Bananas Case & Testlet File (70+ Cases)

1. (Case Study): Old lady stroke wheelchair. Smokes. Fracture of left zygoma affecting motor expression. Also has
Osteoporosis + bisphosphonates. Has had clicking for many years (Sept 2016)
a. Broke femur 1 month ago what type of bone? Woven
i. Alternate: 5 years ago? Remodeling
b. Can’t feel under her right eye what injury Right parietal
c. Warning sign of another stroke? Right arm numbness
d. What nerve damaged? Facial nerve
e. Discolored teeth due to? Bisphosphonates
f. What will affect healing of tooth extraction? Hypertension, NOT SMOKING
g. What’s a possible cause of this patient’s osteonecrosis (no osteoporosis)? Osteoarthritis

2. (Case Study): Girl gets all 3rd molars (#1, 16, 17, 32) extracted. Pain in lower left after extraction. Swollen in lower left by #19.
Pus drainage (Sept 2016).
a. What’s cause of pain in lower left extraction? Osteomyelitis (indicating infection)
i. Osteomalacia, Osteopenia
b. Lymph node drainage? Submandibular
c. Wants to numb lower lip? Mental Nerve

3. (Case Study): Boy has bumps on right side of face face, right cheek, mouth, vestibule, palate. Ulcer on palate. Crown on #2
a. What disease? Herpes Zoster (Shingles, unilateral)
b. INCORRECT crown directions on #2? Facial HoC= cervical 1/3rd (should be middle 1/3rd)
c. Epithelium next to ulcer? Parakeratinized

4. (Case Study): 70 yo male farmer with dark lesion on upper lip. Bx showed crusty lesion next to nose. White leukoplakia on
floor of mouth. Has Hepatitis C. Allergic to Penicillin (Sept 2016)
a. What is the crusty lesion? Actinic keratosis
b. What is it most likely caused by? Chronic Sun Exposure
c. What characterizes the nose growth? Basal cell Carcinoma
d. Leukoplakia surrounded by what tissue (floor of mouth)? Non-Keratinized Simple Squamous
e. True about Hepatitis C EXCEPT? Doesn’t have a carrier state (it does!)
f. Give him penicillin, reaction? Anaphylactic, IgG
g. Ethics if you give him penicillin? Non-Maleficence

5. (Case Study): 55 yo male. Has hyperlipidemia, hypertension. On Antidiuretic med, anti-lipid med, hypertension meds.
Wants Viagra. Complains of weird bitter taste in back of throat plus the sore spot on buccal of #3. Has parulis by #3 on
buccal gingiva.
a. Characteristic of Viagra EXCEPT? ______
i. Increase blood pressure, Vasodilation,
b. Bone you can feel through upper buccal vestibule in back of mouth? Zygomatic
c. What nerve affected in lower vestibule? Buccal? V2?
d. Which of the 5 tastes can you taste at low concentration? Bitter
e. Mechanism of bitter taste in back of throat? G Protein-coupled receptors
i. NOT TTX-sensitive Na+

6. (Case Study) 16 yo Girl with from Cambodia has Tuberculosis (TB); Medication + dental problems, parents don’t speak
English. Ends up getting 2 TEs. (Aug 2016)
a. Antibiotic most frequently used in treatment of TB? Rifampin (antibiotic)
b. How does drug work? Inhibits RNA Synthesis (transcript), 6-9 months
c. Do you treat this patient? Delay tx until pt is not infectious.
d. If emergency? Urgent dental care in OSHA approved facility.
e. Parents don’t speak, what is the ethical thing to do (non-emergency)? Get a translator and do tx
f. Do a RCT and still radiolucent, biopsy finds epithelium? Cyst
g. All of these bacteria will give a positive PPD test EXCEPT for? Leprosy, Pertussis?

