Multiple questions for review...

1. Absolute contraindication for prescribing oral contraceptive pills in women of reproductive age group is
A epilepsy
B diabetesmellitus
C milk hypertension
D congenital hyperlipidemia ✔

2. most effective copper t is
A CU T380
B c u t 220
C CU t 200
D ML CU 250✔

3.  the most common side effect of intrauterine device insertion which requires its removal is
A bleeding
B pain✔
C pelvic infection
D ectopic pregnancy

 4. most common side effect of iucd insertion is
A bleeding✔
B pain
C pelvic infection
D ectopic pregnancy

5. copper t is preferably inserted postnatal after
A 2 weeks
B 4 weeks
C 5 weeks
D 8 weeks✔

The working time of elastomeric impression material | AIPGDEE Preparations

The working time of elastomeric impression material is defined as:
A. The time from the start of the mixing till the material is fully set.
B. The time elapsed from beginning of mixing until curing has advanced
C. The time from start of mixing till just before the elastic properties have fully developed
D. The time elapsed from beginning of mixing until reaction is complete.

     Ans. (C) The time from start of mixing till just before the elastic properties have full; developed: Repeat AIPG 2007- Q34: “The working time, begins at the start of mixing & ends just before the elastic properties have developed; must exceed the time required for mixing, filling the syringe &/ or tray, injecting the material on to the tooth preparation, & seating the tray.” Setting time can be described as the time elapsed from the beginning of mixing until curing has advanced sufficiently so that impression can be removed from the mouth with a minimum of distortion.

The half life of mercury in human body | MDS entrance preaparations

The half life of mercury in human body is:
A. 55 days
B. 55 hours
C. 55 week
D. 55 months

      Ans. (A) 55 days: “An average half time of mercury in human body is 55 days”. 

     Other important facts related to mercury:- 

•    Mercury that is absorbed in circulatory system may be deposited in any tissue.

•    Higher than average accumulations occur in the brain liver and kidneys.

• In the dental office, the dentist, assistant, hygienist and other staff are at more risk of mercury toxicity than patient because of long term contact with mercury vapour.

The main excitatory neurotransmitter in the CNS | MDS entrance preaparations

The main excitatory neurotransmitter in the CNS is:
A. Glycine 
B. Acetylcholine 
C. Aspartate 
D. Glutamate

Purkinje cells | MDS entrance preaparations

Cerebellar connection to other parts of the brain is projected through which cell:
A. Golgi cells 
B. Basket cells 
C. Purkinje cells 
D. Oligodendrocytes

Ans. C 

Purkinje cells are amongst the biggest neurons in the body. Their axons are the only output from the cerebellar nuclei from where they are projected to other part viz, thalamus, brainstem. Granule cells are excitatory

Dental tracts is concerned with pain & temperature | AIIMS MDS Preparations

Which of the following tracts is concerned with pain & temperature?
A. Pyramidal tract          
B. Anterior spinothalamic tract        
C. Lateral spinothalamic tract      
D. Vestibular tract

       Ans C 

        Proprioceptive information is transmitted up the spinal cord in the dorsal columns, majority of the proprioceptive inputs goes to the cerebellum but some passes to the cortex also (conscious Proprioception). There is some evidence that proprioceptive information passes to consciousness in the antero-lateral columns of the spinal cord. Conscious awareness of position of various parts of the body in space depends in part on impulses from sense organ in and around the joints. The organs involved are slowly adapting spray endings, structure that resemble golgi tendon organs, & probably pacinian sorpuscles in the synovia & ligament.

A measure of location which divides the distribution in the ratio of 3:1 is:| AIPGDEE Guide

A measure of location which divides the distribution in the ratio of 3:1 is:
A. Median 
B. First quartile
C. Third Quartile
D. Mode

.  Ans. (C) Third Quartile: (Quartiles denote division of entire range of distribution into four parts of equal probability by three equidistant points. Quartile: Will have 25% observations to the left and 75% to the right. 2nd Quartile: Will have 50% observations on either side. 3rd Quartile: Will have 75% observations to the left 25% on the right.

- The division in question is 3:1. This would mean three observations stand to the left and one of the right in a range of 4 (3+1) i.e. third quartile.

