1

MCQs In
Oral Surgery
By
Babu S.Parmar

Hint: Answers in the end of the book

With best wishes

2
 MCQs
Oral Surgery

Babu S.Parmar
MDS, FAOMSI

Professor and Head

Department of Oral and Maxillofacial Surgery
Government Dental College and Hospital
New Civil Hospital Campus, Asarwa
Ahmedabad - 380016
Member: Dental Council of India, New Delhi
Hon. Dental Surgeon to HE The Governor of Gujarat

Foreword
Neelima A Malik
JAYPEE BROTHERS
MEDICAL PUBLISHERS (P) LTD
New Delhi

3
 Prof. Dr. (Mrs.) Neelima A. Malik
M.D.S. (Bom.), F.I.A.O.S.
ORAL & MAXILLOFACIAL SURGEON
HEAD OF THE DEPT. OF.
ORAL & MAXILLOFACIAL SURGERY
NAIR HOSPITAL DENTAL COLLEGE
DR. A. L. NAIR ROAD, MUMBAI-400 008. INDIA.
Hosp. Tel.: 308 2714
FOREWORD
Since the advent of entrance examinations for various graduate courses
in our country, the criterion for admission is solely based on their
performances in the MCQ based examinations. The Postgraduate
entrance examinations for MDS course, though, began a bit later,
however; have gained a momentum presently all over India for most of
the institutions. Preparation for these examinations is totally different
from that preparing for the other undergraduate examinations. Lot of
hard work with logical learning is required for high marks. In such a
competitive arena, there is a long felt need for good standard MCQ
books, which are more specific and comprehensive with regards to a
particular subject. I personally feel that such books are not only meant
for the entrance examination, but also useful in enrichment of the
knowledge. Professor Babu S.Parmar wishes to publish a book on
MCQs in Oral Surgery. I have seen the manuscript on the laptop and I
am pleased to endorse the work of Dr.Babu S.Parmar, whom I know
from his student days. He has risen in the field of Oral and Maxillofacial
Surgery through his hard and sincere work as a dynamic individual. He
is a dedicated teacher and academician. His vast experience as a DCI
member and an Inspector for various dental colleges has aided in the up
liftmen of the academic standards of the dental students across the
4
country. This book is a collection of MCQs, which have stratified into
the important topics pertaining to Oral and Maxillofacial Surgery. These
topics have thoroughly researched upon and a very concise, yet easy to
comprehend text has laid forth. I being an author of a Textbook of Oral
and Maxillofacial Surgery, know that writing a book is a tedious and
time-consuming job and hence the efforts of Dr.Parmar are commend-
able. His book has almost covered the entire syllabus in the subject,
providing organized, reliable information for the post-graduate entrance
examinations. I am sure that the students, who aspire for success in the
entrance examination, will get high yielding results.
I congratulate and compliment Dr.Babu S.Parmar for his well thought
student friendly excellent work and wish him all the best in his future
endeavors. I also take this opportunity to congratulate the publishers,
who are also providing a platform for all deserving authors through their
constant encouragement, and motivation. Once again, congratulations to
all involved and best wishes.

5
 Preface
Life transforming ideas have always come to me through books.
— Bell Hooks
The field of Oral and Maxillofacial Surgery has been ever changing
since past 50 years. The newer advances in the field of reconstruction,
repair, anesthesia and pain has made it a branch of interest not only for
the people belonging to the fraternity but even other specialties.
In this gruesome world of tough competition I felt under moral
obligation to do something related to my field for those struggling young
minds who aspire to specialize and super-specialize but are defeated by
the system of entrance examinations.
This is a comprehensive book comprising of about 1500 Multiple
Choice Questions assorted from all the topics of Oral Surgery. I have
tried to include all possible questions, which in one or other form can
asked in the forthcoming entrance examinations or will be of aid to
undergraduate students in their syllabus.
The book also tends to needs of Postgraduate students in giving them a
bird sight view of the subject and can aid them in viva-voce. It is a
matter of pride that the book has been under-taken for publishing by
Jaypee Brothers Medical
Publishers (P) Ltd., New Delhi, whose name in Publishing parallels
authenticity.
Undertaking of such a magnitude cannot completed without the
cooperation and support of some individuals. I sincerely thank to my
postgraduate students for their timely help and support during the
writing of the book.

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I am also indebted for life to my family for their belief in me and their
unconditional support when I could not spare even minimal time for
them.
I extend a token of gratitude to my Department, Dept. of Oral and
Maxillofacial Surgery, Government Dental College and Hospital,
Ahmedabad for their cooperation. Last but not the least I thank almighty
for his blessings.
Babu S.Parmar

7
 Contents

1- Surgical Anatomy ………………………………….. 1

2- LA/GA/Pain Control ……………………………….. 17
3- Sterilization and Instruments ………………………. 78
4- Exodontia/lmpaction ……………………………….. 85
5- Minor Surgical Procedure …………………………... 130
6- Cyst Tumor/Surgical Pathology …………………….. 146
7- Facial Space Infection/Osteomyelitis ……………….. 174
8- TMJ and Maxillary Sinus …………………………… 191
9- Maxillofacial Injury …………………………………. 205
10- Reconstructive and Orthognathic Surgery …………... 243
11- Medical Emergency …………………………………. 253
12- Implant ………………………………………………. 297
13- Miscellaneous ……………………………………….. 304

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Chapter 1: Surgical Anatomy
1. The major blood supply of the Dura mater is via which of the
following artery:
A. Internal carotid
B. Middle cerebral
C. Accessory meningeal
D. Middle meningeal

2. The osteum of the maxillary sinus normally communicates with the

nasal cavity via:
A. The ethmoid infundibulum
B. The infratemporal fossa
C. The nasolacrimal duct
D. Below the level of inferior turbinate

3. When attempting to ligate the lingual artery low in the submandibular

triangle, which of the following nerve is most susceptible to damage?
A. Facial
B. Lingual
C. Accessory
D. Hypoglossal

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4. The ramus mandibularis branch of the facial nerve has a constant
relationship with which of the following veins in the region of the
mandibular angle.
A. Internal jugular
B. External jugular
C. Deep lingual
D. Retromandibular

5. Which of the following artery is most commonly involved in

extradural hemorrhage?
A. Meningeal branch of the ascending pharyngeal
B. Anterior cerebral
C. Middle meningeal
D. Accessory meningeal

6. When attempting veni puncture in the region of the anti cubital fossa
which of the following artery is most likely to be encountered?
A. Deep brachial
B. Brachial
C. Recurrent radial
D. Radial

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7. In a patient presenting with a dilating pupil should suspect
involvement of the:
A. Ophthalmic division of the trigeminal nerve
B. Superior cervical ganglion
C. Ciliary ganglion
D. Maxillary division of the trigeminal nerve

8. Aphasia involves the lesion of which of the following areas

A. Cerebral cortex
B. Medulla oblongata
C. Spinal cord
D. Cerebellum

9. In removal of the sub maxillary gland which of the following nerves

are most likely to be damaged?
A. Lingual and glossopharyngeal
B. Lingual and hypoglossal
C. Facial and glossopharyngeal
D. Facial and accessory

