AIIMS May 2003 Questions and Answers

AIIMS MAY 2003
~Questions~
AIIMS MAY 2003 - QUESTIONS 621
1. In dislocation of the jaw, displacement of the 7. At the physiological pH the DNA molecules are:
articular disc beyond the articular tubercle of the a. Positively charged
temporomandibular joint results from spasm or b. Negatively charged
excessive contraction of the following muscle: c. Neutral
a. Buccinator d. Amphipathic
b. Lateral pterygoid
c. Masseter 8. An obese lady aged 45 years, was brought to
d. Temporalis emergency in a semicomatose condition. The
laboratory investigations showed K+ (5.8 mmol/L);
2. Father-to-son inheritance is never seen in case of: Na"1 (136 mmoI/L); blood pH (7.1); HC03~ (12
a. Autosomal dominant inheritance mmol/L); ketone bodies (350 mg/dl). The expected
b. Autosomal recessive inheritance level of blood glucose for this lady is:
c. X-linked recessive inheritance a. <45 mg/dl
d. Multifactorial inheritance b. <120 mg/dl
c. <180 mg/dl
3. Acetyl Co-A acts as a substrate for all the enzymes d. <75 mg/dl
except:
a. HMG-CoA synthase 9. All of the following features are suggestive of
b. Malic enzyme asbestosis except:
c. Malonyl CoA synthetase a. Occurs within five years of exposure
d. Fatty acid synthetase b. The disease progresses even after removal of
contact
4. The activity of the following enzyme is affected by c. Can lead to pleural mesothelioma
biotin deficiency: d. Sputum contains asbestos bodies
a. Transketolase
b. Dehydrogenase 10. A screening test is used in the same way in two
c. Oxidase similar populations; but the proportion of false-
d. Carboxylase positive results among those who test positive in 08
population A is lower than those who test positive
in population B. What is the likely explanation?
5. A 55-year-old male accident victim in casualty
a. The specificity of the test is lower in
urgently needs blood. The blood bank is unable to
population A
determine his ABO group, as his red cell group and
b. The prevalence of the disease is lower in
plasma group do not match. Emergency transfusion
of patient should be with: population A
a. RBC corresponding to his red cell group and c. The prevalence of the disease is higher in
colloids/crystalloid population A
b. Whole blood corresponding to his plasma d. The specificity of the test is higher in
population A
group
c. O positive RBC and colloids/crystalloid
11. Residents of three villages with three different
d. AB negative whole blood
types of water supply were asked to participate in a
study to identify cholera carriers. Because several
6. Km of an enzyme is:
cholera deaths had occurred in the recent past,
a. Dissociation constant virtually everyone present at the time submitted to
b. The normal physiological substrate examination. The proportion of residents in each
concentration village who were carriers was computed and
c. Substrate concentration at half maximal compared. This study is a:
velocity a. Cross-sectional study
d. NunlSrically identical for all isozymes that b. Case-control study
catalyze a given reaction
622 DENTAL MATRIX (AIIMS edition)
c. Concurrent cohort study c. Allopurinol

d. Non-concurrent d. Orotic acid
12. An investigator wants to study the association 18. The most common cause of death in a patient with
between maternal intake of iron supplements (Yes primary amyloidosis is:
or No)/ and birth weights (in gm) of newborn a. Renal failure
babies. He collects relevant data from 100 pregnant b. Cardiac involvement
women and their newborns. What statistical test of c. Bleeding diathesis
hypothesis would you advise for the investigator in d. Respiratory failure
this situation?
a. Chi-square test 19. With reference to Bacteroides fragilis all of the
b. Unpaired or independent t-test following statements are true except:
c. Analysis of variance a. It is the most frequent anaerobe isolated from
d. Paired t-test clinical samples
13. Pin index system is a safety feature adopted in b. It is not uniformly sensitive to metronidazole
anaesthesia machines to prevent: c. The lipopolysaccharide formed by B.fragilis is
a. Incorrect attachment of anaesthesia machines structurally and functionally different from the
b. Incorrect attachment of anaesthesia face masks conventional endotoxin
c. Incorrect inhalation agent delivery d. Shock and disseminated intravascular
d. Incorrect gas cylinder attachment coagulation are common in bacteremia due to
B. fragilis
14. The usefulness of a screening test depends upon its: 20. Streptococcal toxic shock syndrome is due to the
a. Sensitivity following virulence factor:
b. Specificity a. M protein
c. Reliability b. Pyrogenic exotoxin
d. Predictive value c. Streptolysin O
d. Carbohydrate cell wall
08 15. For testing the statistical significance of the
difference in heights of school children among 21. The virulence factors of Neisseria gonorrhoea
three socio-economic groups the most appropriate include all of the following except:
statistical test is: a. Outer membrane proteins
a. Student's |M test b. Ig A Protease
b. Chi-squared test c. M - Proteins
c. Paired W test d. Pilli
d. One way analysis of variance (one way
ANOVA) 22. The most common congenital anomaly seen in
pregnancy with diabetes m el lit us is:
16. A 24-year-old female has flaccid bullae in the skin a. Multicystic kidneys
and oral erosions. Histopathology shows b. Oesophageal atresia
intraepidermal acantholytic blister. The most likely c. Neural tube defect
diagnosis is: d. Duodenal atresia
a. Pemphigoid
b. Erythema multiforme 23. Direct impact on the bone will produce a:,
c. Pemphigus vulgaris a. Transverse fracture
d. Dermatitis herpetiformis b. Oblique fracture
c. Spiral fracture
17. All of the following form radiolucent stone except: d. Comminuted fracture
a. Xanthine
b. Cysteine
24. All of the following are seen in rickets except: c. Thyroxin

a. Bow legs d. VitD3
b. Gunstock deformity
c. Potbelly 32. Modulus of elasticity means:
d. Cranio tabes a. Rigidity or stiffness of the material
b. Ability to be stretched with permanent
25. Kenny Packs were used in the treatment of: deformation
a. Poliomyelitis c. Ductility of a material
b. Muscular dystrophy d. Malleability of the metal
c. Polyneuropathies
d. Nerve injury 33. As the gold content of a dental solder decreases,
the:
26. Which type of radiation effect results in radiation- a. Hardness decreases
induced thyroid cancer? b. Ductility increases
a. Somatic c. Corrosion resistance decreases
b. Genetic d. Ultimate tensile strength decreases
c. Teratogenic
d. Autosomal 34. The property of amalgam that makes it undesirable
to bevel occlusal margins of an amalgam cavity
27. The treatment of choice for stage 1 cancer larynx is: preparation is its:
a. Radical surgery a. Flow
b. Chemotherapy b. Ductility
c. Radiotherapy c. Brittleness
d. Surgery followed by radiotherapy d. Malleability
28. Stapes footplate covers: 35. Enamel etched by a tooth conditioner but not
a. Round window covered with a fissure sealant:
a. Will remineralize within a month 08
b. Oval window
c. Interior sinus tympani b. Will remineralize within 3 months
d. Pyramid c. Will absorb stain and discolor the tooth
d. Will leave the tooth more susceptible to caries
29. All the following muscles are innervated by the attack
facial nerve except:
a. Occipito-frontalis 36. A 2%-year-old child has an acute oral infection
b. Anterior belly of diagastric characterized by small, reddish yellow vesicles on
the facial mucosa and the hard palate. The oral
c. Risorius
temperature 102°F. The child cannot eat or drink.
d. Procerus
The condition is most likely:
a. Candidiasis
30. Periconceptional Use of the following agent leads
b. Acute herpetic stomatitis
to reduced incidence of neural tube defects:
c. Acute streptococcal infection
a. Folic acid
d. Recurrent herpetic gingivostomatitis
b. Iron
c. Calcium
37. Stainless steel orthodontic wire can be hardened by:
d. Vitamin A
a. Tempering
b. Work hardening
31. Osteoclast specific receptor for:
c. Age hardening
a. Parathyroid hormone
d. Precipitation hardening
b. Calcitonin
38. Most common route for metastasis of oral cancer is 44. "Pickling" of the casting:
by: a. Is done by immersion in 35% phosphoric acid
a. Direct extension b. Is done by using concentrated tartaric acid
b. Lymphatics c. Is done to remove surface irregularities on the
c. Blood vessels casting
d. Aspiration of tumor cells d. Means to remove surface contaminants
39. Barbiturates in paediatric dentistry: 45. Failure of partial dentures due to poor clasp design
a. Are contraindicated can best be avoided by:
b. Have a low safety margin a. Using stress breakers
c. Can be used safely b. Using bar-type clasps
d. Are not required and therefore not necessary to c. Altering tooth contours
use d. Clasping only those teeth with fairly long
crowns and normal bone support
40. Repair of cleft lip should be ideally done:
a. After 3 years of age 46. Repeated fracture of a porcelain fused- to-metal
b. Between 2 and 12 weeks of life restoration is primarily due to:
c. Immediately after birth a. Occlusal trauma
d. At least 12 months after birth b. Improper firing schedule
c. Failure to use a metal conditioner
41. An X-ray picture shows bone expansion with d. An inadequately designed framework
honeycomb or soap bubble appearance and is
eccentrically ballooned. Cortical bone is destroyed 47. The advantage of metal base denture is:
and a periosteal reaction evident Most a. Increase in tissue tolerance
Likely the lesion could be: b. Easy laboratory procedure
a. Malignant melanoma c. Rebasing and relining are quite easy
b. Central ossifying fibroma d. Increase in restorative cost
08 c. Aneurysmal bone cyst
d. Giant cell tumor 48. Normal dentition in centric occlusion, opposing
contact may be expected at:
42. Which of the following statements about high
copper silver alloy compared to conventional alloy a. Buccal slopes of buccal cusps of maxillary
is not true? posterior teeth
b. Buccal slopes of lingual cusps of maxillary
a. It has increased tensile and compressive
strength posterior teeth
b. It has poor tarnish and corrosion resistance c. Lingual slopes of lingual cusps of mandibular
posterior teeth
c. Its edge strength is greater
d. All slopes of lingual cusps of mandibular
d. A mercury content in the final restoration is
posterior teeth
less
43. A patient has well-adjusted and seated onlays on 49. In which type of lesion 'eburnation' of the dentine is
upper second premolar and molar. After four weeks seen?
he complains of the fracture of the lingual cusps of a. Acute caries
the first premolar. Most likely this may be caused b. Chronic caries
by all except. c. Arrested caries
a. Onlays are in supraocclusion d. Root caries
b. Onlays are in intraocclusion
c. Accentuation of the nonworking contacts 50. The lateral spread of dental caries is facilitated
d. Biting on the hard food most by the:
a. Enamel spindles
b. Dentinoenameljunction 56. An 11-year-old child comes to the dental office one

