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BDS3 PAST PAPER > 2018 MSA > Flashcards

2018 MSA Flashcards

1
Q

What are two aims for raising a flap in oral surgery?

A
  • better access
  • better vision/view
  • protection of soft tissues
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2
Q

What 4 things influence flap design in oral surgery?

A
  • the type of surgery being carried out
  • proximity of important structures such as nerves & muscles
  • area of the mouth (aesthetics may play a part)
  • how much access needed
  • personal preference of clinician
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3
Q

What type of handpiece is used for bone removal in oral surgery?

A
  • electrical straight handpiece with saline cooled burs
  • round or fissure tungsten carbide burs
  • air driven handpiece may lead to surgical emphysema
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4
Q

what are the three methods of debridement in oral surgery?

A
  1. Physical
    - bone file or handpiece to remove sharp bony edges
    - mitchell’s trimmer or victory curette to remove soft tissue debridement
  2. Irrigation
    - sterile saline into socket and under flap
  3. Suction
    - aspirate under flap to remove debris
    - check socket for retained apices
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5
Q

What is the clinical name of dry socket?

A

Alveolar Osteitis
- inflammation of lamina dura

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6
Q

What are 3 predisposing factors for development of dry socket?

A
  • smoking
  • female
  • molars more common
  • oral contraceptive pill
  • previous experience
  • excessive rinsing
  • female
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7
Q

What are 3 signs & symptoms of dry socket?

A
  • dull aching pain
  • pain radiates to ear & is continuous
  • being kept up at night
  • bad smell/bad breath/ bad taste
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8
Q

what are 3 treatment options for patients with dry socket?

A
  • supportive reassurance with systemic analgesia
  • irrigate socket with warm saline to remove any debris
  • curettage/debridement to encourage formation of new clot
  • pack the socket with antiseptic alvogyl
  • LA to help with pain
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9
Q

What drug family does Apixaban belong to?

A

NOAC
- novel oral anticoagulant

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10
Q

What does Apixiban inhibit to work?

A

Factor Xa (10a)
- inhibits conversion of prothrombin to thrombin stopping the production of the fibrin clot

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11
Q

What else is apixaban used for?

A
  • treatment or secondary prevention of DVT
  • prevention of pulmonary embolism
  • prevention of stroke
  • treatment of AF
  • heart valve disease
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12
Q

What blood tests should be done before treating a patient taking Apixaban?

A

APTT (activated partial thromboplastin time)

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13
Q

What would you do in terms of dosage for surgical dental treatment vs simple extraction with a person taking apixaban?

A

Surgical dental treatment = miss morning dose for apixaban

Simple extraction = treat without interrupting (if they are very high risk of bleeding you would also miss morning dose)

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14
Q

What are 3 methods used for achieving haemostatic control?

A
  • bite on damp gauze
  • LA with vasoconstrictor
  • suture
  • diathermy
  • bone wax
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15
Q

What are 4 physical features of Down’s Syndrome?

A
  • broad flat face
  • short nose
  • small arched palate
  • macroglossia
  • abnormal ears
  • dental abnormalities
  • hypodontia
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16
Q

What genetic test result would confirm a patient has Down’s Syndrome?

A

extra copy of chromosome 21

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17
Q

Give 2 reasons a patient with Down’s Syndrome may have increased incidence of periodontal disease?

A
  • poor OH due to mental retardation
  • immunocompromised (impaired neutrophils)
  • less saliva/of a poorer quality
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18
Q

What would be 2 examples of things that result in a patient not having capacity?

A
  • end stage dementia
  • severe learning disability
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19
Q

What is the difference between a welfare guardian and a welfare power of attorney?

A

Welfare guardian has responsibility over persons health and financial status (property, finance & even marital affairs), has to be court appointed.

Welfare POA only has responsibility for health & wellbeing NOT financial decisions.

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20
Q

What antibiotic could be prescribed for antibiotic prophylaxis & what dosage?

A

Amoxicillin 3g oral powder sachet 60 mins before procedure
OR
2 Clindamycin capsules (300g each, 600g total) 60 mins before procedure

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21
Q

When should antibiotic prophylaxis be given? (timescale)

A

60 mins before procedure

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22
Q

What are 3 clinical features of Parkinson’s?

A
  • bradykinesia (slow movement)
  • rigidity (increased muscle tone)
  • tremor
  • mask like face
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23
Q

How does Parkinson’s differ from other cerebellar diseases?

A

Parkinson’s = resting tremor

Other cerebellar diseases = intentional active tremors

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24
Q

Why might Parkinson’s patients have dry mouth?

A

Anticholinergic effects of drug treatment (benztropine)

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25
Q

How could you help prevent dentures being lost in the care home?

A
  • mark initials on denture during development
  • store in a labelled container
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26
Q

Why might you choose not to extract teeth of a Parkinson’s patient to make dentures?

A

Tremor could make extraction difficult
Poor mouth opening due to rigidity

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27
Q

What would be the 2 most important things in the provision of a Parkinson’s patients future treatment?

A
  1. prevention (OH may get compromised due to poor motor function, disease will progress)
  2. relief of pain
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28
Q

What is local malocclusion?

A

A localised problem or abnormality within either arch, usually confined to one, two or several teeth producing a malocclusion.

Tends to get worse with time, can be caused by variation of tooth number

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29
Q

What are 4 reasons for abnormalities of tooth number?

A
  1. supernumerary teeth
  2. hypodontia
  3. retained primary teeth
  4. early loss of primary teeth
  5. unscheduled loss of permanent teeth
30
Q

What are the 4 types of supernumerary teeth?

A
  1. conical
  2. tuberculate
  3. supplemental
  4. odontome
31
Q

Give 2 ways to measure anterio-posterio skeletal relationship?