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10. One of the earlier signs of cavernous sinus thrombosis is due to
deficit in the function of:
A. Trochlear nerve
B. Abducent nerve
C. Oculomotor nerve
D. Ophthalmic division of trigeminal nerve

11. Which of the following best illustrates the symptoms of Horner's

syndrome?
A. Myosis and ptosis of the upper eyelid
B. Mydriasis and ptosis
C. Myosis and exopthalmos
D. Ptosis and hydrosis

12. Ataxia involves the lesion of the:

A. Spinal cord
B. Cerebral cortex
C. Medulla oblongata
D. Cerebellum
13. The mandibular branch of the trigeminal passes through the:
A. Foramen ovale
B. Foramen rotundum
C. Foramen lacerum
D. Foramen spinosum
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14. Roof of pterygomandibular space is formed by:
A. Cranial base
B. Temporal muscle
C. Medial pterygoid
D. Lateral pterygoid

15. The source of motor innervation of the larynx:

A. Glossopharyneal
B. Facial
C. Hypoglossal
D. Vagus

16. Which of the following nerves are involved in the gag reflex?
A. Hypoglossal
B. Hypoglossal and glossopharyngeal
C. Glossopharyngeal and vagus
D. Accessory and vagus
17. Which are the following cranial nerves does not make the cranial
component of the parasympathetic system?
A. Occulomotor
B. Accessory
C. Facial
D. vagus

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18. Which of the following innervates the buccal gingiva of maxillary
second premolar?
A. Buccal nerve
B. Anterior palatine nerve
C. Posterior palatine nerve
D. Middle superior alveolar nerve

19. Which is the only medial branch of the external carotid artery?
A. Ascending pharyngeal
B. Superior thyroid
C. Lingual
D. Internal maxillary

20. Which is not one of the main sensory branches of the mandibular
division of the trigeminal nerve?
A. Lingual nerve
B. Inferior alveolar nerve
C. Nerve to the mylohyoid
D. Auriculo temporal nerve
21. Which duct provides drainage to the parotid gland?
A. Bartholin's
B. Santorinis
C. Warthon's
D. Stenson's
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22. In acute airway obstruction should it be necessary to perform a
coniotomy the entry should be made at:
A. Cricoid sartilage
B. Thyroid notch
C. Cricothyroid ligament
D. Thyroid membrane

23. In the pterygomandibular space the inferior alveolar nerve passes:

A. Medial to the pterygomandibular ligament
B. Medial to the medial pterygoid muscle
C. Lateral to the sphenomandibular ligament
D. Anterior to the deep tendon of temporalis muscle

24. During removal of the torus palatinus the mid portion of the palatine
process of the maxilla is inadvertently removed. One would expect to
see:
A. An opening in to the nasal cavity
B. A vertical fracture of the maxilla
C. An opening in to maxillary antrum
D. A horizontal fracture of maxilla

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25. Blood vessels and nerves are generally scarce in which component
of TMJ
A. Anterior portion of disc
B. Posterior portion of disc
C. Central portion of disc
D. Articular capsules

26. The facial nerve exits from skull from which foramen?
A. Ovale
B. Rotundum
C. Stylomastoid
D. Spinosum

27. Motor innervation of the muscle of facial expression is via:

A. Abducent nerve
B. Facial nerve
C. 1st division of the trigeminal nerve
D. 2nd division of the trigeminal nerve
28. The middle meningeal artery is associated with which foramen?
A. Ovale
B. Rotundum
C. Stylomastoid
D. Spinosum

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29. A lesion of the lingual branches of the glossopharyngeal nerve
would result in the loss of taste from which portion of the tongue?
A. Anterior third
B. Anterior two-third
C. Posterior third
D. Posterior two-third

30. Langer's line in the face usually are:

A. Parallel to the natural creases of the face
B. At right angle to the natural creases of the face
C. Due to subcutaneous interstitial fluid
D. Due to subcutaneous fat of the face

31. Which of the following is not a structural part of the

temporomandibular joint?
A. Sigmoid notch
B. Condylar process
C. Articular disc
D. Capsular ligament
32. Which is not an anterior triangle of neck?
A. Diagastric
B. Muscular
C. Parotid
D. Subclavian
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33. Which autonomic ganglion is not associated with the function of the
major salivary gland?
A. Otic
B. Ciliary
C. Submaxillary
D. None of the above

34. The hypoglossal nerve provides:

A. Motor innervation to all of the muscles of the tongue both intrinsic
and extrinsic
B. Sensory innervation to the anterior two-third of the tongue
C. Motor innervation to the styloglossus and hypoglossus muscles only
D. Sensory innervation to the posterior third of the
Tongue

35. In phonation, the true vocal cords deal primarily with:

A. Expiration
B. Inspiration
C. Both of the above
D. None of the above

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36. In the inferior alveolar nerve block, the needle is inserted adjacent
and lateral to a raphe formed by the buccinators and the:
A. Temporalis
B. Internal pterygoid
C. Superior constrictor of the pharynx
D. Middle constrictor of the pharynx

37. Classic Bell's palsy results from a lesion involving which of the
following nerves?
A. Trigeminal
B. Hypoglossal
C. Glossopharyngeal
D. Facial

38. The lingual artery is a branch of which of the following artery?

A. External carotid
B. Internal carotid
C. Internal maxillary
D. External maxillary

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39. Which one of the following vein does not drain into the internal
jugular?
A. Vein
B. Posterior facial (retromandibular)
C. Anterior facial
D. Posterior auricular

40. The mesenteric artery arises from which of the following artery:
A. Middle meningeal
B. Internal maxillary
C. External maxillary
D. Inferior alveolar

41. The triangle of the lingual artery is:

A. Lesser's triangle
B. Carotid triangle
C. Submental triangle
D. Muscular triangle
42. Severe trismus resulting from acute dental pathology indicates
swelling in which one of the following spaces:
A. Sublingual
B. Carotid
C. Retropharyngeal
D. Masticator
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43. Which of the following muscle is an intrinsic muscle of the tongue?
A. Chondroglossus
B. Glossopalatinus
C. Transverses lingual
D. Hypoglossus

44. Which of the following is not a branch of the internal maxillary

artery?
A. Posterior auricular
B. Infraorbital
C. Posterior superior alveolar
D. Inferior alveolar

45. Which of the following is innervated by vagus nerve?

A. Mylohyoid muscle
B. Tensor veli palatine
C. Levator veli palatine
D. Posterior belly of diagastric
46. Which muscle does not function in opening of the mandible?
A. External pterygoid
B. Diagastric
C. Hypoglossus
D. Mylohyoid

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47. The carotid triangle is separated from the submaxillary triangle by:
A. The superior belly of omohyoid muscle
B. The hyoid bone
C. Anterior belly of diagastric
D. Posterior belly of diagastric

