4-5 Feb 2021-Solved rqs- NBDE 2

Feb 4-5, 2021 RQ’s
1. Disulfiram to treat which dependence? alcohol, benzo, or heroin

2. Incisal guide pin–in contact or not in contact or at occlusal plane level?

3. Omeprazole works on what? h2 proton pump ( decrease acid production in the stomach)

4. Benzo work on what receptor? GABA

5. Primary molar first or second mesial or distal pulp horn easiest to pulp out on? -Mesial pulp horn =higher

6. Periodontal disease bone loss horizontal ( most comom) vertical circumferential

7. Old people: increased perio disease, tooth loss, or loss of tooth translucency?8. T. denticola red complex (PTT)

9. Primary etiology gingival pregnancy : – plaque – progesterone

10. Palatogingival groove which max teeth? incisors (Mx Lat) canine premolar or molar

 

11. Ptsd ( pos trauma stress disorder) no visual hallucinations/auditorio? 30% to 40% report auditory or visual hallucinations and/or delusions.???12. Most common type of arthritis? Osteoarthritis

13. Not something to consider tx planning an endo tooth? -Function -adjective tooth -place in arch -amount of structure remaining

14. What is it called when Dental manager not on site but still controlling things→ General supervision

15. Not a function of Diazepam? Emesis Function-alleviate anxiety and induce sleep,sedative hypnotics).

16. Something to do with a palavag something causes hypernasality stuttering nasal emissions or something else=
velopharyngeal defect

17. Shows a little tooth but the mulo chamber #7 but the tooth is small and has lots of radiolucencies inside of it–
what is it? Odontodysplasia, microdontia, dens in dente18. What’s Monoamines endogenous→Epinephrine norepinephrine dopamine serotonin

19. Indirect retainer class 1 div 1 it div 2 not class 2 option
indirect retainer should be placed as far from the distal extension base as possible in a prepared rest seat on a tooth
capable of supporting its function.. class 1 divisor 1 is ideal to accommodate this. “ its a repeated qst”

20. 5ml 3% mepi mg? 30 x 5 = 150mg

21. Premolar buccal root over temporal out buccal side which space lymph drainage?–> submandibular space22. SRP an option for pregnant woman?
Second trimestrer → supine position23. Study that measured people who had the disease but measured them wrong, resulting in a lot of false
positives? specificity

24. Which one is quantitative? Case control, cohort, cross-sectional, meta-analysis

25. Which is last to stop to growing? Cranial base, cranial vault, maxilla, mandible

26. What is trephination? Hole drilled into bone to relieve pressure from an infection at apex of tooth. (Another
answer was to get through the mucoperiosteum or something like that but it made it sound like it was more on
the tissue than the bone so i went with the other answer)

27. Which one has a serious reaction but does NOT invade the basement membrane? Dysplasia, hypoplasia,
hyperplasia, SCC.

28. What’s the best way to diagnose a leukoplakia? Incision, smear cytology, other stuff

29. What’s the best way to tell the blood flow in a tooth? Pulp test, sonogram, laser doppler some weird answer
I’ve never heard of before. I picked the weird answer30. Why does a tooth with an open apex have a better chance of healing than a tooth not with an open apex after
an avulsion? Bc there are more odontoblasts, bc the apex being open allows for greater blood flow. Don’t
remember the other options but I think the answer was one of those

31. Which one of these is caused by an endodontic infection? Peripheral giant cell granuloma, CGCG, apical
granuloma, another answer

32. How do you take an impression if patient has flabby maxillary palatal tissue? I think the answer was basically just “gently” =passive pressure Hypertrophied tissue should be recorded in its passive form. With zinc oxide eugenol impression paste

33. Acute primary herpetic gingivostomatitis peaks at what age? 2 years

34. Acantholysis? Pemphigus Vulgaris 35. Turner tooth? Trauma or local infection

36. Pedal edema, pitting ? CHF

37. Lady with migraines? Loud noises/ tx : Immitrex

38. Most likely to find in CP? Fractured anterior teeth
Fracture of enamel and dentine was the most common type of injury (62%) in cerebral palsy (CP)

