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Best of Fives for Dentistry > Oral surgery > Flashcards

Oral surgery Flashcards

1
Q
  1. Which one of the following is not a complication of removal of mandibular wisdom teeth?
    a. Dry socket
    b. Anaesthesia of the inferior dental nerve
    c. Paraesthesia of the facial nerve
    d. Paraesthesia of the lingual nerve
    e. Trismus
A

 C. Paraesthesia of the facial nerve.
 Consent for mandibular wisdom tooth removal should include inferior dental/lingual nerve paraesthesia/anaesthesia, pain, swelling, bruising, need for antibiotics and analgesia. The facial nerve is not involved.

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2
Q
  1. Which is the correct acronym for a common treatment or a fractured mandible?
    a. OTIF
    b. ORIF
    c. RIMA
    d. LIMA
    e. OSIM
A

 B. ORIF
 ORIF stands for Open Reduction and Internal Fixation.
 This is one of the most common ways of treating a fractured mandible. It involves an operation to realign and fix the mandible in place, most commonly with plates and monocortical non-compression screws +/- intermaxillary fixation. RIMA and LIMA stand for right internal mammary artery and left internal mammary artery, respectively, and are common in coronal artery bypass grafting.

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3
Q
  1. Which is the resorbable suture of choice when suturing intra-orally after a surgical extraction?
    a. Black silk sutures 3/0
    b. Polypropylene 3/0
    c. Vicryl 3/0
    d. Prolene 3/0
    e. Catgut 3/0
A

 C. Vicryl 3/0
 Catgut is resorbable suture, but has not been used for years. Its use is now illegal. All the other suture materials apart from Vicryl require removal.

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4
Q
  1. An incisional biopsy is indicated in which of the following lesions?
    a. Squamous cell carcinoma
    b. Fibroepithelial polyp of the lip
    c. Buccal haemangioma
    d. Palpable submandibular gland lump
    e. Amalgam tattoo
A

 A. Squamous cell carcinoma
 An excisional biopsy is contraindicated in squamous cell carcinoma but is indicated for a fibroepithelial poly. An amalgam tattoo requires no treatment. Submandibular gland lumps are investigated via fine needle aspiration. A haemangioma should not be biopsied, as it may well bleed dangerously and be life-threatening.

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5
Q
  1. After repair of an oroantral fistula, which of the following is unnecessary?
    a. Analgesia
    b. Antibiotics
    c. Ephedrine nasal sprays/drops
    d. Steam inhalations
    e. Referral to ENT team
A

 E. Referral to ENT team
 A referral to ENT is unnecessary as the tx is very often successful. All of the other choices are usually prescribed postoperatively.

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6
Q
  1. Which one of the following is not a common sign of fractured zygoma?
    a. Subconjunctival haemorrhage with no visible boundary.
    b. Diplopia
    c. Paraesthesia of the infra-orbital nerve
    d. Epistaxis
    e. Anosmia
A

 E. Anosmia
 Anosmia is loss of smell and commonly occurs when the olfactory bult is damaged. There are many causes of diplopia (double vision). The infra-orbital nerve exists from the infra-orbital foramen on the zygoma, and is easily damaged or bruised. Epistaxis occurs when blood leaks from the maxillary antrum.

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7
Q
  1. Which of the following statements regarding the temporomandibular joint is correct?
    a. The disc attaches to the capsule anteriorly
    b. The articular surface of the disc is made of hyaline cartilage
    c. The articular surfaces are covered with hyaline cartilage
    d. The articular surfaces are covered with fibrocartilage
    e. The middle region of the disc is the most vascular region
A

 D. The articular surfaces are covered with fibrocartilage.
 The articular surfaces of both the disc and the joint are made of fibrocartilage. The most central part of the disc is avascular.

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8
Q
  1. Which one of the following statements regarding the temporomandibular joint is incorrect?
    a. The temporomandibular joint is related to the lateral aspect of the joint.
    b. The sphenomandibular ligament is an embryological remnant of Meckel’s cartilage.
    c. The sphenomandibular ligament extends from the spine of the sphenoid to the lingula.
    d. The stylohyoid ligament extends from the tip of the styloid process to the hyoid bone.
    e. The stylomandibular ligament is a remnant of the deep cervical fascia as is passes lateral to the parotid gland.
A

 E. The stylomandibular ligament is a remnant of the deep cervical fascia as it passes lateral to the parotid gland.
 The stylomandibular ligament is a remnant of the deep cervical fascia as it passes medial to the parotid gland.

