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BDS3 Past Papers & Quizzes > MSA 2015 > Flashcards

MSA 2015 Flashcards

1
Q

non setting calcium hydroxide - why is it an ideal interappointment medicament

A

high pH 12.5 - allows killing of bacteria

hydrolysis of lipopolysaccharide which reduces inflammatory potential

removes tissue debris

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2
Q

3 reasons for obturating

A

to create fluid tight seal apically

to prevent reinfection of the canal

to seal off any bacteria within the canal thus preventing any bacterial growth

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3
Q

components of GP (other than rubber) (3)

A

zinc oxide 65%

radiopacifiers 10%

plasticisers 5%

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4
Q

reasons for sealer when using cold lateral compaction (3)

A

seals space between detinal wall and core

fills voids and irregularlities in canal, lateral canals and between GP points in lateral condensation

lubricates during obturation

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5
Q

technical term for dry socket

A

alveolar/localised osteitis

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6
Q

predisposing factors for dry socket (8)

A
  • molars more common - risk increases from anterior to posterior
  • mandible more common
  • smoking
  • female
  • oral contraceptive pill
  • local anaesthetic - vasoconstrictor
  • excessive trauma during extraction
  • excessive mouth rinsing post extraction
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7
Q

presenting symptoms and signs of dry socket (4)

A
  • dull aching pain: moderate to severe
  • usually throbs can can radiate to pt ear
  • continuous, kept awake at night
  • smell/bad odour and pt complain of bad taste
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8
Q

4 management techniques of dry socket

A

supportive, reassuranc/systemic analgesia

  • LA block
  • irrigate socket with warm CHX or saline to wash out food and debris
  • WHVP or Alvogyl
  • curettage/debridement to encourage bleeding and new clot formation
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9
Q

5 common features of parkinsons

A

resting tumour

rigidity

bradykinesia

mask like facial expression

postural instability

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10
Q

difference of movement of parkinsons from other cerebral disease

A

parkinsons is a resting tremor

cerebellar tremour is an intention tremor

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11
Q

most likely reason for dry mouth in parkinsons

A

antimuscarininc/cholinergic effect of drugs

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12
Q

ways to help pt prevent loosing dentures

A

mark initials on the denture during procedure

if already constructed then can make using sandpaper or use sealant

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13
Q

3 reasons to be cautious of extracting teeth in parkinson pt (resting tremor)

A

tremor could make extraction more difficult

poor mouth opening

will require new prostheses to replace missing teeth - will they be able to manage

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14
Q

reason of concern for parkinson pt future oral health

A

poor motor function therefore the ability to maintain sufficient oral hygiene is compromised

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15
Q

MOM for elevating mandible

A

masseter

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16
Q

MOM for protruding mandible

A

lateral pterygoid

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17
Q

anterior convex part of TMJ

A

articular eminence

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18
Q

posterior concave part of TMJ

A

mandibular fossa

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19
Q

4 forms of candidosis

A

pseudomembranous

erythematous

hyperplastic

angular cheilitis

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20
Q

azole action

A

prevents the biosynthesis of ergosterol by inhibiting the enzyem 1,4 dimethylase

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21
Q

3 resistance mechanisms of antifungals

A

changes in the ergosterol target enzyme

upregulation of efflux pumps

biofilm formation

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22
Q

2 species of candida and how to differentiate

A

candida albicans

candida glabrata

CG is resistant to fluconazole

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23
Q

paeds order for tx plan general

A

OHI

fluoride varnish

fissure sealants

upper filling NO LA

upper filling LA

lower filling LA

pulpotomy

extraction

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24
Q

signs of anxious pt

A

palpitations, perspiration, breathlessness

figedity - twiddling thumb

time delay by asking Qs

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25
Q

wide confidence interval may reflect

A

small sample size

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26
Q

master impression a.k.a

A

definitive impression

secondary impression

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27
Q

2 factors affecting physical retention

A

border seal

post dam

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28
Q

anatomical features for position of posterior border of upper denture

A

palatine fovea at vibrating line

hamular nothces

border of hard palate

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29
Q

3 anatomical features to include on mandibular denture

A

residual ridge

buccal shelf

retromolar pad

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30
Q

2 materials that can be used for master impression on lowers

A

polyvinyl siloxane (extrude)

alginate

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31
Q

3 characteristics of biofilm extra cellular matrix which causes resistance to antimicrobials