c. Enamel lamellae hour after injury to a maxillary central incisor. The
d. Strieof Retzius tooth is vital and slightly mobile. Radiographic
examination reveals a fracture at the apical third of
51. What is destroyed first? In the progressing the root What is the best treatment at this point of
destruction of the tooth structure due to caries: time:
a. The organic portion alone a. Render palliative therapy
b. The inorganic portion alone b. Extract the tooth
c. Both organic and inorganic are destroyed c. Relieve the occlusion and splint the tooth
simultaneously d. Perform immediate root canal treatment and
d. Intermittently organic and inorganic splint
52. The probable reasons for a high incidence of dental 57. A mother and her 4-year-old son are seated alone in
caries in the teenage population related most a reception area with the child staring off into
directly to: space, rocking and constantly twisting a strand of
hair about his fingers. Upon entry of another
a. Rapid growth
person, the child begins to beat his fist against the
b. Frequency of sucrose intake
side of his face and behaves as though he does not
c. Negligence in visiting the dentist
hear his mother speaking to him. This behaviour is
d. Carelessness in oral hygiene habits most characteristic of:
a. An autistic child
53. The logical explanation for the unique and b. A mentally retarded child
cariogenic property of most silicate cements in:
c. First dental appointment anxieties of a 4-year-
a. The reduction in enamel solubility due to old child
fluoride uptake by enamel
d. A child with a chronic seizure disorder
b. That beryllium flux is used in silicates
c. That silicates show very little leakage at the
58. The parents of a 4-year-old girl are distressed
margins of the restoration
because her thumb sucking habits has resulted in an
d. Due to the high silica content 08
anterior open bite of approximately 3 mm. Most
authorities agree that the parents should be advised
54. A patient complains of prolonged pain in the to:
condensed amalgam in a class V restoration placed a. Stop worrying about the habit
six months back. This could be due to: b. Do their best to break the child's habit, even if
a. Development of irreversible pulpitis considerable unpleasantness is involved
b. Fracture of the restoration c. Have their dentist constructed an appliance to
c. Gingivitis stop the habit
d. Tooth brush abrasion d. Consult a psychologist or a psychiatrist as the
child may have psychological disturbances
55. An 8-year-old patient with all primary molars still
present exhibits a cusp to- cusp relationship of 59. At birth child shows marked convex profile. This is
permanent maxillary and mandibular first molars. due to:
The dentist should: a. Protruded maxilla
a. Continue regular recalls b. Retruded mandible
b. Plan serial extractions for more normal c. Large size maxilla
adjustment of the occlusion d. Small sized mandible
c. Refer the patient to an orthodontist for
consultation
60. Sequence of eruption of primary teeth:
d. Disk the distal surfaces of primary mandibular
a. ABCDE
second molars to allow normal adjustment of
b. ABDCE
permanent molars
c. ABDEC 66. Extraction of a tooth during acute infection: Ipl

d. ABEDC a. Can cause extensive spread of infection
b. Helps drainage and relieves pain if proper
61. Extraction of maxillary third molars, done between antibiotic is given and its adequate blood level
7 and 9 years of age: is reached
a. Is ideal because tooth buds are easier to extract c. Can cause sudden death due to pulmonary
than fully formed teeth embolism
b. Would improve the growth of maxilla at the d. Can lead to trigeminal neuralgia in
tuberosities postoperative period
c. Is not indicated as it is traumatic procedure
d. Would improve the prognosis of orthodontic 67. Juvenile periodontitis is associated pP- with:
treatment result a. Cyclic eosinophilia
b. Pernicious anemia
62. If continuous hypersensitivity develops in recently c. Neutrophil chemotactic defect
restored tooth: d. Mouth breathing and occlusal traumatism
a. No treatment necessary
b. Remove the restoration and place ZoE 68. The usual radiographic appearance of an
c. Perform pulpectomy osteosarcoma is:
d. Perform direct pulp capping a. Discrete radiolucency with regular borders
b. Multicystic radiolucency with a soap bubble
63. Focal sclerosing osteomyelitis is: appearance with an irregular peripheral border
a. Due to excessive periosteal bone formation c. Sunburst pattern with radiopaque strands
b. An extremely painful condition extending from the cortical plates
c. Due to low grade chronic infection d. Cotton wool appearance with an irregular
d. A common sequel following sequestrectomy peripheral border
64. Which of the following statements is true about a 69. The soft tissue-tooth interface that forms after flap
08 one-week-old oro-antral fistula? surgery in a previously denuded area is a:
a. This should first be treated conservatively a. Long junctional epithelium
b. This should be closed immediately by use of b. Collagen adhesion
tongue flap c. Scar tissue attachment
c. Antibiotics should not be prescribed as it may d. Connective tissue attachment
mask the symptoms
d. Patient should be advised hot fomentation over 70. A periodontal pocket 8 mm deep, having the
the face to improve the vascular supply and functional epithelium coronal to the cemento-
hasten the self healing of the fistula enamel junction is:
a. An infrabony pocket
65. Fluoride supplement for a 4-year-old child in an b. A pseudopocket
area where community water supply contains 0.2 c. A true periodontal pocket
ppm of fluoride is: d. A furcation involvement
a. One mg of fluoride tablet/day
b. Topical fluoride in form of daily rinsing with 71. For periodontal patients, the most frequently
2% solution of NaF recommended tooth brushing technique is:
c. Application of fluoride varnish every three a. Scrub technique
months b. Roll technique
d. Unnecessary as the crowns of most of the c. Sulcular technique
deciduous teeth are already formed d. Transverse scrubbing technique
72. What type of fibres are principal fibres of the 79. Pain in 'cracked tooth syndrome11 is:
periodontal ligament? a. Continuous in nature
a. Elastic b. Variable as the name indicated
b. Reticular c. Elicited mainly when pressure is applied
c. Collagenous d. Elicited mainly when applied pressure is
d. Collagenous and elastic relieved
73. In which of the following conditions oral screening 80. A 4-year-old child has a normal complementary
should not be used? primary teeth, but they are gray and exhibit
a. Nail biting habit extensive occlusal and incisal wear. Radiographic
b. Tongue thrusting examination indicates extensive deposits secondary
c. Acute infection of tonsils and adenoids dentin in these teeth. Most likely the condition is:
d. Thumb sucking a. Neonatal hypoplasia
b. Amelogenesis imperfecta
74. When all diagnostic procedures fail to detecting c. Cleidocranial dysplasia
proximal caries, last resort is: d. Dentinogenesis imperfecta
a. Mechanical separation
b. Preparation of the test cavity 81. An abnormal resorption pattern in primary teeth,
c. Transillumination delayed eruption of permanent teeth and a large
d. Caries activity tests tongue are the features of:
a. Addison's disease
75. Arch perimeter can be measured with: b. Hypothyroidism
a. Cephalogram c. Hyperthyroidism
b. Brass wire d. Von-Recklinghausen disease
c. Vernier calipers
d. Occlusal radiograph 82. A 10-year-old girl presents with a 1.5 mm diastema
between the maxillary central incisors. A very
fibrous maxillary frenum is present and inserts on 08
76. By joining which of the following landmarks the
the palatine papilla. When tension is applied to the
Frankfort-horizontal reference plane is constructed:
frenum, the papilla blanches. The treatment of
a. Nasion and sella
choice is to:
b. Porion and sella
a. Perform maxillary frenectomy to allow the
c. Porion and orbitale teeth to close
d. Basion and orbitale b. Close'the space orthodontically expecting, the
frenum to atrophy due to pressure
77. Facial and lingual walls of the proximal box of c. Postpone treatment until complete eruption of
class II amalgam cavity preparation in a primary maxillary canines
tooth should: d. Close the space with a composite/veneer
a. Be parallel to each other
b. Diverge toward the occlusal surface 83. In which of the following disorders a circulating
c. Converge toward the occlusal surface antibody directed to interceullar cementing
d. Follow the direction of the enamel rods substance of stratified squamous epithelium is
observed:
78. Which of the following is related to reciprocal a. Lichen planus
anchorage in orthodontic mechanotherapy: b. Verrucus vulgaris
a. Tipping a tooth c. Bullous pemphigoid
b. Extra oral force d. Pemphigus vulgaris
c. Bodily movement of a tooth
d. Equal and opposite forces
84. Which of the following condition has the potential 86. To localize a supernumerary or an impacted tooth
of undergoing "spontaneous “malignant and determine its exact relationship to the other
transformation: teeth, which of the following radiographs would be
a. Osteomalacia most effective?
b. Albright's syndrome a. A periapical and an occlusal view
c. Paget's disease of bone b. An occlusal view using a high angle
d. Von-Recklinghausen's disease of bone c. A panoramic radiograph
d. Two or more periapical views at different
85. Distortion of a X-ray image can be reduced when angles and an occlusal view
the film is kept at a distance from the teeth to
maintain a parallel axis with the long-axis of the 87. Serial extraction is indicated primarily in:
teeth by: a. Class I malocclusion
a. Decreasing the target-film distance b. Class II Div I malocclusion
b. rH9ecrease the KVp c. Class II Div II malocclusion
c. Increasing the target-film distance d. Class III malocclusion
d. Increasing the KVp
08
AIIMS MAY 2003
~Answers & Explanations~
AIIMS MAY 2003 - ANSWERS AND EXPLANATIONS 631
Ans 1: Option B (Lateral pterygoid)

