness and an enhanced capacity to respond to suggestion.

Capsid Shapes

 # One of the principal capsid shapes is a 20-sided figure with 12 evenly spaced corners referred to as a(n) _____ capsid. 

A. Spiked

B. Complex

C. Icosahedral

D. Helical

E. Buckeyball

The correct answer is C. Icosahedral.

In geometry, an icosahedron (/ˌaɪkɒsəˈhiːdrən, -kə-, -koʊ-/ or /aɪˌkɒsəˈhiːdrən/) is a polyhedron with 20 faces. The name comes from Ancient Greek εἴκοσι (eíkosi) meaning "twenty" and from Ancient Greek ἕδρα (hédra) meaning "seat". The plural can be either "icosahedra" (/-drə/) or "icosahedrons".

Virus

 # Viruses have all the following except :

A. Definite shape

B. Metabolism

C. Genes

D. Ability to infect host cells

E. Ultramicroscopic size

The correct answer is B. Metabolism.

Viruses are non-living entities and as such do not inherently have their own metabolism. However, within the last decade, it has become clear that viruses dramatically modify cellular metabolism upon entry into a cell.

Viruses consist of nucleic acid (genetic material) surrounded by a capsid (protein coat). Most scientists consider viruses to be nonliving because they can't carry out the most basic processes of life. Viruses can't metabolize (break down) food to release energy (carry out respiration) or grow.

Endodontic Surgery should be avoided in

 # Endodontic Surgery should be avoided in:

A. Short rooted teeth

B. Teeth with periodontal disease

C. Lingual surface of mandibular molars

D. All of the above

The correct answer is D. All of the above.

Because of inaccessibility and difficulty to gain access to the surgical site through dense layers of bone, endodontic surgery should be avoided on lingual surfaces of molars or external oblique ridge of mandible. 

Immunoglobulin most commmon in Periodontitis

#Which immunoglobulin is most common in patients with periodontal disease?

A. IgA

B. IgD

C. lgG

D. lgE

E. IgM 

The correct answer is C. IgG. 

The presence of IgG in gingival crevicular

fluid is a product of actively secreting plasma cells stimulated by chronic plaque/calculus accumulation. 

The next abundant type is IgA, There is a negligible amount of lgM.

lg A predominates in saliva to agglutinate

bacteria so they are more easily swallowed

and evacuated from the oral cavity.

Lingual holding arch

# A mandibular lingual holding arch with loops mesial to each molar band is used in children for:

A. Correction

B. Regaining space

C. Space maintenance only

D. Correction of distally tilted molars 

 

The correct answer is B. Regaining space.

Normal passive mandibular lingual holding arch is used for space maintenance in mandible. This is  a preventive procedure.

Lingual arch with U loops mesial to each molar band is a modification of mandibular lingual arch. The loops are opened periodically and this can bring about distalization of molars by 1 to 2 mm. This is an interceptive procedure.

Primary source of anaerobic bacteria in diseased periodontal tissue

 # Which of the following is the primary source of anaerobic bacteria in diseased periodontal tissue?

A. Supragingival plaque

B. Blood

C. Subgingival plaque

D. Calculus

The correct answer is C. Subgingival plaque. 

Subgingival plaque is most likely to contain the anaerobic bacteria that cause periodontal disease.

Remember that although calculus is a secondary etiologic factor, the primary etiologic factor of periodontal disease is dental plaque.

All Ceramic Restorations

 # Which of the following is the BEST way to avoid porcelain failure in all-ceramic restorations?

A. Rounded angles of the preparation

B. Minimal occlusal forces

C. Porcelain is 3.5mm thick

D. Porcelain is not more than 0.5mm thick 

The correct answer is A. Rounded angles of the preparation.

All ceramic restorations should include rounded angles in the tooth preparation in order to reduce stress concentration along these areas. Sharp angles within tooth preparations are areas where stress is concentrated, and may cause fracturing.

Porcelain thickness is also an important factor in its fracture toughness. All porcelain crowns should have a minimum thickness of 1mm circumferentially and about 1.5mm along the occlusal/ incisal to

achieve strength (Not including the framework of the restoration).

Proper case selection and occlusal load analysis is also an important factor in preventing failure of an all ceramic restoration. 

