FINAL COMED 2016 - SUBJECTIWSE

BY DR SURESH SHENVI

GENERAL ANATOMY , EMBRYOLOGY AND HISTOLOGY

1) Secretomotor fibres to parotid gland arise from

a. Superior salivatory nucleus
b. Nucleus ambiguous
c. Inferior salivatory nucleus
d. Lacrimatory nucleus

Ans c - Inferior salivatory nucleus

B D Chaurasias Human Anatomy,4rd ed Vol III page 137

Inferior salivatory nucleus -- IX nerve tympanic branch -- tympanic plexus -- lesser

petrosal nerve -- relays in otic ganglion-- parotid gland.
Edinger-westphal nucleusIIIrd nerve -- Inferior oblique-- branch to ciliary ganglion
-- relay-- short ciliary nerves supply ciliaris and constrictor pupillae muscle.
Superior salivatory nucleus of VII nerve -- VII nerve-- chorda tympani branch--
via lingual nerve -- submandibular ganglion -- Relays -- submandibular gland and
lingual salivary gland via lingual nerve.
Lacrimatory nucleus of VII nerve -- VII nerve -- greater petrosal nerve + deep petrosal
nerve -- nerve of pterygoid canal -- pterygopalateroid ganglion -- relays to supply
glands of nose, palate, pharynx and pass along maxillary nerve, zygomatic, temporal
nerve, lacrimal nerve to supply lacrimal gland.

2) Which of the following do NOT increase in size after birth

a. External auditory meatus
b. Sphenoidal air sinus
c. Mastoid antrum
d. Ear Ossicles

Ans d - Ear ossicles

Gray's Anatomy: The Anatomical Basis of Clinical Practice 41st ed Pg 627

Middle ear, ossicles, and inner ear are of adult size at birth hence does not increase in size later

3) Which of the following statements about macrophages is TRUE?

a. They participate in the effector phase of humoral immunity
b. They are derived from T lymphocyte
c. They are also known as natural killer (NK) cells
d. They are the cells that synthesize immunoglobulins

Ans a They participate in the effector phase of humoral immunity

Robbins and Cotran Pathologic Basis of Disease, Professional Edition By Vinay Kumar
9th ed Pg 912

Macrophages
Macrophages that have phagocytosed microbes and protein antigens process the
antigens and present peptide fragments to T cells.
Thus, macrophages function as antigen-presenting cells in T-cell activation.(THEY
ARE NOT DERIVED FROM T CELL)
Macrophages are key effector cells in certain forms of cell-mediated immunity, the
reaction that serves to eliminate intracellular microbes. In this type of response, T cells
activate macrophages and enhance their ability to kill ingested microbes (discussed
later).
Macrophages also participate in the effector phase of humoral immunity.
Macrophages efficiently phagocytose and destroy microbes that are opsonized (coated)
by IgG or C3b.
Friends.. Please note that B- LYMPHOCYTES synthesize imuunoglobins

4) Intermediate mesoderm is the precursor of the

a. Somites
b. Urogenital system
c. Body wall
d. Heart

Ans b - Urogenital system

Human Embryology and Developmental Biology by Bruce Page 376

Intraembryonic mesoderm is divided into paraxial mesoderm that becomes segmentally

arranged into somites. It continues laterally as a segmentally arranged mass of
intermediate mesoderm.
The intermediate mesoderm then leads into lateral plate mesoderm.
Somites become divided into sclerotomes (precursors of vertebral bodies and the
annulus fibrosus) and dermomyotomes (precursors of segmental dermis and skeletal
muscle).
The urogenital system irises from the intermediate mesoderm of the early embryo..
Several major themes underlie the development of urinary and genital structures from
this common precursor.

5) Derivatives of the neural crest are the following EXCEPT

a. Cortex of suprarenal gland
b. Spinal ganglia
c. Sympathetic ganglia
d. Sensory ganglia of cranial nerves

Ans - a - Cortex of suprarenal gland

Ten Cate's Oral Histology: Development, Structure, and Function 7th ed pg 30

NEURAL CREST DERIVATIVES

Neuronal cells
o Sensory ganglia of cranial nerves V, VII, IX, X
o Spinal ganglia
o Ganglion cells of the autonomic nervous system
Supportive cells of the nervous system
o Glial cells of the peripheral ganglia
o Schwann cells of peripheral nerves
o Meninges of the anterior brain
Pigment cells - (except for pigmented retina )
Endocrine and paraendocrine cells
o Adrenomedullary cells(NOT THE CORTEX )
o Calcitonin-producing cells
o Type I cells of the carotid body
Mesectodermal derivatives - (cephalic neural crest)
o Visceral and facial skeleton
o Cranial vault
o Walls of large arteries derived from the aortic arches
o Connective tissue of thymus and parathyroid glands
o Dermis of neck and facial regions

GENERAL PHYSIOLOGY

6) All the following hormones have receptors on the plasma membrane of target
tissues EXCEPT
a. Epinephrine
b. Estradiol
c. Glucagon
d. Thyrotropin

Ans - b Estradiol
Guyton and Hall Textbook of Medical Physiology 13th ed Pg 959

Hormones can be classified according to their chemical nature as below:

Steroid hormones: For example. Corticosteroids. Sex steroids, Mineralocorticoids.
Vitamin D.
Proteins or polypeptide hormones: For example. Pituitary hormones. Parathyroid
hormone. Insulin. Glucagon.
Amino Acid Derivative Hormones : For example, thyroid hormones, catecholamines
(epinephrine, norepinephnne. dopamine).

Mechanism of Action of Hormones

All hormones act through specific binding sites on target tissues called receptors.
 Receptors are protein molecules which may be situated on the cell membrane,
cytoplasm or nucleus of the target cells.
All protein and polypeptide hormones combine with the cell membrane receptors,
while the steroid hormones bind with the cytoplasmic receptors as they are readily
lipid soluble
Thyroid hormones combine with TSH receptor on plasma membrane

7) Excessive production of aldosterone results in

a. Hypotension
b. Acidosis
c. Plasma rennin activity suppression
d. Potassium retention

Ans c - Plasma rennin activity suppression

Guyton and Hall Textbook of Medical Physiology -13th ed Page 981

Primary Aldosteronism (Conn's Syndrome)

Tumor of the zona glomerulosa cells may secretes large amounts of aldosterone
The resulting condition is called primary aldosteronism or Conn's syndrome.
Also, in a few instances, hyperplastic adrenal cortices secrete aldosterone rather than
cortisol.
The effects of the excess aldosterone may vary.
The most important effects are hypokalemia, mild metabolic alkalosis, a slight increase
in extracellular fluid volume and blood volume, a modest increase in plasma sodium
concentration (usually <4 to 6 mEq/L increase), and, almost always, hypertension.
One of the diagnostic criteria of primary aldosteronism is a decreased plasma renin
concentration.
This decrease results from feedback suppression of renin secretion caused by the
excess aldosterone or by the excess extracellular fluid volume and arterial pressure
resulting from the aldosteronism

8) Which of the following statements about macrophages is TRUE?

a. They participate in the effector phase of humoral immunity
b. They are derived from T lymphocyte
c. They are also known as natural killer (NK) cells
d. They are the cells that synthesize immunoglobulins

Ans a They participate in the effector phase of humoral immunity

Robbins and Cotran Pathologic Basis of Disease, Professional Edition By Vinay Kumar
9th ed Pg 912

Macrophages
Macrophages that have phagocytosed microbes and protein antigens process the
antigens and present peptide fragments to T cells.
 Thus, macrophages function as antigen-presenting cells in T-cell activation.(THEY
ARE NOT DERIVED FROM T CELL)
Macrophages are key effector cells in certain forms of cell-mediated immunity, the
reaction that serves to eliminate intracellular microbes. In this type of response, T cells
activate macrophages and enhance their ability to kill ingested microbes (discussed
later).
Macrophages also participate in the effector phase of humoral immunity.
Macrophages efficiently phagocytose and destroy microbes that are opsonized (coated)
by IgG or C3b.
Friends.. Please note that B- LYMPHOCYTES synthesize imuunoglobins

9) The Normal Thrombocyte count in a PCR male is.

a. 1.5-4 lakhs/mm3
b. 4-6 lakhs/cc
c. 1.5 4 lakhs / cc
d. 4-6lakhs/ mm3
Ans a - 1.5-4 lakhs/mm3
Mosby's Diagnostic and Laboratory Test Reference 12th ed pg 718

Blood Normal findings

Adult/elderly: 150,000-400,000/mm3 or 150-400 x 10 V /L (SI units)
Premature infant: 100,000-300,000/mm3
Newborn: 150,000-300,000/mm3
Infant: 200,000-475,000/mm3
Child: 150,000-400,000/mm3

BIOCHEMISTRY

10) Cystatin C is a novel marker of

a. Fatty liver
b. Glomerular filtration
c. Vitamin K status
d. Cholestasis

Ans b - Glomerular filtration

Textbook of Biochemistry for Medical Students by Vasudevan 7th ed Page 369

Cystatin C is produced at a constant rate and is freely filtered by kidney glomeruli

It is completely reabsorbed, but degraded in the tubules, thus making it an excellent
GFR marker
The blood levels are not depended on age. sex. muscle mass or inflammatory processes.
It is sensitive to changes in the so-called creatinine blind area of GFR (40 70 mL nun
1.73ml)
 So. serum level of cystatin is a better test for kidney function (GFR) than serum
creatinine levels Since, there is no tubular secretion of Cystatin C.
It is extremely sensitive to minor changes in GFR in the earliest stages of chronic kidney
diseases.

11) Which pair of amino acids, amongst the following do NOT participate in
transamination at some point in their catabolism?
a. Leucine, threonine
b. Lysine, tyrosine
c. Leucine, tyrosine
d. Lysine, threonine

Ans d - Lysine, threonine

Textbook of Biochemistry for Medical Students by Vasudevan 7th ed Page 201

Transamination diverts the excess amino acids towards energy generation.

The amino acids undergo transamination to finally concentrate nitrogen in glutamate.
Glutamate is the only amino acid that undergoes oxidative deamination to a
significant extent to liberate free NH3 for urea synthesis.
Lysine, threonine and Proline do not undergo transamination.

12) All the following are biotin independent carboxylation reactions, EXCEPT:
a. Addition of CO2 to from C6 in purine ring.
b. Carbamoyl phosphate synthetase
c. Acetyl CoA carboxylase
d. Conversion of pyruvate to malate by malic enzyme

Ans c - Acetyl CoA carboxylase

Textbook of Biochemistry for Medical Students 7th ed Page 486

Acetyl-CoA carboxylase is a biotin-dependent enzyme that catalyzes the irreversible

carboxylation of acetyl-CoA to produce malonyl-CoA through its two catalytic
activities, biotin carboxylase and carboxyltransferase.

13) Activity of which of the following enzyme is NOT affected by insulin

a. Glycogen synthase
b. HMG Co A reductase
c. Glucokinase
d. Hexokinase

Ans d Hexokinase
Textbook of Biochemistry for Dental Students by By DM Vasudevan, 2nd ed Pg 42

Glucose is activated by phosphorylation to glucose-6-phosphate

 The enzyme is Hexokinase (HK) which splits the ATP into ADP, and the Pi is added
on to the glucose.
The energy released by the hydrolysis of ATP is utilized for the forward reaction.
Hexokinase and glucokinase may be considered as isoenzymes.
Glucokinase is under the influence of insulin; but hexokinase is not.

14) The genetic defect in Refsums disease lies in

a. Fatty acid synthase complex
b. Recognition of apo A1
c. LDL receptors
d. Alpha oxidation of fatty acids

Ans d - Alpha oxidation of fatty acids

Textbook of Biochemistry for Medical Students By D M Vasudevan, 7th ed pg 155

It is a metabolic error in Alpha oxidation of fatty acids due to lack of alpha-

hvdroxylase (phytanic acid oxidase) so that alpha oxidation does not occur and phytanic
acid accumulates in the tissues
The patient presents with severe neurological symptoms, polyneuropathy, retinitis
pigmentosa, nerve deafness and cerebellar ataxia
Regression of symptoms is observed with restricted dietary intake of phytanic acid.

15) Base Stacking of DNA is by

a. Hypochromicity
b. Electrophoresis
c. Linear dichromicity
d. Hyperchromicity

Ans d Hyperchromicity
Harper's Biochemistry 25th ed Page 404

The heat denaluration of DNA, also called melting, can be monitored experimentally
by observing the absorption of ultraviolet light.
The bases absorb light in the 260-nm-wavelength region. As the DNA is heated and the
strands separate, the wavelength of absorption does not change, but the amount of light
absorbed increases
This effect is called hyperchromiaty.
It is based ont he fact that the bases, which are stacked on top of one another in
native DNA. become unstacked as the DNA is denatured.

16) . is synthesized from linolenic acid and particularly needed for

development of the brain and retina during the neonatal period
a. Stearic acid
b. Dehexaenoic acid
c. Docosa pentaenoic acid
 d. Palmitic acid

Ans b - Dehexaenoic acid

Essentials of Biochemistry (for Medical Students) by Pankaja Naik 1st ed Page 31

Docosahexaenoic acid which is synthesized from linolenic acid is particularly needed for
development of the brain and retina during the neonatal period.

DENTAL MATERIALS

17) The noble metals that are used in dentistry include all, EXCEPT
a. Platinum
b. Gold
c. Silver
d. Palladium

Ans c Silver
Craig's Restorative Dental Materials 13th ed Page 215

SILVER (Ag)
Foods containing sulfur compounds cause severe tarnish on silver, and for this
reason silver is not considered a noble metal in dentistry.
Pure silver is not used in dental restorations because of the black sulfide that forms on
the metal in the mouth.
Adding small amounts of palladium to silver-containing alloys prevents the rapid
corrosion of such alloys in the oral environment.

18) Low fusing metal alloys was introduced by

a. Nicholas Chamant
b. Pierre Fauchard
c. Jean Darcet
d. Claude Mouton

Ans c - Jean Darcet

Restorative Dental Material by Craig 7th ed pg 8

Low-fusing metal alloy was introduced by Jean Darcet in 1770.

19) The ideal way to control setting time of alginate is

a. Use of warm water
b. Alter the W/P ratio
c. Alter mixing time
d. Selection of fast setting alginate

Ans d - Selection of fast setting alginate

Phillips' Science of Dental Materials 12th ed Page 173

Friends. This is a old question but little twisted options. If you remember the old
question which surely says best control the setting time by altering the temperature
of the water for mixing alginate material.
I am sure many of you might opt OPTION A HERE due to this information
But WAIT!! The question does ask not whether you want to make alginate set faster.
In that case hot water can be used. But the question asks control of setting time in
general. So Option A would be wrong as it does not contain Cold in it. So option D
would be better. As the 12th ed of Philips says selecting the regular set or fast set of
alginate gives good choice for the operator

20) Disinfection duration of alginate impressions when immersion method is used

should NOT exceed:-
a. 30 min
b. 5 min
c. 10min
d. 20 min

Ans- c- 10min
Prosthodontic Treatment for Edentulous Patients: Complete Dentures and ...
By George A. Zarb, 13th ed Pg 127

Alginates are dimensionally unstable.

