| Post Name | Assistant Professor in Oral Medicine and Radiology- Medical Education |
|---|---|
| Question Paper Code | 049/2024/OL |
| Category Code | 291/2023 |
| Date of Test | 3 May 2024 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
A 51-year-old man presents with a 9-month history of ulcers in mouth causing discomfort while eating. On examination, there are large blisters on labial mucosa that rapidly bursts. Also, there areeroded skin lesions on his back. No ocular or genital symptoms. Nikolsky sign is positive. The investigation to make definitive diagnosis include
Answer
A. Direct immunofluorescence of perilesional tissue and indirect immunofluorescene of blood stream
2
A 50 year old male patient reported to the dental OPD with complaint of recurrent erosions in oral cavity since last 6 months. He also complained of bloodstained nasal discharge, painful lesions in both the eyes with diminished vision for the past 4 months. Oral examination revealed multiple, erythematous, erosive lesions over gingiva, buccal mucosae, soft palate and tongue. Immunofluorescence staining showed autoimmunity against Laminin 332. The condition the patient is likely suffering from
Answer
C. Cicatricial pemphigoid
3
A 60-year-old male reported with a chief complaint of bleeding gums. He had a history of paroxysmal supraventricular tachycardia, pulmonary embolism, type-2 diabetes mellitus, hypertension, hyperlipidemia and was on metformin, warfarin, atorvastatin and aspirin. Examination revealed BP-140/90mmHg and diffuse gingival bleeding. Which of the following tests would provide a definitive diagnosis ?
Answer
Question Cancelled
4
Diagnosis of Lupus erythematosus can be done by lupus band test. It is ______ to reveal ______
Answer
C. Direct immunochemistry; IgM, IgG, IgA and C3
5
A 57-year-old male chronic tobacco chewer presented with an ulcero- proliferative growth with indurated margins on left buccal mucosa. Which of the following genetic markers play a crucial role in the carcinogenesis ?
Answer
B. Tumor suppressor genes such as p-16 and p53
6
A 12 year old female reported with a swelling in left cheek region, Intraorally, large soft tissue mass was evident in left buccal mucosa. Incisional biopsy revealed features suggestive of rhabdomyosarcoma with clusters of small round cells. Immunohistochemistry of which below marker is specific for this condition ?
Answer
B. Desmin
7
A 30 year old female patient reported with chief complaint of altered taste in mouth. She also stated reduction in the intensity of taste perception. Which is one of the recent investigative method to observe the nature of tongue papillae ?
Answer
D. Videomicroscopy
8
A 4 year old male child was brought to dental OPD in view of red and white patches in the mouth. General examination revealed dysplastic nails, reticular pattern of skin hyperpigmentation evident on the face and neck. Intraorally, there were areas of erosive lesions interspersed within leukoplakic lesions in buccal mucosa. Genetic testing revealed mutation in DKC1 gene. Which is the first hematological sign seen in this patient ?
Answer
C. Thrombocytopenia
9
A 45 year old male patient reports with pain and crepitus in left TMJ with restricted mouth opening and tenderness on palpation. There is shift of mandible towards left side. The CBCT shows new bone suggestive of osteophytes on the superior surface of condyle. Which of the following investigation is specific for this patient ?
Answer
C. ACPA (Antibodies to Citrullinated Proteins)
10
A 24-year-old female presents with headache, anorexia, chills, with discomfort on both sides of her jaw. Physical examination reveals bilaterally enlarged parotid glands, elevating the ear lobule, that are doughy, elastic, and slightly tender. Papilla of the parotid duct on the buccal mucosa is puffy and reddened. Her abdomen is soft with bilateral lower quadrant abdominal tenderness. A temperature of 38.5°C; and a pulse rate of 92/min. Hemoglobin 13 g/dL; White Blood Cells (WBC) 9000/mL, with 35% segmented neutrophils, 7% monocytes, and 58% lymphocytes. Which of the following is the most likely diagnosis ?
