lymphatic drainage of the oral structures- mcq review

1.You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the

a) hard palate.

b) hard palate and upper lip.

c) hard palate, upper lip and upper central incisor.

d) hard palate, upper lip, upper central incisor and lower first molar.

2.The regional lymphatic drainage of the left side of the tip of the tongue is to the

a) left submental lymph node.

b) left and right submental lymph nodes.

c) left submandibular lymph node.

d) left and right submandibular lymph nodes.

The skin of the head and neck drains

The scalp drains into the occipital, mastoid and parotid nodes.

Lower eye lid and anterior cheek drains into buccal LNs.

The cheeks drain into the parotid, buccal and submandibular nodes.

The upper lips and sides of the lower lips drain into the submandibular nodes.

 The middle third of the lower lip drains into the submental nodes

The skin of the neck drains into the cervical nodes.

The drainage of the oral structures

The gingivae drain into the submandibular, submental and upper deep cervical lymph nodes.

The palate lymph vessels may pass to submandibular or superior deep cervical nodes (level II). Retropharyngeal nodes are very rarely involved.

Teeth drain into the submandibular and deep cervical lymph nodes.

Anterior part of mouth floor drain into submental and upper deep cervical.

Posterior part of mouth floor  into submandibular and upper deep cervical.

Inferior alveolar nerve block- mcq review

During an inferior alveolar nerve block the needle ideally passes

a) posterior and medial to medial pterygoid.

b) anterior and lateral to medial pterygoid.

c) through medial pterygoid.

d) inferior to medial pterygoid.

MANDIBULAR FRACTURES MCQ REVIEW

TYPE OF FRACTURE

Simple

Includes a closed linear fractures of the condyle, coronoid, ramus and edentulous body of the mandible.

Compound

Fractures of tooth bearing portions of the mandible, into d mouth via the periodontal membrane and at times through the overlying skin.

Communited

Usually compound fractures characterized by fragmentation of bone

Pathological

Results from an already weakened mandible by pathological conditions.

SITE OF FRACTURE

Dentoalveolar

Condyle

Coronoid

Ramus

Angle

Body (molar and premolar areas)

Parasymphysis

Symphysis

CAUSES OF GINGIVAL RECESSION MCQ REVIEW

What  is Periodontal fremitus

Periodontal fremitus occurs in either of the alveolar bones when an individual sustains trauma from occlusion. It is a result of teeth exhibiting at least slight mobility rubbing against the adjacent walls of their sockets, the volume of which has been expanded ever so slightly by inflammatory responses, bone resorption or both. As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect fremitus.

EFFECTS OF DRUGS ON THE TEETH, ORAL MUCOSA AND SALIVARY GLANDS

Best of fives for dentistry- Sjögren's syndrome mcq review

                                                           Sjögren's syndrome

What is CREST?

CREST is a form of Systemic Sclerosis (scleroderma) which is characterized by Calcinosis (calcium deposits), usually in the fingers; Raynaud's;loss of muscle control of the Esophagus, which can cause difficulty swallowing; Sclerodactyly, a tapering deformity of the bones of the fingers; and Telangiectasia, small red spots on the skin of the fingers, face, or inside of the mouth. (Also see: What is Scleroderma?, Types of Scleroderma and Systemic Symptoms)

Calcinosis            Raynaud's              Esophagus            Sclerodactyly            Telangiectasia

It takes only two of the five CREST symptoms for a diagnosis of  CREST (either "pure" or "plus") to be made. For example, a patient with Calcinosis and Raynaud's would have CREST (which for precision may also be written as CRest, but it is CREST nonetheless.)

CALCINOSIS

The systemic forms of scleroderma can cause small white calcium lumps to form under the skin on fingers or other areas of the body.

This is called calcinosis . The lumps may break through the skin and leak a chalky white liquid.

These most commonly occur on the hands, or near joints such as elbows or knees, although they may appear anywhere.

Raynaud's

Raynaud's is a vascular disorder commonly found in sclerodema. It is an extreme spasm of blood vessels in response to cold or stress. The fingers and/or toes become white and/or blue, and may become red on re-warming.

sclerodactyly

When the skin on the fingers become tight, stretched, wax-like, and hardened it is called sclerodactyly. Sclerodactyly is commonly associated with atrophy of the underlying soft tissues.

