PGCEE MDS 2022: Collum angle is seen in:

 # Collum angle is seen in:

a) Class I bimaxillary protrusion

b) Class II div 1

c) Class II div 2 

d) Class III

The correct answer is C. Class II div 2.

The angle which is formed by the intersection of the long axes of the crown and root angulation is called Collum angle. It is decreased in Class II Div 2 cases. Due to this reason the crown appears to be lingual from the long axis of the roots in class II div 2 cases. Collum angle has been confused with interincisal angle. Interincisal angle is decreased in Class II div 1 and increased in class II div 2.

PGCEE MDS 2022 : Most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity

 # The most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity is :

A. Lignocaine

B. Quinidine

C. Verapamil

D. Amiodarone

The correct answer is A. Lignocaine.

The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias. Fab dose can be determined by two different methods. First method is based on the amount of digoxin ingested whereas the second method is based on the serum digoxin concentration and the weight of the person.

Other treatment that may be used to treat life-threatening arrhythmias until Fab is acquired are magnesium, phenytoin, and lidocaine. Magnesium suppresses digoxin-induced ventricular arrhythmias while phenytoin and lidocaine suppresses digoxin-induced ventricular automaticity and delay afterdepolarizations without depressing AV conduction. In the case of an abnormally slow heart rate (bradyarrhythmias), Atropine, catecholamines (isoprenaline or salbutamol), and/or temporary cardiac pacing can be used.

USES OF LIDOCAINE

Lidocaine is safe if given by slow i.v. injection; is used to suppress VT and prevent VF. It is ineffective in atrial arrhythmias. Because of rapidly developing and titratable action it is a good drug in the emergency setting, e.g. arrhythmias following acute MI or during cardiac surgery. In acute MI, i.v. infusion of lidocaine can prevent VF, but a metaanalysis has shown that it fails to improve survival; may even increase short term mortality. Therefore, lidocaine is no longer administered prophylactically to all MI patients, but may be used in selected cases, and to treat ventricular arrhythmias when they occur. Efficacy of lidocaine in chronic ventricular arrhythmia is poor, but it suppresses VT due to digitalis toxicity, for which it is used because it does not worsen A-V block.

PGCEE MDS 2022: Least invasive way to treat the fracture of edentulous mandible is:

 # Least invasive way to treat the fracture of edentulous mandible is:

A. External splint fixation

B. Open reduction with transosseous wire ligation

C. Percutaneous intramedullary pinning

D. Gunning splint

The correct answer is D. Gunning Splint.

Treating edentulous mandibular fracture is difficult in elderly patients due to compromised medical condition of the patient and various contraindications for the surgical approach. The complication rate of infection or malunion is higher compared to fractures in younger, dentulous patients. For such conditions, ‘Gunning splint’ is a better option as it provides close reduction and stabilization of mandibular fracture, thus improving the prognosis.

A Gunning splint is a type of orthopedic splint that can be used to immobilize and support the mandible. It is typically made of a rigid material, such as metal or plastic, and is shaped to fit around the mandible. The splint is named after William Gunning, who is credited with developing the design in the 19th century. Gunning splints are typically used to treat injuries or conditions that affect the mandible, such as fractures, sprains, or strains. They are also used to support and stabilize the mandible following surgery. The splint is typically attached to the mandible using wires or bands that are passed through holes in the splint and secured to the teeth or gums. The splint is then tightened to hold the mandible in place.

PGCEE MDS 2022 : The active ingredient of tooth mousse is:

 # The active ingredient of tooth mousse is:

A. Xylitol

B. Calcium

C. Casein

D. Chlorhexidine

The correct answer is C. Casein.

Tooth Mousse is a topical oral health product that was developed at the Melbourne Dental School, University of Melbourne.

Tooth Mousse comes in the form of a foamy crème, and is available in a range of flavours including: Melon, Strawberry, Tutti-Frutti, Mint and Vanilla.

Tooth Mousse contains casein (a major milk protein), as well as calcium and phosphate. Calcium and phosphate are the major minerals that teeth are made from.

Tooth Mousse is available in two product options: with or without fluoride. The general Tooth Mousse product does not contain fluoride, whereas Tooth Mousse Plus does contain fluoride.

Tooth Mousse is not toothpaste. It is made of milk products so swallowing the product is safe and it can be used throughout the day.

PGCEE MDS 2022: Which periodontal fibres are consistent

 # Which periodontal fibres are consistent and are reconstructed even after the destruction of the alveolar bone? 

A. Apical

B. Oblique

C. Alveolar crest group

D. Transseptal

The correct answer is D. Transseptal.