A

biofilm impairs diffusion

causes binding of antibiotics

extracellular DNA persisters

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32
Q

bacteria involved in periodontal disease according to socranskys

A

p.gingivalis

treponema denticola

tanerrella forsythia

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33
Q

2 bacteria involved in caries

A

streptococcus mutans

lactobacillus acidophillus

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34
Q

4 key features that enable caries bacteria to adhere and survive in acidic environment

A
  • adhesins: SpaP - makes up fibrillar layer of cell wall
  • Binding proteins: glucosyltransferase, fructoslytransferase, gluten binding protein
  • Sugar modifying enzymes: fructanase, dextranase
  • Polysaccharides
  • Acid tolerance and adaptation: F1F0 ATPase
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35
Q

3 systemic diseases caused by periodontal disease

A

diabetes - up to 6 fold

cardiovascular disease - 1.2-3.9 fold

rheumatoid arthritis

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36
Q

nurse doesn’t wash hands before pt what to do

A

challenge her practice by asking her why she has not washed her hands and ask her to refer to the SOPs

carry out an audit to determine if this is common practice

37
Q

if making a presentation about hand hygiene for your practice what are 4 topics to include

A
  1. when to carry out hand hygiene
  2. 6 steps of hand hygiene
  3. different types of hand hygiene: social, surgical, alcohol gel only
  4. reasons for non-compliance
38
Q

if you see dentist ‘double gloves’ and deliberately booking blood disease pt for end of day what should you tell him

A

he is not allowed to discriminate between pts and he should tx pt according to standard infection control precautions

by using double gloves he is discriminating

39
Q

how to ensure SOPs followed

A

ensure staff attend all relevant CPD and training sessions relating to SICPs and hand hygiene

observe future clincial practice

40
Q

4 PPE for carrying out manual cleaning

A

apron

mask

full face visor

gloves and thick marigold gloves

41
Q

when to degas ultrasonic

A

necessary before every fill, before instruments are processed

42
Q

why does ultrasonic need degas

A

oxygen legft in water inhibits cavitation

therefore bubbles of lower intensity are formed meaning the ultrasonic is less effective at cleaning

43
Q

degassing ultrasonic

A

remove any gases and ensures that bubbles are only produced from ultrasonic activity and that all bubbles are of the same intensity

44
Q

2 types of manual cleaning and name examples of each

A

immersion - non lumen devices e.g. probes, mirrors

non-immersion - lumened devices e.g. handpieces

45
Q

why use deionised water in a steriliser

A

to remove suspended particles and minerals which could create a rough surface on instruments for micro-organisms to cling to

46
Q

% affect by sensitivity after tooth bleaching

A

60%

47
Q

5 predisposing factors to sensitivity after bleaching

A

pre-exisiting sensitivity

high concentration of bleaching agent

frequency of change

gingival recession

bleaching method

48
Q

bleaching method of action for external cervical resorption

A

due to diffusion of H2O2 through dentine into periodontal tissues

high concentration and heat would increase effect

49
Q

causes of root resorption due to bleaching

A

heat during bleaching process

higher concentration of H2O2

history of trauma

50
Q

how to prevent root resorption due to bleaching

A

place 1mm of RMGIC over GP to seal canal

seals dentine and prevents resorption

51
Q

3 reasons for non surgical perio tx before surgical perio tx

A
  • allows evaluation of pts motivation and plaque control
  • improve soft tissue consistency for easier sugical management
  • some deep pockets may heal following non-surgical therapy
52
Q

2 indication for surgical perio tx at re-evaluation

A

pockets of 5mm or greater persist in the presence of excellent OH

furcation involvement

53
Q

when to re-evaluate non-surgical perio tx

A

4-6 weeks after non-surgical therapy

54
Q

aim of surgical perio tx (2)

A

to arrest disease by gaining access to complete root surface debridement

to regenerate lost periodontal tissue

55
Q

supportive role of GDP after surigcal perio tx carried out by specialist (5)

A
  • periodontal pocket chart annually and carry ut oral exam including plaque & bleeding scores
  • review oral hygiene and use TIPPS
  • remove supragingival and subgingival plaque and calculus deposits
  • carry out RSD when needed
  • re-apprasie mechanical plaque control
56
Q

link of radiotherapy in parotid region to formation of ulcers

A

modderate to high dose levels are given to overlying tissue

can result in mucositis

57
Q

why is enhanced prevention needed for radiotherapy of head and neck pts

A
  • will suffer xerostomia due to impact of radiotherapy on salivary glands
    • reduced salivary flow can lead to an increased caries risk as less salivary buffering and clearance ability
  • oral hygiene instruction and fluoride application would need to be conducted
58
Q

complication of extarction of radiotherapy of head and neck pt

why

A

irridiation of bone can result in osteoradionecrosis

may impair the healing of sockets post extraction

59
Q

effects of chemo on blood count

A

bone marrow suppression

pancytopenia - inc WBC (infection), platelets (bleeding risk)

