For a successful intraoral palatal second divisions nerve block anesthesia, the needle should enter the:

 # For a successful intraoral palatal second divisions nerve block anesthesia, the needle should enter the:

A. Incisive canal

B. Infraalveolar foramen

C. Greater palatine foramen

D. Stylomastoid foramen

The correct answer is C. Greater palatine foramen.

Area of insertion: palatal soft tissue directly over the greater palatine foramen

Target area: the maxillary nerve as it passes through the pterygopalatine fossa; the needle passes through the greater palatine canal to reach the pterygopalatine fossa

Ref: Handbook of Local anesthesia, Malamed, 6th Edition Page 220

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The first line of treatment in a patient with syncope due to local anesthesia is administration of:

 # The first line of treatment in a patient with syncope due to local anesthesia is administration of:

A. Oxygen

B. Respiratory stimulant

C. Adrenaline

D. Diazepam

The correct answer is A. Oxygen.

Definitive care after syncopal attack:

-Administer O2

- Monitor vital signs

- Perform additional procedures: Administer aromatic ammonia vaporole; Administer “sugar” (e.g., orange juice, non-diet soft drink)

- Administer atropine if bradycardia persists

- Do not panic!

Reference: Medical Emergencies in the Dental Office, Malamed, 7th edition Page no: 151

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What is the fate of nitrous oxide when administered for relative analgesia?

 # What is the fate of nitrous oxide when administered for relative analgesia?

A. Excreted by kidney

B. Detoxified in liver

C. Exhaled by lungs

D. Exhaled by sweat glands

The correct answer is C. Exhaled by lungs.

As the sole agent, N2O (50%) has been used with O2 for dental and obstetric analgesia. It is

nontoxic to liver, kidney and brain. However, prolonged N2O anaesthesia has the potential to

depress bone marrow and cause peripheral neuropathy. Metabolism of N2O does not occur;

it is quickly removed from the body by lungs. It is cheap and commonly used.

Reference: Essentials of Medical Pharmacology, KD Tripathi, Seventh edition page no 378

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Hematoma formation after posterior superior alveolar nerve block

 # If hematoma formation occurs after posterior superior alveolar nerve block, it is due to the damage of:

A. Pterygoid venous plexus

B. Small capillaries and arterioles in the region

C. Facial artery

D. Internal maxillary artery

The correct answer is A. Pterygoid venous plexus.

Complications after posterior superior alveolar nerve block

1. Hematoma:

a. This is commonly produced by inserting the needle too far posteriorly into the pterygoid plexus of veins. In addition, the maxillary artery may be perforated. Use of a short needle minimizes the risk of pterygoid plexus puncture.

b. A visible intraoral hematoma develops within several minutes, usually noted in the buccal tissues of the mandibular region.

(1) There is no easily accessible intraoral area to which pressure can be applied to stop the hemorrhage.

(2) Bleeding continues until the pressure of extravascular blood is equal to or greater than that of intravascular blood.

Reference: Handbook of Local Anesthesia, Malamed, 6th Edition, Page 195

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AIIMS NOVEMBER 2015 MDS PAST ENTRANCE EXAM MCQs

# Medial dislocation of fractured condyle in subcondylar fracrure is caused by:
A. Medial pterygoid
B. Lateral pterygoid
C. Masseter
D. Buccinator

# A dental surgeon has recoverd from Hepatitis B by 3 months rest. His laboratory findings are normal but he is not allowed to attend patients as per medical board as he is:
A. healthy carrier
B. active carrier
C. convalescent carrier
D. paradoxical carrier

AIIMS NOVEMBER 2014 MDS ENTRANCE EXAM PAST QUESTIONS

# Which of the following is not seen in posterior triangle of neck:
A. Hypoglossal nerve
B. Subclavein vein
C. External jugular vein
D. Phrenic nerve

# Which of the following is derived from second brachial arch:
A. muscle of facial expression
B. masticatory muscles
C. mandible
D. condyle

The duration of fixation generally required for fracture of mandible:

 # The duration of fixation generally required for fracture of mandible:

A. 2-4 weeks

B. 3-5 weeks

C. 6-8 weeks

D. 8-10 weeks

The correct answer is C. 6-8 weeks.

In the past, one of the major considerations in the immediate postoperative period was the difficulty resulting from IMF. When  the jaws are wired together, the patient has initial difficulties in obtaining adequate nutrition, performing necessary oral hygiene, and communicating verbally. The average IMF period ranges from 6 to  8 weeks.

Reference: Contemporary Oral and Maxillofacial Surgery, James R. Hupp, 6th Edition 2013, Page No:  557

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