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BDS3 Past Papers & Quizzes > MSA 2016 > Flashcards

MSA 2016 Flashcards

1
Q

5 factor categories that can cause candidsis

A

physiological

trauma

haematological

iatrogenic

endocrinological

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2
Q

physiological factors for oral candidosis

A

pregnancy

age

saliva flow

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3
Q

trauma factors for candidosis

A

cellular immunodeficiency

neutropenia

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4
Q

iatrogenic factors for oral candidosis

A

antibiotics

catheters

surgery

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5
Q

endocrinological factors for candidosis

A

diabetes

addison disease

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6
Q

organisms that causes candidosis

and 3 virulence factors of it

A

candida albicans

hyphe, adhesins, hydrolytic enzymes

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7
Q

4 key stages of biolfilm formation

A

adhesion

colonisation

accumulation to form complex commuity

dispersal

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8
Q

how would you test for candida albicans and suggest a lab identification method

A

take a swab and culture the swab content’s on Sobouraud’s Agar and if present candida will present as white creamy colonies

lab testing - germ tube formation

PCR

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9
Q

example azole and mechanism

A

fluconazole

work by indirectly targeting th ergosterol in the fungi cell wall by interrupting the activity of the enzyme that produces it - 14 alpha demethylase

FUNGISTATIC

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10
Q

example polyene antifungal and mechanism of action

A

nystatin

directly target the ergosterol and cause perforation and leakage of intracellular contents

FUNGICIDAL

higher virulence but less well tolerated

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11
Q

example echinocandins and action

A

micafungin

FUNGICIDAL

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12
Q

3 classess of antifungals

A

azoles

polyenes

echinocandins

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13
Q

2 year with caries in all upper incisors and 6s

pattern of caries here

A

nursing bottle/early childhood caries

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14
Q

explain pattern and distribution of decay in nursing bottle/early childhood caries

why are some teeth not in the pattern?

A

lower incisors are spared from decay as they are physically protected by the nursing position of the child’s tongue - the artifical nipple of bottle rests against the palate, while tongue is extended over the lower incisors

maxillary incisors - 1st to experience the cariogenic challenge and suffer the longest cariogenic attack because of early eruption

if habit continues, other teeth (mandibular canines and all 6s) will be subjected to the cariogenic challenge in sequence of eruption

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15
Q

5 causes of nursing bottle/early childhood caries

A
  • no brushing of teeth - minimal fluride exposure
  • child put to bed with a bottle thus allowing prolonged exposure of the baby’s teeth to cariogenic sugars
  • as a result of inappropriate use of feeding bottles and cups (contents sugar)
  • prolonged breastfeeding
  • baby may not swallow all milk or contents of bottle and therefore remnants can swirl around the oral cavity for prolonged timeframes
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16
Q

fluoride regime for 2 year old with high caries risk in dental setting

A
  • 0.25ml F varnish (5%) - 22600ppm applied twice a year in the dental setting
  • Fluoride toothpaste 1000ppm - smear on toothbrush
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17
Q

4 brushing instructions for high caries risk 2 year old

A
  • 2-3 times a day
  • spit don’t rinse
  • assisted brushing until age of 7
  • fluoride toothpaste of 1000ppm
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18
Q

ED# in 8 year old boy

most important emergency tx

A

aim to retain vitality of any damaged or displaced tooth by protecting exposed dentine by means of an adhesive dentine bandage

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19
Q

9 signs/symptoms to track progression of trauma (things on trauma stamp)

A
  • sinus
  • colour
  • mobility
  • displacement
  • TTP
  • percussion note
  • sensibility testing
  • thermal testing
  • radiographs
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20
Q

4 radiographic signs of non-vital tooth

A

peri-apical radiolucency

internal inflammatory resorption

external inflammatory resorption

ankylosis

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21
Q

child who has history of trauma is continuing to play active contact sports (rugby) what should you do

A

provide him with a mouthguard

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22
Q

5 signs digit sucking habit

A

proclined upper incisors

retroclined lower incisors

anterior open bite or incomplete open bite

unilateral posterior cross bite

narrowed upper arch

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23
Q

how does thumb sucking affect posterior dentition

A

pt thumb and digits are positioned in the mouth in such a way that they result in the mandible to drop open