39. What causes Cerebral Palsy ? Repeated trauma to the brain

40. Stretch white cheeks and it disappears? Leukoedema41. Showed x-ray that looked really similar to this one. I think ans was osteomyelitis
Acute → Radiographic changes (diffuse lucency) appear only after the inflammation has been present for an
extended period.
Chronic→ Lucent or mottled radiographic pattern

42. Slow-growing paresthesia in the lip? Malignancy

43. Why would you not find the MB2? Calcification. You don’t have a microscope, so refer to endodontist.

44. If you fracture 2 mm off the incisal, what’s the best Tx? Glass ionomer, veneer, resin + pins, composite
Mosbys → Enamel fracture (Ellis class I).
a. Definition—involves enamel only (enamel chipping and incomplete fractures or cracks).
b. Treatment—grinding and smoothing the rough
edges or restoring lost structure.
c. Prognosis—good

45. Lots of surface caries? Glass ionomer

46. Why would someone have incisal caries? Don’t remember options but I went with xerostomia

47. Best way to tell the diff between perio and endo lesion→ Vitality, percussion and EPT

48. Best way to test vitality? Thermal

49. 8 yr old with broken tooth? Pulpotomy or apexogenesis
For young 8yrs patients with immature, still developing teeth, it is advantageous to preserve pulp vitality by pulp capping or partial
pulpotomy.
• Calcium hydroxide or MTA (white) are suitable materials for the procedure.
• In older patients, root canal treatment can be the treatment of choice, although pulp capping or partial pulpotomy may also be
selected. (SIDE NOTE!)

50. Purpose of CaOH? Antibacterial51. Most common med for pulpotomy/pulpectomy? I think it’s formocresol

52. Find a periapical lesion on a kid? In the furcation – el meastro question (QUESTION: In a primary tooth apical
infection the first radiograph sign is where?)

53. Which one has numbing properties? ZOE ( eugenol)

54. Which one inhibits resin bonding? ZOEugenol

55. 13 yr old with twisted central incisor but the other one looks normal. What do you do? I went with check to see
if he has any abnormal habits like thumb-sucking Mesiodens/central impacted ??

56. Primary purpose of straight-line access? So you don’t break the instrument or strip the canals better/safe
instrumentation

57. In a kid, which tooth are you most likely to pulp out on? 1st or 2nd Molar, mesial or distal (I think the answer
was mesial of 1st molar)

58. Large MOD on a molar and patient calls a week later in pain. What do you do? Redo it, redo it and replace it
with a calming medicament (Occlusion was NOT an answer)→ redo it and replace it with a calming
medicament RCT

59. Mandibular molar access shape? Trapezoid60. Which one is true regarding an amalgam prep? Walls are convergent, proximal boxes are greater than 1.5 mm
Primary retention form Convergence occlusally

61. What don’t strep mutans eat? Dextran xylitol sucrose

62. What’s the role of NaF? Substantivity, causes fluorapatite (exact words–didn’t say “helps formation of
fluorapatite” but that it causes it)

63. Curette for mesial of mandibular teeth? Gracey 11/1264. After SRP (i think), how do the PDL, cementum, and alveolar bone regenerate? Long Junc.Epithelium-New
attachment

65. Pockets greater than 5mm–which one is true? flap and piezo both Piezo totally treats it, operator with great
hand skills is able to get definitive positive result, unclear if you’ll get good results since you can’t get down
there

66. Why come for perio maintenance after 3 months? One answer was that’s when subgingival bacteria starts to
build up

67. What do you not do at a perio maintenance appt? SRP on 1-3 mm→ perio maintenance appointments are 6
moths

68. All of the following cause gingival hyperplasia except? Verapamil, nifedipine, phenytoin, there were 2 others so
it must have been one of thoseALL cause gingival hyperplasia
Phenytoin Phenobarbital Lamotrigine Vigabatrin Ethosuximide Topiramate Primidone Nifedipine Diltiazem
Amlodipine, cyclosporine , Verapamil

