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BDS3 past papers > 2016 > Flashcards

2016 Flashcards

1
Q

what are the predisposing factors of oral candidosis?

A
  • prolonged antibiotic use
  • poor oral hygiene
  • denture wearer
  • immunocompromised
  • diabetes
  • dialysis
  • burn unit patient
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2
Q

what are the virulence factors of candida albicans?

A
  • phospholipase contributes to host cell penetration
  • haemolysin facilitates hyphal invasion
  • proteinase aids in adhesion to epithelial cells
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3
Q

what infections can be caused by candida?

A
  • periodontitis
  • denture stomatitis
  • UTIs
  • endocarditis
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4
Q

what classification of oral candidosis is shown here?

A

pseudomembranous

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5
Q

what classification of oral candidosis is shown here?

A

chronic hyperplastic

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6
Q

what classification of oral candidosis is shown here?

A

angular chelitis

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7
Q

what are the 3 types of erthematous candidosis?

A

newtons type 1- localised inflammation
newtons type 2- diffuse inflammation
newtons type 3- granular inflammation

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8
Q

what are the signs and symptoms of denture induced stomatitis?

A
  • inflamed mucosa, particularly under upper denture
  • burning sensation
  • discomfort
  • bad taste
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9
Q

name 4 types of candida species

A
  • albicans
  • glabrata
  • parasilosis
  • tropicalis
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10
Q

how is denture stomatitis diagnosed in the lab?

A
  • smear test / microscopy
  • swab /culture on sabouraud’s agar / germ tube formation

angular cheilitis and acute pseudomembranous candidosis also the same

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11
Q

what are the 3 types of antifungal therapy?

A
  • echinocandins
  • azoles- fluconazole
  • polyenes
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12
Q

how would you treat denture stomatitis in an immunocomprosed patient?

A
  • systemic antifungal- fluconazole
  • topical antifungal (nystatin)/ chlorhexidine rinse
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13
Q

how would you treat an oral fungal infection in a patient with poor oral hygiene?

A
  • need to improve oral hygiene first
  • chlorhexidine rinse
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14
Q

how would you treat an oral fungal infection in a patient with dry mouth?

A

topical antifungal e.g. nystatin
avoid systemic antifungals

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15
Q

how would you treat an oral fungal infection in a patient with large erosive lesions?

A

same as an immunocompromised patient
systemic antifungal with either topical antifungal or chlorhexidine rinse

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16
Q

give an example of an azole (antifungal medication)

A

fluconazole

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17
Q

give an example of a polyene (antifungal medication)

A

nystatin

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18
Q

give an example of an echinocandin (antifungal medication)

A

micofungin

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19
Q

what is the drug action of flucanazole?

A

interupts conversion of lanosterol to ergosterol by interacting with the enzyme which catalyses the conversion which stops formation of fungal membrane

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20
Q

what is the drug action of nystatin?

A

binds to sterols in plasma membrane of fungi, causing cells to leak
this causes fungal cell death

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21
Q

what are the four key design elements of randomised control trials?

A
  • specification of participants
  • control/comparison groups
  • randomisation
  • blinding/masking
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22
Q

name an advantage of randomised control trials

A

provide the strongest and most direct epidemiologic evidence for causality

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23
Q

give disadvantages of randomised control trials

A
  • more difficult to design and conduct than oberservational studies
  • not suitable for all research questions
  • high costs
  • still some risk of bias
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24
Q

what is a cross-sectional study?

A

observational study that analyses data collected from a population, or a representative subset, at a specific point in time

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25
Q

what is a case-series report?

A

description of the medical history of one or more patients

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26
Q

what is a case-control study?

A

people with a disease are matched to those without it and earlier exposure to different factors are compared

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27
Q

what is a cohort study?

A

participants are recruited to a study and followed up over time. Exposures and diseases are measured prospectively

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28
Q

what is a systematic review and meta analysis?

A

all the evidence for RCTs looking at effectiveness of a particular treatment are synthesised

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29
Q

what are case-series reports used for?

A
  • hypothesis generation
  • to identify a new disease outcome
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30
Q

what are the disadvantages of case series reports?

A
  • cannot demostrate valid statistical associations
  • lack of control group
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31
Q

what are cross sectional studies used for?

A
  • estimating prevalence of a disease
  • to investigate potential risk factors
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32
Q

what are the disadvantages of cross-sectional studies?

A
  • recall bias
  • causality
  • confounding factors
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33
Q

what are case-control studies used for?

A

looking at potential causes of a disease

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34
Q

what are the disadvantages of case-control studies?