48. The hypoglossal nerve is:

A. Purely sensory nerve
B. Mixed nerve
C. Autonomic nerve
D. Purely motor nerve

49. Which are components of the posterior triangle of neck?

A. Occipital triangle
B. Carotid triangle
C. Subclavian triangle & occipital triangle
D. Muscular triangle

50. The trigeminal nerve is:

A. Mixed nerve
B. Purely motor nerve
C. Purely sensory nerve
D. Mixed and autonomic nerve

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51. Which one of the following bones does not form the part of the
orbit?
A. Palatine
B. Maxillary
C. Frontal
D. Nasal

52. The no of branches of the internal carotid artery in the neck:

A. None
B. 1
C. 2
D. 3

53. Which one of the following nerves has a constant relation to the
occipital artery as it arises from the external carotid artery?
A. Vagus
C. Accessory
B. Glossopharyngeal
D. Hypoglossal
54. The semilunar/gasserian ganglion is found in a space known as:
A. Scarpa's space
B, Meckel's cavity
C. Antrum of Highmore
D. Rathke's pouch
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55. The course of the lingual nerve in relation to the submaxillary duct
as it passes forward is sequentially:
A. Below, medial, superior, lateral
B. Above, medial, inferior, lateral
C. Above, lateral, inferior, medial
D. Below, lateral, superior, lateral

56. The intrinsic muscles of the larynx deals with the true and false
vocal cords. Which cranial nerve innervates these muscles?
A. Vagus
B. Spinal accessory
C. Hypoglossal
D. Glossopharyngeal

57. Which structure passes between two roots of the auriculotemporal

nerve?
A. Inferior alveolar artery
B. Internal maxillary artery
C. Middle meningeal artery
D. Sphenomandibular ligament

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58. The ansa hypoglossal is composed of the:
A. Ascending cervical and ascending hypoglossal nerve
B. Ascending cervical and descending hypoglossal nerve
C. Descending cervical and ascending hypoglossal nerve
D. Descending cervical and descending hypoglossal nerve

59. Which syndrome consists of flushing, warmness, perspiration over

the cheek and pinna of the ear on one side following ingestion of highly
seasoned foods?
A. Cushing's syndrome
B. Horner's syndrome
C. Auriculotemporal syndrome
D. Fanconi's syndrome

60. The common carotid artery usually divides into the external and
internal carotid arteries at the level of:
A. Hyoid bone
B. Above the level of hyoid bone
C. Superior border of thyroid cartilage
D. Inferior border of thyroid cartilage

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61. The maxillary branch of trigeminal nerve passes through the:
A. Foramen ovale
B. Foramen rotundum
C. Superior orbital fissure
D. Foramen lacerum

62. Which is not a branch of facial nerve?

A. Zygomatic
B. Temporal
C. Buccal
D. Greater auricular

63. Which artery is not a part of circle of Willis?

A. Internal carotid
B. Posterior communicating
C. Anterior cerebral
D. Vertebral
64. The schneiderian membrane lines the:
A. Maxillary sinus
B. Oral cavity
C. Heart
D. Inner ear

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65. The motor component of the trigeminal nerve supplies all of the
following except:
A. Muscles of mastication
B. Anterior belly of digastric
C. Tensor tympani
D. Platysma muscle

66. The maxillary sinus is also known as:

A. Meckels cave
B. Aantrum of Highmore
C. Burns space
D. Rathke's pouch

67. Which nerve supplies sensory innervation for taste to the anterior
two-third of the tongue?
A. Hypoglossal
B. Lingual
C. Chorda tympani
D. vagus
68. Which nerve is not a branch of the trigeminal?
A. Digastric
B. Mandibular
C. Maxillary
D. Lingual
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69. Waldeyer's ring contains what type of tissue:
A. Muscle
B. Nerve
C. Lymphoid
D. None of the above

70. Motor innervation to the sternocleidomastoid muscle is supplied by:

A. Hypoglossal
B. Spinal accessory
C. Glossopharyngeal
D. vagus

71. The facial nerve supplies all of the following except:

A. Anterior belly of digastric
B. Posterior belly of digastric
C. Platysma
D. scalp

72. The left common carotid artery usually arises from:

A. Left auricle of the heart
B. Costocervical trunk
C. Arc of aorta
D. Brachiocephalic artery

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73. Greater palatine foramen is situated:
A. Between first and second maxillary molars
B. Between second and third maxillary molars
C. Between two central incisors
D. Between first and second maxillary premolars

74. Of the following which artery is most commonly involved in stroke?

A. Lenticulostriate artery
B. Cerebral artery
C. Ophthalmic artery
D. None of the above

75. Any laceration of the scalp causes less bleeding:

A. Because of less blood supply
B. Because the vessels are bound loosely in the connective tissue and
retract readily
C. All of the above
D. Above statement is wrong
76. Mental foramen opening is directed in:
A. Forward and medial direction
B. Backward and medial direction
C. Forward and lateral direction
D. Backward and lateral direction

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77. In pterygomandibular space the inferior alveolar nerve passes:
A. Medial to stylomandibular ligament
B. Anterior to the deep tendon of the temporal muscle
C. Lateral to the spheno mandibular ligament
D. Superior to lateral pterygoid muscle

78. Of the following which tissue has the least regenerating capacity
after injury?
A. Bone
B. Liver
C. Peripheral nerve
D. Tendon

79. Sensory fibers of lingual nerve supplies to:

A. Tongue
B. Lingual surface of mandible
C. Floor of the mouth
D. All of the above
80. All of the following bones contain air sinuses except:
A. Frontal
B. Nasal
C. Sphenoid
D. Ethmoid

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Chapter 2: LA\GA\Pain Control
1. Epinephrine is added to local anesthetics because
A. Decreases the rate of absorption of the local anesthetic at the injection
site
B. Prevents the rapid deterioration of the local anesthetic solution
C. Increases the rate of destruction of the local anesthetic
D. Potentiates the action of all local anesthetics

2. The most likely cause of trismus after block anesthesia for surgery in
the mandibular molar area is:
A. Excessive edema
B. Damage to the medical pterygoid muscle on injection
C. Stretching of the lateral pterygoid muscle
D. Submandibular cellulitis

3. The patient has received an injection of 1.8 ml of local anesthetic

containing 2 percent lidocaine with epinephrine. Thirty seconds later he
goes into syncope. The most probable cause is:
A. Bradycardia
B. Tachycardia
C. Cerebral hypoxia
D, A toxic reaction to the lidocaine

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4. Nitrous oxide alone isn’t used as a general anesthetic agent because of
the:
A. Difficulty in maintaining an adequate oxygen concentration
B. Expense of the agent and its explosive hazard
C. Adverse effects on the liver
D. Poor analgesic properties

5. When attempting to achieve an intraoral palatal second division block

anesthesia, the needle should enter the:
A. Greater palatine foramen
B. Stylomastoid foramen
C. Nasopalatine foramen
D. Foramen rotundum