(B.D. Chaurasia, Vol III, 3rd edition, page 124-125)
 Temporomandibular joint is formed between the temporal bone and the mandible
 The joint cavity is divided into upper and lower parts by an intraarticular disc
 The movements at the joint can also be divided into those between the upper articular surface and the articular
disc and those between disc and the mandible
 The dislocation of the jaw occurs during forward movement of the joint i.e. protrusion.
 Protrusion of the jaw occurs due to contraction of lateral pterygoid.
Ans 2: Option C (X-linked recessive inheritance)

(Chandrasoma Taylor, 3rd edition, page 234-236; Robbin’s 6th edition, page 146)
 X –linked recessive inheritance is a sex linked disorder i.e. they are transmitted by sex chromosomes
 Remember that all sex linked diseases are linked to X- chromosomes so it is quite obvious that none of the sex
linked disease ( whether X-linked recessive or X- linked dominant) will be transmitted from father to son, as
father transmits only Y chromosome to the son
 So its clear that:
o An affected male does not transmit the disorder to his sons, but all daughters are carrier
o Sons of heterozygous women have 50% chance of receiving the abnormal gene
o It usually affects males because of the presence of Y- chromosome which is not homologues to X-
chromosome and therefore the mutant genes on the X is not paired with alleles on the Y
o It is rare in females , only possible when mother is carrier and father has overt disease
Ans 3: Option B ( Malic enzyme)

Read below:
“Acetyl-CoA carboxylase catalyzes the synthesis of malonyl-CoA, the first committed reaction of fatty acid biosynthesis.
When synthesis of malonyl-CoA is inhibited, subsequent reactions of fatty acid synthesis cease due to lack of
substrates” (Harper’s Biochemistry, 26th edition, page 73)
 Hence Option C is not the answer here
“Acetyl-CoA, formed from pyruvate by the action of pyruvate dehydrogenase, is the major building block for long-chain
fatty acid synthesis in nonruminants. (In ruminants, acetyl-CoA is derived directly from acetate)” (Harper’s 08
Biochemistry, 26th edition, page 35)
 Hence option D is not the answer here
“Initially, two molecules of acetyl-CoA condense to form Acetoacetyl-CoA catalyzed by cytosolic thiolase. Acetoacetyl-
CoA condenses with a further molecule of acetyl-CoA catalyzed by HMG-CoA synthase to form HMG-CoA, which is
reduced to mevalonate by NADPH catalyzed by HMG-CoA reductase” (Harper’s Biochemistry, 26th edition, page 219)
 So from above lines, it is clear that answer has to be Malic acid. Read further:
“Other sources of NADPH include the reaction that converts malate to pyruvate catalyzed by the “malic enzyme”
(NADP malate dehydrogenase) and the extramitochondrial isocitrate dehydrogenase reaction” (Harper’s
Biochemistry, 26th edition, page 176)
 So clearing further, Acetyl CoA is not the substrate for Malic enzyme, Malate acts as substrate for it
Ans 4: Option D (Carboxylase) (Harper’s Biochemistry, 25th edition, page 634)

 Biotin is a co-enzyme required for carboxylase reactions. It functions as a component of specific multi-
subunit enzymes that catalyze carboxylase reactions……….. Harper
 Biotin dependent enzymes are:
o Pyruvate carboxylase
o Acetyl CoA carboxylase
o Propionyl CoA carboxylase
 Also know
o Avidin which is a protein present in egg white combines very tightly with biotin preventing its
absorption and inducing biotin deficiency
Ans 5: Option C (O-positive RBC and colloids/crystalloids)

(Wintrobes Clinical Haematology, Vol. I, 10th edition, page 833)
SELECTION OF BLOOD FOR EMERGENCY TRANSFUSION:
 If the patient’s blood group is known:
o Unmatched blood group of the same group may be used
 If the patient’s blood group cannot be determined:
o Group O RBCs should be chosen
o Such unmatched blood should be Rh –ve when used in women of child bearing age in whom
sensitization to Rh-antigen would be undesirable
o As Rh-ve blood is often in limited supply, Rh +ve blood is used in the emergency transfusion of older
females and males of unknown blood group. In such cases sensitization may occur but the risk of an
immediate haemolytic reaction is low
o So in the given question the blood bank is unable to determine the patient blood group; so he should
be given RBCs of O blood group which is the universal donor
o Since he is an old male, he can be given Rh+ ve in case of unavailability of Rh-ve group
o Hence the choice of answer is option C
Ans 6: Option C (Substrate concentration at half maximal velocity)
(Harper, 25th edition, page 95; Satyanarayana, 2nd edition, page 88-93)
“The substrate concentration that produces half- maximal velocity, termed the Km value or Michaelis constant” --
Harper
“Km or the Michaelis –menton constant is defined as the substrate concentration (expressed in moles/lit) to produce
half-maximum velocity in an enzyme catalysed reactions. It indicates that half of the enzyme molecules (i.e. 50%) are
bound with the substrate molecules when the substrate concentration equals the Km value” -- Satyanaryana
ALSO REMEMBER:
o Km value is constant and a characteristic feature of a given enzyme
o It is a representative for measuring the strength of ES- complex
o A low km value indicates a strong affinity between enzyme and substrate and vice versa
o For majority of enzymes , the Km values are in the range of 10-5 to 10-2 moles
08
Ans 7: Option B (Negatively charged) (Ronald Hofman Hematology, 2nd edition, page 2202)
 DNA molecules are negatively charged, this is evident as it is stained by a cationic ( positively charged) dye
Read the following lines for Ronald Hoffman Hematology:
“Anionic cellular elements (nuclear DNA) react with cationic dye (Methylene blue)”
Ans 8: Option C (> 180mg/dl) (Harrison’s, 17th edition, page 2283, 290)
Metabolic acidosis (pH 7.1 and HCO3 12 mmol/l), presence of ketone bodies and increased potassium (Normal 3.5
mmol/l to 5 mmol/l) favours the diagnosis of diabetic ketoacidosis
 Diabetic ketoacidosis occurs when the serum glucose level is around 300-600 mg/dl
 Laboratory values in diabetic ketoacidosis are
o Glucose ………300-600mg/dl
o Sodium ………..125-135
o Potassium ……..normal to increased
o Magnesium …….normal
o Chloride ……….normal
o Phosphate ……..decreased
o Creatinine ………slightly increased
o Osmolality ………300-320
o Plasma ketones……+ + + +
o Serum bicarbonate….<15 meq/l
o Arterial pH…….6.8-7.3
o Arterial Pco2 mm Hg…20-30
o Anion gap [ Na- ( Cl + HCO3]…..increased
 Note : For every 100mg elevation of glucose in serum the Na+ concentration decreases by 3 meq
Ans 9: Option A (occurs within five years of exposure) (SPM Park 17th edition, page 577,578)
 Asbestos is the commercial name given to certain types of fibrous material. They are silicates of varying
composition, the silica is combined with such bases as magnesium, iron ,calcium, sodium and aluminium
 The disease does not usually appear until 5-10 years of exposure
 Once established ;the disease is progressive even after removal of the worker from contact
 Most common manifestation is------------ pleural plaques
 Most common site of calcification is ------along the lower lung fields, diaphragm and the cardiac border
 Asbestos bodies consists of asbestos fibres coated with an iron containing proteinaceous material
Ans 10: Option C (Prevalence of the disease is higher in population A)

(SPM Park 18th edition, page 116,117; 17th edition, page 111 & 112)
 In the question same screening test is used in the same way in both the population. The sensitivity and
specificity will remain same. So the nature of the population will begin to play important role for e.g. If we
take two population A and B of 100 people each and in A the no. Of persons with the disease are 80 and in B
no. Of persons with the diseases are 60
 So in population A
o 80 persons are diseased, the remaining 20 are not diseased
o If the specificity of the test is 90% then
 No. Of true negatives = (90 x 20)/100 =18
 Remaining two who actually do not have the disease but are not excluded by the disease are
false positive
 Now in population B
o 60 persons are diseased, the remaining 40 do not have the disease
o If the specificity of the test is 90% then
 No. Of true negatives = (90 x40)/100=36
 So no. Of false positive =4
 Thus this example makes it clear that if the sensitivity and specificity remains the same the no. Of false positive 08
varies inversely with the prevalence of diseases in population
 Hence Option C is the answer of choice
ALSO REMEMBER
 If the specificity of a test is high, there will be increase in true negatives and decrease in false positives. If
the specificity decreases reverse will occur
Ans 11: Option A (Cross-sectional study) (SPM Park 18th edition, page 63; 17th edition, page 60)
 Here a single examination is undertaken at one point of time to study the whole population ( three villages)
 This type of study is called cross-sectional study
 Park states “cross sectional study is the simplest form of an observational study. It is based on a single
examination of a cross section of population at one point of time. The results of which can be projected on
the whole population
Remember about cross-sectional studies:

o Also known as prevalence study
o These are more useful for chronic than short lived diseases
o It provides very little information about incidence
Ans 12: Option B (unpaired or independent t-test) (NMS Biostatistics, page 59; BK Mahajan 6th edition, page 130)
 First let us see the various statistical tests
Chi –square -- It is used for qualitative data, data in which there is no notion of magnitude or size of the
test attribute
-- The data is in the form of proportions
-- The data are classified by counting the individuals having the same characteristics or
attributes
Student –t -- Used for quantitative data i.e. the data has a magnitude and is normally distributed in the
test population ( i.e. continuous data) e.g. each individual has one measurement from a continuous
spectrum or range such as body temperature, height, weight, blood pressure etc.
-- It is of three types
-- Student –t test for single small sample
-- Student –t test for independent samples ( also known as unpaired test)
--Student –t test for paired sample ( paired t-test)
Paired t-test -- It compares the means of two paired samples ( when two readings, are taken from the same
group, before and after an intervention)
Analysis of -- Used for same data’s as the t-test
variance -- Whereas t-test is appropriate for making just one comparison( between two sample means,
(ANOVA) or between a sample mean and hypothesized population mean), ANOVA is used when more
than one comparison is to be made ( when means of more than two groups are being
compared)
 In the given question since we have only two samples i.e.

