# Spontaneous bleeding usually occurs with a platelet count of:

 # Spontaneous bleeding usually occurs with a platelet count of:

A. Less than 50000/mm3

B. 50000-75000/ mm3

C. 75000-100000/ mm3

D. 100000-150000/mm3

The correct answer is: A. Less than 50000/mm3.

Spontaneous bleeding does not usually occur until the platelet count falls below 20 × 109/L, unless their

function is also compromised. Purpura and spontaneous bruising are characteristic but there may also be oral, nasal, gastrointestinal or genitourinary bleeding. Severe thrombocytopenia (< 10 × 109/L) may result in retinal haemorrhage and potentially fatal intracranial bleeding, but this is rare.

Reference: Davidson's Principles and Practice of Medicine, 22nd Edition, Page No. 1008.

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Chancre most commonly occurs on:

 # Chancre most commonly occurs on:

A. Genitals

B. Tonsils

C. Tongue

D. Floor of the mouth

The correct answer is A. Genitals.

A chancre is a painless genital ulcer most commonly formed during the primary stage of syphilis. This infectious lesion forms approximately 21 days after the initial exposure to Treponema pallidum, the gram-negative spirochaete bacterium yielding syphilis. Chancres transmit the sexually transmissible disease of syphilis through direct physical contact. These ulcers usually form on or around the anus, mouth, penis and vagina. Chancres may diminish between four and eight weeks without the application of medication.

Chancres, as well as being painless ulcerations formed during the primary stage of syphilis, are associated with the African trypanosomiasis sleeping sickness, surrounding the area of the tsetse fly bite.

Reference: https://en.wikipedia.org/wiki/Chancre

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Management of a hemophilic patient is done with:

 # Which one of the following can be used in the management of a hemophilic patient?

A. Ascorbic acid

B. Tranexamic acid

C. Acetic acid

D. Palmitic acid

The correct answer is B. Tranexamic Acid.

Tranexamic acid may be useful in mucosal bleeding. For more serious or persistent bleeds, haemostasis can be achieved with selected factor VIII concentrates which contain considerable quantities of vWF in addition to factor VIII. Young children and patients with severe arterial disease should not receive DDAVP, and patients with type 2B disease develop thrombocytopenia which may be troublesome following DDAVP. Bleeding in type 3 patients responds to nothing apart from concentrate.

Reference: Davidson's Principles and Practice of Medicine, 22nd Edition, Page no: 1054

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Main laboratory findings in Rheumatoid arthritis

 # What are the main laboratory findings in Rheumatoid arthritis?

A. Elevated ESR and RA factor positive

B. Decreased ESR and RA factor negative

C. Increased level of uric acid in blood

D. Decreased level of calcium in blood

The correct answer is A. Elevated ESR and RA factor positive.

The diagnosis of RA is based on clinical grounds but investigations are useful in confirming the diagnosis and assessing disease activity. The ESR and CRP are usually raised but normal results do not exclude the diagnosis. ACPA are positive in about 70% of cases and are highly specific for RA, occurring in many patients before clinical onset of the disease. Similarly RF is positive in about 70% of cases, many of whom also test positive for ACPA. Low titres of RF are found in about 10% of the normal population and in other diseases. 

Reference: Davidson's Principles and Practice of  Medicine, 22nd Edition, Page no 1100

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The most common organism causing infective endocarditis following dental manipulation is a:

 # The most common organism causing infective endocarditis following dental manipulation is a:

A. Streptococcus viridans

B. Staphylococcus aureus

C. Group A Streptococci

D. Gram –ve rod

The correct answer is A. Streptococcus viridans.

Bacteremias have been shown to cause Infective endocarditis; viridans group streptococci are part of the normal oral flora and have been commonly found in Infective endocarditis; dental procedures can cause bacteremias because of Streptococcus viridans; a large number of case reports associate dental procedures with subsequent Infective endocarditis.

Reference: Contemporary Oral and Maxillofacial Surgery, James R. Hupp, 6th Edition 2013, Page No: 314

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Knoop Hardness Number of enamel

 # Knoop Hardness Number (KHN) of enamel is:

A. 15

B. 55

C. 25-35

D. 350-430

The correct answer is D. 350-430 

The Knoop hardness test employs a diamond-tipped tool. The impression is rhombic in outline, and the length of the largest diagonal is measured. The load is divided by the projected area to give the Knoop hardness number (usually abbreviated as HK or KHN). 

Knoop hardness number of dentin is 68 and that of enamel is 350-459. Unfilled acrylic has KHN of 15 whereas hybrid composites have a KHN of 55-60. 

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Inducing Omission in Behavior management

#  You are treating a child patient. In the process of managing behavior of your patient you plan to induce omission, which refers to:

A. Pleasant consequence following a response

B. Withdrawal of an unpleasant stimulus after a response

C. Removal of a pleasant stimulus after a particular response

D. Presentation of an unpleasant  stimulus after a response

The correct answer is C. Removal of a pleasant stimulus after a particular response

Omission

Also called as ‘timed-out’, involves removal of pleasant stimulus after a particular response. For example if a child who throws temper tantrum has his favorite toy taken away for a short time as a consequence of this behavior, the probability of similar behavior is decreased. Because children are likely to regard attention by others as a very pleasant stimulus, withholding attention following undesirable behavior is use of omission that is likely to reduce the unwanted behavior.

Reference: Pedodontics Practice and Management, Badrinatheswar GV, First Edition 2010 Page no: 101

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