- First quartile would divide the observations in a ratio of 1:3 and not 3:1.

- Median is the mid value when values are arranged either in an ascending or descending order.

- Mode is the most commonly occurring value.

Elements of primary healthcare | MDS entrance preaparations

Elements of primary healthcare include all of the following, except:
A. Adequate supply of safe water and basic sanitation.
B. Providing essential drugs
C. Sound referral system.
D. Health education.

    Ans.  (C) Sound referral system.: (The concept of primary health care came into limelight in 1978 following an international conference in Alma- Ata (USSR).

• The primary health care approach is based on principles of social equity, nationwide coverage, self reliance, inter-sectorial co-ordination and people’s involvement in planning

Chi- Square test | MDS entrance preaparations

Chi- Square test is used to measure the degree of:
A. Causal relationships between exposure and effect.
B. Association between two variables.
C. Correlation between two variables
D. Agreement between two observations.

     Ans. (B) Association between two variables: 

-   The chi-square test is used to measure the qualitative data not quantitative data.

-  The test of association between two events is the most important application of the chisquare test is statistical method.

-   It measures the probability of association between two discrete attributes

- The chi-square test assumes that no association occurs between two events in question unless proved otherwise – Null Hypothesis

Effect of hyperventilation on the oxygen binding affinity of hemoglobin | MDS entrance preaparations

What effect does hyperventilation have on the oxygen binding affinity of hemoglobin-

A.P02 and 02 affinity decrease                                      

B.PO, and O, affinity increase

C.PO, decreases and O, affinity increases                   

D.P02 increases and 02 affinity decreases

Ans. [(B) 

•          During hyperventilation C0₂ washes out, PC0₂ falls, P0₂ increases. As a result, Hb does not release oxygen and the affinity of Hb for oxygen increases.

•          Cheyne-Stokes breathing is seen in voluntary hyperventilation.

-          Cheyne-Stokes breathing is caused by a fall of PC0₂ in blood feeding the medullary respiratory centre.

-          Blood C0₂ is low, there is no stimulation of central chemoreceptor cells in medulla and apnea follows.

PC0₂ rises again and the respiration resumes, but if the PC0₂ now is even slightly higher than normal, there will be a short phase of hyperpnoea followed by apnea

Bio-Chem Structures | AIPGMEE Preparations

Unidirectional flow of a nerve impulse | Crack AIPGDEE

Unidirectional flow of a nerve impulse is at:

A. Synapse                     

B. Axon                    

C. Dendrites                   

D. All of the above

Ans. A

Synapses generally permit conduction of impulses in one direction only, from presynaptic to post-synaptic neurons.

Any impulse conducted antidromically up the axons dies out because, post synaptical part of neurons lack chemical synaptic vesicles that are needed for synaptic transmission. Therefore an impulse arriving at the post synaptic membrane cannot release synaptic mediator.

Axons can prevent impulses in both directions.

Dendrites are found on the axon’s endings and so behave in the same way as the axons i.e. bi-directional.

Antibodies

Antibodies

🎸🎺✋
IgG about 80 % of antibodies in serum
🎸🎺✋
IgG provides long term protection because it persists for months and years after the prescence of the antigen that has triggered their production
🎸🎺✋
IgG They can leave the blood cells and move to ares of inflammation
🎸🎺✋
IgG Monomer
🎸🎺✋
IgG Crosses the placenta providing the foetus with passive immunity
🎸🎺✋
IgG Protect against bacteris, viruses, neutralise bacterial toxins, trigger compliment protien systems and bind antigens to enhance the effectiveness of phagocytosis
🎸🎺✋
IgA 10-15% of antibodies
🎸🎺✋
IgA consists of two monomners joined togther
🎸🎺✋
IgA The most common form of antibodies in mucous membranes and body secretion. E.g. mucus, saliva, tears, breast milk
🎸🎺✋
IgA Main function is to bind antigens on microbes before they invade tissues. It aggregates the antigens and keeps them in the secretions so when the secretion is expelled, so is the antigen
🎸🎺✋
IgM Make up 10-15% of Antibodies
🎸🎺✋
IgM Large size so do not leave the blood vessels - Pentamer
🎸🎺✋
IgM Involved in the ABO blood group antigens on the surface of RBCs
🎸🎺✋
IgM Effective in aggregating antigens because it has ten binding sites
🎸🎺✋
IgM Involved in compliment
🎸🎺✋
IgM Enhance ingestions of cells by phagocytosis
🎸🎺✋
IgD 0.2% of serum antibodies
🎸🎺✋
IgD Found in te blood, lymph and especially on the surface of B cells. We have limited knowledge of their function
🎸🎺✋
IgD Monomer
🎸🎺✋
IgE 0.0002% of antibodies
🎸🎺✋
IgE Bind to mast cells and basophils wich participate in the immune response
🎸🎺✋
IgE When and antigen such as pollen binds to ths antibody, the mast cell or basophil releases histamine..