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9
Q
  1. Which one of the following is not a risk factor for oral cancer?
    a. Smoking
    b. Alcohol
    c. Previous trauma to the site
    d. Social deprivation
    e. Betel nut chewing
A

 C. Previous trauma to the site.
 The risk factors for oral cancer include smoking, tobacco chewing, snuff, betel nut, alcohol consumption, immunocompromised patients (human immunodeficiency virus (HIV) infection). Trauma is not a risk factor.

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10
Q
  1. Which one of the following is an indication for extraction of a lower wisdom tooth?
    a. Anterior crowding
    b. The tooth is distoangular in position.
    c. The patient has had two episodes of pericoronitis.
    d. To ‘balance’ the extraction of one tooth on one side of the mandible by extracting the wisdom tooth on the other side of the mandible.
    e. To appease a patient who has atypical facial pain.
A

 C. The patient has had two episodes of pericoronitis.
 A single episode of pericoronitis can be an indication for extraction of a wisdom tooth, however it has to be extremely severe. The recommendation is two episodes of pericoronitis. None of the other indication for lower wisdom tooth extraction. Follow NICE guidelines updates!!

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11
Q
  1. Which one of the following statements regarding the submandibular gland is incorrect?
    a. It is the second largest salivary gland
    b. It empties via Wharton’s duct
    c. It has a duct closing related to the lingual nerve
    d. It produces entirely serous saliva
    e. It is most commonly affected by salivary calculi
A

 D. It produces entirely serous saliva
 The submandibular gland produces mixed saliva. The lingual nerve is very easily damaged during removal of salivary calculi as it loops around Wharton’s duct.

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12
Q
  1. Xerostomia does not:
    a. Occur after radiotherapy
    b. Occur in patients with Sjogren’s disease
    c. Occur during panic attacks
    d. Cause an increase in root caries
    e. Occur when taking pilocarpine
A

 E. Occur when taking pilocarpine.
 Pilocarpine is actually the treatment for xerostomia. Patients with Sjogren’s syndrome are prone to dry mouth, dry eyes and dry mucous membranes. Panic attacks lead to dryness of the mouth.

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13
Q
  1. Which one of the following statements regarding the maxillary sinus is incorrect?
    a. It develops by pneumatisation
    b. It is the largest of the paranasal sinuses
    c. When fully grown it is pyramidal in shape
    d. It is lined by pseudostratified ciliated columnar epithelium
    e. It drains via the ostium into the inferior meatus of the nose
A

 E. It drains via the ostium into the inferior meatus of the nose.
 The maxillary sinus drains via the ostium into the middle meatus of the nose. It is small at birth (1cm) and grows by pneumatisation to become the largest of the paranasal sinus. It is lined by pseudostratified ciliated columnar epithelium.

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14
Q
  1. Which one of the following methods of treatment is inappropriate for the reduction of a fracture mandibular angle in a dentate patient?
    a. Inter-maxillary fixation (IMF) with a Gunning splint
    b. IMF using arch bars
    c. IMF using eyelit wires
    d. IMF using mini plates and monocortical non-compression screws.
    e. IMF using Leonard’s buttons.
A

 A. Inter-maxillary fixation (IMF) with a Gunning splint
 IMF using a Gunning splint is a perfectly good treatment for fixation of a fractured mandible, however only in edentulous patients. They are splints which are wired to both the mandible and the maxilla and enable IMF to be achieved so that the fracture can be immobilised and therefore is allowed to heal.

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15
Q
  1. What is the most common cause of a fractured mandible?
    a. Road traffic accidents
    b. Inter-personal violence
    c. Sporting injury
    d. Industrial accidents
    e. Iatrogenic following wisdom tooth extraction.
A

 B. Inter-personal violence
 Inter-personal violence is the most common cause of a fractured mandible. Previously road traffic accidents were the major cause, but the advent of the seatbelt laws results in a decreased incidence of these fracures from this cause.

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16
Q
  1. What is the correct treatment for an asymptomatic torus palatinus?
    a. Antibiotics
    b. Excision
    c. Incisional biopsy
    d. Excisional biopsy
    e. None of the above
A

 E. None of the above.
 No treatment should be prescribed for an asymptomatic torus palatinus. Rarely they have chronic trauma and get secondarily infected, or when dentures are required and it interferes with the design, it needs to be removed.

17
Q
  1. Osteoradionecrosis:
    a. Is treated with 100% oxygen
    b. Commonly affects the maxilla
    c. Commonly occurs following chemotherapy
    d. Occurs due to a reduction in vascularity secondary to endarteritis obliterans
    e. Is the same as focal sclerosing osteomyelitis.
A

 D. Occurs due to a reduction in vascularity secondary to endarteritis obliterans.
 Osteoradionecrosis is frequently treated with hyperbaric oxygen, occurs in the mandible, and commonly occurs following radiotherapy. Focal sclerosing osteomyelitis occurs after a low-grade infection, which mainly affects children.

