The characteristic alarm clock headache is a feature of:

 # The characteristic alarm clock headache is a feature of:

A. Auriculotemporal neuralgia

B. Trigeminal neuralgia

C. Sphenopalatine neuralgia

D. Glossopharyngeal neuralgia

The correct answer is C. Sphenopalatine neuralgia.

Sphenopalatine neuralgia / Lower half Headache / Sluder's headache / Horton's syndrome

• Described by Sudian, who concluded the involvement of Vidian nerve. 

• Pain is thought to be generated at the level of pericarotid or cavernous sinus complex. 

• Characterized by unilateral paroxysms of pain in the region of eyes; the maxilla, the ear and mastoid, and beneath the zygoma. 

• There is no trigger zone. 

• Unfortunately, the attacks develop regularly, usually atleast once a day, over a prolonged period of time. 

• Interestingly in some patients, the onset occurs at exactly the same time of day, because of which it is referred to as alarm clock headache 

Application of fluoride varnish after luting a crown has which of the following beneficial action?

 # Application of fluoride varnish after luting a crown has which of the following beneficial action?

A. Removes fluorides from enamel

B. Reduces the peripheral seal

C. Provides desensitizing action

D. Allows dissolution of marginal cement

The correct answer is C. Provides desensitizing action.

Fluoride applied after crown cementation has the benefit of reducing the decalcification in the area and helps to seal the tubules which may be open at the cervical tooth margin. This provides for additional desensitizing action. 

For maxillary expansion, HYRAX uses a force of:

 # For maxillary expansion, HYRAX uses a force of:

A. 2 to 3 pounds

B. 10 to 20 pounds

C. >25 pounds

D. >50 pounds

The correct answer is B. 10 to 20 pounds.

Hyrax (Hygienic Rapid Expander): 

• It is a fixed tooth borne rapid maxillary expansion appliance. 

• The Hyrax Expander is essentially a non-spring-loaded jackscrew with an all wire frame. The main advantage of this expander is that it does not irritate the palatal mucosa and is easy to keep clean. 

• It is capable of providing sutural separation of 11 mm within a very short period of wear and a maximum of 13 mm can also be achieved. Each activation of the screw produces approximately 0.2 mm of lateral expansion and it is activated from front to back. 

• Fixed appliances like Hyrax or Haas, apply forces about 3 to 10 pounds, which can reach up to 20 pounds in daily activation 

• Rapid maxillary expansion appliances uses 10-20 pounds force, whereas slow arch expansion uses 2-4 pounds. 

Earliest marker of renal damage in a known case of diabetes mellitus is:

 # Earliest marker of renal damage in a known case of diabetes mellitus is:

A. Microalbuminuria

B. Glycosuria

C. Increased serum creatinine

D. Increased serum urea

The correct answer is A. Microalbuminuria. 

Microalbuminuria refers to the urinary excretion of small amounts of albumin. The consistent presence

of albumin in the urine is abnormal and is clinically important in identifying the very early stages of glomerular disease, as occurs in conditions like diabetic nephropathy. Because significant renal damage

has already taken place before standard dipstick tests become positive, patients with diabetes mellitus should be screened regularly for microalbuminuria. Persistent microalbuminuria has also been associated with an increased risk of atherosclerosis and cardiovascular  mortality but neither the mechanism of proteinuria nor an explanation for this association has been established.

Osteomyelitis in early stage on radiograph appear as:

 # Osteomyelitis in early stage on radiograph appear as:

A. Blurring of trabeculae

B. Dense radiopaque areas

C. Radiolucent foci

D. Formation of sequestrum

The correct answer is A. Blurring of trabeculae. 

Osteomyelitis is defined as inflammation of bone and its bone marrow. Acute osteomyelitis progresses rapidly and demonstrates limited radiographic evidence until 1-2 weeks. The earliest change noticed is fuzziness and indistinct trabeculae. Chronic osteomyelitis appears as moth eaten radiolucencies in the bone, along with appearance of radiopaque sequestrum. 

In pantomograph, if patient chin is placed anterior to the focal trough, the structures appears to be:

 # In pantomograph, if patient chin is placed anterior to the focal trough, the structures appears to be:

A. Blurred and diminished

B. Blurred and magnified

C. Either magnified or diminished

D. Only blurred

The correct answer is A. Blurred and diminished.

Anatomic structures present within the focal trough are well defined on panoramic radiographers. If the chin is placed anterior to the focal trough, the structures appear to be blurred and diminished. If the chin is placed posterior to the focal trough, structures appear blurred and magnified. 

Ball in hand appearance is seen in:

 # Ball in hand appearance is seen in:

A. Sialadenosis

B. Benign tumor of salivary gland

C. Sialadenitis

D. Sjogren’s syndrome

The correct answer is B. Benign tumor of salivary gland.

Benign tumors may present as low-intensity (dark) or high-intensity (light) tissue signals on MRI, although the relative intensity of the signal may indicate the presence of lipid, vascular, or fibrous

tissues. Sialography may suggest a space-occupying mass when the ducts are compressed or smoothly displaced around the lesion (the “ball-in-hand” appearance).