Exam questions Flashcards

Question

What is the 2017 Periodontits Case definition?

Answer 1

1.Interdental CAL detectable at 2 non adjacent teeth or 2. Buccal or oral CAL above or equal to 3mm with pocketing equal or more than 3mm at 2 or more teeth AND OBSERVED CAL CANNOT BE ASCRIBED TO NON-PERIODONTITIS CAUSES: SUCH AS VERTICAL ROOT FRACTURE/S

Answer 2

1. Denture consult + primary impressions 2. Secondary impressions 3. Bite registration + shade mould selection 4. Denture try on 5. Denture insert 6. Review denture

Answer 3

It is a pharmacodynamic problem which occurs with use of ACE inhibitor, diuretic and NSAID and can result in Acute Kidney Injury (AKI) Process: 1. ACE inhibitors preserve renal function and also cause relaxation of efferent renal arteriole - reducing the GFR 2. NSAID are able to increase the vasoconstriction of the afferent arteriole by inhibiting the production of prostoglandins - a potent afferent arteriole dilator - reducing GFR 3. Dirutetic drive the increase exertion of water through the renal system thus increasing the amount of blood that is carried to the glomerulus through the afferent arteriole - reducing GFR 4. All three factors compound reduce the GFR significantly to cause kidney injury 5. Solution - avoid NSAIDs

Answer 4

1. Haemophilia 2. Von Willebrands disease 3. Platelet disorder

Answer 5

1. Consent from parent 2. LA + sedation - IANB with 2% lignocaine, 1:80000 adrenaline, 2.2 mL 3. Rubber dam isolation with cuff technique 4. Initial phase - removing disease and bacterially contaminated tissues with use of slow speed handpieces. Previously - acess with high speed bur 5. Remove entire roof of pulp chamber and remove pulp from the entire chamber and root orifice 6. Achieve haemostasis 7. Place medicament over radicular pulp stums - formocresol 8. Condense IRM into chamber 9. Restore with GIC/RMGIC following appropriate GIC/RMGIC procedures 10. Restore tooth with stainless steel crown - coronal sela is essential 11. Review in 3 months - inform the patient that if pain persists you might need to extract

Answer 6

CAMST. Coverage - is the fissure fully covered Amount - is there enough FS material Margins - are the margins sealed & flush Surface - is the surface smooth Tooth - at future appts check the tooth

Answer 7

1. Open questioning 2. Affirmations 3. Reflections 4. Summaries

Answer 8

1. Engaging 2. Focusing 3. Evoking 4. Planning

Answer 9

1. High nicotine dependence 2. Lack of knowledge 3. Not ready to quit 4. Psychological or emotional concerns 5. Fear of weight gain 6. Fear that quit attempt will be unsuccessful 7. Substance use 8. Living with other smokers 9. Giving quitting a low priority due to other circumstances

Answer 10

1. Ask - ask if they smoke 2. Assess - assess their stages of change 3. Advise - information is the key 4. Assist - discuss the benefits of quitting 5. Arrange - arrange for follow-up

Answer 11

Being with OARS 1. Open questions 2. Affirmations on progress 3. Reflections 4. Summaries Find point at which the client is in stages of change, gather information and move on to principles of motivational interviewing 1. Develop discrepancy - change os uncomfortable so it is important to informt he cleint about benefit sof change 2. Roll with resistance - listen to clients arguments, don't refute them, make a neutral statement -DONT GIVE SOLUTION, maybe adressing an issue later will help the client to keep the issue at the back of their mind and build a good relationship with you 3. Build self efficacy - encrouage the client, to benefits of change and affirm general better outcomes - comment that it is good that they thought about the change 4. Express empathy - again change is hard and for a person who is uner pressure it is evne harder.

Answer 12

1. Desire to change " I want to" 2. Ability to change "I think I can" 3. Reasons to change "My kids wnat me to" 4. Need "I think I need to do it"

Answer 13

Zone 1 - Nose and sinuses Zone 2 - Md Body Zone 3 - Articular Eminence, Condyle, Mx Tuberosities, Pterygo Mx Fissures, EAM, Cervical Spine Zone 4 - Epiglottis Zone 5 - Md Ramus and Spine Zone 6 - Dentition

Answer 14

1. 2% Lignocaine with 1:80000 adrenaline (Lignospan special) 2. 3% Mepivicaine (Scandonest Plain) 3. 4% Articaine with 1:100000 adrenaline (Articadent)

Answer 15

TRIM is an acronomy for: Timing Relevance Involvment Method

Answer 16

1. Miller technique - two radiographs are taken at right angles to each other - good at determining the position of an impacted tooth 2. Tube shift - a slight shift of the tube is needed after the first radiograph (SLOB) to discern which root is which

Answer 17

Complete denture retention is the resistance to displacement of the denture base away from the ridge. It provides psychologic comfort to the patient.

Answer 18

Stability is the resistance to horizontal and rotational forces. Stability has been cited as the most significant property in providing for physiologic comfort.

Answer 19

Support is the resistance to vertical movement of the denture base towards the ridge.

Answer 20

1. Alginate - halas 2. PVS - Honigun 3. Polyether - Impregum duosoft

Answer 21

1. Relative radiodensity - mixed, radioopaque or radiolucent - CONSIDER SOFT TISSUE SHADOWS 2. Site 3. Size 4. Shape 5. Outline or border 6. Effects on adjacent structures

Answer 22

Sodium alginate forms a hydrogel former

Answer 23

It provide clcium ions

Answer 24

It controls working time - acts as a retarder of the rapid use of calcium within the reaction

Answer 25

Nasopalatine

Answer 26

Moist hear in the form of saturated steam under pressure in an air tigh vessel. Heat, steam, pressure and air tight vessel.

Answer 27

1. Educate the patient about the diagnosis, peform debridmenet and provide OHI 2. Use soft bristle tooth brush along gingival margins using modified Bass technique 3. Use CHx for 2 weeks

Answer 28

1. Consider multidisciplinery care with GP and oral surgeon 2. Stock dental practice and train personal for hypolglycemic/hyperglycemic situations 3. Consider oral consequences of diabetes: poor healing, increased infection rate, increase xerostomia 4. Risk of periodontitis 5. Consider early appoitments 6. Remember - these patient are immunosupressed

Answer 29

1. People who take warfarin - due to increased risk of bleeding 2. Pregnant ladies - it is a Category C drugs due to risk f foetal damage, decrease growtha dn development of the feutus, potential risk of miscarriage

Answer 30

To remove smere layer to facilitate ion exchange

Answer 31

It is an hibitor that reduces the influx of sodium particles into the nerves thus stopping the genertion of action potential

Answer 32

1. Infection or inflammation in the region causes pH to drop 2. Concentration of the unionised (lipophilic RN) decreases 3. Areas of inflammation also jave increase blood supply due to vasodialation - thus increase LA washout

Answer 33

P. Gingivalis

Answer 34

PREPARED: 1. Prepare for discussion 2. Relate to the person 3. Explore priorities 4. Provide information 5. Acknowldege emotions and concerns 6. Foster realistic hope 7. Encourage questions 8. Document TRIM: 1. Timing - correct amount and type of info - chunk the information 2. Relevance - what will help the patient connect to this info? - relate to patients perspective 3. Involvement - How can patient contribute? - offer suggestions and choices rather than directives 4. Method - Help patient understand and recall? - use visual methods of conveying - PANFLETS SPIKES Setting - Find a quite and private setting Perception - Estabslih how much the patient knows and his or her perceptions abut the medical situation Invitation or information - Ask the patient and significant other how much and what kind of information will be helpful Knowledge - Share bade news with the patient using gentle, nonclinical language is small segments Empathy - Acknowledge the patient's emotions and reaction with appropriate responses Summarise and strategise - summarise in language that the patient can understand. Ask the patient to repeat or summarise the information received and the next steps

Answer 35

1. Dentigerous cyst 2. Odontogenic keratocyst 3. Ameloblastoma 4. Ameloblastic Fibroma 5. Odontogenic myxoma

Answer 36

1. Yellowstone mix is homogenous and smooth - think streakless mix with minimal airbubles 2. Yellowstone has set adequately before removal of impression - think smooth surface with no drag lines 3. Adequate amount of yellowstone - think good anatomy, no airbubles, good thickness 4. Articulation of models - no soft tissue or air bubble interference

Answer 37

1. Decay and periodontal disease 2. Trauma 3. Pathological causes 4. Radiotherapy 5. Impacted or congenital missing teeth

Answer 38

1. Removable denture 2. Implant 3. Fixed pros 4. No treatment

Answer 39

1. Lack of suitable abutment teeth 2. Rampant caries 3. Perio disease 4. Poor oral hygiene 5. Patient can not tolerate them 6. Post readiotion tratment - osteoradionecrosis

Answer 40

1. Restore dentition to a satisfactory condition 2. Comfort 3. Aesthetics 4. Function 5. Speech 6. Preservation of remaining soft and hard tissues

Answer 41

Occlusal vertical dimension. The distance between two selected anatomic or marked points (usually one on the tip of the nose and the other on the chin) when in maximal intercuspal position; syn, VERTICAL DIMENSION OF OCCLUSION

Answer 42

Maximal intercuspal position. The complete intercuspation of the opposing teeth independent of condylar position, sometimes referred to as the best fit of the teeth regardless of the condylar position; comp, CENTRIC OCCLUSION

Answer 43

Rest vertical dimension. The postural position of the mandible when an individual is resting comfortably in an upright position and the associated muscles are in a state of minimal contractual activity syn, PHYSIOLOGIC REST POSITION, VERTICAL DIMENSION OF REST.