🎸🎺✋
IgE Involved in allergicc reactions
🎸🎺✋
IgE It attract complement and phagocytic cells..

Papez Circuit | MDS entrance preaparations

Papez circuit involved in - 
A. Emotions                      
B. Hunger    
C. Sleep                            
D. Motion Sickness

Ans. A) Papez cicuit is a part of limbic system which is responsible for emotions. It connects hippocampus to the mamillary bodies, which are in turn connected to the anterior nuclei of the thalamus by the mamillothalamic tract. The anterior nuclei of the thalamus project to the cingulate cortex, and from the cingulate cortex there are connections to the hippocampus.

The skeletal muscle action potential | MDS entrance preaparations

The skeletal muscle action potential-
A. Is not essential for contraction to occur
B. Has a prolonged plateau phase
C. Spreads inward to all parts of the muscle via the t-tubule system
D. Begins with an inward movement of K+ ions

Ans. (C)

•          The skeletal muscle fibre is so large that action potential spreading along its surface membrane cause almost no current flow deep within the fibre.

•          Current penetration deeply into the muscle fibre to the vicinity of separate myofibrils is achieved by transmission of Action Potentials along 'Transverse tubules' (T tubules) that penetrate all the way through the muscle fibre.

•          The T tubule action potentials cause release of calcium ions inside the muscle fibres, which then cause contraction. This entire process is called 'Excitation-Contraction' coupling.

Increase in Intracranial Pressure | MDS entrance preaparations

Increase in intracranial pressure is not associated with:
A. Deterioration of consciousness        
B. Tachycardia                    
C. Respiratory depression                    
D. Increase in BP

Ans. B

When intracranial pressure is elevated to more than 33 mmHg over a short period, cerebral blood is significantly reduced l/t deterioration consciousness. The resultant ischemia stimulates the vasomotor area & systemic blood pressure rises.

Stimulation of vagal outflow produces bradycardia & respiration is slowed. The blood pressure rise helps to maintain the cerebral blood flow. (Cushing reflex)

Featurea of Residual Cyst | Crack AIPGDEE with B-IDS

Which of the following is not a feature of residual cyst
a) contains Rushton bodies cholesterol and heamosiderin
b) cyst is lined internally by stratified squamous non keratinizing epithelium
c) feeding blood vessel in cystic cavity
d) lacks aracades and strand of epithelium extending into the capsule

 Ans c: The lining and capsule are similar to the radicular cyst however, both appear more mature, with the former lacking the arcades and strands of epithelium extending into the capsule. 

Osteoporosis MCQ | AIIMS MDS Preparations

All of the following statement is correct for osteoporosis except
a) reduction in bone mass per unit volume
b) normal serum calcium level
c) more common in women
d) decreased calcium and phosphate level in serum biochemistry

Ans D: 

A reduction in bone mass per unit volume   Serum biochemistry indices are normal. There is skeletal rarefaction and low trauma fractures often occur, including vertabral fractures..Women are more likely to be affected than men. In the edentulous patient with osteoporosis the residual alveolar ridges may resorb more rapidly.

