The gene that defines the localization of the tooth germs is:

  # The gene that defines the localization of the tooth germs is:

A. FGF-8

B. BMP-2

C. Dlx-5

D. Pax-9

The correct answer is D. Pax-9.

During tooth development, several mesenchymal molecules and their receptors act as mediators of epithelial - mesenchymal interactions. Bone morphogenetic proteins (BMPs) 2,4,7 mRNAs shift between epithelium and mesenchyme during regulation of tooth morphogenesis. Fibroblast growth factor (FGF8, FGF9) have been localized in the dental mesenchyme and act via downstream factors MSX1 and PAX9. Muscle specific homeobox genes MSX-1 and Msx-2, appear to be involved in epithelial mesencymal interactions and craniofacial development, particularly in the initiation of developmental position (Msx-1) and further development (Msx-2) of tooth buds.Pax-9 is transcription factor necessary for tooth morphogenesis. 



Salivary gland aplasia is seen in:

 Salivary gland aplasia is seen in:

A. Hemifacial microsomia

B. LADD syndrome

C. Mandibulofacial dysostosis (Treacher Collins)

D. All of the above

The correct answer is D. All of the above.

Aplasia occurs for unknown reasons as an isolated finding or in conjunction with other developmental defects such as hemifacial microsomia, the LADD syndrome and mandibulo-facial dysostosis (Treacher Collins). In the more severe cases, the ensuing xerostomia causes clinical problems. Salivary loss leads to increased caries, burning sensations, oral infections, taste aberrations and difficulty with denture retention. 

A 70 year old patient comes with complaint of headache, nausea, tenderness over temporal region, diagnosis is:

 # A 70 year old patient comes with complaint of headache, nausea, tenderness over temporal region, diagnosis is? 

A. Aneurysmal arterial dilatation with sub-intimal inflammation 

B. Granulomatous inflammation with giant cell arteritis

C. Luminol thrombosis 

D. Acute organizing thrombus formation

The correct answer is B. Granulomatous inflammation with giant cell arteritis.

Temporal arteritis is to be suspected in an elderly patient presenting with headache, visual symptoms (blindness), fever, malaise, weakness, pain and tenderness over temporal artery (thick cord like sensation) and a raised ESR. 

Temporal (giant cell) arteritis is an inflammatory disorder of arteries that frequently involves the extracranial carotid circulation. The average age of onset is 70 years (elderly), and women account for 65% of cases. About half of patients with untreated temporal arteritis develop blindness due to involvement of the ophthalmic artery and its branches. lschemic optic neuropathy induced by giant cell arteritis (granulomatous inflammation) is the major cause of rapidly developing bilateral blindness in patients >60 years. 

Typical presenting symptoms include headache, polymyalgia rheumatica jaw claudication, fever, and weight loss. Headache is the dominant symptom and often appears in association with malaise and muscle aches. Head pain may be unilateral or bilateral and is located temporally in 50% of patients but may involve any and all aspects of the cranium. Pain usually appears gradually over a few hours before peak intensity is reached; occasionally, it is explosive in onset. 

The erythrocyte sedimentation rate (ESR) is often, though not always, elevated; a normal ESR does not exclude giant cell arteritis. A temporal artery biopsy followed by immediate treatment with prednisone (glucocorticoids) 80 mg daily for the first 4-6 weeks should be initiated when clinical suspicion is high. 

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The assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered is:

 # The assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered is: 

A. Quality Assessment 

B. Quality Assurance 

C. Quality Planning 

D. Guidelines 

The correct answer is B. Quality Assurance.

The ADA defines quality assessment as 'the measure of the quality of care provided in a particular setting'. 

Quality assurance in turn is defined as 'the assessment or measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered'.

The difference in these definitions is important: Quality assessment is limited to the appraisal of whether or not standards of quality have been met, whereas quality assurance includes the additional dimension of action to take corrective steps if needed to improve the situation. 

Collagen turnover rate in the gingiva is:

 # Collagen turnover rate in the gingiva is:

A. lower than that in the periodontal ligament

B. Higher than that in the periodontal ligament

C. Equal to that in the periodontal ligament

D. Very less as collagen fibrils are mature cell components

The correct answer is A. Lower than that in the periodontal ligament.

Overall, collagen turnover rate in the gingiva is lower than that in the periodontal ligament. Slow gingival fiber turnover may result from the lowered functional stress on this tissue as the transseptal fibers function in a manner similar to tendons, providing firm anchorage of the tooth. Remodeling and regeneration of gingival epithelium can also be slow. This is evidenced by the appearance of a red patch in the soft tissue region away from which a tooth is moved, which is caused by exposure of tissues underneath the epithelium.

Commonest type of lung carcinoma in non smokers:

# Commonest type of lung carcinoma in non smokers:

A. Squamous cell carcinoma

B. Adenocarcinoma

C. Alveolar cell carcinoma

D. Small cell carcinoma

The correct answer is B. Adenocarcinoma. 

Types of Lung Carcinoma:

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common type, accounting for about 80% of all lung cancers. Here's a breakdown of the options you provided:

Squamous cell carcinoma: This is a type of NSCLC that typically starts in the flat cells lining the airways of the lungs. Smoking is a major risk factor for squamous cell carcinoma.

Adenocarcinoma: This is also a type of NSCLC, and it's the most common type of lung cancer diagnosed in both smokers and non-smokers. It starts in the gland cells that make mucus in the lungs.

Alveolar cell carcinoma: This is a rare type of lung cancer that starts in the air sacs of the lungs. It's more common in smokers than non-smokers.

Small cell carcinoma: This is an aggressive type of lung cancer that can spread quickly. It's less common than NSCLC and is also more likely to occur in smokers.

Why Adenocarcinoma in Non-Smokers:

While smoking is the leading cause of lung cancer,  adenocarcinoma can develop in people who have never smoked. Here's why it's the most common type in non-smokers:

Risk Factors: Non-smoking related risk factors for adenocarcinoma include exposure to radon gas, secondhand smoke, air pollution, and a family history of lung cancer.

Cell Type: Adenocarcinoma originates in the gland cells lining the lungs, which are less affected by smoking compared to the cells targeted by squamous cell carcinoma.

Mutations:  Non-smokers with lung cancer are more likely to have specific gene mutations, particularly in the EGFR gene, which can drive the development of adenocarcinoma.