Answer 44

freeway space obs, slang: syn, INTEROCCLUSAL REST DISTANCE, INTEROCCLUSAL REST SPACE

Answer 45

1. Consult + alginates 2. Secondary impressions 3. Bite reg + shade, mould selection 4. Try-in 5. Insert 6. Reviews Book all with 2 weeks gap

Answer 46

1. Consult + alginates 2. Secondary impressions 3. Frame try-in, bite reg + shade, mould selection 4. Try-in 5. Insert 6. Reviews Book session 2 a fortnight after 1, appointment 3 4 weeks after that

Answer 47

1. Consult + alginates + shade, mould selection 2. Try-in 3. Insert 4. Review if required

Answer 48

Resting dimension minus freeway space. Think about it if OVD is between 2 point at occlusion, rResting vertical dimension minus freeway space will give you that!

Answer 49

Dental impression creates a negative imprint of hard and soft tissues in order to create a positive cast or model.

Answer 50

1. Saddle 2. Support 3. Retention 4. Connectors 5. Simplification

Answer 51

Kennedy 3 and 4

Answer 52

Not Kennedy but complete denture

Answer 53

Kennedy 1 and 2

Answer 54

Occlusal approaching

Answer 55

Gingival approaching

Answer 56

15 mm for cast clasps 7 mm for wrought clasp

Answer 57

Flat filtrum Hollowing of the cheeks Collapsed appearance of the jaws The distance between the tip of the nose and tip of the chin reduced Increased naso-labial grooves Increased marionette lines

Answer 58

It is OVD. You can calculate it by taking the Resting vertical dimension - 2-4 mm of free way space.

Answer 59

Describe saddles, cross teeth which are not restored Describe support and draw rests, major connector/plat Specify abutment tooth/teeth Specify clasps: rest, retentive, reciprocal Specify flanges gum fitted vs buccal flange Specify the extensions Fill lab form and draw design Obtain tutor signature

Answer 60

Posterior palatal strap Anterior palatal strap

Answer 61

1.5mmx1.5mm with 1.5mm occlusal depth. Meaning if the occlusal is 1.5mm no prep is needed

Answer 62

Free-end Saddle design Bounded saddle

Answer 63

Benefits: aesthetics, preservation of OVD Limitations: Unpredictable, painful, number of appointment and cost

Answer 64

You can use CCA stopper or a wax compound + border molding + taking impression of upper and lower dentures with Upper first. So the wax compound needs to increase the OVD and ned reline will ensure that soft tissue retention and supprot can be achieved. Always use adhesive

Answer 65

1. Before touching a patient 2. Before a procedure 3. After a procedure or body fluid exposure 4. After touching a patient 5. After touching a patient surroundings

Answer 66

1. Hand hygiene, as consistent with 5 moments for hand hygiene 2. The use of appropriate personal protective equipment 3. Safe use and disposal of sharps 4. Routine environmental cleaning 5. Reprocessing of reusable medical equipment and instruments 6. Respiratory hygiene and cough etiquette 7. Aseptic technique – standard or surgical technique 8. Waste management 9. Appropriate handling of linen

Answer 67

It is a classification of instruments depending on their level of causing infection during their use, example is: 1. Critical – using a perio-probe for surgical procedures – anything that pierces the mucosa must be sterilized and recorded (ideally) 2. Semi-critical – single use items such as micro-brushes or curing light with a sleeve – you need to clean it but you might not need to sterilize it 3. Non-critical – example is bib chains – they come in contact with intact ski

Answer 68

1. Pre-cleaning at the chairside 2. Mechanical cleaning using ultrasonic 3. Manual cleaning using of professional cleaning machines 4. Thermal disinfection 5. Thermal disinfection using washer-disinfection 6. Inspection 7. Choice of packaging material and sealing of packages 8. Labelling packages of reuseable medical devices 9. Run a Bowie-Dick type tests for air removal and steam

Answer 69

Class 6 – measuring time, steam and temperature. Class 1 – not great because it only shows temperature. Class 4 – used in SAD

Answer 70

1.Prevent disease 2.Cure disease 3.Decrease mortality 4.Decrease illness 5.Descrease symptoms of illness

Answer 71

1.Right drug 2.Right dose 3.Right frequency 4.Right duration

Answer 72

1.Absorption 2.Distribution 3.Elimination – metabolism and excretion

Answer 73

1.Lumen 2.Enterocytes 3.Portal vein 4.Systemic circulation

Answer 74

200mL as it will make the stomach empty into the small intestine

Answer 75

1.Disease – kidney disease (lover dose), liver disease (no paracetamol) 2.Age – children (hihg clearance) Elderly (lover excretion, polypharmacy, Start Low & Go up slow & don't stay low) 3.Pragnancy – all drugs no, contact GP to prescribe especially first trimeste, no ibuprofen, floconazole and oral isotretinoin – reduced GI motility 4.Genetic 5.Smoking 6.Food – grapefruit juice Drug-drug interaction

Answer 76

Drug induction – Drug A induced Drug B increasing the sites of binding Enzyme inhibition – Drug A blocks metabolism of Drug B resulting in accumulation of Drug B (miconazole) Changes in renal clearance – Ace inhibitors, Nsaids and Diuretics (triple whammy)

Answer 77

Type A – augmented or increase effect - usually okay Type B – Bizarre and unpredictable – high risk of death

Answer 78

Acetylcholine. Store in cells in vesicles and can be released in the systemic circulation (synaptic cleft) by calcium channels. There is 3 such receptors called muscarinic M1, M2, M3 (M3 is one is for glands).

Answer 79

1.Direct acting – bind to activate muscarinic receptors – nicotine, lobeline and muscarine (aka magic mucshroom compound) 2.Indirect acting – inducing acetylcholinesterase (breakdown of acetycholine) Blocking cholinergic pathway result in: Red as a beet Blind as a bat Dry as a bone Full as a flask Stuffed as a pepper Mad as a hatter

Answer 80

1.Drugs for Urinary Incontienence 2.Parkinson's disease 3.Gut motility disorders 4.Motion isckness 5.Pre-anaesthetics 6.Astham: inhalers 7.Antidepressants: Tricyclic antidepressant (not logner used much for depression but used for pain), serotonin selective reuptake inhibitors - important 8.Antipsychotics: Olanzapine, droperidol NOT CLOZAPINE that one cause hypersalivation - important 9.Antihistamines: sedating group is more common - improtant 10.Anxioklytic: anxiety drug 11.Antihypertensive 12.Benign prostatis hyper plasia 13.Appetite suppressants 14.Cytotoxic agents: radiotherapy 15.Diuretics 16Opiods

Answer 81

Efficacy in unproven: 1. Saliva substitutes – Aqueae 2. Salivary peroxidase 3. Mouth washes 4.M3 receptor agonists - slaframine 5.Check prescriptions and maybe stop taking the over counter medications 6.Sip water 7. Ice blocks 8.Spray bottle 9. Suagrless lollies or sugar-free gum 10. Limit caffein & alchohol 11. Adhere to preventative dental program

Answer 82

Remember ePrescriptions are preferred 1. Patient's name, address and DOB 2. Name & address of practitioner, phone number, qualifications, AHPRA reg 3. Drug name – GENERIC 4. Drug form – e.g. tablets 5. Drug strength- e.g 15 mg 6. Drug quantity in pills (word, symbol e.g Ten,10) 7. Dose & frequency of administration 8. Duration of days 9. Instruction clearly 10. Write (For dental treatment only) 11. A line to signify no other prescriptions 12. Signature of prescriber 13. Date of prescription 14. Signature 15. PBS number for prescribers

Answer 83

Prostoglandins – long chains of fatty acids which cause vasodilation, swelling and pain. Additionally, bradykinin is released which causes intense pain.

Answer 84

They block the work of COX1 and COX2 enzymes which prevents the creation of prostoglandins

Answer 85

COX enzymes are present throughout the body. COX1 is abundant and it maints our function. COX2 is in very low amount and lead to inflammation & pain because it is inducible. By inhibiting COX2, we can lower inflammation.

Answer 86

It is an reversible drug. It is a non-selective COX 1 & 2 inhibitor. But is an effective analgesics in presence of inflammation. It reduce the production of psotoglandisnas and make receptors less sensative to bradykinin.

Answer 87

1.Gastrointestinal ulcers 2.Reduce platelet aggregation 3.Respiratory problems: increase asthma attack 4.Kidney: renal failure and water retention leading to heart failure and hypertension 5.Cardiovascular – uncommon BUT BAD 6.Neurological – headaches 7.Hematological – rare 8.Hepatic – rare

Answer 88

1.Kidney impairment 2.Heart failure or arterial fibrilation 3.Active GI ulcer 4.Bleeding disorder and their drugs 5.Corticosteroid or anticoagulation use 6.Multiple risk factors for increase NSAID toxicity 7.If unsure contact GP

Answer 89

1. Have you experience recent changes in your bowel habits, such as black or tarry stools? 2. Any episodes or recent nausea, vomiting or abdominal pain? 3. Have you noticed any changes in your urine output or color? 4. have you experienced any shortness of breath, chest pain or swelling? 5. Do you have a care giver or support group that may aid you or remind you about taking the medication? 6. Do you take any over the counter medications recently that are beyond the once in your medical history? 7. Do you take a deuretic or an ACE inhibitor?

Answer 90

Mild-moderate acute inflammatory pain. Usually 1200mg/day, 400 mg per 6 hours for 2-3 days if pain persists you should go to GP.

Answer 91

Benzydamine, an NSAID in a spray form.

Answer 92

Respiratory depression. Additionally, sedation, nausea, euphoria, constipation and dry mouth.

Answer 93

1. Morphine – not recommended in dentistry as it is not for acute pain 2. Codeine – less potent for gram then morphine about 1/10 - not good for dental pain 3. Oxycodone - not that good 4. Tramadol – not a drug of dependence – a lot of tummy aches - go with this first!

Answer 94

1.Sedatives/hypnotics - IV – most important is brain concentration and elimination of the drug – diazepam (very fast 1-2minutes, half-life of 4-8hours), nidazolam(fast onset 4minutes, half-life 90 minutes) 2.Analgesiscs 3.Muscles relaxants

Answer 95

1. Relatively fast onset 2. Offset can be slow with diazepam 3. Dose-response relationship is very variable 4. CNS – cause convetional sedation, amnesia and anxiolysis 5. Respiratory – ventilatory depression and airway obstruction 6. CVS – mild hypotentison

Answer 96

Give it 10-15 minutes and then reassess after the first dose.