Abutment teeth in a fixed partial denture

 # What is the primary reason why dentists splint adjacent abutment teeth in a fixed partial denture?

A. Improve spacing mesiodistally

B. Stabilize abutment teeth

C. Improve embrasure contours

D. Improve the distribution of the occlusal load 

The correct answer is D. Improve the distribution of the occlusal load 

Abutment teeth are included in fixed partial dentures to provide retention and help disperse the occlusal load placed on the restoration.

Abutment teeth provides support and stability to the pontic.

Abutment teeth allows better distribution of the occlusal forces acting on all teeth and pontic in the fixed partial denture.

Packing acrylic resin into the denture flasks

# After packing acrylic resin into the denture flasks, one should wait to cure the resin to:

A. Assure full flow of acrylic into the denture mold

B. Allow the monomer to reach all acrylic polymer

C. Allow for pressure to be equalized between the acrylic and flask

D. Make sure temperature equilibrium exists between the flask and acrylic 

The correct answer is D. Make sure temperature equilibrium exists between the flask and acrylic

Allowing the dental flask packed with acrylic to remain under the bench press until equilibrium in temperature is achieved will give enough time for the acrylic to achieve better monomer-polymer interaction and create stronger chemical bond.

The curing of resin should be uniformly completed to lessen any chances of distortion before and during the time the flask is immersed in a water bath.

 

Packing the acrylic during the rubbery stage

# When fabricating dentures, what would be the most likely outcome if the lab compressed/packed the acrylic during the rubbery stage?

A. Higher porosity than normal

B. A lot of extra resin being attached to the denture that will take a long time to trim

C. Incomplete picking up of anatomical details

D. The denture would have an increased VDO 

The correct answer is C. Incomplete picking up of anatomical details

Packing and compressing acrylic during denture fabrication should be done in its doughy stage.

The doughy stage is the ideal for packing acrylic resin because it is the moment when acrylic is most packable and workable.

The rubbery stage of acrylic denotes the start of the setting when heat is released from the setting acrylic.

Rubbery acrylic also has a tendency to revert back to its original position regardless of the forces applied to it during packing, resulting in incomplete packing.

VDO (Vertical Dimension of Occlusion) is synonymous with OVD (Occlusal Vertical Dimension) and is the relationship of the maxilla and mandible when the teeth are in maximum intercuspation. 

 

Excess height of the posterior palatal seal

 # Excess height of the posterior palatal seal of a complete maxillary denture will usually result in which of the following?

A. Gagging

B. Increased retention

C. A tingling or tickling sensation

D. Unseating of the denture

The correct answer is D. Unseating of the denture.

Over contouring or excessive beading of the posterior palatal seal causes too much pressure to be exerted on the palatal tissues resulting in the unseating of upper dentures.

The posterior palatal seal is typically placed approximately on the vibrating line between the hard and soft palate and provides a physiologically acceptable tissue pressure within the compressible portion of the soft palate to attain retention and peripheral seal.

Over extending the coverage of seal will cause gaggling and painful swallowing for the part of the patient. 

Flabby maxillary anterior ridge

# Which of the following is associated with a flabby maxillary anterior ridge under a complete denture?

A. Retained mandibular anterior teeth

B. A "V" shaped ridge

C. A "U" shaped ridge

D. A patient with Class Il occlusion

E. Osteoporosis 

The correct answer is A. Retained mandibular anterior teeth.

Combination syndrome is a condition that usually occurs when retained mandibular

anterior teeth opposes a maxillary complete denture.

In combination syndrome, the anterior aspect of upper maxillary ridge becomes highly resorbed and flabby due to the biting force against its natural tooth antagonist.

Since the occlusal force of a natural tooth is stronger than the force of a denture supported by an alveolar ridge, the area under pressure will exhibit higher resorption pattern than the rest of the denture.

Pterygomandibular raphe is a tendon between

# Pterygomandibular raphe is a tendon between which of the following muscles?

A. Masseter and medial pterygoid

B. Anterior belly of the digastric and Buccinator

C. Buccinator and Superior constrictor

D. Buccinator and Masseter

The correct answer is C. Buccinator and Superior constrictor.

Pterygomandibular raphe acts as a tendon between the buccinator and superior Constrictor muscle. It is a landmark used often for the identification of the pterygomandibular space for the administration of an inferior alveolar nerve block.

The injecting needle pierces the buccinator muscle to inject the local anesthetic solution in the pterygomandibular space.