o Birth weight of babies born to mothers taking iron supplements
o Birth weight of babies born to mothers not taking iron supplements and the attribute ( birth weight) is
a quantitative data
 Hence we should use the student –t test
Ans 13: Option D (incorrect gas cylinder attachment) (Paul anaesthesia, 4th edition, page 67)
08  To understand this question we need to have a preliminary knowledge of Boyle anaesthesia machine
 Boyle anaesthesia machine is a continuous flow type of machine used for administration of inhalational
anaesthesia
 It is equipped with two oxygen cylinders, two nitrous oxide cylinders, one carbon dioxide cylinder and one
cyclopropane cylinder
 These cylinders are locked to Boyle apparatus in metal yoke with two pins and fitting holes on the cylinder
head. Each cylinder has a particular pin code and unless the correct cylinder valve is attached the pins and
holes will not coincide. Thus it is practically impossible to fit any cylinder to wrong yokes
Ans 14: Option A (Sensitivity)

Nothing much to explain here. Has been repeated and explained many times before
 The most important criteria for a screening test is sensitivity of the test
 The most important criteria for a confirmatory test is specificity of the test
 For e.g. in AIDS Elisa test is used as screening test because it has a high sensitivity and western blot is used as
confirmatory test because it has high specificity
Ans 15: Option D (one way analysis of variance) (B.K Mahajan, 6th edition, page 152)
 As explained in the q.no.12 , ANOVA test is used for quantitative data’s, when more than two samples are to
be compared
 Here in this question the attribute ( height) is a quantitative data having a continuous distribution in
population and there are three groups to be compared, so ANOVA would be the appropriate test
Ans 16: Option C (pemphigus vulgaris) (Roxburgh’s skin disease, 16th edition, page 86-87)
 Bullae involving oral mucosa with intraepidermal lesions & acantholysis is characteristic of pemphigus
 Also remember about pemphigus that

o Vesicles are seen on the upper part of body. Trunk> limbs
o Lesions are non-itchy and painless
o Oral mucosa involvement is seen in 50% cases
o Lesions are intraepidermal
o Acantholysis present
o Nicolasky sign present
o Age group 40-50
Ans 17: Option B (Cysteine)

(Campbell’s Urology, 8th edition, page 3270; Schwartz Surgery, 7th edition, page 1776)
 Campbell’s Urology writes----
“Cysteine calculi are slightly radiodense because of their sulphur content”
“Only calculi of pure uric acid, xanthine, dihydroxyadenine, indinavir, triamtrene or matrix can be considered
truly radiolucent”
 About option C
o Allopurinal treatment may lead to formation of xanthine stones which are radiolucent
o Campbell says------ occasionally patients who are given allopurinol for the treatment of uric acid
urolithiasis or gout form xanthine calculi
 Option D
o Orotic aciduria is an autosomal recessive disorder caused by defect of enzyme UMP synthase, which
converts orotic acid to UMP. The defect leads to megaloblastic anemia , growth retardation &
neurological abnormalities
o Increased excretion of orotic acid causes crystalluria and stone formation
Ans 18: Option B (Cardiac involvement) (Harrison’s 16th edition, page 2028; 15th edition, page 1364)
 Harrison writes……. “ Involvement of the heart is the most frequent cause of death in primary amyloidosis”
Also know about amyloidosis:
o Most common organ involved in amyloidosis-------kidney 08
o 2nd most common organ involved in amyloidosis------liver
o Gingival and rectal biopsy is helpful in establishing in 70% cases of amyloidosis
o Renal amyloidosis recur frequently in renal transplant ( for amyloidosis)
Ans 19: Option D> B (i.e. shock and disseminated intravascular coagulation are common in bactermia due to B.
Fragilis > it is not uniformly sensitive to metronidazole)
(Anantnarayan 6th ed/pg 246; Harrison 16th ed/pg 945; 15th ed/pg 1011-12, 1015-16, Jawetz 22nd ed/pg 267 &
269)Let’s see each option one by one
 Option A
o “Bacteroides are the most common anaerobes isolated from clinical specimens”---------
Anantnarayan
 Option B
o Resistance to metronidazole has been reported only rarely in Bacteroides species. This well tolerated
drug should be considered first line therapy against Bacteroides------Harrison
o Most active drugs for treatment of anaerobic infection are clindamycin and metronidazole. Relatively
few anaerobes are resistant to clindamycin and few if any are resistant to metronidazole------Harrison
o So its clear from the above that option B is also wrong
 Option C
o Bacteroides fragilis possess lipopolysaccharides ( endotoxins) that are less biologically potent than
endotoxins associated with aerobic gram negative bacteria--------Harrison
o Bacteroides species have lipopolysaccharides ( endotoxins) but lack the lipopolysaccharide structures
with endotoxic activity. The lipopolysaccharides of B. Fragilis are much less toxic than those of
other gram negative bacteria------Jawetz
 Option D
o “Due to the structural and functional defect in lipopolysaccharide the infection caused by Bacteroides
does not directly produce the clinical signs of sepsis ( e.g. fever and shock) so important in infection
due to other gram negative bacteria. When these clinical signs appear in bacteroides infection, they
are a result of the inflammatory immune response to the infection”-------Jawetz
o Hence option D is also wrong and hence the answer of choice
Ans 20: Option B (Pyrogenic exotoxin) (Anantnaryan, 5th/ed, pg 193)

 Streptococcal toxic shock syndrome is caused due to the release of pyrogenic exotoxins or erythrogenic
exotoxins
 These exotoxins are produced only by few strains of beta haemolytic group A streptococci
 Usually these toxins cause scarlet fever but sometimes these strains produce exotoxins that are superantigens
o These superantigens (exotoxins) directly super stimulate T cells to pour out inflammatory cytokines.
This causes streptococcal toxic shock syndrome
 The tests for erythrogenic or pyrogenic exotoxins are:
o Dick test
o Schultz Charlton reaction
Ans 21: Option C (M protein)

(Anantnaryan, 5th/ed pg 209-210; Harrison’s 16th ed/pg 856, 15th ed/pg 932)
 M .protein is not a virulence factor for Neisseria. It is the most important virulence factor for streptococci
Virulence factors for Neisseria Gonorrhoea
 Pilli
o These are hair like structures and they help in attachment of gonococci to mucosal surface
o They also promote virulence by inhibiting phagocytosis
 Opacity associated protein ( OPa)
o It is a gonococcal surface protein responsible for adherence of the organism to epithelial cells
 Porin ( protein 1)
o Most abundant gonococcal surface protein accounting for >50% of the organisms total outer
08 membrane protein
 IgAI protease
o Protects organism from action of mucosal IgA
 Lipoprotein H8
 Transferrin binding protein & lactoferrin binding protein
 Besides these proteins, lipooligosaccharide is also present, which possess marked endotoxic activity and
contributes to local cytopathic effects in fallopian tubes
Ans 22: Option C (Neural tube defect)

(Obstetrics Fernando Areas, 2nd ed/pg 289; Williams Obstetrics, 21st ed/pg 1369)
 Most common single organ system anomaly with diabetes is------heart
 Most common congenital anomaly seen in diabetic mother ------anencephaly
 Most common heart anomaly associated with diabetes is---------Transposition of great vessels
 The most characteristic or specific lesion associated with diabetes----Caudal regression syndrome ( sacral
agenesis)
 Remember sacral agenesis or caudal regression syndrome is the lesion most specifically associated with
diabetes. It is not the most common congenital anomaly seen in diabetic mother
Ans 23: Option A (Transverse fracture)

(Apley’s 8th ed/pg 539; Rockwood and Green’s Fractures in Adults, 4th ed/pg 13)
 A direct force can be of two types
o A direct blow or tapping force
 This causes transverse fracture
o A crushing injury
 Causes communited fracture
 Lets see the type of fracture caused by various modes of injury
Force
Direct Indirect
Direct blow Crushing force Twisting Compression Bending

or tapping
Transverse Communited Spiral Oblique Triangular butterfly
(Ref: This classification is according to Apley’s 8th ed, some books may differ on this)
Ans 24: Option B (Gunstock deformity) (O.P. Ghai 6th ed/pg 127-129; 5th ed/pg 83-85)
The clinical manifestations and other features of Rickets are:
 Earliest manifestation of Rickets is --------Craniotabes
 Clinical manifestation of Rickets appear at--------later half of first year or in 2nd year ( Unusual
below the age of 3 months)
 In rickets the abdomen is protuberant ( pot belly) because of marked hypotonia of abdominal wall
muscles
 Visceral proptosis and lumbar lordosis also occurs in rickets
 Other features are:
o Rachitic rosary
o Poor mineralization of bones
o Ant bowing of legs
o Knock knee 08
o Coxa vera
o Harrison sulcus
o Pigeon Breast
 Earliest radiological changes appear in long bones of radius and ulna
 Cupping of metaphyses
 Large gap between epiphysis and metaphyses( widening of the physis i.e. growth plate)
 Irregular metaphyseal margins ( ill- defined zone of provisional calcification)
 Osteopenia
Ans 25: Option A (Poliomyelitis) (O.P.Ghai 5th ed/pg 184; Dorland’s medical dictionary 28th ed/pg 1736)
 Sister Kenny was the legendary British Nurse and for relief of pain and spasm of muscles she devised a
novel therapy in the form of hot moist packs. This is known as Kenny’s treatment
 It is used for relief of pain during acute stage of poliomyelitis
 Dorland’s Medical Dictionary writes—
“Kenny treatment is a treatment formerly used for poliomyelitis consisting of wrapping of the back and
limbs in hot cloths, followed, after pain has subsided by passive exercise”
Ans 26: Option A (Somatic) (White & Pharoah, 4th ed/pg 37; 5th ed/pg 39-41)
 Radiation induced cancers are the important somatic effects seen in the irradiated individuals
 Examples are radiation induced thyroid, oesophageal, salivary gland cancers etc.
Ans 27: Option C (Radiotherapy)