6. A deep level of general anesthesia is enhanced by:

A. High alveolar concentration of anesthetic agent
B. Loose-fitting mask
C. Nonirritating drug
D. Muscle relaxant
7. A decrease in interstitial fluid pH will:
A. Decrease the effectiveness of a local anesthetic block
B. Increase the effectiveness of a local anesthetic block
C. Have no effect on the effectiveness of a local anesthetic block
D. Decrease, then increase the effectiveness of a local anesthetic block
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8. Which of the following deep bony landmarks is important in
performing a block of the second and third divisions of the trigeminal
nerve from the lateral approach?
A. Mastoid bone
B. Styloid process
C. Temporal surface of the sphenoid
D. Lateral plate of the pterygoid process

9. A history of medication with which of the following drugs requires

special consideration prior to general anesthesia?
A. Estrogen
B. Cortisone
C. Meperidine
D. Phenacetin

10. When administered in concentrations necessary to produce sedation,

nitrous oxide:
A. Does not produce nausea
B. Combines with hemoglobin
C. Involves no risk for the patient
D. Will depress the bone marrow and peripheral white cell counts in
man after prolonged use

33
11. Which of the following areas are anesthetized due to the anterior
(greater) palatine nerve block?
A. Incisors and canine on the injected side
B. Upper lip, nose and lower eyelid
C. Posterior portion of the hard palate and overlying structures up to the
first premolar on the injected side
D. Incisor to premolar on the injected side

12. Of the following which group of drugs eliminate all sensations?

A. Anesthetics
B. Analgesics
C. Narcotics
D. Sedatives

13. Of the following which causes anesthesia of the lower lip?

A. Metastatic malignancy
B. CNS tumor
C. Fracture mandible body region
D. All of the above

34
14. For what purposes adrenaline is added to procaine?
A. Reduction of hemorrhage in the field of operation
B. Prevention of toxic effects from too rapid absorption
C. Prolongation of anesthesia
D. All of the above

15. Following area of the brain is the "last" one depressed by GA agents:
A. Medulla.
B. Cerebellum
C. Pons
D. None of the above

16. The presser effect of both epinephrine and norepinephrine is

increased by which of the following:
A. Procaine
B. Dibucaine
C. Cocaine
D. Lidocaine
17. A nerve is absolutely refractory during:
A. Depolarization
B. After depolarization
C. Hyperpolarization
D. Firing level only

35
18. A nerve can be stimulated during relative refractory period by:
A. Stronger than normal stimuli
B. Sustained normal stimuli
C. Sub threshold stimuli
D. None of the above

19. Local anesthetic agents act by:

A. Increasing the rate of depolarization
B. Shortening the rate of repolarization
C. Decreasing the threshold potential
D. Increasing the threshold potential

20. The local anesthetic agent acts on:

A. Nerve membrane
B. Axoplasm
C. Epineurium
D. Perineurium

21. The most acceptable theory which explains the actions of LA:
A. Surface charge theory
B. Calcium displacement theory
C. Membrane expansion theory
D. Receptor binding theory

36
22. The ultimate action of binding the receptor by agent is brought about
by its:
A. Hydrophilic component
B. Lipophilic component
C. Intermediary chain
D. RN of amide agents

23. Amide group of local anesthetic agents are dispensed as salts of

strong acids because:
A. They are not lipid soluble but stable in air
B. They are not water soluble but stable in air
C. They are not water soluble and unstable in air
D. They are lipid soluble but stable in air

24. In acidic medium (during pyogenic infections) local anaesthetics are

less effective because:
A. More uncharged particles are released
B. Less uncharged particles are released
C. Less charged particles are released
D. None of the above

37
25. Local anaesthetic agents with higher pka would have:
A. Shorter onset of action
B. Longer onset of action
C. No effect on onset of action
D. None of the above

26. Which characteristic of a LA agent is responsible for its penetration

into the nerve?
A. Lipid solubility
B. Water solubility
C. Its ionization
D. None of the above

27. Addition of a vasoconstrictor to LA agents:

A. Increases alkalinity of the solution
B. Increases acidity of the solution
C. Has no effect on the pH
D. None of the above
28. Sodium bisulfite has the following effect on the action of LA
solution:
A. Slows down its onset of action
B. Decreases its duration of action
C. Increases its pH
D. Has no affect
38
29. Increasing the concentration of LA from 2 to 5% would have:
A. Rapid onset and prolonged action
B. Onset would not be affected but action would be prolonged
C. No change on action
D. Rapid onset and duration not affected

30. The efficacy of benzocaine in inflamed area would be:

A. Decreased
B. Increased
C. Not altered
D. Prolonged

31. The main barrier for diffusion of LA into the nerve is:
A. Epineurium
B. Perineurium
C. Endoneurium
D. Neural membrane

32. Which fibers of the nerve are anaesthetized first:

A. Mantle fibers
B. Core fibers
C. Both are anaesthetized at the same time
D. None of the above

39
33. The inadequate pulpal anesthesia in presence of adequate soft tissue
anesthesia can be due to:
A. Faulty technique
B. Insufficient penetration of core fibres
C. Insufficient penetration of fasciculi
D. Insufficient penetration of mantle fibres

34. Prolonged duration of action of drugs like etidocaine and

bupivacaine can be attributed to their:
A. Increased lipid solubility
B. Increased water solubility
C. Increased protein binding
D. Vasoconstrictor action

35. Tachyphylaxis occurs due to:

A. Increased dose of LA
B. Increased dose of vasoconstrictor
C. Repeated use of LA
D. Allergy to sodium metabisulfite
36. Which of the following belongs to ester group of local anaesthetics?
A. Bupivacaine
B. Benzocaine
C. Etidocaine
D. Mepivacaine
40
37. The only local anaesthetic with vasoconstrictor
A. Cocaine
B. Procaine
C. Benzocaine
D. Lidocaine

38. Which of the following is not an ester local anesthesia

A. Propoxycaine
B. Procaine
C. Prilocaine
D. Piperacaine

39. Which of the following local anaesthetics crosses the blood-brain

barrier:
A. Lignocaine
B. Etidocaine
C. Bupivacaine
D. All of the above
40. All of the local anaesthetics cross the placenta:
A. Except mepivacaine
B. Statement is true
C. Statement is false
D. Except lignocaine

41
41. Ester type local anaesthetics are metabolized in the:
A. Liver only
B. Kidney
C. Plasma
D. Lungs

42. A patient who had a history of prolonged apnoea during

administration of muscle relaxant (succinylcholine) should not be given?
A. Ester local anaesthetics
B. Amide local anaesthetics
C. Vasoconstrictors
D. Sodium bisulfite

43. A patient complains of history of hepatitis one month ago should be

preferably given which local anaesthetic agent?
A. Lignocaine
B. Bupivacaine
C. Procaine
D. Procainamide

42
44. One of the complications of prilocaine LA is:
A. Agranulocytosis
B. Hepatic dysfunction
C. Methemoglobinemia
D. None of the above

