Hey guys, finally i’m back from Day 2.
I do not have a good memory skill as others but I am trying to write some hard questions that I have encountered.

1) I had lots of questions (~5) asking about Scarlet Fever. What’s symptoms (except question), what is the meds that we have to avoid, etc.
Symptoms: Red Rash ( begins in face), Red lines, fever , sore throat, Lymphadenopathy of the neck, Nausea Vomiting
Scarlet Fever: Bateria Strepto Pyogenes. Beta Group A . Acts Like super Ag. Complete hemolisis B hemolitic. Oropharingis
1 to 5 weeks latter : Reumatic Fever
Other facts:Pyogenic general infection , Pharyngitis, cellulitis, Impetigo, reumathic fever, Glomerulonephritis.
Complications: Acute Rheumatic feverLungs, Kidneys (Glomerulonephytis) , Blood , Mid ear
M protein, Hyaluronidase, streptokinase, erythrogenic toxin activated by lysogenic convertion(that’s why the pt becomes red), Streptolysin O and Sm exotox A and B
Intrabucal signais: Strawberry Tongue : white tongue with Fungiphormes red ( NOT PHILIFORM)
Spread : person to person : saliva or nasal secretion
Incubation : 2-5 days
Exam : RADT ( rapid antigen detection- throat culture)
AB : Pen V 250 mg ( child :2 or 3 times/ day, adult : 4 times or 500mg 2x) or Amox 50mg/kg once
Avoid aspirine and any medicine with renal problems

2) know ECA branches well. I had 3 questions asking for this
BRANCHES OF THE EXTERNAL CAROTID
■ The mnemonic to remember the branches of the external carotid artery is
SALFOPSM: Some Anatomists Like Football, Others Prefer Soccer
Matches.
Branch Supplies
• Superior thyroid : Thyroid gland, gives off SCM branch and the superior laryngeal artery
• Ascending palatine : Soft palate, eustachian tube, palatine tonsils, levator veli palatini muscle
• Lingual :Tongue
• Facial: Face and submandibular gland
• Occipital: Pharynx and suboccipital triangle
• Posterior auricular :Posterior scalp
• Superficial temporal :Parotid gland, auricle, temple, scalp
• Maxillary Infratempora:l fossa, nasal cavity

Ex of questions: in FB group
1) IANB if u inject in an artery:
A:Lingual Artery from ICA
B: II II ECA
C: Inf Alv Artery from ICA
D : II II II ECA
( we get Lingual nerve, but not lingual artery The inf alv Artery is from The mandibular portion of maxillary artery from ECA)
Ps : In md : From ant to post : LN , IAN, IAA, Lingual artery
2) While working, the patient moved, and the dentist injured her near the cheek. Which artery was injured and caused bleeding?

A. Buccal artery of maxillary artery ITS MORE INTERNAL THAN FACIAL
B. Labial artery of ECA
C. Facial artery of ECA

3) Branch of ECA which arise from BELOW the cornu of hyoid bone?
A) lingual.
B) facial
C) superior thyroid

The superior thyroid artery arises from the external carotid artery just below the level of the greater cornu of the hyoid bone and ends in the thyroid
Lingual Artery-It first runs obliquely upward and medialward to the greater cornu of the hyoid bone

 

3) know pterygomandivular raphe well. Had 3 questions on this
Pterygomandibular ligament band of the buccopharyngeal fascia
1 question: Extention:
• attached superiorly to the pterygoid hamulus of the medial pterygoid plate
• inferiorly to the posterior end of the mylohyoid line of mandibula
2 question : Formed By :
• Supperior constrictor muscle and buccinator

Questions in FB group
3) Which of the following anatomical landmark is used as indicator of the posterior border of ramus of mandible in inferior alveolar nerve block:

A. Mandibular foramen

B. Occlusal plane of mandibular posterior teeth

C. Pterygomandibular raphe (vertical portion)

D. Pterygomandibular raphe (horizontal portion)

E. Coronoid notch

4) To give inferior alveolar nerve block the nerve is approached lateral to pterygomandibular raphe between the buccinator and:
A. Temporalis
B. Superior constrictor
C. Middle constrictor
D. Medial pterygoid

5) If you inject medial to pterygomandibular raphe when giving a local anesthetic, which muscle will you pierce?