The impression can undergo syneresis and imbibition when exposed to air and water.
Once removed from the mouth, the impression should be rinsed with cold water to
remove traces of blood or mucin and then be disinfected.
The protocol that is recommended by the Centers for Disease Control is to use
household bleach (1 to 10 dilution), iodophors, or synthetic phenols.
The impression is sprayed liberally with the disinfectant, wrapped immediately in a
disinfectant-soaked paper towel, and placed in a plastic bag for 10 minutes.
The wrapped impression is then removed from the bag, unwrapped, rinsed, and shaken
to remove excess water and then is poured immediately.
Alternatively, the impression could be immersed in a disinfectant but not for more
than 10 minutes

21) Rouge is used for

a. Polishing noble metal alloys
b. Decreasing the setting time of plaster of paris
c. Roughening enamel for bonding procedures
d. Retention of ceramic material in porcelain fused to metal restoration.

Ans a - Polishing noble metal alloys

Skinner's science of dental materials 9th ed Page 562

Rouge is a fine red powder composed of iron oxide (Fe2O3) that usually is employed in cake
form. It may be impregnated in paper or fabric known as crocus cloth. It is an excellent
laboratory polishing agent for gold and other precious metal

22) The most commonly provided concentration of phosphoric acid used for etching
enamel and dentin is
a. 37% concentration
b. 30% concentration
c. 50% concentration
d. 47% concentration

Ans a - 37% concentration

Sturdevants Art and Science of Operative Dentistry 4th ed Page no 481

Surface irregularities are produced by acid etching enamel with 37 % phosphoric acid.
The primer flows into these irregularities and resin tags are formed providing
mechanical interlocking providing micromechanical bonding
The microtags formed are 2 to 5 microns in length.
Bond strength is in the range of 18 to 22 MPa.
Composites increase resistance form by bonding and strengthening tooth structure

23) The recommended water temperature for mixing alginate impression material is
a. 22C to 23C
b. 37C to 38C
c. 30C to 31C
d. 25C to 26C

Ans a - 22C to 23C

Phillips' Science of Dental Materials ed 12th Page 173

Friends.. A direct pick from the book.

24) The Americal Dental Association (ADA) specification for dental amalgam alloy is
a. ADA specification number 10
b. ADA specification number 5
c. ADA specification number 1
d. ADA specification number 2

Ans c - ADA specification number 1

Craig's Restorative Dental Materials 13th ed Page 208

ADA specification number No. 1: Amalgam alloy

ADA specification number No. 6: Dental mercury

25) The three types of abrasives used in dentistry can be classified as the following,
EXCEPT
a. Cleansing abrasives
 b. Finishing abrasives
c. Polishing abrasives
d. Bleaching abrasives

Ans d Bleaching abrasives

Dental Materials; Properties and Manipulation - by Craig 5th ed Page 98

The three types of abrasives used in dentistry can be classified as

finishing, polishing, and cleansing abrasives.
FINISHING ABRASIVES
o Finishing abrasives are hard, coarse abrasives which are used initially to
develop contour and remove gross irregularities, e.g. coarse stones.
POLISHING ABRASIVES
o Polishing abrasives have finer particle size and are less hard than abrasives used
for finishing. They are used for smoothening surfaces that have been roughened
by finishing abrasives, e.g. polishing cakes, pumice, etc.
CLEANSING ABRASIVES
o Cleansing abrasives are soft materials with small particle sizes and are intended
to remove soft deposits that adhere to enamel or a restorative material.

26) The minimum thickness of an alginate impression material should be

a. 6 mm
b. 5 mm
c. 3 mm
d. 8mm

Ans c 3 mm
Essentials of Dental Materials By Soratur1st ed pg 119

Requirements of Ideal Alginate Impression

Impression should have smooth impression surface. To achieve this, W/P ratio must be
correct. Mix for just under 1 minute. Do not force a material which has already started
gelling
Impression must be free from Air bubblesFor this, air should not be incorporated
during mixing. Mix must be smooth and creamy.
Impression must not break during removalTo achieve this. Gel must have
strengththat means material must be minimum of 3 mm thickness in the tray.

27) Electroplated silver die material is best compatible with all EXCEPT
a. Polysulfides
b. Condensation silicones
c. Polyethers
d. Addition silicones

Ans b - Condensation silicones

Phillips' Science of Dental Materials 12th ed Page 213
ORAL HISTOLOGY AND DENTAL ANATOMY

28) All the following cells of Periodontal ligament are resorptive cell EXCEPT
a. Osteoclast
b. Cementoclasts
c. Fibroblast
d. Odontoclasts.

Ans d - Odontoclasts.
Orban's Oral Histology & Embryology 13th ed Page 182

Connective tissue cells

o Fibroblast
o Cementoblast
o Osteoblast
Resorptive cells
o Osteoclast
o Fibroblast
o Cementoclast
Epithelial rest cells
Defense cells
o Macrophages
o Mast cells

29) The coronal pulp has,

a. Six surfaces.
b. Five surfaces.
c. Four surfaces.
d. Two surfaces.

Ans a - Six surfaces.

Orban's Oral Histology & Embryology 13th ed Page 120

The coronal pulp has six surfaces: the roof or occlusal, the mesial, the distal, the buccal,
the lingual, and the floor.

30) The middle to apical third of the root surface and furcations are covered by
a. Acellular intrinsic fiber cementum
b. Cellular extrinsic fiber cementum
c. Cellular intrinsic fiber cementum
d. Acellular extrinsic fiber cementum

Ans c - Cellular intrinsic fiber cementum

Ten Cate's Oral Histology: Development, Structure, and Function 7th ed pg 248 and
Carranzas Clinical Periodontology 10th ed Pg No 76

TYPE OF CEMENTUM LOCATION

Acellular afibrlllar cementum At the cemento- enamel Junction, on the enamel
Acellular extrinsic fiber cementum Cervical up to the middle of the root
Cellular intrinsic fiber cementum Apical and interradicular root surfaes. resorption
lacunae and fracture lines
Acellular intrinsic fiber cementum Apical and inter- radicular root surfaces
Cellular mixed stratified cementum Apical and inter- radicular root surfaces

31) Col is lined by

a. Orthokeratinized stratified squamous epithelium
b. Parakeratinized stratified squamous epithelium
c. Thick non keratinized epithelium
d. Thin non keratinized epithelium

Ans d - Thin non keratinized epithelium

Carranzas Clinical Periodontology 10th ed Pg No 47

Inderdental col is non-keratinised and less resistant to inflammatory changes.

It is also the site where oral hygiene accessibility is not possible.
It is the area for food entrapment.
Gingival col is _____ (KAR99) Keratinized
The area which is most prone to infection _____ (PGI02) Interdental col

32) The following are coatings of developmental origin EXCEPT:

a. Coronal cementum
b. Reduced enamel epithelium
c. Dental cuticle
d. Saliva

Ans d Saliva
Orban's oral histology and embryology 12th ed Pg 247

Friends.. This is a simple one.

We all know saliva is freshly formed and a form of secretion

Primary enamel cuticle A thin membrane on the surface of enamel. It is formed by

ameloblasts after enamel matrix is completely formed

Nasmyths membrane It is remnant of primary enamel cuticle after eruption.

Reduced enamel Modified epithelial organ in which the cells are reduced to few
epithelium cuboid cells.
 Primary attachment After the crown is emerged into oral activity the reduced
epithelium (junctional enamel epithelium is termed as primary attachment epithelium
epithelium)
Secondary attachment During passive eruption, the primary attachment epithelium is
epithelium separated from the enamel. At this stage, the primary
attachment epithelium is replaced by secondary attachment
epithelium, which is a derivative of gingival epithelium

33) After Tooth Development, the Pulp retains its Ability to form Dentin
a. Till the Age of Twenty Five
b. Throughout Life
c. Till the Third Molar Erupts
d. Till the Age of Twenty One

Ans b - Throughout Life

Tencates Oral Histology 8th ed Pg 170

Friends.. This is a simple one. Remember

Rates of dentin deposition vary not only within a single tooth but also among different
teeth.
Dentin formation continues throughout the life of the tooth, and its formation

34) Following is the regressive change which is seen in the pulp

a. Fibrosis.
b. Odontogenesis.
c. Hyalinisation
d. Amelogenesis.

Ans a Fibrosis

Orban's Oral Histology & Embryology By G. S. Kumar 11th ed pg 140 144

Friends. Remember in n general cells decrease and fibre content increases.

All body tissues undergo change with time. The most conspicuous change is the
decreasing volume of the pulp chamber and root canal brought about by continued
dentin deposition in old teeth.
Such continued restriction in pulp volume probably brings about a reduction in the
vascular supply to the pulp and initiates many of the other age changes found in this
tissue.
From about the age of 20 years, cells gradually decrease in number until age 70, when
the cell density has decreased by about half that the collagen content of the pulp.
Increased in age collagen degradation also increases.
With age there is both a loss and a degeneration of myelinated and unmyelinated axons
that correlate with an age-related reduction in sensitivity.
 A further age change is the occurrence of irregular areas of dystrophic calcification,
especially in the central pulp.
If such areas reach any size, they are known as false pulp stones. It has been emphasized
that the pulp supports the dentin and that age changes within the pulp are reflected in
the dentin. Within dentin there is the continued deposition of intratubular dentin,
resulting in a gradual reduction of the tubule diameter.

35) The unmineralized zone is

a. Intertubular dentin
b. Interglobular dentin
c. Intratubular dentin
d. Predentin

Ans d - Predentin
Orban's oral histology and embryology - 12th ed Pg 87,88

Predentin is a layer of variable thickness (7 micron to 47 microns) that lines the

innemost (pulpal) portion of the dentin.
It is unmineralized dentin matrix and consists principally of collagen,
glycoproteins, and proteoglycans (other constituents of the dentin matrix are added
at the mineralization front).
It is similar to osteoid in bone and is easy to identify in hematoxylin and eosin.
Predentin is thickest where active dentinogenesis is occurring, and its presence is
important in maintaining the integrity of dentin.

The zone of dentin most recently formed and uncalcified is known as ______
(Predentin) (Kar-2K)

TYPES OF DENTIN

Predentin n 1st formed dentin and is not mineralized

n Located adjacent to the pulp tissue and is 2 to 6 mm wide
n Equivalent to matrix of bone

Mantle dentin n It is the 1st formed layer of dentin. Represents primary dentin
n Contains von Korffs fibres

Circum pulpal dentin n Represents the dentin formed prior to root completion
n It forms the bulk of primary dentin
n The circumpulpal dentin contains slightly more mineral than mantle dentin

Peritubular dentin n It is the dentin that surrounds the dentinal tubules

n Highly mineralized than intertubular dentin
n It constricts the dentinal tubules to a diameter of 1 mm near DEJ

Intertubular dentin n Forms the main body of dentin

n It is located between dentinal tubules
n After decalcification, inter tubular dentin is retained, whereas peritubular dentin
is not
 Secondary dentin n Represents the dentin formed after root completion and (adventitious dentin)
contains fewer tubules than primary dentin.
n There is usually bend in the tubules where primary and secondary dentin
interface.

Reparative dentin n It is the dentin that is formed in response to extensive abrasion, caries,
(tertiary or response) bacterial toxic dentin products and chemicals from restorative materials.
All these stimulate pulpal response leading to reparative dentin formation.
n Reparative dentin is characterized by having fewer and more twisted
dentinal tubules than normal dentin.

Sclerotic or transparent n Formation of sclerotic dentin is a protective mechanism.

dentin n In case of caries, attrition, abrasion or erosion, sufficient stimuli are generated
to cause collagen fibres, calcium salts and apatite crystals to begin appearing
in dentin tubules. This condition is prevalent in older individuals, especially in
the roots.
n Sclerotic dentin appears light in transmitted light and dark in reflected light.
Interglobular dentin n Formed by small globular hypomineralised areas, that fails to fuse into homo-
geneous mass.
n Interglobular dentin forms in the crowns of teeth in the circumpulpal dentin
just below the mantle dentin in the coronal portion

Osteodentin n Seen in vit A deficiency. During development sometimes the cells forming
the teriary dentin are included in the matrix giving rise to osteodentin

PHARMACOLOGY

36) A partial agonist at acetylcholine nicotinic receptors that can be used in smoking
cessation programs is
a. Nalbuphine
b. Buprenorphine
c. Acamprosate
d. Varenicline

Ans d Varenicline
Essentials of Medical Pharmacology by Tripathi 7th ed Page 122

VARENICLINE
Is the first pharmaceutically designed compound with partial agonist effects at nicotine
receptors to become available in the market.
Varenicline is a selective partial agonist that stimulates the alpha4 beta2 nicotine
cholinergic receptors and consequently stimulates dopamine release in the nucleus
accumbens, though to a lesser extent (40-60% less) than nicotine itself.

37) Which of the following is true about METFORMIN

a. Reduces the lipogeneis in adipose tissue
b. Hypoglycemia is very common
c. Increases hepatic Gluconeogeneis
d. Increases the secretion of Insulin

Ans a - Reduces the lipogeneis in adipose tissue

Essentials of Pharmacology for Dentistry By KD Tripathi 1st ed pg 221
 Metformin is a biguanides. This group of medication does not increase the release of
insulin but presence of some insulin is must for their action
Because metformin does not stimulate the release of insulin, it is less likely to cause
hypoglycemia
It suppresses the hepatic gluconeogenesis
It reduces the lipogeneis in adipose tissue

38) Which among the following drugs is NOT used orally?

a. Phenytoin
b. Verapamil
c. Lignocaine
d. Quinidine

Ans c Lignocaine
Essentials of Pharmacology for Dentistry By KD Tripathi 1st ed Pg 348

Lignocaine has high first pass metabolism hence not given orally.
Simple isnt it??? Have you heard lignocaine tablet?...NO!!!

39) Which of the following opioid drug is a Partial Agonist

a. Naltrexone
b. Methadone
c. Buprenorphine
d. Codeine

Ans c Buprenorphine
Essentials of Medical Pharmacology, KDTripalhi (5th Ed.) Pg. 362

Buprenorphine is a Partial/weak agonist at opioid receptors.