69. Where can you not do an apical flap? Lingual of max molars

70. Pt with new denture is biting his cheeks a lot. Which part do you take down? Linguals of maxilla & mand,
maxillary buccal, mandibular buccal

71. What do aspirin and tylenol with hydrocodone have in common? POTENT ANALGESICS

72. Ostectomy–removal of supporting or non-supporting bone? Supporting bone

73. Pt turning blue a couple of hours after LA? I think answer was methemoglobinemia
Prilocaine is a secondary-amine local anesthetic related to lidocaine. It is transformed in the liver into aminophenol
metabolites that can oxidize hemoglobin to methemoglobin.

74. Which one comes from endo? Lateral periodontal cyst, apical granuloma, other options

75. Difference between periapical granuloma and periapical cyst? Aspiration, cytology, biopsy, whether patient
ever had pain there

76. Which disease causes expiratory wheezing? Asthma

77. What does the sound of wheezing come from? Vibration of the lungs upon exhalation, sound going through
inflamed bronchioles, others

78. Why do you do cultural sensitivity? When there is antibiotics resistance

79. Nitroglycerin MOA? Increased cardiac output, strengthens diff valvular contractions (multiple answers that
specified specific valvular contractions) (prolonged refractory period not an option)→ nitroglycerin converts to
nitric oxide (NO) in the body. NO then activates the enzyme guanylyl cyclase, which converts guanosine
triphosphate (GTP) to guanosine 3′,5′-monophosphate (cGMP) in vascular smooth muscle and other tissues

80. Which antihistamine causes least amount of tiredness? Claritin

81. Longest-acting NSAID? Naproxen

82. Concentration of APF used in dental offices? 1.23%

83. What causes gingival inflammation with temp crowns? One option was monomer from the acrylic temp or
something, not finish margins

84. What do you base the survey line on? Occlusal surface, cementum surface, dento-enamel junction
Survey line: line on the cast that indicates maximum convexity of the tooth and alveolar bone in
relation to the path of insertion

85. Melanocytic nevus in buccal vestibule above #7 and 8. Sort of looked like this:

86. Osteogenesis imperfecta related to? Dentinogenesis imperfecta

87. Root tip broke off during ext. What to do? Clear area of heme and visualize; x-ray to visualize

88. Can’t remember question, but answer choices were stimuli-caused behavior, behavior is caused by consequences

89. Autism and repetitive behavior

90. Autism and loud noises91. Most likely to cause candidiasis in kid who just started using inhaler? Steroids, albuterol inhaler, different kind
of inhaler