Presence of opaque white patches in the enamel | AIIMS MDS Preparations

Presence of opaque white patches in the enamel, often arranged in a band-like formation also teeth affected are susceptible to a brown discoloration are seen in

a) amelogenesis imperfecta

b) fluorosis

c) bullemia nervosa

d) ectodermal dysplasia

Ans B: 

The effect of fluorosis may be recognized by the presence of opaque white patches in the enamel, often arranged in a band-like formation. Unlike the teeth in other forms of hypoplasia, the teeth affected by fluorosis are susceptible to a brown discoloration that may resemble amelogenesis imperfecta. Similar idiopathic mottling may occur in teeth of patients from non-fluoride areas, but this is rare.

Reactive Thrombocytosis

Secondary or Reactive Thrombocytosis (High Platelet Count) :

Platelets are acute-phase reactants; therefore, they increase in response to various stimuli, including systemic infections, inflammatory conditions, bleeding, and tumors. This is called reactive or secondary thrombocytosis, which is a benign form of thrombocytosis. In contrast, clonal thrombocytosis (primary or essential thrombocytosis) is an unregulated abnormality of platelet production due to a clonal expansion of bone marrow progenitor cells.

Etiologic conditions associated with secondary thrombocytosis (reactive thrombocytosis) include the following:

Infection and inflammatory disorders
Postsplenectomy or hyposplenism
Malignancy
Trauma
Chronic inflammatory conditions
Hemorrhage, blood loss, or both
Iron-deficiency anemia
Rebound thrombocytosis
Asplenia (anatomic or functional)
Idiopathic

Treatment :-

The primary treatment of secondary thrombocytosis (reactive thrombocytosis) should address the underlying cause of the thrombocytosis. For example, iron supplementation may normalize platelet counts in patients with thrombocytosis secondary to inflammatory bowel disease. In general, no treatment is indicated to directly reduce the platelet count

Clinical Case of Patient presented with swollen parotid glands | MDS entrance preaparations

A young female patient  presented with swollen parotid glands and appeared to have generalized skeletal muscle wastage and dental erosion, which of the following condition would be suspected.

a. Malabsorption syndrome        
b. anoroxia nervosa

c. osteomalacia
d. none of the above

Correct Ans: B

 Sialosis (sialadenosis) implies a painless, non-inflammatory, non-neoplastic swelling of the salivary glands ,it may also occur in hormonal abnormalities (diabetes mellitus, acromegaly) and in nutritional deficiency states, including anorexia nervosa and chronic alcoholism

Sassouni Analysis | MDS entrance preaparations

Sassouni Analysis is used to describe skeletal disturbance in which plane? 
A. Vertical
B. Horizontal
C. Transverse
D. Dentoskeletal

Ans. (A)

Sassouni Analysis- The Sassouni Analysis was first cephalometric method to emphasize vertical as well as horizontal relationships and the interactions between vertical and horizontal proportions. Sassouni pointed out that the horizontal anatomic planes- the inclination of anterior cranial base, Frankfort plane, palatal plane, occlusal plane, and mandibular plane- tends to converge toward a single point in a well proportioned faces. The inclination of these planes to each other reflects the vertical proportionality of face. Sassouni Analysis. Although the total arch analysis described by Sassouni is no longer widely used. his analysis of vertical facial proportions has become the integral part of overall analysis of a patient 

Growth of Maxilla | AIPGDEE and AIIMS Guidance

Which out of the following is true? 
A.Condylar Cartilage is the Primary Cartilage.
B.Alveolus is Growth Centre.
C. Growth of Maxilla occurs in downward and forward direction.
D.None

Ans. (C)

The sutures attaching the maxilla posteriorly and superiorly are ideally situated to allow its downward and forward re-positioning.

Interestingly as maxilla grows downward and forward, its front surfaces are remodeled, and bone is removed from most of the anterior surface. The condylar cartilage develops initially as an independent secondary cartilage, which is separated by considerable gap from the body of mandible. Early in fetal life, it fuses with the developing mandibular ramus.

A site of growth is merely a location at which growth occurs, whereas a center is a location at which independent (genetically controlled) growth occurs. All centers of growth also are growth sites, but the reverse is not true. 

Features of facial nerve palsy due to upper motor neuron disease | AIIMS MCQs for PG Entrance

All of the following are features of facial nerve palsy due to upper motor neuron disease except

a) A central lesion that causes partial paralysis of the facial muscles
b) The lower facial muscles, contra lateral to the lesion, are paralysed
c) The blink reflex and movement of forehead muscles unaffected
d) None of the above

Ans D..

