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.