ACFD elegibility exam- question & answer discussion

[liwanag]

Hi everyone!

I have taken the EE in May this year and a bit disappointed with my 80% score. So, i will give it another try this September. Those of you who have taken the exam and planning to take it again, let's share those questions that we have remembered and discuss the answers thru private e-mail.

my e-mail add: [email protected]

thank you and goodluck

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[dosanjh]

1 Symptoms of pain and tenderness upon palpation of TMJ are usuallu associated with which of the following?

A Impacted mandibular third molar
B Flaccid paralysis of the painful side of the face.
C Flaccid paralysis of non painful side of the face.
D Excitibility of 2nd dividion of trigeminal nerve.
E Deviation of the jaw to painful side upon opening the mouth

2 Each of the following are narcotics used in outpaient anesthesia , except one??

A Fentanyl
B Sufentanil
C Meperdine
D Diazepam
E Morphine

whats outpatient anesthesia?

 

[PeterHayek]

1 Symptoms of pain and tenderness upon palpation of TMJ are usually associated with which of the following?

A Impacted mandibular third molar
B Flaccid paralysis of the painful side of the face.
C Flaccid paralysis of non painful side of the face.
D Excitibility of 2nd dividion of trigeminal nerve.
E Deviation of the jaw to painful side upon opening the mouth

2 Each of the following are narcotics used in outpatient anesthesia , except one??

A Fentanyl
B Sufentanil
C Meperidine
D Diazepam
E Morphine

whats outpatient anesthesia?

Outpatient anesthesia is another name for ambulatory anesthesia

 

[chinabuffet]

Infection from a lower 3rd molar usually points and drains into the
a) submandibular space
b) pterygomandibular space

I would guess B. the 2nd molar would be submandibular. and the 1st molar would be the buccal space. Correct if wrong.

 

[liwanag]

Infection from a lower 3rd molar usually points and drains into the
a) submandibular space
b) pterygomandibular space

I would guess B. the 2nd molar would be submandibular. and the 1st molar would be the buccal space. Correct if wrong.

i think it's submandibular space

 

[dr.ymp]

Infection from a lower 3rd molar usually points and drains into the
a) submandibular space
b) pterygomandibular space

I would guess B. the 2nd molar would be submandibular. and the 1st molar would be the buccal space. Correct if wrong.

"submandibular space"

 

[junglebell]

Each of the following are narcotics used in outpatient anesthesia , except one??

A Fentanyl
B Sufentanil
C Meperidine
D Diazepam
E Morphine

Outpatient anesthesia is another name for ambulatory anesthesia

Because Diazepam is not a narcotics. Please correct me if I am wrong. Thanks a lot.

 

[PeterHayek]

Infection from a lower 3rd molar usually points and drains into the
a) submandibular space
b) pterygomandibular space

I would guess B. the 2nd molar would be submandibular. and the 1st molar would be the buccal space. Correct if wrong.

Ans submandibular space

 

[PeterHayek]

Each of the following are narcotics used in outpatient anesthesia , except one??

A Fentanyl
B Sufentanil
C Meperidine
D Diazepam
E Morphine



Because Diazepam is not a narcotics. Please correct me if I am wrong. Thanks a lot.

You're totally right
The question is tricky because Diazepam is used before endoscopies to reduce tension and anxiety, and in some surgical procedures to induce amnesia
But it's not a narcotic

 

[junglebell]

You're totally right
The question is tricky because Diazepam is used before endoscopies to reduce tension and anxiety, and in some surgical procedures to induce amnesia
But it's not a narcotic

Thank you very much for confirming my answer.

 

[dr.ymp]

When you will take first radiograph for patient requiring endodontic treatment
A. At the begining of appointment
B. To detect canal morphology
C. At the time of measuring length of file (to locate apex)

 

[PeterHayek]

When you will take first radiograph for patient requiring endodontic treatment
A. At the begining of appointment the preliminary x-ray
B. To detect canal morphology
C. At the time of measuring length of file (to locate apex)

 

[chinabuffet]

so does extraction of an upper first molar increase the overbite or not?

 

[junglebell]

so does extraction of an upper first molar increase the overbite or not?

Extraction of AN upper first molar doesn't increase the overbite.

Extraction of both upper first molars do increase the overbite.

Please correct me if I am wrong. Thanks a lot.

 

[docnc]

yes junglebell,you are correct i guess ...
if we will extract single max 1st molar,then there will be contralateral max 1st molar which will maintain the occlusion but if we will extract both side of max 1st molars then supraeruption will occur which will affect the vertical dimension of the occlusion...