 

Number of lobes in a tooth

 # The minimum number of lobes from which any tooth may develop is:

A. Two

B. Three

C. Four

D. Five

The correct answer is: C. Four.

Tooth development begins with increased cell activity in growth centers in the tooth germ. A growth center (lobe) is an area of the tooth germ where the cells are particularly active. These lobes are primary centers of calcification and are primary sections of formation in the development of the crown of a tooth. They are represented by a cusp on posterior teeth and mamelons and cingula on anterior teeth. They are always separated by developmental grooves, which are very prominent in the posterior teeth and form specific patterns. With anterior teeth, their presence is much less noticeable and these lobes are separated by what are known as developmental depressions.

Summary of number of lobes:

•All anterior teeth: three labial and one lingual (cingulum)

• Premolars: three buccal and one lingual.

Exception: The mandibular second premolar has three buccal and two lingual lobes.

• First molars (maxillary and mandibular): five lobes, represented by five cusps - one lobe for each cusp

•Second molars (maxillary and mandibular): four lobes, one for each cusp

• Third molars: at least four lobes. one for each cusp ***variations arc seen

Lethal dose of Fluoride

# The lethal dose of fluoride for a typical three-year-old child is approximately :

A. 100 mg

B. 200 mg

C. 350 mg

D. 500 mg

 

The correct answer is D. 500 mg.

The studies and surveys link fluorosis to three factors:

• Fluorosis is more common in geographic areas where the endemic levels of fluoride in the drinking water is higher than three parts per million

• Fluorosis is associated with fluoride supplementation at inappropriately high levels

• The use of fluoridated toothpaste has been implicated in fluorosis

In acute fluoride toxicity, the goal is to minimize the amount of fluoride absorbed. Therefore, syrup of ipecac is administered to induce vomiting. Calcium-binding products, such as milk or milk of magnesia, decrease the acidity of the stomach, forming insoluble complexes with the fluoride and thereby decrease its absorption. Note: Emergency Medical Service should be activated.

In acute fluoride toxicity, symptoms may appear within 30 minutes of ingestion and persist for up to 24 hours. Patients may experience some nausea, vomiting, diarrhea, and abdominal cramping. This may be due to the fact that 90-95% of ingested fluoride is absorbed through the stomach and small intestines. Fluorides are primarily eliminated from the body by way of the kidneys. However, the fluoride that does remain in the body is found mostly in skeletal tissue. In acute fluoride poisoning (which is rare), the most common causes of death are cardiac failure and respiratory paralysis. Fluoride toxicity shows up in the bones as osteosclerosis.

Important: The lethal dose of fluoride for a typical 3-year-old child is approximately 500 mg and would be proportionately less for a younger child and smaller child. To avoid the possibility of ingestion of large amounts of fluoride it is recommended that no more than 120 mg of supplemental fluoride be prescribed at any one time.

Note: If a six-year old child were receiving fluoridated water in the amount of 3 ppm, the result would most likely be fluorosis but not systemic toxicity. On the other hand, if a child in the same age range (6-7) were receiving 8 ppm of fluoridated water, there would be a good chance of systemic toxicity and moderate to severe fluorosis occurring.

Koplik's Spots are seen in

# "Koplik's spots" are associated with:

A. Smallpox (Variola)

B. German measles (Rubella)

C. Mumps

D. (Rubeola)

The correct answer is. D. Measles (Rubeola)

Before immunization, measles was very common during childhood so that 90% of the population had been infected by age 20.

Measles (also called Rubeola) is a highly contagious viral illness characterized by a fever, cough, and a spreading rash. It is caused by a paramyxovirus. The incubation period is 1 to 2 weeks before symptoms generally appear. The oral lesions are pathognomonic of this disease. These characteristic "Koplik's spots" usually occur on the buccal mucosa. They are 1-2 mm, yellow-white necrotic ulcers that are surrounded by a bright red margin.

Rubella (or German measles) is a fairly benign viral disease. The symptoms usually include

a red, bumpy rash, swollen lymph nodes (most often around the ears and neck), and a mild fever. Some people will feel a little achy. The virus can manifest in the oral cavity as small petechiae-like spots of the soft palate. The defects of congenital infection from an infected mother are more severe -enamel defects, hypoplasia, pitting, and abnormal tooth morphology.

