PGCEE MDS 2022 : Most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity

 # The most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity is :

A. Lignocaine

B. Quinidine

C. Verapamil

D. Amiodarone

The correct answer is A. Lignocaine.

The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulin fragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias. Fab dose can be determined by two different methods. First method is based on the amount of digoxin ingested whereas the second method is based on the serum digoxin concentration and the weight of the person.

Other treatment that may be used to treat life-threatening arrhythmias until Fab is acquired are magnesium, phenytoin, and lidocaine. Magnesium suppresses digoxin-induced ventricular arrhythmias while phenytoin and lidocaine suppresses digoxin-induced ventricular automaticity and delay afterdepolarizations without depressing AV conduction. In the case of an abnormally slow heart rate (bradyarrhythmias), Atropine, catecholamines (isoprenaline or salbutamol), and/or temporary cardiac pacing can be used.

USES OF LIDOCAINE

Lidocaine is safe if given by slow i.v. injection; is used to suppress VT and prevent VF. It is ineffective in atrial arrhythmias. Because of rapidly developing and titratable action it is a good drug in the emergency setting, e.g. arrhythmias following acute MI or during cardiac surgery. In acute MI, i.v. infusion of lidocaine can prevent VF, but a metaanalysis has shown that it fails to improve survival; may even increase short term mortality. Therefore, lidocaine is no longer administered prophylactically to all MI patients, but may be used in selected cases, and to treat ventricular arrhythmias when they occur. Efficacy of lidocaine in chronic ventricular arrhythmia is poor, but it suppresses VT due to digitalis toxicity, for which it is used because it does not worsen A-V block.

PGCEE MDS 2022: Least invasive way to treat the fracture of edentulous mandible is:

 # Least invasive way to treat the fracture of edentulous mandible is:

A. External splint fixation

B. Open reduction with transosseous wire ligation

C. Percutaneous intramedullary pinning

D. Gunning splint

The correct answer is D. Gunning Splint.

Treating edentulous mandibular fracture is difficult in elderly patients due to compromised medical condition of the patient and various contraindications for the surgical approach. The complication rate of infection or malunion is higher compared to fractures in younger, dentulous patients. For such conditions, ‘Gunning splint’ is a better option as it provides close reduction and stabilization of mandibular fracture, thus improving the prognosis.

A Gunning splint is a type of orthopedic splint that can be used to immobilize and support the mandible. It is typically made of a rigid material, such as metal or plastic, and is shaped to fit around the mandible. The splint is named after William Gunning, who is credited with developing the design in the 19th century. Gunning splints are typically used to treat injuries or conditions that affect the mandible, such as fractures, sprains, or strains. They are also used to support and stabilize the mandible following surgery. The splint is typically attached to the mandible using wires or bands that are passed through holes in the splint and secured to the teeth or gums. The splint is then tightened to hold the mandible in place.

PGCEE MDS 2022 : The active ingredient of tooth mousse is:

 # The active ingredient of tooth mousse is:

A. Xylitol

B. Calcium

C. Casein

D. Chlorhexidine

The correct answer is C. Casein.

Tooth Mousse is a topical oral health product that was developed at the Melbourne Dental School, University of Melbourne.

Tooth Mousse comes in the form of a foamy crème, and is available in a range of flavours including: Melon, Strawberry, Tutti-Frutti, Mint and Vanilla.

Tooth Mousse contains casein (a major milk protein), as well as calcium and phosphate. Calcium and phosphate are the major minerals that teeth are made from.

Tooth Mousse is available in two product options: with or without fluoride. The general Tooth Mousse product does not contain fluoride, whereas Tooth Mousse Plus does contain fluoride.

Tooth Mousse is not toothpaste. It is made of milk products so swallowing the product is safe and it can be used throughout the day.

PGCEE MDS 2022: Which periodontal fibres are consistent

 # Which periodontal fibres are consistent and are reconstructed even after the destruction of the alveolar bone? 

A. Apical

B. Oblique

C. Alveolar crest group

D. Transseptal

The correct answer is D. Transseptal.

Transseptal group of PDL fibers

Functions: 

- Reconstructed even after destruction of the alveolar bone has occurred in the periodontal disease. 

- Responsible for returning teeth to their original state after orthodontic therapy. 

Position: 

Extends interproximally over alveolar bone crest and embedded in the cementum of adjacent teeth 

PGCEE MDS 2022: Ringer’s lactate does not contain:

 # Ringer’s lactate does not contain:

A. Sodium

B. Chloride

C. Calcium

D. Magnesium

The correct answer is D. Magnesium.

Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by intravenous infusion or applied to the affected area. 

PGCEE MDS 2022 : Commonest cause of TMJ ankylosis is:

 # Commonest cause of TMJ ankylosis is:

a) Trauma

b) Development disturbances

c) Infections 

d) Atrophy

The correct answer is A. Trauma. 

The definite cause of ankylosis of TMJ is unknown. Two main factors predisposing to the ankylosis are trauma and infection in or around the joint region. In 1968, Topazian reported that 26 to 75 percent of cases of TMJ ankylosis are seen following trauma, while 44 to 68 percent are seen due to infection. 

A high percentage of TMJ ankylosis are seen following trauma. At birth, TMJ may receive trauma from a forceps delivery. Trauma during intrauterine life leads to congenital ankylosis.

PGCEE MDS 2022 MCQ: Enzymes are generally:

 # Enzymes are generally:

A. Proteins

B. Carbohydrate

C. Lipid

D. Vitamin

The correct answer is A. Proteins. 

Enzymes may be defined as biocatalysts synthesized by living cells. They are protein in nature (exception - RNA acting as ribozyme), colloidal and thermolabile in character, and specific in their action.