Answer 97

1.Slow onset 2.Offset is fast due to redistribution but then is slow for full clearance 3.Dose-dependent relationship is less variable 4.CNS sedation and anxiolysis 5.Ventilation depression and airway obstruction 6.Moderate-sever hypotension

Answer 98

1. Only use when there are demonstrated benefits 2. In general, the narrower the spectrum you can use the better 3. Single agents unless combination has been proven superior

Answer 99

1.Beta-lactams – inhibit bacterial walls and interference of bacterial wall synthesis. Beta lactamase can build resistance to beta lactams. Good spectrum of action, safe and wide therapeutic index. Generics: benzyl penicillin or phempxymethyl penicillin. Act on gram positive cocci thus can affect oral flora. Could be short spectrum or moderate spectrum (amoxycyllin). Can be used with clavulanate (inhibitor of beta lactamase) making it target anaerobes, good for elderly. Main side effects: allergy, GI issues and hepatoxicity. 2. Cephalsporins – also beta lactam but not pencillins. Broader spectrum. Not very much used. 3. Nitromidazole – metronidozole. Inhibits DNA synthesis and covers anaerobes. Adverse reactions: GI problems, dizziness, bitter and metalic tase. No alcohol as metronidozole inhibits the brekdown of alchohol. Need to wai 72 hours after finishing a script 4. Lincosamides – clindamycin. Inhibits bacteria protein synthesis. Good for Gram positive and anearobic bacteria. Adverse reactions: GI problems (bad ones), allergy 5. Macrolieds – erythromycin. Good for gram positive but not for anaerobes. Adverse effects: GI issues, a lot of drug interactions

Answer 100

Majority will be used to reduce anxiety before/during dental procedures

Answer 101

1.Anxiolytic 2.Sedative 3.Hypnotic

Answer 102

1.Drowsiness 2.Impaired performance 3.Respiratory depression ESPECIALLY WITH OPIODS 4.Paradoxical excitation 5.Retrograde amnesia 6.Fantasy 7.Dependence – give 1-2 tablets only

Answer 103

1.Oxazepam 2.Temzepam 3.Nitrazepam 4.Diazepam – please only prescribe 1-3 tablets

Answer 104

It is when mutliple drugs that increase serotonin are used. This features: Bahvioural changes Altered muscle tone Autonomic isntability Hyperpyrexia and diarrhoea Death

Answer 105

Corticosteroids.

Answer 106

1. Delayed wound healing 2. Increased susceptibility to infection 3. Masking of signs of infection 4. Adrenal suppression

Answer 107

Cyclosporine and tacrolimu for example. They can potentially interfere with healing and immunity. Can also cause gingival hyperplasia.

Answer 108

Something like monoclonal antibodies like interferon. Patient will receive an infusion or an injection periodically.

Answer 109

Aciclovir available orally, IV and topically. Or vallaciclovir or famciclovir.

Answer 110

Amphotericin B. Not obsorbed orally so very good. Nystatin. Not absorbed orally so also very good. Miconazole. Non-pbs but cheap as a cream. Anything azole is a antifungal

Answer 111

1.B2 adrenoreceptors agonist 2.Anticholinergic drugs

Answer 112

1.They relax smooth msucles in airways 2.And stop the mediation factors from wrecking the place up

Answer 113

1.Salbutamol 2.Tobuterol They are short acting and there duration is 3-6 hours or can be made into long acting for upto 12 hours.

Answer 114

1. Anti-inflammatory 2. Reduce bronchial hyperactivity 3. Increase number of beta 2 adrenpreceptors 4. Increase responsiveness to beta 2 agonsits Example: Beclomethasone

Answer 115

1.Oral candida 2.Hoarse voice 3.Rash

Answer 116

Ipratropium or Tiotropium are used in treatment of chronic COPD or acute asthma. Remember, dry mouth

Answer 117

1.Oxygen source 2.Disposable plastic airways 3.Adrenaline 1in 1000 injection 4.Pulse oximeter 5.Glucose 6.Glyceryl trinitrate spray 600 mcg 7.Short-acting bronchodialator and space 8.Aspirin 9.Blood pressure monitor 10.Blood glusode monitor 11.Automated external defibrillator

Answer 118

1. Urticaria – red itchy patches – stop administration of any allergens and administer a less sedating oral antihistamine like cetirizine or fexofenadine (not on PBS but good to have around and they are cheap) 2. Anaphylaxis – cardiovascular collapse and bronchoconstriction – stop administration of any allergens, call 000 and lie patient flat and give intramuscular injection of adrenaline, start supplemental oxygen, support airway, start CPR if needed. Do proper documentation.

Answer 119

1.Stop treatment 2.Pulse oximeter on, see if patient is concious, check heart rate and blood pressure – if no pulse, CPR - ask patient if they used viagra, as it can make GTN way more potent 3.Use glyceryl trinitrate spray 400 micrograms sublinguallt, repeat 5 minutes if pain persists, for total of 3 dosease if tolerated 4.If pain continues, call 000 5.Give 300mg of aspirin orally chewede before swallowing 6.Strat supplemetan oxygen and maintain oxygen between 90-96% saturation

Answer 120

1. Adrenergic – release of adrenaline 2. Neuroglycopenic – damage to neural cell - common in diabetics

Answer 121

1. Stop treatment 2. Give 15 g of glucose and measure glucose level in 15 minutes 3. If still low, administer 3 or more portions 4. f symptoms persist, seek medical advise and call 000 if patient is unconcious 5. IF all is good after a few protions, no dental treatment today, get some longer acting carbohydrates like a sandrwich or yogurt and observe the patient until they feel okay

Answer 122

1. Stop treatment 2. Oximeter is placed straight away moderate is above 94%, sever 90-94%, life threatening below 90% 3. f mild – give 4 puffs of salbutamor via spacer 1 puff at a time with patietbreathing in 4 times 4. Wait 4 minutes, if not imrpoving treat as sever or lifethretening 5. Call 000 6. Maximum of 12 puffs but if it is bad even after just keep giving salbutamo with 4 breaths in between before ambulance arrives

Answer 123

1. What did patient react to? 2. What was the type of rection? Is it really sever, did it limit their function or made them die? Did it have it for mono, that one can create a fake reaction to antibiotic 3. How long after start of treatment did it occur eg after a few hours or many days? 4. How long ago was the reaction? 5. How was it treated? 6. Have they had similar antibiotics since?

Answer 124

1. Uknown reaction more than 10 years ago 2. Childhood exanthem, unlear details with no evidence of hospitalisation 3. Diffuse or localise rash with no other symptoms after 24 hours after strating the antibiotic more than 10 years ago. This make the risk of rash on re-exposing about 5%.

Answer 125

1. Any previous respiratory disressm, swelling of mouth or throat 2. Any history of diffuse rash which comes immediately after starting treatment 3. Diffuse or localised rash which is delayed but occurred less than 10 yearsago Re-exposure may cause anaphylaxis, so non-beta lactam

Answer 126

1.Rash with mucosal ulceration 2.Oustules, blister, desquamation 3.More These features show that the next ras could be fatal. Non-beta lactam antibiotic should be usd.

Answer 127

Primarily for management of cardiac conditions, secondayr prevention of IHD, cerebrovascular, peripheral vascular disease particularly with procedure such as stents. Multiple agents are used I.e. an antiplatelet and an anticoagulant. Used fo artrial fibrilation or if a patient has a history of clots.

Answer 128

Prevent clotes forming at low dosage. Irreversible inhibition of platelet aggregation for 7 days. Need to stop 7 days before surgery for platelet to be replaced with new ones.

Answer 129

Anitplatelets. More effective then aspirin thus more bleeding may occur. Irreversible. Needs 7 days to regenerate. Check with GP/cardiologist before asking patient to stop taking it. Usually used together with aspirin. Greate risk of thrombosis.

Answer 130

Reversible inhibitor. Anti-platelet. Given in high risk situtations. Check with GP/cardiologist before asking patient to stop taking it. Usually used together with aspirin. Greate risk of thrombosis.

Answer 131

Vitamin K antagonist inhibits the clotting factors II, VII, IX, X. Anti-coagulant. Bleeding risk can be measured with INR. 2-3 is manageable and is the therapeutic range. If taken off, restarting takes some time. Warfarin has a lot of drug interactions.

Answer 132

Apixaban, dabigatran, rivaroxaban. Directly acting agent which generally require a single stable dose, and do not need to monitor for effect. Can not measure the effect with INR. Patient may not know they are on anticoagulants. When to stop: dabigatran 1-4 days depending on renal function, apixaban and rivaroxaban: 1-2 days

Answer 133

Less oxygen to the heart then requires, lead to pain (angina) and infarction because of the plaque. Therapeutic objective: rebalance supply of oxygen. Acutely reduce myocardial need for oxygen and chronically: improve coronary blood flow

Answer 134

End in sartan. Similar to ACE inhibotrs but do not cause cough or angiodema.

Answer 135

End in thiazide. Have a diuretic and vasodilator effects. Have a risk of postural hypotension after prologned supine rest or with nitrates.

Answer 136

Heart incapable of pumping sufficient output for needs of the peripheral tissues at usual filling pressure. Result in fluid accumulation, shortness of breath (pulpmonary oedema) from lying down and ankle swelling. Do not take NSAID's please (remember tripple whammy).

Answer 137

Furosemide. Very effective diuretic with repid onset. IF taken in the morning, may need to stop the procedure so they can take a toilet break.

Answer 138

No NSAIDs. Very common cause of renal failure. Very bad very sad. Contraindications.

Answer 139

1. Regulation of metabolism 2. Response to physical stress eg surgery 3. Suppress immune function (block formation of different immune responses)

Answer 140

1. Replacement in hypoadrenalism eg Addison's disease (Addisonian crisis hehehe) 2. Immune suppression (arthitis, skin conditions or even prevention of organ transplant rejection)

Answer 141

The cells within the cortex are not stimulated to grow by ACTH from petuitary gland. This mean when the exogenous source is depleted, there is no support coming from an endogenous source (ie natural source, self-produced by the body). For example in stress. The usual amount is more than 5mg/day of prednisolone for more than 2 weeks will require more corticosteroid.