45. Local anaesthetics are excreted mainly by:

A. Lungs
B. Fecal route
C. Kidneys
D. Uterus

46. Blood level of > 7 ug\ml of LA produces:

A. Anticonvulsive activity
B. Tonic clonic seizure
C. CVS stimulation
D. None of the above

47. The anticonvulsant activity of local anaesthetic agents occurs at:

A. < 4 ug/ml
B. 4-7 ug/ml
C. 7-10 ug/ml
D. 10-12 ug/ml

43
48. The differentiating factor between LA toxicity and developing
syncope would be:
A. CNS stimulation
B. CNS depression
C. Pallor of skin
D. Light reflex

49. The level of 2% lidocaine which reaches blood after use of one or
two cartridges is:
A. 0.5-2 ug/ml
B. 1.5-5 ug/ml
C. 5-10 ug/ml
D. No LA reaches blood if given safely after aspiration

50. A patient with known history of hyperthermia should be given:

A. Lignocaine
B. Procaine
C. Bupivacaine
D. Mepivacaine
51. With overdose of local anaesthetic agent one would observe:
A. Hypertension
B. Hypotension
C. No change in BP
D. Cardiac arrhythmias
44
52. Epinephrine (Adrenalin) which is used in dental cartridge of LA acts
on:
A. a receptors only
B. P receptors only
C. a and P receptors but p predominantly
D. a and P receptors but a predominantly

53. When local anaesthetic agent with adrenalin is injected, the

termination of activity of the vasoconstrictor is brought by:
A. Adrenergic nerve endings
B. Blood enzymes COMT and MAO
C. Excretion in urine (80%)
D. A and B

54. Use of norepinephrine in dental practice is not recommended

because it causes:
A. Bradycardia
B. Intense peripheral vasoconstriction
C. Hypertension
D. Sensitization of myocardium

45
55. When one has to use the weakest vasoconstrictor (e.g. in patient with
history of angina) one should consider:
A. Epinephrine
B. Norepinephrine
C. Phenylephline
D. Levonordefrin

56. Rebound phenomenon is most commonly seen with use of:

A. Epinephrine
B. Norepinephrine
C. Phenylephrine
D. Levonordefrin

57. The absolute contraindication for use of adrenalin in LA is:

A. Myocardial infarction, 3-6 months ago
B. Angina pectoris
C. Hyperthyroidism
D. Pregnancy
58. Adrenalin should not be used when halothane is used during GA
because halothane:
A. Sensitizes the myocardium to adrenalin
B. Increases the heart rate
C. Increases the blood pressure
D. Interferes with AV conduction
46
59. A cartridge of LA contains adrenalin, it indicates that there is:
A. 0.005 mg/ml of adrenalin
B. 0.065 mg/ml of adrenalin
C. 0.0125 mg/ml of adrenalin
D. 0.02 mg/ml of adrenalin

60. Maximum dose of adrenalin which can be given to a patient with

history of cardiovascular disease is:
A. 0.2 mg/ml
B. 0.2 mg
C. 0.04 mg
D. 0.005 mg/ml

61. To a patient of 50 kg weigtt how many cartridges of LA with 1:

200,000 adrenalin can be given (considering patient is normal, healthy
and lignocaine toxicity is not considered):
A. 10.5
B. 22
C. 32
D. 40

47
62. Lidocaine was first prepared by:
A. Nils Lofgren
B. Ekenstam
C. Einhorn
D. None of the above

63. The duration and depth of pulpal anesthesia with lignocaine (2%)
added to epinephrine as compared to 1: 100,000 epinephrine would be:
A. Longer and profound
B. Duration would be two times longer but depth would be same
C. No much difference
D. Duration would be 4 times

64. Three percent lignocaine indicates that there is:

A. 25 mg/ml of lignocaine
B. 30 mg/ml of lignocaine
C. 54 mg/ml of lignocaine
D. 27 mg/ml of lignocaine
65. How many cartridges of 2% lignocaine can be given to a 50 kg man
(with adrenalin)?
A. 6
B. 12
C. 17
D. 25
48
66. When vasoconstrictor is contraindicated, the ideal local anaesthetic
would be:
A. Lignocaine
B. Mepivacaine
C. Cocaine
D. Bupivacaine

67. A patient with respiratory disease presents for treatment, which drug
should not be used:
A. Lignocaine
B. Adrenaline
C. Prilocaine
D. Mepivacaine

68. Which of the following is least toxic LA?

A. Lignocaine
B. Mepivacaine
C. Propoxycaine
D. Bupivacaine

49
69. When injecting into relatively highly vascular area as in posterior
superior alveolar nerve block, one should use needle with:
A. Smaller gauge
B. Larger gauge
C. Gauge does not matter
D. None of the above

70. One should use a needle which has:

A. Greatest angle of bevel
B. Minimum angle of bevel with tip lying in the center of the lumen
C. No bevel at all
D. None of the above

71. Which of the following is a long acting LA agent?

A. Mepivacaine
B. Bupivacaine
C. Prilocaine
D. Propoxycaine

50
72. The safest local anaesthetic agent:
A. Cocaine
B. Procaine
C. Chloroprocaine
D. Propoxycaine

73. Which local anaesthetic agent when used topically interferes with
sulphonamide action:
A. Lidocaine base
B. Lidocaine
C. Benzocaine
D. Propoxycaine

74. Self-aspirating syringes, provide aspiration by:

A. Pulling the thumb ring
B. Negative pressure created due to elasticity of rubber diaphragm
C. Pressure release on thumb disc
D. All of the above
75. The jet injectors are used to obtain:
A. Pulpal anesthesia
B. Topical anesthesia
C. Regional block
D. Nerve block also

51
76. The gauge of needle used in dental syringes refers to:
A. Internal diameter of the lumen
B. External diameter of needle
C. Diameter of bevel only
D. Diameter of hub

77. Sodium bisulphite used in dental LA cartridge acts as:

A. Antioxidant for adrenalin
B. Antioxidant for lignocaine
C. Antibacterial for lignocaine
D. Not used any more

78. The allergic reactions commonly seen following use of cartridge of

LA is due to:
A. Lignocaine
B. Vasoconstrictor
C. Methyl paraben
D. Sodium metabisulphite
79. Glass LA cartridge should be sterilized by:
A. Autoclaving
B. Dry heat
C. Cold sterilization
D. None of the above

52
80. If the diaphragm of cartridge is soaked in isopropyl alcohol for
purpose of antisepsis, it may result in:
A. Reduced anesthesia
B. No anesthesia
C. Long-term paresthesia
D. None of the above

81. Local infiltration should be:

A. Paraperiosteal
B. Subperiosteal
C. Transeptal
D. None of the above

82. Infiltration is not successful for anaesthetizing buccal roots of:

A. Maxillary 1st permanent molar
B. Maxillary 1st deciduous molar
C. Mandibular 1st permanent molar
D. Deciduous maxillary 1st molar
83. For posterior superior alveolar nerve one should use:
A. Long needle (40 mm)
B. Short needle (25 mm)
C. Length not a criterion
D. Only bevel should be considered

