Acetone breath is a feature of:

 # Acetone breath is a feature of:

A. Sinusitis

B. Renal disease

C. Liver disease

D. Diabetes mellitus

The correct answer is D. Diabetes mellitus.

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. A person's breath may develop a specific "fruity" smell. Onset of symptoms is usually rapid. People without a previous diagnosis of diabetes may develop DKA as the first obvious symptom.

DKA happens most often in those with type 1 diabetes but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke and certain medications such as steroids. DKA results from a shortage of insulin; in response, the body switches to burning fatty acids, which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH and ketoacids in either the blood or urine.

On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, a rapid heart rate and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity" or like "pear drops". The smell is due to the presence of acetone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.

Small children with DKA are relatively prone to brain swelling, also called cerebral edema, which may cause headache, coma, loss of the pupillary light reflex, and can progress to death. It occurs in about 1 out of 100 children with DKA and more rarely occurs in adults.

Glass ionomer cement was introduced by Wilson and Kent in:

 # Glass ionomer cement was introduced by Wilson and Kent in:

a.1969

b.1972

c.1896

d.1989

The correct answer is B. 1972.

Glass ionomer cements are adhesive tooth colored anticariogenic restorative materials which were originally used for restorations of eroded areas. Current glass ionomers have been modified to allow a wider application. These cements evolved from a general dissatisfaction with silicate cements. The first usable glass ionomer system was formulated in 1972 by Wilson and Kent and was known as ASPA (alumino silicate polyacrylic acid). Subsequently great improvements were made and today these materials are very popular and widely used.

Crepitus will be seen in the tissues surrounding an infection by:

 # Crepitus will be seen in the tissues surrounding an infection by:

A. Staphylococcus

B. Streptococcus

C. Clostridium tetani

D. Clostridium perfringes

The correct answer is D. Clostridium perfringes. 

■ Clostridium perfringens causes gas gangrene or myonecrosis. 

■ Gas gangrene is characterized by skin colour change from pallor to bronze/purple discoloration and the skin is tense and exquisitely tender. 

■ Gas in the tissues may be obvious with crepitus on clinical examination or visible on radiograph. 

■ Surgical debridement, antibiotic therapy with high-dose I.V penicillin, clindamycin and metronidazole and hyperbaric oxygen therapy are used for treating gas gangrene [Note: Hyperbaric oxygen therapy is also used for osteoradionecrosis and chronic osteomyelitis]. 

■ Cl. tetani causes tetanus and cl. difficile causes pseudomembranous colitis. 

Acute rheumatic fever occurs most commonly in:

 # Acute rheumatic fever occurs most commonly in:

A. 5-14 years

B. 15-20 years

C. 21-25 years

D. 26-30 years

The correct answer is A. 5-14 years.

The incidence of acute rheumatic fever is highest in school aged children. The highest incidences recorded are in those aged 5-14 years. One study reported a median age of diagnosis of acute rheumatic fever of 10.4 years with an interquartile range between 8.7-14.3 years. 

The active ingredient of anticalculus dentifrices is:

 # The active ingredient of anticalculus dentifrices is:

A. Fluoride

B. Potassium nitrate

C. Ammonia

D. Pyrophosphate

The correct answer is D. Pyrophosphate.

Pyrophosphate has received particular attention in view of its proposed rote in inhibition of crystal growth. Nevertheless, it is unlikely that pyrophosphate in toothpastes will persist for a reasonable length of time in the mouth, because of the presence of considerable amounts of pyrophosphatase enzymes in saliva and oral bacteria. Pyrophosphate, when introduced into a simulated oral environment, is hydrolyzed by various phosphatases with concomitant loss of its inhibitory activity for calcification in vitro. To overcome this problem, a copolymer of vinyl methyl ether maleic anhydride (Gantrez) and NaF has been introduced in order to inhibit the hydrolysis of pyrophosphate. Animal and clinical studies have shown that toothpaste containing a combination of pyrophosphate, NaF and Gantrez, was highly effective in retarding supragingival calculus formation. 

Disease transmitted from father to all daughters would be:

 # Disease transmitted from father to all daughters would be:

A. Autosomal dominant

B. Autosomal recessive

C. X linked dominant

D. Mitochondrial

The correct answer is C. X linked dominant.

Father gives X to daughter and Y to son. Any X linked dominant disorder in father will affect all daughters. 

Compound odontoma shows on a radiograph as:

 # Compound odontoma shows on a radiograph as:

A. Supernumerary teeth

B. Radiolucent and radiopaque areas

C. Mass of calcified areas

D. Distinguishable tooth like structures

The correct answer is D. Distinguishable tooth like structures.

The radiographic appearance of the odontoma is characteristic. Since most odontomas are clinically asymptomatic and are discovered by routine radiographic examination, the dentist should be familiar with their appearance. They are often situated between the roots of teeth and appear either as an irregular mass of calcified material surrounded by a narrow radiolucent band with a smooth outer periphery, or as a variable number of tooth like structures with the same peripheral outline. This latter type of odontoma may contain only a few structures resembling teeth, or it may contain several dozen. Both forms of odontoma are frequently associated with unerupted teeth. It is of interest that the majority of odontomas in the anterior segments of the jaws are compound composite in type, while the majority in the posterior areas are complex composite.