A 70 year old patient comes with complaint of headache, nausea, tenderness over temporal region, diagnosis is:

 # A 70 year old patient comes with complaint of headache, nausea, tenderness over temporal region, diagnosis is? 

A. Aneurysmal arterial dilatation with sub-intimal inflammation 

B. Granulomatous inflammation with giant cell arteritis

C. Luminol thrombosis 

D. Acute organizing thrombus formation

The correct answer is B. Granulomatous inflammation with giant cell arteritis.

Temporal arteritis is to be suspected in an elderly patient presenting with headache, visual symptoms (blindness), fever, malaise, weakness, pain and tenderness over temporal artery (thick cord like sensation) and a raised ESR. 

Temporal (giant cell) arteritis is an inflammatory disorder of arteries that frequently involves the extracranial carotid circulation. The average age of onset is 70 years (elderly), and women account for 65% of cases. About half of patients with untreated temporal arteritis develop blindness due to involvement of the ophthalmic artery and its branches. lschemic optic neuropathy induced by giant cell arteritis (granulomatous inflammation) is the major cause of rapidly developing bilateral blindness in patients >60 years. 

Typical presenting symptoms include headache, polymyalgia rheumatica jaw claudication, fever, and weight loss. Headache is the dominant symptom and often appears in association with malaise and muscle aches. Head pain may be unilateral or bilateral and is located temporally in 50% of patients but may involve any and all aspects of the cranium. Pain usually appears gradually over a few hours before peak intensity is reached; occasionally, it is explosive in onset. 

The erythrocyte sedimentation rate (ESR) is often, though not always, elevated; a normal ESR does not exclude giant cell arteritis. A temporal artery biopsy followed by immediate treatment with prednisone (glucocorticoids) 80 mg daily for the first 4-6 weeks should be initiated when clinical suspicion is high. 

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The assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered is:

 # The assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered is: 

A. Quality Assessment 

B. Quality Assurance 

C. Quality Planning 

D. Guidelines 

The correct answer is B. Quality Assurance.

The ADA defines quality assessment as 'the measure of the quality of care provided in a particular setting'. 

Quality assurance in turn is defined as 'the assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered'.

The difference in these definitions is important: Quality assessment is limited to the appraisal of whether or not standards of quality have been met, whereas quality assurance includes the additional dimension of action to take corrective steps if needed to improve the situation. 

Collagen turnover rate in the gingiva is:

 # Collagen turnover rate in the gingiva is:

A. lower than that in the periodontal ligament

B. Higher than that in the periodontal ligament

C. Equal to that in the periodontal ligament

D. Very less as collagen fibrils are mature cell components

The correct answer is A. Lower than that in the periodontal ligament.

Overall, collagen turnover rate in the gingiva is lower than that in the periodontal ligament. Slow gingival fiber turnover may result from the lowered functional stress on this tissue as the transseptal fibers function in a manner similar to tendons, providing firm anchorage of the tooth. Remodeling and regeneration of gingival epithelium can also be slow. This is evidenced by the appearance of a red patch in the soft tissue region away from which a tooth is moved, which is caused by exposure of tissues underneath the epithelium.

Commonest type of lung carcinoma in non smokers:

# Commonest type of lung carcinoma in non smokers:

A. Squamous cell carcinoma

B. Adenocarcinoma

C. Alveolar cell carcinoma

D. Small cell carcinoma

The correct answer is B. Adenocarcinoma. 

Types of Lung Carcinoma:

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type, accounting for about 80% of all lung cancers. Here's a breakdown of the options you provided:

Squamous cell carcinoma: This is a type of NSCLC that typically starts in the flat cells lining the airways of the lungs. Smoking is a major risk factor for squamous cell carcinoma.

Adenocarcinoma: This is also a type of NSCLC, and it's the most common type of lung cancer diagnosed in both smokers and non-smokers. It starts in the gland cells that make mucus in the lungs.

Alveolar cell carcinoma: This is a rare type of lung cancer that starts in the air sacs of the lungs. It's more common in smokers than non-smokers.

Small cell carcinoma: This is an aggressive type of lung cancer that can spread quickly. It's less common than NSCLC and is also more likely to occur in smokers.