A) superior pharyngeal constrictor
B) medial pterygoid

6) What is the correct position of the needle tip for the administration of local anesthetic for an inferior alveolar nerve block?

A. Anterior to the buccinator muscle.
B. Medial to the medial pterygoid muscle.
C. Lateral to the ramus of the mandible.
D. Superior to the mandibular foramen.
E. Inferior to the pterygomandibular raphe

7 ) IANB goes medial to pterygomandibular raphe. Which muscles does it hit?
Medial pt and sup constrictor

8 ) After receiving an inferior alveolar nerve block the patient develops a needle track infection. Which of the following anatomic spaces might have been involved?

A- Temporal

B- Submandibular

C- Pharyngeal

D- Pterygomd

4) know marijuana well. what’s the effect, Moa, what med can’t we use, etc
Effect Cannabinoids:Type 1 – cannabinoid receptor CB1 are found in CNS ( its stimulation effects: anticonvilsivant, antiemetic/antinausea)

CBD x THC
Hemp-derived YES NO
Marijuana-derived YES* NO
Illegal NO (See below) YES (See below)
Produce a “high” NO YES
Interact with endocannabinoid system YES YES
Side effects Almost none Psychoactive side effects
Shows on drug test Possibly** YES
Pain reliever YES YES
Reduces nausea YES YES
Eases migraines YES YES
Reduces anxiety YES YES
Eases depression YES NO
Decreases seizures YES NO
Anti-inflammatory YES YES
Helps with insomnia YES YES
Helps with psychosis YES NO
Increases appetite NO YES
Used for various other conditions YES YES
CBD can be extracted from hemp (cannabis plants that contain less than 0.3 percent THC) or from marijuana plants (cannabis plants with higher concentrations of THC).
** CBD isn’t detected in hemp products, but hemp products may contain trace amounts of THC. THC may show up in high enough concentrations to produce a positive drug test.
Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.
COULDN’T FIND DRUG INTERACTIONS!!!!!!!!!!!
5) know pharm very well in general.
6) know how to control asthma patients. How to treat them in emergency situation
• SPORT: Stop treatment , Position , Oxigen, Reassure, Take vital
• Avoid Nsaids ( ibu + Aspirin) and Narcotics ( oxicim)
• Use 2 puffs of Alguterol ( relax the smooth muscle of Bronchions)
DD:
An acute asthmatic attack is best treated by administration of supplemental oxygen with an inhalaled beta2-adrenergic agonist (a/buterol, terbutaline). If the patient is resistant to beta agonists, theophylline should be considered. In a severe asthmatic attack that is unresponsive to the above treatment, 0.3 mg of 1: 1000 epinephrine should be administered subcutaneously

General guidelines for the management of patients with asthma:
• Minimize stress: short appointments, use sedation techniques (nitrous, diazepam or other oral antianxietymedications).
• Avoid antihistamines
• Minimize epinephrine use (local anesthesia up to 2 carpules of 2% lidocaine with I: 100, 000 epinephrinemay be used)
• Avoid erythromycins and clarithromycin in patients on theophylline
• Be aware of aspirin sensitivity: there is a clinical triad of asthma, nasal polyps, and aspirin sensitivity. I is important to be sure that the patient with asthma does not have this triad when aspirin-containing preparations are prescribed.

DENTIN:

(Asthma, Bronchitis, Emphysema):
• Sit patient upright in dental chair.
• No rubber dam in severe cases.
• No N2O if severe emphysema.
• Avoid barbiturates, narcotics, anti-histamines.
• Avoid erythromycin, clarithromycin if patient takes
theophylline.
ASTHMA:
• Have patient bring their bronchodilator inhaler to each
appointment.
• Avoid Aspirin, NSAIDs, narcotics/barbiturates.
• Avoid Erythromycin if patient takes theophylline.
• Avoid sulfite-containing local anesthetics.
• Can use N2O or Diazepam for anxious patient.
• Use pulse oximeter if necessary.
7) veracity well. Had 2 q on day 1 and 2 on day 2
• Autonomy (“selfgovernance”).The dentist has a duty to respect the patient’s rights to self-determination and confidentiality.
• Nonmaleficence (“do no harm”).The dentist has a duty to refrain from harming thepatient.
• Beneficence (“do good”). The dentist has a duty to promote the patient’s welfare.
• Justice (“fairness”). The dentist has a duty to treat people fairly.
• Veracity (“truthfulness”). The dentist has a duty to communicate truthfully.

