Jerusalem

Day 2

March 31st 2022:

Day 2

Case #1:

A 3 YRs old kid with no teeth and per orbital wrinkles

Diagnosis: Ectodermal Dysplasia

Refer to whom: Multi-disciplinary team

One of the major features: Heat intolerance

Case #2:

A 10 YRs old kid with no teeth on one side, OPG shows ghost teeth

Diagnosis: Regional odontodysplasia

Kind of disease: Developmental

Treatment: Removable partial denture

Case #3:

A 20 YRs old Female with a white hairy lesion on the dorsum of the tongue, she’s concerned about the
appearance:

Treatment: Essential mouth rinse

Type of biopsy: Oral brush biopsy

Case #4:

A 45 YRs old Female patient, with desquamative gingivitis:

Diagnosis: Pemphigus vulgaris

Type of biopsy: Perilesional biopsy

Treatment: cortisone

What not to use: No water jet

Case #5:

A 10 YRs old kid, toke anesthesia had rashes and hives:

Diagnosis: Type I hypersensitivity reaction

Management: Epi pin

Had another reaction after 4 weeks:

Diagnosis: Type IV hypersensitivity reaction

Management: Cortison

Case #6:

Extracted upper 3rd molar, dark lesion on gingiva:

Diagnosis: Amalgum tattoo

Case #7:

Lesion between soft and hard palate: all could be a differential diagnosis except:

Nasopalatine cyst

Case #8:

Lesion on the dorsum of the tongue: granular cell tumor

Case #9:

A 45 YRs old male, alcoholic has liver cirrhosis, wears a partial denture, man complains about bad
breath, erythema bellow denture base:

Diagnosis: Candida

Treatment: Antifungal cream

Case #10:

A 50 YRs old female, with white stria on her cheek:

Diagnosis: Lichen Planus

Treatment: Clobestol (corticosteroid)

Case #11:

A 20 YRs old female, with a lesion on the lower lip that needs a biopsy, what are the arteries that supply
the lower lip:

Inferior labial + Mental

Case #12:

A 35 YRs old male with pain on upper left central incisor, pain is on biting, radiograph shows #9 with root
canal treatment, abscess above the tooth was traced by using Gutta percha:

Diagnosis: acute exacerbation of chronic periapiacl abscess

Case #13:

A 25 YRs old male with pain on upper right central incisor, pain that awakens the patient at night, on
cold test patient had lingering pain for more than 12 seconds, tooth is not TTP:

Diagnosis: Irreversible pulpitis

Case #14:

A 16 YRs old female with pain on upper right first premolar, pain that awakens the patient at night, on
cold test patient had lingering pain for more than 12 seconds, tooth is TTP:

Diagnosis: Irreversible pulpitis with symptomatic apical periodontitis

Case #15:

A 12 YRs old kid, comes for checkup his OPG shows late mixed dentation, upper right second molar has
erupted but the left side has not:

Diagnosis: Normal tooth sac, and tooth development

Case #16:

A film that has dark lines scattered on it:

Artifact in the film, from bending

Case #17:

A patient was asked if it’s ok to examine his teeth, what the type of consent is:

Informed consent

What type of ethical code?

Autonomy

Case #18:

A patient wants to extract all his teeth, dentist refused to provide treatment:

Breach of Autonomy

Case #19:

Principle of ethics for different treatment options:

Autonomy

Case #20:

A general dentist said that he is a specialist what code of ethics has he breached?

Veracity

Case #21:

A 5 YRs old kid came to your clinic needs treatment, from whom should you take the consent?

Mother or Kid?

Mother 
Case #22:

A patient with Hep B and C and liver cirrhosis, what pain killer not to give:

Hydrocodone

Case #23:

Mode of action of Nitroglycerin?

Nitric oxide that is released stimulates guanylyl cyclase in smooth muscle, producing an increase in
cGMP which causes vasodilation.

Case #24:

Mode of action of Ibuprofen?

Non selective reversible COX 1 and COX 2 inhibitor.

Case #25:

Mode of action of Carbamazepine?

Enhancement of sodium channel inactivation by reducing high-frequency repetitive firing of action
potentials.

Case #26:

Mode of action of Zometa?

zoledronic acid inhibits osteoclastic activity and induces osteoclast apoptosis.

Case #27:

Mode of action of diuretics?

Diuretics act primarily by blocking reabsorption of sodium.

Case #28:

Mode of action of humira?

HUMIRA specifically binds to TNF alpha, an inflammation-causing protein, and blocks its interaction with
other cells.
Case #29:

Mode of action of prednisone?

Prednisone decreases inflammation via suppression of the migration of polymorphonuclear leukocytes

and reversing increased capillary permeability.

Case #30:

A 4 YRs boy with Muscular dystrophy, needs pulp treatment of lower 2nd molar.

What kind of anesthesia to use?

pt with muscular dystrophy LA are not
Intraligamentary
contraincared anwers is AIN
If mother is a carrier and father has no disease what is the percentage that the kid will have the disease?

25%

Case #31:

A patient with thrombocytopenia, what blood test has to be done?