92. Max NO2 for kids? 50%

93. For PFM, how many mm to take off incisal 1/3rd of the facial? 0.5, 1, 1.5, 3

94. MOA of Sulfonylurea drugs? Stimulate beta cells in pancreas and stimulate to produce insulin

95. Which one prevents rotation? Indirect, direct, circumferential, major connector, another one

96. Concrescence? 2 roots fused by cementum

97. Questions on fusion and gemination
98. X-ray with a tooth that looked like this. It’s regional odontodysplasia – Ghost teeth
99. #12 drains from which lymph node to the thoracic duct→ Deep cervical100. Occipital deep cervical submandibular or submental
101. Lots of questions on bumps on the gingiva like what are they
102. Leukoplakia one was smear one was incision
103. What muscle attaches to the zygoma→ Masseter
104. 5 year old luxate primary central tooth extract monitor105. Purpose of a distal shoe→ space maintainer
106. Dude with xerostomia chlorhexidine twice daily or chew xylitol gum
Xylitol increases saliva production. It moisturizes the mouth without harsh chemicals or detergents (or sugar) that can cause more dryness.
This and other oral health benefits is why the most common use of xylitol is in oral health products such as dry mouth mouthwashes, xylitol
mints, and xylitol gum
107. What is not a risk factor for him – it was osteoradionecrosis because he had radiation therapy but it was on his
colon or something tricky question→
108. Dude’s on aspirin and plavix and said does he need to stop before a “routine dental procedure…”→
The distal extension, also called a distal
shoe, is used when the second primary
molars are lost prior to the eruption of the
first permanent molars (i.e., very
premature loss). Space maintainer!109. Had a brown stain like a nevus anterior max buccal vestibule what is it→MELANOMA
110. Small round brown pigment posterior maxilla palate what is it→ Dentin—> Oral Melanotic Macule intra-oral
lesion found on the gingiva, buccal mucosa, and palate. Most lesions are under 1.0 cm in diameter
111. What receptors lisinopril B1 b2 a1 a2→ Alpha1
Alpha 1 receptors are the classic postsynaptic alpha receptors and are found on vascular smoot … Alpha-adrenergic
receptors play an important role in the regulation of blood pressure (BP)
112. Moa of xanax ( alprazolam) ? Gaba (binds to gaba receptor to enhance it)113. Kid with congenital atrial septal defect where will blood flow be messed up? Between right atrium and right
ventricle I went with that
From Left atrium to right atrium
A birth defect that causes a hole in the wall between the heart’s upper chambers (atria).
In a child with ASD, blood can travel across the hole from the left upper heart chamber (left atrium) to the right upper
chamber (right atrium) and out into the lung arteries.
114. Pt with deep overbite and crowded lower anteriors which statement is true? Went with you can leave deep
overbite but will need lower ipr
115. COPD which is true? Less goblet cells? Collagen fibers aren’t being made? Smooth muscle atrophy?
116. Least amount of o2 for a 16 year old during nitrous? I went with 30% for 16 years old
117. Identify hyoid118. Had this pretty much exactly:
119. X-ray of ext oblique ridge:
120. Identify ear lobe on a pan121. Had this pic. Went with Melanotic macule:
melanotic macule is a well-defined, oval, brown to black, flat patch on the central third of the lower lip. It is the name
for a freckle arising on the lip. It is also sometimes called a labial lentigo and when multiple lesions are present,
mucosal melanosis
122. Radiograph of a RCT anterior (I think 9) that had internal resorption
123. Q asking if the endodontist is at fault for the RCT? TRICKY! if you look carefully he wayyyy under filled the
gutta percha at the apex missed it by like 7mm.124. Pt had 4 premolars extracted as a kid, one from each arch–why are there spaces between teeth? Went with
teeth drifted
teeth shifting/ drifting is a natural consequence of aging and regular activity like chewing but can lead to problems if not addressed or severe.
125. Crossbite on one side went with unilateral maxillary constriction because the mandibular looked like they were
in the right place
functional shift (MFS) is an intractable type of malocclusion for orthodontists. It is clinically characterized by facial
asymmetry, dental midline discrepancy, and unilateral crossbite, and it is highly correlated to temporomandibular
disorder (TMD). … MFS is relatively common in patients with malocclusion. When upper jaw or dental arch is narrow
patient needs to slide the jaw to one side in order to fit the teeth together. This shift is called functional.
126. Patient with prosthetic knee replacement 6 month ago, H/O bypass surgery and radiotherapy for prostate
adenocarcinoma. Taking many medications.
