The most important diagnostic test to differentiate between an acute periapical abscess and a phoenix abscess is: PGCEE MDS 2022

 # The most important diagnostic test to differentiate between an acute periapical abscess and a phoenix abscess is: 

a) Pulp testing

b) Radiographs

c) History

d) Percussion

The correct answer is B. Radiographs.

Phoenix abscess is an acute inflammatory reaction superimposed on an existing chronic lesion, such as a cyst or granuloma. The exacerbation of a chronic lesion is most commonly associated with the initiation of root canal therapy in a completely asymptomatic tooth. In such a tooth, radiographs show well-defined periradicular lesions.

The deciduous tooth which does not have a resemblance to any other teeth is: PGCEE MDS 2022

 # The deciduous tooth which does not have a resemblance to any other teeth is:

a) Maxillary first molar 

b) Mandibular first molar

c) Maxillary 2nd molar 

d) Mandibular canine

The correct answer is B. Mandibular first molar.

The deciduous mandibular first molar is unique in that it has a crown form unlike that of any permanent tooth. It does, however, have two strong roots, one mesial and one distal—an arrangement similar to that of a mandibular permanent molar. These two primary teeth, the maxillary and mandibular first molars, differ from any teeth in the permanent set when crown forms are compared, in particular.

The microorganism most commonly cultured from a chronic bilateral ulcer at the corner of the mouth: PGCEE MDS 2022

 # The microorganism most commonly cultured from a chronic bilateral ulcer at the corner of the mouth:

a) Mucor 

b) Candida

c) Treponema 

d) Aspergillus

The correct answer is B. Candida. 

Angular cheilitis (AC) is inflammation of one or both corners of the mouth. Often the corners are red with skin breakdown and crusting. It can also be itchy or painful. The condition can last for days to years. Angular cheilitis is a type of cheilitis (inflammation of the lips).

Angular cheilitis can be caused by infection, irritation, or allergies. Infections include fungi such as Candida albicans and bacteria such as Staph. aureus. Irritants include poorly fitting dentures, licking the lips or drooling, mouth breathing resulting in a dry mouth, sun exposure, overclosure of the mouth, smoking, and minor trauma. Allergies may include substances like toothpaste, makeup, and food. Often a number of factors are involved. Other factors may include poor nutrition or poor immune function. Diagnosis may be helped by testing for infections and patch testing for allergies.

Phlegmon is a: PGCEE MDS 2022

 # Phlegmon is a:

a) Sexually transmitted disease

b) Type of cellulitis

c) Type of osteomyelitis 

d) Venereal disease

The correct answer is B. Type of  cellulitis.

Cellulitis or Phlegmon is a diffuse inflammation of soft tissues that\ is not circumscribed or confined to one area, but which, contrary to the abscess, tends to spread through tissue spaces and along fascial planes. This type of reaction occurs due to infection by microorganisms that produce significant amounts of streptokinase, hyaluronidase (the spreading factor of Duran-Reynolds) and fibrinolysins, which act to breakdown or dissolve hyaluronic acid, the universal intercellular cement substance, and fibrin. Streptococci are particularly potent producers of hyaluronidase and are therefore a common causative organism in cases of cellulitis. Streptococci in their growth phase consume local oxygen and metabolize nutrients to produce an acidic environment, which is conducive to the subsequent growth of anaerobic microbes. The anaerobes such as Prevotella and Porphyromonas species destroy collagen.

PGCEE MDS 2022: Hesitation cuts are seen in a case of:

 # Hesitation cuts are seen in a case of:

A. Homicide 

B. Suicide

C. Accident 

D. Fall from height

The correct answer is B. Suicide.

Hesitation cuts/marks or tentative cuts or trial wounds: These cuts are multiple, small, and superficial often involving only the skin, and are seen at the beginning of the incised wound, presumably hesitating while gaining the courage to make a final decisive cut.

- A person who commits suicide exposes his body by opening his clothes and then inflicts the wounds.

- When a safety razor blade is used, unintentional cuts are found on the fingers where the blade has been gripped.

- Most people have a vague knowledge of anatomy and do not know where to cut a major blood vessel, and may cut their forearms vertically, rather than horizontally.

PGCEE MDS 2022: Radiographic investigation for multiple implant screening is:

 # Radiographic investigation for multiple implant screening is: 

A. Intraoral periapical radiograph

B. Panoramic radiograph

C. CBCT

D. Magnetic resonance imaging

The correct answer is B. Panoramic radiograph.

The primary advantage of the panoramic radiograph is that it is a screening tool to evaluate for pathology within the hard tissues. It may also be beneficial to ensure that root tips and other structures are not in the surgical site. As a general rule, sinus pathology is difficult to observe on this film, and other tools are usually necessary (e.g., CT scans).

When the 25% average magnification is accounted for on the film, it may categorize the patient into three different groups:

(1) there is obviously enough vertical bone to place and implant,

(2) there is obviously not enough vertical bone to place an implant, or 

(3) the amount of vertical bone necessary to place an implant is not obvious.

Advantages of panoramic radiograph

• Easy identification of opposing landmarks

• Initial assessment of vertical height of bone

• Convenience, ease, and speed in performance in most dental offices

• Evaluation of gross anatomy of the jaws and any related pathologic findings*

Limitations

• Distortions inherent in the panoramic system

• Errors in patient positioning

• Does not demonstrate bone quality

• Misleading measurements because of magnification and no third dimension

• No spatial relationship between structures

PGCEE MDS 2022: Most common mode of transmission in nosocomial infections is by:

 # Most common mode of transmission in nosocomial infections is by:

A. Contact transmission

B. Droplet transmission

C. Airborne transmission

D. Vector borne transmission

The correct answer is A. Contact transmission.

A hospital-acquired infection, also known as a nosocomial infection (from the Greek nosokomeion, meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a healthcare–associated infection. Such an infection can be acquired in hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. 

Main Roots of Transmission

I) Contact Transmission: The most important and frequent mode of transmission of nosocomial infections is by direct contact.

II) Droplet transmission: Transmission occurs when droplets containing microbes from the infected person are propelled a short distance through the air and deposited on the patient's body; droplets are generated from the source person mainly by coughing, sneezing, and talking, and during the performance of certain procedures, such as bronchoscopy.

III) Airborne transmission: Dissemination can be either airborne droplet nuclei (small-particle residue {5 µm or smaller in size} of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or dust particles containing the infectious agent. Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors; therefore, special air-handling and ventilation are required to prevent airborne transmission. Microorganisms transmitted by airborne transmission include Legionella, Mycobacterium tuberculosis and the rubeola and varicella viruses.

IV) Common vehicle transmission: This applies to microorganisms transmitted to the host by contaminated items, such as food, water, medications, devices, and equipment.

V) Vector borne transmission: This occurs when vectors such as mosquitoes, flies, rats, and other vermin transmit microorganisms.