Transseptal group of PDL fibers

Functions: 

- Reconstructed even after destruction of the alveolar bone has occurred in the periodontal disease. 

- Responsible for returning teeth to their original state after orthodontic therapy. 

Position: 

Extends interproximally over alveolar bone crest and embedded in the cementum of adjacent teeth 

PGCEE MDS 2022: Ringer’s lactate does not contain:

 # Ringer’s lactate does not contain:

A. Sodium

B. Chloride

C. Calcium

D. Magnesium

The correct answer is D. Magnesium.

Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by intravenous infusion or applied to the affected area. 

PGCEE MDS 2022 : Commonest cause of TMJ ankylosis is:

 # Commonest cause of TMJ ankylosis is:

a) Trauma

b) Development disturbances

c) Infections 

d) Atrophy

The correct answer is A. Trauma. 

The definite cause of ankylosis of TMJ is unknown. Two main factors predisposing to the ankylosis are trauma and infection in or around the joint region. In 1968, Topazian reported that 26 to 75 percent of cases of TMJ ankylosis are seen following trauma, while 44 to 68 percent are seen due to infection. 

A high percentage of TMJ ankylosis are seen following trauma. At birth, TMJ may receive trauma from a forceps delivery. Trauma during intrauterine life leads to congenital ankylosis.

PGCEE MDS 2022 MCQ: Enzymes are generally:

 # Enzymes are generally:

A. Proteins

B. Carbohydrate

C. Lipid

D. Vitamin

The correct answer is A. Proteins. 

Enzymes may be defined as biocatalysts synthesized by living cells. They are protein in nature (exception - RNA acting as ribozyme), colloidal and thermolabile in character, and specific in their action.

Nerve involved in Saturday night palsy is:

 # Nerve involved in Saturday night palsy is:

A. Radial

B. Median

C. Auxiliary

D. Facial

The correct answer is A. Radial. 

THE TERM Saturday night palsy has become synonymous with radial nerve compression in the arm resulting from direct pressure against a firm object. It typically follows deep sleep on the arm, often after alcohol intoxication. The commonly accepted origin of the phrase is the association of Saturday night with drinking alcohol heavily.

Multiple odontogenic cysts are seen in:

 # Multiple odontogenic cysts are seen in:

A. Cherubism

B. Apert’s syndrome

C. Marfan’s syndrome

D. Down’s syndrome

The correct answer is C. Marfan's syndrome.

Oral Manifestations of Marfan's syndrome

According to Baden and Spirgi, who have reviewed the oral manifestations of this disease, a high, arched palatal vault is very prevalent and may be a constant finding. Bifid uvula is also reported as well as malocclusion. In addition, multiple odontogenic cysts of the maxilla and mandible have occasionally been reported, most recently by Oatis and his coworkers. One additional finding sometimes present, is temporomandibular dysarthrosis

Right coronary artery arises from:

 # Right coronary artery arises from:

A. Anterior aortic sinus

B. Posterior aortic sinus

C. Right aortic sinus

D. Left aortic sinus

The correct answer is A. Anterior aortic sinus.

An aortic sinus is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve. These widenings are between the wall of the aorta and each of the three cusps of the aortic valve. 

There are generally three aortic sinuses: (one anterior and 2 posterior sinus) 

• Right coronary artery arises from anterior aortic sinus of ascending aorta. 

• Left coronary artery arises from left posterior aortic sinus. 

• Right posterior aortic sinus is non-coronary sinus. 

A sphygmomanometer reading can be correct only when:

 # A Sphygmomanometer reading can be correct only when :

A. Deflation is 5-10 mm Hg per heart beat 

B. cuff is slightly full on applying to patient's arm 

C.  the cuff width is 25% of the diameter of the patient's arm 

D. length of the bladder encircle 80% of the patient's arm 

The correct answer is D. length of the bladder encircle 80% of the patient's arm.

Choosing appropriate sized cuff is vital to record accurate blood pressure in children. Small sized cuff gives elevated blood pressure readings and bigger sized cuffs give low blood pressure reading. The inflatable bladder inside the cuff should have an ideal width of at least 40% of the mid arm circumference and a cuff length that is 80 - 100% of the arm circumference. 

Nomenclature of Hand Instruments

# The shape of the shank of an instrument is described by: 

A. Class 

B. Subclass 

C. Suborder 

D. Order 

The correct answer is B. Subclass.

Dr. G.V. Black established a nomenclature for hand instruments, similar to the biological classification. 