Thrombocytopenia PPT

Case #32:

A 35 YRs old patient with RA, she takes Methotrexate AND humira medication?

What blood test has to be done?

CBC

Moa of humira?

HUMIRA specifically binds to TNF alpha, an inflammation-causing protein, and blocks its interaction with
other cells.

What can RA lead to? vasculitis, interstisial lung diseases,

cardiovascular diseases, anemia, osteoporosis,
Myocardial infarction
ocular involved (scleritis,
keratoconjutivitis, and uveitis.
Case #33:

A 20 lady came. Her C/C was that when she opens her jaw. Her jaw deviates towards left. She denies
pain when that happens. With assisted mouth opening she opens with pain up to 32mms.

What is the cause of the chief complaint?

Muscle spasm

Which muscle is responsible?

Left lateral pterygiod

What is the best medication to give?

Voltarin

How to make diagnosis?

Trigger point injection

Case #34:

A 12 YRs old kid with complicated crown fracture, Eliss class 3, negative reaction to pulp testing?

Treatment: Root canal treatment

Case #35:

An 8 YRs old patient with a non-complicated crown fracture, Eliss class 1, and positive reaction to pulp
testing, only a small piece of enamel is chipped of?

Treatment: Enameloplasty or resin

Case #36:

A patient with exocytosis, if a biopsy was take what will be seen under microscope?

Normal mucosa and normal bone

Case #37:

Retraction cord used for a patient, what will it do to the gingiva?

Horizontal dilatation of gingiva

Not vertical
Case #38:

An epileptic female patient with a porcelain fused to metal crown, metal is showing on the fractured
part of the crown (fractured crown). CC was dissatisfaction with the discoloration.

What is the treatment?

Change the crown

What material to use?

Zirconia (strength)

Type of cement?

RMGI or GI
What should be used for maintenance of the crown?

Soft night guard

Case #39:

Upon crown cementation, the crown didn’t go done, and had open margins, what is the cause?

Tight contacts

Case #40:

How to check interferences in inner surface of a restoration on upper central incisor?

Bite checker. Articulating paper wasn’t there.

Case #41:

What happens in periodontitis?

Loss of attachment
Case #42:

A 32 YRs old female patient, with a crown on upper central that keeps on falling, patient has deep bite.

What is the cause of the problem?

Problematic occlusion

What to do next?

Analysis of occlusion

What is not needed?

A free gingival graft

Case #43:

A patient that takes zometa had an extraction done by another dentist, has exposed bone with darning
pus on the extraction site:

Diagnosis: MRONJ

Management: Conservative (No surgical exploration)

Refer to Maxillofacial surgeon

Case #44:

A diabetic patient with HBA1C 10:

Should you prescribe antibiotics: Yes

HBA1C measures: HbA1c is the average blood glucose (sugar) levels for the last three months.

(HbA1c) test measures the amount of blood sugar (glucose) attached to hemoglobin.

Case #45:

A patient came with a broken bridge and tooth tilted distally, with a rest and non-rigid attachment
fractured distally:

Type of connector: non rigid attachment

Treatment: change the rest and put it mesial

Cause: tooth tilted distally because of the wrong position of the distal non rigid attachment.
What is the main purpose of the non-rigid attachment?

1. Support
2. Retention
3. Stability

What is the main advantage of the non-rigid attachment?

1 Support
2 Retention
3 Stability

Case #46:

A female patient came with a bridge from upper right canine to upper left lateral incisor, patient is
complaining of an open margin with metal showing.

What should be done for diagnosis?

Occlusal analysis

What is the definitive long term treatment?

New bridge design

Case #47:

Patient with HIV what test has to be done?

CD4 test

Case #48:

A 65 YRs old female with a history of angina, came to the clinic with her sub lingual nitrate medication
inside her purse, during treatment the patient had mild chest pain.

How to proceed?

Let the patient use here own medication

Case #49:

A 70 YRs old male patient came to the clinic and had severe chest pain.

How to proceed?

Call 911

Case #50:

MI episode less than 3 months, what ASA classification?

IV

Case #51:

A female patient came with a crown on the lower right first molar, metal is showing.

Treatment?

Emax crown

Type of finish line?

Shoulder shoulder with bevel or chamber

Type of cement used?

Dual cure resin cement

Case #52:

Patient with mitral valve prolapse, would you give antibiotics?

NO

Case #53:

Patient with prosthetic heart valve, would you give antibiotics?

YES
Case #54:

What is the most important thing in post and core?

Apical seal

How many mms of dentine should be kept on the peripheries alongside the post?

2mm diameter of dentine 1.5mm to 2mm

How many mms of GP should be kept apically?

4-5 mms

What makes the tooth resistant to fracture?

Ferrule effect

Case #55:

Minimal amount of bone for implant placement?

(7mm) other numbers where unreasonable, and yes the question was exactly like that.

How many mms should be the implant away from the inferior alveolar nerve?

2mms

Case #56:

A radiograph of a failed root canal treatment, what is the cause?

Short G.P

Case #57:

A patient with peptic ulcer, what is the microorganism that is responsible for peptic ulcer?

H. pylori

Case #58:

Complication of clindamycin?

