Bilateral Mandibular Fracture

# Following bilateral mandibular fracture in the canine region, the following muscles will tend to pull the mandible back:
A. Genioglossus and anterior belly of digastric
B. Genioglossus and mylohyoid
C. Genioglossus and thyrohyoid
D. Genioglossus and masseter

The correct answer is A. Genioglossus and anterior belly of digastric

- Symphysis fracture displacement result from action of mylohyoid muscle resulting from imbalance of action of museles attached to genial tubercles on either side.

- Bilateral fracture in canine region when run obliquely forward muscles acting on it are geniohyoid and genioglossus and anterior belly of digastric muscles.

- Lateral pterygoid muscles inserted into medial fossa on anterior aspect of condyle.

- In condylar fracture head is displaced anteriorly and medially

#Recurrent vesicles which are distributed along the sensory nerve trunk

# The Lesion which is erythematous and with recurrent vesicles that are distributed along the sensory nerve trunk is?
(A). Herpes Zoster
(B). Erythema Multiforme
(C). Recurrent Aphthous
(D). Herpes Gingivostomatitis

The correct answer is A. Herpes Zoster.

VARICELLA-ZOSTER VIRUS INFECTIONS
HERPES-ZOSTER (SHINGLES)

Herpes Zoster is a recurrent regional infection caused by the Herpes Zoster virus and is characterized by vesicular eruptions over the skin and mucous membrane in a distinctively unilateral pattern.

Pathogenesis
After producing chickenpox, the V-Z virus remains dormant in the trigeminal ganglion for decades. The virus may become reactivated following stress, trauma, malnutrition and immune suppression, etc.

Clinical Features
The first branch of the trigeminal nerve is most commonly affected and the disease beside affecting the first branch, may also involve the following other branches like:
- Nasociliary nerve-Causing herpetic Keratitis
 Ciliary nerve- Causing Argyll Robertson pupil.
-Facial nerve- Causing Ramsay Hunt syndrome.

- After the prodromal phase of intense pain, the disease produces clusters of vesicles over the skin and oral mucosa; which characteristically develop on one side of the face up to the midline.

- The lesion usually develops and spreads along the distribution of the sensory nerve unilaterally on one side of the face, while the other side of the face remains completely free of symptoms.

- Within the oral cavity the vesicles also develop unilaterally over the buccal mucosa, soft palate and tongue, etc. and cause stinging pain, paresthesia and severe stomatitis.

- In due course of time the fragile vesicular lesions of the skin and the oral mucosa rupture and they leave painful, 'crateriform' ulcers. 

Histopathology
-  Herpes-zoster is histologically characterized by swelling of the infected epithelial cell cytoplasms due to intracellular edema (ballooning degeneration).

Clinical: The disease is nearly always diagnosed on the basis of its very characteristic clinical findings, e.g.
- Unilateral distribution of the lesion. 
- Early severe pain and paresthesia.
- Facial rash accompanying the stomatitis.

Serology: The disease is diagnosed by the detection of virus-specific antibodies in the serum.

Cytologic smear: Cytologic smears prepared from the vesicular fluid reveal inclusion bodies and ballooning degeneration of the infected cell.

Culture: Tissue culture using vesicular contents produces change in the culture cells which could be correlated with the clinical findings found in the primary infection.

Immunofluorescence: HZV specific antibodies are labeled with a fluorescent dye and seen microscopically.

Treatment
Aniviral drugs such as acyclovir is given along with antibiotics to prevent secondary infections. 

Principal fibers of PDL

# All of these are principal fibers of Periodontal ligament except:
A. Dentoalveolar crest fibers
B. Apical fibers
C. Horizontal fibers
D. Transseptal fibers

The correct answer is:
 D. Transseptal fibers

Principal Fibers of Periodontal Ligament are:

-Alveolar crest,

-horizontal,

-oblique,

-apical, and

-interradicular fiber bundles

Boundaries of Pharynx

# Pharynx extends up to which cervical vertebra? [Nepal Medical Council, Dec 2019]
A. C3
B. C4
C. C5
D. C6

The correct answer is D. C6

Pharynx
The word throat is used for the parts of the neck anterior to the vertebral column, especially the pharynx and the larynx. The pharynx is the part of the digestive system situated posterior to the nasal and oral cavities and posterior to the larynx. It is therefore divisible into nasal, oral, and laryngeal parts: the (1) nasopharynx, (2) oropharynx, and (3) laryngopharynx. The pharynx extends from the base of the skull down to the inferior border of the cricoid cartilage (around the C6 vertebral level), where it becomes continuous with the esophagus. Its superior aspect is related to the sphenoid and occipital bones and the posterior aspect to the prevertebral fascia and muscles as well as the upper six cervical vertebrae. The pharynx is a fibromuscular tube lined by mucous membrane.