1. Order : Purpose of instrument Eg : excavator or scaler. 

2. Suborder : Position or manner of use Eg : Push, pull 

3. Class : Form of working end, Eg : hatchet, chisel. 

4. Subclass : Shape of shank Eg : Monoangle or binangle. 

Naming usually moves from 4 to 1. 

Which of the following teeth have more than one occlusal form?

 # Which of the following teeth have more than one occlusal form?

A. Maxillary first premolar

B. Maxillary second premolar

C. Maxillary first molar

D. Mandibular first molar

The correct answer is C. Maxillary first molar.

The maxillary first molar is the largest tooth in volume and one of the most complex in root and canal anatomy. The pulp chamber is widest in the buccolingual dimension, and four pulp horns are present (mesiobuccal, mesiopalatal, distobuccal, and distopalatal). The pulpchamber's cervical outline form has a rhomboid shape, sometimes with rounded corners. The mesiobuccal angle is an acute angle; the distobuccal angle is an obtuse angle; and the palatal angles are basically right angles. 

Commonest site for venous ulcer is:

 # Commonest site for venous ulcer is:

A. Instep of foot

B. Lower 1/3rd leg and ankle

C. Lower 2/3rd of leg

D. Middle 1/3rd of leg

The correct answer is B. Lower 1/3rd leg and ankle.

Venous ulcer is the commonest ulcer of the leg. The basic cause of venous ulcer is abnormal venous hypertension in the lower-third of the leg, ankle and dorsum of the foot. This ulcer may be associated with demonstrable varicose veins or may follow thrombosis and phlebitis in the deep and perforating veins. 

Eicosapentaenoic acid (EPA) is present in:

 # Eicosapentaenoic acid (EPA) is present in:

A. Soyabean oil

B. Corn oil

C. Sunflower oil

D. Fish oil

The correct answer is D. Fish oil.

Eicosapentaenoic acid (EPA) is one of several omega-3 fatty acids. It is found in cold-water fatty fish, such as salmon. It is also found in fish oil supplements, along with docosahexaenoic acid (DHA). Omega-3 fatty acids are part of a healthy diet that helps lower risk of heart disease.

Which of the following cements have highest water solubility?

 # Which of the following cements have highest water solubility? 

A. Zinc phosphate 

B. Zinc oxide eugenol 

C. Zinc silicophosphate 

D. Zinc polycarboxylate 

The correct answer is C. Zinc silicophosphate.

Of the given choices, ZOE cements have the highest solubility in oral environment. But, water solubility of ZOE is less while that of silicophosphate is quite high. The oral solubility is different from water solubility. This is because the oral environment is mildly acidic while the water is neutral. Thus, in oral environment, ZOE has maximum solubility while in water, silicophosphate has maximum water solubility.

Tumor suppressor gene in head and neck cancer is:

 # Tumor suppressor gene in head and neck cancer is: 

A. Erb-b 

B. C-myc 

C. Bcl 

D. p16INK4A 

The correct answer is D. p16INK4A.

Tumor suppressor genes have been associated with sites of chromosome abnormalities where loss of genetic nucleic segments has been reported to commonly involve chromosome arms 3p, 4q, 8p, 9p, 11q, 13q, and 17p. TSGs involved in HNSCC are P53, Rb (retinoblastoma), and p16INK4A. Other candidates include FHIT (fragile histidine triad), APC (adenomatous polyposis coli), DOC1 VHL (gene for von Hippel‐Lindau syndrome), and TGF‐R‐II (gene for transforming growth factor type II receptor).

Ref: Burket's Oral Medicine, 13th Edition.

Non scrappable white papules intermixed with areas of erythema and erosion most likely falls under:

 # Non scrappable white papules intermixed with areas of erythema and erosion most likely falls under: 

A. Candidiasis 

B. Erythroleukoplakia 

C. Leukoplakia 

D. Erythroplakia 

The correct answer is B. Erythroleukoplakia.

The term 'non homogeneous' is ascribed to lesions with two different features, usually having both red and white areas, but also to all those without redness but containing verruciform exophytic elements. Due to the combined appearance of white and red areas, the nonhomogeneous oral leukoplakia has also been called erythroleukoplakia and speckled leucoplakia. The clinical manifestation of the white component may vary from large white verrucous areas to small nodular structures. If the surface texture is homogeneous but contains verrucous, papillary (nodular), or exophytic components, the leukoplakia is also regarded as nonhomogeneous.

The glycoprotein antigen chiefly detected in pemphigoids is:

 # The glycoprotein antigen chiefly detected in pemphigoids is: 

A. BP 180 and 230 

B. DSG 2 and 3 

C. BP 130 and 280 

D. DSG 1 and 4 

The correct answer is A. BP 180 and 230.