 

[liwanag]

just wanted to confirm my ans.

contraction of the external (lateral)ptrerygoid muscle pulls the disc of the TMJ?
a. forward and medially
b. backward and medially
c. forward and laterally
d. backward and laterally
e. none of the above

according to the textbook: during protrusion and retrusion of the mandible, the head and articular disk slide anteriorly and posteriorly in the articular surface of the temporal bone, w/ both sides moving together.

 

[PeterHayek]

just wanted to confirm my ans.

contraction of the external (lateral)ptrerygoid muscle pulls the disc of the TMJ?
a. forward and medially
b. backward and medially
c. forward and laterally
d. backward and laterally
e. none of the above

according to the textbook: during protrusion and retrusion of the mandible, the head and articular disk slide anteriorly and posteriorly in the articular surface of the temporal bone, w/ both sides moving together.

When a muscle contracts, it attracts the non-fixed attachment toward the direction of its fibres
The external pterygoid muscle has an antero-posterior and medio-lateral dircetion so it pulls the disc medially (inside) and forward

 

[liwanag]

thanks so much for your explaination. really appreciate it.

When a muscle contracts, it attracts the non-fixed attachment toward the direction of its fibres
The external pterygoid muscle has an antero-posterior and medio-lateral dircetion so it pulls the disc medially (inside) and forward

 

[drika11]

A periapical infection of a mandibular third molar
may spread by direct extension to the
1. parapharyngeal space.
2. submandibular space.
3. pterygomandibular space.
4. submental space.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The most frequent cause of malocclusion is
A. thumbsucking.
B. mouth breathing.
C. heredity.
D. ectopic eruption.
Which of the following pharmacokinetic change(s)
occur(s) with aging?
1. Absorption is altered by a decrease in the
gastric pH.
2. Metabolism is decreased by a reduced
liver mass.
3. Distribution is altered by a decrease in
total body fat.
4. Excretion is reduced because of lessened
renal blood flow.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A 12 year old child presents with characteristic
tetracycline discoloration of the maxillary and
mandibular incisors and permanent first molars.
The probable age at which this child received
tetracycline therapy was
A. 6 years.
B. 4 years.
C. 1 year.
D. before birth.
A single hypoplastic defect located on the labial
surface of a maxillary central incisor is most likely
due to a/an
A. dietary deficiency.
B. endocrine deficiency.
C. tetracycline therapy.
D. trauma to the maxillary primary central
incisor.
E. high fluoride intake.
In primary molars, radiographic bony changes
from an infection are initially seen
A. at the apices.
B. in the furcation area.
C. at the alveolar crest.
D. at the base of the developing tooth.
In children, the most common cause of a fistula is
a/an
A. acute periradicular abscess.
B. suppurative periradicular periodontitis.
C. acute periodontal abscess.
D. dentigerous cyst.
The absence of a pulp chamber in a deciduous
maxillary incisor is most likely due to
A. amelogenesis imperfecta.
B. hypophosphatasia.
C. trauma.
D. ectodermal dysplasia.
E. cleidocranial dysostosis.
A patient telephones and tells you he has just
knocked out his front tooth but that it is still intact.
Your instructions should be to
A. put the tooth in water and come to your
office at the end of the day.
B. wrap the tooth in tissue and come to your
office in a week's time.
C. put the tooth in alcohol and come to your
office immediately.
D. place tooth under the tongue and come to
your office immediately.
E. place the tooth in milk and come to your
office immediately.
When sutures are used to reposition tissue over
extraction sites, they should be
1. placed over firm bone where possible.
2. interrupted, 15mm apart.
3. firm enough to approximate tissue flaps
without blanching.
4. tight enough to produce immediate
hemostasis.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following nerves should be
anesthetized for extraction of a maxillary lateral
incisor?
1. Nasociliary.
2. Nasopalatine.
3. Sphenopalatine.
4. Anterior superior alveolar.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The most likely complication associated with the
extraction of an isolated maxillary second molar is
A. a dry socket.
B. nerve damage.
C. fracture of the malar ridge.
D. fracture of the tuberosity.

Trismus is most frequently caused by
A. tetanus.
B. muscular dystrophy.
C. infection.
D. mandibular fracture.

 

[dralana1977]

Is there anyone from Brazil here in Canada that is studying for the eligibility exam????

 

[dent rdh]

ok guys I am a dental hygienist in canada, Dentist from pakistan .i have taken EE twice i don't know where am i going wrong my best score has been 70% ,which is really bad .Can someone please help me decide.

Also is doing masters /phd really worthwhile .