  • this cause the pt’s tongue to be held and occupied in a lower position that what is deemed normal

sucking action initiaited by the muscular forces in the cheek’s narrows the maxillary arch - causing posterior cross bite

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24
Q

4 methods of preventing/stopping a digit sucking habit

A
  • behaviour management therapy (positive reinforcement)
  • plasters, gloves or bitter flavoured agents applied to digits to make habit less satisfying
  • URA with a rake
  • habit reversal - do another activity when urge to suck arises
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25
Q

local cause of malocclusion

A

a localised problem or abnormality within either arch, usually confined to 1, 2 or several teeth producing a malocclusion

it is something that tends to get worse with time

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26
Q

4 conditions of tooth number which can cause malocclusion

A
  • supernumerary teeth
  • hypodontia
  • retained primary teeth
  • early loss of primary teeth
  • unscheduled loos of permanent teeth
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27
Q

4 supernumerary teeth

A
  • conical
  • tuberculate
  • supplemental
  • odontome
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28
Q

4 factors of anatomy which can cause tooth mobility

A

width of PDL

height of PDL

inflammation

number, length and shape of roots

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29
Q

4 pathological reasons for tooth mobility

A

periodontal disease

periapical abscess

trauam

external inflammatory resorption

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30
Q

3 times when you would intervene to stop tooth mobility

A

if it is progressively increasing

if it gives rise to symptoms

if it creates difficulty with restorative treatment

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31
Q

would you expect tooth mobility to inc or dec in a pt with moderate-advanced perio disease following HPT - why?

A

expect to decrease

expect clinical reattachment via long junctional epithelium

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32
Q

pt has mobile lower incisors and refuses XLA

what would you advise? what are disadv?

A

splinting may be appropriate when tooth mobility is caused by advanced LOA, or causing discomfort or difficulty chewing

but splinting does not influence the rate of periodontal destruction and may create hygiene difficulties

  • last resort Tx
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33
Q

components of stainless steel (5)

A

iron

chromium

nickel

titanium

carbon

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34
Q

iron % in stainless steel

A

72

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35
Q

chromium % in stainless steel

A

18

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36
Q

nickel % in stainless steel

A

8

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37
Q

titanium % in stainless steel

A

1.3

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38
Q

carbne % in stainless steel

A

0.7%

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39
Q

describe work hardening

A

work done on a metal at low temperatures which causes slip, which is where dislocations collect at grain boundaries - thus resulting in a stronger harder material

40
Q

what is meant by springiness

A

ability of a material to undergo large deflections

can undergo large deflections without permanent deformation

41
Q

2 disadvantages of self cure PMMA

A

poor mechanical properties

  • poor compressive strength
  • poor tensile strength

residual monomer (allergy

42
Q

if Risk ratio is less than 1

A

outcome less likely

43
Q

if Confidence interval is 0.5-3.3

is there sufficient evidene

A

no

as CI contains 1

44
Q

randomised contol trial

A

specification of participants for a representative sample, randomisation by computer, control used

Gold standard study for clinical trials

they are particularly useful for clinical studies and incorporate 4 design elements - specification of particpants (inclusion/exclusion criteria), control, randomisation, blinding

45
Q

randomised control trial

4 design element

A

specification of particpants (inclusion/exclusion criteria), control, randomisation, blinding

46
Q

cohort study

A

prospective study

establish group and measire exposures

following group over time, identify thost that develop disease

used for estimating incidence and causes of disease

47
Q

case control study

A

retrospective study

looks back to exposure of particular risk factor and looks at potential causes of disease

48
Q

examples of relationships/patterns from graphs

A

sections to not reach threshol/ annomalies

trends

difference - greatest between…

49
Q

SIMD

A

scottish index of multiple deprivation

ranks 6600 data-zones in order of deprivation (1 most), area based index of multiple deprivation

derived from a range of data sources looking at: employment, income, health, education, skill, training, geography access to services, crime, housing

50
Q

5 roles of epidemiology

A
  • measurement of amount and distribution of disease, and natural history of disease
  • study of causes/determinants of disease
  • assess people’s risk of disease
  • health care needs assessment and service planning
  • development of preventative programmes
51
Q

incidence

A

number of new disease cases devloping over a specific period of time in a defined population

