4th Year BDS - Public Health Dentistry - VIIth Sem Exam, Feb 2018 - BPKIHS

B.P. Koirala Institute of Health Sciences
Dharan, Nepal
4th year BDS
Internal Assessment, February 2018
Subject: Public Health Dentistry
Date: 14th February, 2018
Time : 1 Hour 20 minutes
Total marks: 60

SECTION 'A'

SHORT ANSWER QUESTIONS

Maximum Marks  - 30

1. Enlist and explain the principles of primary health care.     (1+4=5)

2. Diffferentiate between case control and co-hort studies.   (5)

3. Describe the expression repeat restoration cycle.   (5) 

4. Define Dental Public Health. Briefly explain the characteristics of public health work. (1+4=5)

5. Explain various methods by which you can prevent transmission of infections between patient and health care personnel.    (5)

6. Explain Salivary reductase caries activity test.   (5)

SECTION 'B' 

MODIFIED ESSAY QUESTION

Maximum Marks - 30

I. In a recent epidemiological study, it was observed that among 50 individuals with oral cancer, 40 

consumed smokeless tobacco at least 4 times a day and the rest did not consume tobacco at all. Among the group of 200 individuals without oral cancer, 120 consumed tobacco in the same frequency.

1. Justify the type  of epidemiological study that was conducted.  (3)

2. Describe the basic steps for conducting the study.  (3) 

3. Identify and explain the epidemiological tools to  be used in the study.  (3)

4. Describe the appropriate analyses and obtain the results.  (6)

II. Water is a vital factor to all forms of life. It has a great role to play in the socio-economic development of huma population. UnitedNations General Assembly had launched the International Drinking Water Supply and Sanitation decade 1981-1990 and it is also emphasized that water is a basic element of primary health care. Water is also integrated with other PHC components because It is an essential part of health education, food and nutrition an also Maternity and Child Health.

Q5. Enlist the properties of water intended For human consumption. Mention the advantages and disadvantages of ground water. (2+2+1=5) 

Q6. Briefly explain biological filter. (5) 

Q7. How can you purify water for household use? Explain. (5) 

Drug Interactions with Local Anesthetics

1. Cimetidine increases the plasma half life of circulating lidocaine. So this combination is relatively contraindicated in CHF patients.
2. Esters such as procaine and tetracaine may inhibit the bacteriostatic action of sulfonamides.
3. The administration of adrenaline in patients being treated with non-selective beta blockers (such as propranolol, tinolol, atenolol, increases the likelihood of serious elevation of the blood pressure.
4. Tricyclic antidepressants (eg: Imipramine) and monoamine oxidase inhibitors (eg: Isocarbaxazid) potentially increase the cardiovascular actions of exogenously administered vasopressors.

Dentosphere: World of Dentistry - Video Competition

Dentosphere : World of Dentistry announces VIDEO COMPETITION on the occasion of its second anniversary  and reaching the 3000 subscribers mark in its YouTube Channel. We are grateful to all our Subscribers and are pleased to announce a video competition.

RULES:
1. The deadline for submission is 25th March 2018. All the videos will be uploaded by 31st March 2018. The video getting highest  number of views until 31st May will be announced as winner on 1st June 2018. NOTE: The earlier you submit, the more chance of your video getting more views before the deadline.

2. Length of the video can be anywhere between 3-15 minutes. (at least 3 minutes)

3. Appropriate references and credits should be placed by the creators themselves for academic information.

4. The videos may be slightly edited before uploading.

5. The video must be your original work. Any videos copied from online media will be detected and automatically disqualified.

Some ideas for video topics may be:
# Oral Cancer Prevention
# Toothbrushing Techniques
# Hand Washing Technique
# How to use a dental floss
# The reasons you should quit smoking
# Oral health is overall health
# Health hazards of Cigarette Smoking and other forms of Tobacco
# Dental Caries : Prevalence and Prevention
# Roles of a Dentist towards Community
And many more. You can choose any topic you like.

For any queries and any help if needed, please contact: dentosphere.worldofdentistry@gmail.com

You may visit our channel Dentosphere : World of Dentistry at: www.youtube.com/DentCareNepal

PLEASE SHARE THIS TO YOUR STUDENTS, COLLEAGUES AND FRIENDS OF YOUR COLLEGE AS WELL AS ANY OTHER DENTAL COLLEGES.