 

[dent rdh]

This is what i think

A periapical infection of a mandibular third molar
may spread by direct extension to the
1. parapharyngeal space.
2. submandibular space.
3. pterygomandibular space.
4. submental space.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The most frequent cause of malocclusion is
A. thumbsucking.
B. mouth breathing.
C. heredity.
D. ectopic eruption.
Which of the following pharmacokinetic change(s)
occur(s) with aging?
1. Absorption is altered by a decrease in the
gastric pH.
2. Metabolism is decreased by a reduced
liver mass.
3. Distribution is altered by a decrease in
total body fat.
4. Excretion is reduced because of lessened
renal blood flow.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A 12 year old child presents with characteristic
tetracycline discoloration of the maxillary and
mandibular incisors and permanent first molars.
The probable age at which this child received
tetracycline therapy was
A. 6 years.
B. 4 years.
C. 1 year.
D. before birth.
A single hypoplastic defect located on the labial
surface of a maxillary central incisor is most likely
due to a/an
A. dietary deficiency.
B. endocrine deficiency.
C. tetracycline therapy.
D. trauma to the maxillary primary central
incisor.
E. high fluoride intake.
In primary molars, radiographic bony changes
from an infection are initially seen
A. at the apices.
B. in the furcation area.
C. at the alveolar crest.
D. at the base of the developing tooth.
In children, the most common cause of a fistula is
a/an
A. acute periradicular abscess.
B. suppurative periradicular periodontitis.
C. acute periodontal abscess.
D. dentigerous cyst.
The absence of a pulp chamber in a deciduous
maxillary incisor is most likely due to
A. amelogenesis imperfecta.
B. hypophosphatasia.
C. trauma.
D. ectodermal dysplasia.
E. cleidocranial dysostosis.
A patient telephones and tells you he has just
knocked out his front tooth but that it is still intact.
Your instructions should be to
A. put the tooth in water and come to your
office at the end of the day.
B. wrap the tooth in tissue and come to your
office in a week's time.
C. put the tooth in alcohol and come to your
office immediately.
D. place tooth under the tongue and come to
your office immediately.
E. place the tooth in milk and come to your
office immediately.
When sutures are used to reposition tissue over
extraction sites, they should be
1. placed over firm bone where possible.
2. interrupted, 15mm apart.
3. firm enough to approximate tissue flaps
without blanching.
4. tight enough to produce immediate
hemostasis.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following nerves should be
anesthetized for extraction of a maxillary lateral
incisor?
1. Nasociliary.
2. Nasopalatine.
3. Sphenopalatine.
4. Anterior superior alveolar.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The most likely complication associated with the
extraction of an isolated maxillary second molar is
A. a dry socket.
B. nerve damage.
C. fracture of the malar ridge.
D. fracture of the tuberosity.

Trismus is most frequently caused by
A. tetanus.
B. muscular dystrophy.
C. infection.
D. mandibular fracture.

 

[meher]

ok guys I am a dental hygienist in canada, Dentist from pakistan .i have taken EE twice i don't know where am i going wrong my best score has been 70% ,which is really bad .Can someone please help me decide.

Also is doing masters /phd really worthwhile .

i think, from earning point of view, its not worth to do phd, rather working as a dental hygienist would be better. i am thinking about geting dental hyiegene deploma, please tell me the requierments

 

[dent rdh]

with Denntal hygiene earning is good i agree but i want to do something more .....................anyways u just need to apply to anyone of the colleges some of them have entry tests too ,it isn't an easy 2 yr program but it is a lot better then assissting i find.

 

[Foulys]

Hi,
I started preparing for EE and plan to take the exam in 2008 just wondering if theres anyone from Winnipeg Canada who is preparing for the exams too.

hi there, i am in winnipeg, and getting ready for ee, are you intersted in group study

 

[digital braces]

hi there, i am in winnipeg, and getting ready for ee, are you intersted in group study

hi i'm in vancouver BC n preparing for sept ee. really need sumone to study wid..like discussions on net etc. i m little blank about how to study. hope u vil reply n count me in. i am a dentist from pakistan.

 

[uzair]

Trismus is most frequently caused by
A. tetanus.
B. muscular dystrophy.
C. infection.
D. mandibular fracture


The answer for this isC- Infection ,because examiner is asking about the 'Most frequent cause' .

 

[drdiya]

hi i'm in vancouver BC n preparing for sept ee. really need sumone to study wid..like discussions on net etc. i m little blank about how to study. hope u vil reply n count me in. i am a dentist from pakistan.

i am also from pakistan i am also in the same condition and want to appera in sep if u can share some info

 

[Docn]

-

 

[Docn]

PLEASE CHECK MY ANSWERS ARE CORRECT ..IN COLOR RED

Exfoliative cytology will help diagnose
1-Candidiasis.
2-Herpetic gingivostomatitis.
3-shingles.
4-cold sores.
-chiken pox.
6-hairy leukoplakia.