(Dhingra E.N.T. 3rd /pg 373; 2nd ed/pg 306; Logan Turner 10th ed/pg 178)
Treatment of Laryngeal Cancer:
 For supraglottic & Glottic cancer
o Stage I & II ------- radiotherapy only
o Stage III & IV ------surgery + Rx
 For subglottic cancer
o Neither radiotherapy nor surgery is helpful so we give radiotherapy initially and if tumours recur,
total laryngectomy is done. At the same time paratracheal nodes should be removed
Ans 28: Option B (Oval Window) (Dhingra 3rded /pg 7; 2nd ed/pg 6)
 Oval window is present in the medial wall of the middle ear. It is covered by foot plate of stapes
 The other window round window is also present on the medial wall. It is covered by secondary tympanic
membrane
 Role of these two windows in hearing

o Oval window
 It receives sound vibration and transmits it to labyrinth
o Round window
 It acts as a relief window
 Absence or damage of either of these windows will lead to loss of movement of cochlear
fluids resulting in conductive hearing loss
Ans 29: Option B (Anterior belly of diagastric) (B.D. Chaurasia, Vol III 2nd ed/pg 37, 41, 128)
 Anterior belly of digastric is supplied by nerve to mylohyoid (br. Of mandibular)
 Muscles supplied by facial nerve are:
o All facial muscles except levator palpebri superioris ( supplied by 3rd nerve)
o Post belly of Digastric
o Stapedius
08 o Stylohyoid
o Occipito-frontalis
o Platysma
o Auricular muscles
 Note : Procerus and Risorius are muscles of face
Ans 30: Option A (Folic acid) (Harper’s Biochemistry, 26th ed/pg 494)
 Supplements of 400ug/d of foliate begun before conception result in a significant reduction in the incidence of
neural tube defects as found in Spina bifida------- Harper 26th ed/pg 494
 Elevated blood homocysteine is an associated risk factor for atherosclerosis, thrombosis and hypertension. The
condition is due to impaired ability to form methyl-tetrahydrofolate by methylene-tetrahydrofolate reductase
,causing functional folate deficiency and resulting in failure to remethylate homocysteine to methionine
Ans 31: B (Calcitonin)

(Harrison’s, 16th ed/pg 2239; 15th ed/pg 2208, K.D. Tripathi, 4th ed/pg 332-335)
Hormones Bone cells on which their receptors are present
Calcitonin Osteoclasts
Parathyroid Osteoblasts
Vitamin D Osteoblasts
Ans 32: Option A (Rigidity or stiffness of the material) (Anusavice; 10th ed/pg 54)
“The term elastic modulus describes the relative stiffness or rigidity of a material, which is measured by the slope of the
elastic region of the stress-strain diagram”--------- Anusavice
 very hard to find the appropriate reference for If the tensile stress below the proportional limit or the
compressive stress ( below the proportional limit) is divided by its corresponding strain value, that is tensile
stress/tensile strain or compressive strain/stress, a constant of proportionality will be obtained that is known as
the Elastic modulus or modulus of elasticity or young’s modulus
 It measures the relative rigidity or stiffness of a material
 The elastic modulus of enamel is about three times greater than that of dentin, and thus enamel is a stiffer
and more brittle than dentin. Conversely dentin is more flexible and tougher
 It is given in units of force per unit area , typically , giga newtons per square meter( GN/m2), or giga pascals (
GPa)
Ans 33: Option C (Corrosion resistance decreases) (Anusavice; 10th ed/pg 645, Manappallil; 2nd ed/pg 388-389)
“Tarnish and corrosion resistance increases as the gold content increases”---- Manappallil
 Silver solders have reduced tarnish resistance when compared to gold alloy solders
 Gold solders have adequate strength and hardness and are comparable to dental cast gold alloys having a
similar gold content
Ans 34: Option C (Brittleness) (Anusavice; 10th ed/pg 376, Sturdevant; 4th ed/pg 157)
 “Amalgam is very “brittle” material. It is not capable of much plastic deformation before fracture when
stressed at moderate to high strain rates, such as during vigorous chewing. Therefore traumatic stresses
during chewing can produce fracture in an amalgam without sufficient bulk”---------- Sturdevant
 The most common evidence of degradation of low-copper amalgam is marginal fracture.
Ans 35: Option B (will remineralize within 3 months)

 We tried this question to support our answer and all we could get was this:
“All surfaces that were etched should be coated with the bonding agent. Uncoated areas may take as long as 2-3
months to remineralize and if left unprotected, may stain or discolour and allow a more rapid attachment of
plaque” (Veterinary dentistry: principles and practice, by Robert B. Wiggs, page 383)
08
Ans 36: B (Acute Herpetic stomatitis)

(Shobha Tandon 1st ed/pg 661; Shafer’s 4th ed/pg 365; Carranza 9th ed/pg 303-304)
Features which clinch our diagnosis toward Acute herpetic gingivostomatitis( AHG) are:
a) Age of 3 years( most common in children less than 6 years)
b) Fever
c) Reddish yellow ulcers on facial mucosa & tongue
Clinical features of AHG are:
 Age < 6 years
 Equal frequency in males & females
 Primary infection is asymptomatic
 Oral signs include: discrete, spherical grey vesicles in initial stages, which may occur on gingival,
labial & buccal mucosa, soft palate, pharynx, sublingual mucosa & tongue
 Course limited to 7-10 days
 Scarring does not occur in healed ulcers
 Cervical adenitis , fever as high as 101-1050 F & generalized malaise are common
Ans 37: Option B (Work hardening) (Proffit 2nd ed/pg 291; Phillips 10th ed/pg 642,643)
 “A typical formulation for orthodontic use has 18% Cr & 8% Ni (thus the material is often referred to as an
18-8 stainless steel)…… The properties of these steel wires can be controlled over a reasonably wide range by
varying the amount of cold working & annealing during manufacture. Steel is softened by annealing &
hardened by cold working”---------- Proffit
 In contrast Elgiloy ( Co-Cr) is hardened by heat treatment
More about work hardening:

o It is the change in physical properties of a metal which results from cold working ( i.e. deformation at
room temperature)
o Also called strain hardening
o The surface hardness, strength & proportional limit increase by work hardening while ductility &
resistance to corrosion decrease
o Elastic modulus is not changed appreciably by it as it is a structure insensitive property
o It is possible due to the presence of lattice imperfections which allow dislocations to occur along
superior planes .When no more dislocations can occur, fracture occurs
Ans 38: Option B ( Lymphatics) (Shafer’s 4th ed/pg 117 ; 5th ed/pg 150)
 Metastasis from intraoral carcinoma of different sites involves chiefly the submaxillary and superficial and
deep cervical lymph nodes. Occasionally , other nodes such as the submental , preauricular and postauricular
nodes and supraclavicular nodes may be involved but blood stream metastasis from oral cancer is
uncommon”---- Shafer 4th ed/117
Ans 39: Option B (Have a low safety margin)
(Oral & maxillofacial surgery, Volume 6 by Raymond J. Fonseca, page 150)
 Barbiturates are membrane depressants ; therefore their action is apparent primarily on the CNS and
cardiovascular system
 They produce dose- dependent effects ranging from relaxation and sedation to hypnosis and general
anaesthesia.
 They have minimal effects on respiratory function at therapeutic doses, although respiratory drive may be
inhibited at higher doses
 The use of barbiturates in paediatric sedation has been limited for three reasons:
o Their reputed ability to induce paradoxical excitement
o Their limited therapeutic dosage range
o And the lack of reversing agents
 Inadequate doses are ineffectual and may cause disinhibition, that is, cause an uncooperative child to become
more unmanageable
 Even at higher doses in the therapeutic range, some children demonstrate paradoxical excitement,
08 particularly when stimulated. Finally, the CNS depressant effects seen with barbiturate overdose are not
easily managed and its specific reversing agents have not been developed yet.
Ans 40: Option B (Between 2 and 12 weeks of life)
(Bailey 24th ed/pg 649; Proffit 2nd ed/pg 256-58; Bhalajhi 2nd ed/pg 430; Schwartz 7th ed/pg2107)
 Proffit says that presurgical movement of maxillary segment is done at 3-6 weeks so that lip closure can be
carried out at around 10 weeks ( app.3 months)
 Also Bailey clearly states that surgical repair of cleft lip is done between 4-6months
 Also know Millard’s rule of 10’s : Cleft lip is repaired when
o Child is 10 weeks old
o Weight of the child is 10 lbs ( pounds)
o Hb is more than 10 gm/dl
 Cleft uvula is the most common type of cleft palate. Palatal clefts of left side are more common as compared to
right side
Ans 41: option C (Aneurysmal bone cyst) (Shafer’s 6th edition, page 134)
 Aneurysmal bone cyst is an interesting solitary lesion of bone which was separated as a distinct entity in 1942
by Jaffe and Lichtenstein
 Radiographic features are:
o The radiographic picture of the lesion is often distinctive
o The bone is expanded , appears cystic with a honeycomb or soap-bubble appearance in many cases
and is eccentrically ballooned
o The cortical bone may be destroyed and a periosteal reaction may be evident
 Gross findings at the time of operation are characteristic. Upon entering the lesion, excessive bleeding is
encountered, the blood “welling up” from the tissue.
Ans 42: Option B (It has poor tarnish and corrosion resistance) (Anusavice; 10th edition, page 382-383)
 “Because the gamma-2 phase is the most anodic of those present in set amalgam alloys, the high-copper
amalgams, which virtually eliminate this phase, show improved laboratory corrosion behaviour compared
with traditional amalgams” Anusavice
 Corrosion products containing copper can also be found in high –copper amalgams. However , the corrosion
process is more limited, because the n-phase is less susceptible to corrosion than is the gamma -2 phase of
traditional amalgams” Anusavice
Ans 43: Option B (Onlays are in infraocclusion) (Strudevant 5th ed/pg 872-886)
 It is quite obvious that onlays in infraocclusion will never cause fracture of the cusps
 The cast metal onlay restoration spans the gap between the inlay , which is primarily an intracoronal
restoration and the full crown which is a totally extracoronal restoration
 The cast metal onlay by definition caps all of the cusps of a posterior tooth and can be designed to help
strengthen a tooth that has been weakened by caries or previous restorative experiences
 It can be designed to distribute occlusal loads over the tooth in a manner that greatly decreases the chance
of further fracture
Ans 44: Option D (means to remove surface contaminants) (Marzouk 1st ed/pg 388; Philips 11th ed/pg 336)
 The casting recovered from investment is dark in colour due to surface oxides formation
 This casting is cleaned by heating it in HCl or sulphuric acid. This is called as pickling
 The best solution for gold based alloys is 50% HCl, which aids in removal of any residual investment as well
as oxide coating
 The disadvantage of HCl is fumes that are a health hazard, so the laboratory has to be well ventilated
 The casting is placed in a dish and warm HCl is poured on the casting. After pickling the casting is removed
and cleaned
 The pickling solution should be renewed frequently
 Steel tongs should not be used as copper gets contaminated by galvanic cell which is present due to
electrolytes dissolved from the previous castings
 Base metal alloys and platinum or gold based metal ceramic alloys are not pickled
08
Ans 45: Option C (Altering tooth contours)
(Stewart: Clinical removable partial Prosthodontics, pg 232)
According to stewart:
 If the buccally inclined teeth are located on one side of the arch only, tilting the surveying table away from the
teeth may lower the height of contour sufficiently to permit the clasps to be located in a nearly ideal position
 But if these inclined teeth are located on both sides of the arch, changing the tilt of the cast will have no helpful
effect. If the tipping is not too severe, contouring the enamel surfaces to lower the survey line may be
attempted. Most often, however, full crown restorations will be required to produce a height of contour that
will satisfy the requirement for clasp placement.
Ans 46: option D (An inadequately designed framework) (Skinner’s, 10th edition, page 435)
Fracture of porcelain fused to metal restoration occurs primarily due to:
 Inadequately designed metal framework
 Centric occlusal contacts at the porcelain –metal interface
 Contamination of metal prior to opaque porcelain application
Ans 47: Option A (increase in tissue tolerance) (Boucher’s 12th edition, page 206)
Advantages of metal denture bases are:
 Good tissue tolerance
 Light weight of dentures
 Easiness in getting accuracy of fit
Disadvantages are:
 Less margin of error in posterior palatal seal
 It is difficult to reline. But an acrylic denture base can be relined easily as compared to the metal one because
the tissue surface can be reduced with a bur which is not possible for metal
Ans 48: Option B (Buccal slopes of the lingual cusps of maxillary posterior teeth)
(Wheeler’s 6th edition, page 395-407)
 Relationship of opposing teeth in centric occlusion:
o In centric occlusion, facial views of the normal dentition show each tooth of one arch in occlusion
with portions of two others in the opposing arch with the exception of the mandibular incisors and
maxillary third molars which have only one antagonist in the opposing jaw
o In cusp-fossa relationship mesiolingual cusp portions of the maxillary molars fit into the major
fossae of lower molars in centric occlusion, known as key to occlusion. This is more important than
the relationship of buccal cusps of maxillary molars to buccal grooves of mandibular molars-----
Wheeler’s 6th ed /pg 407
 Hence its clear from the above that option B is the answer of choice
Ans 49: Option C (Arrested caries) (Shafer’s 6th ed/pg 439; Sturdevant 5th ed/pg 27-28, 92)
 Arrested caries has been described as caries which becomes static and does not show any tendency for further
progression
 The deciduous and permanent dentition are both affected by this condition
 It occurs almost exclusively in caries of occlusal surfaces and is characterized by a large open cavity in which
there is lack of food retention and in which the superficially softened and decalcified dentin is gradually
burnished until it takes on a brown stained, polished appearance and is hard. This has been referred to as
“Eburnation of dentin”------------ Shafer’s 6th ed/pg 439
 Eburnated dentin refers to the outward( exposed) portion of reactive sclerotic dentin, where slow caries has
destroyed formerly overlying tooth structure, leaving a hard, darkened , cleanable surface-------- Sturdevant
5th ed/pg 27
08 Ans 50: Option B ( Dentinoenamel junction) (Shafer’s 4th ed/pg 441-445; 5th ed/pg 605)
 “Caries of the dentin begins with the natural spread of the process along the DEJ and the rapid involvement of
great numbers of dentinal tubules, each of which acts as a tract leading to the dental pulp along which the
microorganisms may travel at a variable rate of speed, depending upon a number of factors”---- Shafer’s
 In some instances carious invasion appears to occur through an enamel lamella so that little if any visible
alteration in the enamel occurs
 Thus ,when lateral spread at the DEJ occurs with the involvement of underlying dentin, a cavity of
considerable size may actually form with only slight clinically evident changes in the overlying enamel
except for its undermining
Ans 51: Option A (Organic portion alone) (Shafer’s 4th ed/pg 410)
 “Dental decay is chemico-parasitic process consisting of two stages, the decalcification of enamel which
results in its total destruction and the decalcification of dentin, as a preliminary stage, followed by dissolution
of the softened residue”-Shafer
 The initiation and progression of dental caries are two distinct processes and must be differentiated
 The acidogenic organisms are responsible for the initial decalcification occurring in the carious process
 The organic matrix is destroyed by the action of proteolytic enzymes produced by microorganisms deep in the
cavity
Ans 52: Option B (Frequency of sucrose intake) (Shafer’s 4th ed/pg 410; 5th ed/pg 573)
 Due to the emotional conflict at this age, adolescents frequently neglect their oral hygiene
 Also the adolescent is actively growing & hence has heightened energy requirements & so he eats more
frequently
 Also at this stage increased consumption of junk food is common, which is a good substrate for microbes
because :
o It is high in fermentable carbohydrates
o Being stick is retained for a longer time in oral cavity
 So there are two reasons for more caries incidence in adolescence
o Negligence in oral hygiene habits
o Increased frequency of sucrose intake
 But increased frequency is much more related to caries incidence and hence our answer of choice
Ans 53: Option A (The reduction in enamel solubility due to fluoride uptake by enamel ) (Anusavice 10th
ed/pg 528)
 “It is commonly recognized that the incidence of secondary caries is markedly less adjacent to the silicate
cement restoration than that associated with all other filling materials”------ Anusavice
 Laboratory studies show that fluoride is released from silicate and other fluoride containing cements into an
aqueous medium in small but significant amounts for an indefinite period
 This release of fluoride apparently can last throughout the life of the restoration , but the rate of release is
expected to decrease over time
 Fluoride contributes to caries inhibition in the oral environment by means of both physicochemical and
biologic mechanisms
Ans 54: Option A (Development of irreversible pulpitis) (Grossman 11th edition, page 68)
 Prolonged pain under a amalgam restoration as in this case goes in favour of irreversible pulpitis
 Other features of irreversible pulpitis are:
o Pain develops following sudden temperature changes, particularly cold
o Pain is spontaneous , sharp, piercing or shooting type
o Pain is increased when the patient bends over or lies down. This is due to change in intrapulpal
pressure when the patient changes his position
o This pain persists even after the removal of stimulus but not in case of reversible pulpitis
Ans 55: Option A (Continue regular calls) (Bhalajhi’s, 3rd edition, page 43) 08
 Flush terminal plane or End-on occlusion is a normal feature of deciduous dentition
 In this, the distal surface of upper and lower second deciduous molars are in one vertical plane
 For a transition to a class-I molar relation, the permanent first moalrs drifts mesially by utilizing the
physiologic spaces and leeway space in the lower arch. Hence no treatment is required for this condition
Ans 56: Option C (Relieve the occlusion and splint the tooth)
(Shobha Tandon, 1st ed/pg 521, Grossman 11th ed/pg 284)
 Fractures occurring in the apical third have the best prognosis
 The teeth usually remains vital and firm in the socket
 Periodic vitality testing and radiographic examination with no other treatment is indicated
 If the tooth is mobile it should be splinted with acid etched resin and occlusion is relieved
 If the pulp in the coronal segment dies, then endodontic treatment is indicated
 If the tooth fails to recover, the apical root fragment should be removed surgically
 Coronal and middle third fractures have the poor prognosis and vertical root fractures have the worst
prognosis.
Ans 57: Option A (An autistic child) (Mc Donald 8th edition, page 543)
 Autism is an incapacitating disturbance of mental and emotional development that causes problems in
learning, communicating and relating others
 The disease manifests itself during the first 3 years of life and is difficult to diagnose
 It is believed to be caused by a physical disorder of the brain
 The affected children will usually have IQ scores between 50 and 70
 The affected children will have multiple medical and behavioural problems that make dental treatment difficult
 They have poor muscle tone, poor coordination, drooling, a hyperactive knee jerk and strabismus and 30%
eventually develop epilepsy
 During provision of treatment the use of papoose board or pedi-wrap and preappointment conscious
sedation are necessary sometimes
Ans 58: Option A (Stop worrying about the habit) (Bhalajhi 3rd ed/pg 97; Proffit’s 4th ed/pg 68,147,149)
 Thumb and digit sucking is one of the commonly seen habits that most children indulge in
 Recent studies have shown that thumb sucking may be practised even during intrauterine life
 The presence of thumb sucking is considered quite normal till the age of 31/2 – 4 years. Persistence of the
habit beyond this age can lead to various malocclusions” ----- Bhalajhi 3rd ed/pg 97
 Phases of development of thumb sucking habit are:
o Phase I----normal and sub-clinically significant
o Phase II----clinically significant sucking
o Phase III---Intractable sucking
Ans 59: Option D (Small sized mandible) ( Shobha Tandon, 2nd ed /pg 56)
Features of mandible at birth are: (Shobha Tandon 2nd Ed /pg 56)
 The two rami are short
 Condylar development is minimal
 A thin line of fibrocartilage and connective tissue exists at the midline of the symphysis to separate the right
and left mandibular bodies
 The symphysial cartilage is replaced by bone ( between 4 months of age and end of the 1st year)
 The alveolar process and the muscles are poorly developed at this age, so that its basal arch mainly determines
the shape of the mandible in the neonate
 At birth the structure of mandible is shell like with the 10 alveolar sockets for the developing tooth gum
 Off all the facial bones, the mandible shows not only the largest amount of postnatal growth , but also the
largest individual variation in morphology
So from above its clear that Option D is the right answer here
08 Ans 60: Option B (ABDCE) (Wheeler’s 6th ed/pg 24, Shobha Tandon, 2nd ed/pg 90)
 Calcification of the deciduous teeth begins about the fourth month of foetal life; near the end of the sixth
month, all of the deciduous teeth have begun to develop
 The usual order of appearance of the deciduous teeth in the mouth is as follows----- Wheeler’s 6th ed/pg 27
o Central incisors
o Lateral incisors
o First molars
o Canines
o Second molars
Ans 61: Option C (Is not indicated as it is a traumatic procedure)