18
Q
  1. After extraction of a lower right first molar, how long should you keep the records for?
    a. 1 year
    b. 4 years
    c. 11 years
    d. 25 years
    e. 50 years
A

 C. 11 years.
 Notes for adults should be kept for 11 years. children’s notes should be kept for 11 years or until the patient is 25 years of age, whichever is longer.

19
Q
  1. After the extraction of the lower right first permanent molar, under which of the following conditions would sterilisation be achieved?
    a. 112C for 15 minutes
    b. 112    C for 5 minutes
    c. 121C for 15 minutes
    d. 121    C for 5 minutes
    e. 143*C for 1 minute
A

 C. 121C for 15 minutes.
 For sterilization to occur at 134C it requires the temperature to be maintained for 3 minutes at least. At 121*C it requires a maintenance of the temperature for 15 minutes for sterilisation to occur.

20
Q
  1. Which one of the following antibiotic cover regimens is appropriate for patients with cardiac pacemakers who require dental extractions?
    a. Under LA with 3g amoxicillin orally, 1 hour pre-operatively
    b. Under LA with 600mg clindamycin orally, 1 hour pre-operatively
    c. Under La with 1g amoxicillin orally, 1 hour pre-operatively, and 500mg amoxicillin 6 hours later.
    d. Under GA with 1g amoxicillin and 120mg gentamicin intravenously at induction.
    e. None of the above.
A

 E. None of the above.
 Antibiotic prophylaxis is not required for patients with a cardiac pacemaker.

21
Q
  1. What is the name of the instrument below?
    a. Howarth’s periosteal elevator
    b. Bowdler-Henry Rake retractor
    c. Ward’s buccal retractor
    d. Laster’s retractor
    e. Straight Warwick-James elevator
A

 B. Bowdler-Henry Rake retractor.

22
Q
  1. Which tooth would you extract using the forceps shown?
    a. LL8
    b. UL6
    c. LL2
    d. UL2
    e. LR6
A

 C. LL2
 These are lower root forceps. They are contra-angled, which rules out maxillary teeth. The molar forceps have a wider beak than the anterior teeth forceps.

23
Q
  1. What is the name of the instrument shown below?
    a. Laster’s retractor
    b. Ward’s buccal retractor
    c. Howarth’s periosteal elevator
    d. Bowdler-Henry rake retractor
    e. Collins’ cheek retractor
A

 A. Laster’s retractor
 Collin’s cheek retractor does not exist.

24
Q
  1. What would you use a Laster’s retractor for?
    a. Lower wisdom tooth extraction
    b. Upper wisdom tooth extraction
    c. Maxillary advancement osteotomy
    d. Sialography
    e. Apicectomy
A

 B. Upper wisdom tooth extraction
 Laster’s retractor is used for the retraction of mucoperiosteal flaps to aid visibility during surgical extraction of upper wisdom teeth.

25
Q
  1. Which one of the following statements regards the muscles of mastication is correct?
    a. The temporalis can be divided into anterior, middle and posterior fibres, all of which carry out the same movements.
    b. The posterior fibres contribute to the protrusion of the mandible.
    c. The anterior and middle fibres contribute to the retrusion of the mandible.
    d. The anterior and middle fibres contribute to the elevation of the mandible.
    e. The anterior and middle fibres contribute to the protrusion of the mandible.
A

 D. The anterior and middle fibres contribute to the elevation of the mandible.
 The temporalis has three parts which produce different movements. The posterior fibres retract the mandible, and the anterior + middle fibres elevate the mandible.

26
Q
  1. Which antibiotic should be prescribed post-operatively, after a surgical extraction?
    a. Clindamycin
    b. Metronidazole
    c. Amoxicillin
    d. Erythromycin
    e. Cefuroxime
A

 B. Metronidazole.
 Metronidazole is the correct antibiotic to be prescribed after surgical extraction. It is effective against anaerobes which are the most common organisms in the mouth.

27
Q
  1. What is the motor nerve supply to the tongue?
    a. Lingual nerve
    b. Glossopharyngeal nerve
    c. Hypoglossal nerve
    d. Vagus nerve
    e. Facial nerve
A

 C. Hypoglossal nerve.
 The hypoglossal nerve is motor to the intrinsic muscles of the tongue, hypoglossus, genioglossus, styloglossus, thyrohyoid and geniohyoid.