     Characteristics of upper motor neurone disease

• A central lesion that causes partial paralysis of the facial muscles
• The lower facial muscles, contralateral to the lesion, are paralysed
• The orbicularis oculi and frontalis muscles, which receive bilateral cortical fibres, have limited function
• The blink reflex and movement of forehead muscles unaffected

Medical management of Cluster Headache | AIIMS MCQs for PG Entrance

All of the following are used in the medical management of cluster headache except

a) histamine
b) serotinine antagonist
c) beta blockers 
d) Sumatriptan

Ans a: 

The most widely used treatments once an attack commences are ergotamine or sumatriptan. Drugs effective in preventing attacks of cluster headaches such as pizotifen (antihistamine and serotonin antagonist), calcium channel blockers (e.g. verapamil) and beta-blockers may be taken as prophylaxis.

Masters dentistry volume 1 page 220

Medicine INVESTIGATION OF CHOICE: Part 2

INVESTIGATION OF CHOICE: Part 2

• Single Bone Metastasis – CT

• Multiple Bone Metastasis – Bone scan

• Spine Metastasis – MRI

• Avascular necrosis- MRI

• Bone Density/Osteoporosis- DEXA (Dual energy x ray absorptiometry)

• Aneurysm/ AV Fistula- Angiography

• Dissecting Aneurysm (Stable) - MRI (Unstable)-Trans oesophageal USG

• Pericardial Effusion- Echocardiography

• Lobulated pericardial effusion- MRI > CT

• Minimum Pericardial Effusion- Echocardiography 

• Ventricular Function- Echocardiography

• Radiotherapy/Chemotherapy induced cardiotoxicity- Endomyocardial Biopsy

• Pulmonary Embolism- CECT> Pulmonary Angiography > V/Q Scan

• Interstitial lung disease(Sarcoidosis)- HRCT

• Bronchiectasis- HRCT scan

• Solitary Pulmonary Nodule- High resolution CT (HRCT)

• Posterior Mediastinal Tumor- MRI

• Pancoast Tumor (Superior Sulcus Tumor) – MRI

• Minimum Ascites/Pericardial effusion/Pleural effusion – USG

• Traumatic Paraplegia- MRI

• Posterior Cranial Fossa – MRI

• Acute Haemorrhage- CT

• Chronic Haemorrhage- MRI

• Intracranial Space Occupying Lesion- MRI

• Primary brain tumour- contrast MRI (Gold standard however remains to be biopsy)

• Metastatic brain tumor- (Gadolinium) contrast enhanced MRI

• Temporal Bone-CT

• SAH Diagnosis- unenhanced CT

• SAH aetiology- 4 vessel MR Angiography > CT Angiography > DSA

• Nasopharyngeal angiofibroma- CECT scan

• Acoustic neuroma- Gadolinium DTPA enhanced MRI

• Obstetrics- USG

• Calcifications- CT

• Blunt abdominal Trauma- CT

• Acute Pancreatitis- CT

• GERD- pH manometer > endoscopy

• Dysphagia- Endoscopy

• Congenital hypertrophic pyloric stenosis- USG

• Extrahepatic biliary atresia- perioperative cholangiogram

• Obstructive Jaundice/GB Stones- USG
• Diverticulosis – barium enema

• Diverticulitis – CT scan

• Renal TB (early) – IVP (Late)- CT

• Posterior Urethral Valve- MCU

• Ureteric stone- non contrast CT

• Renal Artery Stenosis- Percutaneous Angiography

• Extraintestinal Amoebiasis- ELISA

• Discrete swelling(solitary nodule) of thyroid- FNAC

Oral Health Status Index in 1980 | AIPGMEE Preparations

Oral Health Status Index in 1980 given by? 
A. WHO
B. Rosebraun
C. Greene and Vermilion
D. Marcus & Gershen

Ans. (D) 

Oral Health Status Index (OHSI)- In an attempt to develop a new ora: health status indicator, Marcus M. , Koch A.L and Gershen, J.A. developed Oral Health Status Index (OHSI) in 1980. 