Bullous Pemphigoid is an autoimmune disease caused by the binding of autoantibodies to specific antigens found in the lamina lucida region of the basement membrane on the hemidesmosomes of epithelial basal cells. These antigens are glycoproteins referred to as bullous pemphigoid antigens, BP 180 and BP 230. Binding of antibody to antigen activates both leukocytes and complement, causing localized damage to the basement membrane, resulting in vesicle formation in the subepithelial region.

Blisters containing clear fluid, less than 1cm in diameter is:

 # Blisters containing clear fluid, less than 1cm in diameter is: 

A. Vesicle 

B. Bulla 

C. Pustule 

D. Nodule 

The correct answer is A. Vesicle.

Vesicles: These are small blisters containing clear fluid that are less than 1 cm in diameter.

Bullae: These are elevated blisters containing clear fluid that are greater than 1 cm in diameter.

Pustules: These are blisters containing purulent material and appear yellow.

Nodules: These lesions are present within the deep mucosa. The lesions may also protrude above the mucosa forming a characteristic dome‐shaped structure. A good example of an oral mucosal nodule is the irritation fibroma.

Ref:  Burket's Oral Medicine, 13th Edition.

Dressler syndrome is a complication of:

 # Dressler syndrome is a complication of:

A. Hypertension

B. Pericarditis

C. Mitral stenosis

D. Myocardial infarction

The correct answer is D. Myocardial infarction.

Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.

Dressler syndrome is also known as postmyocardial infarction syndrome and the term is sometimes used to refer to post-pericardiotomy pericarditis.

It was first characterized by William Dressler at Maimonides Medical Center in 1956.

Beyron point is located at:

 # Beyron point is located at:

A. 13 mm anterior to posterior margin of tragus on a line from center of tragus to outer canthus 

B. 11 mm anterior to posterior margin of tragus on a line from parallel to and 7 mm below FHP 

C. 10 mm anterior to posterior margin of tragus on a line from center of tragus to outer canthus 

D. 13 mm anterior to tragus on a line from base of tragus to outer canthus 

The correct answer is A.  13 mm anterior to posterior margin of tragus on a line from center of tragus to outer canthus. 

The first step in placing a face bow is to locate the hinge axis on the skin on the each side of the patients face. One frequently recommended method is to position the condyle rods on a line extending from the counter canthus of the eye to the top of the tragus of the ear and approximately 13 mm in front of the external auditory meatus is called Beyron Point.This placement generally locates the rods within 5mm of the true center of the opening axis of the jaws. The imaginary line joining the two Beyron points is an approximate hinge axis. 

Dens evaginatus is most commonly found in:

 # Dens evaginatus is most commonly found in:

A. Premolar

B. Lateral incisor

C. Canine

D. Molar

The correct answer is A. Premolar.

Dens evaginatus or leong's premolar or evaginated odontome or occlusal tuberculated premolar is a developmental condition that appears as an accessory cusp or a globule of enamel between the buccal and lingual cusps of premolars, unilaterally or bilaterally, though it had been known to rarely occur on molars, cuspids and incisors.

Which of the following lesions/conditions is not caused by virus?

 # Which of the following lesions/conditions is not caused by virus?

A. Koplik’s spots

B. Herpetiform ulcers

C. Herpes labialis

D. Ramsay-Hunt syndrome

The correct answer is B. Herpetiform ulcers.

Koplik's spots are seen in the buccal mucosa in patients with measles, which is an infection caused by paramyxovirus. Herpes labialis is caused by the herpes simplex virus and Ramsay-Hunt syndrome is due to herpes zoster of the geniculate ganglion. Herpetiform ulcers are a type of aphthous ulcer and are not caused by a virus. Lyme disease is caused by Borrelia burgdorferi, a spirochaetal bacterium, and is spread via ticks. 

Which of the following does not cause oral cancer in children?

 # Which of the following does not cause oral cancer in children?

A. Herpes simplex

B. Epstein barr

C. Cytomegalovirus

D. Varicella zoster

The correct answer is D. Varicella zoster.

HSV has been possibly associated with hit and run mechanism in oral cancer causation. Epstein barr virus causes African jaw lymphoma, CMV possibly is associated with Kaposi's sarcoma. Hence Herpes zoster is the best option. 

Osteoblastic secondaries are present in which carcinoma?

 # Osteoblastic secondaries are present in which carcinoma?

A. Carcinoma lung

B. Carcinoma breast

C. Carcinoma urinary bladder

D. Carcinoma prostate

The correct answer is D. Carcinoma prostate.