Telangiectasia are dilated superficial blood vessels

Candidosis mcq review

Kaposi's sarcoma

giant cell arteritis

Orofacial granulomatosis MCQ review

Bilateral parotid swelling MCQ review

Trigeminal Neuralgia mcq review

best of five in dentistry review

Recurrent herpes(herpes labialis)

                                                  Giant cell arteritis

                                              Burning mouth syndrome

Best of five Review - Angular cheilitis

Angular cheilitis

Angular cheilitis is a combined staphylococcal, streptococcal, and candidal infection, involving the tissues at the angle of the mouth, often with an underlying precipitating factor, e.g. iron deficiency and B12 deficiency anaemia. Therefore, haematological deficiency should be investigated with a FBC red cell folate, B12, and glucose.

Anecdote suggests an inadequate OVD can also predispose, but correction of this alone will not resolve the condition. Often associated with chronic atrophic candidosis. Clinically, see red, cracked, macerated skin at angles of the mouth, often with a gold crust.

Infecting organisms can be identified on culture of swabs of the area, although it is usual to make a clinical diagnosis.

Rx: miconazole cream, which is active against all three infecting organisms. Rx needs to be prolonged, up to 10 days after resolution of clinical lesion, and carried out in conjunction with elimination of any underlying factors.

Unless the classic golden yellow crusts associated with S. aureus are present, treatment should be commenced with antifungal drugs, e.g. a combined miconazole/hydrocortisone cream (miconazole has some antibacterial properties).

When clinical features indicate S. aureus infection, fusidic acid cream is appropriate. If intra-oral candidiasis is present, this must be treated concurrently or recurrence of the angular stomatitis will occur. Iron deficiency is a significant aetiological factor in angular cheilitis.

Patterson–Brown-Kelly syndrome (Plummer–Vinson syndrome)

Dysphagia (due to a post-cricoid candida web), microcytic

hypochromic anaemia, koilonychia and angular cheilitis (secondary to the anaemia)

MCQ Questions and Answers in Dentistry- IV

1. Examination reveals area of gingival recession, exposed wide area of dental roots. Which is the procedure of choice to obtain coverage of the root surface

 A. Free gingival autograft

B. Sub-epithelial tissue graft

C. Apically positioned graft

D. Free gingival graft

E. Modified wide flap

2. What does contra indicate distal wedge in molars’ area

 A. Distal fluting

B. Long attached gingiva

C. Sharply ascending ramus that limits space distal to molars

D. Supra bony pockets distal to molars

3. Which of the following is not a property of Fluoride ion

 A. Crosses placental barrier

B. Deposits in bone

C. Excretes rapidly by kidney

D. Bacteria static

E. Produces extrinsic tooth stain

4. Two conditions of enamel facilitate post eruptive uptake of fluoride element

 A. Hyper mineralisation and surface dentine

B. Surface demineralisation and hypo mineralisation

C. Dental fluorosis and enamel opacities

5. In regards to topically applied fluoride

A. Effective in incorporated into dental plaque

B. Inhibits acid demineralisation of enamel

6. Flexibility of the retentive clasp arm Does not relate to

 A. Length

B. Cross section

C. Material

D. Degree of taper

E. Under cut area

7. How long it would take to see the dentinal bridge after direct pulp capping by using Calcium hydroxide.

 A. 6-8 weeks

B. 4 weeks

C. 6-8 months

D. 4 months

8. What is contraindicated to the use of calcium hydroxide for pulp capping

 A. Accidental exposure of pulp

B. Carious exposure of pulp in otherwise asymptomatic tooth

C. Carious exposure of pulp in tooth that has been painful for weeks

9. How would you treat hyperaemia “hyperaemic tooth”

 A. Zinc Oxide and eugenol cement

B. Calcium hydroxide

C. Corticosteroid paste

10. Bilateral symmetrical swelling of the mandible of a child is likely to be caused by

 A. Acromegaly

B. Paget’s disease

C. Giant cell lesion

D. Primordial cysts

E. Dental cysts

Answers

Q1=A double check

Q2=C

Q3=E

Q4=C

Q5=A & B

Q6=E

Q7=A, 4 weeks in indirect pulp capping and 6-8 weeks in direct pulp capping

Q8=C

Q9=C, Useful when there is a hyperaemic pulp and failure of local anaesthesia; most commonly when there is an irreversible pulpitis and/or carious exposure. Use of these pastes may cause relief of symptoms, decreased inflammation with ability to successfully anaesthetise the tooth on the next