Answer 142

1. Find out how long they have been on steroids 2. Reduce stresses 3. If extraction or other steroids, to prevent an Addisonia crisis start teatment in the morning and get more steroids the day before (double the dose) and the day of treatment (double the dose) - contact GP prior.

Answer 143

They stimulate the release of insulin from pancrease. Can cause hypoglycemia. Abuse pancrease so no good. Causes weight gain.

Answer 144

Gliflozins. Inhibits glucose transported in renal tubules. Associated with weight loss. Can cause dehydration and infection in the urinary tract.

Answer 145

Omeprazole or other. Irreversibly inhibit the proton pump stopping the production of gastric acid. Very rare adverse effect.

Answer 146

Aceetylcholine and histamine 1 at the vomiting center. Also, drugs and toxins are detected by chemoreceptor trigger zone in the brain which use dopamine 2, 5ht3 (seratonin), neurokanine 1 so you need to block the chemoreceptor trigger zone.

Answer 147

1. Metoclopramide – dopamine antagonist (please don’t use in Parkinson's disease) - may cause extrapyramidal effects – use 10mg 6-8 hour;y oral 2. Prochlorperazine – dopamine antagonists, also anthistamine, alpha blocker and anticholinergic – problems: drowsiness, hypotentsion, dry mouth also cardiac effect

Answer 148

1. Anxious patient 2. Older children with poor dental experiences 3. Complex or long procedures 4. Child with special needs 5. Fear of needles 6. To aid analgesia 7. Increased gage reflex 8. AND MEDICALLY FIT ASA I AND ASA II

Answer 149

It has very low solubility in blood. It is absorbed rapidly through the pulmonary alveoli and enters the serum. It acts on the cental nervous system through crossing blood brain barrier. Peak effect achieved within 3-5 minutes. Rapid and complete recovery.

Answer 150

1. CNS euphoric and depressant effect 2. Still responds to instruction 3. Children are more relaxed and feel happier

Answer 151

Maybe the GABAA receptors or opioid receptors f the CNS.

Answer 152

Mostly associated with overdose! Following: 1. Nausea or vomiting 2. Sleep 3. Visual disturbance 4. Excessive laughing 5. Sweating

Answer 153

1. Detachment/dissociation 2. Dreaming, hallcination or fantasizing 3. Out of body experiences 4. Floating or flying 5. Inability to move 6. Humming

Answer 154

1. Slow induction 2. Keep N2O concentration below 50% 3. Reduce N2O concentration slowly 4. Monitor patent closely

Answer 155

1. Provide a source of additional gas should the patient inspire more gas than is being supplied ◦ 2. Provides a mechanism for monitoring the patient’s respiration (watch the expansion and contraction of the bag) and for adjusting the flow (not too stretched or collapsed) 3. Functions in an emergency as a method of providing positive pressure oxygen

Answer 156

1. Parents must sign a consent form 2. Make sure equipment is set up properly BEFORE the patient comes in 3. Patient must cooperate

Answer 157

Slow – best suited for inexperienced operators. Increase from 0-30% in 10% intervals every 1 minutes Rapid – better for young children – jump to higher concertation

Answer 158

1. Signed consent form 2. Indication of use 3. Nitrous oxide dosage 4. Patient response

Answer 159

1. First impression matter 2. Assessment of the child's behaviour 3. To greet the child 4. To compliment a child in order to build rapport

Answer 160

1. Act natural 2. Make an effort 3. Find the point of ice breaking such as compliments, pets or school

Answer 161

Pulmonary heart disease Sever asthma Blocked nose Refusal to breathe through nose CNS disease Otitis media or middle year disturbance/surgery - only active Claustrophobia GI issues Cystic fibrosis

Answer 162

Use slow induction technique – from zero to desired 10% at a time per minute Keep N2O concentration below 50% Reduce concentration N2O If patient falls asleep, turn O2 to 100% Avoid fluctuations Monitor patient closely Use 100% of oxygen for 5 minutes at the end of the session

Answer 163

1. Gas delivery machine – continuous flow of O2 and N2O, minimum 2.5L/minute, for children 4-5/L 2. Nasal hood – various sizes and flavours 3. Inflatable bag – provide source of additional gas, mechanisms for patient respiration, in emergency used as a method of providing positive pressure oxygen 4. Scavenging system – to trap experied gas by the patient 5. O2 flush valve – in emergency to provide jet ventilation, can cause barotrauma

Answer 164

1. Signed informed consent 2. Indications of Use 3. Nitrous oxide dosage in percent of N2O and O2 with flow rates and duration of the procedure 4. Patient response

Answer 165

1. IF there is a reasonable belief that another person has reported abuse 2. IF the suspecion was due soley to being informed of the abuse by a police officer or child protection officer

Answer 166

1. Lower central incisors – 6-10 months 2. Upper Central inicsor – 8-12 months 3. Upper Lateral inicsor – 9-13 months 4. Lower lateral incosr – 10-16 5. Upper First molar – 13-19 months 6. Lower First Molar – 14-18 7. Upper Canine – 16-22 months 8. Lower canine – 17-23 months 9. Lower seond molar – 23-31 months 10. Upper Second molar 25-33 months

Answer 167

1.Lower central incisors – 6-7 years 2.Upper First molar – 6-7 years 3.Lower First molar – 6-7 years 4.Upper Central Incisors – 7-8 years 5.Lower Lateral Incisors – 7-8 years 6.Upper Lateral Incisors – 8-9 years 7.Lower canine – 9-10 years old 8.Upper first premolar – 10-11 years 9.Lower first premolar – 10-12 years 10.Upper second premolar – 10-12 years 11.Upper cannines – 11-12 years old 12.Lower second molar – 11-13 years old 13.Upper second molar – 12-13 years old 14.All third molars 17-21 years old

Answer 168

1. Classic: stimulus resposnse ie white coat = needle 2. Operant: action reenforced with a rewards or punishment . 3. Social: modeling – very good, monkey see monkey do

Answer 169

Positive reinforcement – all adults and children are influenced by reinforcement. This is also very relevant for small children. The more consistent the reinforcement, the more likely a desired behaviour is reached. ALWAYS BE PRAISING. PLEASE SAY PLEASE AND THANK YOU. Be specific and consistent with your praise

Answer 170

1. Motivational advice 2. Verbal praise, non-verbal such as smile or STICKERS

Answer 171

It is a scale of co-operation and fears. Please put it into notes. Uses ++, +, -, -- scale for general idea.

Answer 172

1.Time efficiency – kids do not like to sit in the chair for too long 2.Behaviour management techniques: Modelling for the first visit, Tell-Show-Do to reduce anxiety, Voice control do not yell, Use of appropriate language to the kid like euphemism (sleep juice from a magic wand), monitoring the child for sense of control, distractions with triplex or wrigling the toes, positive reinfocement, systemic desensitazantion (a bit advanced and for older children because they realise that fear is irrational), behaviours shaping where you slowly shape the child behaviour from non-cooperative to cooperative with ability to retrace your steps 3.If the kids is dangerous, you can use aversie conditioning BUT NOT IN AUSTRALIA you can just do GA 4.Do not do the treatment if child does not cope with it, it is about quality treatment and overall positive treatment outcomes

Answer 173

1.Retrace your steps. The show componenet needs to be modified 2.Ask the child how they are feeling, if they are withdrawn they are probably just anxious 3.Maybe to give them a more sense of control, do it on your fingernail first 4.Then let a child hold a hand mirror next to your finger to give them a sense of control 5.After do it on their finger 6.And finally on their tooth 7.Praise the child for being brave 8.Promise a sticker if you can do it on al teeth – children love stickers

Answer 174

1.Patient age 2.Patienet behaviour 3.Treatment required 4.Medical condiitons 5.Distance travelled 6.Language barrier 7.Risk and benefits 8.Practitioner experience 9.Informed consent

Answer 175

4.4. mg/kg and one carpule has 44mg. So per every 10 kg you can have 1 carpule max. So for a 25 kg child you can have 2-3 carpule with some interspacing. Also remember about topical.0.1g has about 5 mg!

Answer 176

1.Soft tissue trauma 2.Overdose – CNS depression, seizures, decrease cardiac output and cardiovascular collapse

Answer 177

It is half of that of lignocaine, so if you use 3 carpules for ligno, use 1.5 for articaine.

Answer 178

1.Tell them about the taste 2.Supraperiosteal infiltration for upper only 3.Inferior alveolar block with long buccal 4.How is the syringe passed is important – under the chair 5.Inject slowly 6.Use behavior management in conuction with pharmacological one

Answer 179

Mutants streptococci are associated with early childhood caries. These mutants stretococci do not appear in the childrens mouth from birth, rather they are transmitted vertically (by parebnt via saliva) or horizontally (byu siblings or other kids via saliva). If a child does not have mutants streptococci before the age of 2, they will only develop caries in about 25% of the situations.

Answer 180

1.Previous carious experience – but not when super young lol 2.Visible plaque – remember to screen all children 3.Dietary factors – especially sleeping with a bottle of something sugary and free sugars 4.Breast feeding IS NOT assoicated with ECC – because lactoferin kills MS 5.Enamel developmental defects 6.Low socioeconomic and sociocultural factors 7.Children with medical conditions – such the ones that need to use meidcations causing xerostomia or that predispose them to enamel hyperplasia

Answer 181

1.Follows the pattern of eruption – starts with lagial, gingival and lingual surfaces of maxillary incisors and spread to molars 2.Rapid progression – DO NOT OBSERVE MAY LEAD TO DISASTER

Answer 182

1.Pain 2.Sepsis 3.Space loss 4.Disruption to quality of life 5.Disruption of growth and development 6.Possible disruption of intellectual development 7.Hospitalisation 8.Greater risk of caries 9.Death

Answer 183

Composite resin strip crowns. 80% success rate! Also early screening, prevention or use of silver diamine fluoride, dietary changes, behaviour change, habbit change, fissure sealants and constant use of fluoride.