Answer
B. Mumps
11
A 17-year-old male presents with tooth ache in right mandibular region. Gives 1-week history of malaise and anorexia followed by fever and sore throat. On physical examination, cervical lymphadenopathy was present and the liver and the spleen were palpable. On intraoral examination, few palatal petechiae and inflamed throat with no evidence of exudate were observed. Throat culture was negative for group A streptococci. Blood work revealed WBC : 14,000/ L; Lymphocytes: 60%; Monocytes: 10%; Bilirubin total: 2.0 mg/dL; AST: 40 U/L (normal 8 to 20 U/L); ALT: 35 U/L (normal 8 to 20 U/L). The diagnostic test is
Answer
C. Heterophile antibody
12
A 32 year-old male patient reported to OPD with chief complaint of swollen gums. On examination, extensive hemorrhagic enlargement of maxillary and mandibular gingivae was observed. Poorly differentiated leukemic cells seen in peripheral blood and bone marrow. Most probable diagnosis will be
Answer
A. Chronic myeloid leukemia
13
A 30-year old male reported with chief complaint of recurrent ulcers in mouth. History of burning sensation during micturition. Skin lesions revealed scattered, tender erythematous nodules. Intraorally, numerous irregular areas of ulcerations of the ventral surface of the tongue noted. The most likely diagnostic test for this condition will be
Answer
C. Pathergy test
14
A patient was clinically diagnosed with oral candidiasis. Smear from infected area was obtained. Which additional examination can be done to discriminate between different candidal species ?
Answer
C. Pagano-Levin agar
15
A 45 year old male presented with symptoms of fever and ulcers on nose, mouth including tongue, pharynx and gums. Microscopic examination shows thick walled cells that form the classical 'Steering Wheel' or 'Mickey Mouse' structures that are diagnostic of the fungus. Most probable diagnosis
Answer
C. Paracoccidioidomycosis
16
Patient presents with squamous cell carcinoma involving left buccal mucosa measuring 4 cm in diameter, 6 cm ipsilateral lymph node with lung metastasis, the TNM staging of this patient would be
Answer
D. Stage IVC
17
In Oncology practice, various bone-modifying agents are commonly used to reduce the risk of skeletal bone fracture in patients with skeletal metastatic disease. Which class of agents are used under this category ?
Answer
D. All of the above
18
Which one of the following is a tool of medication assessment to evaluate polypharmacy in elderly patients to improve patient's functional status and mobility ?
Answer
A. ARMOR
19
A 12 year old boy reports with his mother for missing and malaligned teeth. On extraoral examination, there is frontal and parietal bossing with brachycephalic skull. On intraoral examination, there is evidence of retained maxillary and mandibular deciduous molar and absence of permanent premolars. PA skull revealed multiple wormian bones. Chest X-ray shows hypoplasia of bilateral clavicles. OPG shows multiple impacted supernumerary teeth in both the jaws. What is the diagnosis for this condition and the underlying pathology ?
Answer
D. Cleidocranial dysplasia, mutation in Runx2 gene
20
Constellation of localized pain, motor and sweat abnormalities and trophic changes in soft tissues of muscle and skin is known as
Answer
A. Regional sympathetic dystrophy
21
A 30 year old female reported with painless swelling of lower jaw since 10-15 days. On intraoral examination, a well circumscribed, bony hard swelling was evident over lingual surface of right body of mandible. On mandibular occlusal radiograph, circumscribed, round radiolucent lesion with a small central radiopacity was seen attached to the lingual cortex in region of mandibular molar. What is the most probable diagnosis ?