7. (Case Study) Man with 2 RPD’s, mandibular has bad posterior abutment. Pain by #3. It get worst at night, sharp pain and
comes suddenly and leaves suddenly. On exam everything is NORMAL except palpation of the buccal gingiva hurts. On 2 nd
exam, put on Nitrous Oxide. (September 2016)
 a. Pain fibers? A delta
b. Pain unit? Substance P
c. Nerve affected? V2
d. What is the diagnosis for the case? Trigeminal neuralgia.
e. Patient can’t take the pain, wants all teeth out + make him a removable.
i. Which two principles conflict? Autonomy & non-maleficence.
f. Nitrous oxide question

8. (Case Study): Guy with bad breath and ulcers. Hygienist cuts patient distal to MN 2 nd molar, 1 cm from midline.
a. Which muscle is not damaged from scaling? Musculus Uvula
b. After cuts patient, what do you do? Stop tx and tell patient + tell options
c. Patient is bleeding profusely from what artery? Greater palatine artery

9. (Case Study): Hurts to eat and chew purulent swelling under tongue. Alcoholic (Sept 2016)
a. Where does submandibular duct empty in mouth? Sublingual caruncle
b. What innervates gland? VII
c. Alcoholic? Affects cerebellum
d. Shows up drunk? Have emergency contact pick her up
e. Why does she have esophageal varicies- Liver congestion
f. What do u expect to see in her liver- Fatty metaplasia

10. (Case Study): Dry mouth burning lymphocytes in gland (Sept 2016)
a. What fibers? A-delta
b. What is CC? Burning mouth syndrome
c. What is causing dry mouth-? Sjorgens
d. What type of disease- Autoimmune
e. Crusty lips related EXCEPT? (vit b def, candidiasis) Decreased VDO
f. She sucks on candy what do u do- Fluoride mouthrinse
g. Biopsy includes lower lip mucosa? Mental nerve

11. (Case Study) Dead girl has swollen right cheek with hematoma on the lateral rim of the right orbit. Erupted lower canines but
not upper canines. Rattlesnake bites her lateral of the right forearm (Aug 2016)
a. What’s the age of this girl? 9-10 yrs (max canine = 11-12 yrs)
b. Which bone of the orbit is probably broken? Zygomatic
c. On the x-ray, there is a line of radiolucency on the left orbital lateral margin? Normal suture
d. In a scar tissue we have what type of bone formation? Metaplasia / metaplastic bone
i. formed within dense collagenous scar tissue.)
e. What would the coup contrecoup injury be (opposite side of impact) Right sphenoid
f. What nerve is most prone to injury in the forearm? Radial nerve (elbow)
g. What bone is subjacent? Radius

Alternate: Medial wall fractured

h. Which bone has probability of breaking? Ethmoid bone.
i. Contain? Lamina Papyracea

Alternate: Superior wall of orbit fractured

i. What arteries are injured? Lacrimal artery
j. What nerves are injured? III, IV, V1 (Frontal+Lacrimal+Nasociliary branch), VI

12. (Case Study): Ulcer in Mid / Hard Palate (Aug 2016)

a. What causes it? Viral infection, Fever/Heat blister?
i. Smoking, pizza burn,tobacco,viral/bacterial infection)
b. If biopsy epithelium around gingival ulcer what type of epithelium? Keratinized or Para?
i. Not: Para, Ortho, Non-
c. What type of epithelium IN the ulcer? Dermis?
d. Based on med hx, what should dentist be concerned with in the chair? Syncope, orthostatic hypotension

13. CASE: Either 6 or 9 yo male presents with extreme carious teeth. Diet includes fast food and soda. Pt presents wearing long
sleeves on a hot summer day. When he rolls up the sleeves, you observe contusions on his arms. Pt flinches throughout the pt
interview. Highly worn enamel on all surfaces.  Mental retardation, with facial deformity (Aug 2016)
a. Facial deformity caused by? Down Syndrome
 b. White patches in mouth that could be scraped off? Candida
c. Why all anterior, F/L teeth had no enamel Diet
d. He wore big sweater on really hot day, raised arms had lesions, flinched a lot—why? Possible child abuse
e. What teeth do you expect to see? Ex: 6 primary teeth + 4 perm 1st molars + 6 ant teeth

14. (Case Study) 6 weeks pregnant lady (Aug 2016).

a. How long do you wait to treat her? 6 weeks (completion of organogenesis)
b. Tell her to take care of oral health why? Gingival bleeding

15. (Case Study) 6 weeks pregnant women taking tetracycline for rosacea. (Aug 2016)
a. What does not occur during 6 weeks of fetus? Palatal shelves fusion (7 weeks)
i. Bone formation
ii. fusion of medial and maxillary processes (tricky to avoid)
iii. neural tube formation
b. Seen in fetus but not mother? Ductus venosous
c. What is the problem with using tetracycline for the fetus? Discoloration (dentin)
d. At what time is best for elective dental tx as it would affect organogenesis of the fetus? After 10 weeks (or is it 24?)