Although most of such metastases produce osteolytic lesions and thus appear as a radiolucency, certain tumors produce osteoblastic lesions or lesions and are most often associated with carcinoma of the prostate, and occasionally, of the breast and lung. 

Most common complication of mumps is:

 # Most common complication of mumps is:

A. Myocarditis

B. Orchitis

C. Uveitis

D. Conjunctivitis

The correct answer is B. Orchitis.

Mumps is characterized by triad of pathological involvement- epidemic parotitis, orchitis-oophoritis, and pancreatitis. Meningoencephalitis, epididymitis, and encephalitis are other complications of mumps. When mumps involves adult male, orchitis is a great danger. Involvement of pancreas causes an increase in serum lipase enzyme.

PGCEE MDS 2022: Sicca complex is associated with:

 # Sicca complex is associated with:

A. Primary Sjogren’s syndrome

B. Secondary Sjogren’s syndrome

C. Peutz Jeghers syndrome

D. Plummer Vinson Syndrome

The correct answer is A. Primary Sjogren's syndrome.

Primary Sjogren's syndrome (Sicca complex)

- When the disease affects only salivary and lacrimal glands without other co-existing systemic autoimmune diseases, it is called primary Sjogren's syndrome or Sicca complex. Primary Sjogren's syndrome is also referred to as "sicca syndrome" in which dry mouth (xerostomia) and dry eyes (xerophthalmia or keratoconjunctivitis sicca) are the principal features. 

Secondary Sjogren's syndrome 

Secondary sjogren's syndrome characteristically has xerostomia, xerophthalmia and an associated autoimmune connective tissue disease, usually the rheumatoid arthritis, SLE, scleroderma, polyarteritis nodosa etc. Patients with sicca complex and Sjogren's syndrome have sera antisalivary duct antibody. In addition, They are found to be associated with the HLA system, specifically HLA-DR3 and HLA-B8 which are associated with primary form of the disease and HLA-DRw52 is seen to be associated with both the forms of Sjogren's syndrome. 

Mobility of teeth in carcinoma of maxillary sinus is due to involvement of

 # Mobility of teeth in carcinoma of maxillary sinus is due to involvement of ___________ by tumor.

A. Anterior wall of the sinus

B. Posterior wall of the sinus

C. Roof of the sinus

D. Floor of the sinus

The correct answer is D. Floor of the sinus.

The clinical features of the neoplasm depend on the direction of spread of the neoplasm or the involvement of the surrounding structures. The floor of the sinus is associated with oral structures like mobility of teeth. Medial wall involvement causes nasal obstruction. Superior wall involvement produces displacement of the eyes. Lateral wall involvement produces bulging of the cheek. 

Flumazenil can reverse the action of:

 # Flumazenil can reverse the action of:

A. Fentanyl

B. Propofol

C. Ketamine

D. Midazolam

The correct answer is D. Midazolam.

Flumazenil is a benzodiazepine (BZD) antagonist. It competes with benzodiazepine agonists and inverse agonists for the benzodiazepine receptor and reverses their depressant or stimulant effects respectively. Flumazenil abolishes the hypnogenic, psychomotor, cognitive and EEG effects of benzodiazepines. Among the options provided, Midazolam is a benzodiazepine. 

Uses: 

• To reverse benzodiazepine anaesthesia 

• Benzodiazepine overdose 

Jannetta procedure is done in:

 # Jannetta procedure is done in:

A. Bell’s palsy

B. Trigeminal neuralgia

C. Herpes Zoster

D. Paresthesias

The correct answer is B. Trigeminal neuralgia.

Microvascular decompression (MVD), also known as the Jannetta procedure, is a neurosurgical procedure used to treat trigeminal neuralgia (along with other cranial nerve neuralgias) a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm. The procedure is also used experimentally to treat tinnitus and vertigo caused by vascular compression on the vestibulocochlear nerve.

Angle between Frankfort horizontal plane and occlusal plane is:

 # Angle between FH plane and Occlusal plane is:

A. 1 degree

B. 10 degrees

C. 27 degrees

D. Parallel to each other

The correct answer is B. 10 degrees.

This is from Down's analysis. The cant measures the slope of occlusal plane to the Frankfort horizontal plane. When the anterior part of plane is lower than the posterior, the angle would be positive. Large positive angles are found in Class II facial patterns. A long mandibular ramus also tends to decrease this angle. The mean value is +9.3° with a range of +1.5° to +9.3°. 