53
84. Greater palatine foramen is present:
A. Between 1st and 2nd maxillary molars
B. Between 2nd and 3rd maxillary molars
C. Distal to 3rd maxillary molar
D. Mesial to 1st maxillary molar

85. In 80% of patients infraorbital nerve block is effective for buccal

aspect of:
A. Central incisors and canines
B. Central incisors to 1st premolars
C. Central incisors to mesiobuccal root of 1st maxillary molar
D. Central incisors only

86. In greater palatine nerve block the needle should be:

A. Parallel to mucosa
B. Perpendicular to mucosa
C. 450 inclined to mucosa
D. Parallel to roots of molars

54
87. The two techniques used for maxillary block are:
A, Greater and lesser palatine approach
B. Greater palatine and high tuberosity approach
C. Greater tuberosity and retromolar approach
D. Gow gates and Akinosi technique

88. Inferior alveolar nerve block anaesthetizes all except:

A. Body of mandible lower part
B. Mandibular teeth
C. Mucous membrane anterior of first mandibular molar
D. Mucous membrane distal to 1st mandibular molar

89. The needle while giving inferior alveolar nerve block passes
through:
A. Buccinator muscle
B. Pterygomandibular raphe
C. Buccal fat
D. Stylomandibular raphe

55
90. While giving inferior alveolar nerve block the needle is lateral to:
A. Lingual nerve
B. Sphenomandibular ligament
C. Medial pterygoid muscle
D. All of the above

91. If bone is not contacted before injecting local anaesthetic in inferior

alveolar nerve block, there are chances of:
A. Lingual nerve anaesthesia
B. Transient facial palsy
C. Transient maxillary anaesthesia
D. None of the above

92. Inferior alveolar nerve block at times is not very effective because
which of the nerves is not anaesthetized:
A. Mental nerve
B. Lingual nerve
C. Mylohyoid nerve
D. Incisal nerve

56
93. Gow gates technique is for:
A. Mandibular nerve block
B. Inferior alveolar nerve block
C. Trigeminal ganglion block
D. V2, V3, block

94. The target of Gow Gates technique is:

A. Coronoid notch
B. Sigmoid notch
C. Foramen ovale
D. Neck of condyle

95. In patients with reduced mouth opening which technique of

mandibular anesthesia should be used?
A. Gow gates
B. Akinosis
C. Labyrinths
D. Williams
96. For extra oral maxillary nerve block the target area is:
A. Posterior to lateral pterygoid plate
B. Anterior to lateral pterygoid plate
C. Pterygomandibular fissure
D. Pterygomandibular fossa

57
97. For extra oral mandibular nerve block the needle should be inserted
from:
A. Above the zygomatic arch
B. Below the zygomatic arch
C. Coronoid notch
D. None of the above

98. If needle breaks during injecting LA and radio graphically it appears

to be deep in tissues, the advised management would be:
A. Removal of needle under LA
B. Removal of needle under GA
C. Leaving the needle in the tissue
D. None of the above

99. Use of which of the solutions relatively can have more burning
sensation?
A. Plain lignocaine
B. Isotonic solution
C. Lignocaine and adrenalin
D. Hypotonic solution

58
100. Persistent anesthesia can result most often in which of the nerves,
after LA injection?
A. Inferior alveolar
B. Lingual nerve
C. Infraorbital nerve
D. Mental nerve

101. Aspiration should be carried out at least in:

A. One plane
B. Two planes
C. Three planes
D. Four planes

102. ECG changes can first be observed when level of lignocaine is

more than:
A. 5-6 ug/ml
B. 10-12 ug/ml
C. 2-4 ug/ml
D. 1-2 ug/ml

59
103. To control tonic clonic seizures following lignocaine toxicity the
drug of choice would be:
A. Pentobarbital
B. Diazepam
C. Succinylcholine
D. Antihistaminic

104. Succinylcholine can be used for control of tonic clonic seizures but
along with this:
A. Pentobarbitone should be used
B. Artificial respiration is must
C. Atropine should be given
D. Neostigmine should be given to terminate its action

105. Postictal phase, which follows CNS toxicity with Lignocaine

should be managed by:
A. CNS stimulants
B. Analeptics
C. Supportive therapy only
D. Diazepam

60
106. During CVS depression in lignocaine toxicity, one should
administer:
A. Vasoconstrictors
B. Atropine
C. Crystalloids
D. All of the above

107. Gingival retraction cords contain adrenalin in concentration of:

A. 1:200,000 / inch
B. 0.3 ug / inch - 1.0 ug / inch
C. 300 ug/inch-1000 ug/inch
D. 1000 ug/inch-2000 Pig/ inch

108. Extraction of deciduous teeth in dental clinic can be carried out in

which stage of general anesthesia:
A. Stage I
B. stage II
C. stage III plane II
D. stage III plane III

61
109. Surgical plane for major surgery during general anesthesia is
during:
A. stage III plane I
B. stage III plane II
C. stage III plane III
D. stage HI plane IV

110. Succinylcholine is administered during GA for:

A. Better control
B. Intubation
C. Prevention of apnoea
D. Decreasing respiratory rate and thus decreasing GA toxicity

111. Nowadays induction phase of GA has been reduced because of use

of:
A. Halothane
B. Ether, halothane combination
C. Thiopentone sodium
D. Ether, N2O, halothane combination

62
112. If long acting muscle relaxants are used during GA, their action is
terminated by use of:
A. Neostigmine
B. Atropine
C. Ketamine
D. Succinylcholine

113. The N2O gas cylinder used in GA is:

A. White and black coloured
B. Blue coloured
C. Red and yellow coloured
D. White and blue coloured

114. For maxillofacial injuries one should always use which

endotracheal tube for GA
A. Non inflatable
B. Inflatable cuffed
C. Catheterized
D. None of the above
115. The endotracheal tube should be placed for GA:
A. In right bronchus
B. In left bronchus
C. Above cricoid
D. In laryngopharynx
63
116. Rotameter on Boyle's trolley for GA is used to measure:
A. Pressure of gas in the cylinders
B. Pressure of halothane
C. Flow of gases in the tubes
D. None of the above

117. Goldman's vapourizer is used for:

A. N2O
B. 50% N2O + 20% O2 mixture
C. 50% N2O + 50% O2 mixture
D. 50% either + 20% O2 mixture

118. In TMJ ankylosis patient, GA cannot be administered

A. Oral intubation
B. Blind nasal intubation
C. Fiberoptic assisted intubation
D. B and C

119. In TMJ ankylosis patient, GA can be administered

A. Oral intubation
B. Blind nasal intubation
C. Fiberoptic assisted intubation
D. B and C

64
120. A patient who is being operated under halothane should not be
given:
A. Lignocaine
B. Lignocaine + adrenalin
C. Propoxycaine
D. Mepivacaine