Smallpox (Variola) is an acute viral disease, it manifests itself clinically by the occurrence of a high fever, nausea, vomiting, chills, and headache. The skin lesions begin as small macules and papules which first appear on the face, but rapidly spread to cover much of the body. Oral manifestations include ulceration of the oral mucosa and pharynx. In some cases, the tongue is swollen and painful, making swallowing difficult.

Mumps is an acute contagious viral infection characterized chiefly by unilateral or bilateral swelling of the salivary glands, usually the parotid (parotitis). Although it is usually a disease of childhood, mumps may also affect adults. The papilla of the opening of the parotid duct on the buccal mucosa is often puffy and reddened.

3M Ketac Molar Easymix Glass Ionomer Cement

 This particular brand of Glass Ionomer Cement Ketac Molar Easymix by 3M Germany was available in the dental clinic where I work. The powder felt like wheat flour and even after mixing repeatedly, I couldn't get the required consistency. I had used exactly one scoop of powder by the scoop provided by the manufacturer with one drop of liquid. Have you experienced the same problem? Or is this a great GIC product What about its clinical success? Please leave your honest feedback.

Seizure in the dental clinic

# Which of the following is true concerning a young epileptic who has a grand mal seizure in the dental office?
A. It is generally fatal
B. It is best treated by injecting insulin
C. They generally recover if restrained from self-injury and oxygen is maintained
D. It can be prevented with antibiotics

 The correct answer is C. They generally recover if restrained from self-injury and oxygen is maintained

Of the multiple types of seizures, the tonic-clonic (grand mal) type is the most frightening and the one that most often requires treatment. Grand mal seizures are manifested in four phases: the prodromal phase, the aura, the convulsive (ictal) phase, and the postictal phase.

The prodromal phase consists of subtle changes that may occur over minutes to hours. It is usually not clinically evident to the clinician or the patient. The aura is a neurologic experience that the patient goes through immediately prior to the seizure. It is specifically related to trigger areas of the brain in which seizure activity begins. It may consist of a taste, a smell, a hallucination, motor activity, or other symptoms. As the CNS discharge becomes generalized, the ictal phase begins. The patient loses consciousness, falls to the floor, and tonic, rigid skeletal muscle contraction ensues. This usually lasts 1 to 3 minutes.

As this phase ends, the muscles relax and movement stops. A significant degree of CNS depression is usually present during this postictal phase, and it may result in respiratory depression. Management of the seizure consists of gentle restraint and positioning of the patient in order to prevent self-injury, ensuring adequate ventilation, and supportive care, as indicated, in the postictal phase, especially airway management. Single seizures do not require drug therapy because they are self-limiting.

Important: Should the ictal phase last longer than 5 minutes or if seizures continue to develop with little time between them, a condition called status epilepticus has developed. This may be a life-threatening medical emergency. This condition is best treated with intravenous diazepam, and transport should be arranged to take the patient to the hospital.

Oral manifestation of Achondroplasia

 # An outstanding oral manifestation of achondroplasia is:

A. Rampant caries

B. Periodontal disease

C. Overcrowding of teeth

D. Supernumerary teeth

The correct answer is C. Overcrowding of teeth.

Achondroplasia is the most common form of short-limb dwarfism. It occurs in all races and with equal frequency in males and females. An individual with achondroplasia has a disproportionate short stature -- the head is large and the arms and legs are short when compared to the trunk length. Other signs are a prominent forehead and a depressed bridge of the nose. Many of these children die during the first year of life. Deficient growth in the cranial base is evident in many children that survive.

Important: The maxilla may be small with the resultant crowding of the teeth.

Note: A Class III malocclusion is very common.

Remember: The oral manifestations of the following disorders in children:

• Gigantism: enlarged tongue, mandibular prognathism, teeth are usually tipped to the buccal or lingual side, owing to enlargement of the tongue. Roots may be longer than normal.

• Pituitary dwarfism: the eruption rate and the shedding of the teeth are delayed, clinical crowns appear smaller as do the roots of the teeth, the dental arch as a whole is smaller causing malocclusion, and the mandible is underdeveloped.

Iron content in each ml of blood

 # Each milliliter of red cells contain how much elemental iron ?

A. 1 mg

B. 2 mg

C. 3 mg

D. 4 mg

The correct answer is A. 1 mg.

Each milliliter of red cells contains 1 mg of elemental iron.