40) Total analgesia is characteristic of which stage of anesthesia?

a. Stage 2 plane 1
b. Stage 1 plane 3
c. Stage 4 plane 2
d. Stage 3 plane 3

Ans b - Stage 1 plane 3

McDonald and Avery's Dentistry for the Child and Adolescent 10th ed pg 336

STAGES OF ANESTHESIA
Stage 1
o Plane 1 and Plane 2 Relative analgesia
o Plane 3 Total analgesia
Stage 2
 o Excitement
Stage 3
o Plane 1 2 3 4 - Surgical Anesthesia
Stage 4
o Respiratory paralysis

MICROBIOLOGY

41) Streptococcus agalactiae

a. Belongs to lancefield group C
b. Causes aseptic meningitis in neonates
c. Produces alpha hemolysis on blood agar
d. Has capsule as its virulence factor.

Ans d - Has capsule as its virulence factor.

Textbook of Microbiology & Immunology By Subhash Chandra Parija 2nd ed pg 191

S. agalactiae is the only species belonging to group B streptococci.

This is a pathogen of the cattle causing bovine mastitis, hence named agalactiae.
Produces beta hemolysis on blood agar
S. agalactiae are Gram-positive cocci arranged in pairs and short chains in clinical
specimens and are morphologically similar to S. pyogenes.
The cocci grow readily on enriched medium, such as blood agar and produce large
colonies after overnight incubation.
S. agalactiae are found as commensals in the genitourinary tract and lower
gastrointestinal tract.
S. agalactiae in neonates can cause either early-onset or late- onset infections.
Early-onset infection is acquired either in utero or from mothers vagina during delivery.
o The clinical symptoms develop during the first week of life.
o The condition is characterized by septicemia, Septic meningitis, or pneumonia.
Late-onset infection is acquired from mother or from another infant
(environment) during 2-12 weeks of life.
o The condition manifests as septicemia and meningitis.
S. agalactiae in pregnant women causes urinary tract infection particularly
immediately after delivery.
The capsule of S. pneumonia is a proven virulence factor.

42) Presence of Cryptosporidium in a stool sample is identified using

a. Iodine staining
b. Warthin Starry stain
c. Modified Acid fast staining
d. Iron haematoxylin stain

Ans c - Modified Acid fast staining

Textbook of Diagnostic Microbiology by connie 1st ed Page 660

The recommended detection methods for Cryptosporidium infection are the modified acid-
fast stain and a direct fluorescent.

43) Which of the following parasite causes anaemia

a. Isospora belli
b. Entamoeba histolytica
c. Trichomonas vaginalis
d. Diphyllobothrium latum

Ans d - Diphyllobothrium latum

Bailey & Scott's Diagnostic Microbiology 13th ed Page 679

Parasite-creating anemia is the fish tapeworm Diphyllobothrium latum.

D. latum, a common parasite of freshwater fish, in particular salmon, is distributed
widely in the lakes of many parts of Europe as well as those of the northern part of
central North America.
Human infestation results from ingestion of inadequately cooked fish.
Carriers of D. latum develop megaloblastic anemia because the tapeworm competes
with the host for dietary B12 and is able to take up and firmly bind the vitamin.

44) Which of the following cells is instrumental in transmitting human

immunodeficiency virus (HIV) to CD4+ T lymphocytes?
a. Neutrophils
b. NK cells
c. Dendritic cells
d. CD8+ cells

Ans c - Dendritic cells

Harrison internal Medicine 16/e, p 1093

The DCs play a major role in initial HIV infection and dissemination as they are
potentially the first cells to be infected by HIV in the genital mucosa.
A variety of C-type lectins on DCs, importantly DC-SIGN, are involved in uptake of
HIV by endocytosis, and subsequently direct infection of CD4+ cells takes place as
HIV is passed to them by DCs in the lymphoid tissue.

45) Prions are easily destroyed by?

a. Boiling
b. Ionising radiation
c. None of the above
d. Formaldehyde

Ans c -None of the above

Textbook of Microbiology by Ananthanarayan 8th ed Pg 553

Prions are resistant to physical and chemical agents such as heat irradiation, formalin
and UV rays.
They can be deactivated by using autoclave.

46) What is erysipelas

a. Superficial cellulitis
b. Secondary reaction to localized infection
c. Aggressive infection
d. Lesion of Anthrax

Ans a - Superficial cellulitis

Oral and maxillofacial pathology by Brad W. Neville 5th ed pg 164

ERYSIPELAS

Erysipelas is a type of superficial cellulitis that involves not only the epidermis but
also the underlying dermis and lymphatic channels.
Also known as
o Ignis sacer
o Holy fire
o St. Anthony's fire
Is an acute Streptococcus pyogenes (also known as beta-hemolytic group A streptococci
infection of the upper dermis and superficial lymphatics)
"Saint Anthony's fire", named after monks of the Order of St. Anthony who were
particularly successful at treating this ailment.

47) The Immunoassay performed in HIV to detect the presence of antibodies to

individual viral proteins is
a. NASBA
b. Western Blot
c. PCR
d. ELISA

Ans b - Western Blot

Bailey & Scott's Diagnostic Microbiology 13th ed Page 152

Western Blot Immunoassays

Requirements for the detection of very specific antibodies have driven the
development of the Western blot immunoassay
 The method is based on the electrophoretic separation of major proteins of an infectious
agent in a two-dimensional agarose (first dimension) and acrylamide (second
dimension) matrix.
A suspension of the organism is mechanically or chemically disrupted, and the
solubilized antigen suspension is placed at one end of a polyacrylamide (polymer) gel.
Under the influence of an electrical current, the proteins migrate through the gel. Most
bacteria or viruses contain several major proteins that can be recognized based on their
position in the gel after electrophoresis.
Smaller proteins travel faster and migrate farther in the lanes of the gel. The protein
bands are transferred from the gel to a nitrocellulose or other type of thin membrane,
and the membrane is treated to immobilize the proteins.
The membrane is then cut into many thin strips, each earning the pattern of protein
bands. When patient serum is layered over the strip, antibodies bind to each of the
protein components represented by a band on the strip.
The pattern of antibodies present can be used to determine whether the patient has a
current infection or is immune to the agent.

GENERAL PATHOLOGY

48) All are features of apoptosis EXCEPT

a. Absence of adjacent inflammation
b. Disruption of plasma membrane
c. Shrinkage of cell size
d. Fragmentation of nuclei

Ans b - Disruption of plasma membrane

Harshmohans Textbook of Pathology 4th ed Pg no 36

Apoptosis
Is a form of coordinated and internally programmed cell death.
Apoptosis is a Greek word meaning falling off or dropping off.
Also called as cell suicide
Whereas Necrosis is cell murder
CapsasesInvolved in final pathway of apoptosis
Fas- a trasmembrane protein on T lymphocyte and natural killer cell
TNF- Tumor necrosis factor also involved in apoptosis
Smac/DIABLO- and cytochrome-C are imp in apoptosis

DIFFERENTIAL FEATURES OF APOPTOSIS AND

NECROSIS
APOPTOSIS NECROSIS
Affects single cells Affects groups of neighboring cells

No inflammatory response Significant inflammatory response

 Cell shrinkage Cell swelling

Membrane blebbing but Loss of membrane integrity

integrity maintained
Increased mitochondria Organelle swelling and lysosomal
membrane permeability, release leakage
of proapoptotic proteins and
formation of apoptotic bodies
Chromatin condensation and Random degradation of DNA
non-random DNA
fragmentation
Apoptotic bodies ingested by Lysed cells ingested by
neighboring cells macrophages

GENERALSURGERY

49) Mechanical bowel preparation is used in surgery for

a. Stomach
b. Appendicitis
c. Intussusception
d. Colon

Ans d Colon
Bailey & Love's Short Practice of Surgery 26E - Page 1165

Mechanical bowel preparation defined as the use of an oral preparation given prior to
surgery to clear fecal material from the bowel lumen, is often prescribed preoperatively for
patients undergoing elective colorectal surgery.

50) The treatment of choice in case of primary thyrotoxicosis is

a. Beta blockers
b. Antithyroid drugs
c. Radioiodine I131 ablation
d. Surgical extirpation of the gland

Ans c - Radioiodine I131 ablation

Harrison's Principles of Internal Medicine 14th ed Page 2026 AND MANY OTHER
REFERENCE
 Radioactive iodine is an effective treatment for Graves disease (Primary
thyrotoxicosis) because it reduces the volume of functioning thyroid tissue.
The advantages of using radioactive ablation over antithyroid medication are its lack
of side effects and its efficacy.
Nonetheless, hyperthyroidism may not be reversed for many months.
Thus, severely ill patients may need to be pretreated with antithyroid medication until
they are more stable.
Before therapy, iodine-containing drugs and contrast agents must be avoided.
Currently, permanent radioactive iodine ablation is the treatment of choice for
Graves disease.

51) Which of the following blood product is stored at -400C to 500C with a two year
shelf life?
a. Fresh frozen plasma
b. Cryoprecipitate
c. Prothrombin complex concentrates
a. Autologous blood

Ans a - Fresh frozen plasma

Bailey & Love's Short Practice of Surgery 26E - Page 21

Fresh-frozen plasma
o Fresh-frozen plasma (FFP) is rich in coagulation factors and is removed
from fresh blood and stored at -40 to -50C with a two-year shelf life.
o It is the first-line therapy in the treatment of coagulopathic haemorrhage.
o Rhesus D-positive FFP may be given to a rhesus D-negative woman although it
is possible for seroconversion to occur with large volumes due to the presence
of red cell fragments, and rhesus D immunization should be considered.

Cryoprecipitate
o cryoprecipitate is a supernatant precipitate of FFP and is rich in factor VIII and
fibrinogen. It is stored at -30C with a two- year shelf life.
o It is given in low fibrinogen states or factor VIII deficiency.

Prothrombin complex concentrates

o Prothrombin complex concentrates (PCC) arc highly purified concentrates
prepared from pooled plasma. They contain factors II, IX and X. Factor VII may
he included or produced separately. It is indicated for the emergency reversal of
anticoagulant (warfarin) therapy in uncontrolled haemorrhage.

Autologous blood
o It is possible for patients undergoing elective surgery to pre- donate their own
blood up to 3 weeks before surgery for retransfusion during the operation.
o Similarly, during surgery blood can be collected in a cell-saver which washes
and collects red blood cells which can then be returned to the patient.
GENERAL MEDICINE

52) Which of the following statements is true regarding digital clubbing?

a. Clubbing always indicates heart diseases
b. Presence of clubbing warrants a search for sickle cell disease
c. Clubbing is common in cirrhosis of the liver
d. Clubbing is seen in pulmonary arteriovenous fistula

Ans d - Clubbing is seen in pulmonary arteriovenous fistula

Clinical Examination: A Practical Guide in Medicine By Hira Harmanjit Singh 5th ed pg
26
Clubbing may be present in one of five stages

1. Fluctuation and softening of the nail bed (increased ballotability)

2. Loss of the normal <165 angle (Lovibond angle) between the nailbed and the fold
(cuticula)
3. Increased convexity of the nail fold
4. Thickening of the whole distal (end part of the) finger (resembling a drumstick)
5. Shiny aspect and striation of the nail and skin
Clubbing is associated with:
Lung disease
o Lung cancer, mainly non-small-cell (54% of all cases), not seen frequently in
small-cell lung cancer (< 5% of cases)
o Interstitial lung disease most commonly fibrosing alveolitis
o COPD (clubbing is never found in asthma)
o Complicated tuberculosis
o Suppurative lung disease: lung abscess, empyema, bronchiectasis, cystic
fibrosis
o Mesothelioma of the pleura
o Arteriovenous fistula or malformation
Heart disease:
o Any disease featuring chronic hypoxia
o Congenital cyanotic heart disease (most common cardiac cause)
o Subacute bacterial endocarditis
o Atrial myxoma (benign tumor)
o Tetralogy of Fallot
Gastrointestinal and hepatobiliary:
o Malabsorption
o Crohn's disease and ulcerative colitis
o Cirrhosis especially in primary biliary cirrhosis
o Hepatopulmonary syndrome, a complication of cirrhosis
Others:
 o Graves' disease (autoimmune hyperthyroidism) in this case it is known
as thyroid acropachy
o Familial and racial clubbing and "pseudoclubbing" (people of African descent
often have what appears to be clubbing)
o Vascular anomalies of the affected arm such as an axillary artery aneurysm (in
unilateral clubbing)

53) A 40 year old male, known case of type 2 DM has recently presented with
hypertension. His urine is positive for micro-albumin . Which of the following is
first line anti-hypertensive drug.
a. Enalapril
b. Hydrochlorothiazide
c. Verapamil
d. Furosemide

Ans a Enalapril
Pharmacology and Pharmacotherapeutics by Satoshkar 24th 3d pg 430

ENALAPRIL
Its a Angiotensin Converting Enzyme Inhibitors used as an antihypertensive
drug
It is a prodrug and is converted in the body to the active metabolite enalaprilate
Food does not interfere with its absorption
It is more potent than captopril
Its action is slower but lasts longer.
All Angiotensin Converting Enzyme Inhibitors protect kidneys and decrease
microalbuminuria in patients with insulin dependent diabetes mellitus and
nephropathy and hence in patients who have diabtetic neuropathy this medication is
given.

54) Referred pain at left shoulder in patients with spleenic rupture is known as
a. Murphys sign
b. Iris sign
c. Rovsings sign
d. Kehrs sign

Ans d- Kehrs sign

Interpreting Signs and Symptoms edited by Lippincott 1st ed Pg 355

Kehrs sign
A cardinal sign of hemorrhage within the peritoneal cavity, Kehr's sign is referred left
shoulder pain due to diaphragmatic irritation by intraperitoneal blood.
The pain usually arises when the patient assumes the supine position or lowers his head.
 Such positioning increases the contact of free blood or clots with the left diaphragm,
involving the phrenic nerve.
Kehr's sign usually develops right after the hemorrhage however, its onset is sometimes
delayed up to 48 hours.
Friends. Its a classic symptom of a ruptured spleen

55) The commonest type of Porphyria is

a. Congenital erythropoietic porphyria.
b. Variegate porphyria
c. Acute Intermittent porphyria
d. Porphyria cutanea tarda

Ans d- Porphyria cutanea tarda

Wintrobe's Clinical Hematology 13th ed Page 676

Porphyria is due to inborn errors of porphyrin metabolism, characterized by

Overproduction of uroporphyrin.
Excretion of red urine containing much uroporphyrin,
Photo sensitivity,
Vesicular eruptions containing Serous fluid that exhibits red fluorescence,
Staining of deciduous and permanent dentitions
The deciduous and permanent teeth may show a red or brownish Discoloration and
exhibit red fluorescence.(MAHARASHRTA - 2011)
Deposition of porphyrinin bone and teeth is due to its physical affinity for calcium
phosphate
The most common type of porphyria is sporadic porphyria cutanea tarda

56) Velcro crackles are heard in

a. Pleural effusion
b. Pneumothorax
c. Lung cancer
d. Pulmonary fibrosis

Ans d - Pulmonary fibrosis

Essentials of Rubin's Pathology 5th ed Page 265

Pulmonary fibrosis is suggested by a history of progressive (worsening over time)

shortness of breath with exertion.
Sometimes, during examination of the lungs with a stethoscope, the doctor can hear
crackling sounds in the chest.
These crackles have a very characteristic sound and are very similar to the sound heard
when Velcro is pulled apart.
These are often referred to as "Velcro crackles (or rales)".

