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MCQs on Oral Histology - Salivary Glands


# The normal pH of saliva is about:
A. 5.5
B. 9.5
C. 7.5
D. 8.5

# Of the total amount of saliva secreted by all the salivary glands, about 60% is secreted by :
A. Parotid glands
B. Sublingual glands
C. Submandibular glands
D. None of the above

# The basket cells are also known as :
A. Myoepithelial cells
B. Endothelial cells
C. Parenchymal cells
D. None of the above

# The three bilaterally paired major salivary glands are located :
A. Extraorally
B. Intraorally
C. In tongue
D. In neck

# The parotid glands open through the :
A. Stensen's duct
B. Wharton's duct
C. Bartholin's duct
D. Blandin's duct

# The saliva is neutralised due to:
A. Mucin
B. Ammonia
C. Amino acids
D. Bicarbonates

# Among various glands, salivary gland secretion is unique in that, its secretions are controlled by:
A. Hormones
B. Nerves
C. Chemicals
D. All of the above

# The content of saliva include all except:
A. Amylase
B. Urea
C. Lysoenzyme
D. Lipase

# The ducts of glands opening into the floor of the mouth are :
A. Submandibular and sublingual
B. Submandibular and parotid
C. Sublingual and parotid
D. Von Ebner


# Sublingual gland is a :
A. Mixed gland
B. Serous gland
C. Mucous gland
D. Present in root of tongue

# Bartholin's duct is the name of:
A. Parotid duct
B. Submandibular duct
C. Sublingual duct
D. Lacrimal duct

# The glands of Blandin and Nuhn are:
A. the posterior lingual glands
B. the anterior lingual glands located near the apex of the tongue
C. the glossopalatine glands
D. the palatine glands

# A purine which is found in saliva is :
A. Uric acid
B. Thymine
C. Adenosine
D. Hypolithinium

# Which of the folowing is not found in saliva?
A. Lysozyme
B. Phosphate
C. Bicarbonate
D. Trypsin

# Mucin in mucous cells are usually demonstrated by:
A. PAP stain
B. H and E stain
C. Mucicarmine stain
D. Mallory stain

# The functions of myoepithelial cells may be:
A. Initiating contraction
B. Support for the end piece during active secretion of saliva
C. Provide signals to the acinar secretory cells for structural reorganization
D. All of the above

# Myoepithelial cells are present in:
A. Striated duct
B. Intercalated duct and terminal duct
C. Serous cells
D. Mucous cells

# Carmalt's glands are:
A. Major salivary glands
B. Minor salivary glands(Retromolar)
C. Minor salivary glands (lingual)
D. Taste buds


# On passing from acini to ductal orifices after ductal modifications, saliva becomes _________ as compared to plasma.
A. Hypertonic sometimes
B. Hypotonic
C. Isotonic
D. Hypertonic always

# Tuft cells are receptors seen on:
A. Cell rich zone
B. Lining of maxillary sinus
C. Salivary duct
D. TMJ capsule

# The parotid gland opens:
A. on the floor of the mouth
B. at the side of the lingual frenum
C. at the caruncula
D. on the buccal mucosa opposite the maxillary second molar

# Which of the following is purely serous in nature?
A. parotid and Von ebner's glands
B. Palatine glands only
C. Glossopalatine glands
D. Lingual glands

# The total volume of saliva secreted daily is :
A. 750 ml
B. 1.5 liters
C. 2 liters
D. 3 liters

# Largest amount of saliva is produced by :
A. Submandibular glands
B. Sublingual Glands
C. Parotid glands
D. Von ebner Glands

# The immunoglobulin present in saliva is:
A. IgG
B. IgA
C. IgM
D. IgE

# Salivary glands are not found in:
A. Anterior part of the hard palate
B. Posterior part of the hard palate
C. In mandible posterior to the 3rd molar
D. Nasopalatine canal

# Which of the following is purely mucous?
A. Palatine glands
B. Glossopalatine glands
C. Posterior lingual mucous glands
D. All of the above

# The minor salivary glands begin their development in fetal life during :
A. 1st month
B. 2nd month
C. 3rd month
D. 4th month

# Salivary flow is reduced in:
A. Sjogren's syndrome
B. Xerostomia
C. Inflammation of glands
D. All of the above

# The severance of duct of minor salivary glands and pooling of saliva in the tissues is called as:
A. Ranula
B. Congenital Epulis
C. Mucocele
D. Sialadenitis