-Loss of proximal contact in class II amalgam is most probably due to MUTLIPLE ANSWERS
1-over-tightened matrix.
2-improperly placed wedge.
3-insuffecient condensation.
4-simultaneously placed restorations in adjacent teeth.

-A child with acute herpetic gingivostomatitis, the most appropriate treatment is
1-Topical antiviral.
2-Topical antifungal.
3-Antibiotic.
4-Analgesic & hydration management.

-The effect of local anesthesia injected directly (thru access cavity) into a very inflamed pulp depends on
1-Dissociation factor(PKa) of L.A agent.
2-% of vasoconstrictor in solution.
3-Forceful injection. (1or3?)

-The major reason not to extract a mandibular 3rd molar accompanied with pericoronitis is fear of
1-Osteomyelitits.
2-Spread of infection.
3-Anesthesia won’t work.
4-Bacteremia.

-A bitewing radiograph in a mixed dentition, should include what surfaces
1-Mesial of 1st primary molar to distal of 1st permanent molar.
2-Distal of canine to mesial of 1st permanent molar.
3-Mesial of 1st primary molar to mesial of 1st permanent molar.
4-Distal of canine to distal of 1st permanent molar.
-The appliance that is going to interfere the most with speech is
A-anterior & posterior palatal bar.
B-Thick narrow palatal plate.
C-Narrow horse-shoe shaped appliance(used when there is a palatal torus).
D-Thin broad palatal strap.

- In periapical films, the coronoid process can obliterate the apices of
A- Maxillary 3rd molars.
B- Maxillary 2nd molars.
C- Mandibular 3rd molars.
D- Mand 2nd molars.

-Difference between Osteosarcoma & fibrous dysplasia is that osteosarcoma
A- can invade soft tissue.
B- is an ill-defined radiolucency.
C- is Malignant.
D- difficult to irradiate(?) from normal bone.

-In bruxism, what is in action
1- A Delta & C fibers.
2- Sphenopalatine ganglion.
3- Basilar ganglion.
4- ?
(some people think it is A delta & C fibers)

-Chronic Nasal constriction with resultant mouth breathing, may cause
A- Increase in lower facial height.
B- Increase in lower facial height & maxillary constriction.
C- Increase in lower facial height, maxillary constriction & crowding of lower anterior teeth.
D- Difficult to evaluate.

-Which is more apt to cause displacement of neighboring teeth
A- Dentigerous cyst.
B- periapical Abscess.
C- Radicular cyst.
D- Lateral periodontal cyst.
E-Cementoma.

-Infrabony pocket occurs mostly in
A- Cancellous bone.
B- Cortical bone.
C- Interseptal bone.
D- Bundle bone.

-Primary reason for mandibular growth: MULTIPLE ANSWERS
A-Genetic.
B-epigenetic.
C- Functional.
D- Environmental.
(epigenetic: refers to inheritable information that is encoded by modifications of the genome and chromatin components that affects gene expression. It does not include changes in the base sequence of DNA)

-Fracture of mandible during normal mustication; most probably due to:
A- Large intraosseous lesion.
B- Osteoporosis.
C- An impacted tooth along the lower border.

-Cementum & dentine blunting (resorption at apex) with non-vital tooth; is what type of resorption
1-surface.
2-Replacement.
3-inflammatory.
4-intraradicular.

-1-Accessory canals are most probably found in the
1-cervical 3rd.
2-middle 3rd.
3-apical 3rd of the root.

-When placing a full crown on a tooth with large MOD amalgam restoration; you place the finishing line
a-on amalgam.
b-1mm gingival to amalgam.
c-2mm gingival to amalgam.
d-same level as amalgam ends.

-A radiolucent multilocular expansile lesion in the mandible which shows benign giant cells and … and fibers; what should you do
1-order further microscopic examination.
2-examine blood calcium.
3-prescribe antibiotic therapy.

-Of the following; The most important diagnostic element to assess perio status of a patient is
1-vitality tests.
2-radiograph appearance.
3-depth of pockets.
4-mobility of tooth
-In gingivitis predominant bacteria is
1- gr+.
2-gr-.
3-diplococi.
4-spirochetes

-Which indicate cracked tooth
1-Periapical radiolucency.
2-pain upon pressure.
3-negative vitality tests.
4-hypersensitivity to thermal stimuli

-Which of the following will increase the chance of a replantation of an avulsed tooth
1-placing tooth into mouth.
2-placing tooth into physiologic saline water.
3-placing tooth into fluoride.
4-waiting till next day.