57) The dicrotic notch on the aortic pressure curve is caused by

 a. Closure of the pulmonary valve
b. Rapid filling of the left ventricle
c. Closure of the aortic valve
d. Contraction of the atria

Ans c- Closure of the aortic valve

Harrisons Internal Medicine 16th ed Pg 1034

ARTERIAL PRESSURE PULSE

The normal central aortic pulse wave rapid rise to a rounded peak
The anacrotic shoulder present on the ascending limb, occurs at the time of peak rate of
aortic flow just before maximum pressure is reached.
The less steep descending limb is interrupted by a sharp downward deflection,
coincident with aortic valve closure, called the incisura.
As the pulse wave is transmitted peripherally, the initial upstroke becomes steeper, the
an acrotic shoulder becomes less apparent, and the incisura is replaced by the smoother
dicrotic notch which signals the closure of the aortic valves

ORAL PATHOLOGY AND ORAL MEDICINE

58) Multiple odontogenic cysts seen in

a. Cherubism
b. Aperts syndrome
c. Marfans syndrome
d. Downs syndrome

Ans c - Marfans syndrome

Textbook of Oral Pathology By Anil Ghom 1st ed 619

Martan's Syndrome
It is also called as 'Marfan-Achard syndrome', 'arachnodactyly'. It is hereditary disease
transmitted as autosomal dominant trait. It is basically a disease of connective tissue
related to defective organization of collagen which is abnormally soluble.
Clinical Features
o Excessive length of the tubular bones resulting in disproportionately long thin
extremities, the finger and toes are long, thin and tapering so that the name
'spider finger' has been applied.
o The shape of face and skull is characteristically long and narrow.
o Hyperextensibility of joint with habitual dislocations, kyphosis or scoliosis
and flatfoot.
o Bilateral ectopia lentis: It caused by weakening or rupture of the suspensory
ligaments.
o Cardiovascular complications like aortic aneurysm and aortic regurgitation,
valvular defects and enlargement of the heart are common.
Oral Manifestations
o High-arched palatal vault is very prevalent.
 o Bifid uvula, malocclusion and multiple odontogenic cysts of maxilla and
mandible.
o There may be temporomandibular dysarthrosis.

59) The depth of invasion of a melanoma is measured by

a. Breslow thickness
b. Clarkes levels
c. Radial growth
d. Broders classification

Ans a - Breslow thickness

Shafer's Textbook of Oral Pathology 7th ed Page 131

Tumor thickness as defined by the Breslow's Depth of Invasion is the most important
determinant of prognosis for melanomas. Increased tumor thickness is correlated with
metastasis and poorer prognosis.

Recent findings have shown that the presence of ulceration microscopically is the
second most important determinant of prognosis.

Clark's Level of Invasion measures the level of tumor invasion through the layers of
the skin, but has recently been shown to affect prognosis only in melanomas that are <1
mm depth.

Breslow's Depth of Invasion (Thickness)

Breslow's depth of invasion is an actual measurement of the depth of the lesion, measured
vertically in millimeters from the top of the granular layer (or base of superficial ulceration) to
the deepest point of tumor involvement. Tumors are classified into four categories based on
the depth:

Less than or equal to 0.75 mm (equivalent to Clark's Level II)

0.76-1.5 mm (equivalent to Clark's Level III)
1.51-4 mm (equivalent to Clark's Level IV)
Greater than or equal to 4 mm (equivalent to Clark's Level V)

Clark's Level of Invasion

Clark's level of invasion is based on the level of tumor invasion relative to the layers of the
skin. Tumors are classified into five levels:

Level I - All tumor cells are confined to the epidermis, above the basement membrane
(in situ)
Level II - Tumor invades into the papillary dermis, past basement membrane
Level III - Tumor fills the papillary dermis and extends to the interface between the
papillary and reticular dermis
Level IV - Tumor invades the reticular dermis
 Level V - Tumor invasion of subcutaneous tissue

60) The growth of odontogenic keratocyst mainly takes place in the direction of
a. Superio inferior
b. Buccolingual
c. Inferio lateral.
d. Anterior posterior

Ans d - Anterior posterior

Sataloff's Comprehensive Textbook of Otolaryngology 1st ed Pg 774

OKC often resorb the roots of adjacent teeth.

They expand more from the anterior to the posterior rather than buccolingually when
they are present in mandible.( I BELIVE THE QUESTION ASKS ABOUT
MANDIBULAR OKC )
However, in the maxilla there is more buccal expansion than palatal expansion since
the cyst tends to extend through bone with the least density.

61) The typical triad of maxillary sinusitis are

a. Nasal congestion, Pathological secretion, Headache
b. Nasal congestion, trismus, epiphora
c. Nasal congestion, maxillary tooth pain, bloody discharge from the sinus
d. Nasal obstruction, Headache, Ear ache

Ans a- Nasal congestion, Pathological secretion, Headache

Oral and Maxillofacial Pathology Neville 4th ed Page 187

Presenting symptoms of acute sinusitis in adults include

Headache, fever, facial pain over the affected sinus.
Anorexia, photophobia, and malaise also may be seen.
Anterior nasal or posterior pharyngeal discharge is present
Children, with their less complex sinuses, typically have only persistent cough, fever,
and purulent rhinorrhca.
Localized involvement of the maxillary sinus can occur as pain over the cheekbone,
toothache.

62) The clinical finding most suggestive of an inflammatory cause of joint pain is
a. Joint deformity
b. Swelling and warmth
c. Painful range of motion
d. Crepitus

Ans b - Swelling and warmth

Textbook of Oral Medicine By Anil Govindrao Ghom, 3rd ed pg 576
Inflammatory joint disease is characterized by an activation of the body's inflammatory
response leading to Overlying warmth and erythema which are specific signs
of inflammation in or about the joint, but may be absent in less acute cases of arthritis.

63) The fastest growing human cancer which doubles in size every day 1 -3 days
occurring in young children manifesting as rapidly growing extra nodal jaw tumor
is
a. Burkitts lymphoma
b. Multiple myeloma
c. Multiple sclerosis
d. Solitary myeloma

Ans a - Burkitts lymphoma

Burket's Oral Medicine: Diagnosis & Treatment 10th ed Page 450

BURKITT'S LYMPHOMA
Primary tumor cell has been shown to be a poorly differentiated B lymphocyte.
The African form of BL most frequently manifests itself as rapid-growing extranodal
jaw tumors in young children, but it also may be first detected as an abdominal mass
involving the kidneys or ovaries.
The tumor expands rapidly and may double in size every 1 to 3 days, making it the
fastest growing human cancer.
This rapid growth nullifies the usefulness of the Ann Arbor classification used for
other NHLs.
BL patients are divided into two categories: small tumor burden and large tumor
burden.

64) Bruxims causes the following EXCEPT

a. Caries.
b. Attrition of primary & permanent teeth.
c. Muscular tenderness.
d. TMJ disorder

Ans a- Caries.
Cawson's Essentials of Oral Pathology and Oral Medicine 8th ed Pg 74

Bruxism is the term given to periodic repetitive clenching or rhythmic forceful grinding
of the teeth.
Bruxism is divided into nocturnal and daytime types.
In nocturnal bruxism, the teeth are clenched or ground many times each night but for
only a few seconds at a time.
Bruxism is often performed in a protrusive or lateral excursion so that the forces are
borne on few teeth and in an unfavourable direction.
The resulting attrition can be deeply destructive
The muscle pain of bruxism is felt in the morning and is the same as muscular pain
after exercise.
 Bruxism is often considered to be linked to pain dysfunction syndrome and TMJ
problems

65) Which among the following is NOT a common feature of trigeminal neuralgia
a. Sharp, stabbing pain lasting seconds.
b. Pain usually crossing the midline of the face.
c. Usually affecting the middle aged and elderly.
d. The most common sites involved are the mandibular canine and maxillary
canine areas.

Ans b - Pain usually crossing the midline of the face

Burket's Oral Medicine 11th ed - Page 279

Trigeminal nueralgia or Fothergills disease or Tic Doulourex

A major neuralgia involving teeth, face and jaws.
Usually occurs among midle aged people (above 35 years of age) and right side of the
face is affected more frequently than the left side.
Seldom occurs below 35 years.
Presence of trigger zones is characteristic in nature.
The disease never crosses midline.

66) For the analysis of bitemarks which of the following reference scale is used?
a. (ABFO) No. 5
b. (ABFO) No. 1
c. (ABFO) No. 2
d. (ABFO) No. 3

Ans c - (ABFO) No. 2

Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology by Ongle 2nd ed pg 676

High-quality photographs provide a permanent record of the bite mark appearance. No

time should be lost in obtaining photographs as the injury rapidly changes appearance
due to healing in living victims or postmortem change in the deceased. Color and black-
and-white photographs may be taken using off-angle light source.
Orientation and close-up photographs should be taken: orientation photographs depict
the location of the bite mark on the body
Close-up photographs of the bite mark should be made with a rigid reference scale-
a ruler, such as the ABFO No. 2 scale, should be placed on the same plane as the bite
mark.

67) Mask like appearance is seen in

a. Bells palsy
b. All of the above
c. Scleroderma
d. Parkinsons disease

Ans b - All of the above

Burket's Oral Medicine, 12e: - Page 508

Mask like appears of Face

o Scleroderma
o Bells palsy
o Parkinsons disease

68) Which of the following is associated with Hypodontia?

a. Gardner syndrome
b. Cleidocranial dysplasia
c. Ectodermal dysplasia
d. Fibrous dysplasia

Ans c - Ectodermal dysplasia

Shafer'S Textbook Of Oral Pathology (6Th Edition) - Page 47

HERIDITARY ECTODERMAL DYSPLASIA

Involves one or more ectodermal structures and appendages.

Three most outstanding features of ectodermal dysplasia are:-
o Hypohydrosis (lack of sweating)
o Hypotrichosis (absence of hairPILL TORTI kinky hair), and
o Hypodontia (absence of teeth).
Hyper pyrexia is seen due to hypohidrosis, (lack of sweating), and inefficient
temperature control.
In majority of cases of hereditary hypohydrotic (anhidrotic) ectodermal dysplasia is an
x-linked recessive mendelian character,
Males being affected much more frequently than females.
However in some forms the abnormality can also be transmitted as an autosomal
recessive characteristic

Oral manfestations includes:-

Anodontia or Oligodontia.
Malformation of Decidious and permanent dentition.
Jaws are normal.
Salivary glands are hypoplastic resulting in xerostomia and pseudorhagade formation.
Protuberant lips and depressed nasal and supraorbital bridges are important features of
ectodermal dysplasia.

Hyperpyrexia,Protuberant lips and frontal bossing,defective or absence of sweat

glands are seen in :- (AIIMS 90) --ectodermal dysplasia

69) Gustatory sweating is seen in

a. Both a & b
b. Auriculotemporal syndrome
 c. Freys syndrome
d. Hortons syndrome

Ans a Both a & b

Shafers textbook of Oral Pathology 5th ed pg nu 1169

Gustatory sweating or Auriculo temporal syndrome or Freys syndrome arises due to

damage of auriculotemporal nerve and subsequent reinnervation of sweat glands by
parasympathetic salivary fibres.
This usually follows surgical removal of parotid, (or) ramus of mandible which
damages auriculotemporal nerve.
It typically exibits flushing and sweating of the involved side of the face, chiefly in the
temporal area, during eating.

Freys syndrome results from surgery of the (AIPG 99; MAN, AIIMS 2K; KAR
03)--------salivary gland----(parotid)
Gustatory Sweating is seen in which of the following diseases? (AIPG 97, MP 09)-
---- Frey's syndrome

70) Hypercementosis
a. Is seen in cleidocranial dysostosis
b. Is characterised by loss of lamina dura
c. Is associated with Pagets disease of bone
d. Is a neoplastic deposition of cementum

Ans c - Is associated with Pagets disease of bone

Shafers textbook of Oral Pathology 5th ed pg no 1005

Ostestis deformans/pagets disease of bone is generalized skeletal disease characterised by

deposition of excessive amounts of secondary cementum on the roots of teeth and by apparent
disappearance of lamina dura and root resorption some times.

Factors associated with hypercementosis

Local factors Systemic factors.

Abnormal occlusal Acromgaly and

trauma. pituitary gigantism.
Adjacent Aothritis.
inflammation. Calcinosis.
Unopposed teeth Pagets disease of
(& impacted teeth, bone.
embedded, with Rheumatic fever.
out antagonist) thyroid goiter
vit.A.deficiency
 (possibly)

71) Gustafsons method of age estimation does NOT include assessment of

a. Dentin translucency
b. Cementum apposition at root apex
c. Abrasion of teeth
d. Secondary dentin deposition

Ans c- Abrasion of teeth

Textbook of oral pathology by saraf 1st ed pg no 527

GUSTAFSONS METHOD

This is a method of age estimation, based on the microscopic examination of the central
of teeth to assess changes from wear and tear with advancing age:
Attrition
Paradentosis
Secondary dentin
Cementum apposition
Root resorption
Transparency of the root: It is not seen until about 30 years of age. The canals in the
dentin are at first wide. With age they are filled by mineral, so that they become
invisible and the dentin becomes transparent. It is the most reliable of all criteria

72) Disease of Pulp & Periapical Tissues Sensitivity to hot in chronic pulpititis
indicates which fibres stimulation
a. C-fibres
b. A-delta
c. A-Alpha
d. A-beta

Ans a - C-fibres

Cohens Pathway of Pulp 10th ed Page no 50

A Delta fibers C- Fibers

Slightly myelinated Non myelinated

Faster than C fibers Slower conduction
More commonly located around the Respond to all stimuli
odontoblastic layer and terminate at More centrally located
odotonblastic process Has high threshold
Respond to inflammation or tissue
damage
 Primarily respond to the stimuli which Follow all or none phenomenon
change the fluid movement in the 80% of total fibers
tubule Respond ad dull boring pain
Responds mostly to mechanical stimuli
than thermal of chemical
Has high frequency action potential at
central nervous system
20% of total fiers
Respond as sharp pain

73) Tic douloureux affects which cranial nerve?

a. III
b. V
c. XII
d. VII

Ans b - V
Shafers textbook of Oral Pathology 5th ed pg nu 1163

Tic douloureaux is also called as Trigeminal neuralgia or Tic doloreux ---- 5th-nerve --
Trigeminal nerve

BELLS PALSY 7th Facial nerve

HERPES ZOSTER 5th Trigeminal nerve
TRIGEMINAL NEURALGIA OR TIC 5th Triigeminal nerve
DOLOREUX
GLOSSOPHARYNGIAL NEURALGIA 9th Glossopharyngial nerve
AURICULOTEMPORALSYNDROME(OR) 5th Auriculotemporal branch of
FREYS SYNDROME (OR) Trigeminal nerve (COMED 2011)
GUSTATORY SWEATING

74) Osteomyelitis of jaws is caused primarily by

a. E coli
b. Streptococcus (Alpha Haemolytic) & anaerobes
c. Staphyloccocus Aureus
d. Treponema ppalladium

Ans b - Streptococcus (Alpha Haemolytic) & anaerobes

Shafers textbook of oral pathology 5th ed pg no 691

This is just a repeat of Old AIPG question

Acute osteomyelitis is most frequently caused by which of the following
microorganisms AIPG 02, 03)----- Staphylococcus aureus and Staph, albus

75) Suttons disease is .

 a. Scarlet fever
b. TB
c. Recurrent apthous ulcers
d. Congenital syphilis

Ans c - Recurrent apthous ulcers

Shafers textbook of oral pathology 5th ed pg no 919

Apthous major is also known as periadenitis necrotica recurrens or Suttons disease or

Mikuliczs scarring apthae.