Q10=C, like cherubism

15 MCQs On Orthodontics

1. Methods of bite opening includes:

a) Intrusion of posterior teeth and extrusion of anterior teeth.

b) Extrusion of posterior teeth and intrusion of anterior teeth.

c) Mesialisation of posterior teeth.

d) Retroclination of incisors.

e) Lower incisor extraction.

Key: b

2. Cortical drift is a growth process involving:

a) Deposition of bone.

b) Resorption of bone.

c) Deposition and resorption.

d) Bone bending.

e) Apposition of bone.

Key: c

3. The focal film distance for a lateral cephalogram is:

a) Four feet.

b) Three feet.

c) Five feet.

d) Six feet.

e) Two feet.

Key: c

4. Moment is defined as:

a) Force x Distance from centre of rotation.

b) Force x Distance from centre of resistance.

c) Force x Range.

d) Force x Springback.

e) Force x Modulus of elasticity.

Key: a

5. Minimum anchorage is defined as:

a) 2/3 rd of extraction space is utilized by the movement of anchor unit.

b) ½ of the extraction space is utilized by the movement of anchor unit and the remaining ½ by the movement of the moving unit.

c) 1/3 rd of the extraction space is utilized by the movement of  anchor unit.

d) Absolutely no movement of anchor unit.

e) Absolutely no movement of anterior teeth.

Key: a

6. Classical pattern of extraction in Class II camouflage is:

a) Extraction of upper 1^st  premolars and lower canines.

b) Extraction of upper 1^st premolars and lower 2^nd premolars.

c) Extraction of all 2^nd premolars.

d) Extraction of upper 2^nd premolars and lower 1^st premolars.

e) Extraction of all 1st molars.

Key: b

7. Frontal cephalogram is used to:

a) Assess facial symmetry.

b) Overjet.

c) Dental compensation in sagital plane.

d) Deep bite.

e) Open bite.

Key: a

8. Natal teeth are defined as:

a) Teeth present at the time of birth.

b) Teeth erupting in the 2^nd -3^rd month.

c) Teeth erupting between 6 months to 2 year.

d) Teeth erupting after 1 year of age.

e) Teeth erupting after 2 years of age.

Key: a

9. 1^st order bends are:

a) Tipping bends.

b) Toquing bends.

c) In and out bends.

d) Anchorage bends.

e) Up and down bends.

Key: c

10. Cleft lip and palate patient often requires expansion. Appliance of choice in such cases is:

a) Hyrax appliance.

b) Hass appliance.

c) Cap splint type of expansion appliance.

d) SARPE.

e) Spring jet.

Key: c

11. The most common sequence of eruption of permanent dentition in upper arch is:

a) 6-1-2-3-4-5-7.

b) 6-1-2-4-3-5-7.

c) 6-1-2-5-4-3-7.

d) 6-1-3-2-4-5-7.

e) 6-2-3-4-5-1-7.

Key: a

12. Face mask is primarily used to produce:

a) Dorsal effect.

b) AP effect.

c) Ventral effect.

d) Transverse effect.

e) Vertical effect.

Key: b

13. Relapse in rotated teeth can be avoided:

a) By CSF.

b) By frenectomy.

c) By maintaining integrity of arch.

d) By extraction of retained teeth.

e) By scaling.

Key: a

14. Extraction is mandatory in the treatment of crowding if crowding is:

a) Less than 4mm.

b) More than 4mm and less than 9mm.

c) More than 10mm.

d) More than 4mm but O/J more than 6mm.

e) More than 4mm with –ive O/J.

