2016 MSA Flashcards by David Jack

List 4 risk factors for candidosis

Immunocompromised
Broad spectrum antibiotics
Advanced HIV infection
Diabetes mellitus

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Name the organism and virulence factor that causes candidosis

C. albicans
Hydrolytic enzymes eg phospholipase causes host cell penetration

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How does a biofilm form?

Adhesion
Colonisation
Accumulation
Formation of a complex community
Dispersal

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How would you test for C. albicans and suggest a lab identification method

Oral swab from localised area
16S rRNA gene sequencing

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Give an example of an azole antifungal and describe its mechanism of action

Fluconazole
Inhibits synthesis of ergosterol, a component of the fungal cell membrane

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Give an example of a polyene antifungal and describe its mechanism of action

Nystatin
Binds to ergosterol, increasing membrane permeability and eventually leading to cell death

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Give 3 study designs other than RCT

Cohort study
Cross sectional study
Case control study

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Describe a cohort study

Follows a group of individuals over time to identify those that develop a certain disease to investigate incidence and risk factors

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Describe a cross sectional study

Observation of defined population at a certain time to investigate prevalence and risk factors of a disease

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Describe a case control study

Study of people with a disease and a suitable control group of people without the disease
Looks back in time at exposure to particular risk factors in both groups

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What is the preferred method of correcting an amalgam overhang?

Remove the entire restoration and replace it with a new one

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Give 5 functions of a provisional crown

To maintain aesthetics
To maintain occlusal relationship
To maintain masticatory function of tooth
To test run fit of definitive crown
Prevent sensitivity due to exposed dentine

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Name 3 types of prefabricated crowns

Stainless steel
Polycarbonate
Clear plastic

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List 2 disadvantages of a prefabricated crown

Large bank of crowns needed
Unlikely to fit cervically, interproximally or occlusally

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List 2 treatment steps of an ED fracture in an 8 year old boy

Either bond fragment to tooth or place composite bandage
Take 2 periapical radiographs to rule out root fracture or luxation

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List 4 radiographic signs of a non-vital tooth

Loss of PDL space
Loss of lamina dura
Root resorption
Periapical radiolucency

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List 4 things from a trauma stamp

Any 4 from:
- TTP
- Percussion note
- ECl
- EPT
- Colour
- Mobility
- Radiograph
- Sinus

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Explain the pattern of distribution of nursing caries

Lower incisors protected from decay by tongue
Maxillary incisors are the first to experience cariogenic challenge and suffer the most due to their early eruption
If the habit continues, the other teeth will be affected in sequence with their eruption order

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Give 4 reasons for nursing caries

Poor OH
Inappropriate use of bottle feeding
Prolonged breastfeeding
Child swirls liquid around mouth instead of swallowing

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What flouride regime would you use for a 2 year old with high caries risk in a dental setting

Sodium fluoride varnish 22,600ppm twice yearly
Recommend using a smear of 1,000-1,500ppm fluoride tooth paste

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What 4 things for tooth brushing would you advise for a 2 year old with high caries risk?

Parental supervision when brushing
Spit, don’ rinse
Brush last thing at night and one other time during the day
Use 1,000-1,500ppm fluoride toothpaste

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Name 3 types of dementia

Alzheimer’s
Vascular
Dementia with Lewy bodies

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List 4 signs of late stage dementia

Inability to recognise familiarly people, objects and surroundings
Incontinence
Gradual loss of speech
Difficulty eating and swallowing

Name 2 cognitive tests for dementia?

Mini-mental state examination
Blessed dementia scale

List 3 ways a dental practice can be made dementia friendly

Reception desk visible from entrance Signage at eye level with simple, clear text and colour Colour and tone of walls distinctive from flooring

What is meant by a dentally fit patient?

Good oral hygiene with no active caries or dental infection

What is an MDT?

Multidisciplinary team Group of medical professionals that share their expertise to provide the best holistic care for a patient

List 4 members who could be in an MDT?

Dentist Oncologist Surgeon Pathologist

Name 3 complications of radiotherapy to the head and neck

Trismus Increased risk of ORN Oral mucositis

List 4 modifiable factors for the aetiology of head and neck cancer

Smoking Alcohol consumption Sun exposure Malnutrition

List 4 signs of a digit sucking habit

Proclined upper incisors Retroclined lower incisors Anterior open bite Unilateral posterior crossbite

How does a digit sucking habit affect the posterior dentition?

Lower position of tongue causes musculature to move the teeth palatally narrowing the upper arch The mandible must deviate upon closing to achieve ICP causing a unilateral posterior crossbite

Define a local malocclusion

A local problem or abnormality affecting 1, 2 or several teeth in either arch that produces a malocclusion

Name 4 conditions of tooth number which can result in malocclusion

Supernumeraries Hypodontia Retained primary teeth Early loss of primary teeth

List 4 supernumerary teeth

Conical Tubercular Supplemental Odontome

What is meant by SIMD?

Scottish Index of Multiple Deprivation Ranks data zones based on levels of deprivation using factors such as education, housing, employment, income and crime

What are 2 roles of epidemiology?

To assess people’s risk of disease To study the causes and determinants of disease

Define incidence

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

Define prevalence

Proportion of the population affected by a disease at a single point in time

Name the constituents of stainless steel and their proportions

Iron - 72% Chromium - 18% Nickel - 8% Titanium - 1.7% Carbon - 0.3%

What is work hardening?

Work done to a metal at low temperature such ad bending, rolling or swaging Causes dislocations at grain boundaries making a harder, stronger material

What is meant by springiness?

The ability of a material to undergo large deflections without permanent deformation

Give 2 disadvantages of self-cure PMMA

Poor mechanical properties Allergy to residual monomer

Name 4 factors which can result in tooth mobility?

Occlusal trauma Attachment loss Root resorption Periodontal inflammation

Name 2 circumstances of tooth mobility that you would intervene

If mobility is symptomatic If mobility is progressively increasing

Would you expect tooth mobility to increase or decrease in a patient with moderate/advanced periodontal disease, following HPT. Explain why?

Decrease Removal of bacteria causing attachment loss will promote attachment of long junctional epithelium to the root, increasing stability of the tooth

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

Splinting Can create difficulties in oral hygiene

A patient has an unstable INR. How would the GP assess this?

FBC to assess patients blood clotting factors Adjustment in dosage or type of anticoagulant medication

What is the mechanism of apixaban?

Factor Xa inhibitor

How is facial palsy caused?

LA injected in to the parotid gland which is enclosed by the parotid capsule Causes anaesthesia of the facial nerve and paralysis of the facial muscles innervated by it

Give 3 differences between stroke and a facial palsy

Stroke only affects lower facial muscles, not upper LA causes palsy of the same side Stroke causes palsy of the opposite side

Name 4 ways you could initially manage a facial palsy

Reassure the patient Inform patient sensation will return in a few hours Keep eye patch over eye to prevent drying out as patient does not have blink reflex Assess whether it is a facial palsy or a stroke

How would you determine if an impression is usable?

Accuracy of capturing tooth position Fine detail reproduction Material uniformity

List 4 potential faults of an inlay impression?

Distortion or tears Air bubbles or voids Poor detail reproduction Insufficient thickness

How would you decontaminate an impression?

Place in perform solution for 10 minutes Rinse before and after placing in perform Wrap in damp gauze and place in a sealable, labelled bag