76) Noonans syndrome is associated with.

a. Osteopetrosis
b. Cherubism
c. Macrognathia
d. Cleidocranial dysplasia

Ans b - Cherubism
Shafers textbook of Oral Pathology 5th ed pg no 982

Cherubism( Familial Fibrous Dysplasia of Jaw)

o Autosomal dominant
o Involves more than one quadrant
o Stabilizes after growth period(starts by 14 months to 3 years)
o Gene 4p16.3 affected
Clinical features
o Cherubic look
o More in males
o Mostly bilateral
o Cervical lymphadenopathy
o Eye in to heaven appearance- a rim of sclera visible below iris
o Associated with Noonans Syndrome
Radiographic Features
o Floating tooth syndrome
o Ground glass appearance
Histologic Feature - Eosinophilic cuffing

77) Ameloblastoma which metastasizes is

a. Ameloblastic carcinoma.
b. Peripheral ameloblastoma.
c. Ameloblastic fibroma.
d. Malignant Ameloblastoma.

Ans d - Malignant Ameloblastoma

Shafers textbook of oral pathology 5th ed pg no 380-381

Metastasizing ameloblastoma
 Metastasizing ameloblastoma is an ameloblastoma that metastasizes in spite of a
benign histologic appearance.
Metastasizing ameloblastoma shows no specific features different from
ameloblastomas that do not metastasize
Therefore, this diagnosis can only be made in retrospect, after the occurrence of
metastatic deposits
It is clinical behaviour and not histology that justifies a diagnosis of metastasizing
ameloblastoma

78) The triad of interstitial keratitis, notched central incisors and eighth nerve
deafness is seen in
a. Congenital syphilis
b. Cytomegaloviral infection
c. Toxoplasmosis
d. Congenital rubella

Ans a - Congenital syphilis

Shafers textbook of oral pathology 5th ed pg no 71,453

Hutchinson triad

Found in congenital syphilis

Mulberry molars (MOONS molars Or FOURNIERS molars) - occlusal one third
of tooth is arranged in an agglomerate mass of globules (AIPG 91, 94)
Hutchinsons incisors screw driver(AIPG - 2011) incisors and the mesial and distal
surfaces of crown are tapered and the incisal edge is usually notched are found in
congenital syphilis

Gumma is found in tertiary syphilis.

Small round superficial erosions in the mouth which coalesce to from the so called
snail track ulcers are seen in--- Kar 2011 - Secondary syphilis
Snail track lesions or mucous patches -(COMED 08 , KCET 2010)- Found in
secondary syphilis

79) Scarlet fever is caused by

a. Beta haemolytic streptococci
b. Staphylococcal
c. Streptococcal impetigo
d. Streptococcus pyogens

Ans d - Streptococcus pyogens

Shafers textbook of oral pathology 5th ed pg no 436
 Scarlet fever in children is caused by B-hemolytic type of streptococci.
The oral manifestations are known as Stomatitis scarlatina.
The Tongue exhibits a white coating and the fungiform papilla are
hyperemic,projecting above the surface. This is known as Strawberry tongue.
Later, the coating is lost and the tongue becomes red and smooth except for swollen
hyperemic papilla. This is known as Raspberry Tongue.

80) Internal resorption of tooth is also called as?

a. Chronic hyperplastic pulpitis
b. Pink tooth of Mummery
c. Pulp atrophy
d. Pulp hyperemia

Ans b - Pink tooth of Mummery

Shafers textbook of Oral Pathology 5th ed pg nu 775

Pink tooth of mummery is due to internal resorption

Pink disease is seen due to poisoning of Mercury

81) Which of the following is the inflammatory cyst

a. Odontogenic Keratocyst.
b. Radicular cyst.
c. Dentigerous Cyst.
d. Lateral Periodontal cyst.

Ans b - Radicular cyst.

Shafer's Textbook of Oral Pathology 6th ed Page 259

TYPES OF CYSTS (WHO-Modified)

ODONTOGENIC CYST NON ODONTOGENIC
DEVELOPMENTAL INFLAMMATORY CYST
Nasopalatine duct (incisive
Odontogenic keratocyst (primodial Radicular cyst canal) cyst
cyst) (periapical cyst) Nasolabial (nasoalveolar)
Dentigerous (follicular) cyst o Apical
cyst
Eruption cyst
o Lateral
Lateral periodontal cyst
Gingival cyst of infarcts (epstein o Residual
pearls)
Gingival cyst of adults Paradental cyst
Glandular odontogenic cyst;
sialoodontogenic
cyst
Orthokeratinized odontogenic cyst
 82) Epstein pearls are formed along the
a. Mid palatine raphe
b. Buccal and lingual aspect of the dental ridges
c. Crest of the maxillary and mandiular dental ridges
d. Border of the tongue

Ans a - Mid palatine raphe

Shafers textbook of oral pathology 5th ed pg no 368

Friends.. they are also called as palatal cysts of the new born

Bohns nodules Derived from epithelial remnants of developing

Epsteins pearls
Dental lamina cysts of
new born.
palatal salivary glands.
Usually scattered over the hard palate and tend to be most
numerous along the junction of hard and soft palate.
Usually present along the median raphae of hard palate
and appeared to be derived from entrapped epithelial
remnants along the line of fusion.
Found on alveolar ridges and are derived from
remnants of dental lamina.

Remember BJPBohns nodules at Junction of palate( hard and soft ) ,Midline ----
epstein pearls

ORAL RADIOLOGY

83) Which anatomical structure can appear as soap bubble in panoramic image?
a. Glenoid fossa of TMJ
b. Pterygomaxillary fissure
c. Shadow of hard and soft palate
d. Zygomaticotemporal suture

Ans - a - Glenoid fossa of TMJ

Oral Radiology: Principles and Interpretation By Stuart C. White 7th ed pg 181

Friends. I searched a lot for the reference but I did not find a book which clearly
says that glenoid fossa appears as Soap bubble in TMJ but I did find the following
lines in the above reference which is very close to the answer.
The glenoid fossa is part of the temporal bone, and it can be pneumatized by the mastoid
air cells.
This can result in the appearance of a multilocular radiolucency in the articular
eminence and the roof of the glenoid fossa, which is a variant of normal.
 84) The rare earth elements used in intensifying greens which emit green light are
a. Gadolinium oxysulfide, niobium activated
b. Gadolinium oxysulfide, terbium activated
c. Yttrium tantalite, terbium activated
d. Yttrium tantalite, niobium activated

Ans- b - Gadolinium oxysulfide, terbium activated

Oral Radiology: Principles and Interpretation By Stuart C. White 7th ed Pg 67

INTENSIFYING SCREENS RARE EARTH ELEMENTS USED

EMISSION PHOSPHOR
Green Godolinium oxysulfide, terbium activated
Blue and UV Yttrium tantalite, niobium aagivated

85) Reverses smile line appearance of panoramic image is formed due to positioning
of patients head
a. Anterior to focal trough
b. Upward overangulation
c. Downward overangulation
d. Posterior to focal trough

Ans- b - Upward overangulation

Textbook of Oral Radiology By Ghoms 1st ed pg 288

Effect of patient positioning in the focal trough on the resultant image

Patient Position in focal Trough Image characteristics

Patient overbites on the bite block. The The mandibular anterior teeth appear narrow
incisal edges of teeth placed way ahead of and fuzzy and the mandibular ramus and
the groove on the bite condyles will be superimposed by the image
of the cervical spine

However, this technique may be empbyed if the

area of interest is the maxillary sinus and the
nasal cavity

Patient's anterior teeth way too short of the Anterior teeth appear horizontally magnified
bite and blurred

Patient is positioned with the chin tipped The area in the mandibular anterior region
down too steeply may appear blurred. Anterior teeth in the
maxilla appear elongated and those of the
mandible will appear stunted

Patient is positioned with the chin lifted
up
Improper midline orientation of the patient
within the focal trough
Patient's neck is slumped and not straight
and extended
Moreover, the hyoid bone may appear
superimposing on the roots of the
mandibular premolars and molars and the
TMJ region may not be imaged
A 'smile-line' is created
The occlusal plane in the resultant image
either appears flat or as a reverse curve .
This has been referred to as a 'sad line' or a
frown However, this technique of patient
positioning may be used to improve imaging of
mandibular anterior teeth
Posterior teeth out of the focal trough will
appear broad and exhibit proximal overlap,
whereas on the contralateral side the teeth
will appear slender
A vertical opaque shadow is seen obscuring
the midline structures

Patient instructed to swallow and hold the This technique will prevent superimposition
tongue against the hard palate of the pharyngeal air space over the roots of
the maxillary anterior teeth

86) An exaggerated smile line seen in OPG is due to

a. Patients head positioned too far forward
b. Patients chin positioned too high
c. Patients chin positioned too low
d. Patients head positioned too far back

Ans c - Patients chin positioned too low

Textbook of Oral Radiology By Ghoms 1st ed pg 288

A "reverse smile line" is seen on a panoramic film when the patient's chin is tipped up

87) The radiographic appearance of Botryoid odontogenic cyst is

a. Apple green appearance
b. Orange peel appearance
c. Lemon peel appearance
d. Grape bunch appearance

Ans d - Grape bunch appearance

Textbook of Oral and Maxillofacial Surgery by Nelima Malik 3rd ed Page 498

The botryoid odontogenic cystis a particular multilocular cyst that gives a "grape
bunch" multilocular radiolucent appearance
The polycystic variant of lateral periodontal cysts is called Boryoid odontogenic cyst.
 Botryoid odontogenic cyst is a variant of (MAN 02)------ Lateral periodontal cyst.

88) An anatomic structure which has a worm hole radiolucency is characteristic of

a. Nutrient canal
b. Mandibular canal
c. Maxillary sinus
d. Mental foramen

Ans a Nutrient canal

Differential Diagnosis of Oral and Maxillofacial Lesions by Norman Kenyon Wood 5th ed
pg 297

Nutrient canals are obvious in the mandibular periapical radiographs of some individuals and
appears as worm hole radiolucency which runs parallel to the alveolar crest

89) Pepper and salt appearance is the radiographic description of which of the
following lesion?
a. Ameloblastoma
b. Calcifying odontogenic cyst
c. Follicular cyst.
d. Calcifying epithelial odontogenic tumor.

Ans b - Calcifying odontogenic cyst

Burkets Oral Medicine 9th ed Page no 427

A "salt and pepper" appearance of the glands on MRI is particularly suggestive of SS

Salt and pepper appearance of IOPA X-rays is seen in Thalassaemia.

ORTHODONTICS

90) In Occipital pull headgear, if the force is inferior to both center of resistance of
maxilla and maxillary dentition, results in
a. Anterior (Anti-Clockwise) rotation of maxilla & Posterior (Clockwise) rotation
of maxillary dentition
b. Anterior (Anti-Clockwise) rotation of maxilla & Anterior (Anti-Clockwise)
rotation of maxillary dentition
c. Posterior (Clockwise) rotation of maxilla & Anterior (Anti-Clockwise) rotation
of maxillary dentition
d. Posterior (Clockwise) rotation of maxilla & Posterior (Clockwise) rotation of
maxillary dentition

Ans d - Posterior (Clockwise) rotation of maxilla & Posterior (Clockwise) rotation of

maxillary dentition
 91) Which of the following is an example of antisialogogues used to control moisture
during orthodontic bonding
a. Epinephrine
b. Banthine
c. Betamethasone Dipropionate
d. Paracetamol

Ans b - Banthine
Orthodontics by Graber 3rd ed Pg 560

Present experience indicates that antisialagogues are generally not needed for most
patients.
When indicated, Banthine tablets (50 mg per 100 lb [ 45 kg] body weight) in a sugar-
free drink, 15 minutes before bonding, may provide adequate results during the bonding
procedures in orthodontics

92) The ratio between the anatomic portion to artistic portion in a well trimmed study
models should be
a. 2:1
b. 1:3
c. 1:4
d. 1:2

Ans a - 2:1

Orthodontics by Kharbanda 1st ed Pg 125

Orthodontic study models consist of two parts

Anatomic part.
o The anatomic part of the study model consists of the actual impression of the
dental arch and its surrounding structures and is usually made in stone plaster.
Artistic part.
o The artistic part of the study model consists of a symmetrical plaster base that
supports the anatomic portion and helps in analyzing the occlusion and
orientation of the study models.
The ratio of the anatomic portion to the artistic portion should he 3:1. (OPTION A
IS CLOSE TO THIS HENCE THE RIGHT ANSWER)
Preferably both the anatomic and the artistic parts should be poured in the same
orthodontic grade stone plaster.

93) Cepalometric analysis used for the assessment of antero-posterior jaw relationship
a. R angle
b. Wits
 c. Facial axis
d. Jaraback

Ans- b Wits
CONTEMPORARY ORTHODONTICS Proffit 4th ed Pg 212

The Wits appraisal of jaw disharmony employs just one measurement and is intended as a
diagnostic aid whereby the severity or degree of anteroposterior jaw disharmony can be
measured on a lateral cephalometric head film.