121. Glycopyrolate is usually used during GA to:

A. Reduce heart rate
B. Increase BP
C. Reduce secretions
D. Control bleeding

122. In most surgical procedures, GA with N2O is given

A. 70% N2O + 30% O2
B. 70% N2O + 20-30% O2 + other GA agent
C. 50% N2O + 50% O2 + other GA agent
D. 70% O2 + 20% N2O

65
123. Which of the following is used as a dissociative the anaesthetic
agent:
A. Fentanyl
B. Thiopentone
C. Ketamine
D. Halothane + either mixture

124. During GA oxygen concentration of blood should not fall below:

A. 90%
B. 60%
C. 40%
D. 20%

125. Local anesthetics are most effective in tissue that have what pH?
A. Below 7
B. Above 7
C. Below 4
D. Makes no difference what the pH of the tissue is

66
126. A 40-year-old male develops right facial and head pain which is
intermittent with abrupt onset and cessation. It usually occurs at night
awakening him from sleep. The pain is associated with unilateral
flushing, sweating, rhinorrhea and increased lacrimation. What is the
most likely diagnosis?
A. Tic doulourcux
B. Vidian neuralgia
C. Sphenopalatine ganglion neuralgia
D. Histamine cephalgia

127. Which local anesthetic listed below may possibly manifest its
toxicity clinically by initial depression and drowsiness rather than
stimulation and convulsion?
A. Lidocaine
B. Procaine
C. Benzocaine
D. Tetracaine

128. How will a larger than normal functional residual capacity affect?
A. Nitrous oxide sedation
B. Nitrous oxide sedation will happen much quicker
C. Nitrous oxide sedation will take longer
D. Functional residual capacity does not affect nitrous oxide sedation

67
129. A patient who is allergic to para-amino benzoic acid will also be
allergic to which of the following:
A. Lidocaine
B. Tetracaine
C. Prilocaine
D. Carbocaine

130. Nitrous oxide works on which system listed below?

A. Peripheral nervous system (PNS)
B. Central nervous system (CNS)
C. Autonomic nervous system (ANS)
D. None of the above

131. During an inferior alveolar block injection, the needle passes

through the mucous membrane and the buccinator muscle and lies lateral
to which muscle listed below?
A. Masseter
B. Lateral pterygoid
C. Hypoglossus
D. Medial pterygoid

68
132. After receiving an injection of a local anesthetic containing 2
percent lidocaine with epinephrine, the patient loses consciousness.
Which of the following is the most probable cause?
A. Acute toxicity
B. Allergic response
C. Syncope
D. Hyperventilation syndrome

133. How many milligrams of epinephrine are in each cartridge (1.8 cc)
of 2% lidocaine with epinephrine?
A. 0.018 mg
B. 18 mg
C. 0.036 mg
D. 36 mg

134. Local anesthetics act directly on the nerve membrane in what way?
A. Decrease the membrane's permeability to sodium
B. Increase K + flux
C. Increase the membrane's permeability to sodium
D. Increase membrane excitability

69
135. Phlebitis of a vein after administration of IV valium is usually
attributed to the presence of which of the following in the mixture?
A. Hydroquinone
B. Water
C. Alcohol
D. Propylene glycol

136. Which drug listed below is most commonly used to attain general
anesthesia?
A. Valium
B. Chloral Hydrate
C. Phenargan
D. Methohexital

137. Which of the following is a peculiar thermal alteration that occurs

during surgery in susceptible persons?
A. Malignant hypothermia
B. Heat stroke
C. Malignant hyperthermia
D. None of the above

70
138. The maximum allowable dose for 2% lidocaine with epinephrine is
what?
A. 2.0 mg lidocaine/per pound
B. 3.5 mg lidocaine/per pound
C. 5.0 mg lidocaine/per pound
D. 7.5 mg lidocaine/per pound

139. Which vein listed below is the optimum site for IV sedation for an
outpatient?
A. Median basilica
B. Median cephalic
C. Median antebrachial
D. Angular

140. What is usually the first clinical sign of mild lidocaine toxicity?
A. Itching
B. Nervousness
C. Vomiting
D. Sleepiness

71
141. The CNS and respiratory depressant effects of barbiturates can be
enhanced by concomitant use of:
A. Phenothiazines
B. Alcohol
C. Both of the above
D. None of the above

142. Productive cough, often with wheezing, is a universal factor of

which disease:
A. Emphysema
B. Congestive heart failure
C. Chronic bronchitis
D. Hepatitis

143. The amount of vasoconstrictor in 1ml or 2% lignocaine solution

with adrenaline is:
A. 0.5 mg
B. 0.05 mg
C. 0.005 mg
D. 0.0005 mg

72
144. The latest drug of choice in the management of trigeminal neuralgia
is:
A. Valproic acid
B. Carbamazepine
C. Diphenhydantoin
D. Carbazepine

145. Medical oxygen is stored in steel cylinders painted:

A. Black
B. Blue
C. White
D. Green

146. How much lignocaine is present in 2.0 ml of 2% lignocaine

solution?
A. 42.6 mg
B. 21.3 mg
C. 32.1 mg
D. 02.31 mg

73
147. Following a right inferior alveolar nerve block, the patient
experiences difficulty in closing the eyelid of the right side. The problem
cause is:
A. Anesthesia of the motor branch of the mandibular nerve
B. Anesthesia of the facial nerve within the parotid gland
C. Anesthesia of an aberrant branch of the cervical colli nerve
D. Anesthesia of the infra-orbital nerve because the injection was too
high

148. Local anaesthetics produce anesthesia by:

A. Depolarizing a nerve
B. Inhibiting the influx of sodium ions through the never membrane
C. Creating negative after potentials
D. Increasing the outflow of Potassium ions through the nerve
membrane

149. When blocking a nerve containing both motor and sensory fibers,
the last functional property lost is?
A. Temperature
B. Pain
C. Proprioception
D. Touch

74
150. Sodium meta-bisulfite is added in local anaesthetic solutions to:
A. Act as a preservative
B. Maintain the pH of the solution
C. Act as an anti-oxidant for adrenaline
D. Prevent the spontaneous dissociation of lignocaine in solution

151. In tracheostomy, the entry into the trachea is through the:

A. Cricoid cartilage
B. First tracheal ring
C. Second and third tracheal ring
D. Fourth and fifth tracheal ring

152. The following is true for percutaneous tracheostomy, expect:

A. No pretracheal dissection is required
B. Can be carried out at the bedside
C. A transverse incision is used
D. Treatment of choice in intubated patient
153. Trismus after an inferior alveolar nerve block most likely results
from:
A. Damage to the inferior alveolar nerve
B. Damage to the Medial pterygoid muscle
C. Myositis of the buccinator muscle
D. Accidental blockade of a major branch of the trigeminal nerve motor

75
154. The maximum safe dose of adrenaline that can be given in a local
anaesthetic solution to a healthy dental out patient is:
A. 0.002 mg
B. 0.2 mg
C. 2.0 mg
D. 0.02 mg