Rhabdomyoma | MDS Preparations

Rhabdomyoma is the neoplasm of? 
A.Benign Neoplasm of striated muscles 
B.Benign Neoplasm of smooth muscles 
C.Malignant Neoplasm of striated muscles 
D.Malignant Neoplasm of smooth muscles

Ans. (A) 

Rhabdomyoma- The term rhabdomyoma was introduced by Zenker (1864) to indicate a benign tumor showing skeletal muscle cell with varying degree of differentiation and maturity. Rhabdomyoma are currently defined as benign neoplasm of striated muscle tissue. 

Revention of onset of risk factor | Crack AIPGDEE

Revention of onset of risk factor is ? 
A. Primary Prevention 
B. Secondary Prevention 
C. Tertiary Prevention 
D. Primordial Prevention

Ans. (D) 

Primordial Prevention- A new concept, is receiving special attention in the prevention of chronic diseases. This is primary prevention in its purest sense, that is, prevention of the emergence or development of risk factors in countries or population groups in which they have yet not appeared. 

Exodontia Process | Crack AIPGDEE

During Exodontia the force applied firstly in which direction? 
A.Apical 
B. Buccal 
C. Lingua! 
D. Coronal

Ans. (A) 

Forces exerted during extraction- The beaks of forceps are inserted under the gingival margin higher up on to the neck of the tooth to rest on the cementum by using an apical force. Then the pressure is applied as under .. 

INVESTIGATION OF CHOICE:

INVESTIGATION OF CHOIC

INVESTIGATION OF CHOICE:

• Single Bone Metastasis – CT

• Multiple Bone Metastasis – Bone scan

• Spine Metastasis – MRI

• Avascular necrosis- MRI

• Bone Density/Osteoporosis- DEXA (Dual energy x ray absorptiometry)

• Aneurysm/ AV Fistula- Angiography

• Dissecting Aneurysm (Stable) - MRI (Unstable)-Trans oesophageal USG

• Pericardial Effusion- Echocardiography

• Lobulated pericardial effusion- MRI > CT

• Minimum Pericardial Effusion- Echocardiography 

• Ventricular Function- Echocardiography

• Radiotherapy/Chemotherapy induced cardiotoxicity- Endomyocardial Biopsy

• Pulmonary Embolism- CECT> Pulmonary Angiography > V/Q Scan

• Interstitial lung disease(Sarcoidosis)- HRCT

• Bronchiectasis- HRCT scan

• Solitary Pulmonary Nodule- High resolution CT (HRCT)

• Posterior Mediastinal Tumor- MRI

• Pancoast Tumor (Superior Sulcus Tumor) – MRI

• Minimum Ascites/Pericardial effusion/Pleural effusion – USG

• Traumatic Paraplegia- MRI

• Posterior Cranial Fossa – MRI

• Acute Haemorrhage- CT

• Chronic Haemorrhage- MRI

• Intracranial Space Occupying Lesion- MRI

• Primary brain tumour- contrast MRI (Gold standard however remains to be biopsy)

• Metastatic brain tumor- (Gadolinium) contrast enhanced MRI

• Temporal Bone-CT

• SAH Diagnosis- unenhanced CT

• SAH aetiology- 4 vessel MR Angiography > CT Angiography > DSA

• Nasopharyngeal angiofibroma- CECT scan

• Acoustic neuroma- Gadolinium DTPA enhanced MRI

• Obstetrics- USG

• Calcifications- CT

• Blunt abdominal Trauma- CT

• Acute Pancreatitis- CT

• GERD- pH manometer > endoscopy

• Dysphagia- Endoscopy

• Congenital hypertrophic pyloric stenosis- USG

• Extrahepatic biliary atresia- perioperative cholangiogram

• Obstructive Jaundice/GB Stones- USG
• Diverticulosis – barium enema

• Diverticulitis – CT scan

• Renal TB (early) – IVP (Late)- CT

• Posterior Urethral Valve- MCU

• Ureteric stone- non contrast CT

• Renal Artery Stenosis- Percutaneous Angiography

• Extraintestinal Amoebiasis- ELISA

• Discrete swelling(solitary nodule) of thyroid- FNAC