16. (Case Study): You do an ejection into the MX molar and the patient comes in the next day with a hematoma
a. What could you have hit? Pterygoid Plexus (needle violated)

17. (Case Study) Patient with Grave’s disease (Aug 2016)

a. Grave’s disease is a form of (hint: ism)? Hyperthyroidism
b. What happens to thymus? Hypertrophy
c. Mechanism against Graves’ Disease: Binding of Ig antibodies to TSH receptor in the thyroid
i. (mimics TSH) stimulate production of thryroxin
d. Graves’s disease causes/lab test show? High T3/T4, low TSH (on a graph)
e. What are the symptoms of Graves’ disease? Exophthalmos (bulging eyes) (Goiter wasn’t asked)
f. Postoperative, she has tetany and low Ca2+, what caused it? Excision
g. Random note? Is the problem in the anterior pituitary or is the problem on the thyroid

18. (Case Study): Dude with Myasthena Gravis (Aug 2016)

a. Select 3 muscles that would be affected?
b. What’s the effect on the neurotransmitter?
c. What is the tx?
d. Side effect of medication?
e. Tumor associated with myasthenia gravis?
Muscles for eye and eyelid movement, facial expression, swallowing
Decreased Acetylcholine Receptors (Targeted by auto-antibodies)
Acetylcholinesterase inhibitor (Incr neurotransmitter in cleft)
Increased heart rate
Thymoma

19. (Case Study) Patient has Myasthenia Gravis

a. Causes Decreased acetylcholine receptors
b. Mechanism: Antibodies against post-synaptic NMJ Ach receptor
c. Medication MoA: Acetylcholinesterase inhibitor
d. Patient refuse treatment & can only afford to do a proph? Present all options & refer him to specialty as needed.

20. Case/Testlet: Guy that needs root planning (Aug 2016)

a. Ethics question, his insurance only covers prophy, he only wants that? Explain all of his options
i. one of the other choices was dismiss him as a patient, another one was do a prophy anyway, due to self govern?)
b. What areas would give you trouble during root planning? Mesial of 5 + 12, Distals of 1st molars

21. Case/Testlet: - Girl, #22 needed a root canal (Aug 2016)

a. She’s giving speech, doesn’t want tongue to be numb. How do you numb tooth but not tongue? mental, incisive
b. What do you have to worry about for the morphology of the restored crown of this tooth? ______

22. (Case Study): Growth on palate next to #15 (Aug 2016)

a. What type of tissue would you see next to it? Parakeratinized or orthokeratinized
b. What needs to be ordered before doing a biopsy? Complete blood count
c. What nerve would need to numbed? Greater palatine nerve
23. (Case Study) Patient has Alzheimer’s with cervical caries (Aug 2016)
a. All are true except? Most people experience dementia before age 50
b. You fracture the adjacent tooth during a prep, you should? Tell the wife who is the legal guardian
c. What would you LEAST recommend to an Alzheimer’s patient? Bleaching Trays
i. NOT Motor toothbrush , Fluoride treatment
d. T/F: Depression is risk factor and Alzheimer is a form of dementia. TRUE & TRUE
e. Alzheimer’s = leading form of dementia in US. Mainly occurs in people <50 years of age. TRUE & FALSE

24. (Testlet): 24py smoker with infection/inflammation of submandibular duct/gland, hurts when he eats (during salivation).
Palpated pus came out (Aug 2016)
a. What kind of infection did patient have? Bacterial Infection (because of pus)
b. What was the most likely cause? Smoking (unless radiopacity?)
c. What kind of cells when you biopsy the duct? Neutrophils

25. (Case Study) Woman comes into your office complaining that every time she eats, she gets a swelling that is painful and large.
X-Ray shows radioopacity, 1 cm x 1 cm. Inflammation of the submandibular duct/gland, tenderness.
a. What is the reason for swelling? Bacterial infection
b. What's the diagnosis? Sialolith (the radiopacity)
i. = Calcified mass in salivary gland, usually submandibular.
ii. Symptoms: pain/swelling when salivary gland is stimulated
c. What kind of cells you find when biopsy the salivary duct? Neutrophils