MCQs on Pontics and Finish Lines - Fixed Partial Dentures

# Egg shaped pontic is indicated for the replacement of:
A. Mandibular posteriors
B. Mandibular anteriors
C. Maxillary posteriors
D. Maxillary anteriors

# A pontic as compared to a missing posterior tooth should be:
A. same dimensions as that of natural teeth
B. same dimensions mesiodistally but less faciolingually
C. same dimensions faciolingually but less mesiodistally
D. larger than natural tooth, to exert same forces on mastication

# Which of the following will primarily determine the faciolingual dimension of the occlusal portion of a hygienic pontic?
A. The length of the pontic
B. The masticatory force of the patient
C. The position of the opposing contact areas
D. The width and crestal position of the edentulous ridge

MCQs on Oral Pre-cancer and Oral Cancer - Oral Medicine and Radiology

# The current “gold standard” for predicting the malignant potential of the precancerous lesions is the:
A. presence & degree of dysplasia
B. presence of candidal hyphae
C. presence of red areas in the lesion
D. site of the lesions

# Which of the following viruses is not an oncovirus?
A. Herpes Simplex Virus
B. Human Papilloma Virus
C. Varicella zoster Virus
D. Epstein Barr Virus

# Which type of inflammatory cells predominate in the infiltrate of invasive carcinoma?
A. Monocyte
B. T lymphocyte
C. CD 8 lymphocyte
D. Langerhan's cell

# The fixation of lymph nodes to adjacent tissues in cases of malignancy is due to:
A. Secondary infection
B. protective mechanism of body
C. invasion of malignant cells through capsule
D. matting of lymph nodes

# Which of the following is not a Tumor suppressor gene?
A. p53
B. p161NK4A
C. bcl – 2
D. FHIT (fragile histidine triad)

# A tumor classified as T1 N2 M0 belongs to which stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

# Which is the preferred method of biopsy in case of a malignant involvement of lymph node?
A. Fine needle aspiration
B. Incisional biopsy
C. Excisional biopsy
D. No biopsy

# Leukoplakia in which of the following sites poses high risk comparatively?
A. Gingiva
B. Buccal mucosa
C. Floor of the mouth
D. Palate

# Which of the following statements is true regarding the effects of hyperfractionation of radiation therapy?
A. Chronic complications are more
B. Acute complications are more
C. Acute complications are more & chronic complications are less
D. Both, acute & chronic complications are less

# Which of the following tumors are highly sensitive to radiation therapy?
A. Well differentiated squamous cell carcinoma
B. Malignant lesion with bone invasion
C. Mucosal lesions
D. Lesions with extensive node involvement

# Which of the statements given below is true?
A. Leukoplakia in nonsmokers has a greater risk for malignant transformation than leukoplakia of smokers
B. Alcohol consumption alone can be associated with an increased risk of developing leukoplakia
C. Invasion of dysplastic epithelial cells is seen in basement membrane zone in Carcinoma in situ
D. Verrucous leukoplakia is usually seen in older adults


# Which of the following investigative procedures is gold standard for achieving the diagnosis in case of a oral leukoplakia?
A. Toluidine blue staining
B. Brush biopsy
C. Cytosmear
D. Biopsy

# Choose the correct sequence. The risk of malignant conversion of oral leukoplakias in decreasing order is:
A. Homogenous – verrucous – speckled
B. Verrucous – homogenous – speckled
C. Speckled – homogenous – verrucous
D. Speckled – verrucous – homogenous

# Bowen?s disease mimics which of the following lesions
A. Erythroplakia
B. Leukoplakia
C. Verrucous carcinoma
D. Traumatic keratosis

# Erythroplakic lesion of oral cavity mimics all of the following lesions except:
A. Denture stomatitis
B. Vascular lesion
C. Syphilitic patch
D. Inflammatory lesion

# Which of the following diseases has the highest malignant transformation rate?
A. Leukoplakia
B. Erythroplakia
C. Oral Lichen planus
D. Oral submucous fibrosis

# Widely accepted etiological factor in case of oral submucous fibrosis is:
A. Areca Nut
B. Tobacco
C. Chillies
D. Vitamin deficiency

# Which of the following is not a premalignant condition?
A. Oral lichen planus
B. Oral submucous fibrosis
C. Xeroderma pigmentosum
D. Cheilitis granulomatosa

# Exposure to ultraviolet rays, particularly from sun light causes all of the following lesions except:
A. Basal cell carcinoma
B. Actinic keratosis
C. Adenoid cystoc carcinoma
D. Malignant melanoma

# Which of the following is an antioxidant that is used in the chemoprevention of oral cancer?
A. Iron
B. Bleomycin
C. Methotrexate
D. Selenium