- Most common cause of class II division 1 malocclusion
1- Maxillary prognathism.
2-maxillary retrognathism.
3-mandibular prognathism.
4-mandibular retrognathism.

-which of the following is most resistant to antibiotics
1)streptococci.
2)lactobaclilli.
3)staphylococci
(staphylococcus aureus and streptococcus pneumococcus are the most antibiotic resistant).

-a patient with severe bleeding disorder; which of the following holds the least risk:
1)injection of inf.alv.nerve block.
2)a subgingival restoration.
3)scalling supragingivally

-After relining mandibular bi-distal extension RPD, the occlusal rests are seated but the acrylic base doesn’t fit in place. Most probably due to
1)resorption of alveolar ridge.
2)shrinkage of denture base material.

-causes of composite polymerization shrinkage during setting
1-Evaporation of the by-product.
2-Evaporation of unreacted monomer.
3-temp change occurring during polymerization
4-replacment of 1ry bonds by 2ry bonds (or 2ry bonds by 1ry bonds, can't remember)

-which has better prognosis regarding furcation involvement
1) wide furcation. 2)narrow furcation.

-a patient whose mandible deviates to left upon opening causing a unilateral crossbite; when he closes in centric he presents bilateral cross bite and the midline is concomitant. This patient has
1)two separate occlusions. 2)true unilateral crossbite. 3)hypertrophy of one of the TMJs. 4)occlusal interference.

-FAILURE after treatment of furcations is indicated by
1)widening of furcation. 2)narrowing of furcation. 3)formation of furcation ride(?).

- Which of the following is not associated with Infectious mononucleosis (MULTIPLE ANSWERS??)
1-Pharyngitis.
2-Lymphadenopathy.
3-Peteciae.
4-Gingival enlargement.
5-Fatigue.

-The most important mechanical property for a PFM long & narrow span brige is
1-elastic modulus.
2-P.L.
3-Toughness.
4-Tensile strength.
(elastic modulus is most important if I fear deformation as high elastic modulus will mean high stresses are needed to produce a specific strain, while Toughness is most important if I fear fracture as high toughness means high energy is needed to produce fracture)

-major vascular supply of buccal gingiva is thru
1)intra-alveolar vessels.
2)Superficial vessels.
3)PDL vessels.

-34 yr old male with night sweats, weight loss, male anorexia, low grade fever. Clinical exam shows nodular, ulcerated lesion on the palate. This is mostly
1-Viral hepatitis.
2-infectious mononucleosis.
3-tuberculosis.
4-actinomycosis.

-27 yrs old complains of burning mouth, fatigue, palpitation, lack of energy. Clinical exam shows angular cheilitis & atrophic glossitis. Most probable diagnosis is
1-Iron deficiency.
2-Crohn's disease.
3-Chronic lymphocytic leukemia.
4-plummer Vinson syndrome

-Patient with anaphylactic shock is given epinephrine because it (MULTIPLE ANSWERS?)
1-reduces heart rate.
2-relaxe respiratory muscle.
3-???. 4-causes vasoconstriction of vascular smooth muscles.

acute localized periodontal abcess treatment
1-root planning & scaling.
2-occlusion adjustment.
3-antibiotics.
4-analgesic.

-Lipid-soluble vitamin MULTIPLE ANSWERS
1-Vitamin E:antioxidant.
2-Vitamin C:healing&collagen formation
. 3-Vitamin K prothrombin formation.
4-Vitamin A:integrity & proliferation of mucosal tissues.

-Primary radiograph for endo is to determine
1-working length. 2-shape of chamber & canals.

 

[DrArmani]

Hey Docn, just out of curiousity how did you come to this answer???


- In periapical films, the coronoid process can obliterate the apices of
A- Maxillary 3rd molars.
B- Maxillary 2nd molars.
C- Mandibular 3rd molars.
D- Mand 2nd molars.

Why not Maxillar 3rd Molars????

 

[Docn]

THANKS DRARMANI ..,
FOR CORRECTING ME ..

The coronoid process of the mandible sometimes appears on maxillary molar films as a triangular opaque area located in the region of or distal to the maxillary tuberosity.




PLEASE CORRECT ME KNOW IF I AM STILL WRONG .

I LIKE FELLOWS HELPING EACHOTHER..

Hey Docn, just out of curiousity how did you come to this answer???