26. (Case Study): Erythematous lupus. Pt had ulcer all over her body. Pt had wear on the facial* surfaces of maxillary incisors
and linguals of mandibular incisors (Aug 2016).
a. She began developing ulcers in her mouth, what is the cause? Lupus (or meds)
b. What is the cause of the location of wear on her incisors? Class III Occlusion (tricky)

27. (Case Study) Dental assistant w hand’s shakes due to Parkinson’s (Aug 2016)
a. Which part of brain affected? Substantia nigra
b. Neurotransmitter affected how? Lack of dopamine
c. This dental assistant is still performing work so what moral value? Non-Maleficence
d. Muscles are involved in swallowing for pt’s dysphagia? Picked 3 of 5
i. Palatoglossus, palatopharyngeus, stylopharyngeus, levator veli palatine, suprahyoid muscles
e. If ignored, what is going to happen? Foot Drop (part of shuffling gait)

28. (Case Study) Patient with Parkinson’s

a. Which part of brain affected? Substantia nigra
b. Neurotransmitter affected how? Lack of dopamine
c. Symptom? Lewy bodies
d. What do you NOT have to worry about when treating? __________
i. Drooling yes
ii. Lack of blinking yes
iii. Twitches yes

29. (Case Study) Patient has gestational diabetes & is 10 weeks pregnant. Multiple sexual partners in past (Aug 2016).
a. What has not formed? TMJ formation (12 weeks)
i. Palate closes @ 10 weeks, tooth bud forms @ 8 weeks
b. What happens to her hormones? ↑ in HcG, ↓ in FSH & LH
i. ii. All increase , iii. All decrease
c. What happens to her hormones? ↑ in HcG, ↑ Progesterone, ↓ in LH
d. Glucose level was 210, what is this caused by? Gestational diabetes
e. Had a lot of sex and can get cervical cancer, cause? Papilloma virus
f. Where are melanocytes? Basale

30. (Case Study) Obese man with Type II diabetes mellitus & drinks alcohol comes in for extraction of #14 (Aug 2016)
a. Bad breath (halitosis) cause? Oral hygiene (Type ONE has ketoacidosis, tricky)
b. What is it most related to? Overweight/diet
c. Related to Diabetes Type II except? Autoimmune (Type ONE is destruction of beta cells)
d. Related to Diabetes Type II except? Destruction of Beta cells
 e. Informed Consent doesn’t cover? Damage to #3 (while working on 14)
f. Informed Consent FOR? Maxillary Sinus
g. TE w pseudostratified ciliated epithelium at root tip. Where from? Maxillary sinus

31. (Case Study): Diabetic / Diabetes patient, hypertensive

a. Pt with HBA1C of 11%; this is a test for what condition? Type II diabetes
b. Are likely to be associated with this person’s existing condition EXCEPT? Angioedema
i. (choices: angioedema, MI, angina, and one other)

32. (Testlet) - 75 yr old lady has type 1 diabetes mellitus & takes insulin. She also has medications for high BP and
hypercholesterolemia. She comes in with her breath smelling “fruity”
a. What is the cause of fruity breath? Hyperglycemia (ketoacidosis = type 1)

33. (Case Study) Some girl got HPV vaccine

a. Linked to? Cervical cancer
b. Type of epithelium in vagina that would be susceptible to metastasize? Stratified nonkeratinized
c. Epithelium affected in HPV Simple Cuboidal (in colorectoid)
i. Squamous stratified in cervix

34. (Case Study) Woman walks into dental office, complaining of TMJ pain. She is taking NSAIDs for TMJ and taking
Prednisone. She has Polymyalgia rheumatica + Osteoarthritis.
a. She has crepitus in the TMJ, what is the cause? Osteoarthritis of the condyle
b. Symptom of osteoarthritis EXCEPT? Fever
c. Where would she have pain? Pectoral girdle (shoulder/neck) & hips
d. What type of disease is polymyalgia rheumatica? Autoimmune (Causes Inflammation)
e. Patient w polymyalgia rheumatic, what problem does she NOT have? Splenomegaly
f. Pt taking NSAIDS and anemic, why hemorrhage /bleed during tx? NSAIDs, platelets don’t stick
i. Osteo = wear and tear, rheumatic = autoimmune
g. Innervation to TMJ for motor? Masseteric Nerve
h. She had fibroid tumors in uterus removed? Benign and smooth muscle

