Molar-incisor hypoplasia in primary teeth

 # Molar-incisor hypoplasia in primary teeth at the occlusal level is due to developmental defect occurring during? 

A. Birth to 12 months 

B. 4th month intra-uterine to birth 

C. 22 months to 26 months 

D 24 months to 48 months 

The correct answer is B. 4th month intra uterine to birth.

# The most common dental complication of problems in utero is enamel hypoplasia. The deciduous teeth most effected by hypoplasia are maxillary incisors. They are the first teeth to start calcification, between the 3rd-4th months of intrauterine life. Amelogenesis of deciduous incisors is nearly completed at term birth. 

#Mineral is deposited in the matrix formed by ameloblastic activity from the fourth month of intrauterine life to form the enamel of the deciduous teeth (which is nothing but, 10-12 months in case of molars and incisors). Any severe illness in the mother is likely to be reflected in diminished amneloblastic activity. 

Guerin’s sign is:

 # Guerin’s sign is: 

A. Ecchymosis at greater palatine foramen 

B. Ecchymosis at mastoid region 

C. Ecchymosis at condylar region 

D. Ecchymosis at infraorbital foramen 

The correct answer is A. Ecchymosis at greater palatine foramen.

Guerin's sign is bruising in the palate in the region of the greater palatine arteries. We present a patient who sustained blunt facial trauma and as a result had a mobile maxilla and a severe malocclusion. An associated laceration in the palate pointed to a split palate confirmed on CT. This is a reminder to clinicians, especially those working in acute medicine to conduct thorough examination of the oral tissues. A laceration in the palate can be easily missed and should be looked for as part of a systematic examination. Intraoperative management may change depending on the fracture pattern and displacement.

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184606/

Medical complexity status classification and protocol

Medical complexity status classification and protocol.

Major categories

MCS 0 - Patients with no medical problems

MCS 1 - Patients with controlled or stable medical conditions

MCS 2 - Patients with uncontrolled or unstable medical conditions

MCS 3 - Patients with medical conditions associated with acute exacerbation, resulting in high risk of mortality

Subcategories

A - No anticipated complications

B - Minor complications are anticipated. “Minor complications” are defined as complications that can be successfully addressed in the dental chair

C - Major complications are anticipated. “Major complications” are defined as complications that should be addressed by a medical provider and may sometimes require a hospital setting

According to ASA a patient with an incapacitating systemic disease that is constant threat to life falls under:

# According to ASA a patient with an incapacitating systemic disease that is constant threat to life falls under: 

A. ASA I 

B. ASA II

C. ASA III

D. ASA IV

The correct answer is D. ASA IV

American Society of Anesthesiologists (ASA) physical status classification system.

ASA I : A normal healthy person

ASA II : A patient with a mild disease

ASA III : A patient with a severe systemic disease

ASA IV : A patient with a severe systemic disease that is a constant threat to life

ASA VI : A declared brain‐dead patient whose organs are being removed for donor purposes

Restricting size of beam is done by:

 # Restricting size of beam is done by:

A. Collimator

B. Transformer

C. Tube head seal

D. Beam indicating device

The correct answer is A. Collimator.

A collimator is a metallic barrier with an aperture in the middle used to restrict the size of the x-ray beam and the volume of tissue irradiated. Round and rectangular collimators are most frequently used in dentistry. Dental x-ray beams are usually collimated to a circle 4 inches (7 cm) in diameter at the patient’s face. A round collimator is a thick plate of radiopaque material (usually lead) with a circular opening centered over the port in the x-ray head through which the x-ray beam emerges. Typically, round collimators are built into open-ended aiming cylinders. Rectangular collimators further limit the size of the beam to just larger than the x-ray film, further reducing patient exposure. Some types of film-holding instruments also provide rectangular collimation of the x-ray beam. 

Reference: White and Pharoah's Oral Radiology, 7th Edition

In CBCT technology, the speed with which individual images are acquired is called:

 # In CBCT technology, the speed with which individual images are acquired is called:

A. Running rate

B. Frame rate

C. Projection rate

D. Image rate

The correct answer is B. Frame rate.

The number of images constituting the projection data throughout the scan is determined by the detector frame rate (number of images acquired per second), the completeness of the trajectory arc (180 to 360 degrees), and the rotation speed of the source and detector. The number of basis images making up a single scan set may be fixed or variable. Higher frame rates have both desirable and undesirable effects. Higher frame rates increase the signal-to-noise ratio, producing images with less noise and reducing metallic artifacts. However, a higher frame rate is associated with a longer scan time and higher patient dose. In addition, more data are obtained, and primary reconstruction time is increased.

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Hemorrhage secondary to heparin administration can be corrected by administration of:

 # Hemorrhage secondary to heparin administration can be corrected by administration of:

A. Vitamin K

B. Whole blood

C. Protamine

D. Ascorbic acid

The correct answer is C. Protamine.

The half life of intravenous heparin is about one hour and if a patient bleeds, it is usually sufficient just to discontinue the infusion; however if the bleeding is severe, the excess can be neutralized with intravenous protamine.