94) Gnathostatics was developed by

a. Burstone
b. Proffit
c. Paul Simon
d. Kesling

Ans c - Paul Simon

Textbook of orthodontics by Premkumar 2nd ed Page 242

Gnathostatic casts reproduce the inclination of the occlusal plane with reference to the
Frankfort plane.
Gnathostatics is a diagnostic medium relating teeth and their base to each other and to
craniofacial structures.
Gnathostatics was developed by Paul Simon.
Symmetry in cast can be analyzed by placing transparent ruled grid.
The symmetry of the dental cast is measured using midpalatal raphe as the indicator.
The prominence of the chin compared with the prominence of lower incisors is
determined by holdaway ratio.
Maxillary incisors are not taken into account in mixed dentition analysis because the
lateral incisors are variable.
The base of the model and the occlusal plane should be parallel.
The back of the model and the midpalatal line should be perpendicular.
The angle between the posterior cuts of the model and the base is 130-135 degrees.

95) In case of Activator Headgear Orthopedics, the recommended extra oral force
levels per side for full permanent dentition is
a. 150 to 400 grams
b. 400 to 500 grams
c. 150 to 250 grams
d. 250 to 300 grams

Ans b - 400 to 500 grams

Textbook of Orthodontics Bhalaji 3rd ed pg 369

Recommended extraoral force levels per side for head gear are as follows
 Full mixed dentition 300 to 400 gms
Mixed dentition during exfoliation 150 to 250 gms
Full permanent dentition 400 to 600 gms

96) The Bionator (modified activator) was developed by

a. Moyers
b. Bimler
c. Balters
d. Neumann

Ans c Balters
Textbook of Orthodontics By Gurkeerat Singh 3rd ed - Page 530

The Bionator is an activator-derived device that was introduced by Balters (18931973)

97) Stainless steel was introduced for the construction of orthodontic appliances by
a. Burstone
b. Friel
c. Anderson
d. Friel

Ans b - Friel
History of Orthodontics 1st ed pg 41

A nobble advance was the introduction of stainless steel, which was employed in the
construction of bands, arches and springs.
Stainless steel was much cheaper and more clinically effective than the previous metal
of choice, gold.
However, considerably more skill was required to work the new material, stainless steel
being difficult to weld.
Friel was a major pioneer for the introduction of stainless steel, and several other
British orthodontists contributed to the realization of its clinical potential.

PROSTHODONTICS

98) To change patients vertical dimension the following record is needed

a. Interocclusal record
b. Kinematic facebow
c. Graphic record
d. Arbitrary facebow

Ans b- Kinematic facebow

Contemporary Fixed Prosthodontics By Rosensteil Page 42

A kinematic face-bow is required if vertical dimension is to be changed

 The kinematic facebow is placed on the hinge axis (the horizontal axis around which
the mandible purely rotates when opening and closing), the location of which has
been previously determined.
Using the hinge axis is especially necessary when the vertical dimension is altered in
the articulator or when an interocclusal record was made at a vertical dimension of
occlusion different from the one to be used.

99) The type of minor connector that connects denture base indicated only in tooth
supported application is
a. Lattice type
b. Nail head type
c. Mesh type
d. Strip type

Ans b - Nail head type

Textbook of Prosthodontics By Nallaswamy 1st ed pg 343

Bend, Wire or Nail Head Indriect retainer

The minor connector directly lines the edentulous ridge without any relief.
Acrylic denture base is attached to the outer surface of the minor connector and
retention is obtained by the projections of metal on the superior surface.
These projections may be beads, nails, or pointing wires
Beads are prepared by placing acrylic balls on the meshwork pattern, burnout and cast.
This minor connector is indicated for tooth supported dentures with well-healed
ridges where frequent relining and rebasing are not anticipated.

100) The Hanau Arcon H2 was introduced in

a. 1926
b. 1977
c. 1938
d. 1954

Ans b 1977

Reference - Journals and articles of Prosthodontics

HANAU ARCON H2 : (MODEL 158) Introduced by Hanau in 1977

101) The floor of the rest seat preparation must be at what angle to the long axis
of the tooth?
a. No specific angle
b. More than 90*
c. Less than 90*
d. Parallel
Ans c - Less than 90*
Removable Partial Dentures: A Practitioners Manual edited by Olcay akar 1st ed pg
96

The angle formed by the floor of the rest and the minor connector should be less than
90 so that the transmitted occlusal forces can be directed along the vertical axis of the
tooth.
If the angle is greater than 90, the prosthesis can slip away from the abutment teeth.
The appropriate angle can be achieved by preparing a spoon shaped rest seat to
avoid excess inclination, which is not recommended

102) Posterior mandible resorbs at a rate approximately ------ times faster than
the anterior mandible
a. 2 times
b. 8 times
c. 4 times
d. 6 times

Ans c - 4 times
Contemporary Implant Dentistry by Carl 3rd ed pg 178

The posterior edentulous mandible resorbs at a rate approximately four times faster
than the anterior edentulous mandible.
It has been suggested that, in the mandibular synthesis, females present higher total
reduction and more rapid bone loss during the first 2 years
Complete denture have the higher rate of resorption in the first year of edentulouness.
The anterior maxilla resorbs in height slower than the anterior mandible.

103) Emergency retentive force for the maxillary complete denture is

a. Posterior palatal seal
b. Deep palate
c. Soft palate
d. Base of the tongue

Ans d - Base of the tongue

Boucher's Prosthodontics 11th ed pg 42

Friends. This is something new. I am sure you must have seen one old question about
Emergency retentive force.. Do you remember that ?? ..This is different!!
The base of the tongue serves also as an emergency retentive force for some patients.

PEDODONTICS
 104) In mixed dentition, permanent mandibular 1st molar emerge, move
primary molars mesially, close the space distal to primary canines, convert the
straight terminal plane to a mesial step, reduce arch length in mandible and allow
permanent maxillary molars to emerge into class I relationship. This has been
referred as
a. Early mesial shift
b. Cortical drift
c. Late mesial shift
d. Secondary displacement

Ans a - Early mesial shift

Balaji text book of orthodontics 3rd ed page no 43

Forward movement of the first permanent molar utilizing the primate space is termed
as early mesial shift.

Early shift occurs during the early mixed dentition period. The eruptive force of the
first permanent molar is sufficient to push the deciduous first and the second molars
forward in the arch to erupt in class I molar relationship.

105) Treatment for ankylosis of primary molar with absence of permanent

successor
a. Willets guiding shoe appliance
b. Stainless steel crown
c. Extraction of primary molar
d. Band and loop space maintainer

Ans b - Stainless steel crown

Principles and Practice Of Pedodontics By Arathi Rao 3rd ed pg 92

Management of Ankylosed Primary Tooth

Surgical removal, if the permanent successor is present.
If permanent teeth are missing, functional occlusion is established with stainless steel
crowns on the affected tooth.

106) Which of the following is NOT an indication for Pit & Tissues sealant
a. Questionable caries
b. Deep pits & fissures with supplemental Anatomy and small areas of decay
c. Stained Pits & fissures with Minimum appearance of decalcification
d. Teeth with interproximal caries

Ans d - Teeth with interproximal caries

Principles and Practice Of Pedodontics By Arathi Rao 3rd ed pg 203

Contraindications for pit and fissure sealants

 Shallow fissures
Well coalesced pits
Fluoride rich enamel
Low caries rate
Occlusal or proximal caries
Adults

107) Discharge criteria following sedation includes all EXCEPT

a. Patient can eat
b. Airway patency is uncompromised and satisfactory
c. Patient can ambulatory
d. State of hydration is adequate

Ans a - Patient can eat

Modern Pediatric Dentistry by By Vinay Kumar Srivastava 1st ed Page 242

Discharge criteria following sedation are as follows

Airway patency is uncompromised and satisfactory

Patient is easily arousable and protective reflexes are intact.
State of hydration is adequate.
Patient can talk, if applicable.
Patient can sit unaided, if applicable.
Patient can ambulate, if applicable, with minimal assistance.
If the child is very young or disabled, incapable of the usually expected responses, the
presedation level of responsiveness or the level as close as possible for that child has
been achieved.
Responsible individual is available.

108) According to the AAPD, in children younger than 3 years, any sign of
smooth surface caries is indicative of
a. Feeding bottle caries
b. Early childhood caries
c. Severe Early childhood caries
d. Rampant caries

Ans c -Severe Early childhood caries

Mosby's Review for the NBDE - Part , 2nd ed Page 210

Early childhood caries (ECC).

ECC definition by the American Academy of Pediatric Dentistry (AAPD)the presence
of more than one decayed (noncavitated or cavitated), missing (owing to decay), or
filled tooth surface in any primary tooth in a child younger than 6.
Severe ECC.
o Younger than 3 yearsany sign of smooth surface decay.
 o Ages 3 to 5
One or more cavitated, missing (owing to caries), or filled smooth
surface in primary maxillary anterior teeth.
A decayed, missing, or filled surface (DMFS) score of greater than 4
(age 3), greater than 5 (age 4), or greater than 6 (age 5).

PERIODONTICS

109) If a patient had 28 teeth and 20% of sites has attachment loss, the number
of periodontally involved sites will be
a. 22
b. 20
c. 28
d. 112

Ans a 22
Carranza's Clinical Periodontology 12th ed pg 70

One tooth has 4 surfaces of attachment

In the above case 20% of 28 teeth is 5.6
So 5.6 multiplied by 4 sites each
Hence the answer 22.4
Or simply multiply 28 by 4 and get 20 % of it.. The answer will be the same

110) A pediatric patient belonging to sub Saharan Africa with severe

malnourishment living in close proximity to fuso bacterium necrophorum is
suffering from
a. Noma
b. Pemphigoid
c. Pemphigus vulgaris
d. Paraneoplastic pemphigus

Ans a Noma
Cawson's Essentials of Oral Pathology and Oral Medicine 8th ed pg 108

Noma is severe oral infection, extending on to and destroying part of the face, and fatal
if inadequately treated.
Mostly affect children
Noma widespread in sub-Saharan Africa
In adults, the development of Noma is likely to be secondary to HIV infection, but only
rarely, despite the severity of the immune deficiency.
Etiological factors include severe malnutrition, poor oral and general hygiene, and
contributory infections such as measles which impair immunity
The main bacteria isolated are anaerobes including Fusobacterium necmphorum.
 111) The following are true of attrition facets EXCEPT
a. Horizontal facets direct forces more favourably to the periodontium than
angular facets
b. Facet prevalence is universal
c. They are occlusal or incisal surfaces worn by attrition
d. They are sensitive to thermal and tactile stimulation

Ans d- They are sensitive to thermal and tactile stimulation

Caranza Clinical Periodontology 8th ed Page 180

Occlusal or incisal surfaces worn by attrition arc called facets.

Shiny, smooth, and curviplanar facets are usually the best indicator of ongoing fric-
tional activity
If dentin is exposed, a yellowish brown discoloration is frequently present
Facets vary with regard to size and location, depending on whether they are produced
by physiologic or abnormal wear.
Facets are usually not sensitive to thermal or tactile stimulation.
Facets generally represent functional or parafunctional wear as well as iatrogenic dental
treatment through coronoplasty (occlusal adjustment).
However, coronoplasty does not appear to contribute to higher ratings of wear
Excessive wear may result in the obliteration of the cusps and the formation of either a
Hat or a cuneiform (cupped-out)occlusal surface
The angle of the facet on the tooth surface is potentially significant to the periodontium.
Horizontal facets tend to direct forces on the vertical axis of the tooth to which the
periodontium can adapt most effectively.
Angular facets direct occlusal forces laterally and increase the risk of periodontal
damage
However, gradual attrition may be compensated for by continuous tooth eruption
without alveolar bone growth, and it is characterized by a lack of inflammatory changes
on the alveolar bone surfaces '

112) Hydroxyapatite coating of dental implants was introduced by

a. Kay
b. Clemow
c. DeGroot
d. Hahn and Palich

Ans c- DeGroot
Dental Biomechanics edited by Arturo N. Natali Page 83

Standard deposition of hydroxyapatite on implant surface was introduced by De Groot in 1990

113) Which of the following is correctly matched for treatment planning ?

a. Phase IV- surgical treatment
b. Phase III- restorative treatment procedures
 c. Phase I- emergency treatment
d. Phase II Oral prophylaxis

Ans b- Phase III- restorative treatment procedures

Carranzas Clinical Periodontology 10th ed Pg No 628

TREATMENT PLAN IS DIVIDED INTO

Preliminary therapy Any emergency procedure like

extractions (or) periodontal abscess
should be treated.
Phase I therapy (or) preparatory phase Plaque control, diet control, removal
(or) etiotropic phase of calculus and root planning
restoration etc
Phase II or surgical phase Periodontal surgeries including
implants and root canal therapy are
carried out.

Phase III or restrorative phase Fixed and removable prosthodontic

appliances and final restoration are
placed.

Phase IV therapy or maintenance therapy Periodic recall visits and checking for
plaque and calculus formation and to
preventrecurrence of the disease.

Maintainence phase therapy starts

with phase I therapy

114) In which of the brushing techniques the bristles are placed at 45 degree
angulation facing the occlusal surfaces of teeth?
a. Charters technique
b. Bass technique
c. Modified bass technique
d. Fones technique

Ans a - Charters technique

Lindhe Periodontology 5th ed Pg No 707 &708

Charter's method

The end of the bristles are placed in contact with the teeth and the gingiva.
The bristles are pointed at 45 degree angle towards the plane of occlusion.
 A downward and lateral pressure is placed upon the brush and the brush is gently
vibrated back and forth, or short circular strokes are made.

Bass method

Most widely accepted technique for effective plaque removal and gingival stimulation.
In this method the brush is placed at 45 degree angle to the long axis of the teeth.
The bristles are gently forced into the interproximal areas and gingival sulcus.
The brush is moved with a vibratory action in short back and forth motions for 10 to 15
seconds for each area

115) One of the radiographic finding of Aggressive periodontitis is arc shaped

bone loss extending from
a. Distal surface of the second premolar to mesial surface of second molar
b. Distal surface of the first premolar to mesial surface of first molar
c. Mesial surface of the second molar to distal surface of the first premolar
d. Mesial surface of the first premolar to distal surface of the second premolar

Ans a - Distal surface of the second premolar to mesial surface of second molar
Carranzas Clinical Periodontology 10th ed Pg No 507

LJP is characterized by distribution of lesions in the 1st molars and incisors with least
destruction in the cuspidpremolar area whereas in generalized JP there is generalized
involvement of teeth.
Vertical bone loss around incisors and molars in otherwise healthy teenagers is
diagnostic of LJP.
There is a Arc shaped bone loss extending from distal surface of second premolar to
mesial surface of second molar creating a mirror image type of bone loss is
characteristic of juvenile periodontitis

116) One wall vertical defect is also known as

a. Osseous crater
b. Reversed architecture
c. Hemiseptum
d. Ledges

Ans c - Hemiseptum
Carranzas Clinical Periodontology 10th ed Pg No 460

Angular defects are classified according to the number of walls remaining.