Extension of Pharynx

# Pharynx extends up to which cervical vertebra? [Nepal Medical Council, Dec 2019]
A. C3
B. C4
C. C5
D. C6

CLICK HERE FOR CORRECT ANSWER WITH EXPLANATION

Orthodontics - COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up
Subject: Orthodontics                                                                                                             Time: 2 hr. 30 mins.
Date: 6/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]
1. Enumerate therapeutic methods of gaining space. Discuss in detail about the expansion in
orthodontics. [2+4=6]

2. Explain in detail about the biology associated with orthodontic tooth movement. Add short notes
of iatrogenic effects of inappropriate forces.  [2+3=5]

3. Classification of habits. Describe the etiology, clinical features, and management of tongue
thrusting habits.   [2+3=5]

4. Write short notes on: [3*3=9]
a. Down's skeletal parameters
b. Kesling tooth positioner
c. Methods of studying growth

SECTION "C" [25 Marks]

5. 20-year male reported to the department with chief complaint of forwardly placed upper front teeth. Intra oral examination shows bilateral class II molar relation with overjet of 6mm. Cephalometric examination shows SNA angle 84 degrees and SNB 80 degrees.
[2+2+2 =6]
a. What is your diagnosis What are the investigations you advice?
b. How would you treat this case?
c. If the patient is growing than how do you manage this condition.

6. Enumerate the etiology of cleft lip and palate. Orthodontic management of cleft lip and palate [2+3=5]

7. What is myofunctional therapy Describe the mode of action of twin block appliance and how does it differ from a functional regulator. [2+3=5]

8. Write short notes on: [3*3=9]
a. School of retention
b. Management of open bite
c. Corticotomy

Periodontics - COMS, Teaching Hospital, Bharatpur IV year BDS Send Up Exam 2019

COLLEGE OF MEDICAL SCIENCES. TEACHING HOSPITAL BHARATPUR

          Dec-Jan 2019-2020

Level: IV BDS                                                                                                                            Exam: Send up
Subject: Periodontics                                                                                                             Time: 2 hr. 30 mins.
Date: 6/11/2019                                                                                                                          Full marks: 50

INSTRUCTIONS TO THE CANDIDATE

• Write brief, relevant and legible answers
• Illustrate your answer with well labeled diagrams wherever required. 
• All questions are compulsory. 

SECTION 'B' [25Marks]
1. Define gingiva. Describe different parts of the gingiva. Mention the name of various gingival fibers and blood supply of gingiva.    [1+3+2=6]

2. Write down the composition of calculus. Mention the important differences between supragingival and subgingival calculus. Highlight on the modes of attachment of calculus and its role in periodontal disease. [1+2+2=5]

3. A patient came with the chief complaint of progressive mobility of upper right lateral incisor since last six months. On clinical examination, there was grade II mobility of the tooth with three-degree positive fremitus test. [1+3+1=5]
a. What is your diagnosis & classify the condition?
b. What are the tissue responses seen in this case?
c.Write about possible radiographic changes in this case?

4. Write short notes on: [3*3=9]
a Local drug delivery
b. Halitosis
c. Resective osseous surgery

SECTION "C" [25 Marks]

5. A 28-year-old patient came with the chief complain of a progressive downward shift of gum exposing mandibular right central incisors. What is your differential diagnosis, investigations and
treatment plan for the case? [1+2+3=6]

6. Define Aggressive Periodontitis. Write down the causes of area-specific distribution of Localized Aggressive Periodontitis (LAP). Highlight on the clinical features of LAP. [1+2+2=5]

7. Define Furcation Involvement (FI). What are the predisposing factors for Furcation involvement?
Write about different therapeutic modalities in the management of FI.  [1+1+3=5]

8. Write short notes on:  [3*3=9]

a. Host modulation therapy (HMT)
b. Chemical plaque control
c. Modified Widmann flap