52
Q

prevalence

A

number of disease cases in a population at a given time

53
Q

types of dementia

A
  • Alzheimer’s disease
  • vascular
  • dementia with Lewy bodies
  • fronto-temporal
  • Korsakoff’s syndrome
54
Q

5 signs of late stage dementia

A

unaware of time and place

difficulty in recognising faces of friends and relatives

increasing need for self care help

difficulty walking

behaviour changes - aggression

55
Q

4 cognitive tests for dementia

A

mini-mental state exam (MMSE)

blessed dementia scale

montreal cognitive assessment (MoCA)

single test - clock draw, delayed word recall, category fluency

56
Q

4 ways to make dental practice dementia friendly

A

reception disk visible from entrance

signage at eye level - clear text, colour and pictorial elements

colour and tone of walls should be distinct from flooring and furniture

staff or locked rooms coloured the same as the walls to avoid attention

57
Q

dentally fit

A

being free of dental disease and any oral sources of infection at the start of cancer tx

58
Q

multidisciplinary team

A

team of individuals from a wide variety of disciplines/specialities who work alongside each other in order to provide the best and holistic care for the pt

59
Q

example members of cancer pt MDT

A
  • oral maxiollofacial surgeon
  • radiologist
  • chemotherapist
  • cancer nurse specialist
  • speech and language therapist
  • pathologist
  • ENT
60
Q

3 complications of radiotherapy to head and neck

A

xerostomia

mucositis

osteoradionecrosis

61
Q

4 modifiable factors for head and neck cancer

A

smoking

alcohol

oral hygiene

betal chewing (tobacco)

62
Q

9 functions of provisional restorations

A
  • restore aesthetics and function
  • prevent sensitvity and micro leakage of bacteria
  • coronal seal of an endodontic tx
  • prevent plaque build up and caries
  • preserve or improve function (mastication and speech)
  • prevent drifiting or tilting of prepared teeth
  • maintain gingival health and contour
  • isolation for RCT
  • matrix for core build up
63
Q

3 types of preformed provisional crowns

A
  1. polycarbonate (silica) - tooth coloured
  2. clear-plastic crowns forms: filled with composite (strip crowns)
  3. metal: aluminium, stainless steel
64
Q

2 adv of preformed crowns

A

cheaper

no need for lab involvement so can construct tooth prep and cement crown in 1 visit

65
Q

5 stages in changing standard operating procedures

A
  1. identify the problem
  2. set criteria and standard
  3. observe practice/data collection
  4. compare performance with set out standards
  5. implement change
66
Q

4 principles of wast disposal

A
  1. segregation
  2. storage
  3. disposal
  4. documentation
67
Q

laws and regulations relating to waste disposal

A
  • Health and Safety at Work Act 1974
  • The Controlled Waste regulations 2012
  • The hazardous waste directive 2011
  • the carriage of dangerous goods regulations
  • control of substances hazardous to health (COSHH) 2002
68
Q

3 design components of amalgam container

A

leak and spill proof

mercury vapour suppressant lid

white body and red lid drum

69
Q

disinfect blood spill

A

sodium dichlorosiocyanurate or sodium hypochlorite

70
Q

active ingredient and concentration for blood spill

A

sodium hypochlorite/dichloroisocyanurate

10,000ppm chlorine solution for 3-5 mins

71
Q

3 ways to ensure SOP changes are followed up by colleagues

A
  • carry out another clinical audit
  • take a day out to observe the practice disinfection control
  • ensure colleagues attended required CPD session (training)
72
Q

dentist causes facial palsy as a result of right IAN block

pt has sore right TMJ

how is the facial palsy caused?

A

if the clinician doesn’t hit the bone and inserts the needle too far back, LA is deposited in parotid gland

facial nerve runs through it, due to the dense fascia around the gland the LA will remain for a long time and cause paralysis of the facial muscles that the nerve innervates

73
Q

dentist causes facial palsy as a result of right IAN block

pt has sore right TMJ

3 differences between stroke and facial palsy

A
  • facial palsy occurs as a result of LA administered into the parotid gland and affects the side injected
    • stroke causes loss of movement of facial muscles on opposite side
  • if it is stroke, the pt can still wrinkle their forehead on the affected side
74
Q

explain the neural anatomy which accounts for difference between stoke and facial palsy