Answer
Question Cancelled
22
A 32-year-old woman presented with history of fatigue since 9 months and progressive difficulty in swallowing solids for 2 months. On examination, she was pale and had glossitis, cheilitis, and koilonychia. Blood picture revealed microcytic hypochromic anemia with anisocytosis. Laboratory investigations showed hemoglobin level of 6 g/dL and raised total iron-binding capacity. The most probable diagnosis for this condition is
Answer
B. Paterson Kelly syndrome
23
A 43 year old female presented with 5 mm diameter ill defined pigmented macule at interdental gingiva between maxillary left lateral incisor and canine which she observed few days back. She gave recent history of trauma due to impingement of fish bone in the same region. No other abnormal finding was present. On biopsy, there was proliferation of benign dendritic melanocytes throughout spongiotic epithelium with mild lymphocytic infiltrate. Lesion healed following biopsy. What could be the probable diagnosis ?
Answer
D. Melanoacanthoma
24
A 20 year old female complains of multiple lumps on her gums and cheek for past few months. She presented with recent abnormalities in her menstrual cycle for which she was undergoing gynecological examination and ultrasound revealed multiple ovarian masses. Clinically multiple papillomatous lesions were appreciated in lips, gingiva and palate. What is your most probable diagnosis ?
Answer
A. Cowden's syndrome
25
A 50-year-female presented with history of asymptomatic pigmented spots on tongue, lower lip, fingers, and toes which had developed gradually over last 2 years. There was no family history of similar skin disease. Clinical examination revealed brown colored pigmented macules 1-3 mm in size. Examination of hands revealed round to oval well-defined brown-colored macules 1-5 mm in diameter on the palmar aspect of the tips of all the fingers. Laboratory investigations showed a hemoglobin value of 11.2 gm%. ESR was raised to 42 mm/h. Biopsy showed no increase in the number of melanocytes and no junctional activity or melanin incontinence. Further examination showed no systemic abnormality. The patient is most likely a case of
Answer
B. Laugier Hunziker syndrome
26
Which of the following drug regimens for systemic use need not be changed in patients with chronic renal failure ?
Answer
B. Codeine
27
Which amongst the following is a contraindication for the use of Pilocrapine ?
Answer
D. Uncontrolled Asthma
28
A 15 year old male complains of spontaneous bleeding episodes from gums. He gives a history of prolonged bleeding after minor bruise. His routine hematologic tests are within normal limits. Various laboratory tests for assessing hemostasis like bleeding time, PT/INR, aPTT and platelet count are also within normal range. Which of the following disorders is the most probable cause ?
Answer
B. Factor XIII deficiency
29
A 40 year old female complains of recent onset fatigue, decreased mental concentration, dysphagia and burning sensation of the tongue. Clinically she presented with inflamed tip and margins of tongue with papillary atrophy. Which of the following interpretations will determine the diagnosis ?
Answer
Question Cancelled
30
A 60 year old female complains of burning sensation of mouth while taking spicy foods. She is also reporting pain in knees, facial skin eruptions and malar rash for past few months. Intraorally multiple erythematous and ulcerative lesions are appreciated over bilateral buccal mucosa and tongue. Which of the following serological examinations will help in diagnosis of the condition ?
Answer
A. ANA, anti ds DNA, anti U1 RNP, anti phospholipids
31
Lesions strongly associated with HIV infection are all except
Answer
D. Mycobacterium tuberculosis infection
32
In leukemia patients undergoing haematopoietic cell transplant, chronic GVHD may be considered beneficial because of the following reason
Answer
B. Immunologic process eliminates persistent leukemic cells
33
In some HIV patients, HAART-induced immune recovery results in a spectrum of presentations ranging from clinical worsening of established opportunistic infection and the appearance of new opportunistic infections to autoimmune disorders. This phenomenon is also known as
Answer
D. Immune reconstitution inflammatory syndrome
34
Platelet transfusions are the main treatment modality for which of the following disorders ?
Answer
C. Bernard-Soulier syndrome
35
OraQuick is a test for which of the following infections ?
Answer
A. HIV
36
Which of the following are the surrogate tests to assess folate and vitamin levels ?
Answer
A. Homocysteine and methylmalonic acid levels
37
The cardiac conditions associated with the highest risk of adverse outcomes from endocarditis for which antibiotic prophylaxis with dental procedures is recommended are all except
Answer
C. Coronary artery disease
38
A patient with sickle cell anemia may develop sequestration syndrome which can involve all the following organs with respective disorders except
Answer
D. Brain (encephalopathy)
39
Which of the following is a long acting type of insulin ?
