Sturge Weber Syndrome

# Sturge Weber syndrome is characterized by all EXCEPT:
a) Exophytic oral hemangioma
b) Facial hematoma
c) Tramline calcification of dura on lateral cephalogram
d) Facial hemangioma

The correct answer is B. Facial hematoma.


Though the skin and oral lesions of hemangioma are most deforming and disfiguring, the CNS involvement often results in serious problems of epilepsy, hemiplegia, mental retardation and retinal changes. Sturge-weber syndrome is probably the most common of these malformations. It is characterized by angiomatosis of face, laptomeningeal angiomas, contralateral hemiplegia, massive gingival growths and asymmetric jaw growth. The patients are treated for many years with phenytoin.

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Most common site of Oral Leukoplakia

# Most common site of oral leukoplakia is :
a) angle of mouth
b) cheek mucosa
c) Soft palate
d) Gingiva

The correct answer is B. Cheek mucosa.

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Standard airway for Ludwig's Angina

# Standard Airway for Ludwig's Angina is: a) Tracheotomy
b) Cricothyrotomy
c) Nasal intubation
d) Oral intubation

The correct answer is B. Cricothyrotomy.

In Ludwig's angina, cricothyrotomy is always preferred over option A, i.e., Tracheotomy. Tracheotomy is avoided because of the following reasons.
• Identification of landmarks is difficult due to associated massive edema and tissue distortion.
• Sometimes, tracheostomy may lead to spread of infection to deeper tissues.
• May result in Tracheal stenosis in 25 -50% of cases.
• Chances of getting pneumonia will always be there.
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Trotter's Triad

# Trotter's triad is seen in:
a) Angiofibroma
b) Nasopharyngeal carcinoma
c) Laryngeal carcinoma
d) Growth in fossa of Rosenmuller

The correct answer is B. Nasopharyngeal carcinoma.

Trotter's triad:
1) Conductive deafness (Eustachian tube blockade)
2) lpsilateral temporoparietal neuralgia (Cranial Nerve V)
3) Palatal paralysis (Cranial Nerve X)

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Nasopharyngeal carcinoma virus

#The virus associated with nasopharyngeal carcinoma is:
a) Epstein Barr
b) Cytomegalo virus
c) Hepatitis
d) Herpes virus

The correct answer is A. Epstein Barr.

Nasopharyngeal carcinoma affects younger age group and half of the patients will present with secondaries in neck.

Epstein-Barr virus is also implicated as an etiological factor for Burkitts Lymphoma and infectious mononucleosis.

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Punched out edge of ulcer

# Punched out edge is characteristic of which type of ulcer?
a) Tuberculosis
b) Rodent
c) Syphilitic
d) Non specific

The correct answer is C. Syphilitic.

•  Non-specific ulcer = Shelving edge
• Tuberculous ulcer = Undermined edge
• Rodent ulcer = Raised, pearly white and beaded 
• Squamous cell carcinoma = Rolled out, everted 
• Syphilitic = Punched out edge; Base covered with wash leather slough

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Cellular response to Stress and Noxious Stimuli

Cellular responses to stress and noxious stimuli:
Normal cells handle normal physiologic demands, maintaining a steady state called homeostasis.

More severe physiologic stresses and some pathologic stimuli may bring about a number of physiologic and
morphologic cellular adaptations, during which new but altered steady states are achieved, preserving the viability of the cell.

The adaptive response may consist of an increase in the number of cells, called hyperplasia, increase in the
sizes of individual cells, called hypertrophy.

Conversely, Atrophy is an adaptive response in which there is a decrease in the size and function of cells.

Nature of the stimulus and Cell response/adaptation towards it
- Increased demand = Hyperplasia and hypertrophy
- Decreased nutrients and stimuli = Atrophy
- Chronic irritation = Metaplasia
- Reduced oxygen supply, chemical and microbial injury = Acute reversible injury
- Progressive damage including the DNA = Necrosis and Apoptosis
- Metabolic alterations = Intercellular accumulations and calcification