# The pH of whole saliva is :
A. 1.2 - 2.4
B. 3.0 - 5.6
C. 6.7 - 7.4
D. 7.0 - 8.2


Management of Hospital waste in BPKIHS


B.P. Koirala Institute of Health Sciences (BPKIHS) is a tertiary health care center and referral center in eastern development region. Thousands of patients come here every day seeking outpatient medical care. It also has got a 700-bedded inpatient ward and the largest (in terms of manpower) emergency unit in the nation. There is also a separate College of Dental Surgery(CODS) for dental facilities which consist of nine different departments. So, a large amount of general waste and biomedical waste is produced from the hospital every day.  General waste includes paper and plastic packages of medicine, wrappers of junk foods, kitchen waste from hospital kitchen, etc. and biomedical waste includes used gloves, cotton dressings and gauges, used syringes and medicine bottles, excised body parts, etc. These waste materials must be suitably disposed of immediately lest they putrefy, emit foul smells, act as a source of infection and disease, and become a public health hazard. It is the responsibility of the healthcare institute producing those wastes for the proper management of health care waste, not the government or local governing unit.

In BPKIHS too, there is a provision of proper waste disposal, which, however, is not the best protocol to follow. Juniormost staffs are responsible for the collection and disposal of the waste. For the workers’ health and safety, Health welfare scheme/Treatment facility is provided by the institution. The workers are vaccinated and Personal protective equipment (PPE) viz. Long boots, gloves, face mask, Cap and plastic apron are also provided for the employees. The materials used for the collection of the wastes are:
-Plastic bags (Black)
-Cartons (Red/Orange/Green colored)
- Plastic buckets
-Wheel big plastic bins (Red/Orange/Green)
Trolley

The wastes are segregated by using different color coded containers for different types of wastes.
The Nepal Health Research Council (NHRC) guidelines are followed as listed below:
Green Box (Non- Infectious): Non-infected stuffs/General waste
Orange box / Red box (Infectious): Infected Stuffs – Gauze/ bandage/cannula/urobag/blood/bodyfluid contaminated stuffs
Sharp Box: Needle/syringe/surgical blade/infected sharp materials

The collection and transportation of infectious wastes from wards to the incinerator is done in two shifts per day. And the residual sterile waste is disposed of to the dumping site. This is done by the attendants posted at the incinerator.

Similarly, the non-infectious waste is collected in two shifts from the wards to the bay/Collection container by ward attendants. Then, it is transported to the dumping site by sanitary workers in three shifts. 

Though the waste segregation system has been applied, it’s not properly followed due to unawareness. Also, The spread of infection from the open dumping site and direct contact transmission of disease to those poverty struck rag-pickers from the dumping site is always a risk which may cause a serious health hazard. Besides, A clean hospital and good housekeeping have a direct effect on the health, comfort and morale of patients, visitors and hospital personnel alike. Cleanliness radiates cheer and a well-kept hospital would give the public a feeling of confidence. So, due care has to be given in proper management of wastes and adequate budget should be allocated for that purpose.


MCQs on Oral Histology : Dental Pulp


# Which of the following structure is not found in a living pulp ?
A. Collagen fibers
B. Haversian fibers
C. Non myelinated nerve fibers
D. Reticulum

# The dental pulp contains nerve endings / receptors for:
A. Pain
B. Pressure
C. Proprioception
D. Temperature

# The dental pulp is derived from :
A. Dental papilla
B. Dental Sac
C. Odontoblasts
D. Stellate reticulum

# Pulp responds to all stimuli by pain because it has only:
A. Free nerve endings
B. Krause end bulbs
C. Pacinian corpuscle
D. Ruffini corpuscle

# All of the following are true about functions of dental pulp EXCEPT:
A. Formation of dentin
B. Nerve supply to dentin
C. Sends impulse to CNS
D. Nerve supply to enamel through fibers

# Odontoblasts are derived from :
A. Undifferentiated mesenchymal cells
B. Histocytes
C. Macrophages
D. Lymphocytes

# The primary function of the dental pulp is:
A. Nutritive
B. Production of dentin
C. Production of enamel
D. Vascular supply to the teeth

# The radicular pulp is continuous with tissues of the periapical area via the :
A. Pulp canal
B. Pulp chamber
C. Mental foramen
D. Apical foramen

# Weil's zone of pulp is :
A. Cell degenerated zone
B. Cell rich zone
C. Cell regenerated zone
D. Cell free zone

# The cells of the dental pulp which are responsible for the deposition of reparative dentin are:
A. Osteoblasts
B. Odontoblasts
C. Ameloblasts
D. Osteocytes


# Histologically, the dental pulp most closely resembles:
A. Nerve tissue
B. Vascular tissue
C. Granulation tissue
D. Loose connective tissue

# Pericytes are found:
A. In thymus
B. Around capillaries of pulp
C. In gall bladder
D. Along with Heparin on surface of mast cells

# The odontoblasts killed during cavity preparation are derived from :
A. Unaffected odontoblasts from the pulp
B. Undifferentiated cells
C. Histocytes
D. Osteoblasts