Answer
B. Ultralente
40
Following are the components of fresh frozen plasma except
Answer
Question Cancelled
41
A 50-year-old female complains of pain on the Right side of her lower jaw for the past 25 days. The patient gives a history of extraction of the mandibular right third molar 2 months back. Pain is moderate in intensity, described as burning and persistent in nature. On examination, there is no significant pathology evident on both clinical as well as radiological examination. The most likely diagnosis of the above condition is
Answer
B. Post traumatic trigeminal neuropathy
42
A 45 year old male complains of severe stabbing and burning pain on left side malar prominence region which is triggered by touching face and innocuous stimuli. They remain for very short period and there is no fixed pattern of repetition. It is always associated with lacrimation, redness of eyes and eyelid edema. What is your probable diagnosis ?
Answer
A. SUNCT
43
In which of the following TMJ disorders, there is history of chronic TMJ click with intermittent locking of TMJ. The first-time occurrence of acute lock is associated with pain, which increases on mouth opening although mouth opening is severely reduced. Further, mandible deviates to affected side and limited lateral movement to contralateral side.
Answer
B. Anterior disc displacement without reduction (Acute closed lock)
44
Which of the following conditions is characterized by the presence of tender points in specific areas of the face and neck, often associated with widespread musculoskeletal pain ?
Answer
D. Fibromyalgia
45
Which of the following are normal range of maximum mouth opening and lateral/protrusive movements ?
Answer
D. ≥40 mm, ≥7 mm respectively
46
Which of the following is not generally recommended for the management of Burning Mouth Syndrome ?
Answer
B. Tramodol
47
A 45 year old male complains of scratching or foreign body sensation in the throat. He gets sharp shooting, lancinating pain at the base of tongue region as well as pharyngeal region which radiates to ear. Pain event subsides on its own in around 2 min. Such episodes occur three to four times daily. The pain gets aggravated especially while swallowing, chewing, talking, coughing and/or yawning, sneezing etc. The patient's CT image of neck region was normal without any pathology. What is your probable diagnosis ?
Answer
C. Glossopharyngeal Neuralgia
48
In which of the following tests, the patient is asked to open mandible slightly and to keep remain in one position, while the patient resists the slowly increasing manual force applied by the examiner in each of right lateral, left lateral, upward and downward directions ?
Answer
D. Static muscle contraction test
49
In which of the following conditions, there is facial asymmetry, the chin may deviate to the unaffected side, or it may remain unchanged but with an increase in the vertical dimension of the ramus, mandibular body, or alveolar process of the affected side. As a result of this growth pattern, patients may have a posterior open bite on the affected side or a crossbite on the contralateral side ?
Answer
A. Condylar hyperplasia
50
Which of the following disorders could be prevented by use of vaccine especially in old age people ?
Answer
B. Post herpetic neuralgia
51
Purely serous salivary gland
Answer
D. von Ebner's gland
52
Indicator of oral dryness
Answer
A. Lipstick sign
53
The following salivary gland imaging modality is used for detecting perineural spread
Answer
C. Magnetic Resonance Imaging
54
A benign, self-limiting, reactive inflammatory disorder most frequently affecting minor salivary glands
Answer
B. Necrotizing Sialometaplasia
55
Medications causing hypersalivation
Answer
A. Cholinergics
56
X rays were discovered by Wilhelm Conrad Roentgen in which year ?