A
  • confounding factors
  • recall/selection bias
  • time relationships (did exposure occur before disease)
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35
Q

what are cohort studies used for?

A
  • estimating incidence of disease
  • investigating cause of disease
  • determining prognosis
  • timing and direction of events
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36
Q

what are disadvantages of cohort studies?

A
  • controls are difficult to identify
  • confounding factors
  • blinding is difficult
  • need large samples for rare diseases
  • very expensive and time consuming
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37
Q

what does a confidence interval do?

A

tells us the range of values that a true population treatment effect is likely to lie

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38
Q

what does a confidence interval that overlaps the value of no difference between treatments indicate?

A

there is insufficient evidence for a difference. between the treatment and control group in the population

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39
Q

what does it mean if the confidence interval overlaps 1?

A

there is insufficient evidence that there is a difference between the drug and the placebo

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40
Q

what is the absolute risk difference?

A

the difference in risk between groups

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41
Q

what is the value of no difference?

A

when there is no absolute risk difference

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42
Q

what is the ‘number needed to treat’ (NNT)?

A

the number of patients you would need to treat to prevent one patient from developing the disease/condition/outcome

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43
Q

what is the risk ratio?

A

number of events of interest/
total number of observations

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44
Q

what is the odds ratio?

A

number of events of interest/
number without the event

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45
Q

what are the principles of waste disposal?

A
  • segregation
  • storage
  • disposal
  • documentation
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46
Q

name 3 regulations for waste disposal

A
  • the controlled waste regulations 2012
  • the hazardous waste directive 2011
  • the environmental protection act 1990
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47
Q

what procedures can be put in place to keep an amalgam container safe?

A
  • spill proof container
  • leak proof container
  • mercury vapour suppressant in lid
48
Q

what chemical would you use to clean blood?

A

sodium hypochlorite

49
Q

what concentration of sodium hypochlorite would you use for a blood spillage?

A

1000ppm

50
Q

what is the active agent used for blood spillage?

A

chlorine/chloride

51
Q

what are causes of an overhang?

A
  • poor adaptation of the matrix band
  • excessive force applied when condensing amalgam
52
Q

what are the short and long term complications of overhangs?

A
  • food trap
  • difficulty cleaning
  • plaque stagnation
  • secondary caries
  • gingivitis and periodontal diseae
53
Q

what is the preferred method for correcting an overhang?

A

replacement of the restoration

54
Q

what are all of the treatment options for correcting an overhang?

A

replace restoration
finishing strips
soft flex files

55
Q

list functions of a provisional crown for an EDP# and exposed RCT

A
  • improve aesthetics and provide pt with realistic expectations
  • improve functions of mastication and speech
  • resolve gingival inflammation and provide adequate gingival health prior to fitting the definitive restoration
  • to act as a marker for the dentist for tooth prep
  • prevents sensitivity
  • preserves tooth vitality
  • used as isolation for RCT
56
Q

name 3 types of prefabricated crowns

A
  • polycarbonate crowns
  • clear plastic
  • metal (aluminium/stainless steel)
57
Q

give disadvantages of prefabricated crowns

A
  • inaccurate fit ervically, occlusally, interdentally
  • if a large bank of crowns is needed it is very expensive
58
Q

how would you manage an 8 year old boy with an ED#?

A
  • cover exposed dentine with either GI or if fractured tooth piece available, bond it back to the tooth with composite
  • sensibility tests
  • periapical to ensure no root displacement
59
Q

what are radiographic signs that a tooth is non-vital?

A
  • internal inflammatory resorption
  • external inflammatory resorption
  • periapical abscess
  • widened pdl
  • loss of lamina dura
60
Q

what is included in a trauma stamp?

A
  • colour
  • mobility
  • TTP
  • radiograph
  • sensibility testing
  • thermal testing
  • displacement
  • sinus
61
Q

explain the distribution of decay in nursing bottle caries

A
  • lower incisors protected by tongue
  • maxillary incisors are affected the worst as they eruptic first
  • if habit continues, mandibular canines and all 6s will be subjected to cariogenic challenge in sequence with their eruption order
62
Q

what causes nursing bottle caries?

A
  • going to bed with a bottle
  • prolonged breastfeeding
  • baby using bottle as a comforter rather than a dummy
  • innapropriate use of feeding bottles and cups
63
Q

how would you manage a 2 year old with high caries risk?

A
  • application of fluoride varnish
  • high fluoride toothpaste- 1450ppm
64
Q

what toothbrushing advice would you give to the parent of a high caries risk 2 year old?

