The principal action of ammonia in syncope is as a:

 # The principal action of ammonia in syncope is as a:

A. Respiratory stimulant

B. Vagal stimulant

C. Vasomotor stimulant

D. Inhibitor of vasomotor tone

The correct answer is A. Respiratory Stimulant.

Aromatic ammonia is used to treat vasodepressor syncope as well as respiratory depression not induced by opioid analgesics

Aromatic ammonia is the agent of choice for inclusion in the emergency kit as a respiratory stimulant. It is available in a silver-gray vaporole, which is crushed and placed under the breathing victim’s nose until respiratory stimulation is effected. Aromatic ammonia has a noxious odor and irritates the mucous membrane of the upper respiratory tract, stimulating the respiratory and vasomotor centers of the medulla. This action in turn increases respiration and blood pressure. Movement of the arms and legs often occurs in response to ammonia inhalation; these movements further increase blood flow and raise blood pressure, especially in the patient who has been positioned properly (e.g., supine with feet elevated slightly).

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Flap with no vertical incision is called:

 # Flap with no vertical incision is called:

A. Triangular

B. Semilunar

C. Envelope

D. Trapezoidal

The correct answer is: C. Envelope

Basic requirements of a flap:

• Flap must be designed to provide an adequate exposure of the surgical area.

• Flap must have a broad base and good vascular supply.

• When placed back, flap should rest on healthy bone.

Envelop flap: Incision along free gingival margin with no vertical incision. 

Two sided triangular flap: It is an envelop flap with a releasing incision on one side.

Three sided rhomboid flap: It is modification of two sided flap with addition of a second vertical incision.

Semilunar flap: is designed when periapical area is required to be exposed. It is always kept 5mm away from the gingival margin.

Pedicle flap; It is a flap based on a particular blood vessel. Eg:- Palatal flap along the length of greater palatine artery. 

Random flaps: Flaps that are not based on a specific blood vessel.

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Extraction of tooth during acute infection:

 # Extraction of tooth during acute infection:

A. Can cause extensive spread of infection

B. Helps drainage and relieves pain if proper antibiotic is given and its adequate blood level is reached

C. Can cause sudden death due to pulmonary embolism

D. Can lead to trigeminal neuralgia in postoperative period

The correct answer is B. Helps drainage and relieves pain if proper antibiotic is given and its adequate blood level is reached

The most rapid resolution of an infection secondary to pulpal necrosis is obtained, when the tooth is removed as early as possible. Therefore acute infection should not be a contraindication to extraction. If access and anesthetic considerations can be met, the tooth should be removed as early as possible after maintaining proper antibiotic level. 

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Saw toothed Rete Pegs are seen in:

 #  Saw toothed Rete Pegs are seen in:

A. Lichen planus

B. Lichenoid reaction

C. Leukoplakia

D. Leukoedema

The correct answer is A. Lichen Planus.

Histopathologic examination of lesional tissue is the most relevant investigation in cases of Oral Lichen Planus. Typical findings include hyperparakeratosis or hyperorthokeratosis with thickening of the granular layer, acanthosis with intracellular edema of the spinous cells in some instances, the development of a ‘saw tooth’ appearance of the rete pegs. Band-like subepithelial mononuclear infiltrate consisting of T-cells and histiocytes; increased numbers of intraepithelial T-cells; and degenerating basal keratinocytes that form colloid (Civatte, hyaline, cytoid) bodies, which appear as homogenous eosinophilic globules are consistently seen.

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Bleeding joints is a characteristic feature of:

 #  Bleeding joints is a characteristic feature of:

A. Vitamin C deficiency

B. Vitamin K deficiency

C. Hemophilia

D. Thrombocytopenia

The correct answer is C. Hemophilia.

Patients with hemophilia exhibit persistent bleeding, either spontaneous or following even slight trauma that produces the mildest of abrasions or cuts. Hemorrhage into the subcutaneous tissues, internal organs, and joints is also a common feature and may result in massive hematomas.

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An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This mass is most likely to be:

 # An asymptomatic tooth has deep caries on occlusal surface. Radiograph shows radiopaque mass at apex of the tooth. This  mass is most likely to be:

A. Cementoma

B. Condensing osteitis

C. Chronic apical periodontitis

D. Acute apical periodontitis

The correct answer is B. Condensing osteitis.

In condensing osteitis, radiographs demonstrate radiopacity which is not attached to tooth, entire root outline is visible, lamina dura intact and periodontal ligament is widened. These features differentiate it from cementoblastoma, in which the radiopacity is attached to tooth, lamina dura absent and root outline is not visible. In condensing osteitis the tooth may be vital or non-vital.

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In a leukemic patient, bleeding does not stop because:

 # In a leukemic patient, bleeding does not stop because:

A. Decreased platelet count 

B. Increased WBC count

C. Decreased calcium level

D. Decrease in coagulation level

The correct answer is A. Decreased Platelet Count

The sign and symptoms of acute leukemia result from either bone marrow suppression or infiltration

of leukemic cells into organs tissues. These changes cause anemia, thrombocytopenia and a decrease in

neutrophils. Thrombocytopenia causes spontaneous bleeding such as petechiae, ecchymoses, epistaxis,

melena. It may necessary to perform surgery on patients with platelet counts in the range of 25,000

because of the difficulty in achieving platelet levels due to circulating platelet antibodies.

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