Ref: Harrison’s 18th Ed. 845

Flexural strength

# The term "flexural strength" describes a material with the ability do which of the following?
A. Be visually detectable in radiographs
B. Sustain deformation without permanent change in
size or shape
C. Resist fracture during bending
D. Resist the propagation of a crack

The correct answer is C. Resist fracture during bending. 

Flexural strength is the ability of a material

to resist fracture while bending and is also

known as modulus of rupture, bend

strength, or fracture strength.

The transverse bending test is most

frequently employed to evaluate the flexural strength of a material using a 3-point flexural test technique.

The flexural strength gives the highest

stress experienced within the material at its

moment of rupture.

The significance of flexural strength is

commonly expressed in class V cervical

restorations.

Low tensile and high compressive strength

# A material with a low tensile strength and high compressive strength can be described as which of the following?
A. Ductile
B. Malleable
C. Resilient
D. Brittle
E. Tough

The correct answer is D. Brittle. 

Brittle materials can be hard solid materials

that can withstand heavy compression but

not tension.

Brittle materials exhibit low tensile strength and may fracture or break instead of being deformed when under tensile stress.

Ductile materials exhibit high tensile

strength and low compressive strength,

making them capable of being drawn into

wires.

Excessive segmentation of nucleus of neutrophils

# Excessive segmentation of nucleus of neutrophils is a manifestation of ?
A. Folate or vitamin B12 deficiency
B. Iron deficiency
C. Thalassemia
D. Repeated blood transfusion

The correct answer is: A. Folate or vitamin B12 deficiency.

Nucleus of neutrophils normally contains up to four segments. Excessive segmentation (>5

nuclear lobes) is seen in folate or vitamin B12 deficiency & congenital neutropenia syndrome of

warts, hypogammaglobulinemia, infections & myelokathexis (WHIM).

Ref: Harrison’s 18th Ed. 473

Contraindication for splenectomy

# Which out of the following is a contraindication for splenectomy ?
A. Iatrogenic splenic rupture
B. Thrombocytopenia
C. Presence of bone marrow failure
D. Hairy cell leukemia

The correct answer is C. Presence of bone marrow failure.

The only contraindication to splenectomy is the presence of marrow failure, in which the

enlarged spleen is the only source of hematopoietic tissue.

Ref: Harrison’s 18th Ed. 471

Weight of Normal Spleen

# Weight of a normal spleen is ?
A. < 150 grams
B. < 250 grams
C. < 350 grams
D. < 450 grams

The correct answer is B. < 250 grams.

Normal spleen weighs <250 grams.

Ref: Harrison’s 18th Ed. 468

Enlarged, grayish yellow or orange tonsils are pathognomic of

# Enlarged, grayish yellow or orange tonsils are pathognomic of ?
A. Waldenström’s macroglobulinemia
B. Polycythemia vera
C. Wolman disease
D. Tangier disease

The correct answer is D. Tangier Disease.

Tangier disease is associated with cholesterol accumulation in reticuloendothelial system with

hepatosplenomegaly & enlarged, grayish yellow or orange tonsils.

Ref: Harrison’s 18th Ed. 3154

Preauricular lymphadenopathy

# Preauricular lymphadenopathy accompanies which of the following?
A. Scalp infection
B. Ear infection
C. Conjunctival infections
D. Tooth infection

The correct answer is: C. Conjunctival infections.

Preauricular adenopathy accompanies conjunctival infections and cat-scratch disease.

Ref: Harrison’s 18th Ed. 466

Occipital lymphadenopathy

# Occipital lymphadenopathy accompanies which of the following ?
A. Scalp infection
B. Ear infection
C. Conjunctival infections
D. Tooth infection

The correct answer is : A. Scalp infection.

Occipital adenopathy often reflects infection of the scalp.

Ref: Harrison’s 18th Ed. 466

Platelet count rise at what time of menstrual cycle?

# During menstrual cycle, platelet count rise at what time ?
A. Following ovulation
B. At the onset of menses
C. After completion of menstrual flow
D. Before ovulation

The correct answer is A. Following ovulation.

Platelet count varies in menstrual cycle, rising following ovulation & falling at onset of menses.
Ref: Harrison’s 16th Ed. 673

Major risk factor for arterial thrombosis

# The major risk factor for arterial thrombosis is ?
A. Atherosclerosis
B. Hyperhomocysteinemia
C. Dysfibrinogenemia
D. Hormonal therapy

The correct answer is: A. Atherosclerosis. 