A
  • small headed toothbrush with soft bristles
  • brush twice a day for 2 minutes
  • adult should be brushing the child’s teeth
  • 1450ppm toothpaste
  • spit dont rinse
65
Q

name 4 types of dementia

A
  • alzheimers
  • vascular
  • frontotemporal
  • dementia with lewy bodies
66
Q

what is the most common form of dementia?

A

alzheimers

67
Q

how does alzhemiers affect the brain?

A
  • reduction in size of cortex
  • severely affects hippocampus
68
Q

what causes alzhemiers?

A

abnormal protein fragments (beta-amyloid) build up in spaces between nerve cells forming plaques and disrupting brain function

69
Q

what are the features of alzheimers?

A
  • short term memory loss
  • aphasia
  • communication difficulties
  • muddled over everyday activities
  • mood swings
  • withdrawn
  • loss of confidence
70
Q

what are the risk factors of alzheimers?

A
  • age
  • gender
  • head injury
  • genetic- abnormalities of chromosomes 1,14,21
  • lifestyle- smoking, hypertention, low folate, high cholesterol
71
Q

what is the cause of vascular dementia?

A

reduced blood flow to the brain
damages and eventually kills the brain cells

72
Q

what causes vascular dementia to develop?

A
  • narrowing/blockage of small blood vessels into the brain
  • single large stroke
  • lots of mini-strokes that cause small, but widespread damage
  • underlying health conditions
73
Q

what are the features of vascular dementia?

A
  • memory problems of sudden onset
  • visuospatial difficulties
  • anxiety
  • delusions
  • seizures
74
Q

what causes dementia with lewy bodies?

A

deposits of abnormal proteins called lewy bodies inside brain cells

75
Q

what are the features of dementia with lewy bodies?

A
  • short term memory loss
  • cognitive ability fluctuates
  • visuospatial difficulties
  • attentional difficulties
  • overlapping motor disorders
  • speech and swallowing problems
  • sleep disorders and delusions
76
Q

lewy bodies can be found in patients with what cerebellular disease?

A

Parkinson’s disease

77
Q

what are the features of frontotemporal dementia?

A
  • uncontrollable repition of words
  • short term memory loss (sometimes)
  • personality changes
  • decline in personal and social conduct
78
Q

what are the symptoms of late stage dementia?

A
  • inability to recognise familiar objects, surroundings or people
  • difficulty eating and swallowing
  • incontinence
  • gradual loss of speech
79
Q

what is the most common way to test for dementia?

A

the mini mental state examination (MMSE)

80
Q

name 3 cognitive testing methods for dementia

A
  • MMSE
  • blessed dementia scale
  • the montreal cognitive assessment (MoCA)
81
Q

what are the advantages of the mini mental state examination?

A
  • well known
  • easy to administer
82
Q

what are the cons of of the mini-mental state examination?

A
  • not sensitive to mild impairment
  • not sensitive in testing frontal lobe
  • non-standardised time between registration and recall
83
Q

what is the treatment for dementia?

A
  • councelling can delay residential care up to 1 year
  • aspirin/reducing cardiac risks can halt deterioration of vascular dementia
  • NSAIDs may slow progression
  • vitamin E can slow progression
  • anticholinesterases for mild/moderate alzheimers
  • cerebrolysin improves cognitive function for vascular dementia
84
Q

when would treatment for a patient with dementia be stopped?

A
  • when it is deemed that treatment is no longer working
  • the MMSE score falls below 10
85
Q

what can care homes do to be more dementia friendly?

A
  • make walls, flooring, skirting different colours
  • add labels/images to drawers etc. to help pts find things
  • bedroom WC should be visible from bed
  • position personal pics/items with personal relevance
86
Q

how can healthcare environments be made more dementia friendly?

A
  • reception desk visible from front door
  • no non-essential signs
  • staff only doors same colour as walls
  • colour of walls different from floor/celing
  • signs should be simple, colourful;, eye level
87
Q

what is meant by a dentally fit patient?

A

being free from any active dental disease

88
Q

what is an MDT?

A
  • multi-disciplinary team
  • team of individuals from a wide variety of disciplines/specialities who work alongside each other in order to provide the best and hollistic care for the patient
89
Q

list members of a cancer MDT

A
  • cancer nurse specialist
  • oncologist
  • special care dentist
  • restoartive dentist
  • physiotherapist
  • speech and language therapist
  • social worker
  • radiologist
90
Q

name complications of radiotherapy to the head and neck

A
  • mucositis
  • xerostomia
  • osteoradionecrosis
  • radiation induced caries
91
Q

name modifiable factors for the aetiology of head and neck cancer

A
  • alcohol
  • smoking
  • chewing tobacco
  • diet
  • exposure to UV light
92
Q

list signs of a digit sucking habit

A
  • proclined upper incisors
  • retroclined lower incisors
  • anterior open bite
  • incomplete open bite
  • narrow upper arch
  • unilateral posterior cross bite
93
Q

how do you prevent/stop a digit sucking habit?