Answer 184

We getting more caries, oh no 🙁. There is a theory that this occurs due to consumption of non-fluoridated bottled water.

Answer 185

Occlusal pit and fissures followed by interproximal. Usually caries are bilateral especially in molars and anterior.

Answer 186

1.Challenging age group 2.Unique oral health problems 3.Less parental influence 4.Increase in independence 5.Caries susceptibility 6.Erosion risk 7.Smoking 8.Need to update medical history regularly 9.Increase carbohydrate

Answer 187

CAMBRA – caries management by risk assessment. It is a questionnaire that recommends tratment. Not good for idnividuals treatment. Bad caries progression – WREC – whites spots, restorations past 3 years, enamel lesions and cavities At risk – BAD – bad bacteria, absence of saliva, dietary habits Protective factors – SAFE – saliva & sealants, antibacterials, fluoride, effective diet

Answer 188

6-17 months – no fluoride 18 months – 6 years – childrens toothpaste (400-550ppm) 2x per day spit no rinse 6+ years – normal tooth paste 1000ppms x2 a day spit no rinse 6+ years + high risk of caries – 5000ppm tooth paste 2x times a day spit no rinse

Answer 189

Every 6 months for 4 minutes at 12300 ppm. Not recommended to less than 10 year old.

Answer 190

3-5mg of fluoride/Kg. Toospase has 1mg/g. Meaning a 10kg baby needs about 30mg or 30 grams.

Answer 191

1.Second deciduous molars with roots 2.Broken down crowns with limited amount for forceps application 3.Complete loss of crown structure 4.Molar teeth with complete lost of the crown 5.Previously pulp[otemised teeth 6.Full rooted deciduous canines 7.Asnkylosed teeth

Answer 192

A IANB and a buccal infiltration

Answer 193

Stop if the kid says ouch, especially if they are cooperative and top up 1.Expansion of the bony socket to permit removal of its contained tooth. 2.Use elevators with utmost caution 3.Use three basic mations: wheel and axle (screwdriver), wedge and lever. Alvaolar bone is the fulcrum 4.Support jaw bone with your other hand 5.Use of level and fulcrum principle to force tooth or root out of socket along the path of least resistance 6.Always use the forceps as sungingivally as possible 7.Push buccaly for 3 seconds, then move to figure of 8 8.Repeate until the tooth is out

Answer 194

Up until reversible pulpitis as after, according to the continuum of Pulp Status, an extraction or a pulpectomy is recommended. Followign symptoms are bad: 1.Spontaneous pain kept awake at nigh 2.TTP 3.Abscess 4.Mobility 5.Facial swelling celulitis

Answer 195

Session 1:First impression, history, examination, X-rays, consent and tretament plan debridment, improvement in OHI and diet, Prophylaxis and fissure sealants if possible. If too much suggest GA. Session 2: RA + Q1 Session 3: RA + Q2 Session 4: RA + Q3 Session 5: RA + Q4 3 months recall, more treatment if need

Answer 196

1. Hypoplasia – quantitative – deficiency in tooth substance due to ameloblast desruption 2. Hypomineralisation – qualitative – disturbance in the initial enamel calcification and/or maturation leading to lower mineral content

Answer 197

It is a qualitative enamel defects of systemic origin, affecting one to four first permanent molars and frequently associated with affected incisors

Answer 198

Hypomiralisaed second primary molars is a condition where the second primary molar is hypomineralised. There is association between that and Molar hypomineralisation (MH)

Answer 199

Ameloblast are exteremly sensetive to any systemic, local or genetic factors. But the insult intesity and timing are important. Usually: In primary dention, the insult occurs prenatally or before first eyar of life Permanent incisors and permanent first molar are more suscpetible in peri-natal and first 3 years of life – consitent with MIH Permanent canines and second molars around pre-school years Insults could be cause by: 1.Disease 2.Medications 3.Fluoride 4.Trauma

Answer 200

1.Describe the distinct border 2.Describe the type 3.Resulting enamel – smooth or soft and pourus 4.If there is any unprotected dentine 5.If there is any caries 6.Is there post-eruptive breakdown of the dental hard tissue 7.ALWAYS perform examination on wet teeth as drying teeth may result in pain

Answer 201

1.It has an increased instance of enamel fractures 2.It has a decreased ability for retention of adhesive materials

Answer 202

1.Reduce pain & sensitivity 2.Provide adequate restoration 3.Eliminate need for multiple repeat restorative procedures 4.Minimise dental anxiety and fear 5.Maintain occlusion and minimise cplexity of any furutre ortho treatment 6.Aesthetic rehabilitation

Answer 203

1.Risk identification – assess medical history 2.Early diagnosis – examine at-risk molars on radiographs if available 3.Remineralisation and desensitisation – before breakdown, as soon as erupted 4.Prevention of dental caries & post-eruptive breakdown – F/S 5.Restoration or extraction – SSC can be used even for initial stage even in permanent dentition, but especially in deciduous if there is severe-moderate MIH. GIC good for interim 6.Maintanance

Answer 204

1.Remineralisation 2.Fissure sealant

Answer 205

1.Immediate treatment – desensitising 2.Intermediate treatment – SSC 3.Long-term treatment – extraction or complex restoration 4.Always consider extraction in young patient as it prevent need of life-long maintanance

Answer 206

A pattern of malformations resulting from the action of a single cause on more than one developmental field.

Answer 207

1.Significant oral implications 2.Malocclusion 3.Increase instances of oral diseases 4.Pain and sensitivity 5.Disfiguring 6.Genetic implications

Answer 208

It is the agenesis of less than 6 teeth

Answer 209

It is the agenesis of more than 6 teeth

Answer 210

When you have 0 teeth

Answer 211

1.Trauma 2.Infection 3.Radiation 4.Chemotherapy 5.Endocrine disturbances 6.Sever intrauterine disturbances

Answer 212

Impacted maxillary canines and peg-shaped lateral

Answer 213

Joining teeth by cementum. Usually occurs in second molar fused to third, impacted molar

Answer 214

Joining of teeth by dentine and or pulp

Answer 215

Budding of a second tooth from a single tooth germ

Answer 216

1.Fissure sealing 2.Surgical separation 3.Ortho, implants, autotransplants or prosthesis

Answer 217

They are cusp-like elevations of enamel located in central groove or lingual of premolars and molars. They are prone to fractures so early diagnosis is essential. Partial pulpotomy might be beneficial. Can occur in anterior teeth as "talon cusp", and it should be removed.

Answer 218

They are deep surface invaginations of inner enamel. Most common in lateral incisors. Needs fissure sealing and maintenance of clean fissures as they are at generally higher risk of pulpal necrosis and abscess.

Answer 219

A group of inherited conditions that adversely affect the development of dental enamel causing anomalies in it's amount, structure and composition. Distinguished by dental abnormalities + pattern of inheritance. Results from mutation of AMELX, ENAM, and MMP20 gene

Answer 220

1.Clinical exam – visual and flaking 2.Family history 3.Radiographic assessment 4.Scanning with electron microscope

Answer 221

1.With replacement resorption – bone is replacing dentine 2.Without replacement resorption - no bone replacing den

Answer 222

1.Facial trauma, frontal force 2.Transverse fracture – occurs if dentine, cementum and pulp involved, if enamel is also involved – it is a crown root fracture 3.Take radiograph and do all of the test 4.Reparative tissue in a form of tertiary dentine is laied down in the fracture area 5.Over time – root canal stenosis may occur – pulpal tissue will be replaced with deposited hard tissue through "buldging hard tissue" with prior joining of fracture line with fibrous connective tissue - this is done primarily by the pulp - the reparative capacity of dental hard tissue should not be underestimated

Answer 223

1. Through deposition of reparative hard tissue 2. Fibrous hard tissue 3. Bone and periodontal ligament 4. No healing and pulp necrosis of the coronal portion (trick question) - this one is pretty rare

Answer 224

1. haemostasis and coagulation - this is where suturing in warfarin is important 2. Inflammation 3. Proliferation 4. Modeling and remodeling

Answer 225

Tranexamic acid is antifibrinolytic which means it prevents breakdown of already created clots. Apixaban inhibits factor Xa which revents fromation of thrombin and consequently fibrin clots, which means is stop coagulation before tranexamic acid can safe the clot, by not creating a clot to begin with. Warfarin works on vitamin K as an antagonist (affecting factors II, VII, IX and X). Which means, it reduces reduces the clotting factors but does not eliminate the. This means that tranexamic acid can work on small amoutn of forming clots.

Answer 226

Metronidozole

Answer 227

1.ABC – airway, breathing consciousness 2.Neurological symptoms 3.Stability - is patient stable 4.Full secondary survey with primary care pshycision at the hospital. Head to toe with all histories taken if the patient is awake. 5.Diplopia – eye movement exams. Up,down, side to side 6.Nose, upper and lower jaw examination 7.Assessment of cranial nerves especially 5 + 7 but also all other nerves 8.Intra-oral examination - find all teeth, order chest x-ray if one is missing 9.Radiology order – plain x-rays first with OPG, PA skull, submentovortex and Lat ceph 10. Treatment planning for surgery including history 11. Consent from patient

Answer 228

1. Order of toxicology report for recent drug use 2. Order a blood cell count (full blood count test) 3. Order blood glucose level test if they have diabetes 4. Order IV antibiotics to reduce the chance of infection as well as IV fluids and alagesia 4. Order 1 bag of blood if need, tho not very common for facial fracutre surgery 5. Contact naethetis and book an operating room

Answer 229

1. Direct epihpyseal fracture of the mandible, single, closed 2. Indirect fracture of the RHD condular head Treatment for 1 - exposure of the fracture at site at the mandible and placement of direct plating of the fracture (ORIF) Treatment for 2 - intermaxillary fixation with use of arch bars to allow the condyle to heal if it is not displaced, comminuted or severely damage in other way. This will manage the occlusion. TMJ ficxation with direct bars may be possible. Remember: Soft food, and wire shut jaw for the next 3 months at least. After the surgery, patient needs to be observed until reasching 12 hour stability. Review 24 hours, a week, a month and 3 months after. If any complications occur, review. Remove arch bars when the condyle is healed. A period of physiotherapy might be needed.