Why Adenocarcinoma in Non-Smokers:

While smoking is the leading cause of lung cancer,  adenocarcinoma can develop in people who have never smoked. Here's why it's the most common type in non-smokers:

Risk Factors: Non-smoking related risk factors for adenocarcinoma include exposure to radon gas, secondhand smoke, air pollution, and a family history of lung cancer.

Cell Type: Adenocarcinoma originates in the gland cells lining the lungs, which are less affected by smoking compared to the cells targeted by squamous cell carcinoma.

Mutations:  Non-smokers with lung cancer are more likely to have specific gene mutations, particularly in the EGFR gene, which can drive the development of adenocarcinoma.

Capacitation occurs in:

 # Capacitation occurs in:

A. Female genital tract

B. Sertoli cells

C. Rete testis

D. Seminiferous tubules

The correct answer is A. Female genital tract.

Capacitation is the process that sperm undergo in the female reproductive tract to become able to fertilize an egg. It does not happen in the male reproductive organs. 

Capacitation occurs in the female reproductive tract. It’s a crucial step in the maturation of mammalian spermatozoa, rendering them competent to fertilize an oocyte. During capacitation, the sperm undergo biochemical changes that prepare them for the acrosome reaction, allowing penetration of the egg’s outer layer for fertilization. So, the correct answer is A. Female genital tract.

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Which among the following is not a feature of Mediterranean anemia?

 # Which among the following is not a feature of Mediterranean anemia?

A. Rodent like facies

B. Fessa bodies

C. Rib within rib appearance

D. Platybasia

The correct answer is D. Platybasia.

Mediterranean anemia, also known as thalassemia, is a group of inherited blood disorders characterized by reduced or absent production of normal hemoglobin. This leads to various clinical manifestations, including skeletal changes due to bone marrow expansion. However, platybasia (flattening of the skull base) is not typically associated with thalassemia.

Rodent-like facies: This is a characteristic of sickle cell anemia, not thalassemia. It refers to the overgrowth of the maxillary bones and protrusion of the upper incisors.

Fessas bodies: In heterozygotes, the disease is mild and is called thalassemia minor or thalassemia trait. It represents both α-and β-thalassemia. Homozygotes may exhibit a severe form of the disease that is called thalassemia major or homozygous -thalassemia, in which the production of β-chains is markedly decreased or absent, and a consequent decrease in synthesis of total hemoglobin occurs. This results

in severe hypochromic anemia. Furthermore, excess α-chains, which synthesize at the normal rate, precipitate as insoluble inclusion bodies within the erythrocytes and their precursors.

The presence of such intracellular inclusion bodies (Fessas bodies) leads to increased erythrocyte hemolysis and severe ineffective hematopoiesis. Approximately 70–85% of marrow normoblasts are destroyed in severely affected patients. These processes result in profound anemia and an associated increase in marrow activity, which is estimated to increase 5- to 30-fold.

Rib within rib appearance: This is also known as "rib notching" and is caused by bone marrow expansion eroding the undersurface of the ribs.

Reference:

Radiopaedia: https://radiopaedia.org/articles/thalassaemia

All are features of Keratocystic odontogenic tumor EXCEPT:

# All are features of Keratocystic odontogenic tumor EXCEPT:

A. Most common location is the posterior body of the mandible

B. Shows evidence of a cortical border, when not secondarily infected

C. Internal structure is most commonly radiopaque

D. Curved internal septa may be present

The correct answer is C. Internal structure is most commonly radioopaque.

Keratocystic odontogenic tumors (KCOTs) are benign but locally aggressive lesions. Their radiographic appearance is typically:

Radiolucent: KCOTs appear as dark areas on radiographs, indicating that they are less dense than the surrounding bone.

Well-defined borders: They usually have clear and distinct margins.

Unilocular or multilocular: They can be single-chambered (unilocular) or multi-chambered (multilocular).

Scalloped borders: The edges of the lesion may have a wavy or scalloped appearance.

Curved septa: If multilocular, the internal septa may appear curved.

Reference:

Odontogenic keratocyst | Radiology Reference Article | Radiopaedia.org: https://radiopaedia.org/articles/odontogenic-keratocyst