Key: c

15. Decompenstaion is done as part of:

a) Convetntional orthodontics.

b) Pre-surgical orthodontics.

c) Camouflage treatment.

d) Surgical camouflage.

e) Interceptive orthodontics.

Key: b

MCQ Questions and Answers in Dentistry- III

16. Which of the following is TRUE in regards to high risk patient ?

A.  0.1ml of blood from Hepatitis B carrier is less infective than 0.1ml of blood from HIV patient

B. 0.1ml of blood from Hepatitis B carrier is more infective than 0.1ml of blood from HIV patient

C. Level of virus are similar in the blood and saliva of HIV patient

D. Level of virus in the saliva is not significant for Hepatitis B patient

E. The presence of Hepatitis B core Antigen in the blood means that active disease is not present

17. Your employer in an attempt to update office sterilization procedures; what would you recommend as the BEST method to verify that sterilization has occurred?

A.  Use spore test daily

B. Use indicator strips in each load and color change tape on each package

C. Use indicator strips daily and spore test weekly

D. Use color change tape daily and spore test monthly

E. Use color change tape in each load and spore tests weekly

18. A 65 year old woman arrived for dental therapy. The answered questionnaire shows that she is suffering from severe cirrhosis. The problem that can be anticipated in the routine dental  therapy is

A.  Extreme susceptibility to pain

B. Tendency towards prolonged haemorrhage

C. Recurring oral infection

D. Increased tendency to syncope

E. Difficulty in achieving adequate local anaesthesia

19. Loss of sensation in the lower lip may be produced by

A.  Bell’s palsy

B. Traumatic bone cyst 

C. Trigeminal neuralgia

D. Fracture in the mandible first molar region      

E. Ludwig’s angina

20. Patient received heavy blow to the right body of the mandible sustaining a fracture there. You should suspect a second  fracture is most likely to be present in

A.  Symphysis  region

B. Left body of the mandible

C. Left sub-condylar region

D. Right sub-condylar region

E. sub-condylar region

21. Signs and symptoms that commonly suggest cardiac failure in a patient being assessed for oral surgery are

A.  Elevated temperature and nausea

B. Palpitations and malaise

C. Ankle oedema and dyspnoea

D. Erythema and pain

E. Pallor and tremor

22. A cyst at the apex of an upper central incisor measuring 1 cm in diameter is visualized in radiograph and confirmed by aspiration biopsy; which method of treatment would you consider

A.  Extraction of the central incisor and retrieving the cyst through the socket

B. Exteriorizing the cyst through the buccal bone and mucosa

C. Making a mucoperiosteal flap and removing the cyst through an opening made in the alveolar bone, followed by tooth removal.

D.  Making a mucoperiosteal flap and removing the cyst through an opening made in the alveolar bone, followed by endodontic treatment.

E. Routine orthograde endodontic treatment followed by observation.

23. A persistent oroantral fistula for a 12 weeks period following the extraction of a maxillary first permanent molar is best treated by

A.  Further review and reassurance since it will most probably heal spontaneously

B. Antibiotic therapy and nasal decongestants

C. Curettage and dressing of the defect

D. Excision of the fistula and surgical closure

E. Maxillary antral wash out and nasal antrostomy.

24. The most significant finding in clinical evaluation of parotid mass may be accompanying

A.   Lymph adenopathy

B. Nodular consistency

C. Facial paralysis

D. Slow progressive enlargement 

E. Xerostomia

25. As far as surgical removal of wisdom teeth is concerned which of the following is true

A.   Prophylactic prescription of antibiotic reduces dramatically the chances of infection

B. Raising a lingual flap will increases the incidence of neurapraxia but will reduce the incidence of neurotmesis with respect to the lingual nerve

C. Prophylactic prescription of dexamethasone will dramatically reduces post operative swelling 

D. Inferior dental nerve injury is unlikely since the nerve passes medial to the wisdom tooth root

E. The use of vasoconstrictors in local anaesthetics will increase the chances of infection.

(Q16=B , Q17=E, Q18=B or prolonged bleeding , Q19= D, Q20=C, Q21=C , Q22=D Boucher 434 , Q23=D, Q24= C, Q25=A)

