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3 past papers > 2018 MSA > Flashcards

2018 MSA Flashcards

1
Q

Give two aims for raising a flap

A

Maximal access with minimal trauma
Protection of soft tissues

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2
Q

Give 4 things that influence flap design

A

Retraction
Location of surgical site
Surgical procedure being carried out
Post-operative aesthetics

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3
Q

What type of handpiece is used for bone removal?

A

Electric straight handpiece with saline cooled bur

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4
Q

What are the 3 methods of debridement?

A

Suction - aspirate under flap to remove debris
Irrigation - sterile saline into socket and under flap
Physical - bone file or handpiece to remove sharp bony edges

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5
Q

What is the name for a dry socket?

A

Localised osteitis/alveolar osteitis

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6
Q

Give 3 disposing factors for a dry socket

A

Mandibular teeth
Females
Smoking

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7
Q

Give 3 signs and symptoms of a dry socket

A

Malodour of the socket
Exposed bone is sensitive
Dull, aching pain

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8
Q

How is a dry socket treated? (3 marks)

A

Reassure patient
Recommend optimal analgesics
LA
Debridement of bone
Pack with alvogyl

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9
Q

What is the drug family of apixaban

A

DOAC

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10
Q

What does apixaban inhibit?

A

Factor Xa

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11
Q

What else is apixaban used for? (2 marks)

A

Prevention of DVT
Prevention of pulmonary embolism

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12
Q

What blood tests should you get before treatment for a patient on abixaban?

A

aPTT - activated partial thromboplastin time

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13
Q

What should you do with apixaban dosage for surgical tx vs a simple extraction?

A

Simple extraction is low risk - treat without interrupting medication
Surgical treatment is high risk - ask patient to miss morning dose on day of treatment

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14
Q

Give 3 methods of haemostatic control

A

Pressure - bite on damp gauze
LA with adrenaline as a vasoconstrictor
Diathermy

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15
Q

Give 4 physical features of Down syndrome

A

Broad flat face
Short neck
Reduced muscle tone
Upwards slanting of eyes

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16
Q

What is the result of a positive Down syndrome test?

A

Full trisomy of chromosome 21

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17
Q

Why may patients with Down syndrome have increased levels of periodontal disease?

A

Systemic immunodeficiency
Inability to carry out good OH practices

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18
Q

Give 2 medical reasons that a patient with Down’s syndrome may lack capacity

A

Intellectual disability
Dementia

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19
Q

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

A

PoA is drawn through a solicitor and granted by the adult before they lose capacity
Welfare guardian is appointed by the courts to a person who does not have capacity

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20
Q

What drug and dosage is used for antibiotic prophylaxis?

A

Amoxicillin 3g

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21
Q

When should antibiotic prophylaxis be taken?

A

60 minutes before procedure

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22
Q

Give 3 features of Parkinson’s

A

Bradykinesia - slow movement
Resting tremors
Posture instability

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23
Q

How does Parkinson’s differ from other cerebellar diseases?

A

Parkinson’s is caused by loss of dopamine receptors
Others are caused by damage to the cerebellum

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24
Q

For what reason may a patient have a dry mouth?

A

Medications

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25
Q

How can you prevent a denture from being lost in a care home? (2 marks)

A

Initial the denture during processing
Store them in a labelled container

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26
Q

Why wouldn’t you extract teeth for denture reasons in a Parkinson’s patient?

A

The patient won’t tolerate the denture making process

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27
Q

What are the 2 most important things in the provision of future treatment for a Parkinson’s patient?

A

Mastication function
Relief of pain

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28
Q

What is a local malocclusion?

A

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

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29
Q

Give 4 reasons for abnormality of tooth number

A

Supernumeraries
Hypodontia
Early loss of primary teeth
Retained primary teeth

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30
Q

What are the 4 types of supernumeraries?

A

Conical
Tuberculate
Supplemental
Odontome

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31
Q

What 2 ways can you measure antero-posterior skeletal relationship?

A

Palpate skeletal bases
Visual assessment

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32
Q

What 2 ways can you measure vertical skeletal relationship?

A

FMPA - if average, planes should meet at external occipital protuberance
LAFH to TAFH ratio - if average should be approximately 55%

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33
Q

What position should a patients head be in for orthodontic assessment?

A

Frankfort plane parallel to the floor

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34
Q

How is porcelain surface prepped in lab for bonding?

A

Etch with hydrofluoric acid

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35
Q

What is used to bond porcelain to composite luting resin?

A

Silane coupling agent

36
Q

How does a silane coupling agent act chemically?

A

C=C bonds on one side of silane react with composite composite
Oxide groups on other side of silane form strong bonds with porcelain

37
Q

When would you use a dual cured material?

A

For thick porcelain and metal restorations

38
Q

Why would you still light cure a dual cured material?

A

Mechanical properties are reduced if not dual cured

39
Q

What can be used instead of a porcelain veneer?

A

Composite restoration

40
Q

What would you do in a lab to prepare a metal?

A

Sandblast

41
Q

What chemical agent is used to bond metal?

A

MDP

42
Q

What metal can be used for an acid etch retained bridge?

A

CoCr

43
Q

What 4 things can you ask a patient about smoking?

A

How many cigarettes per day
What do they smoke
How many years have they smoked for
What age did they start smoking at

44
Q

What 3 things should you tell patients about e-cigarettes?