The less the number of walls remaining, the poor is the prognosis.

ONE WALL DEFECT THREEWALL OSSEOUS DEFECT

 Is also called as Hemiseptum. Is also called infrabony defect (MAN2K)

Prognosis is poor for onewall defects, as Prognosis is better for three-wall defects
they have to be recontoured surgically.

Regenerative procedures cannot be carried Regenerative procedure can be carried out

out in onewall defects easily

117) Minimum amount of Biological width required for the health of the
periodontium is
a. 2 mm
b. 2 cm
c. 0 mm
d. 5 mm

Ans- a 2 mm
Carranzas Clinical Periodontology 10th ed Pg No 1045

Friends.. This is asked commonly. I am sure you would have read it in old papers.
Biologic width (2.04mm ) =Junctional Epithelium( 0.97mm) + Connective tissue
attachment(1.07mm)
Hence there should be at least 3mm gap between the margin of restoration and alveolar
crest.

118) Mouth breathing predispose to localized gingivitis in

a. Maxillary anterior region.
b. Mandibular posterior region.
c. Mandibular anterior region.
d. Maxillary posterior region.

Ans a - Maxillary anterior region.

Essentials of Clinical Periodontology and Periodontics By Shantipriya Reddy 2nd ed pg

413

Mouth-breathing leads to localized gingival inflammation that is usually confined to

the labial gingiva of the maxillary anterior teeth.
The tissue becomes reddened and swollen and it bleeds easily. The surface of
the gingiva is shiny.

Gingival changes associated with mouth-breathing are:

Localized gingival inflammation in the maxillary anterior region.
Crowding of teeth with gingivitis.

Diagnosis
It can be made by simple tests:
 o Mirror test: A double side mirror is held between the nose and the mouth.
Fogging on the nasal side of the mirror indicates nasal-breathing while fogging
towards the oral side indicates oral breathing.
o Cotton test: A butterfly-shaped piece of cotton is placed over the upper lip below
the nostrils. If the cotton flutters down it indicates nasal breathing.
o Wafer test The patient is asked to fill his mouth with water and retain it for a
period of time. While nasal breathers accomplish this with ease, mouth-
breathers find the task difficult

ORAL SURGERY

119) Obturators are used

a. As a root canal filling in primary teeth
b. In Cleft palate children.
c. Epileptic children.
d. In Cl II malocclusion.

Ans b - In Cleft palate children

Textbook of Prosthodontics By Nallaswamy 1st ed Pg 706

Surgical Obturators
It is defined as, "A temporary prosthesis used to restore the continuity of the hard palate
immediately after surgery or traumatic loss of a portion or all of the hard palate and/or
contiguous alveolar structures (i.e. gingival tissue, teeth)".GPT
o Immediate surgical obturator: Inserted at the time of surgery.
o Delayed surgical obturator Inserted 7-10 days after surgery.

Interim Obturators or Tentative Obturators

o It is defined as, "A prosthesis that is made several weeks or months following
the surgical resection of a portion of one or both maxillae. It frequently includes
replacement of teeth in the defect area. This prosthesis, when used, replaces the
surgical obturator that is placed immediately following the resection and may
be subsequently replaced with a definitive obturator".GPT

Definitive Obturators
o It is defined as, "A prosthesis that artificially replaces part or all of the maxilla
and the associated teeth lost due to surgery or trauma".GPT

120) The recommended level of anti coagulation for most patients is an INR of:
a. 3.0-4.5 6. K
b. 1.0-2.0
c. 2.0-3.0
d. 2.5-3.5

Ans c - 2.0-3.0
Ingle's Endodontics 6th - Page 760
Protocols for Treating the Patients on Anticoagulants
Proper historydrug dosage, status of medical condition, PTR and INR level.
Schedule the appointment within 2 days, once desired range of PTR and INR
o INR 2.0 to 3.0do not stop or alter the drug dosage(RECOMMENDED)
o INR 2.5 to 3.5dosage may be altered
o PTR > 2.5 and INR > 3.5delay invasive procedure, until dosage is decreased.
o Physicians should be consulted regarding the dosage modification.
o Confirm status of PTR and INR on the day of surgery.
o Use atraumatic surgical technique.
o Control postoperative bleeding by local measures.
o Patients anticoagulant dosage can be regulated back in 48 to 72 hours in
consultation with physician.

121) Enophthalmos is
a. Diplopia
b. Increase in the volume of the orbit.
c. None of the above.
d. Sinking inward of the eye.

Ans d - Sinking inward of the eye.

RB's Surgery for Dental Students 2nd ed Page 431

Enophthalmos is due to herniation of the orbital fat across the fracture floor of the orbit into
the antrum which results in inward sinking of the eye.

122) Flattening of the cheek seen

a. Condylar fractures.
b. Orbital injuries.
c. Maxillary fractures.
d. Zygomatic bone fractures

Ans d - Zygomatic bone fractures

Textbook of Oral Radiology By Ghom 1st ed pg 596

Signs of the zygomatic bone fracture

o Flattening of the cheek
o swelling of the cheek
o Periorbital haematoma

CONSERVATIVE DENTISTRY

123) In an ideal tooth width proportions when viewed from front, the width of
the maxillary lateral incisor should be
a. 62% of the central incisor
b. 52% of the central incisor
c. 72% of the central incisor
 d. 42% of the central incisor

Ans a - 62% of the central incisor

Contemporary Fixed Prosthodontics By Stephen F. Rosenstiel, 5th ed pg 643

GOLDEN PROPORTION

The anterior teeth have to be manipulated to reflect the golden proportion to get the
highest esthetics
According to this rule the lateral incisors are 62% the width of the central incisors,
and the canines are 62% the width of the lateral incisors.

124) The range of wavelength of visible light curing system is:

a. 365-400nm
b. 410- 500nm
c. 400-700nm
d. 700-900nm

Ans b - 410- 500nm

The Art and Science of Operative Dentistry BY Sturdevant 3rd ed Page 260

Visible light-curing involves light energy in the range of 410 to 500 nm with a peak
intensity of about 470 nm.

125) All of the following are chemomechanical methods of caries removal

EXCEPT
a. Papacarie
b. Carisolv
c. Caridex
d. Air Abrasion

Ans d - Air Abrasion

Sturdevants Art and Science of Operative Dentistry 4th ed Page no 328

Papacarie , Carisolv , Caridex are gel-based Chemico-mechanical dentine caries removal

system that reacts with carious dentine that has undergone proteolytic breakdown of collagen.
causing further collapse of the collagen network for easy final removal with curetting hand
instruments. This chemistry confers an element of self-limiting caries removal ability.

AIR ABRASION OR KINETIC CAVITY PREPARATION

Depends on the transfer of energy from a stream of powder particles (Aluminum oxide)
on the surface of tooth structure or a restoration
Ideal Distance from tooth 3 -5 mmm
Ideal angle of attack 60 to 90 degree
Duration 2 to 20 sec
Motion 12mm/sec
 Particle size 20 to 250 micron
Pressure 20 to 55 psi
The most common error for operators of air abrasion units is to hold the tip at the wrong
distance from the surface,

ENDODONTICS

126) Which of the following is a foldable rubber dam frame?

a. Youngs metal frame.
b. Nygaard-Ostby
c. Le cadre articul.
d. Starlite visuframe

Ans c - Le cadre articul.

Ingles Endodontics 5th ed Pg 396

An innovative, articulated frame developed to facilitate endodontic radiography is le

Cadre Articule
Developed in France by Dr. G. Sauveur, it is curved to fit the face and is hinged in the
middle to fold back, allowing easier access for radiographic film placement.

127) Microscopic Endodontics

a. Does not help in Identification of Microfactures in teeth
b. Does not Aid in the Removal of Diseased Dental Tissue.
c. Improves Posture of Operator
d. Increases Neck and back Fatigue

Ans c - Improves Posture of Operator

Cohen's Pathways of the Pulp Expert Consult 11th ed Pg 162

According to the AAE. microscope benefits are as follows:

Locating hidden canals obstructed by calcifications or reduced in size
Removing materials such as solid obturation materials (silver points and carrier-based
materials), posts, or separated files
Removing canal obstructions
Assisting in access preparation to avoid unnecessary destruction of mineralized tissue
Repairing perforations
Locating cracks and fractures that not clinically visible or palpable with an endodontic
explorer
Facilitating all aspects of endodontic surgery, particularly in root-end resection and
placement of retrofitting material
Photographic documentation enhancement
Microscopic endodontics improves posture and reduces neck and back fatigue
 128) The Initial Rapid Bone Resorption in Apical Periodontitis can be Prevented
by the administration of
a. Aspirin
b. Indomethacin
c. Acetaminophen
d. Ibuprofen

Ans b - Indomethacin
Ingle Endodontics - Volume 1 , 5th ed Page 177

Use of indomethacin, a prostaglandin inhibitor, experimentally reduces bone resorption,

indicating that prostaglandins are also involved in the pathogenesis of periradicular lesions.

129) Corrosion of Silver cones is due to presence of

a. Nickel
b. Cobalt
c. Zinc
d. Tin

Ans a Nickel
Textbook of Endodontics by Nish garg 3rd ed Page 286

Metal like copper nickel add up to the corrosion of the silver cones.
Hence solver cone is not used in todays endodontic world.

130) Disease of Pulp & Periapical Tissues In pulp hyperemia which nerve fibres
are stimulated
a. A-Gamma
b. A- delta
c. A-Beta
d. A-alpha

Ans b - A- delta
Cohens Pathway of Pulp 10th ed Page no 50

A Delta fibers C- Fibers

Slightly myelinated Non myelinated

Faster than C fibers Slower conduction
More commonly located around the Respond to all stimuli
odontoblastic layer and terminate at More centrally located
odotonblastic process Has high threshold
Primarily respond to the stimuli which Respond to inflammation or tissue
change the fluid movement in the damage
tubule Follow all or none phenomenon
80% of total fibers
 Responds mostly to mechanical stimuli Respond as dull boring pain
than thermal of chemical
Has high frequency action potential at
central nervous system
20% of total fiers
Respond as sharp pain

131) The disadvantage of using Mineral Trioxide Aggregate when used as a

retrofilling material is that it
a. Is sensitive to moisture contamination
b. Can discolor the tooth
c. May elicit adverse tissue response
d. Has a long setting time

Ans d - Has a long setting time

Textbook of endodontics by Nishagarg 1st ed Pg 313.

MTA is prepared by mixing the powder with sterile in a 3:1 powder-to-liquid

ratio.
MTA is currently marketed in 2 forms: gray (GMTA) and white (WMTA).
WMTA can be mixed with sterile water, lidocaine, or saline
The mean setting time of MTA is 165 minutes, which is longer than amalgam,
Super EBA, and intermediate restorative material (IRM)
The pH value of MTA is 10.2 after mixing. This value rises to 12.5 at 3 hours

132) The Predominant Microbe in Root Canals Undergoing Retreatment is

a. Fusobacterium Nucleatum
b. Treponema Denticola
c. Enterococcus Faecalis
d. Streptococcus Mutans

Ans c - Enterococcus Faecalis

Cohens Pathways Of Pulp 10th ed Page no 892

Enterococcus faecalis, which is usually found in a low percentage in primary

endodontic infections, is found in almost 30% to 40% of root canal failures.
E. faecalis may be resistant to chemomechanical endodontic procedures and to calcium
hydroxide, a common intracanal medication.
Increased resistance to antibiotics has also been noted in this species.
E. faecalis has ability to occupy depper potion of dentinal tubule hence making it
difficult to remove
 133) The flap design ideal for root end surgical procedures in upper anterior
teeth with ceramic crowns is the
a. Trapezoidal flap
b. Triangular flap
c. Submarginal scalloped flap
d. Semilunar flap

Ans c - Submarginal scalloped flap

Grossmans Endodontic Practice 11th ed Page no 401

DIFFERENT FLAP DESIGNS

CLASSIFICATION OF FLAPS

By GUTMANN & HARRISON

Full mucoperiostal flaps
Limited mucoperiostal flaps

Full mucoperiosteal flaps:

Triangular flap
Trapezoidal flap.
Horizontal (Envelope) flap.

Limited mucoperiosteal flaps:

Submarginal curved flaps (semilunar)

Submarginal rectangular (Leubke Ochsenbein) flaps.

Triangular flap:

It is formed by a horizontal, intrasulcular incision and a single vertical releasing incision.

Advantage:- Rapid wound healing is instituted

Disadvantage:- Limited surgical access due to single vertical releasing incision.

Indications:

o Maxillary anterior teeth.

o Maxillary and mandibular posterior teeth.

Rectangular flap:

It is formed by a horizontal intrasulcular incision and two vertical releasing incisions.

Advantage:- Enhanced surgical access

Disadvantages:

o Flap reapproximation is difficult.

o Post surgical stabilization is difficult.
o Potential for flap dislodgement.

Trapezoidal flap:

o It is formed by two releasing incisions which join a horizontal, intrasulcular

incision at obtuse angles.
o It is contraindicated in periradicular surgery because it deprives the
unflapped tissues adjacent to the angular margins of flap, from adequate
blood supply, thus, jeopardizing nutrient supply and hence leading to
ischaemia and sloughing.

Horizontal flap:

It is formed by a single, horizontal intrasulcular incision.

Advantages:

o Enhanced wound healing, due to uncompromised blood supply.

o Ease of wound closure and post surgical stabilization.

Disadvantage:- Extremely limited surgical access

Indications:

o Palatal surgery
o Corrective endodontic surgery.
-

Limited mucoperiosteal flaps- DD not include the marginal and interdental gingiva in the
reflected flap.

Disadvantages:

o Disruption of blood supply to unflapped tissues.

o Flap shrinkage
o Difficult flap reapproximation.
o Untoward post surgical sequelae.
o Limited use in mandibular sugery.

Sub marginal curved flap: (Semilunar flap)

It is formed by a single curved incision beginning in the alveolar mucosa, extending coronally
into attached gingiva and curving back into alveolar mucosa.

This flap has no place in modern endodontic surgery due to the following disadvantages:

o Limited surgical access

o Restricted surgical field
o Difficult wound closure
o Poor apical orientation
o Disruption of blood supply to unflapped tissues.

Sub marginal rectangular flap: (Luebke-Oschenbein flap)

It is formed by a scalloped horizontal incision in attached gingiva and two vertical releasing
incisions It does not involve marginal or interdental gingiva (thus, good post operative
esthetics).

