What is the area of biopsy of an ulcer?

 # What is the area of biopsy of an ulcer?

A. Center of ulcer 

B. Edge of ulcer 

C. Adjacent mucosa 

D. Margins of ulcer

The correct answer is B. Edge of ulcer.

The edge of the ulcer is the preferred site for biopsy because it is most likely to contain a mixture of both the pathological tissue and relatively healthy tissue, making it easier to assess the nature of the lesion. The center of the ulcer may contain necrotic tissue, which can obscure diagnosis, while adjacent mucosa and margins might not provide the necessary diagnostic material.

While the terms "edge" and "margin" may seem similar, in the context of ulcer biopsy, they refer to different areas:

Edge of the ulcer: This refers to the transitional zone where the ulcerated tissue meets the adjacent normal or mildly affected tissue. It contains a mix of pathological changes (inflammation, dysplasia, or neoplastic transformation) and some relatively intact tissue. This makes it ideal for biopsy because it provides a clearer picture of the disease process.

Margin of the ulcer: This term typically refers to the boundary or outer rim of the ulcer where the surrounding tissue is largely unaffected or healthy. A biopsy from the margin might miss the abnormal cellular changes that are occurring in the active disease area.

In summary, the edge includes both ulcerated and transitioning tissue, making it more useful for diagnosis, whereas the margin is often farther out in the healthier tissue, which may not show the necessary pathological changes.

Posterior triangle of neck is subdivided into two parts by which muscle?

 # Posterior triangle of neck is subdivided into two parts by which muscle?

A. Sternocleidomastoid

B. Superior belly of Omohyoid

C. Inferior belly of Omohyoid

D. Pulley of Trapezius

The correct answer is C. Inferior belly of Omohyoid.

The posterior triangle of the neck is divided into two smaller triangles: the occipital triangle and the subclavian (supraclavicular) triangle. This division is created by the inferior belly of the omohyoid muscle.

Here’s a breakdown of the other options:

A. Sternocleidomastoid: Forms the anterior border of the posterior triangle, but does not subdivide it.

B. Superior belly of Omohyoid: Lies more anteriorly and is not involved in subdividing the posterior triangle.

D. Pulley of Trapezius: The trapezius muscle forms the posterior boundary of the posterior triangle but does not subdivide it.

Which of the following clinical features is not seen in Bell’s palsy?

 # Which of the following clinical features is not seen in Bell’s palsy?

A. Lacrimation

B. Xerostomia

C. Drooling of saliva

D. Sensory loss over affected side

The correct answer is D. Sensory loss over affected side.

Bell’s palsy primarily affects the motor function of the facial nerve (cranial nerve VII), leading to muscle weakness or paralysis on one side of the face. Sensory loss is typically not a feature of Bell’s palsy, as the facial nerve is primarily motor, with only a small contribution to sensory function (taste sensation on the anterior two-thirds of the tongue). Sensory loss over the face would more likely be associated with trigeminal nerve issues (cranial nerve V).

Here’s a breakdown of the other options:

Lacrimation (A): The facial nerve affects the lacrimal gland, and changes in tearing can occur in Bell's palsy.

Xerostomia (B): The facial nerve also has parasympathetic fibers that innervate salivary glands, so dry mouth (xerostomia) can be a symptom.

Drooling of saliva (C): Muscle weakness can lead to drooling due to poor control of the facial muscles.

Anti caries vaccine is based on which immunoglobulin?

 # Anti caries vaccine is based on which immunoglobulin?

A. IgA

B. IgE

C. IgM

D. IgG

The correct answer is A. IgA.

The major immunoglobulin in saliva is secretory IgA. whereas IgG, which comprises about 80% of the total immunoglobulin in serum, is found only in low level in salivary secretions. The molecular configuration renders the secretory IgA antibody exceptionally resistant to digestion by proteolytic enzymes. Consequently, it can function highly effectively in an oral environment which contains microbial proteases. Salivary IgA plays an important role in the defense of the host against colonization of streptococci by agglutination of the organisms. 

Increased ketone bodies are seen in:

  # Increased ketone bodies are seen in:

1. Uncontrolled diabetes

2. Protein deficiency

3. Well fed state

4. Prolonged starvation

A. 2 and 4

B. 1, 2 and 3

C. 1 and 2

D. 1 and 4

The correct answer is D. 1 and 4.