The major risk factor for arterial thrombosis is atherosclerosis. Risk factors for venous thrombosis

are immobility, surgery, underlying medical conditions, malignancy, hormonal therapy, obesity,

and genetic predispositions.

Epistaxis is the most common symptom in

# Epistaxis is the most common symptom in ?
A. Hemophilia A
B. Ehlers-Danlos syndrome
C. Hereditary hemorrhagic telangiectasia
D. Cushing’s syndrome

The correct answer is C. Hereditary hemorrhagic telangiectasia

Epistaxis is the most common symptom in hereditary hemorrhagic telangiectasia & in boys with Von Willebrand Disease.

Ref: Harrison’s 18th Ed. 460

Poikilocytosis

# Poikilocytosis is related to which feature of RBC ?
A. Size
B. Shape
C. Number
D. Colour

The correct answer is: B. Shape.

Variations in red cell shape is called poikilocytosis. Poikilocytosis suggests a defect in the
maturation of red cell precursors in bone marrow or fragmentation of circulating red cells.

Ref: Harrison’s 18th Ed. 450

Anisocytosis

# Anisocytosis is related to which feature of RBC ?
A. Size
B. Shape
C. Number
D. Colour

The correct answer is A. Size.

Variations in red cell size is called anisocytosis.

Ref: Harrison’s 18th Ed. 450

Palmar creases are lighter - Low Hemoglobin

# If palmar creases are lighter in color than surrounding skin, hemoglobin level is usually ?
A. < 10 g/dL
B. < 8 g/dL
C. < 6 g/dL
D. < 4 g/dL

The correct answer is B. < 8g/dL.

If the palmar creases are lighter in color than the surrounding skin with hyperextended hand,

the hemoglobin level is usually < 8 g/dL.  

Ref: Harrison’s 18th Ed. 449

Erythropoietin is produced by

# Erythropoietin is produced and released by ?
A. Glomerular capillaries
B. Proximal tubular cells
C. Peritubular capillary lining cells of kidney
D. All of the above

The correct answer is C. Peritubular capillary lining cells of kidney.

Physiologic regulator of RBC production, glycoprotein hormone EPO, is produced & released by
highly specialized epithelial-like peritubular capillary lining cells within kidney.

Ref: Harrison’s 18th Ed. 448

Role of Erythropoietin

# In the absence of erythropoietin (EPO), committed erythroid progenitor cells undergo ?
A. Stunted growth
B. Halting of growth
C. Programmed cell death (apoptosis)
D. Change to other series of hematopoietic cell

The correct answer is C. Programmed cell death (apoptosis).

For RBC production, EPO is the regulatory hormone. It is required for maintenance of committed

erythroid progenitor cells which undergoes programmed cell death (apoptosis) if EPO is absent.

Ref: Harrison’s 18th Ed. 448

Painful preauricular lymphadenopathy is a feature of

# Painful preauricular lymphadenopathy is a feature of ?
A. Cat-scratch disease
B. Tularemia
C. Tuberculosis
D. Syphilis

The correct answer is B. Tularemia.

Painful preauricular lymphadenopathy is unique to tularemia and distinguishes it from catscratch

disease, tuberculosis, sporotrichosis, and syphilis. 

Ref: Harrison’s 17th Ed. 978

Tularemia, also known as rabbit fever, is an infectious disease caused by the bacterium Francisella tularensis. Symptoms may include fever, skin ulcers, and enlarged lymph nodes. Occasionally, a form that results in pneumonia or a throat infection may occur.

The bacterium is typically spread by ticks, deer flies, or contact with infected animals. It may also be spread by drinking contaminated water or breathing in contaminated dust. It does not spread directly between people. Diagnosis is by blood tests or cultures of the infected site.