a. Reason for dry mouth? Xerostomia due to medication
b. He needs antibiotic prophylaxis for what reason? prosthetic knee replacement
c. Has a white lesion on floor of mouth..It could be anything except SCC. Verrucous carcinoma,
Nicotinic stomatitis? It depends on the options
127. What can silver diamine fluoride cause? went with staining128. Pt has crepitus no pain what kind of arthritis? OSTEOARTHRITIS don’t remember if she had asthma
129. 5 year old–is her chronological age older younger or same as her dental age? I went with CHRONICAL AGE is
younger because she has erupted 6 year molars
chronological age is the amount of time that has passed from your birth to the given date. It’s your age in terms of years, months, days, etc so
by seen the x-ray or clinically or whatso ever.. its evident all 6 molars are erupted.. patient identified as YOUNG. “they use this in forensics”
130. Lady on bisphosphonates needs a tooth extracted. You explain reasons and tell her it needs exo- beneficence,
nonmaleficence, veracity, justice (Didn’t have autonomy went with beneficence).
Beneficence is defined as an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation.
All professionals have the foundational moral imperative of doing right
131. Same bisphosphonate case as above. What is the Tx for that tooth? Went with RCT and coronectomy because
of bisphosphonates
132. Girl who had a trauma tooth with a “bubble on the gums”, she also drank a ton of soda? Bubble on gum is
related to abscess
133. A man who is smoker with knee replacement 6 month ago, White lesion under the tongue. Brown pigment near
midline of palate. Hypertensive, took many meds and he had weird occlusion of post class II and anterior cross
bite. Missing upper canine (premolar took place and function as a canine, noticed it was missing when asked
history) and the other side, he was missing 1M.
a. The decision to give prophylactic antibiotic is based on: According to the patient AND physician
recommendation or preference
b. The cause for this pt occlusion is: Early loss of a maxillary tooth
c. What to do with the lesion, cytology or biopsy? Biopsy
d. If you would do emergency surgery to this pt, the MOST you would concern is Prolonged bleeding or
Cardiovascular issues? CVS (because of profound bleeding not prolonged, he was not on aspirin)e. Lesion could be any of these except: Nicotine Stomatitis (reverse smoking to be exact cause
smoker’s keratosis.. smokeless won’t appear on palate.. they cause Verrucous Carcinoma. Nicotine
melanosis and stomatitis both by smoking)
f. The pigment is most likely caused by? Smoking
g. The biopsy of the lesion came back with increase melanin in epithelial layer so the lesion is? nicotine
stomatitis-increased production of melanin by the normal number of melanocytes(melanin 1q) A
benign lesion on the hard palate typically associated with pipe and cigar smoking.(smoke 2q)
h. There’s one more q to this case in the unicorn file but i didn’t have that q (RO body in upper 1PM
socket? Remaining root tip)
134. Wear on buccal maxillary posterior cusps why? Working non-working protrusive. Went with working
135. What block to use for an anterior central extraction when local doesn’t work INFRAORBITAL
136. A few on meds causing xerostomia but one of them the guy smoked also didn’t know which to choose
137. Pt bites down on max M1, which has big amalgam filling, and breaks off cusp supragingivally. What Tx? PFM
crown
138. Pic with spots on palate–nicotinic stomatitis (spots were very hard to see!)139. Leukoplakia on FOM–which is not in differential? Nicotinic stomatitis
140. New pt with lot of issues. Which not to do at first visit? think answer was full SRP on all 4 quads because his
pockets were only 4mm (there were like 2 5’s no 6’s) and the other answers made more sense
141. Case with 5 years old girl. She had all first molars and erupting max central. Second central incisors – had
accident and was avulsed.
a. What you do with concussion? observe and control max central (only said observe not control on my
exam)
b. What is her dental age? the same as bone age (I went with dental age is advanced bc 1st molar
already erupted)
c. She had dark changes in her gingival? racial changes sth like this
d. On her gingiva above her central incisor.? It was sinus tract because of her accident 3 months earlier.
e. Again, more q’s to this case in unicorn that I didn’t have (171. She has lateral crossbite – how to treat
it.? maxillary expansion; 172. Can you give her for daily use CHX – T/F? True; 173. You should show
her and her parent how to brush T/F?

Hey Guys! If you want to look at the solutions to these questions, you can check the document below.

4-5 solved Feb 2021

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