1. Uncontrolled diabetes: In uncontrolled diabetes, especially type 1 diabetes, there is a lack of insulin, leading to increased lipolysis and subsequent production of ketone bodies, resulting in diabetic ketoacidosis. 

4. Prolonged starvation: During prolonged starvation, the body depletes its glucose stores and starts breaking down fats, leading to an increase in ketone bodies for energy. 

2. Protein deficiency (Incorrect) 

Protein deficiency does not typically lead to an increase in ketone bodies. 

3. Well-fed state (Incorrect) 

In a well-fed state, the body has sufficient glucose for energy, so ketone body production is minimal. 



A 5 year old child is diagnosed with leukocyte adherence deficiency and is also affected with generalized severe bone loss adjacent to his primary teeth. What is the diagnosis?

 # A 5 year old child is diagnosed with leukocyte adherence deficiency and is also affected with generalized severe bone loss adjacent to his primary teeth. What is the diagnosis?

A. Generalized aggressive periodontitis

B. Generalized chronic periodontitis

C. Gingival diseases modified by systemic factors

D. Periodontitis as a manifestation of systemic disease

The correct answer is D. Periodontitis as a manifestation of systemic disease.

Leukocyte adhesion deficiency (LAD) is a rare immunodeficiency disorder that impairs the body's ability to fight infection. This condition is associated with early, severe periodontitis due to the inability of leukocytes (white blood cells) to migrate to infection sites, leading to impaired immune responses and increased susceptibility to bacterial infections. The severe bone loss around the primary teeth is a manifestation of this systemic disease. Therefore, the periodontitis is secondary to the systemic condition, which makes D the most appropriate choice.



Which of the following premalignant conditions has the highest potential to become malignant?

  # Which of the following premalignant conditions has the highest potential to become malignant?

A. Proliferative verrucous leukoplakia

B. Speckled leukoplakia

C. Lichen planus

D. Tobacco pouch keratosis

The correct answer is A. Proliferative verrucous leukoplakia.

Which of the following contains all three germ layers?

  # Which of the following contains all three germ layers?

A. Teratoid cyst

B. Hamartoma

C. Dermoid cyst

D. Sebaceous cyst

The correct answer is A. Teratoid cyst.

 In 1955, Meyer updated the concept of dermoid cyst to describe three histological variants, that is, the true dermoid, epidermoid and teratoid cyst. True dermoid cysts are cavities  lined with epithelium with keratinization and skin appendages  in cyst wall. Epidermoid cysts do not show skin appendages. 

The lining of teratoid cyst varies from stratified squamous to a ciliated respiratory epithelium containing derivatives of  ectoderm, mesoderm and endoderm.

Teratoid cyst rarely arises in the head and neck region, in the  oral cavity; these cysts occur in the area of the floor of the  mouth and may also occur on the tongue, lips, buccal mucosa or the interior of the bone.



What is not included in the measurement of the facial angle?

  # What is not included in the measurement of the facial angle?

A. Facial height

B. Frankfort horizontal plane

C. Nasion point

D. Pogonion point

The correct answer is A. Facial height.

The facial angle is used to measure the degree of retrusion or protrusion of the lower jaw. This is the

inferior inside angle in which the facial line (nasion-pogonion) intersects the Frankfort horizontal

(FH). The mean reading for this angle is 87.8 degrees (SD, 3.6) with a range of 82 to 95 degrees. A prominent chin increases this angle, whereas a smaller than average angular reading suggests a retrusive  chin.

Therefore, the facial angle indicates the degree of recession or protrusion of the mandible in relation

to the upper face at the point in which the Frankfort horizontal is related to the facial line (nasion-pogonion). The magnitude of this angle increases with a prominent chin.



Non surgical treatment for pericoronitis

 Sometimes, the gingival tissue over your third molar teeth may become inflammed because of bacterial infections or food lodgement under the gums. The condition is very painful and may need extraction of third molar tooth or operculectomy for definitive management. However, for those patients unwilling to have their tooth extracted, conservative treatment with medication can be done for 1-2 episodes before they are ready to have the offending tooth extracted. 

These medicines should be used for complete 5 days and consultation with registered doctor should be done before taking these. If you are allergic to penicillins and its congeners, these should not be taken. Stop the drug immediately and visit the emergency if you develop any rashes, difficulty in breathing after taking medicines.