35. (Case Study): Cadaver, bullets present at two spots on the skull, one on the posterior skull and one right above the eyebrow.
a. Which two bones are LEAST likely to be affected? Maxillary, temporal)
i. (Other answers had frontal or occipital in them, the MOST likely affected)
b. Which of the following bones does not contact the sphenoid? Mandible
i. (choices: maxilla, palatine, temporal, mandible)
c. Which cranial nerve is affected when you crush the jugular foramen? IX, X, and XI would be affected

36. (Case Study):Swelling patient Pt has an infection of #29

a. Pt has a swelling at the mesial border of the mandible; what are the borders of this space Anterior Digastric
i. Aka asking for submandibular triangle
ii. (choices: stylohyoid, mandible, SCM, anterior digastric)
b. Where could the infection from #29 spread? Sublingual space
c. How is the mandible formed? Intramembranous

37. (Case Study): Progressive difficulty opening mouth

a. Which condition is primarily associated with his chief complaint? Scleroderma
i. = hardening of skin = Trismus
b. Which of the following is related to bruxism? Wear Facets
i. (choices: mobility, mandibular tori, wear facets, other choice related to wear)

38. (Case Study): Pt with a radiolucency between 8 and 9

a. What is it most likely? Incisive foramen
i. Mesiodens would be an opacity

39. (Case Study): Pt w Xerostomia / Dry Mouth. Taking TCA’s

a. What is the most likely cause of this patients dry mouth? Medication

40. (Case Study): P has #3 messed up, buccal nodule or something like that:
a. What nerve sense pain in that tooth? MSA
i. Auriculotemporal, Greater palatine
 b. What neurotransmitter is in nerves that transfer pain? Substance P (Sub P = nociception)
i. Ach +iii. Norepinephrine, GABA
c. Buccal of #3 across from what skin? Stratified Squamous Non-Keratinized

41. (Case Study): Pt had tooth #3 infected

a. Where would infection from #3 go? Infratemporal
b. Which nerves supply #3? PSA and MSA

42. (Case Study) Patient with RCT #3 & the radiolucency did not resolve. The histological section showed non-keratinized
epithelium
a. Where would the infection from #3 go? Infratemporal
b. What is the radiolucency? Cyst (Option: abscess, granuloma)
i. Cyst is a fluid-filled sac = don’t resolved after RCT (abscesses tend to)
1. non-keratinized stratified squamous epithelium w/ PMNs
ii. Both abscess & cyst are non-keratinized epithelium
c. During extraction you break the adjacent marginal ridge of amalgam? Stop everything inform patient

43. (Case Study) Patient bleeding a lot

a. Why? Because of taking Antiplatelet cortisone.

44. (Case Study): Hepatitis C pt

a. Type of Virus? Flavivirus
b. Needle biopsy liver of HepC pt, what do you see more of? Collagen (in fibrosis of liver)
i. Hepatocytes
ii. Neutrophills
c. Hepatocellular carcinoma, chronic hepatitis

45. (Case Study): Hysterectomy due to tumor

a. What kind of tumor? Benign and smooth muscle
i. Hysterectomy = removal of uterus

46. (Case Study): Laceration of mucosa 1 cm lingual to the 2nd MX molar?

a. Which soft palate muscle not affected? Musculus Uvulae
i. a. Tensor veli palatini b. Palato-glossal c. Palato pharyngeal d. Levator veli palatani

47. (Case Study): Patient that had a stroke on the motor lesion on the left side below eye muscles (indicating facial nerve)
a. Which muscle not affected? Masseter (muscle of mastication)
i. Buccinator, Orbicularis Oris

48. (Case Study): Patient with pain for 2 years

a. What fiber? C Fiber (Chronic pain)
i. A alpha (Proprioception, aka stretch)
ii. A beta (Touch)
iii. A delta (Pain + Temperature)

49. (Case Study): Patient is given topical

a. Relieve what fibers? A Delta (Pain + Temp)

50. (Testlet): Left maxillary canine experiences sharp shooting pain.

a. What kind of fibers are responsible for the pain? A Delta
b. No sign of decay. What is the most likely cause of the pain? Maxillary Sinus Infection
i. Or Broken root ?