- In periapical films, the coronoid process can obliterate the apices of
A- Maxillary 3rd molars.
B- Maxillary 2nd molars.
C- Mandibular 3rd molars.
D- Mand 2nd molars.

Why not Maxillar 3rd Molars????

 

[dr.ymp]

THANKS DRARMANI ..,
FOR CORRECTING ME ..

The coronoid process of the mandible sometimes appears on maxillary molar films as a triangular opaque area located in the region of or distal to the maxillary tuberosity.




PLEASE CORRECT ME KNOW IF I AM STILL WRONG .

I LIKE FELLOWS HELPING EACHOTHER..

Maxillary Third molar

 

[dr.ymp]

A radiolucent multilocular expansile lesion in the mandible which shows benign giant cells and … and fibers; what should you do
1-order further microscopic examination.
2-examine blood calcium.
3-prescribe antibiotic therapy.

Hi,Can you explain this answer .....???

Thnks

 

[DrArmani]

Hey Dr. Ymp, so the correct answer is Maxillary 2nd molar or Maxillary 3rd molar??? What ever it is can you explain your answer please!!!!

For your question, you would order further microscopic examination because, will rule out most of the conditions such as, Cherubism, Giant cell granuloma, Aneurysal bone cyst and hyperthyroidism. If you only examine blood calcium, you would only be able to diagnose or rule out Hyperparathyroidism, point being you can rule out and test for more with microscopic examination. And obviously a part of this question is missing, but from my understanding it is cherubism because, the lesional tissue consists of VASCULAR FIBROUS TISSUE CONTAINING VARIABLE NUMBERS OF MULTINUCLEATED GIANT CELLS. Hope this helps!!!
And is it Maxillary 2nd or Maxillary 3rd molars, and why?? Thank you!!

 

[dr.ymp]

Hey Dr. Ymp, so the correct answer is Maxillary 2nd molar or Maxillary 3rd molar??? What ever it is can you explain your answer please!!!!

For your question, you would order further microscopic examination because, will rule out most of the conditions such as, Cherubism, Giant cell granuloma, Aneurysal bone cyst and hyperthyroidism. If you only examine blood calcium, you would only be able to diagnose or rule out Hyperparathyroidism, point being you can rule out and test for more with microscopic examination. And obviously a part of this question is missing, but from my understanding it is cherubism because, the lesional tissue consists of VASCULAR FIBROUS TISSUE CONTAINING VARIABLE NUMBERS OF MULTINUCLEATED GIANT CELLS. Hope this helps!!!
And is it Maxillary 2nd or Maxillary 3rd molars, and why?? Thank you!!

Hi, thnks for the explanation first abt question of coronoid process, Its seen mostly on maxillary third molar region and very rarely on maxillary second molar (Ref: White and Pharoz, book of Radiology)

Well abt question of Giant cell and Multilocular radiolucent lesion, I agree with you thought but
As lesion is having giant cell then you can suspect Hyperparathyrodism, Giant cell granuloma, Even Aneurysmal bone cyst
If we talk abt multilocular radiolucent lesion you can suspect Hyperparathyroidism, Cheburism, Giant cell granuloma, Aneurysmal bone cyst...
So in other word, question ask us to differentiate above said four lesion with the help of which investigation??.... If we consider "do further histological examination" answer, what we gonna find???? As none of this lesion have charecteritic histological finding other than giant cell...

I mean how will you differentiate this four lesion by doing further histological analysis... can you please explain

Thnks

 

[nkhalid]

Q: Patient comes to clinic and chronic pain disappears. Why?

 

[DrArmani]

Ok here we go Dr. YMP, i thought about this long and hard. you have a very valid point!!! Now let me put it to you this way, say you do a serum calcium test and its normal than what are you gonna do. Fine you ruled out Hyperparathyroidism(Brown Tumour) Now you got three left!!! Histolgically the main components are the same, MULTNUCLEATED GIANT CELLS!!! The difference are what other type of cells, tissue, vascular etc. etc.

Giant cell Granuloma - has ovoid spindle shaped mesenchymal cells, stroma is loosely arranged and edematous, or it could be quite cellular, areas of erythrocyte extravasation and hemosiderin deposition are prominent

Cherubism - vascular fibrous tissue, stroma in cherubism often tends to be more loosely arranged than seen in giant cell granuloma, some cases reveals eosinophillic cufflike deposits surrounding small blood vessels, the eosinophillic cuffing appears to be specefic for cherubism

Aneurysmal Bone Cyst - space filled with unclotted blood surrounded by cellular fibrolastic tissue containing multinucleated giant cells and trabeculae of osteid, wall contains an unusual lacelike pattern of calcification that is uncommon in other intraosseous lesions

These H/P features are just a few i have mentioned. I hope this helps. When are you giving your EE, where are you from and where did you do your dentistry???

