One of the earlier signs of cavernous sinus thrombosis is due to deficit in the function of:

# One of the earlier signs of cavernous sinus thrombosis is due to deficit in the function of:

A. Trochlear nerve

B. Abducens nerve

C. Oculomotor nerve

D. Ophthalmic division of trigeminal nerve

The correct answer is B. Abducens nerve.

Because the abducens nerve (cranial nerve VI) is usually the first nerve to become involved due to its location in the lateral wall of the cavernous sinus, an early sign may be an internal strabismus.

Ref: ORAL AND MAXILLOFACIAL PATHOLOGY, A Rationale for Diagnosis and Treatment, Second Edition Page no 77

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Exfoliative cytology is mainly used in the definitive diagnosis of the:

 # Exfoliative cytology is mainly used in the definitive diagnosis of the:

A. Oral cancer

B. Fungal infection

C. Vesiculobullous diseases

D. Viral infection

The correct answer is C. Vesiculobullous diseases.

It has been recognized that the exfoliative oral cytologic smear is also of value in the diagnosis of diseases other than carcinoma, particularly diseases which are characterized by the presence of certain specific cells. Thus, cytologic smears have been useful in the diagnosis of lesions of herpes simplex infection, herpes zoster, pemphigus vulgaris, benign familial pemphigus, keratosis follicularis, hereditary benign intraepithelial dyskeratosis, white sponge nevus, and pernicious and sickle cell anemia.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 597

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The prognosis of epidermoid carcinoma is least favorable

 # Of the following locations, the one in which the prognosis of epidermoid carcinoma is least favorable is:

A. Lower lip

B. Hard palate

C. Buccal mucosa

D. Posterior lateral border of tongue

The correct answer is D. Posterior lateral border of tongue.

The epidermoid carcinoma/ squamous cell carcinoma is the most common malignant neoplasm of the oral cavity. Although it may occur at any intraoral site, certain sites are more frequently involved than

others. Because of the differences in clinical appearance, the nature of the lesion and particularly the prognosis, it is well to describe the tumors individually, as they may arise in these various areas.

Of the areas of the oral cavity, the mortality rate is lowest for lip cancer (0.04 per 100,000) and highest for the tongue (0.7 per 100,000).

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 103

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The most common development disorder affecting the tongue is:

 # The most common development disorder affecting the tongue is:

A. Median rhomboid glossitis

B. Abnormally fissured tongue

C. White spongy nevus

D. Black hairy tongue

The correct answer is B. Abnormally fissured tongue.

Fissured tongue is a condition frequently seen in the general population and it is characterized by grooves that vary in depth and are noted along the dorsal and lateral aspects of the tongue. Although a definitive etiology is unknown, a polygenic mode of inheritance is suspected because the condition is seen clustering in families who are affected.

Patients are usually asymptomatic, and the condition is initially noted on routine intraoral examination as an incidental finding. 

Reference: Shafer’s Textbook of ORAL PATHOLOGY, 7th Edition, Page No: 29

 

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Ankylosis of the TMJ is best treated with:

 # Ankylosis of the TMJ is best treated with:

A. Exercise and massage

B. Sclerosing solutions

C. Antibiotics

D. Condylectomy

The correct answer is D. Condylectomy.

The treatment of TMJ ankylosis is always surgical. Early surgical correction of the ankylosed joint is highly desirable, if satisfactory function is to be regained. Surgical strategy adopted depends on the following:

a. Age of onset of ankylosis.

b. Extent of ankylosis.

c. Whether there is unilateral or bilateral involvement.

d. Associated facial deformity.

Surgical techniques

Number of techniques have been advocated by different surgeons. Critical analysis of all, filters only to three basic methods.

I : Condylectomy

II : Gap arthroplasty

III : Interpositional arthroplasty

Most surgical procedures can be done through a preauricular incision alone. The Popowich‘s incision is

chosen for its obvious advantages. Whenever required, additional submandibular incision can be used for fixation of the graft, etc.

Ref: Textbook of Oral and Maxillofacial Surgery, Neelima Anil Malik, 3rd Edition, Page 267

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Best treatment for pericoronitis associated with impacted mandibular third molar is:

 # Best treatment for pericoronitis associated with impacted mandibular third molar is:

A. Irrigating under the operculum

B. Antibiotic and analgesic therapy

C. Extraction of impacted third molar

D. Operculectomy

The correct answer is C. Extraction of impacted third molar. 

Patients who have severe pericoronitis around an impacted mandibular third molar should not have the tooth extracted until the pericoronitis has been treated. Nonsurgical treatment should include irrigations, antibiotics, and removal of the maxillary third molar, if necessary, to relieve impingement on the edematous soft tissue overlying the mandibular impaction. If the mandibular third molar is removed in the face of severe pericoronitis, the incidence of complications increases. If the pericoronitis is mild and the tooth can be removed easily, then immediate extraction may be performed.

Pericoronitis is most common cause for removal of impacted mandibular third molars. It is recurrent

in nature and may cause the damage of bone around the 2nd and 3rd molars. So extraction of the involved tooth is the best treatment.

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Anemia can manifest as all EXCEPT:

 # Anemia can manifest as all EXCEPT:

B. Vertigo

A. Headache

C. Delirium

D. Tinnitus

The correct answer is C. Delirium.

Headache and dizziness(vertigo) are common symptoms of anemia.

Tinnitus is the perception of sounds that occurs in the absence of external acoustic stimulus. The pathomechanism of tinnitus is thought to be complicated and therefore remains debatable. Among several risk factors, such as increased age, female gender, and hearing loss, anemia is especially related to pulsatile tinnitus due to an altered hemodynamic status although the prevalence of pulsatile tinnitus in anemia patients has not been reported in previous studies. Anemia results in decreased oxygen carrying capacity of the blood, which carries an associated risk of insufficient oxygen delivery and cellular hypoxia. The compensatory increased flow state and turbulence are perceived as tinnitus in the ear, and the recognition of a hyperdynamic circulatory state as the cause of the tinnitus avoids unnecessary diagnostic tests and is essential in determining appropriate treatment.

Ref: https://doi.org/10.1016/j.anl.2018.04.001

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