Under metabolic conditions associated with a high rate of fatty acid oxidation, liver produces

 # Under metabolic conditions associated with a high rate of fatty acid oxidation, liver produces:

A. Glutamate

B. Acetoacetate

C. Cholesterol

D. Glycine

The correct answer is B. Acetoacetate.

- The ketone body formation occurs primarily due to non-availability of carbohydrates to the tissues and excessive utilization of fatty acids to meet the energy requirements of the cells. 

- Acetone, Acetoacetate and Beta-hydroxybutyrate are the ketone bodies. 

- Glucagon stimulates ketogenesis whereas insulin inhibits ketogenesis. 

Delhi boil refers to:

 # Delhi boil refers to:

A. Solar keratosis

B. Malignant pustule

C. Leishmania Tropica

D. Venereal ulcer

The correct answer is C. Leishmania Tropica.

Cutaneous leishmaniasis (also known as oriental sore, tropical sore, chiclero ulcer, chiclero's ulcer or Aleppo boil) are sores resulting from a tropical infection by protozoa of the genus Leishmania which are spread by sandflies. Delhi boil is a chronic inflammatory disease, most commonly met with in India, especially towards the end of the wet season. The common staphylococcal skin infections- Furunculosis of the external auditory meatus is extremely painful, as the skin is attached to the underlying cartilage, and swelling is accompanied by considerable tension. 

Vacancy for Dental Surgeon and Dental Hygienist Jobs in Nepal - Vacancy for Dentists and Dental Hygienists - NMC registered Dental Surgeons and NHPC registered Dental Hygienists

1. Dentist

Apply Before: 31st January 2023

Basic Job Information

No. of Vacancy/s : 1

Apply Before(Deadline) : Jan. 31, 2023

Job Specification

Education Level : Bachelor in Dental Surgery (BDS)

Experience Required : More than 2 years

Dentist

Himalayan Trust Nepal (HTN) is hiring a qualified Dentist to work at Namche Dental Clinic located in Namche Bazar Solukhumbu. The clinic is supported by the American Himalayan Foundation and managed by HTN in partnership with the Namche Dental Clinic Management Committee.

Job responsibility: This position holder is responsible to provide dental health services to local residents and visitors.

Qualification: BDS degree with a license from Nepal Medical Council and minimum work experience of 2 years with good written and verbal communication in English and Nepali. A good level of physical fitness to live and work at a high altitude is preferred.

Gross salary: Rs. 90,000/month including tax. The clinic operates only 9 months a year, but the job holder will get 12 months' salary. Food and accommodation will be provided.

Contract period: Initial one-year contract and will be renewed annually. Starting Date: 1 March 2023

Application Deadline: 31 January 2023

Interview Date: 8 February 2023 (for short-listed candidates only)

Please keep visiting this page for latest vacancies for Dental surgeons and Dental hygienists available in Nepal.

CLICK THIS LINK TO FILL UP A FORM FOR YOUR VACANCY ANNOUNCEMENT NOTICE

Histologically, presence of numerous mast cells is diagnostic feature of:

 # Histologically, presence of numerous mast cells is diagnostic feature of:

a. Fibroma

b. Neurofibroma

c. Traumatic neuroma

d. Malignant Peripheral Nerve Sheath Tumor

The correct answer is B. Neurofibroma.

Solitary and multiple neurofibromas have the same microscopic features. They contain spindle-shaped

cells, with fusiform or wavy nuclei found in a delicate connective tissue matrix; this matrix may be notably myxoid in character. Lesions may be well circumscribed or may blend into surrounding connective tissue. Mast cells are characteristically scattered throughout the lesion. A histologic subtype

known as plexiform neurofibroma is regarded as highly characteristic of neurofibromatosis. In this variety, a collagen matrix supports extensive interlacing masses of nerve tissue. Small axons may be seen among the proliferating Schwann cells and perineural cells.

Mandible is the common site for Ameloblastoma due to:

 # Mandible is the common site for Ameloblastoma due to:

a. SMO mutation

b. BRAF mutation

c. p53 mutation

d. SH3BP2 mutation

The correct answer is B. BRAF mutation.

Mutations in the oncogenes BRAF (kinase signaling pathway) in mandibular tumors and SMO (hedgehog signaling pathway) in maxillary tumors have been discovered in a large proportion of

ameloblastomas. Drugs developed to inhibit the mutated proteins of these genes may have a role in the future treatment of ameloblastomas. Mutations of the p53 gene do not appear to play a role in the development and growth of ameloblastoma; a role for ameloblastin protein has been identified, although it is not specific to ameloblastoma.