 

[dr.ymp]

Ok here we go Dr. YMP, i thought about this long and hard. you have a very valid point!!! Now let me put it to you this way, say you do a serum calcium test and its normal than what are you gonna do. Fine you ruled out Hyperparathyroidism(Brown Tumour) Now you got three left!!! Histolgically the main components are the same, MULTNUCLEATED GIANT CELLS!!! The difference are what other type of cells, tissue, vascular etc. etc.

Giant cell Granuloma - has ovoid spindle shaped mesenchymal cells, stroma is loosely arranged and edematous, or it could be quite cellular, areas of erythrocyte extravasation and hemosiderin deposition are prominent

Cherubism - vascular fibrous tissue, stroma in cherubism often tends to be more loosely arranged than seen in giant cell granuloma, some cases reveals eosinophillic cufflike deposits surrounding small blood vessels, the eosinophillic cuffing appears to be specefic for cherubism

Aneurysmal Bone Cyst - space filled with unclotted blood surrounded by cellular fibrolastic tissue containing multinucleated giant cells and trabeculae of osteid, wall contains an unusual lacelike pattern of calcification that is uncommon in other intraosseous lesions

These H/P features are just a few i have mentioned. I hope this helps. When are you giving your EE, where are you from and where did you do your dentistry???

You are absolutely right... The histological difference you had mentioned are looking good

Giant cell Granuloma:
"In most instances, the microscopic findings have guided the investigators into diagnosis of giant cell tumor rather than Giant cell granuloma"
(Ref: Sheffar; Fourth Edition; Page: 147)

Cheburism:
Histopathology: "The lesions are virtually indistinguishable from the giant cell granuloma of the jaws"
(Ref: Sheffar; Fourth Edition; Page: 701)

Hyperparathyrodism
These foci are indistinguishable from giant-cell granulomas
of the jaws. Unlike the latter, there are characteristic changes in
blood chemistry
(Ref: Cawson; 7th Edition; Page 160)

• Hyperparathyroidism. Histologically indistinguishable from giant
cell granuloma but serum calcium levels are raised
• Cherubism. May be indistinguishable from giant-cell granuloma
histologically, but lesions are symmetrical, near the angles of the
mandible
• Giant-cell tumour (osteoclastoma). Aggressive tumour of long
bones. Broadly similar histologically to giant-cell granuloma but a
distinct entity in terms of behaviour
• Aneurysmal bone cysts may contain many giant cells but consist
predominantly of multiple blood-filled spaces

(Ref: Cawson; 7th Edition; Page 141)

So, what i wonna say is, The histological differences may or may not be find, As histological difference you mentioned is even there in book but in all cases book says may be found... So that doent help in Definative diagnosis.

 

[looking20100]

hi i m preparing for EE this september...i m looking for study partner ....if any one interested pls reply me.

 

[looking20100]

hi im preparing for EE this september i m looking for study partner if any one intersted pls reply .

 

[Docn]

..

1 Precipitation of salivary calcium salts to form
calculus is
A. promoted by a higher buffering*
capacity.
B. inhibited by a higher buffering
capacity.
C. inhibited by a higher pH.
D. promoted by a higher pH.*

I do know that lower pH will promote calcium internal absorption. Is that mean higher PH will promote calcium precipitation?

Higher buffering capacity of salivary , means higher pH of saliver , so answer should be A/D



D


The dissociation of hydroxyapatite is very sensitive to the pH of the surrounding medium and exerts its effect by altering the concentration of both un protonated phosphate ions and hydroxyl ions.
At Neutral pH (7.0) saliva is supersaturated with calcium phosphate with most of the phosphate present in either mono-or di-hydrogen phosphate form.However,as the pH becomes more acid the degree of supersaturation decreases untill a point is reached where the aliva ceased to be saturated with respect to the tooth mineral.This is known as "Critical pH".
Conversely ,if the pH becomes more alkaline the degree of saturation with respect to tooth mineral increases and eventually the calcium phosphate in solution becomes unstable and precipitated ,not as hydroxyapatite but as the more readily mineral, bru****e. This precipitation is promoted by nucleating centres within dental plaque and is called calculus.

 

[dr.ymp]

..

1 Precipitation of salivary calcium salts to form
calculus is
A. promoted by a higher buffering*
capacity.
B. inhibited by a higher buffering
capacity.
C. inhibited by a higher pH.
D. promoted by a higher pH.*

I do know that lower pH will promote calcium internal absorption. Is that mean higher PH will promote calcium precipitation?