# Proprioceptors are seen in all EXCEPT:
A. Skeletal muscle
B. TMJ
C. Pulp
D. None of the above

# Cells occurring in greatest number in pulp are :
A. Cementoblasts
B. Fibroblasts
C. Osteoblasts
D. Ameloblasts

# Pulp tissue contains all except:
A. Fibroblast
B. Capillary
C. Collagen
D. Cell rests of Malassez

# The cell free zone in pulp lies:
A. Above odontoblast
B. Below odontoblast
C. In radicular pulp
D. In pulp horn

# Aging process affects pulp tissue by:
A. Decreasing the size and shape of pulp tissue and cellular component
B. Increase cellular component at the expense of fibrous componenet
C. Increases vascularity of the pulp
D. Decreases the calcific component of the pulp

# The number of pulp organs in a person is :
A. 32
B. 20
C. 52
D. 62

# The total volume of all permanent pulp organ is:
A. 0.38 cc
B. 0.58 cc
C. 0.02 cc
D. 3.8 cc

# The size of apical foramen of maxillary teeth in adult is:
A. 0.4 mm
B. 0.3 mm
C. 0.2 mm
D. 0.7 mm

# The second most prominent cells in the pulp are:
A. Fibroblasts
B. Defense cells
C. Odontoblasts
D. Histocytes or resting wandering cell


# The fibroblasts associated with capillaries are:
A. Plasma cell
B. Histocytes
C. Lymphocytes
D. Pericytes

# Which of the following is true ?
A. Pulpal pressure is highest among body tissues
B. Majority of nerve that enter the pulp are non myelinated and are sympathetic in nature
C. Plexus of Rashkow or parietal layer of nerves is formed by network of peripheral axons located adjacent to cell rich zone
D. All of the above

# The average life time of primary pulp in oral cavity is:
A. 8.3 years
B. 5 years
C. 7 years
D. 2 and half years

# Regressive changes in pulp include :
A. Increased fibrotic component
B. Decreased cellular component
C. Calcification in blood vessels near apical foramen
D. All of the above

# Which of the following is not correct ?
A. Free denticles are entirely surrounded by pulp tissue (free of dentin)
B. Embedded denticles are entirely surrounded by dentin (embedded in dentin)
C. Attached denticles are partly fused with dentin
D. False denticles contain many dentinal tubules

# The development of pulp begins :
A. 6th week of IU
B. 8th week of IU
C. 10th week of IU
D. 18th week of IU

# Size of pulp chamber :
A. Increases with age
B. Decreases with age
C. Increases in some cases and decreases in some cases
D. None of the above

# Protein secreted by odontoblast :
A. Chitin
B. Keratin
C. Collagen
D. Elastin

# The primary response of the pulp to tissue destruction is :
A. Necrosis
B. Ulceration
C. Calcific degeneration
D. Inflammation

# Unmyelinated nerve fibers of pulp are:
A. Sensory in nature
B. Respond to hot and cold
C. Carry pain sensation
D. Associated with blood vessels and are sympathetic in nature

# Vitality of pulp depends upon:
A. Blood supply
B. Nerve supply
C. Lymphatic supply
D. All of the above

# Dystrophic calcification is seen most commonly in which of the following oral tissues?
A. Enamel
B. Pulp
C. Dentin
D. Periodontal ligament

# The Plexus of Rashkow is present in which of the following zones in the pulp ?
A. Cell free zone
B. Cell rich zone
C. Odontoblastic zone
D. Pulp core

# The diameter of the largest arterial vessels in the pulp range from:
A. 50-100 miocrometers
B. 101-150 micrometers
C. 151-200 micrometers
D. 201-250 micrometers

# Pain originate in dental pulp due to :
A. Free nerve ending in cell rich zone
B. Free nerve ending at sub odontoblastic layer
C. Krause bulb at the center of the pulp
D. Meissner's corpuscles at cell rich zone

# The pulp stem cells are :
A. Pluripotent in nature
B. Totipotent in nature
C. Multipotent in nature
D. None of the above


Dental MCQs - Multiple Choice Questions in Dentistry


*** AIIMS May 2011


# DENTAL MATERIALS

*** Restorative Resins

# GENERAL ANATOMY


#GENERAL PATHOLOGY


# PHYSIOLOGY

# ORAL ANATOMY AND HISTOLOGY


*** Growth and Development

# ORTHODONTICS
# PUBLIC HEALTH DENTISTRY
*** Epidemiology
*** Biostatistics


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Different Types of Pathological Calcification

Q. Discuss the types of calcification.

The mineralisation of body tissues with calcium is a normal physiological process in tissues like bones and teeth, termed as physiological calcification. However, sometimes the visceral tissues and other soft tissues may also get calcified in many diseased states, which is called pathological calcification. In addition to the calcium salts, smaller amounts of iron, magnesium and other minerals may also be deposited.