Addison's disease is due to:

 # Addison's disease is due to:

a. Chronic insufficiency of adrenal cortex

b. Chronic insufficiency of adrenal medulla

c. Insufficiency of pancreas

d. Hypofunction of thyroid gland

The correct answer is A. Chronic insufficiency of adrenal cortex.

Addison's disease, also known as primary adrenal insufficiency, is a rare long-term endocrine disorder characterized by inadequate production of the steroid hormones cortisol and aldosterone by the two outer layers of the cells of the adrenal glands (adrenal cortex), causing adrenal insufficiency. Symptoms generally come on slowly and insidiously and may include abdominal pain and gastrointestinal abnormalities, weakness, and weight loss. Darkening of the skin in certain areas may also occur. Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. Mood changes may also occur. Rapid onset of symptoms indicates acute adrenal failure which is a serious and emergent condition. An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection. 

The mitochondrial enzyme involved in the metabolism of clopidogrel and proton pump inhibitors is:

 # The mitochondrial enzyme involved in the metabolism of clopidogrel and proton pump inhibitors is:

a. CYP 2A

b. CYP 2B

c. CYP 2C19

d. CYP 2C20

The correct answer is C. CYP 2C19.

Like ticlopidine, clopidogrel is also a prodrug. About 50% of the ingested dose is absorbed, and

only a fraction of this is slowly activated in liver by CYP2C19, while the rest is inactivated by other enzymes. It is a slow acting drug; antiplatelet action takes about 4 hours to start and develops over days. Since CYP2C19, exhibits genetic polymorphism, the activation of clopidogrel and consequently its antiplatelet action shows high interindividual variability. Some patients are nonresponsive. Omeprazole, an inhibitor of CYP2C19, reduces metabolic activation of clopidogrel and its antiplatelet action. However, like ticlopidine, the action of clopidogrel lasts 5–7 days due to irreversible blockade of platelet P2Y12 receptors. 

Reference: KD Tripathi's Essentials of Medical Pharmacology

Tooth affected with dentinogenesis imperfecta are generally of which shape

 # Tooth affected with dentinogenesis imperfecta are generally of which shape?

A. Tulip

B. Conical

C. Shell

D. Ovoid

The correct answer is A. Tulip.

Aberration in chromosome 4 (loci4q21.3) is associated with Dentinogenesis imperfecta. It encodes dentin specific sialophospho protein (DSPP) gene. Deficiency of sialoprotein is also suggested as a causative factor for Dentinogenesis imperfecta. Tooth affected with dentinogenesis imperfecta are generally tulip shaped. 

Brittle bone syndrome is caused by:

 # Brittle bone syndrome is caused by:

A. Improper synthesis of procollagen 

B. Polymerisation of collagen 

C. Increase osteoclastic activity 

D Increase fibroblastic activity 

The correct answer is A. Improper synthesis of procollagen.

Osteogenesis imperfecta, also known as Brittle Bone Disease, or 'Lobstein syndrome' is disorder of congenital bone fragility caused by mutations in the genes that codify for type I procollagen. This deficiency arises from an amino acid substitution of glycine to bulkier amino acids in the collagen triple helix structure. If the body does not destroy the improper collagen, the relationship between the collagen fibrils and hydroxyapatite crystals to form bone is altered causing brittleness. The following 4 types of osteogenesis imperfecta have been reported. Type I -mild form, type II -extremely severe, type III -severe, type IV -undefined. These partly depend on the genetic subtype. Type I and IV are the most common forms of osteogenesis imperfecta. 

Goldenhar syndrome is:

 Goldenhar syndrome is:

A. Facial deformity, auricular abnormalities and vertebral deformity 

B. Facial deformity, auricular abnormalities, vertebral deformity and genital lesion 

C. Facial and auricular abnormalities only 

D. Auricular abnormalities only 

The correct answer is A. Facial deformity, auricular abnormalities and vertebral deformity.

Goldenhar syndrome or oculoauriculovertebral dysplasia is caused by abnormality in the vascular supply of the head. Hemifacial microsomia is second most common craniofacial anomaly, causing reduced growth and development of one half of the face. The mandible, maxilla, zygoma, external & middle ear, hyoid bone, parotid gland, 5th & 7th nerves, musculature and other soft tissues. When hemifacial microsomia is associated with vertebral abnormalities and epibulbar dermoids, it is known as Goldenhar syndrome. 

Cooley’s Anemia is also known as:

 # Cooley’s Anemia is also known as:

A. Sickle cell anemia

B. Alpha thalassemia

C. Beta thalassemia

D. Aplastic anemia

The correct answer is C. Beta Thalassemia.