Answer 230

Prerprocedural checks Chief concern and history taking Taking the PA Consultation with the patient and tutor EPI calculation Procedural Step 1: Initial acess Apply anaesthetic and isolate the appropriate tooth using single clamp Using a high speed, end cutting bur such as 838 to gain initial access to the pulp chamber – always refer back to the PA Switch to the non-end cutting endo-z bur in order to expand the access cavity Use endoprobe to locate the canal Pre-curve size 10 file and insert it a few mm into the canal Take a PA Irrigate the canal with a pre-bent hypochlore 1% Step 2: Expansion of the coronal aspect Using size 2 and 3 gate glitten bur, brush it a few mm into the canal coronally to expand the access Irrigate Step 3: Working length determination Determine the working length using electronic apex locator, attach the device, advance to 1mm away from apex and have a good refrence point, take a PA to confirm When confirmed chart as correct working length Irrigate Step 4: Pre-cruve files and set them to the correct working length Starting with the smallest file (size 10) instrument using clokc winding technique Irrigate Ensure canal is very loose for the smallest file – move to file that is 1 size larger Irrigate and recapitulate and irrigate again Ensure canal is very loose for the size up file – move to the file that is 1 size larger Continue until you reach file 30 – take a PA of master apical file at 25 to confirm Step 5: Step back Pre-cruve file 30 and 35, set to correct working length Create a stepback of 1mm with file 30 Irrigate Create a stepback of 2mm with file 35 Irrigate Step 6: Medicaments Use calcium hydroxide for non-symptomatic and odontopaste for symptomatic Apply using a file or a lentulo spiral at low rpm Step 7. Interim restoration 1. Put a nice layer of cavit in the pulp chamber – use a small cotton pallet with water to engae it Use RMGIC to restore – check occlusion and recall the patient in 4 weeks

Answer 231

1.Pulp and root canal condition – necrotic pulp/irreversible pulpitis 2.Periapical status – chronic/acute apical periodontitis evident radiographically

Answer 232

1.Strategic value of the tooth 2.Periodontal factor – if the tooth is grade III mobility what si the point of endodontically treating it? 3.Patient factors – MHx, motivation, age, compliance with treatments 4.Restorability options – consider the entire mouth

Answer 233

1.Percussion of tooth 2.Palpation around the soft tissue 3.Periodontal examination – cracks and fractures 4.Pulp sensibility tests – cold, hot or electric 5.Radiographs – PAs and BWs with or without use of GP with fistula 6.Special test – removal of restoration, selective LA, transillumination oe fracture finder on each cusp 7.Full data analysis and appropriate diagnosis presented to patient with options – two component diagnosis pulp+root canal AND periapical status – IT IS SEEN ON MY UNI REMMEBER IT 8.Patient need to be informed about the time, cost, step-by-step of each procedure, risks and need to consider a crown restoration 9.Ask the patient "is there anything you want to ask me, your opinion is essential for your own wellbeing" 10.Accurate record keeping

Answer 234

One or two of the following: 1. ASA class 3 patient 2. Vasoconstrictors intolerance 3. Anxiety 4. Limitation in opening 5. Gagging 6. Moderate pain or swelling 7. extensive differential diagnosis 8. Difficulty in obtaining radiographs 9. 1st molar 10. Moderate inclination - 10-30 degress 11. Soem trouble with rubber dam 12. Coronal distruction or complex restoration 13. Canal morphology is slightly more complex 14. Pulp stones 15. 3-5 mm near the IAN 16. Minimal apical resorption 17. Crown fracture 18. Previous access without complications 19. Endo-perio lesion

Answer 235

3 or more in moderate difficulty and at least one in the high diffuculty such as? 1. ASA 4 2. Can't get anaesthesia 3. Uncooperative 4. Significant limitation in opening 5. Extreme gaggin 6. Sever pain 7. History of orofacial pain 8.2nd or 3rd molar 9. Extreme inclanation 10. Extreme rotation 11. Significant deviation from normal tooth/root form 12. C-shape morphology, extreme curvature or S-shape curve, rare root morphology, very long teeth 13. Pulp chaber not visible 14. extremly close to IAN (<3mm) 15. Extreme resopriton 14. Root fractures 15. Previous endo

Answer 236

1.Craze line – very common and only in enamel – use transillumination 2.Fracture cusp – usually from insufficient cusp support from deepest point of restorative material – sharp pain on biting usually on non-funcitonal cusps 3.Cracked tooth – centered, vertical crack that has pulpal symptoms and can be in none restored teeth – typically mandibular second mollars 4.Split tooth – progression of cracked tooth – hopeless prognosis 5.Veritcal root fracture – a longitudinally oriented fracture extending from the root canal to the periodontium – hopeless prognosis

Answer 237

1.Occlusal factors – posterior buccal crossbites, anterior open bites, steep cusps 2.Parafunction 3.Age 4.Width and depth of cavity 5.Use of rotary instrumental – common in vertical root fractures

Answer 238

1.Patient symptomatology 2.Vision enhancers 3.Symptom reproducers – Very important 4.Radiographs

Answer 239

Due to peripheral location and low excitability threshold of A-beta and A-delta fibers, rapid sharp pain is generated. In cracked teeth, the increased rapid movement of dentine fluid in dentinal tubules during relaxation after prolonged biting result in such symptom. When bacterial toxins infiltrate the pulp, hyperalgesia can result. This is a state of pulpal inflammation, which lowers the threshold of stimulation of A-delta fibers. Thus patient feels pain easier. A second type of pulpal stimulation is occurs through activation of C-fibers. C-fibers have a higher threshold of excitability thus only respond to prolonged inflammation of pulpal tissues. C-fibers activation means more than likely, pulp treatment is needed.

Answer 240

1.Removal of restoration + invastigate crack + remove or reduce any cracked cusps + restore 2.Provisional restoration and review in 3 months to confirm diagnosis 3.Consider crown 4.Reduce caueses of the crack

Answer 241

1.Endodontic access + investigate crack 2.Temporize with ortho band and proceed with RCT or extract 3.Consider causes of this and try to reduce them

Answer 242

1.Poor – segment separation, crack crossing pulpal floor, periodontal pocketing at fracture line, damaging habits not amenable to change 2.Guarded – crack extends to the floor of the pulp chamber 3.Good – crack into roof of the pulp chamber, does not reach pulpal floor

Answer 243

1.Broad-based soft tissue swelling in the mid-root 2.Sinus tract bilaterally on 2 aspects 3.Depp pockets on 2 bilateraly surface (eg buccal-lingual) 4.J-shapped lesion/defect on the radiographs 5.Presents of isolated horizontal/angular bone loss 6.Visual confirmation through raising the flap

Answer 244

1.Dentinal tubules – only through patent dentinal tubules due to loss of cementum 2.Lateral and accessory canals – seen in 30-40% of the teeth usually around the apical 1/3 of the tooth 3.Apical foramen – possibly the main avenue – acts as entry and exit

Answer 245

1.Pulpal pathosiis occur 2.The bi-products of pulpal pathosis are release in proximity to the preidontal ligament through accessory canals/apical foramen, eliciting an inflammatory response from PDL 3.Increase in vascularity and creation of temporary periodontal pocket – know as retrograde periodontitis 4.In addition – use of endodontic macterials or procedural errors could create moderate to sever periodontal consequences

Answer 246

1.Primary endo – secondary perio – drainage through sulcus – treatment: root canal 2.Primary perio – secondary endo – treatment: non-surgical periodontal therapy, control of local factors, control of systemic facots and endo-treatment if needed 3.True combined lesion – primary endo treatment then perio then finish treatment with obturation, also remedicate canal if periodontal treatment is not finished

Answer 247

1.Periapical curettage 2.Apicectomy 3.Retrograde endodontic treatment

Answer 248

1.Presen of disease after treamenet/re-treatment 2.Re-treatment not viable 3.Adjunct to re-treatment – re-treatment and surgery 4.Preservation of adequate coronal restoration 5.Costs

Answer 249

1.Re-treatment viable 2.Poor coronal restoration 3.Medical contraindication – radiotherapy or bisphosphonates 4.Anatomical contraindication – sinus or IAN 5.Other patient factors – fear factor

Answer 250

1.Incision at the gingiva – submarginal or full thickness flap 2.Periosteal elevator to raise the flap 3.Retract the flap with retractor 4.Osteotomy using a round or flat fissure bur to create a window in bone to access the lesion 5.Endo-curette is use to remove the soft tissues of the lesion and resection is performed 6.Micro-mirrors are used to observe the resected root 7.Preparation of the root end with ultrasonic tip 8.Use haemostatic agent to control contamination of prepare root end tip 9.MTA is used with sterile water and inserted to the root end 10.Suturing is performed

Answer 251

1.Iatrogenic perforation 2.Patency at apical terminus 3.Extrusion of root fillings

Answer 252

1.With or without communication with the oral cavity 2.Corona/apical 3.Size 4.Delay in treatment – need for repair

Answer 253

1.Pain is not spontaneous 2.Short duration 3.Localised 4.Sharp 5.Disappears immediately upon withdrawal of stimulus 6.Stimulated by: cld and occlusal interference

Answer 254

1.Pain keeps patient at night and is lengthy 2.Localised 3.Aggravated by heat, spontaneous, when removed pain persists 4.Throbbing or dull pain 5.Analgesics do not word

Answer 255

1. Sodium perborate – in SADS – available in powder form 2. Hydrogen peroxied – can burn tissues 3. Carbamide peroxide – ususally used for external bleaching