60
Q

who can consent for a pt if they are unable to do so

A

welfare power of attorney

welfare guardian

doctor or dentist under section 47 of AWI act - need to have certificate

61
Q

incapacity act

A

Adults with Incapacity Act (Scotland) 2000

62
Q

questions to ask pt who smoke

A
  • how long have you smoked for
  • how many do you smoke a day
  • have you considered giving up
  • do you know the harmful effects of smoking
  • have you tried quitting in the past
63
Q

2 service you can refer smoker who wants to quit to

A

smoking cessation groups

local pharmacy

64
Q

types of e-cig

A

disposable (rare)

rechargeable with replaceable cartridges

rechargable and re-fillable

advanced personal vaporiser (APVs) or MODS (adjustable wattage tanks)

rechargeable 2 and 3 piece (Cigalites)

65
Q

advice on e-cigs

A

they are not harmless but likely to be considerably safer than conventional cigarettes if used in moderation

early research suggests they help quitting overall

not a lot research regarding health effects - less toxinc in them than normal tobacco cigs (no firm evidence regarding which is better)

use of nicotine replacement therapy is highly recommended

66
Q

upper central incisor fails to erupt, trauama to previous primary exfoliated

4 inital management options

A
  • check if contralateral has erupted and when it erupted (radiograph)
    • palpate palatally and buccally in case ectopic
  • maintain space/create space
    • surgical exposure
    • bond with orthodontic gold chain
  • monitor for 1.5 year

refer to orthodontic/paed specialist

67
Q

3 causes of failed eruption

A

supernumerary - tuberculate

early loss of primary tooth

hypodontia

68
Q

4 aims of ortho tx

A

restore

  • stability
  • function
  • aesthetics

aid other forms of dentistry - restorative (crowns, bridges etc)

69
Q

horizontal line for OPT parallel to floor

A

frankfort plane

70
Q

why may anteriors be horizontal magnified on OPT

A

pt too far back in machine

canine behind the guideline

71
Q

why may posteriors on one side be horizontally magnified

A

pt is rotated in the machine

72
Q

features of ghost image (3)

impact

A
  • always higher
  • always horizontally magnified
  • on the opposite side

can interfere with Dx

73
Q

before extraction of 48 and 28

what type of radiograph

A

right half panoramic

74
Q

what radiograph should be used as second resort for child with caries who cannot tolerate bitewings

A

OPT

75
Q

what border of maxillary sinus is above the molars (horizontal)

A

inferior

76
Q

what border of maxillary sinus is vertical to 3rd molar

A

posterior border

77
Q

carious lower 6s in child

special investigation

A

OPT

check formation of other teeth

78
Q

what are you looking for to show suitable extraction timing of 6s

(4)

A
  • bifurcation of 7s
  • 5s and 8s present
  • mild buccal segment crowding
  • class I incisor relationship
79
Q

tx for upper non carious 6

A

compensating extraction

80
Q

2 adv of extraction of carious 6s at right time

A

caries free dentition

allows spontaneous eruption of the 7 therefore relieving the need for orthodontic tx

81
Q

3 disadv of extraction of carious 6s

A

loss of permanent tooth

possible GA exposure risk

bad experience could affect future dental visits

82
Q

2 methods to aid extraction of anxious child

A

GA, inhalation sedation, acclimatising

83
Q

surgical extraction of roots 45

nerves to anaesthetise (3)

A

Inferior alveolar nerve

mental nerve

lingual nerve

84
Q

how to test if IAN, mental nerve and lingual nerve anesthetised for extraction 45 roots

A

numbness of the tongue and lower lip

probe around tooth and determine if pain felt

85
Q

5 possible nerve deficits

A
  1. anaesthesia (numbess)
  2. paraesthesia (tingling)
  3. dyseasthesia (umpleasant/pain)
  4. hypoaesthesia (reduced sensation)
  5. hyperaesthesia (increasd sensation)
86
Q

neurpraxia

A

contusion of the nerve

continuation of epineural sheath/axons maintained

87
Q

axontmesis

A

continuity of axond but epineural sheath disrupted

88
Q

neurotmesis

A

complete loss of nerve continuity/ nerve transected

89
Q

4 causes of nerve damage

A
  • crush injuries
  • cutting/shredding injuries
  • transection
  • damage from surgery or damage from LA

BDS3 Past Papers & Quizzes (14 decks)

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