A

in a stroke there is interruption of supra nuclear fibres from the motor areas of cerebral cortex, before they reach the facial motor nucleus

the upper part of the facial motor nucleus receives crossed and uncrossed fibres and the frontalis and orbicularis oculi still have the ability to function as a result

unlike in facial palsy

75
Q

dentist causes facial palsy as a result of right IAN block

pt has sore right TMJ

4 ways to intially manage the pt

A

reassure them

tell them that sensation will return in a few hours

cover the eye with an eye patch to prevent cornea drying out

give a contact number

76
Q

3 things to assess to determine if impression is usable

A
  • no air blows present on the impression
  • ensure impression is not separated from impression tray
  • ensure all soft tissue anatomy (e.g. gingival margin) is recorded
77
Q

list 4 potential faults with impressions

A

air blows/voids

missing anatomy

dragging due to removal prior to material set

tear upon removal

78
Q

reasons for potential impression faults

A
  • wrong or no adhesive applied to impression trays prior to loading of impression material
  • ? hydrophobic impression used when haemostasis or moisture control poor
  • retraction cord or past not used to retract soft tissues
  • wrong ration of base paste and catalyst paste
  • impression material used is expired
79
Q

how to decontaminate an impression

A
  • rinse the impressin under cold running water prior to putting into the perform to remove gross debris and saliva
    • inspect impression prior to disinfection
  • disinfect in perform for at least 10 mins
    • sodium benzoate and potassium peroxomonosulphate
  • take it out and rinse under cold water, wrap in damp gauze and put it in a plastic bag with pt details and sent it to lab
80
Q

XLA of lower premolar

list 4 preoperative complications

A
  • tooth position inadequate for access for elevators or forceps
  • pt medical history states bleeding tendency
  • radiograph shows teeth appear likly to be ankylosed or infraoccluded or sings of hypercementosis
  • close to revelant antatomical structure (here metal foramen)
81
Q

XLA of lower premolar

14 perioperative complications

A
  • difficulty of access
  • fracture tooth/root
  • fracture alveolar plate
  • fracture tuberosity
  • jaw fracture
  • loss of tooth
  • soft tissue damage
  • damage to nerves/vessels
  • haemorrhage
  • dislocation of TMJ
  • damage to adjacent teeth/restorations
  • extraction of permanent tooth germ
  • wrong tooth

if upper - involved of maxillary antrum (OAC/OAF)

82
Q

pt root fracture during standard XLA procedure

what radiograph to take

A

periapical radiograph

83
Q

draw flap design for 44

A

crevicular incision with a distal relieving incision

mind mental foramen

84
Q

where is the mental foramen

A

between the 4 and 5

85
Q

mental nerve innervates

A

lower lip and chin

lower teeth anterior to the mental nerve

86
Q

INR table - values, dates, signature

what 2 coloumns most useful for XLA a pt with warfarin

A

INR and date columns

must be within the last 24 hrs and INR below 4

87
Q

what would you want INR of pt on warfarin to be for XLA

A

must be within the last 24 hrs and INR below 4

stable

88
Q

most appropriate post op analgesic for warfarin pt

aspirin, paracetamol, warfarin

A

paracetamol

89
Q

how does the GP assess if pt INR is unstable

A

by taking a blood sample of a pt to assess the prothrombin time

90
Q

mechanism of apixaban

A

factor Xa inhibitor

91
Q

do you need to make alterations regarding apixaban for restoration of tooth 16 occlusal?

A

no

proceed because procedure is minimum risk

92
Q

do you need to make alteration regarding apixaban for XLA of uncomplicated 22

A

no change

low bleeding risk according to SDCEP

93
Q

2 reasons for amalgam overhangs

A

poor adaptation of matrix band

excessive force applied when condensing amalgam

94
Q

5 complications of overhangs

A
  • food trap
  • difficulty cleaning
  • plaque stagnation
  • secondary caries
  • eventually gingivitis and periodontal disease
95
Q

2 ways to manage overhangs

A

by retreatment - replace restoration

  • use wedges to ensure well adapted
  • preferred method if caries detected on radiograph under restorations
    • can result in further tooth tissue loss

using finishing strips or soft flex discs

  • no need for LA
  • only is no need for replacement indicated

BDS3 Past Papers & Quizzes (14 decks)

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