Advantage

o It does not expose crestal bone.

o Adequate surgical access and good wound healing.
o Unaltered soft tissue attachment levels.

Disadvantages:

o It disrupts the vertically oriented supraperiosteal vessels.

o Potential for flap shrinkage
o Delayed healing and scarring.

Indications:- Maxillary anterior and posterior teeth

Flap design considerations in palatal surgery:

Only two types of flaps are indicated for palatal surgery:

Triangular design.
Horizontal design.

134) Disease of Pulp & Periapical Tissues Sharp, Shooting pain in reversible
pulpitis indicates
a. A-l fibre stimulation
b. A- g fibre stimulation
c. A- d fibre stimulation
d. A- b fibre stimulation

Ans - c- A- d fibre stimulation

Cohens Pathway of Pulp 10th ed Page no 50

Most of the A Delta fibers primarily respond to the stimuli which change the fluid
movement in the tubule

135) Toxicity of AH26 sealer is due to release of

a. Resin acid
b. Formaldehyde
c. Gluteraldehyde
d. Eugenol

Ans b Formaldehyde
Ingle's Endodontics 6th ed - Page 1036

AH-26 Endodontic Sealer

Its a resin based sealer.
Available Powder-liquid system
When freshly prepared, releases small amounts of formaldehyde which is toxic
and may stains the tooth
To overcome this disadvantage AH PLUS sealer was introduced in market

136) Which among the following statements is true regarding posts in

Endodontics
a. Posts preserve the remaining tooth structure.
b. Provide retention for the core
c. They stabilize a periodontally compromised tooth.
d. They strengthen the tooth structure

Ans b - Provide retention for the core

Contemporary Fixed Prosthodontics by Rosenstiel 5th d Page 285

The endodontic post are indicated when there is less amount of remaining coronal tooth
structure.
Research has shown that the metal post indeed weaken the root structure
In the above question Option B is right as it provides the retention for the core.
Also remember that the recent post like fiber post are better for the root structure
compared to metal.

The fiber post are have the district esthetic advantage over the metal post, they
also distribute forces throughout the root and also has the ability to bond to dentin
when used along with the proper bonding agent.

FIBER POST
 Advantages Disadvantages
Esthetically acceptable Poor radiographic visibility
Modulus of elasticity similar to dentin Expensive
Biocompatible Technique sensitive
Distributes stresses over a broad surface
area, thus increasing the load threshold
Easy to handle and place
Less time consuming
Favorable retention in conjunction with
adhesive bonding technique
High resistance to fracture
Easy retrieval

COMMUNITY DENTISTRY

137) The process in which waste is shredded & heated in a rotating auger is
a. Encapsulation
b. Microwave irradiation
c. Screw Feed Technology
d. Inertisation

Ans c - Screw Feed Technology

Safe Management of Wastes from Health-care Activities By A. Prss 1st ed Pg 104

Screw-feed technology

Screw-feed technology is the basis of a non-burn, dry thermal disinfection process in

which waste is shredded and heated in a rotating auger. Continuously operated units,
also called continuous feed augers, are commercially available and already in use in
several hospitals. The principal steps of the process are the following:
The waste is shredded to particles about 25 mm in diameter.
The waste enters the auger, which is heated to a temperature of 110- 140C by oil
circulating through its central shaft.
The waste rotates through the auger for about 20 minutes, after which the residues are
compacted.
The waste is reduced by 80% in volume and by 20-35% in weight. This process is
suitable for treating infectious waste and sharps, but it should not be used to process
pathological, cytotoxic, or radioactive waste. Exhaust air should be filtered, and
condensed water generated during the process should be treated before discharge.

Encapsulation
Disposal of health-care waste in municipal landfills is less advisable if it is untreated
than if it is pretreated.
One option for pretreatment is encapsulation, which involves filling containers with
waste, adding an immobilizing material, and sealing the containers.
 The process uses either cubic boxes made of high-density polyethylene or metallic
drums, which are three-quarters filled with sharps and chemical or pharmaceutical
residues.
The containers or boxes are then filled up with a medium such as plastic foam,
bituminous sand, cement mortar, or clay material. After the medium has dried, the
containers are sealed and disposed of in landfill sites.
Encapsulation alone is not recommended for non-sharp infectious waste, but may be
used in combination with burning of such waste. The main advantage of the process is
that it is very effective in reducing the risk of scavengers gaining access to the
hazardous health-care waste.

Microwave irradiation
Most microorganisms arc destroyed by the action of microwaves of a frequency of
about 2450 MHz and a wavelength of 12.24cm.
The water contained within the wastes is rapidly heated by the microwaves and the
infectious components are destroyed by heat conduction.

Inertization
The process of inertization" involves mixing waste with cement and other substances
before disposal in order to minimize the risk of toxic substances contained in the waste
migrating into surface water or groundwater.
It is especially suitable, for pharmaceuticals and for incineration ashes with a high
metal content (in this case the process is also called stabilization'*).
For the inertization of pharmaceutical waste, the packaging should be removed, the
pharmaceuticals ground, and a mixture of water, lime, and cement added.
A homogeneous mass is formed and cubes (e.g. of 1 m ') or pellets are produced on site
and then can be transported to a suitable storage site. Alternatively, the homogeneous
mixture can be transported in liquid state to a landfill and poured into municipal waste.

138) In the prevention of disease the earliest discovery is attributed to

a. James Lind for scurvy
b. Louis Pasteur for Rabies
c. Bruce for sleeping sickness
d. Edward Jenner for small pox

Ans b - Louis Pasteur for Rabies

Modern Dental Assisting 11th ed Page 268
Pasteur prepared the first vaccine for the fatal animal disease rabies

139) Mode in statistics mean

a. Most frequency occurring member
b. Highest number
c. Not at all seen number
d. Least frequently occurring number

Ans a - Most frequency occurring member

Essentials of Preventive and Community dentistry- Soben peter, 4th edition, page no-381

ARITHMETIC MEAN, MEDIAN, MODE ARE COMMON MEASURES OF CENTRAL

TENDENCY

Arithmetic Simplest measure of central tendency

mean (X) Obtained by summing up all the observations divided by the number
of observations
It is not an appropriate measure for very skewed distributions as it is
very sensitive to extreme scores
Median The values are arranged from lowest to highest in ascending order.
(Md) It is the simplest division of a set of measurements into two halves
the upper and lower half.
The point on the scale that divides the group in this way is median
when the distribution has odd number of elements, middle value
is median.
When the distribution has even number of elements, the average
of two middle scores is median
Median is insensitive to small numbers of extreme scores in a
distribution, therefore it is a very useful measure of central
tendency for the highly skewed distributions
Mode It is the most frequently occurring value in a set of observations
If only two scores with greatest frequency, the distribution is
biomodal.
If more than two scores occur with greatest frequency, the distribution
is multimodal

140) The concentration of acidulated phosphate fluoride gel used for caries
prevention is
a. 0.05%
b. 1.23%
c. 1.1%
d. 0.2%

Ans- b - 1.23%
Essentials of Preventive and Community dentistry- Soben peter, 4th edition, page no-258

Acidulated phosphate fluoride (APF) gel and solution (1.23%)=12,300 ppm

Gels are thixotropic and flow easily into interproximal space.

APF solution is called Brudevold solution.
 Brudevolds solution or APF solution is prepared by dissolving 20 g of NaF in 1 litre
(2% NaF) of 0.1 M orhtophosphoric acid and to this 50% hydro fluoric acid is added
to adjust the pH at 3.0 and fluoride ion concentration at 1.23%.
In gels, gelling agent is methylcellulose (or) hydroxy ethylcellulose, adjusted to pH
45.
APF solution is usually applied annually.
Main disadvantage is it etches porcelian restorations

141) The trend of events with the passage of time can be shown by
a. line diagram
b. Pie chart
c. Spot maps.
d. Pictogram

Ans a - line diagram

Essentials of Preventive and Community dentistry- Soben peter, 4th edition, page no-372

DEPENDING ON THE NATURE OF DATA, WHETHER IT IS QUALITATIVE

OR QUANTITATIVE, ANY ONE OF THE FOLLOWING DIAGRAMS MAY BE
CHOSEN.

Bar diagram This diagram is used to represent qualitative data. It represents only one
variable

Multiple bar This diagram is used to compare qualitative data with respect to a single
variable like sex-wise or with respect to time or region. This diagram is
similar to the bar diagram except that for each category of the variable we
have a set of bars of the same width corresponding to the different sections
without any gap in between the width and the length.

Component Also represents qualitative data when it is desired to represent both the
bar diagram number of cases in major groups as well as subgroups simultaneously.

Line Used to study changes of values in variable over time.

diagram

Proportional This diagram is used to represent Qualitative data. When it is desired to

bar diagram compare only the proportion of subgroups between different major groups
of observations, then bars are drawn for each group with the same length,
either as I or 100%. These are then divided according to the sub-group
proportion in each major group.
 Pie diagram These are popularly used to show percentage breakdowns for qualitative
data. It is so called because the entire graph looks like a pie and its
components represent slices cut from a pie. A circle is divided into different
sectors corresponding to the frequencies of the variables in the distribution.

Histogram This diagram is used to depict quantitative data of continuous type.

A histogram is a bar diagram without gap between the bars. It represents a

Frequency distribution

Frequency This is used to represent frequency distribution of quantitative data and is

polygon useful to compare two or more frequency distributions.

Cartograms These maps are used to show geographical distribution of frequencies of

or spot map a characteristic.

Scatter It is graphic representation made to show the nature of correlation between

diagram two variables in the same person or groups, such as height and weight in
men aged 20 years. It is also called correlation diagram.

142) Etiologic pile was described by

a. John Snow
b. Miller
c. Sreebny
d. Edgar

Ans b - Miller
The Practice of Periodontia: (oral Medicine) by Sidney Sorrin - Page 99

The Etiologic Pile

Friends.This concept explains that no single factor causes periodontal disease, but
that a multiplicity of factors is at work.
Miller devised the etiologic pile
 143) Supervised school brushing programs by the community can be
categorized under which preventive service of levels of prevention?
a. Specific protection
b. Rehabilitation
c. Health promotion
d. Disability limitation

Ans a - Specific protection

Text book of Preventive and Community dentistry- Soben peter, 4th edition, page no- 18

Friends. Please refer our Dentest - Clinical science book for the explanation of this. There is
a big chart given in the community subject which explains all the levels of prevention.

144) New Cross Auxiliaries mean

a. Dental Nurses in Singapore
b. Dental Nurses in Britain
c. Denturists in Denmark
d. Dental Nurses in Malaysia

Ans- b- Dental Nurses in Britain

A Short TB of Preventive and Community Dentistry by Jayaprakash 1st ed Page 80

New Cross Auxiliaries

New Cross Auxiliaries In Britain, the first operating auxiliary were graduated in
1962.
They are generally known as new cross auxiliaries, because the training school is
located in the new cross area of South London.
They may work only in community dental clinics operated by local government or in
hospitals.
Supervision is more direct, and completed care must be checked by the supervising
dentist before the patient is dismissed.

145) The first distinguished epidemiologist in public health was

a. Sir John Simon
b. John Snow
c. Thomas Sydenham
d. William Budd

Ans c - Thomas Sydenham

Introduction to Epidemiology by Ray M. Merrill 4th ed Page 25

Thomas Sydenham, regarded as the first distinguished epidemiologist, made a differential

diagnosis of scarlet fever, malaria, dysentery, and cholera in 1658, establishing these diseases
as separate and distinct.
 146) Discarded medicines are best disposed by
a. Destruction & disposal in secured land fills
b. Discharge into drains
c. Microwaving
d. Disinfection lay chemical treatment

Ans a - Destruction & disposal in secured land fills

Advances in Pediatrics By Anupam Sachdeva, AK Dutta 2nd ed pg 497

Option Treatment & Disposal Waste Category

Cat. No. 1 Incineration /deep burial
Cat. No. 2 Incineration /deep burial
Cat. No. 3 Local autoclaving/ micro waving/
incineration
Cat. No. 4 Disinfections (chemical
treatment /autoclaving/micro
waving and mutilation shredding
Cat. No. 5 Incineration / destruction &
drugs disposal in secured
landfills
Cat. No. 6 Incineration , autoclaving/micro
waving
Cat. No. 7 Disinfections by chemical
treatment autoclaving/micro
waving& mutilation shredding.
Cat. No. 8 Disinfections by chemical
treatment and discharge into
drain
Human Anatomical Waste (human
tissues, organs, body parts)
Animal Waste Animal tissues, organs,
Body parts carcasses, bleeding parts,
fluid, blood and experimental animals
used in research, waste generated by
veterinary hospitals / colleges,
discharge from hospitals, animal
houses)
Microbiology & Biotechnology waste
(wastes from laboratory cultures, stocks
or specimens of micro-organisms live
or attenuated vaccines, human and
animal cell culture used in research
and infectious agents from research and
industrial laboratories, wastes from
production of biological, toxins, dishes
and devices used for transfer of
cultures)
Waste Sharps (needles, syringes,
scalpels blades, glass etc. that may
cause puncture and cuts. This includes
both used & unused sharps)
Discarded Medicines and Cytotoxic
drugs (wastes comprising of
outdated, contaminated and
discarded medicines)
Solid Waste (Items contaminated with
blood and body fluids including cotton,
dressings, soiled plaster casts,
line beddings, other material
contaminated with blood)
Solid Waste (waste generated from
disposable items other than the waste
sharps such as tubing, catheters,
intravenous sets etc.)
Liquid Waste (waste generated from
laboratory & washing, cleaning ,

Cat. No. 9 Disposal in municipal landfill
Cat. No. 10 Chemical treatment &
discharge into drain for liquid &
secured landfill for solids
house-keeping and disinfecting
activities)
Incineration Ash (ash from incineration
of any bio-medical waste)
Chemical Waste (chemicals used in
production of biological, chemicals,
used in disinfect ion, as insecticides,
etc)

147) Who is the principal advisor to the Union government in both medical
and public health matter?
a. Medical council of India
b. The directorate General Health & Family welfare
c. Union Ministry of Health & Family Welfare
d. The central council of Health & Family welfare

Ans b - The directorate General Health & Family welfare

Manual of Community Health Nursing by I Clement 1st ed Page 63

Directorate General of Health Services

The Directorate General of Health Services is the principal advisor to the Union
Government in both medical and public matters.
The Directorate General of Health Services is headed by Director General (DG) who renders
technical advice on all medical and public health matters and is involved in the implementation
and monitoring of various health scheme.

INCOMEPLETE QUESTION

148) The condition usually lasts for approximately

a. 6 weeks
b. 6 hours
c. 6 years
d. 6 days

Ans a 6 weeks