# Which stage of syphilis is a pre-disposing condition to oral cancer?
A. Primary stage
B. Secondary stage
C. Tertiary stage
D. Syphilis is not a predisposing condition to oral cancer

# Malignant transformation rate of oral leukoplakia globally is:
A. 18 - 20 %
B. 3 - 6 %
C. 0 - 1 %
D. 0.5 - 0.1 %

# Presence of multiple pre-malignant lesions in oral cavity is aptly called as:
A. Premalignant condition
B. Field cancerization
C. Immunocompromised
D. Premalignant syndrome

# “Ebbing tide type” leukoplakias are described in which part of oral cavity?
A. Buccal Mucosa
B. Gingiva
C. Vestibule
D. Floor of mouth

# “Eliptical rima Oris” is a clinical feature of:
A. Oral Submucous fibrosis
B. Oral lichen planus
C. Oral cancer
D. Oral erythroplakia

# Spindle cell carcinoma is also known as Carcino-sarcoma because:
A. it is a combination of carcinoma & sarcoma
B. Sarcoma occurs in a carcinomatous tissue later
C. presence of Spindle shaped cells gives false appearance of sarcoma
D. it is a lesion which can metastasize in both blood & lymphatics

# In vital staining technique using toluidine blue for detection of oral precancer & cancer __________ acid is used.
A. 4% hydrochloric acid
B. 1% Sulphuric acid
C. 1% Acetic acid
D. 10% Formic acid

# Which of the following variety of oral cancer has slow growth & rarely metastasizes?
A. Verrucous carcinoma
B. Melanocarcinoma
C. Adenocarcinoma
D. Carcinosarcoma

# Which are the two more parameters that were later added to TNM system of staging?
A. Age and sex
B. Age and Site
C. Site and pathology
D. Sex and pathology

# One of the following clinical features is not seen in Oral sub mucous fibrosis:
A. Xerostomia
B. Pain in ear
C. Excessive salivation
D. Enlarged uvula

# “Ribbon like” epithelium is seen in which of the following diseases histopathologically?
A. Oral Lichen planus
B. Oral Submucous Fibrosis
C. Verrucous carcinoma
D. Leukoplakia

# Deficiency of which vitamin can induce metaplasia & keratinisation of certain epithelial structures leading to oral leukoplakias?
A. Vit. A
B. Vit. C
C. Vit. D
D. Vit. K

# Muscle degeneration is seen which of the following precancerous conditions?
A. Lichen planus
B. Oral submucous fibrosis
C. Discoid Lupus erythematosus
D. Xerostomia pigmentosum

# In radiation therapy, deep seated lesions are usually irradiated with:
A. X ray photon
B. Electron
C. Neutron
D. Proton

# Radioisotopes are used in which of the following treatment procedures of cancer?
A. Teletherapy
B. Chemotherapy
C. Brachytherapy
D. Immunotherapy

# Most of the ____________ carcinomas of oro-facial region spread by local infiltration, or perineural invasion or hematogenous spread and less commonly through lymphatics.
A. Melano
B. Adeno
C. Basal
D. Neuro

# Which of the following adeno-carcinomas have a capsule?
A. Acinic cell carcinoma
B. Clear cell carcinoma
C. Adenoid cystic carcinoma
D. Mucoepidermoid carcinoma

# Which of the following malignancies has the highest incidence of metastasizing to jaws?
A. Thyroid
B. Breast
C. Prostate
D. Renal

# Intra epithelial carcinoma is a:
A. Pre-cancerous lesion
B. Squamous cell carcinoma
C. Lesion which can metastasize to different epithelia
D. Aggressive lesion

# Chemotherapy is used to treat oral malignancies in:
A. order to cure the lesion completely
B. advanced disease & recurrent tumors
C. order to control primary tumor
D. adjuvant with immunotherapy

Oral Medicine and Radiology MCQs - Acute and Chronic infections of the Jaw

# Cotton Wool appearance on a radiograph may be indicative of:
A. Acute suppurative osteomyelitis
B. Chronic suppurative osteomyelitis
C. Diffuse sclerosing osteomyelitis
D. Proliferative periostitis

# Lues maligna is a form of:
A. Severe malignant melanoma
B. Lyell's disease
C. Secondary syphilis
D. Hansen's disease

SYNOPSIS - INTRODUCTION TO ORTHODONTICS

Orthodontics (Greek. orthos = correct; odontos = teeth) is that branch of dentistry concerned with prevention, interception and correction of malocclusion and other abnormalities of the dento-facial region. The term 'Orthodontics' was first coined by le Felon.