Answer 256

1.Patient need to be elidgible – no EMERINT PROSGENINT OR EMERREPAIR COCs 2.Consent – multiple appoitments, replacemen of restoration, upredictable, not stable and retreatment may be possible. Cervical resorption may occur 3.Titanium – 117- application of internal bleaching, 990-subsequent application of internal bleaching 4.Remove extrinsic staining 5.Record pre-op shade 6.Rubber dam 7.Remove restorative mamterial from access cavity, keep stained dentine 8.Remove endodontic filling 1-2mm below CEJ 9.Seal the access to the endodontic filling wit 2mm of GIC or cavit 10.Etch pulp chamber, rinse and dry 11.Mix sodium perborate with water until stiff paste is formed 12.Place into the labila surface of the access cavity 13.Cover the bleach with cotton pellet and seal with cavit or GIC 14.Repeate steps of bleaching every 7 days untile desired colour is achieved 15.Remove all bleaching material an rinse throughly 16.Record post-op shade 17.No definite resoration for 7 days because enamel might have been weakened

Answer 257

1.Movement artifact – shown as multiple lines– patient need to be very still 2.No soft tissue resolution – use convetional CT

Answer 258

75 uSv (microSieverts)

Answer 259

MDCT – multi detector computer tomography – 200 microSieverts

Answer 260

Yes because: 1.It provides a provider number to allow Medicare rebates 2.Review of all areas of the scan 3.Removes much of the legal responsibility

Answer 261

Dentists who record OPG radiographs must take responsibility for all non-dental diagnosis from such images or alternatively have them assessed on referral by an oral radiologist or medical radiologist and include this cost in their estimate of fees to the patient.

Answer 262

Don't Order Tests that Don't Affect Management

Answer 263

As Low As Reasonably Achievable

Answer 264

1.Beam hardening – streaks arising from very dense objects 2.Scatter – soft streaking 3.Motion – blurry or double vision 4.Poor machine care – multiple artifacts 5.Faulty detector – rind around the jaw

Answer 265

1.From down to up 2.From outside to inside 3.From Left to right

Answer 266

1.Dense bone Islands 2.Torus 3.Osteomas 4.Degenerative Joint Disease 5.Chondrocalcinosis 6.Synovial osteochondromatosis 7.TMJ Dysfunction 8.Sinus pathology 9.Nasal septum pathology – including different sinusitis, and mucucoel 10.Nasal cycles

Answer 267

1.If above the mandibular canal – possibly dental origin because only non-dental related pathology occurs bellow the mandibular canal 2.Non-dental lesions are move common in tooth bearing areas

Answer 268

1.Location 2.Margin – well-defined or illdefined 3.Zone of transition – short or long 4.Periosteal reaction 5.Internal matrix 6.Single vs multiple 7.Relationships to the joints 8.Effect on soft tissue

Answer 269

1.Well-defined margin 2.Often schlerotic border 3.Short zone of transition 4.Little or no periosteal reaction 5.Bone often thinned and/or expanded 6.Minimal effect on soft tissues

Answer 270

1.Poorly-defined margin 2.Long zone of transition 3.Periosteal reaction may be extensive 4.Bone often destroyed 5.Permeative appearance 6.Soft tissue involvement is common

Answer 271

Lesion consists of a lucent centre and a thin, well-defined sclerotic rim. Cortical bone destruction may occur if cyst becomes too big.

Answer 272

Lesion uniformly lucent with a thin, well-defined sclerotic rim attached to the cemento-enamel junction.

Answer 273

Odontogenic keratocyst is a well-defined sclerotic which causes less jaw expansion and grows along the jaw bone.

Answer 274

Has aggressive growth characteristics. Typically well-defined and radiolucent. Cause root resorption, tooth displacement and bone expansion. Floating tooth appearance.

Answer 275

Anterior mandible, well defined with corticaed border. Tooth displacement is common, root resorption is uncommon.

Answer 276

Mandible, fibrous capsule gives a thin raiolucent halo. Rapid expansion and tooth displacement. May contain abnormal bone and cementum like tissue.

Answer 277

Slow growing lesion full of cementum like tissue. Attached to root apex. Well-defined with cortical border.

Answer 278

Anterior to first molar. Slow growing with well-defined margin. Some cortical expansion can occur.

Answer 279

A defined radiolucency that occurs in the palate

Answer 280

It is a salivary inclusion cyst. A well-defined oval lucencies anterior to angle of mandible.

Answer 281

Solitary lesion, well-defined bu non-corticated with irregular margins. DESTROYS BONE AND LEAVES THE FLOATING TOOTH APPEARANCE. Periosteal new bone formation is common.

Answer 282

At apex bone is replaced with fibrous material. Lesion persistent after extraction.

Answer 283

Smoking adults. Ill-defined, permeative lesion. Spread localy and lymph nodes. Destroys bone.

Answer 284

Well-defined border in posterior body or angle of mandible.

Answer 285

Posterior mandible. Painless swelling. Ill-defined borderd\s. "Sun-ray" spiculation appearance. Breaks bone.

Answer 286

Usually from renal, breast, lung, colon and prostate. Affect posterior mandible. Ill-defined, lytic lesions with clear bone destruction.

Answer 287

PAIn _ subtle changes in bone density. Bone destruction with sequestration formation.

Answer 288

Pains, swelling and draining sinuses. Bone destruction. Periosteal reaction is common.

Answer 289

1.Darkening of the roots 2.Interruption of the white line 3.Diversion of the mandibular canal 4.Deflection of the roots 5.Narrowing of the roots 6.Dark and bifid roots 7.Narrowing of mandibular canal

Answer 290

Genetic disorder resultin in replacing of bone with fibrous tissue. Ill-defined margin and grounnd-glass appearance. Only condition that can displace the mandibular canal superiorly.

Answer 291

7-10 mm of crestal bone need to be available to withstand stresses.

Answer 292

Opalascence – the ability of the body to look different in reflected or transmitted light Fluorescence – the ability of the body to emit light that is a wavelength less then incident radiation e.g. crime scene fluoresent lights Translucence – the ability of the body to appear to transmit light and reflect little of it back

Answer 293

Hue – base pigment – red, pink, green, blue and other Value – most important – quantity of light reflected – how bright is the object can be shown with black and white images Saturation – chroma – intensity or vividness – how much of base pigment is there within tooth structure

Answer 294

Vita classical – used commonly in many aspects of dentistry – does not sit in the tooth banana nicely thus covers it inconsistently, with some fall outside of the banana, really incosistent value Vita 3D Master Shade Guide – amazing for dentistry – sit nicely in the shade banana, amazing value when shown in black and white when going from 1-5 (5 is darkest thus lowest value) - Number 1 is value, Letter 1 is hue, Last number is chroma A3 and 3m2 is nearly the same colour. Infinitely compatible.

Answer 295

It is the V shaped area between the incisors. It needs to be at 90 degrees to both of the teeth making up the incisal configuration

Answer 296

It is the line drawn at the terminus of the gingival margin at each incisors. Low gingival zenith in central and high in laterals will result in poor aesthetics. It central incisor and canine should coincide.

Answer 297

When we see more then 3mm of gingiva past the gingival margin in a person.

Answer 298

It is a negative space in the corners of the smile that is not filled by tooth structure. 15.-2.5 mm is ideal.

Answer 299

You can you putty or isolating material like PTFE tape and old, out of date composite just to get a nice 3D, functional structure. Do not bond as you need to remove it. Check with patient. Create a clear PVS bite reg material to register the prototype restoration so you can replace with permanent one – key guide.

Answer 300

4th generation ethc-prime-bond-composite.

Answer 301

1.Build up of palatal wall with dentine shade 2.Apply the needed maverick colours with use of bonding resin and stains. Separate the two and use with probe to dip into both and apply to the needed translucent halo area. 3.Layer with body shade 4.Layer the most superficial layer with enamel shade

Answer 302

For signs of erosion, attrition and abrasion. Parafunctional wear = poor longevity of a restoration. Patient will need a night guard.

Answer 303

1.As an acute exacerbation of untreated perio 2.During periodontal therpay or immediatley after scaling 3.In refractory periodontitis (low response to treatment) 4.Due to dislodgement of calculus 5.Treatment with antibiotics but without debridement – change in subgignival microbiota leading to superinfection

Answer 304

1.FUrcation areas 2.Patients with diabetes – impaired cellular immunited, decreased leukocyte chemotaxis and bactericidal activity

Answer 305

1.Impaction of foreign bodies like orthodontic elastics or popcorn 2.Local factors affecting tooth morphology

Answer 306

1.Ovoid elevation of the gingival along lateral aspect of the root 2.Oedematous, red gingiva with calculus usually present 3.Pus coming out of the gingival margin 4.Increased tooth mobility 5.Pain on plapation 6.Some systemic symptoms may be observed

Answer 307

1.Fully debried the area with or without use of surgery, under LA with saline irrigation 2.Analgesia in form of panadol I3.f systemic symptoms exist – amoxicillin 500mgs tds+ metronidozole 400 mgs bs x 5-days

Answer 308

1.Necrosis of interdental papillae 2.Bleedin, halitosis and pain in the site 3.Punched-out and cratered depression/lesions in interdental sites covered with greay or grey-yellowish pseoudomembrane 4.Patient complains of metallic taste

Answer 309

Referral to specialist – IMMEDIATE

Answer 310

It is a localised infection in gingival tissue and mucosa surrounding a partially erupted tooth. Patient complain of a sore tooth. Explain to patient that pain actually arises from infection and inflammation in the soft tissues surrounding the tooth and not the tooth itself.

Answer 311

1.Difficulty swallowing 2.Limited opening 3.Enlarged lymph nodes 4.Fever 5.Facial cellulitis 6.Pain 7.Localised swelling 8.Pus discharge

Answer 312

1.Debride area under operculum using monoject 2.Place patient on chlorexidine for a week 3.If major or systemic symptoms give amoxicillin in combination with metronidazole for one week 4.If it is recurring and tooth has a terrible position – extraction or operculectomy

Answer 313

The goal and purpose can only be considered in conjuction with complete periodontal treatment. SO first initial closed surgical root debridement and then open surgical root debridement.