Multiple Choice Questions In Conservative Dentistry - Tooth Colored Restorations

# Restoration of angle fracture of anterior teeth can be done by:
A. Amalgam
B. Composite resin
C. Glass ionomer cement
D. All of the above

# Replanted avulsed tooth can be aesthetically stabilized by:
A. Occlusal splints
B. Composite resins
C. Arch bar
D. All of the above

# The main disadvantages of composites not being recommended for class II posterior restorations are:
A. Color matching is not good
B. Lacks sufficient strength
C. Occlusal wear
D. Frequent fractures at the isthmus

Not a contraindication to dental implant

# Which of the following conditions is not a contraindication to dental implant placement?
A. Diminished healing capacity of the patient's tissues
B. Current chemotherapy for the treatment of cancer
C. History of radiation therapy to the maxillofacial complex
D. Dysmorphophobia
E. Advanced patient age

Advanced patient age is not a contraindication to implant treatment. The ability of the
patient to withstand surgical treatment, etc. is a decision resting on the systemic health
of the patient.

Any condition that causes an impairment of the patient's ability to heal should be considered
as a contraindication to implant treatment. Serious psychiatric conditions such as psychoses should be considered a contraindication to implant treatment. Dysmorphophobia is an extremely irrational fear of being disfigured by treatment. Psychiatric complications can make the patient change his or her opinion about the acceptability of treatment which is difficult for the clinician to overcome.

Greatest esthetic challenge for the restorative dentist

# The greatest esthetic challenge for the restorative dentist occurs in the patient having a:
A. High smile line, thick periodontal biotype
B. Low smile line, thin periodontal biotype
C. Low smile line, thick periodontal biotype
D. High smile line, thin periodontal biotype

The correct answer is D. High Smile line, thin periodontal biotype

A low smile line indicates that the patient does not lift the lip upwards when smiling to
the extent that the gingival-restorative interface can be seen by the observer. Consequently,
esthetic compromises may be more acceptable to the patient because they are not routinely
visible. A thick periodontal biotype indicates that the patient has thicker, denser gingiva with a less pronounced scallop. This type of tissue is more resistant to the recession caused by restorative procedures and materials, a lower chance of "show-through" of the implant or abutment, and a lower chance of loss of the papillae adjacent to the implant.

Shade selection for composite restoration

# Shade selection for composite restoration in anterior teeth should be done:
 A. After end of etching
 B. After prolonged drying
 C. Before prolonged drying
 D. After applying bonding agent

The correct answer is C. Before prolonged drying.

For shade selection, the teeth should be moist and should not be dehydrated. A dehydrated tooth gives a whiter appearance due to scattering and reflection of light. Bleaching procedures if any should be done before shade selection.

Permanent dentition stage normally begins with:

# The permanent dentition stage normally begins with which of the following?

A. Exfoliation of the primary mandibular central incisor

B. Exfoliation of the primary maxillary 2nd molar

C. Eruption of the permanent mandibular 1st molar

D. Eruption of the permanent maxillary 1st molar

E. Exfoliation of the primary mandibular 1st molar

The correct answer is B. Exfoliation of the primary maxillary 2nd molar. 

The permanent dentition stage does not

begin until the final primary tooth is

exfoliated.

The term "'mixed dentition" describes the

time between the eruption of the permanent 1st molars until the exfoliation of the last primary tooth.

Patients who retain primary teeth don't

leave the mixed dentition stage until the

primary teeth are lost.

Primary dentition: 6 months- 6 years

Mixed dentition: 6 years- 12 years

Permanent dentition: 12 years +

Most effective topical anesthetic

# Which of the following is most effective as a topical anesthetic?
A. Lidocaine
B. Bupivacaine
C. Procaine
D. Prilocaine
E. Articane

The correct answer is A. Lidocaine.


Lidocaine is proven to be an effective
topical anesthetic drug that can effectively
numb the mucosal surfaces the oral cavity.

It is a strong anesthetic drug usually
delivered in gel, liquid, lotion, spray or
cream form.

Lidocaine topical anesthetic can penetrate
approximately 2-3mm deep into the
mucosal layer when applied properly.

Impurity found in nitrous oxide

# The impurity that is theoretically found in nitrous oxide that is considered slightly toxic is:
A. Methane
B. Cyclohexane
C. Ethylene oxide
D. Nitric oxide

The correct answer is D. Nitric oxide.

Nitrous oxide is a gas that creates
analgesia and dissociated anesthesia and
is commonly used in dentistry.

Nitrous oxide was first used by Horace
Wells for his own tooth extraction by his
assistant.

Nitrous oxide is used in general anesthesia
to enhance the effect of other drugs being
administered by allowing the concentration
of other drugs to be decreased without
decreasing their effect.

When nitrous oxide reacts with oxygen and
is converted into nitric oxide, causing
vasodilation.