Pseudomembranous colitis
Case #59:

Patient with moderate pain after extraction of 2 3rd molars what pain killer to give?

400mg Ibuprofen+325mg Acetaminophen

Case #60:

Patient with a level of pain of 3 out of 10, what pain killer to give?

Acetaminophen

Case #61:

Patient with swelling bellow lower 1st mandibular molar,

Which space is involved?

Submandibular space

What is the emergency that could happen?

Ludwig’s angina

Case #62:

Nerve supply of upper first permanent premolar?

Middle superior alveolar

Case #63:

A female patient with a lesion on the lower lip, needs a biopsy.

What is the blood supply for the lower lip?

Inferior labial artery+ mental artery

Case #64:

A 15 YRs old female patient that was so lethargic, her blood pressure was 80/60, has bronze
pigmentation.

Diagnosis: Addison’s disease

What kind of medication should be given in an emergency situation for this patient?

Corticosteroids
Case #65:

Drug that causes gingival enlargement?

Cyclosporine

Case #66:

Patient with COPD, metaplasia happens to respiratory cells, into what kind of cell do lung cells change
to?

Stratified squamous non keratinized epithelium.

Case #67:

A patient with a history of thyroid surgery, has hoarseness of voice. Which nerve is responsible?

Recurrent laryngeal nerve.

Case #68:

First sign of anaphylaxis?

Skin rash

Case #69:

A patient with hyperglycemia developed hypoglycemia during treatment

What to give? Glucose tabs

Case #70:

How dose type 2 DM develop?

Resistance of cells to insulin

Case #71:

Lesion on the tongue, all could be a diagnosis?

Nicotinic stomatitis
Case #72:

Primary bacteria in dental caries?

S.mutans

Case #73:

Side effect of Losartan?

Altered taste

Case #74:

Side effect of hydrochlorothiazide?

Xerostomia

Case #75:

Patient with pain in submandibular area on meal times?

Diagnosis: sialolithiases

What kind of film should be used?

Occlusal

Case #76:

Patient with scurvy for 20 years, has periodontitis and bleeding in gingiva?

Cause? Nutritional deficiencies

Case #77:

A patient with an upper canine that was RCT treated and needs re treatment, tooth is fractured
subgingivaly.

What is the next step?

Crown lengthening
Case #78:

MOA of statins?

Inhibition of HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase.

Case #79:

A deaf and mentally retarded patient, came for treatment, his wife is his legal guardian?

Who should sing the consent? The patient’s wife.

Case #80:

Amphetamine MOA?

Amphetamine is a central nervous (CNS) system stimulant that functions by increasing the amounts of
dopamine, norepinephrine, and serotonin (to a lesser extent) in the synaptic cleft through a variety of
mechanisms.

Case #81:

A patient has HIV, Hepatitis and is alcoholic, what medication could cause bleeding?

Citalopram it is antipressant of the

selective serotonin reuptake
inhibitor
Case #82:

When CO2 decreases in blood what happens for respiration?

Low levels of carbon dioxide in the blood cause low levels of hydrogen ions in the brain, leading to a
decrease in the rate and depth of pulmonary ventilation, producing shallow, slow breathing.

Case #83:

A 50 YRs old male patient with a history of prostate cancer, has taken radiation in the site on cancer
patient has xerostomia.

What is the least cause of xerostomia?

Radiation (because the radiation site is away from the oral cavity)

if in the option are chemotherapy and

radioterapic in this case the correct answer
is radioterapic, since chemotherapy cause the
xerostomia
Case #84:

What is the structure in the oral cavity that does not have salivary glands?

Attached gingiva

Case #85:

What medications cause calcification in pulp chamber?

Statins they can cause chronic periodontitis, dental pulp cells, alveolar bone lost,
salivary gland function. osteointegration of implants.

Case #86:
An 8 YRs old male patient came with his parents with an avulsed upper right central incisor, tooth was
brought to the clinic in a HBSS media, tooth has open apex.

What is the other media that can you put the tooth in?

Milk

Splint time?

One week

When to do RCT?

After 2 weeks

Case #87:

A radiograph with silver color on the ridge.

What is the diagnosis?

Foreign body (amalgam tattoo)

Case #88:

A patient came to the clinic with severe pain in upper first molar with a blood pressure 185/115, with no
symptoms related to high B.P.

Management: conservative treatment then refer to hospital, if patient had symptoms from high B.P
refer immediately to ER.
Case #89:

Best predictor for an endodonticaly treated tooth? Q was written in this exact wording.

Full crown coverage.

Case #99:

Patient came with periocoronites and sever pain.

One of the signs of infection?

Fever 101 f

Management?

Extraction with antibiotics

Spread of infection goes to?

Submandibular space

Case #100:

An OPG with a lower left 3rd molar erupting horizontally and pushing lower left second molar.

Lower left second molar has resorption distally, what is the kind of resorption?

External root resoprption.

Case #101:

Per apical abscess on lower right mandibular first molar.

Treatment? RCT

Source of infection? Necrotic pulp

Access cavity design? Rhomboidal

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EA March 31st 2022