MCQ Questions and Answers- II

06.  A  45  year  old  patient  awoke  with  swollen  face,  puffiness around the eyes, and oedema of the upper lip with redness and dryness.  When  he  went  to  bed  he  had  the  swelling,  pain  or dental  complaints.  Examination  shows  several  deep  silicate restorations in the anterior teeth but examination is negative for  caries,  thermal  tests,  percussion,  palpation,  pain,  and periapical  area  of  rarefaction.  The  patient’s  temperature  is normal. The day before he had a series of gastrointestinal x-rays at the local hospital and was given a clean bill of health. The condition is

A.   Acute periapical abscess

B.   Angioneurotic oedema

C.   Infectious mononucleosis

D.   Acute maxillary sinusitis

E.   Acute apical periodontitis

07. Internal resorption is

A.   Radiolucency over unaltered canal

B.   Usually in a response to trauma

C.   Radiopacity over unaltered canal

08. On replantation of an avulsed tooth could see

A.  Surface resorption, external resorption

B. Internal resorption

C. Inflammatory resorption

D. Replacement resorption

E. A, C and D

F.  All of the above

09. The junction between primary and secondary dentine is?

A.   A reversal line

B.   Sharp curvature

C.   A resting line

D.   A reduction in the number of tubules

10. What is the correct sequence of events?

A.  Differentiation of odontoblast, elongation of enamel epithelium, dentine formation then  enamel formation.

B.  Differentiation of odontoblast, dentine formation then enamel formation, elongation of enamel epithelium.

C.  Elongation of enamel epithelium, differentiation of odontoblast, dentine formation then enamel formation.

11. What is the sequence from superficial to the deepest in dentine caries?

A. Zone of bacterial penetration, demineralisation, sclerosis, reparative dentine 

B. Zone of bacterial penetration, reparative dentine, demineralisation, sclerosis. 

C. Zone of bacterial penetration, sclerosis, reparative dentine, demineralisation.

12. In which direction does the palatal root of the upper first molar usually curve towards

A.  Facial / buccal/

B. Lingual

C. Mesial               

D.  Distal

13. Which of the following would be ONE possible indication for indirect pulp capping

A. Where any further excavation of dentine would result in pulp exposure.

B. Removal of caries has exposed the pulp

C. When carious lesion has just penetrated DEJ

14. Following trauma to tooth, the next day there was no response to pulp tests you should

 A.   Review again later

 B.   Start endodontic treatment

 C.   Extraction of tooth

15. Which is NOT TRUE in relation to the prescription of 5mg or 10mg of diazepam for sedation

A.   Patient commonly complain of post operative headache

B.   An acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively

C.  There is a profound amnesic action and no side affects

D. Active metabolites can give a level of sedation up to 8 hours post operatively

E. As Benzodiazepine the action can be reversed with Flumazepil

(Answers-Q6= B, Q7= B, Q8= E, Q9= C, Q10= A,  Q11= A, Q12= A, Q13= A, Q14= A, Q15=A)

MCQ Questions and Answers I

1. For lower premolars, the purpose of inclining the handpiece lingually is to

A.  Avoid buccal pulp horn

B. Avoid lingual pulp horn

C. Remove unsupported enamel 

D. Conserve lingual dentine

2. For an amalgam Restoration of weakened cusp you should

A.   Reduce cusp by 2mm on a flat base for more resistance

B.   Reduce cusp by 2mm following the outline of the cusp

C.   Reduce 2mm for retention form

3. Before filling a class V abrasion cavity with GIC you should

 A.   Clean with pumice, rubber cup, water and weak acid

B.   Dry the cavity thoroughly before doing anything

C.   Acid itch cavity then dry thoroughly

4. Which one of the following are not used in water fluoridation

A.   SnF2

B.   1.23% APF

C.   H2SiF2

D.   CaSiF2

E.   8% Stannous fluoride

5. The best way to clean cavity before the placement of GIC is

A.   H2O2

B.   Phosphoric Acid

C.   Polyacrylic acid

(Answers-Q1 = A, Q2 = A, Q3 = A, Q4= A, Q5 = C)

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