A

Safer than cigarettes
Safety in long term not known
Contain nicotine but not cancer causing tobacco

45
Q

What is the methodology for smoking cessation?

A

Ask
Advise
Assess
Assist
Arrange

46
Q

What 2 advice services can you refer a smoker to?

A

Pharmacy
Smoking cessation services - quit your way

47
Q

What do you do if a patient doesn’t want to quit smoking?

A

Record this in patient notes with a reminder to bring up again at future appointments

48
Q

What 3mm spacing material is used for impressions and why?

A

Alginate
It is mucocompressive and takes an impression of tissues under load

49
Q

Why isn’t silicone used as a 3mm spacing material?

A

It is mucostatic and so is better for a smaller spacing impression

50
Q

What are the 2 support areas for the maxilla?

A

Hard palate
Residual ridge

51
Q

What are the primary support areas for the mandible?

A

Retromolar pad
Buccal shelf
Residual ridge

52
Q

What part of the mandible interferes during maxillary working impressions?

A

Retromolar pad

53
Q

What is absolute risk difference?

A

The difference in percentage of risk between the exposure group and placebo group

54
Q

What is the most important thing for preventing HAI?

A

Hand hygiene

55
Q

What agents are used for blood spillages?

A

Sodium dichloroisocyanurate
Sodium hypochlorite

56
Q

What strength of agent is used in blood spillages and for how long?

A

10,000ppm
3-5 minutes

57
Q

How do you break the chain of infection at transmission for dirty forceps?

A

By cleaning, disinfecting and sterilising prior to use

58
Q

What 2 features of an ECM make them resistant

A

LPS protective barrier prevents penetration of anti microbials
ECM impairs diffusion

59
Q

Name 2 perio microorganisms in red Socransky’s model

A

P. gingivalis
T. forsythia

60
Q

Name 2 microorganisms associated with caries

A

S. mutans
A.a.

61
Q

Give 2 methods used by S. mutans to survive in high acidic environments

A

Glucans - adhere to enamel surface
ATPase - controls pH

62
Q

Name 2 systemic diseases related to periodontal disease?

A

Down’s syndrome
Chronic granulomatous disease

63
Q

What are Herb Schilder’s 3 endo principles?

A

Create a continuous tapering funnel
Maintain apical foramen in original position
Keep apical opening as small as possible

64
Q

Why is irrigant useful apart from disinfection?

A

To remove debris from the canal
To lubricate the canal

65
Q

What is the best irrigant and what is the ideal strength?

A

Sodium hypochlorite - 0.5-6%

66
Q

Name 3 variables about NaOCl to be taken into account?

A

Concentration
Volume
Contact time with root canal

67
Q

Give 4 indications that a trauma isn’t accidental

A

History of injuries don’t match clinical findings
Multiple injuries around the mouth
Delay in presentation
Bilateral injuries

68
Q

Give 2 effects trauma can have on the primary dentition

A

Discolouration
Infection

69
Q

Give 4 effects trauma in the primary dentition can have on the permanent dentition

A

Ectopic eruption
Ankylosis
Dilaceration of root
Delayed eruption

70
Q

What special investigation should be used for an uncooperative child?

A

OPT

71
Q

Give 2 examples of an ideal time to remove 6s?

A

5s and 8s present
Calcification of bifurcation of 7s

72
Q

Why is it ideal to remove 6s at a certain time?

A

Spontaneous space closure
Caries free dentition

73
Q

What are the disadvantages of removal of 6s?

A

Traumatic experience could affect child’s view of future dental treatment
Risk of GA

74
Q

What should you do with upper 6s if removing lower 6s?

A

Compensating extraction

75
Q

Give 4 reasons for a child to be anxious

A

Past negative dental experience
Negative dental attitude of parents
Fear of injections or drilling
Dental experience of friends and siblings

76
Q

Give 2 ways you can treat an anxious child

A

If the child has pain, ensure this is managed first
Consider dividing treatment into several stages with a month or two between stages
or
GA
Inhalation sedation

Send help pls Matt McGarva is scaring me

77
Q

Name 4 behaviour management methods

A

Behaviour shaping and positive reinforcement
Enhancing control
Tell, show, do
Distraction

78
Q

Name 2 ways an amalgam overhang can be made

A

Excessive force used when condensing amalgam
Poor adaptation of matrix band

79
Q

Give 2 ways you can fix an amalgam restoration

A

Polishing tooth with long tapered finishing bur
Remove entire restoration and place new one

80
Q

Give 2 short term and 2 long term problems of an overhang

A

Short - food trap, difficult to clean
Long - secondary caries, periodontal disease

81
Q

What line should be horizontal when taking an OPT?

A

Frankfort plane

82
Q

Why may anteriors be horizontally magnified in an OPT?

A

Canine behind the guideline
Patient too far back in the machine

83
Q

Why may posteriors be horizontally magnified in an OPT?

A

If patient is rotated in the machine

84
Q

Name 3 features of a ghost image

A

Always higher
Always horizontally magnified
On the opposite side

85
Q

What radiograph should be taken pre-extraction of 48 when there is no sign of the 38?

A

Right half panoramic

86
Q

What are the borders of the maxillary sinus?

A

Mesial - nasal cavity, Inferior - alveolar process of maxilla, Posterior - pterygoid process of sphenoid bone

3 past papers (10 decks)

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