Cephalocaudal gradient of Growth

# Growth trends show that in most patients
a) maxilla and mandible grow in unison
b) maxilla grows more rapidly
c) mandible grows at a faster rate than the middle third of the face
d) no such conclusion could be made

The correct answer is: C. mandible grows at a faster rate than the middle third of the face.

The concept of "Cephalo-caudal gradient of growth" says that there is an axis of increased growth extending from the head towards the feet i.e., structures, which are far from brain grow more compared to other parts. When the facial growth pattern is viewed against the perspective of cephalocaudal gradient, it is not surprising that the mandible, being farther away from the brain tends to grow more and later than the maxilla, which is close to brain.

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Primary displacement vs Secondary displacement

# The movement of bone in response to its own growth is termed as:
a) Rotation
b) Secondary displacement
c) Primary displacement
d) Differentiation

The correct answer is C. Primary displacement.

Types of Bone Growth:
Drift: 
Combinations of deposition and resorption occurring in different bones of skull resulting in growth movement towards depositary surface.

Displacement:
• It is the movement of whole bone as a unit.
• In primary displacement, the bone is displaced as a result of its own growth.
• In secondary displacement, the bone gets displaced as a result of growth and enlargement of adjacent bone.

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Histopathological feature of basal cell carcinoma

# Characteristic histopathological feature of basal cell carcinoma is:
a) Nuclear palisading
b) Keratin pearls
c) Psammoma bodies
d) Foam cells

The correct answer is A. Nuclear palisading.

• In nodular basal cell carcinoma, the tumor cells typically have large, hyperchromatic, oval nuclei with little cytoplasm and nests of tumor cells show peripheral cell palisading.

• Keratin pearls are found in squamous cell carcinoma, while Psammoma bodies are concentric lamellated structures found in papillary thyroid carcinoma, meningioma, papillary serous cystadenocarcinoma of the ovary.

• Foam cells are found in verruciform xanthoma.

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Granularity of oncocytes

# Granularity of oncocyte is due to:
a) Overabundance of golgi bodies
b) Overabundance of mitochondria
c) Deficiency of mitochondria
d) Deficiency of golgi bodies

The correct answer is B. Overabundance of mitochondria.

Oncocytoma is a rare benign salivary gland tumor composed of oncocytes with granular eosinophilic cytoplasm and a large number of atypical mitochondria. The name oncocytoma is derived from the resemblance of these tumor cells to apparently normal cells termed oncocytes found in salivary glands, respiratory tract, breast, thyroid, pancreas, parathyroid, pituitary, testicle, fallopian tube, liver and stomach. Electron microscopic studies have shown that cytoplasm of oncocyte is choked with mitochondria.

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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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