A
  1. palpating the maxilla and mandible with 2 fingers and assessing if the maxilla is infront etc
  2. take a lateral cephalogram and check the ANB angle
32
Q

Give 2 ways to measure the vertical skeletal relationship?

A
  1. assess FMPA (Frankfort mandibular plane angles)
  2. LAFH to TAFH ratio
33
Q

What position should their head be in when taking a cephalogram?

A

frankfort plane parallel to floor

34
Q

How is porcelain surface prepped in the lab for bonding?

A

Hydrofluoric acid used to produce retentive surface on porcelain

35
Q

What do you use to bond porcelain to composite luting resin?

A

Silane coupling agents

36
Q

How does silane coupling agent act chemically?

A

Silane molecule has C=C bond which reacts with the composite resin luting agent

Oxide groups on the porcelain bond with the silane

37
Q

When would you use a dual cured?

A

when using metal restorations as light will not penetrate metal

38
Q

What would you do in the lab to prepare metal?

A

Sandblast it

39
Q

What chemical agent is used to bond metal?

A

MDP and 4-META

40
Q

what metal can be used for an acid-etch retained bridge?

A

CoCr

41
Q

What 4 things would you ask the patient about smoking?

A
  • why do they smoke?
  • how many cigarettes a day?
  • how long have they been smoking?
  • are they thinking of quitting smoking?
42
Q

what 3 things would you tell a patient that uses E-cigarettes?

A
  • not harmless but safer than conventional cigarettes
  • can still cause dry mouth
  • can help patients to quit
43
Q

what is the methodology used for helping patients to quit smoking?

A

5 As
1. Ask
2. Advise
3. Assess
4. Assist
5. Arrange

44
Q

Give 2 advice services you could refer a patient to?

A
  • local pharmacy
  • community smoking support group
45
Q

What should you do if a patient does not want to quite smoking now?

A
  • provide information/leaflet and explain if they ever think about quitting in the future we can support them
  • record advice given in notes
46
Q

What 3mm spacing material is used & why?

A

Alginate
- it is mucostatic & will take accurate record of tissues without displacement

47
Q

Why is silicone not used?

A
  • not effective for undercuts
  • mucocompressive
48
Q

what are the 2 support areas on the maxillary arch?

A
  1. hard palate
  2. ridge crest
49
Q

What is the primary support area of the mandible?

A

buccal shelf & pear shaped pad

50
Q

What part of the mandible interferes during a maxillary working impression?

A

Coronoid process

51
Q

How does PICO relate to study design?

A

Population
Intervention
Comparison
Outcome

52
Q

How can bias be reduced in study designs?

A
  • randomising
  • double blinding
53
Q

What is absolute risk difference?

A

difference between the observed risks in the two groups

54
Q

what is the most important thing in prevention of healthcare associated infections?

A

PPE
- gloves
- aprons
- visors
- masks

55
Q

what are the 10 SICPs?

A
  • patient placement
  • hand hygiene
  • respiratory and cough hygiene
  • PPE
  • safe management of care equipment
  • safe management of care environment
  • safe management of linen
  • safe management of blood & bodily fluid spillages
  • safe disposal of waste
  • occupational safety prevention and exposure management including sharps
56
Q

What is used to clean blood spillages?

A
  • sodium hypochlorite
  • sodium dichloroisocyanurate
57
Q

What strength of cleaning agent is used to clean blood spillage?

A

10,000ppm

58
Q

What time should cleaning agent be used to clean blood spillage?

A

3-5 mins

59
Q

How to break the chain of infection at transmission for use of dirty forceps?

A

Cleaning, disinfecting and sterilising before use

60
Q

What are the Herb Schilder’s endodontic principles?

A
  • create a continuously tapering funnel shape
  • maintain apical foramen in original position
  • keep apical opening as small as possible
61
Q

Why is irrigation useful in endodontics apart from disinfection?

A
  • dissolves organic materials
  • flushes out debris
  • lubricates root canal instruments
  • remove the endodontic smear layer
62
Q

what is the best endodontic irrigant?

A

sodium hypochlorite

63
Q

what is the ideal strength of sodium hypochlorite in endo procedures?

A

3% sodium hypochlorite (2.5-5.25 acceptable)

64
Q

Give 3 features to take into account when using sodium hypochlorite:

A
  • allergic reaction
  • irritate soft tissues
  • apical extrusion leading to tissue necrosis
  • discolouration of patients fabric/top
65
Q

Give 4 indications that trauma isn’t accidental:

A
  • delay in presentation of trauma
  • presentation not compatible with story
  • bilateral injury
  • vague story
  • injury untreated
  • previous history of violence
66
Q

What are 2 effects that trauma has on the primary dentition?

A
  • discolouration
  • delayed exfoliation
67
Q

What are 4 effects that trauma has on the permanent dentition?

A
  • failure of permanent successor to form
  • dilaceration
  • enamel defects
  • abnormal tooth/root morphology
68
Q

What special investigation could be used for a child that is totally unco-operative?

A

OPT

69
Q

When would be the ideal time to remove a child’s carious 6s? why is this?

A
  • bifurcation of the 7s on radiograph
  • 5 & 8 are present
  • mild buccal segment crowding
  • prevents 7s erupting late/early
  • caries free dentition
70
Q

What would be the disadvantage of extracting a child’s carious 6?

A
  • loss of permanent tooth
  • risk of GA
  • bad experience could affect patients future visits
71
Q

Give 4 reasons that a child may be anxious when attending the dentist:

A
  • past negative medical/dental experience
  • influence of friends & family
  • media representation of dentists
  • expectation of pain

BDS3 PAST PAPER (5 decks)

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