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Commonest inherited cause of thrombosis

# Commonest inherited cause of thrombosis in Caucasians is:
a. Protein S deficiency
b. Factor V leiden mutation
c. Anti thrombin III deficiency
d. Protein C deficiency



The correct answer is B. Factor V Leiden mutation.

Factor V Leiden (G1691A or arg 506 glu substitution) and prothrombin (G 20210 A) are rare in African and orientals but they have prevalence in whites, highest prevalence of heterozygotes (11–14%) is reported in Sweden and Arabs.


# 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

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. 

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. 

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

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.

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.