28
Q
  1. Which one of the following statements is true?
    a. The glossopharyngeal nerve serves the posterior third of the tongue for taste only.
    b. The glossopharyngeal nerve serves the posterior two-thirds of the tongue for taste only.
    c. The glossopharyngeal nerve serves the anterior third of the tongue for taste only.
    d. The glossopharyngeal nerve serves the anterior third of the tongue for both taste and sensation.
    e. The glossopharyngeal nerve serves the posterior third of the tongue for both taste and sensation.
A

 E. The glossopharyngeal nerve serves the posterior third of the tongue for both taste and sensation.
 Taste sensation to the anterior two-thirds is supplied by the chorda tympani, an branch of the facial nerve. General sensation of the anterior third of the tongue is supplied by the lingual nerve.

29
Q
  1. Who may be given access to a pt’s notes without the pt’s permission?
    a. Pt’s employer
    b. Pt’s wife or husband
    c. Pt’s children
    d. Pt’s parents
    e. A defence organisation making allegations of negligence.
A

 E. A defence organisation making allegations of negligence.
 A defence organisation may request the records of a patient in regard to a matter of negligence, or you may need to pass records to another healthcare professional, or occasionally you may need to disclose information to a court of law. There should be no other reasons to disclose a pt’s records.

30
Q
  1. The buccal artery is a direct branch of which artery?
    a. Mandibular
    b. Maxillary
    c. Facial
    d. External carotid
    e. Internal carotid
A

 B. Maxillary
 The buccal artery is a direct branch of the maxillary artery as are many others including the greater and lesser palatine arteries, the sphenopalatine artery and the middle meningeal artery

31
Q
  1. Which clotting factors does warfarin interfere with?
    a. II, VII, XI, XII
    b. III, V, VII, IX
    c. II, VII X, XII
    d. II, VII, IX, X
    e. II, III, IX, XI
A

 D. II, VII, IX, X
 Warfarin interferes with the cyclic process converting the oxidised from of vitamin K with the reduced KH2 form necessary for the production of vitamin-K dependent coagulation factors II, VII, IX, and X. Decreased formation of these coagulation factors is responsible for warfarin’s anticoagulant affect.

32
Q
  1. The muscle of mastication that helps retract the mandible is:
    a. Temporalis
    b. Masseter
    c. Lateral pterygoid
    d. Medial pterygoid
    e. Buccinator
A

 A. Temporalis
 The temporalis is the muscle of mastication that helps in elevation of the mandible. It is large and fan-shaped in appearance and covers the temporal area of the skull.
o Origin and insertion: it originates from the parietal bone of the skull and inserts into the coronoid process of the mandible.
o Arterial supply: deep temporal artery
o Nerve supply: trigeminal nerve
o Functions:
 elevation of the mandible
 retraction of the mandible
 crushing of food between the molars.

33
Q
  1. A patient has cellulitis involving the tissues of the floor of the mouth and the sublingual region. The associated swelling happened rapidly and may block the airway. Which eponymous angina does this describe?
    a. Johann’s
    b. Ludwig’s
    c. Karl’s
    d. Jones’
    e. Barnett’s
A

 B. Ludwig’s
 Ludwig’s angina is a serious, potentially life-threatening cellulitis infection of the tissues of the floor of the mouth, usually occurring in adults with concomitant dental infection. Ludwig’s angina should not be confused with angina pectoris, which is otherwise commonly known as angina.

34
Q
  1. Name the instrument shown below.
    a. Mosquito
    b. Bowdler Henry
    c. Spencer-Wells
    d. McIndoe
    e. Spurr
A

 A. Mosquito

35
Q
  1. What is the acronym used when describing the use of plates and screws to fixate a fractured mandible?
    a. OBOE
    b. ORIF
    c. OTEM
    d. MIST
    e. TERM
A

 B. ORIF
 Open reduction internal fixation (ORIF) is a surgical procedure. Open reduction refers to open surgery to set the bones, as is necessary for some fracture. Internal fixation refers to fixation of screws and/or plates to enable or facilitate healing. Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infection. Some surgeons use titanium bone plates and screws to rigidly fix fractures.

36
Q
  1. Which one of the following drugs is safe to prescribe if the patient has penicillin allergy?
    a. Augmentin
    b. Ampicillin
    c. Flucloxacillin
    d. Clarithromycin
    e. Cefuroxime
A

 D. Clarithromycin
 All other drugs are related to penicillin and can cause lethal anaphylaxis if given to those who are allergic to penicillin.

Best of Fives for Dentistry (6 decks)

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