Beta thalassaemia aka Thalassaemia major, Cooleys's anaemia: Beta-thalassaemia is inherited as an autosomal recessive pattern (homozygous). It is due to a mutation in the gene that causes either cause a total absence of beta-globin chain synthesis denoted as beta mutation or a reduced amount of beta-globin chain production denoted as beta mutation. Beta-thalassaemia major or Cooley's anaemia is the most severe form seen in individuals with a homozygous condition. These patients are severely anaemic and are transfusion dependent. 

Herald spots are seen in:

 # Herald spot is seen in:

A. Psoriasis

B. Erythema multiforme

C. Pityriasis rosea

D. Pemphigus 

The correct answer is C. Pityriasis rosea.

Pityriasis rosea is a common benign papulosquamous disease causing acute skin eruption of unknown etiology, often considered to be a viral exanthema. 

It is characterised by the appearance of superficial light red macules or papules, either generalised over most of the skin surface or localised to thighs, trunk, axillae or groin.

The individual exanthematous lesions are ovoid, with long axis parallel to the natural lines of cleavage of the skin, covered by thin, silvery scale. The generalised outbreak is preceded by primary lesion or herald spot, 7-10 days previously, that appears as bright red spot, 3-4 cm in diameter. 

Ketone bodies are normally synthesized from:

  # Ketone bodies are normally synthesized from:

A. Acetyl coA

B. Glucose

C. Glycerol

D. Acetone

The correct answer is: A. Acetyl coA.

Acetoacetic acid, O-hydroxybutyric acid and acetone are collectively called ketone bodies or acetone bodies, and the process of their formation is known as ketogenesis. Only the acetoacetic acid and acetone are the true ketones, while /3-hydroxybutyrate does not possess a keto group. The main site of ketogenesis is the liver. They are major fuel source of brain during prolonged starvation.

 Hydroxybutyryl-CoA and aceto acetyl-CoA are normally produced in penultimate step of beta oxidation. Aceto aceyl-CoA may also be formed from two molecules of acetyl-CoA. The synthesis of ketone bodies occur in liver in the mitochondrial matrix. Acetyl CoA, formed by oxidation of fatty acids, pyruvate and some other amino acids are the precursors for ketone bodies. HMG-CoA synthase is the regulatory enzyme in synthesis of ketone bodies. 

Which of the following is the most common developmental cyst?

  # Which of the following is the most common developmental cyst?

A. Nasopalatine cyst

B. Nasoalveolar cyst

C. Globulomaxillary cyst

D. Median palatal cyst

The correct answer is A. Nasopalatine cyst.

Nasopalatine duct cyst/Nasopalatine canal cyst/ Incisive canal cyst is most common non-odontogenic cyst. Its location is peculiar and specific in that it affects the midline anterior maxilla. 

Option B nasoalveolar cyst is a rare fissural cyst that arise at the junction of globular process, the lateral nasal process and the maxillary process. 

Option C globulomaxillary cyst is found within the bone at the junction of the globular portion of the medial nasal process, maxillary process, the globule maxillary fissure, usually between the maxillary lateral incisor and cuspid teeth. 

Condyloma acuminatum is associated with:

  # Condyloma acuminatum is associated with:

A. HPV

B. HHV 8

C. CMV

D. EBV

The correct answer is A. HPV.

Approximately 90% of condylomata acuminata are related to HPV types 6 and 11. These 2 types are the least likely to have a neoplastic potential. It is characterised by transmissible, autoinoculable soft pink nodules which proliferate and coalesce rapidly to form diffuse papillomatous clusters or as papillomatous, bulbous masses of varying sizes. Topical podophyllin may be used or surgical excision may be needed to treat the lesion. 

The term poikilokaryosis refers to :

 # The term poikilokaryosis refers to :

A. Alteration of nuclear cytoplasmic ratio

B. large, prominent nucleii

C. division of nuclei without division of cytoplasm

D. loss of polarity and disorientation of cells

The correct answer is C. Division of nuclei without division of cytoplasm.

Criteria for diagnosis of epithelial dysplasia in carcinoma include: 

• Increased abnormal mitoses 

• Individual cell keratinisation 

• Epithelial pearls in the spinous layer 

• Alterations in nuclear Cytoplasmic ratio 

• Loss of polarity and disorientation of cells 

• Hyper chromatism 

• Large nucleoli 

• Dyskaryosis or nuclear atypism including giant nuclei. 

• Poikilokarynosis or division of nuclei without division of cytoplasm 

• Basilar hyperplasia Individual cell keratinisation and epithelial pearl formation is absent in carcinoma in situ or intra epithelial carcinoma.