Answer
C. 1895 November 8
57
The total filtration in the path of a x ray beam for a dental x ray machine operating up to 70 kVp to be equal to the equivalent of
Answer
B. 1.5 mm of aluminum
58
Photons in an x ray beam interact with the object, the following occurs
Answer
C. Photoelectric absorption 27%
59
One of the most significant naturally occurring radioactive elements in the earth's crust
Answer
D. Uranium
60
The emission spectrum in the intensifying screens, where phosphor crystals contain rare earth elements of terbium activated gadolinium oxysulfide
Answer
C. Green Light
61
Restrainer in processing solution
Answer
D. Acts as antifog agents
62
The amount of radiation required to produce an image of a standard density
Answer
C. Radiographic Speed
63
In Submentovertex radiographic projection
Answer
B. The patient's neck is extended as far backward as possible, with the canthomeatal line parallel to the image receptor
64
A safelight mounted on the wall or ceiling in the x ray film processing darkroom
Answer
C. 4 feet from the work surface
65
The image frequently seen on periapical radiographs of the maxillary molar region as a triangular radiopacity, with apex directed superiorly and anteriorly and superimposed on the region of the third molar
Answer
A. Coronoid process of the mandible
66
In photostimulable phosphor plates material used for radiographic imaging
Answer
C. Europium-doped barium fluorohalide
67
In radiographic appearance pulp chambers are large, the root canals are wide and the tooth appears as a thin shell of hypoplastic enamel and dentin
Answer
D. Regional Odontodysplasia
68
The multiple radiolucencies appearing as depressions of the inner surface of the cranial vault, which results in a beaten metal or copper appearance seen in
Answer
B. Craniofacial Dysostosis
69
The imaging method of choice for assessment of space occupying lesions like cyst and neoplasm's of the salivary glands
Answer
C. Magnetic Resonance Imaging
70
An inverted pear or tear shaped, well-defined radiolucency between the separated roots of the maxillary lateral incisor and canine suggestive of
Answer
B. Globulomaxillary Cyst
71
In nuclear medicine radionuclide imaging uses radioactive atoms or molecules that emit
Answer
D. Gamma rays
72
Round to oval radiolucent area located above the mandibular canal with well-defined borders and the superior border extends between the roots of the teeth giving a scalloped appearance seen in
Answer
C. Traumatic Bone Cyst
73
Radiographic appearance characterized by an increased density of the entire skeleton resulting in sclerotic appearance and bone may appear dense on a dental radiograph that the roots of the teeth are obscured in
Answer
C. Osteopetrosis
74
The ultrasound signal transmitted into a patient is attenuated by a combination of following except
Answer
A. Ionization
75
The common radiographic appearance of generalized increase in the width of the periodontal ligament spaces around the teeth and unusual pattern of mandibular erosive bone changes seen in
Answer
D. Scleroderma
76
A 30-year-old pregnant female with history of hyperthyroidism complains of unilateral facial swelling, anosmia and visual disturbance. On examination, patient is noted to have flat pigmented spots on the back. Radiograph of the facial swelling shows ground glass appearance of bone. What is the possible diagnosis ?
Answer
C. McCune-Albright Syndrome
77
40-year-old male reported after motor vehicular accident. On examination he was noted to have right eye circumorbital ecchymosis, flattening of right cheek, right infraorbital rim tenderness and step deformity. Radiographs that will best demonstrate the fractures are
Answer
B. Waters view and SMV
78
Radiographic bony change that helps to differentiate between Langerhans' cell Histiocytosis lesion from periodontal disease on an OPG view is
Answer
B. Epicenter of the lesion
79
A 35-year-old female reported with complaint of loose teeth and joint pain. OPG shows radiopaque teeth standing out in contrast to radiolucent jaws, loss of lamina dura. A single well-defined radiolucency noted in maxillary anterior region of bone histologically diagnosed as giant cell granuloma. What screening tests are to be performed in the following case ?
Answer
D. Serum Calcium, PTH and alkaline phosphatase levels
80
A radiologist is asked to evaluate a series of radiographs of a 60 year old male. OPG shows cotton wool appearance with spacing of teeth, hypercementosis of teeth and B/L maxillary sinuses appear clear. Lateral skull view shows increased density and dimension of skull and jaw bones. The most likely diagnosis is
Answer
C. Paget's Disease
81
Which of the following statements are TRUE about Oral Hypoglycemics ? i. Metformin suppresses hepatic gluconeogenesis. ii. Thiazolidinedione agents increase tissue sensitivity to insulin and decrease hepatic gluconeogenesis. iii. Acarbose stimulates pancreatic insulin secretion. iv. Sulfonylureas provoke release of insulin from pancreas.