A
  • URA
  • behavioural management therapy
  • sock on hands at night
  • dummy
  • plaster on thumb
  • bad tasting nail polish
94
Q

describe the local causes of malocclusion

A

localised problem with either arch (1/2/3 teeth)
can be due number, size/form, position, soft tissue or a pathology
ectopic, impacted, missing, trauma, habits, supernumeracy

95
Q

what are the types of supernumerary teeth?

A
  • conical
  • tuberculate
  • supplemental
  • odontome
96
Q

what is meand by ‘SIMD’?

A
  • Scottish Index of Multiple Deprivation
  • ranks data zones from most to least deprived
  • either a scale of 1-5 or 1-10
  • factors of deprivation- unemployment, crime, housing, income, education, health, geographic access to services
97
Q

give roles of epidemiology

A
  • to assess people’s risk of disease
  • to study the causes and determinants of disease
  • to develop preventive programmes
  • to evaluate interventions e.g.oral cancer screening
98
Q

define incidence

A

the amount of new cases in the population in a specific time period

99
Q

define prevalence

A

proportion of a population affected by disease at a single point in time

100
Q

what are the constitutes of stainless steel?

A

72% iron
18% chromium
8% nickel
1.7% titanium
0.3% carbon

101
Q

what is work hardening?

A
  • work done on metal below its recrystallisation temperature causes slip
  • slip= dislocations collect ar grain boundaries hence stronger, harder material
  • the hard wire is made by drawing the metal in a cold state through a series of dies of successively smaller diameter
  • this makes it stronger and gives it spring properties
102
Q

define springiness

A

can undergo large defelctions without permanent deformation

103
Q

give disadvantages of self cure PMMA

A

poor mechanical properties
not suitable for pts w residual monomer allergy

104
Q

what factors can result in tooth mobility?

A
  • traumatic occlusion (bruxism)
  • trauma
  • periodontal disease
  • dental abscess
105
Q

when would you intervene a mobile tooth?

A
  • progressively increasing mobility
  • gives rise to symptoms
  • creates difficulty with restorative treatment
106
Q

how would you expect a mobile tooth to react to HPT?

A
  • decrease in mobility
  • clinical attachment will be gained
    *
107
Q

A patient has mobile lower incisors and refuses XLA. What would you advise him and what are the disadvantages of this?

A

Splinting may be appropriate when there is tooth mobility caused by advanced LOA/if tooth mobility is causing discomfort or difficulty in chewing.

However, splinting does not influence the rate of periodontal destruction and it may create hygiene difficulties.

It is a Tx of last resort.

108
Q

list peri-operative complications

A
  • difficult access
  • abnormal resistance
  • fracture of tooth
  • alveolar plate or tuberosity
  • jaw fracture
  • OAC
  • loss of tooth
  • soft tissue damage
  • haemorrhage
  • dislocation of TMJ
  • damage to adjacent teeth/restoration
  • broken instruments
  • wrong tooth
109
Q

during an extraction, the patient’s root fractures. what radiograph should you take?

A

periapical

110
Q

where is the mental foramen?

A

between apices of lower premolars

111
Q

what structures does the mental nerve innervate?

A

chin
lower lip

112
Q

what analgesic is mostg appropriate post-extraction for a patient who takes warfarin?

A

paracetemol

113
Q

what is the mechanism of apixaban?

A
  • a selective inhibitor of FXa
  • does not require antithrombin III for antithrombic activity
  • inhibits free and clot-bound FXa and prothrombinase activity
  • has no direct affect on platelet aggregation, but indirectly inhibits platelet aggregation induced by thrombin
  • decreases thrombin generation and thrombus development
114
Q

how is facial palsy caused during an IDB?

A
  • if the clinician doesn’t hit bone and inserts too far back, LA is deposited in the parotid gland
  • facial nerve runs through parotid gland and due to dense fascia around the gland, the LA will remain for a long time anf cause paralysis of the facial muscles that the nerve innervates
115
Q

how would you initially manage. apatient with facial palsy?

A
  • reassure- tell patient sensation will return after a few hours
  • keep eye patch over eye to prevent drying out as pt cannot blink
116
Q

how do you decomtaminate an impression?

A
  • rinse under cold running water
  • place in perform for 10 minutes
  • remove and rinse under cold water
  • place damp gauze on impression
  • place into sealable labelled bag

BDS3 past papers (8 decks)

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