51. (Case Study): Patient w stroke

a. In another stroke, when pt has a motor lesion on the left…? Partial numbness on right* arm
i. (motor is opposite, sensory same side)

52. (Case Study): Patient had multiple ulcers in mouth

 a. What did she have? Herpetic stomatitis (often bc of herpes type 1 virus)
i. Not erythema multiforme?
b. Biopsy superficial ulcer cell what do you see? Neutrophils (We’d see “high PMN”s?)

53. (Case Study) Patient with pain in the shoulder that extends down to the arms & hands.
a. What nerve is damaged? T1-T2
b. What innervates the middle finger? C7
c. What innervates the Ring Finger? C8
d. What nerve is involved when she has pain turning her head? Accessory Nerve

54. (Case Study): clicking without symptoms, under stress

a. Where is the problem? Lateral pterygoid (spasm)
i. Not: Post compartment of disc, lat ligament, abnormally shaped disc

55. (Case Study): Exam of cadaver: Female, Left backstab at L1-L2, left adjacent to the vertebra 12 cm depth, has Mallory-Weiss
tear on her esophagus, and multiple mass on her utrerus
a. What is the cause of the Mallory-Weiss tear? Alcoholism (bulimia also would but not answer)
i. (Mallory-Weiss = bleeding/tear at esophagus/stomach jxn)
b. What is the multiple mass on her uterus? Leiomyoma(uterine fibroid/benign Leio = smooth)
c. Which organ is most likely damaged from backstab? Kidney (Pancreas = T6-T9, Kidney = T10-L1)

56. (Case Study) Exam of cadaver. Trauma victim with broken bone & evidence of “woven bone repair” (?)
a. How long as it been since the trauma (woven bone…)? Woven bone = 2-3 weeks
i. Hematoma (first 5 days) -> Soft callus (day 3 – 2 weeks) -> Woven bone (2-3 weeks)
b. What facial bone did she break if it was adjacent to the canthus? Zygomatic bone
i. Canthus = corners of the eye. Medial and Lateral.
ii. “Adjacent” was retarded terminology.wtf
c. Penetration at lower left (stab), which organ was most likely hurt? Kidney

57. (Case Study) Female with hypothyroidism that suffers from dry mouth & is taking thyroid medication.
a. What happens if medication overdose (treats thyroid…)? Tachycardia (tachy = rapid)
b. Cause of her dry mouth (linked to hypothyroidism)? Sjogren's Syndrome (Not medications)
c. Select 3 possible causes of dry mouth? Sjog, medications,

58. (Case Study) Man has fair skin + mole rapidly growing lateral to nose (aka ala of nose). Lesion is growing fast.
a. What is it? Keratoacanthoma
i. Kerato = Keratin (skin)
ii. Acanthoma = tumor of epidermal squamous cells (acanth = “thorn” Lol)

59. (Case Study) Patient has asthma & is on Albuterol (beta-2 agonist) and high blood pressure meds.
a. What is a dental complication? Orthostatic Hypotension
b. Target of Asthma drugs? Beta-2 receptors (causes bronchial relaxation)
i. Asthma caused by bronchospasm
ii. Beta-2 agonists (Such as albuterol) causes bronchiolar relaxation

60. (Case Study) Gunshot through lung on right side, exited L2

a. Which organ most likely damaged? Kidney
b. Which lobe was damaged? Right Inferior Lobe
c. What would have caused a hemothorax in this case (gave list of arteries, veins)? _______