Higher buffering capacity of salivary , means higher pH of saliver , so answer should be A/D



D


The dissociation of hydroxyapatite is very sensitive to the pH of the surrounding medium and exerts its effect by altering the concentration of both un protonated phosphate ions and hydroxyl ions.
At Neutral pH (7.0) saliva is supersaturated with calcium phosphate with most of the phosphate present in either mono-or di-hydrogen phosphate form.However,as the pH becomes more acid the degree of supersaturation decreases untill a point is reached where the aliva ceased to be saturated with respect to the tooth mineral.This is known as "Critical pH".
Conversely ,if the pH becomes more alkaline the degree of saturation with respect to tooth mineral increases and eventually the calcium phosphate in solution becomes unstable and precipitated ,not as hydroxyapatite but as the more readily mineral, bru****e. This precipitation is promoted by nucleating centres within dental plaque and is called calculus.

Increase in PH increase Precipitation of salivary calculus

 

[dr.ymp]

-Loss of proximal contact in class II amalgam is most probably due to MUTLIPLE ANSWERS
1-over-tightened matrix.
2-improperly placed wedge.
3-insuffecient condensation.
4-simultaneously placed restorations in adjacent teeth.

 

[Docn]

answer for no. 1 is candiasis becos:

The diagnosis of primary herpetic gingivostomatitis is usually made on a clinical basis.

The diagnosis of oral candidiasis is most frequently made on the basis of clinical appearance along with exfoliative cytology examination. This involves the histologic examination of intraoral scrapings which have been smeared microscope glass slides. A 10% - 20% potassium hydroxide preparation ("KOH prep") can be used for immediate microscopic identification of yeast cell forms. Alternatively, the slide containing the cytologic smear can be sprayed with a cytologic fixative and stained using PAS (Periodic acid - Schiff) stain prior to microscopic examination.

 

[PLANT]

1 what is the most definite way to differentiate ameloblastoma, and odontogenic keratocyst?
a. smear cytology
b. reactive light microscopy
c. reflective microscopy

2 what happens with intercanine distance after mixed dentition
a. increased
b. decreased
c. stable, no change

 

[dr.ymp]

answer for no. 1 is candiasis becos:

The diagnosis of primary herpetic gingivostomatitis is usually made on a clinical basis.

The diagnosis of oral candidiasis is most frequently made on the basis of clinical appearance along with exfoliative cytology examination. This involves the histologic examination of intraoral scrapings which have been smeared microscope glass slides. A 10% - 20% potassium hydroxide preparation ("KOH prep") can be used for immediate microscopic identification of yeast cell forms. Alternatively, the slide containing the cytologic smear can be sprayed with a cytologic fixative and stained using PAS (Periodic acid - Schiff) stain prior to microscopic examination.

Herpes:
For cytology, a fresh vesicle can be opened and a scraping made from the base of the lesion and placed on a microscope slide.
(Ref: Burkit; Chap 4)

Exfoliative cytologic smear used in the diagnosis of Herpes simplex infection
(Ref: Oral path; Shaffer, Page: 599)

I agree with your source, but as have to choose one only, I will go for Herpes gingivostomatitis....

 

[dralana1977]

-A child with acute herpetic gingivostomatitis, the most appropriate treatment is
1-Topical antiviral. ---Ans
2-Topical antifungal.
3-Antibiotic.
4-Analgesic & hydration management.

If it was multiple answers I'd say 1 and 4; but if it was only one answer I'd say 4. Because acyclovir can be used but more in moderate to severe cases..not rotinely.

Correct if I am wrong

 

[dr.ymp]

-A child with acute herpetic gingivostomatitis, the most appropriate treatment is
1-Topical antiviral. ---Ans
2-Topical antifungal.
3-Antibiotic.
4-Analgesic & hydration management.

If it was multiple answers I'd say 1 and 4; but if it was only one answer I'd say 4. Because acyclovir can be used but more in moderate to severe cases..not rotinely.

Correct if I am wrong

I will go for 4..... not for 1

 

[dralana1977]

Base plate fits master cast but not the patient:
distorted impression
casting error
pouring of master cast was wrong
patients tissues changed

1,2,3
1,3
2,4
4 olny
all of the above

Correct me if I am wrong...and can anyone explain?

 

[Acfd2007]

check it out

1 what is the most definite way to differentiate ameloblastoma, and odontogenic keratocyst?
a. smear cytology
b. reactive light microscopy
c. reflective microscopy

2 what happens with intercanine distance after mixed dentition
a. increased
b. decreased
c. stable, no change

please let me know if i am wrong