Gateway exam

Question 1

What is a sialolith?

Answer 1

a salivary gland calcification

Question 2

Where do the majority of sialoliths occurs?

Answer 2

Submandibular gland - 83-94%

50% in the distal third of the duct
20% in the proximal third
30% within the gland

Question 3

Is a sialolith always symptomatic?

Answer 3

No

Question 4

What symptoms may you get?

Answer 4

meal time syndrome. Sudden onset recurrent swelling associated with eating.
RECURRENT SIALADENITITS

Question 5

What is the peak incidence of a sialolith?

Answer 5

30-50 with males twice as likely to be affected

Question 6

Radiopacity of salivary stones

Answer 6

40% of parotid salivary stones are radiolucent

20% of submandibular stones are radiolucent

Question 7

How can you detect radiolucent stone?

Answer 7

Ultasound

Question 8

What other methods of imaging are there?

Answer 8

2 radiological views at 90 degrees to one another

sialography

Question 9

What may cause cervical lymph node calcification?

Answer 9

Previous chronic infection eg. TB, Cat scratch, radiotherapy

Question 10

Why do lymph nodes calcify?

Answer 10

Inflammation leads to fibrosis and dystrophic calcification.

Question 11

What do calcified lymph nodes look like radiographically?

Answer 11

> 1.5 cm
irregular outline
variable densities

Question 12

What is a tonsillith?

Answer 12

Tonsillar calcifiaction

Question 13

Where and when do you find tonsilliths?

Answer 13

Normally an incidental finding in >40

Overlies the air shadow of the oropharynx as it corsses over the posterior body/ramus of the mandible. SMALL RADIOPAQUE

Question 14

What is the normal length of the stylohyoid muscle?

Answer 14

0.5-2.5cm

Question 15

When is the stylohyoid ligament considered elongated?

Answer 15

> 28 mm on a DPT

Question 16

What is Eagles syndrome?

Answer 16

Elongation of the stylohoid process along with symptoms of pain on turning the head and swallowing

Question 17

What is the most common sight for arterial carotid calcification?

Answer 17

C4, the sight of carotid calcification, adjacent to the upper border of the thyroid cartilage

Question 18

What is a phlebolith?

Answer 18

A venous calcification. it is a calcified thrombus associated with vascular lesions eg, haemangioma

Question 19

Describe the radiological appearance of a phelbolith

Answer 19

Well defined round or ovoid opacity
often centric deposits with central radiolucency
rarely solitary

Question 20

What imaging modality would you suggest if a patient has been suffering from chronic sinusitis for >3 months

Answer 20

CT

Question 21

What is an antrolith?

Answer 21

A calcification in the antrum with an inflammatory aetiology

Question 22

What other conditions can cause calcification of the antrum?

Answer 22

Thalasseamia
sickle cell anaemis
fibrous dysplasia
Pagets disease
osteopetrosis

Question 23

Differentials for odontogenic, unilocular cyts

Answer 23

Radicular cyst
Residual cysts
Lateral periodontal cyst
Dentigerous cyst

Question 24

Differentials for non-odontogenic, unilocular cysts

Answer 24

Nasopalantine cyst
Nasolabial cyst
Bone cyst - solitary/aneurysmal

Question 25

What is the origin of radicular and residual cysts?

Answer 25

Cell rests of Malassez from the epithelial remnants of the Hertwigs epithelial root sheath

Question 26

What is a lesion below the ID canal?

Answer 26

NON-ODONTOGENIC

Question 27

What is the origin of a lateral periodontal cyst?

Answer 27

reduced enamel epithelium

Question 28

What is a botyroid cysts?

Answer 28

A mulitlocular variant of the lateral periodontal cyst. It is rare and seen more commonly in middle age to older adults

Question 29

What is the origin of a dentigerous cyst?

Answer 29

Remenants of the reduced enamel epithelium after tooth formation Usually affecting the crowns of unerrupting teeth such as 3's and 8's

Question 30

What is an eruption cyst?

Answer 30

A term used to describe a dentigerous cyst when it is in the soft tissues overlying the unerupted tooth

Question 31

What is commonly seen in Gorlin-Goltz syndrome?

Answer 31

Odontogenic keratocyst

Question 32

What is an odontogenic keratocyst?

Answer 32

A multilocular odontogenic tumour most commonly seen in the anterior maxilla or posterior mandible

Question 33

What is known as the great mimicer?

Answer 33

Ameloblastoma

Question 34

What is an ameloblastoma?

Answer 34

An multilocular odontogenic tumour. It is rare but very disfiguring. SOAP BUBBLE EFFECT affect the posterior mandible (anterior mandible in black africans)

Question 35

Unicystic ameloblastoma

Answer 35

accounts for ~15% of ameloblastomas. Usually associated with the crown of an unerupted tooth

Question 36

What is the appearance of an odontogenic myxoma?

Answer 36

Mutlilocular - soap bubble/honeycomb | Affects the posterior mandible or maxilla and is of odontogenic origin

Question 37

Cortical expansion of neoplastic lesions

Answer 37

lingual and buccal expansion may be uneven.

Question 38

Malignant periosteal reactions have what effect?

Answer 38

Suburst

Question 39

Differentials for well defined, non-corticated, punched out lesions

Answer 39

Mutiple myeloma Langerhans cell histiocytosis primary malignancy metastasis (breast, bronchus, kidney, thyroid, prostate)

Question 40

What is multiple myeloma?

Answer 40

Multifocal proliferation of the plasma cell series within the bone marrow which leads to the overproduction of immunoglobulins

Question 41

Lamellar type periosteal reaction is common in that?

Answer 41

Osteomyelitis

Question 42

What is osteomyeletis

Answer 42

Infection and inflammation of the bone marrow. It is usually caused by bacteria

Question 43

What is a supplemental tooth?

Answer 43

A supernumerary tooth , where the tooth has a normal shape for a tooth in that series

Question 44

What is the dental relevance of cleidocranial dysplasia?

Answer 44

Multiple supernumerary teeth Failure of eruption of secondary teeth Prgnathic mandible due to hypoplasia of the maxilla