Answer 314

1.Improve access to root surfaces 2.Removal of diseased tissues 3.Pocket elimination 4.Regenerative techniques 5.Removal of severely hyperplastic gingival tissues 6.Exploration of defects 7.Restorative-crown lengthening 8.Remove excess tissues

Answer 315

1.Resective surgery – pocket depth reduction and removal of hyperplastic tissues 2.Access Flap Surgery 3.Periodontal regeneration 4.Mucogingival surgery 5.Implant surgery

Answer 316

1. Gingivectomy – removal of pocket epithelium, connective tissue and mucosal epithelium 2. Modified Widman flap – removal of pocket epithelium and connective tissue +/- osseous, leacing behind mucosal epithelium

Answer 317

1.Gingivectomy – sites can be probed 2-3 weeks after surgery 2.Flap surgery – need to wait 3-4 months

Answer 318

You can add a boney material for regeneration. But remember, no probing for at least this much for each material: Perioglas – 6-12 months Bio-Oss – 12-18 months Emdogain – 2-3 years

Answer 319

1.Bone grafts 2.Membranes 3.Growth factors

Answer 320

Regeneration involved the placmenet of a physical/biological barrier to ensure that the root surface becomes repopulated with cementum, PDL and bone. The placment of the physical/barrier permits the growth of bone and PDL cells rather than epithelial or gingival connective tissue into the periodontal defect.

Answer 321

1.Autogenous – harvested from the patient 2.Autollogus – harvested from same species I.e. dead man bone 3.Alloplastic – bioactive glassis like Perioglass 4.Xenografts – harvested from different species I.e. Bio-Oss which is bovine bone

Answer 322

1.Xenografts – from different species like Bio-gide 2.Synthetic – Polyglyclolic

Answer 323

GBR involves the placement of a physical/biological barrier to ensure that the hard tissue deficiency becomes repopulated with bone.

Answer 324

Class 1 – Bucco-lingual deficiency Class 2 – vertical deficiency Class 3 – combination

Answer 325

Recruitment of immature cells and stimulation of these cells to develop into pre-osteoblast e.g. bone healing situations

Answer 326

It permits bone growth on surface or pores. This occurs in bone implants.

Answer 327

1.Soft tissue resection if there is an overgrowth of tissues 2.Soft and hard tissue resection if bone level is incorrect height

Answer 328

Class I – recession that does not extend to the mucogingival junction with no periodontal bone loss Class II – recession that extends to or beyond mucogingival junction with no bone loss Class III - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area Class IV - recession that extend to or beyond mucogingival junction with loss of bone in the interdental area with exposure of interproximal root surface

Answer 329

Sub-epithelial connective tissue graft Coronally repositioned flap Lateral sliding flap

Answer 330

If history of epilepsy or seisures is present - please use a bite block on the patient 1. Stop dental treatment 2. Ensure patient is not in danger 3. Turn the patient to the side 4. Avoid restrainning 5. Wait until seizure stops 6. Maintain airways 7. Assess the patient 8. If still unconscious, call 000 and maintain airways

Answer 331

1. Greater bleeding tendency due to reduction in platalets 2. Hypertension due to extra blood volume 3.Anaemia 4.Drug intolerance - antibiotic and analgesics 5. Increased susceptibility to infections 6. Halitosis, burning sensation int eh mouth, uremic stomatitis, periodontal disease 7. Xerostomia 8. Impared healing Please consider collaborating with a nephrologis

Answer 332

Consider 1. Time of day for appointment 2. Duration of the appointment 3. Positioning of the patient 4. Pre-procedure preparation/action plan - e.g. ask the patient to bring their medication 5. Use of local anaesthetics 6. Medications - contraindications, toxicities, interaction 7. Caries risk 8. Perio risk 9. Xerostomia

Answer 333

1. If they are managed situational by an inhaler - they are probably okay 2. If they take medication - this may be a little more sus 3. If they have been hospitalised - maybe consult with tutor

Answer 334

Higher Blood glucose leads to advanced glycosylated end products (AGE) and free radicals which damage tissues - mostly on two levels Microvascular damage - think perio Macrovascular - think coronary artery disease and renal disease

Answer 335

1. Leukodema 2. Leukoplakia 3. Lichen Planus 4. Frictional keratosis 5. Oral squamous cell carcinoma

Answer 336

1. Pyogenic granuloma 2. Haemangioma 3. Peripheral Giant Cell Granuloma 4. Erythroplakia 5. Oral squamous cell carcinoma

Answer 337

1. Oral melanotic macule 2. Mucosal melanocytic naevus 3. Amalgam tattoo 4. Malignant melanoma 5. Smokers melanosis

Answer 338

1. Haemangioma 2.Fibroepithelial epulis 3. Pyogenic granuloma 4. Peripheral giant cell granuloma 5. Calcifying fibroblastic granuloma

Answer 339

1. Herpetiform ampthous ulcer 2. Mild amthous ulcer 3. Major ampthous ulcer 4. Traumatic acute ulcer 5. Traumatic chronic ulcer

Answer 340

1. Because they are known to leave moisture bubles at the surface as well as water tress that impare bonding 2. Because there is an issue with the acid that is used with self etching. Essentially a special compound is used to neutraulise the acid over time so that self etching does not continue to destroy tooth structure - but unfortunaley that compound affect may be delayed thus the created resin tags are not formed properly - this reduced their effectiveness thus making the restoration last less time :(

Answer 341

1. Block dentinal tubules - using restorations or protective coverings 2. Block nerve activity - stanous fluoride and potassium nitrate 3. Remove the cause - erosion and toothbrushing technique change

Answer 342

1. Site - using anatomical terminology 2. Size - measure with a probe 3. Morphology - elevated, flat or depressed 4. Colour - compare to adjacent normal tissue 5. Consistency - how it feels (ONLY CLINICAL DO NOT SAY THIS IN EXAM), texture - how the surface looks like (PHOTOS ARE APPROPRIATE :))

Answer 343

Amoxicillin 875 + clavulanate 125mg) orally, 12 hourly for 5 days

Answer 344

Benzylpencilli aintravenously in intensive care 2.4g 4 hourly

Answer 345

Paracetamol 1000mg 4-6 hourly for shortest duration possible

Answer 346

ibuprofen 400mg orally, 6-8 hourly for 5 days if pain persists please seek review with GP PLUS Paracetamol 1000mg orally 4-6 hourly to a maximum of 2g for the shortes duration possible

Answer 347

ibuprofen 400mg orally, 6-8 hourly for 5 days if pain persists please seek review with GP PLUS Paracetamol 1000mg orally 4-6 hourly to a maximum of 2g for the shortes duration possible PLUS oxycodone immediate-release 5mg orally, 4 to 6 hourly, for 3 days. PRESCRIBE small quantities

Answer 348

Miconazole 2% gel 2.5 mL topically then swallowed, 4 times a day after food, 7 to 14 days, continue treatment for at least 7 days after symptoms resolve OR Nystatin liquid 100000 units/mL 1 mL topically after food, 7 to 14 days, continue treatment for at least 2-3 days after symptoms resolve

Answer 349

Miconazole 2% cream topically then swallowed, 2 times a day after food, 14 days, continue treatment for at least 14 days after symptoms resolve

Answer 350

Medication-related osteonecrosis of the jaw (MRONJ) is an area of exposed bone in the jaw persisting for more than 8 weeks in a patient currently or previously treated with an antiresorptive drug, an antiangiogenic drug or romosozumab, who has not received radiation therapy to the craniofacial region. Antiresorptive drugs include bisphosphonates and denosumab. Antiangiogenic drugs (eg bevacizumab, cabozantinib, lenvatinib, sunitinib) interfere with the formation of new blood vessels, and are used in the treatment of some malignancies. Romosozumab, a sclerostin antibody inhibitor, increases bone formation and bone mineral density.

Answer 351

For patients receiving antiresorptive drugs or romosozumab for osteoporosis, the benefits of continued therapy outweigh the low risk of medication-related osteonecrosis of the jaw in most patients—consider the following points: Although stopping bisphosphonates for a short period is unlikely to cause harm in a patient at low risk of fracture, there is no evidence that this approach reduces the risk of medication-related osteonecrosis of the jaw. Denosumab is a reversible antiresorptive administered every 6 months for osteoporosis. If it is possible to delay a bone-invasive dental procedure in a patient taking denosumab for osteoporosis, ideally schedule the procedure just before the next dose of denosumab. It is never appropriate to interrupt or delay the dose of denosumab; withdrawal of denosumab has been associated with an increased risk of spontaneous vertebral fractures. Interrupting treatment with romosozumab results in a loss of bone mineral density and potential risk of fracture.

Answer 352

1. Prosthetic cardiac valve 2. prosthetic material for valve repair 3. previous infective endocarditis 4. Congenetive heart disease but only if it involved: unrepaired cyanotic residual defect and repaired defect with residual defects 5. Rheumatic heart disease

Answer 353

amoxicillin 2g for 60 minutes before a procedure OR clindamycin 600mg orally 60 -120 minutes before the proceudre

Answer 354

1. Emergency phase - e.g. exo 2. Systemic phase - e.g. control systemic diseases 3. Initial phase - e.g. testing and debridement 4. Surgical phase - regenerative surgery 5. Restorative phase - temporary crowns 6. Maintenance phase - depending on risk close recall or normal recall

Answer 355

1. Type of periodontal disease 2. Disease extent 3. Stage 4. Grade 5. Current disease status 6. Risk factor profile E.g. Periodontitis: generalized (65%), Stage III (CAL <10 mm), Grade C (HbA1c 8.9%), currently unstable (PPD <8mm, BOP 45%). Risk factors: uncontrolled diabetes (HbA1c 8.9%), smoking 20 cig/day, high strss levels (change in work)

Answer 356

1. Lateral sliddding flap 2. Coronally repositioned flap 3. Free gingival flap 4. Subepithelial connective tissue graft

Answer 357

Clindamycin and triamcinolone