Veracity:
• facts opposed to veracity: overbilling, unnecessary treatment
• Facts related to veracity: Report adverse effects , returning patient back to the dentist
• Unethical to fee the pt solely bc he is benefiting from insurance

Questions in Fb group
1)Pt w almost all teeth with little propls and ask to remove everything and put Cd: what code of ethic are u breaking?

• A)Options with justice (justice has nothing to do with that)
• B) Veracity and autonomy
2) So there was a question which statement is true and false..clinical case was 60 year old man frustrated with failing restorations…
Intraorally number 3 was grade 2 furcation and grade1 mobility ,missing 4, 12 ,13 and 14 was in good condition.he wanted total extractions
The statements were
– informed consent will involve giving him all tt options including NO treatment T
– the principle of veracity involved giving him option of complete dentures T

Next question was the pts chief complaint which two ethics in conflict
– autonomy & veracity
-Autonomy & beneficienceXxxx
-autonomy & justice

3) dentists responsibility to abide by the ADA code of conduct is what property?
beneficience,
non malefecne,
veracity
justice?

4) Dentist reporting a child abuse, which ethic code
veracity
Justice
beneficence

5) If refusing to treat a hiv patient which ethics code are we breaking
Justice

8) cohort study and how to calculate incidence
Incidence—indicates the number of new cases that are expected to occur within a population over a period of time (e.g., the incidence of people dying of oral cancer is 10% per year in men 55 to 59 inour community).
Number of new cases of a desease / number of people in risk
Ex : Probabiliy of caries : 50 pat have caries, 20 have car + filling, 15 is missing. What are the probability on getting caries or filling? 50+20+15= 85 caries : 20/85 and filling : 15/85
Prospective cohort study—a general populationis followed through time to see who develops the disease, and the various exposure factors that affected the group are evaluated

Retrospective cohort study—used to evaluate the effect that a specific exposure has had on a population (((looks lijke a case control case , but the ase control has the control group)

9) ADHD meds.
All of them sypathomimetic and SH II, Do not remove the medicine for the treatment, just choose the limit dosage of LA of 0,04mg Epinefr instead of 0,2 mg normally considered
(a) Methylphenidate (Concerta, Ritalin, Metadate):adverse effects include nausea, hypertension. (recapat de dopa)
(b) Atomoxetine (Strattera): adverse effects include hypertension, dry mouth, nausea.(stimulate secretion of NE storage)
(c) Amphetamine/dextroamphetamine (Adderall):adverse effects include hypertension, headache, nausea, dry mouth.(II)

10) know how to do some basic ortho movement.. darn i didnt study this part assuming i wouldnt get that many but there were 3 qustions (1 on day 1 and 2 on day 2)

11) i had that question!! If a hyginest hurts the patient, who’s gonna be in charge?
????????

12) i had that question too. Who’s gonna get the least exposure to N2O
• Least exposed: Patient
• Most exposed : D assistant

13) lithium for bipolar – correct
14) sialiolith the most
• Yellow+ stones white
• Sausage links
• Can have bacteria surrounding
• Pain swallow
• Diagn Xray (occlusal) + transillumination
• Ocurrance: 1 Submand , 2 sublin and Parot
• Surgery of te sialolith and sometimes the gland

15) pemphigus/ pemphigoid qustions (2)

PHIGO VULG:
• Suprabasilar,
• acantolise,
• Antibody against Desmossomas,
• Loose of Rete Pegs
• painful ulcer preceded by blisters,
• Nikolsky +,
• fish net,
• doxiciclina 100mg 1/day

GOID: belOOOOOw
• Subasilar
• Antibody Basal membrane
• The detache is deep
• No acantolise
• It can have nick +, but normally the tissue slides

16) fibroma (pic)
17) amalgam tattoo (pic, 2 q on day 2)

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