61. (Case Study) Dentist is asked to help w/ an autopsy. There were 2 bullet wounds, evidence of TB. One bullet hit above the ear
& the other was a bullet through the ribs that injured the lower lobe of the lung.
a. The bullet that hit above the ear came out of where? Temporal bone
b. Bullet entering between 7th & 8th intercostal ribs & exits to the right of T7. What lobe? Right Inferior lobe
c. T/F  Hemothorax (blood in pleural cavity)
d. How could he have gotten TB? Previous infection w actual vaccine itself
62. (Testlet): 50yr old man comes in for ortho treatment. He has an FPD on #12-14. Need to remove #12 anterior abutment
a. NOT likely to be a complication in the extraction of this tooth? 1 root (1st pre = 2 roots)
b. Complication of Coxsackievirus Virus that can be manifested in oropharynx? Herpangina
i. Also associated with Hand-Foot-Mouth disease

63. (Case Study) Diabetic firefighter came into office, has a fractured upper left FPD, wants implant not replacement FPD.
a. What is the problem with implant option? Too close to maxillary sinus
b. Too close to the sinus, what ethics are involved? Non-maleficence & autonomy
c. Implant: which cells = actively dividing? Osteoprogenitor
d. When placing implant, what epithelium is encountered? Pseudostratified columnar ciliated epithelial cells
i. (that line the maxillary sinus, similar to respiratory epi)

64. (Case Study) HIV patient had an ulcer near tooth #15 that is very sore.
a. Biopsy was done on ulcer & it was undifferentiated something, what is it most likely? Kaposi Sarcoma (?)
b. Which injection would u give? PSA /MSA?
c. How to treat patient ideally? Limit/control infection
i. refer to specialist, Do nothing, Dismiss patient bc of HIV
d. Opportunistic infections associated & not associated with AIDS
i. Pneumocystic carinii pneumonia, Cryptosporidium enterocolitis, candidiasis, oral hairy leukoplakia, &
mycobacterial infections (M. Tuberculosis).

65. (Case Study) Patient has RPD

a. What would diagnosis be for slight red inflammation below RPD? Denture stomatitis
b. What is this mainly caused by? Ill-fitting RPD device
c. Type of epithelium of hard palate under dentures? Parakeratinized stratified squamous
i. Studies show dentures = a shift from ortho to para.
d. Type of epithelium found on buccal mucosa? Nonkeratinized squamous

66. (Case Study) 65 yr old patient is hypertensive, has high cholesterol, and is on diuretics. BP of 160/95. 40 pk years smoking.
His dad died of a heart attack at 55 years old. He needs 3 extractions of the maxillary.
a. Which of the following is the most immediate necessary referral? Hypertension
i. Extraction = risk of bleeding.

67. (Testlet): - lady had rheumatoid arthritis, osteoarthritis on hip and knees and couldn’t open her mouth affected her talking
and eating. She took lots of meds for arthritis and antidepressant. 20 pack- year smoker.
a. What is cause of her xerostomia? Medication
b. What is dysguesia (foul taste) associated with? Xerostomia from anti-depressant meds
c. All of these are correct about osteoarthritis, EXCEPT? Fever
d. What is cause of her chief complaint? Her TMJ prob from Osteoarthritis
e. Pain on the posterior part of 2nd molar, what does this mean? Trismus
f. Pt complains of waking up stiff every morning, what is cause of this? Rheumatoid arthritis

68. (Case Study) Ethics: Man comes in with herpes virus in corner of eyes, lips, intra-orally.
a. Which two principles would demonstrate non-ethical complication with referring the patient? Justice & Beneficence
b. What principle is violated if you refer a patient because he has hepatitis? Justice
c. Patient wants to put in composite even though not needed, what do you do? Inform,Put composite (autonomy)
d. What ganglion is this virus located? V2

69. (Case Study) Smoker with some kind of ventricular septum defect. CC: ulcer on his palate.
a. You want to biopsy lesion, what nerve do you anesthesize? Greater palatine
b. What do you need to do before doing treatment? Antibiotic prophylaxis

70. (Case Study): Woman not wearing dentures and has dry mouth:
a. Most common change in interarch relationship? Class 1 and 2
 b. Why dry mouth? Medications

71. (Testlet): which is not a symptom of emphysema? Recall, emphysema type of COPD w damaged alveoli
72. (Testlet): sign that SLE is getting worse? I put rash in middle third of face butterfly rash
73. (Testlet): what does an elevated ESR show? Increased inflammation

74. (Case Study): Patient with spinal surgery on T4 sits in your chair
a. What are you most concerned about? Urine
75. (Case Study) Curvature of spine: Scoliosis