“The 1979 NIH consensus conference reported that although there are cogent orthodontic reasons for early removal of
third molars, the practice of enucleation of third molar buds at age 7 to 9 years is not recommended” (Oral and
Maxillofacial surgery, Volume 6 by Raymond J. Fonesca, page 253)
 Friends please note that there was one other question, asked in AIIMS 1996, almost similar to it with slight
different options. We are mentioning that too here so that you can differentiate between n clear your answer
here only. That que was:
Que: Extraction of 3rd molar tooth bud in 7-9 yr old child:
a) Improves growth of maxilla
b) Causes excessive damage to the mandible
c) Results of future orthodontic treatment are improved anterior teeth
d) Results in less crowding
Option D (Results in less crowding)
Ans 62: Option C (Pulpectomy) (Grossman’s 11th edition, page 68)

 In this case patient has developed continuous hypersensitivity means the pulp is involved and hence the
treatment of choice is pulpectomy
 FOR MORE EXPLANATION REFER TO Q. NO.54 ABOVE
Ans 63: Option C (Due to low grade chronic infection) (Shafer 4th ed/pg 502, 5th ed/pg 686)
 Also called condensing Osteitis
 “It is an unusual reaction of bone to infection, occurring in instances of extremely high tissue resistance or in
cases of a low –grade infection.”------- Shafer
 This form of osteomyelitis arises almost exclusively in young persons before the age of 20 years
 The tooth most commonly involved is the mandibular first molar, which presents a large carious lesion
 There may be no signs or symptoms of the disease other than mild pain associated with an infected pulp
 The periapical roentgenogram demonstrates the pathognomonic, well-circumscribed radiopaque mass of
sclerotic bone surrounding and extending below the apex of one or both the roots
 Histological examination reveals only a dense mass of bony trabeculae with little interstitial marrow tissue
Ans 64: Option C (Antibiotics should not be prescribed as it may mask the symptoms)
 Reference still searching?????
Ans 65: option B (Helps drainage and relieves pain if proper antibiotic is given and its adequate blood level is
Reached) (Peterson’s Oral & Maxillofacial Surgery, 4th ed/pg 118)
 It is clear that the most rapid resolution of an infection secondary to pulpal necrosis is obtained, when the
tooth is removed as early as possible.
 Therefore acute infection should not be a contraindication to extraction. If access and anaesthetic
considerations can be met, the tooth should be removed as early as possible after maintain proper antibiotic
level
Ans 66: Option A (1mg of fluoride tablet/day) (Soben peter 3rd ed/pg 334)
Age Requirement 08
Children below 2 years 0.25mg
2-3 yrs 0.5mg
3-13 yrs 1.0mg
> 13 yrs Fluoride need not to be given
 Here the child is 4 years old and hence 1 mg /day is the requirement
 These fluoride tablets are available in 0.55, 1.1, and 2.2 mg tablets and they yields 0.25mg, 0.5mg,1mg of F
respectively
Ans 67: Option C (Neutrophill chemotactic defect)

(Carranza’s Clinical Periodontology, 9th ed/pg 413, 10th ed/pg 511)
Features of JP are:
 The most common initial features of JP ( aggressive periodontitis) are mobility and pathological migration of
the first molars and the incisors
 There is distolabial migration of the maxillary incisors with diastema formation
 Tooth mobility and presence of deep periodontal pockets with lack of inflammation are the other significant
features of it
 LJP is characterised by distribution of lesions in the 1st molars and incisors with least destruction in the cuspid-
premolar area whereas in generalized JP there is generalized involvement of teeth
 Vertical bone loss around incisors and molars in otherwise healthy teenagers is diagnostic of LJP
 Arc shaped bone loss extending from distal surface of second premolar to mesial surface of second molar
creating a mirror image type of bone loss is characteristic of JP
Ans 68: Option C (Sunburst appearance with radiopaque strands extending from the cortical plate)
(Neville’s Oral & Maxillofacial Pathology, 3rd ed/pg 660)
 Osteosarcoma is the malignancy of mesenchymal cells that have the ability to produce osteoid or immature
bone
 Excluding hematopoietic neoplasms, it is the most common type of malignancy to originate within the bone
 The radiographic findings of it are:
o It vary from dense sclerosis to a mixed sclerotic and radiolucent lesion to an entirely radiolucent
process
o Occasionally there is resorption of the roots of the involved teeth, described as “ spiking resorption”
as a result of the tapered narrowing of the root
o The classic sunburst or sun ray appearance caused by osteophytic bone production on the surface of
the lesion is noted in about 25% of jaw osteosarcomas. Often this is appreciated best on an occlusal
projection
o In few cases a triangular elevation of the periosteum, referred to as Codman’s triangle may be
observed
o An important early radiographic change is symmetrical widening of the PDL space around a tooth
or several teeth
Ans 69: Option A (Long –junctional epithelium) (Carranza’s Clinical Priodontology, 8th ed/pg 405)
“Epithelial adaptation or healing by formation of long junctional epithelium is the close opposition of gingival
epithelium to the tooth surface without complete obliteration of the pocket”---- Carranza
Ans 70: Option B (A pseudopocket) (Glickman’s Clinical Periodontology, 8th ed/pg 281)
 Normal attachment of junctional epithelium occurs coronal to the CEJ on enamel (in stage 1) .A periodontal
pocket forms when the junctional epithelium migrate apically from the CEJ whereas the gingival margin does
not migrate at the same rate. As a result a deepening of gingival sulcus occurs but in pseudopocket deepening
of gingival sulcus is due to coronal movement of the gingival margin
More about pseudopocket (gingival pocket, relative or false pocket)
o Formed by gingival enlargement without obstruction of the underlying periodontal tissue
08 o No change in junctional epithelium attachment
o Coronal migration of gingival margin. E.g. all forms of gingival hyperplasia
o Treatment is surgical removal of excess tissue ( usually gingivectomy/gingivoplasty)
Ans 71: Option C (Sulcular technique) (Glickman 9th ed/pg 656-659, 8th ed/pg 496-497)
 Patients with periodontal disease are most frequently taught a Sulcular brushing technique using a
vibratory motion to improve access in gingival area---- Glickman
Lets review various tooth brushing techniques
Roll Roll method or modified stillman technique
Vibratory Stillman , charters or bass technique
Circular Fones technique
Vertical Leonard technique
Horizontal Scrub technique
 Scrub technique is probably the simplest & most common method of brushing
 Roll technique -------- Least effective as it generates only intermittent pressure against the teeth as compared
with sustained force applied with sulcular & scrub technique
Ans 72: Option C (Collagenous) (Tencate’s 5th ed/pg 263; Orban’s 10th ed/pg 216; Glickman 8th ed/pg 30)
 Most important element of PDL are principal fibres which are collagenous , are arranged in bundles and
follow a wavy course when viewed in longitudinal sections. Terminal portions of principal fibres that insert
into cementum & bone are called Sharpey’s fibres
 Principal fibres of the PDL are
o Transseptal group
o Alveolar crest group

o Horizontal group
o Oblique group
o Apical group
o Interradicular group
Ans 73: Option C (Acute infections of tonsils and adenoids) (Bhalajhi’s Orthodontics, 3rd ed/pg 335)
 The vestibular screen is a simple functional appliance that takes the form of a curved shield of acrylic placed in
the labial vestibule
 This myofunctional appliance was first introduced by Newell in the year 1912
Its indications are:
o Have been used mostly to intercept mouth breathing habit. It can also be used for interception of
habits such as thumb sucking, tongue thrusting, lip biting and cheek biting
o Mild disto-occlusions can be treated using the vestibular screen
o Can be used to perform muscle exercises to help in correction of hypotonic lip and cheek muscles
o Also can be used to correct mild anterior proclination.
Ans 74: option A (Mechanical separation) (Vimal Sikri’s Operative Dentistry, 1st ed/pg 156)
 Many a time’s prior separation of the teeth is necessary to restore a proper contact. The separation is also
helpful in many other situations like - Vimal Sikri 1st ed/pg 156
o For examination of interproximal spaces
o For preparation of cavities
o For insertion and polishing of restorations
o For removal of foreign bodies, such as fruit seeds, fragments of toothpicks, or bone sequestrums etc.
Ans 75: Option B (Brass wire) (Bhalajhi’s Orthodontics, 3rd ed/pg175)

