# Which of the following is the strongest activator of platelet?

 # Which of the following is the strongest activator of platelet? 

a. Thrombin 

b. Serotonin 

c. Thromboxane A2 

d. Epinephrine

The correct answer is: A. Thrombin.

Strong activator: Thrombin Collagen ADP, Shear

Weak: Epinephrine Thromboxane A2/Prostoglandin H2 Serotonin Platelet activating factor Vasopressin Thrombospondin-1 Thrombolytic agent

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Most common cause of thrombocytopenia in children is:

# Most common cause of thrombocytopenia in children is:

a. Aplastic anemia 

b. ITP

c. TTP 

d. Drug induced

The correct answer is B. ITP.

ITP is the most common cause of acquired severe thrombocytopenia and 50% of ITP cases are children, i.e. < 10 years of age. 

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One unit of random donor platelet ideally increases the platelet count in an adult by:

 # One unit of random donor platelet ideally increases the platelet count in an adult by: 

a. 5000 

b. 10000 

c. 15000 

d. 20000

The correct answer is: a. 5000.

The increment in platelet count depends on many factors but if all other factors are absent then 1 unit of whole blood derived random platelet increases the platelet count by 5,000/mm3 per square metre. So in a person of BSA 2 m2. It should raise by 10000/mm3 and of 1.5 m2 by 7500/mm3 respectively. 

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Which of the following can be given safely in pregnancy?

 # Which of the following can be given safely in pregnancy? 

a. Imatinib 

b. Heparin 

c. Warfarin 

d. Thalidomide

The correct answer is B. Heparin.

Human Teratogenic Drugs - Drugs causing human birth defect

Thalidomide – Phocomelia, multiple defects

All anticancer drugs – Multiple defects, fetal death

Androgens – Virilization, limb, esophageal, cardiac defects

Progestins – Virilization of female fetus

Tetracycline – Discolored and deformed teeth, retarded bone growth

Warfarin – Nose, eye and hand defects, growth retardation

Phenytion – Hypoplastic phalanges, cleft lip/palate microcephaly

Phenobarbitone – Various malformations

Chlorpromazine – Neural tube defects

Valproate sodium – Spina bifida and other normal tube defects

Lithium – Fetal goitre, cardiac and other abnormalities

Isotretinoin – Craniofacial, heart and CVS defects

Imatinib – Multiple defects exomphalos, kidney abnormalities

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Internal resorption that has not totally perforated the root surface is best managed by which of the following:

 # Internal resorption that has not totally perforated the root surface is best managed by which of the following?

A. Surgical curettage

B. Root canal treatment

C. Periodic recall and evaluation

D. Incision and drainage

E. Cveck’s Pulpotomy

The correct answer is B. Root canal treatment.

Root canal therapy is indicated for cases involving internal resorption where the root surface is not perforated by the defect.

Internal resorption may occur either in the pulp chamber or the root canal of the tooth and is most commonly caused by trauma and infection.

Infection or trauma results in an inflammatory response within the pulp resulting in abnormal vascularization and production of multinuclear odontoclasts, which initiate the process of resorption.

Root canal treatment is performed in cases of internal resorption where the root surface is not completely perforated. After filling the root canals and resorption defect, follow up radiographs are made after one year to determine if healing has occurred and the resorptive process is halted.

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Adverse effect of internally bleaching an endodontically treated tooth

 # Which of the following is the most likely adverse effect of internally bleaching an endodontically treated tooth with superoxide?

A. Weakening of the remaining tooth structure

B. External cervical root resorption

C. Reinfection of the canal

D. Demineralization of tooth structure

The correct answer is B. External cervical root resorption.

The most common side effect of internally bleaching a tooth with superoxide is external cervical root resorption. 

The presence of a glass ionomer barrier over the root filling material may help to reduce the instances external cervical root resorption if it is at least 4 mm in thickness. 

The walking bleach technique using sodium perborate is NOT associated with external cervical root resorption. 

Bleaching dentin does NOT weaken the tooth structure. 

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The prognosis for internal bleaching is best if the etiology of the stain is:

 # The prognosis for internal bleaching is best if the etiology of the stain is:

A. Amalgam restorations

B. Necrotic pulp tissue

C. Precipitation of metallic salts

D. Silver containing root canal sealers

The correct answer is B. Necrotic pulp tissue.

Internal bleaching treatments are most effective among root canal treated teeth which have internal stains or discoloration due to blood, necrotic tissues and fluids that could have leaked in prior to root canal therapy.

Internal tooth bleaching is done by placing peroxide directly into the pulp chamber of a root canal treated tooth. The peroxide will then directly work on the stains within the tooth structure.

Staining from the silver containing root canal sealers and from mercury of amalgam restorations appear very dark. These stains are seldom treated by bleaching. Restorative treatments provide the most esthetic result because they remove or cover up these stains. 

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