Answer
A. i, ii and iv
82
A 35-year-old patient with history of severe Hemophilia A, needs to undergo extraction of mandibular wisdom tooth. What is the most important precaution to be taken prior to the procedure ?
Answer
A. Prophylactic factor replacement
83
A 60-year-old asthmatic patient using inhalational corticosteroid, reports with oral burning sensation and an erythematous lesion on palate and tongue dorsum. What line of treatment is most likely to relieve the symptoms ?
Answer
C. Prescription of antifungal medication
84
A 45-year-old male patient reported with soreness of jaw muscles, on examination, patient shows sign of severe attrition of teeth. He was treated with botulinum toxin in masseter muscle every 5 months. This treatment helped relieve the symptoms by
Answer
B. Exerting paralytic effect on the muscle by inhibiting the release of Acetylcholine at the neuromuscular junction
85
What precautions need to be taken while prescribing the drug Ketorolac ?
Answer
D. All of the above
86
Dermatitis, Diarrhea and Dementia is noted in deficiency of which Vitamin ?
Answer
B. Niacin
87
Which of the following is NOT TRUE about HIV treatment guidelines ?
Answer
Question Cancelled
88
Which of the following drug CANNOT be used for treating Chronic Orofacial pain ?
Answer
D. Imipenem
89
Which one of the following is the least likely indication for antibiotic prophylaxis to prevent Bacterial Endocarditis ?
Answer
B. Diabetes Mellitus
90
Which is the first line antiepileptic drug that can be used for diagnosis and management of Trigeminal Neuralgia ?
Answer
C. Carbamazepine
91
The diagnosis process (case history and examination) helps a Dentist to i. Recognize deviation from normal general health status that may affect dental treatment. ii. Identify need for medical consultation for further management. iii. Make informed judgement on risk of dental procedures. iv. Completely diminish the need for use of emergency drugs during dental procedures.
Answer
C. i, ii and iii
92
In American Society of Anesthesiologists classification of physical status of patient, ASA-V indicates
Answer
B. A moribund patient who is not expected to survive without the operation
93
Following nail changes may be noted in a patient with iron deficiency anemia
Answer
A. Koilonychia and vertical ridging
94
A 70-year-old male patient presented with a non-healing oral ulcer on right lateral border of tongue from a sharp tooth in relation. On examination the ipsilateral submandibular lymph node is enlarged, hard and fixed. The likely diagnosis for the ulcer is
Answer
C. Malignant ulcer
95
A 34-year-old female who presented with toothache to the dental OPD showed following signs on general examination. 1. Anterior neck swelling 2. Tachycardia 3. Tremors of fingers 4. Positive Von Graefe's sign (upper eyelid lags behind the eyeball on looking down) Patient is most likely to have systematic history of
Answer
B. Primary toxic goiter
96
FDA cleared use of Toluidine blue staining to evaluate the mucosa for potential malignancy in combination with
Answer
B. Chemiluminescent light device
97
On performing Sialometry, the salivary gland hypofunction may be diagnosed when
Answer
B. Unstimulated salivary flow rate is less than 0.1 mL/min and stimulated salivary flow rate is less than 0.7 mL/min
98
Chairside Test to differentiate vascular lesion from pigmented lesion would be
Answer
B. Diascopy
99
Which is the best imaging modality to evaluate joint effusion in TMJ disc displacement with reduction ?
Answer
B. Magnetic Resonance Imaging
100
A 25 year old female undergoes extraction of impacted mandibular third molar and is now suffering from loss of taste sensation from the anterior two thirds of tongue. Which nerve is likely to be damaged ?
Answer
A. Lingual nerve
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