Determination of arch length by CAREY’S analysis:
 It helps in determining the extent of the discrepancy
 It is performed on the lower cast, the same analysis on the upper cast is called as Arch perimeter analysis
 Method : 08
o The arch length anterior to the first permanent molar is measured using a soft brass wire
o The wire is placed contacting the mesial surface of the first permanent molar of one side and is passed
over the buccal cusps of the premolars and along the anteriors and is continued on the opposite side
in the same way upto the mesial surface of the opposite first permanent molar
o In case of proclined anteriors, the wire is passed along the cingulum of anterior teeth
o If the anterior teeth are retroclined, the brass wire in the anterior segment passes labial to the teeth
o If the anterior teeth are well aligned the wire passes over the incisal edge of anteriors
Ans 76: Option C (Orbitale to porion) (Proffit’s 2nd edition, page 164)
“Frankfort plane extends from upper rim of the external auditory meatus (porion) to the inferior border of the orbital
rim (orbitale). It was adopted as best representation of natural orientation of skull at international congress held at
Frankfort, Germany in 1882”----Proffit
 REMEMBER
o S-N plane is oriented at 6-7o to the Frankfort plane
o In contemporary usage, cephalometric film should be taken in natural head position ( NHP) , so that
the physiologic true plane is established
Ans 77: Option C (Converge towards occlusal surface)

(Shobha Tandon, 1st ed/pg 288)
Factors that change pattern of cavity cutting design in deciduous teeth are:
a) Direction of enamel rods
b) Cervical constriction in proximal area that influence proximal box preparation
Modifications of class II cavity in deciduous teeth

 Due to presence of broad contact areas, the gingival floor should be wide to place the margins in self cleaning
area
 Due to cervical constriction, gingival wall should not be too gingival
 The width of isthmus should not exceed 1/3rd of the intercuspal distance
 Because of occlusal direction of enamel rods at the cervical area, the gingival seat should not be bevelled
 Care should be taken to avoid the mesiobuccal pulp horn in case of small first molars
 Estman pattern bur—modified aerator burs with metallic stopper at 1.5mm from tip are used
Ans 78: Option D (Equal and opposite forces) (Bhalajhi’s 3rd ed/pg 205,206)
 Reciprocal anchorage is the resistance offered by two malposed units when equal and opposite forces tends to
move each unit towards a more normal occlusion
 Closure of midline diastema, split expansion appliance and correction of cross bite by elastics are examples of
reciprocal anchorage
 Closure of midline diastema by using a removable appliance and correction of cross bites by intraarch elastics
are an example of Reciprocal single simple anchorage
 Closure of midline diastema by fixed appliance is an example of reciprocal single stationary anchorage
Ans 79: Option D (Elicited mainly when the pressure is relieved) (Marzouk 1st ed /pg 438)
 Cracked tooth syndrome is incomplete fracture of vital posterior tooth
 The fracture generally result from the improper condensation techniques
 This is best diagnosed by RUBBER WHEEL TEST
 Sharp pain on release of biting pressure helps to identify offended tooth
 During release of pressure, rubbing of fractured dentinal surfaces creates hydrodynamic pressure in
the dentinal tubules and evoke pulpal pain
 Radiological findings are absent
 Extra coronal cast restoration is the treatment of choice
 Transillumination detects the cracks in the tooth
08 Ans 80: Option D ( Dentinogenesis imperfecta) (Shafer’s 6th edition, page 54)
 It is an autosomal dominant condition affecting both deciduous and permanent teeth
 Affected teeth are gray to yellowish-brown and have broad crowns with constriction of the cervical area
resulting in a “tulip” shape
 Enamel is easily broken leading to exposure of dentin that undergoes accelerated attrition and there is loss of
DEJ
 On radiographs, the teeth have bulbous crowns, roots that are narrower than normal and pulp chambers
and root canals that are smaller than normal or completely obliterated
 A deficiency of dentin sialophosphosprotein has been suggested as a causative factor in it.
Ans 81: Option B (Hypothyroidism) (Shafer’s 6th edition, page 650, 5th ed/pg 897)
Features of hypothyroidism are:
 Congenital hypothyroidism or cretinism leads to Mental defects, retarded somatic growth, generalized edema
and other changes depending on the severity of the deficiency of thyroid hormone
 Base of skull is shortened
 The face is wide and fails to develop in a longitudinal direction
 The mandible is underdeveloped and maxilla is overdeveloped
 The tongue is enlarged by edema fluid. It may protrude continuously and such protrusion may lead to
malocclusion
 The eruption rate of the teeth is delayed and the deciduous teeth are retained beyond the normal shedding
time
 Concentration of serum protein- bound iodine and radioactive iodine uptake or excretion studies are the
diagnostic tests of value
Ans 82: Option C (Postpone treatment until the complete eruption of permanent canines) (Proffit 2nd ed/pg
205,391,486-488)
“Small spaces between the maxillary incisors are normal before eruption of the maxillary canines. In the absence of
deep overbite, these spaces can close spontaneously. If the space between the maxillary central incisors is greater than
2mm, however, spontaneous closure is unlikely (i.e. less than 2mm space can close spontaneously). The best approach,
however, is to do nothing until permanent canines erupt”----- Proffit/205
“Frenectomy before orthodontic correction ( of midline diastema) is contraindicated and a post treatment frenectomy
should be attempted only if a continued tendency of the diastema to reopen any unresolved bunching of tissue between
the teeth show that it is necessary”-----Profitt /391
Ans 83: Option D (Pemphigus vulgaris) (Shafer’s 6th edition, page 816)
 “Pemphigus vulgaris (PV) is an autoimmune, intraepithelial, blistering disease affecting the skin and mucous
membranes and is mediated by circulating autoantibodies directed against keratinocyte cell surfaces. Clinical
and experimental observations indicate that the circulating autoantibodies are pathogenic”----- Shafer’s
 An immunogenetic predisposition is well established
 Blisters in PV are associated with the binding of IgG autoantibodies to keratinocyte cell surface molecules
 The binding of autoantibodies results in a loss of cell-cell adhesion
 Pemphigus antibody binds to keartinocyte cell surface molecules desmoglein 1 and desmoglein 3
 Patients with the active disease have circulating and tissue bound autoantibodies of both the immunoglobulin
G1 and G4 subclass
Ans 84: Option C (Paget’s disease of bone) (Shafer’s 6th edition, page 732)
“Development of osteosarcoma is the most serious complication of the paget disease” ---Shafer
 Sarcomatous Complications of paget disease are;
o Sarcomatous degeneration of pagetic bone is a deadly complication
o Pagetic sarcomas follows a rapid and fatal course
08
o Sarcomatous degeneration may occur in 5-10% of patients with extensive pagetic skeletal
involvement
o In less widespread involvement, osteosarcoma occurs in less than 1% of patients. Men are affected
slightly more than women
o The femur ( most common) and proximal humerus are the sites most commonly affected; however ,no
bone is exempted, including sites of previously healed fractures
o Incomplete stress fractures occur frequently
Ans 85: Option C (increase the target- film distance) (White & Pharoah, 4th ed/pg 87, 5th ed/pg 90)
 In paralleling angle technique the film is placed parallel to the long axis of the tooth. To achieve this
parallelism the film should be kept at some distance from the object which causes image magnification.
This can be avoided by increasing the target- object distance. So it is called as long cone technique
Ans 86: option D (Two or more periapical views at different angles and an occlusal view)
(White & Pharoah, 4th ed/pg 88; 5th ed/pg 91-92)
 Image in an x-ray is a two dimensional information. To exactly locate the position of an object a three
dimensional information is necessary. To obtain this 2 methods can be used:
o Examining two films projected at right angles to each other
o Examining two films projected at different angles called as CLARK rule or buccal object rule or
tube shift method or SLOB rule
Ans 87: Option A (Class I Malocclusion) (Bhalajhi’s Orthodontics, 3rd ed/pg 228)
Indications:
 Skeletal class I
 Crowding
 Localized gingival recession in lower anterior region
 Ectopic eruption of teeth
 Unilateral or bilateral premature loss of deciduous canines with midline shift
 Space discrepancy should be at least 5mm in all four quadrants ( extraction case of carey’s or arch
perimeter analysis)
 No skeletal discrepancy should be present
Contraindications:
 Class II & III malocclusion with skeletal abnormalities
 Spaced dentition
 Open bite and deep bite cases
 Midline diastema cases
 Class I malocclusion with minimal space deficiency
08

AIIMS May 2003 Questions and Answers

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AIIMS May 2003 Questions and Answers

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AIIMS MAY 2003

c. Concurrent cohort study c. Allopurinol

24. All of the following are seen in rickets except: c. Thyroxin

b. Dentinoenameljunction 56. An 11-year-old child comes to the dental office one

c. ABDEC 66. Extraction of a tooth during acute infection: Ipl

Ans 1: Option B (Lateral pterygoid)

Ans 2: Option C (X-linked recessive inheritance)

Ans 3: Option B ( Malic enzyme)

Ans 4: Option D (Carboxylase) (Harper’s Biochemistry, 25th edition, page 634)

Ans 5: Option C (O-positive RBC and colloids/crystalloids)

Ans 10: Option C (Prevalence of the disease is higher in population A)

Remember about cross-sectional studies:

 In the given question since we have only two samples i.e.

Ans 14: Option A (Sensitivity)

 Also remember about pemphigus that

Ans 17: Option B (Cysteine)

Ans 20: Option B (Pyrogenic exotoxin) (Anantnaryan, 5th/ed, pg 193)

Ans 21: Option C (M protein)

Ans 22: Option C (Neural tube defect)

Ans 23: Option A (Transverse fracture)

Direct blow Crushing force Twisting Compression Bending

Transverse Communited Spiral Oblique Triangular butterfly

Ans 27: Option C (Radiotherapy)

 Role of these two windows in hearing

Ans 31: B (Calcitonin)

Ans 35: Option B (will remineralize within 3 months)

Ans 36: B (Acute Herpetic stomatitis)

More about work hardening:

Ans 61: Option C (Is not indicated as it is a traumatic procedure)

Ans 62: Option C (Pulpectomy) (Grossman’s 11th edition, page 68)

Ans 67: Option C (Neutrophill chemotactic defect)

o Alveolar crest group

Ans 75: Option B (Brass wire) (Bhalajhi’s Orthodontics, 3rd ed/pg175)

Ans 77: Option C (Converge towards occlusal surface)

Modifications of class II cavity in deciduous teeth

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