Tooth most affected by gingivitis

 # Facial surface of which tooth is most affected by gingivitis?

 A. Upper first molar

 B. Lower first molar

 C. Lower central incisor

 D. Lower premolar

The correct answer is A. Upper first molar.

Facial surface of upper first molar and lingual surface of lower central incisors is most affected by gingivitis. This is due to close proximity to opening of salivary ducts.

Life saver shaped gingival enlargement of Marginal Gingiva

 # Life saver shaped gingival enlargement of marginal gingiva is called:

 A. Stillman's cleft

 B. McCall's festoons

 C. Widow peaks

 D. Craters

The correct answer is B. McCall's festoons.

The term McCall's festoons has been used to describe a rolled, thickened band of gingiva that is usually seen adjacent to the cuspids when recession approaches the mucogingival junction.

Stillman clefts are apostrophe shaped indentations extending to marginal gingiva. They are usually present on facial surface. 

Craters are bony defects or concavities found in interdental areas.

Widow peaks are pseudo piling up of gingiva when failed to remove bony discrepancies at gingival line angles during osteotomy procedures. These are peaks of residual cortical bone left out during horizontal grooving at the facial/palatal/lingual line angles. 

Radiographic finding of Aggressive periodontitis

 # One of the radiographic finding of Aggressive periodontitis is arc shaped bone loss extending from:

A. Distal surface of the second premolar to mesial surface of second molar

B. Distal surface of the first premolar to mesial surface of first molar

C. Mesial surface of the second molar to distal surface of the first premolar

D. Mesial surface of the first premolar to distal surface of the second premolar

The correct answer is A. Distal surface of the second premolar to mesial surface of second molar

- Localized Juvenile Periodontitis is characterized by distribution of lesions in the first molars and incisors with least destruction in the cuspid-premolar area whereas in Generalized Juvenile periodontitis, there is generalized involvement of teeth.

- Vertical bone loss around incisors and molars in otherwise healthy teenagers is diagnostic of Localized juvenile periodontits.

- There is an arc shaped bone loss extending from distal surface of second premolar to mesial surface of second molar creating a mirror image type of bone loss which is characteristic of Juvenile periodontitis. 

Malignant involvement of lymph nodes

# Which  is  the  preferred  method  of  biopsy  in  case  of  a  malignant  involvement  of  lymph  node? 

a. Fine needle  aspiration 

b. Incisional  biopsy

c. Excisional biopsy 

d. No  biopsy

The correct answer is A. Fine needle aspiration.

Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, after being stained, are examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC) (the latter to emphasize that any aspiration biopsy involves cytopathology, not histopathology). Fine-needle aspiration biopsies are very safe minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead, eliminating the need for hospitalization. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.

Aspiration is safer and far less traumatic than an open biopsy; complications beyond bruising and soreness are rare. However, the few problematic cells can be too few (inconclusive) or missed entirely (a false negative).

This type of sampling is performed for one of two reasons:

- A biopsy is performed on a lump or a tissue mass when its nature is in question.

- For known tumors, this biopsy is performed to assess the effect of treatment or to obtain tissue for special studies.

When the lump can be felt, the biopsy is usually performed by a cytopathologist or a surgeon. In this case, the procedure is usually short and simple. Otherwise, it may be performed by an interventional radiologist, a doctor with training in performing such biopsies under x-ray or ultrasound guidance. In this case, the procedure may require more extensive preparation and take more time to perform.

Also, fine-needle aspiration is the main method used for chorionic villus sampling, as well as for many types of body fluid sampling.

It is also used for ultrasound-guided aspiration of breast abscess, of breast cysts, and of seromas.

Pulp stem cells are:

 # The pulp stem cells are:

A. Pluripotent in nature

B. Totipotent in nature

C. Multipotent in nature

D. None of the above

The correct answer is A. Pluripotent in nature.

Pulpal stem cells are pluripotent in nature.

The stem cells were shown to undergo proliferation and migrate to the site of injured odontoblasts and produce dentin.

Generalized Anxiety Disorder Treatment

 # A young man of 24 years is suffering from Generalized Anxiety Disorder; which drug may be preferred for his problem?

a. Zolpidem

b. Buspirone

c. Midazolam

d. Triazolam

e. Phenobarbital

The correct answer is B. Buspirone.

Buspirone is the first azapirone, a new class of antianxiety drugs, distinctly different from

Benzodiazepines. 

Buspirone: 

• Does not produce significant sedation or cognitive/functional impairment.

• Does not interact with BZD receptor or modify GABAergic transmission.

• Does not produce tolerance or physical dependence.

• Does not suppress BZD or barbiturate withdrawal syndrome.

• Has no muscle relaxant or anticonvulsant activity.

Buspirone relieves mild-to-moderate generalized anxiety, but is ineffective in severe cases, in those showing panic reaction and in OCD.

Though most patients on buspirone remain alert, those operating machinery/motor vehicles should be cautioned.

Dose: 5–15 mg OD–TDS:

Anemia of chronic disease

# Which of the following is a feature of anemia of chronic disease ?

A.Increased red cell protoporphyrin

B.Hypoproliferative marrow

C.Normal or increased serum ferritin

D.All of the above

The correct answer is D. All of the above. 

Features of anemia of chronic disease are a low serum iron, increased red cell protoporphyrin, hypoproliferative marrow, transferrin saturation of 15 - 20%, & normal or increased serum ferritin.

Ref: Harrison’s 18th edition, Page 849.