Pathological calcification can be broadly classified into two types: Dystrophic Calcification and Metastatic Calcification.

Dystrophic calcification: When the deposition takes place in dead or dying tissues, then it is termed as dystrophic calcification. The serum calcium levels are normal and the calcium metabolism is not deranged. Though hypercalcemia is not a prerequisite for dystrophic calcification, hypercalcemia can exacerbate it. It is seen in areas of tissue necrosis of any type. It is almost always present in the atheromas of advanced atherosclerosis, associated with intimal injury in the aorta and large arteries and characterized by the accumulation of lipids. Sometimes dystrophic calcification may also indicate organ dysfunction, e.g. calcification can develop in damaged heart valves, resulting in severely compromised valve motion. Pathogenesis involves initiation and propagation where crystalline calcium phosphate is formed as the final product.


 Metastatic Calcification: Due to hypercalcemia, metastatic calcification may occur in normal tissues.

 The causes of hypercalcemia may be:
- increased secretion of parathyroid hormone (due to either primary parathyroid tumors or production of parathyroid hormone–related protein by other malignant tumors)
- destruction of bone (e.g. Paget's disease, Myeloma, Leukemia, etc.)
- Vitamin D - related disorders and sarcoidosis
- renal failure, in which phosphate retention leads to secondary hyperparathyroidism

Metastatic calcification can occur widely throughout the body but principally affects the interstitial tissues of the vasculature, kidneys, lungs, and gastric mucosa.

Necrosis Vs Apoptosis

Q. Mention differences between necrosis and apoptosis.

Ans : Though both necrosis and apoptosis are events of cell death, they do differ in various ways. The differences can be observed under following parameters :

a) Cell Size
The cell is enlarged (swelling) in necrosis whereas the cell is reduced (shrinkage) in apoptosis.

b) Fate of Nucleus
In necrosis, nucleus undergoes series of changes like pyknosis ( irreversible condensation of chromatin in the nucleus of a cell ) , karyorrhexis (fragmentation of nucleus) and karyolysis (complete dissolution of the chromatin of a dying cell due to the enzymatic degradation). But, in Apoptosis, nucleus undergoes fragmentation into nucleosome size fragments

c) Plasma Membrane
The plasma membrane is disrupted and is full of leakages in case of necrosis but, it is intact in cells undergoing apoptosis. Only the orientation of lipids in plasma membrane is altered in apoptosis.

d) Cellular contents
Due to ruptured plasma membrane, cellular contents undergo digestion and may leak out of the cell in necrosis. But, the cellular contents are intact in case of apoptosis. However, they may be released in apoptotic bodies.

e) Adjacent inflammation
There is no any adjacent inflammation seen in apoptosis whereas adjacent inflammation can be seen in necrosis.

f) Physiologic or pathologic role
Apoptosis is often physiologic but necrosis is always pathologic.

Necrosis : Definition, Types and Examples

Q. Define Necrosis. Enlist its types with an example of each.

Ans: Necrosis is the type of cell death that is associated with loss of membrane integrity and leakage of cellular contents culminating in dissolution of cells, largely resulting from the degradative action of enzymes on lethally injured cells.

Types of Necrosis:
i) Coagulative Necrosis
- underlying tissue architecture is preserved,

- affected tissues take on a firm texture

- characteristic of infarcts in all of the solid organs except the brain

ii) Liquefactive Necrosis
- seen in focal bacterial or fungal (occasionally) infections

- the dead cells are digested completely, transforming the tissue into a liquid viscous mass

- seen often in hypoxic death of cells within CNS

iii) Caseous Necrosis (Caseous = Cheese like)
- Encountered most often in foci of tubercular infection

 - friable yellow white appearance of the necrotic region

- area of caseous necrosis is often enclosed within a distinctive inflammatory border; this appearance is characteristic of a focus of inflammation known as a granuloma


iv) Fat Necrosis
- focal areas of fat destruction

- seen in Acute Pancreatitis

 - grossly visible chalky white areas can be seen

v) Fibrinoid Necrosis
- special form of necrosis visible by light microscopy

- usually in immune reactions in which complexes of antigens and antibodies are deposited in the walls of arteries.

- a bright pink and amorphous appearance on H&E preparations called fibrinoid (fibrin-like) by pathologists

- seen in  immunologically mediated diseases (e.g. polyarteritis nodosa)

vi) Gangrenous Necrosis
- mostly the affected organ has lost its blood supply and has undergone coagulative necrosis involving multiple tissue layers

- When bacterial infection is superimposed, coagulative necrosis is modified by the liquefactive action of the bacteria and the attracted leukocytes (resulting in so-called wet gangrene)

- e.g. necrosis of a limb (mostly lower)
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