155. The ideal rate if injection of a local anesthetic solution is:

A. 1.00 ml/ min
B. 1.50 ml/ min
C. 1.80 ml/ min
D. 2.00 ml/ min

156. The aims of pre-anaesthetic medication include the following,

except:
A. Allaying apprehension
B. Decreasing oral and gastric secretions
C. Increasing reflex irritability
D. Increasing the pain threshold
157. Gustatory swelling is the chief symptom in:
A. Sjogren's syndrome
B. Frey's syndrome
C. Bell's palsy
D. Sialolithiasis
76
158. The purpose of taping the eyes shut before a patient is draped for
surgery under GA is to:
A. Prevent lacrimal secretions from contaminating the field
B. Prevent corneal abrasions
C. Limit ocular motility
D. All of the above

159. During an oral surgical procedure under general anesthesia, the

anaesthetic technique best suited to avoid aspiration of blood or other
debris is:
A. Open drop
B. Nasopharyngeal intubation
C. Endotracheal intubation with cuffed tube
D. Oropharyngeal intubation

160. Allergic reactions in patients who receive amide type local

anesthetic solutions for tooth extractions are most likely caused by a
reaction to:
A. Lignocaine hydrochloride
B. Adrenaline bitartrate
C. Methylparaben
D. Sodium meta-bisuphite

77
161. Extra-oral injection for obtaining the anesthesia of the entire second
division of the fifth cranial nerve is given in\around the:
A. Infraorbital foramen
B. Foramen ovale
C. Pterygopalatine fissure
D. Foramen spinosum

162. After receiving a posterior superior alveolar block the patient

experiences:
A. Numbness of the molar teeth
B. Numbness of the upper lip
C. Numbness of the side of the face
D. Few subjective signs of anesthesia

163. Which of the following drug is used to manage an acute urticarial

reaction after administration of a local anaesthetic?
A. Intravenous injection of aminophylline
B. Inhalation of aromatic spirits of ammonia
C. Intravenous injection if hydrocortisone methyl acetate
D. Intravenous injection of diphenhydramine

78
164. The most common postoperative complication of outpatient general
anaesthesia is:
A. Syncope
B. Nausea
C. Atelectasis
D. Shivering

165. The piercing of the infra orbital nerve with a 26 gauge needle while
giving a block in the canine fossa produces:
A. Lancinating pain in the lower eyelid
B. A mild, temporary paresthesia of the upper lip
C. Destruction of the nerve
D. Haematoma formation in the region

166. Vascular compression of the gasserin ganglion by the following

blood vessel is thought to be responsible for tic:
A. Superior cerebellar artery
B. Superior cerebral artery
C. Middle cerebral artery
D. Antero-inferior cerebellar artery

79
167. A patient with upper motor lesions of the facial nerve presents with
the following clinical appearance except:
A. Sagging of the corner of the mouth
B. Flattening of the nasolabial furrow
C. Loss of eyebrow and forehead wrinkles
D. Incompetent lip seal

168. Endotracheal intubation is only possible in the following stage of

general anesthesia:
A. stage I
B. stage III, Plane 1
C. stage III, Plane 2
D. stage III, Plane 3

169. The important sign a patient exhibits when the correct level of
sedation is reached while using diazepam sedation is?
A. Blurring of vision
B. Slurring of speech
C. Loss of gag reflex
D. 50% ptosis of the eyelids

80
170. In general anesthesia the loss of eyelash reflex
A. stage I
B. stage II
C. stage III, Plane 1
D. stage III, Plane 4

171. Guedel's criteria for classification of the depth of general anesthesia

are based on:
A. Respiration, eyeball movement and presence and absence of various
reflexes
B. Response to skin incision
C. Pharyngeal and laryngeal reflexes
D. Respiration, eyelid reflex and secretion of tears

172. According to the gate-control theory of pain, impulses traveling in

the A fibers tend to
A. Inhibit the substansia geletinosa cells thereby blocking the pain
stimuli transmitted by the C fibers
B. Excite the substansia gelatinosa cells thereby blocking the pain
stimuli transmitted by the nonmyelinated fibers
C. Be associated with pain of inflammatory origin
D. Bypass the central control process

81
173. The "burning" felt at the site of venipuncture after administration of
diazepam can be attributed to:
A. Propylene glycol in the mixture
B. Benzoic acid in the mixture
C. Use of a blunt or large diameter needle
D. Poor venipuncture technique

174. Nitrous oxide-oxygen inhalation sedation is contraindicated in

patients with:
A. Nasal obstruction
B. Emotional instability
C. Emphysema
D. All of the above

175. Dissociative analgesia is produced using following drug

combination:
A. Ketamine and scopolamine
B. Fentanyl and droperidol
C. Pentobarbital and meperidine
D. Diazepam and atropine

82
176. The minimum distance a nerve should be covered by the
anaesthetic solution to ensure thorough blockade of the nerve impulse,
is:
A. 3-5 mm
B. 5-8 mm
C. 8-10 mm
D. 10-14 mm

177. The absolute contraindication to the use of a local anesthetic

solution with epinephrine is in a patient with:
A. Uncontrolled hypertension
B. Untreated hyperthyroidism
C. Diabetes mellitus
D. Ventricular fibrillation

178. The pH of the tissues does not affect the effective- ness of this
anesthetic agent:
A. Bupivacanie
B. Procaine
C. Benzocaine
D. Mepivacaine

83
179. The most potent vasodilator local anaesthetic agent
A. Cocaine
B. Lignocaine
C. Tetracaine
D. Procaine

180. The following incision is used to gain access to the medial surface
of the mandibular ramus, for inferior alveolar neurectomy:
A. Risdon's incision
B. Ginwall's incision
C. Bayonet incision
D. Crow's foot incision

181. Of the following which is most suitable anesthesia for the

extraction of a deciduous molar?
A. Inferior alveolar nerve block
B. Surface anesthesia
C. Local infiltration
D. None of the above
182. Most reactions following injection of LA are caused
A. Allergy
B. Anxiety
C. Toxicity
D. Over dosage
84
183. Hematoma formation after the posterior superior alveolar nerve
block is due to the damage to:
A. Internal maxillary artery
B. Small capillaries and arterioles in the region
C. Pterygoid venous plexus
D. Facial artery

184. Two minutes following cessation of a two hour treatment session

using 80% N20 and 20% 02 and local anesthesia. The patient becomes
cyanotic and tachycardiaca most probable cause is:
A. Diffusion hypoxia
B. Over oxygenation
C. Under oxygenation
D. Malignant hyperthermia

185. Level of analgesia is best monitored by:

A. Eye movements and absence of corneal reflex
B. Eye movements and absence of conjunctival reflex
C. Respiration, rate, rhythm and type of respiratory movements
D. Verbral response

85
186. Among the following which is the optimum site for intravenous
sedation in an outpatient?
A. Jugular vein
B. Median cephalic vein
C. Dorsal vein back of the hand
D. Popliteal vein

187. Which respiratory conditions is most alarming during patient

sedation in dental hospital?
A. Tachypnoea
B. Dyspnoea
C. Apnoea
D. Hyperpnoea

188. The common anesthetic complication occurring within first day

after surgery under GA is:
A. Cardiac failure
B. Renal failure
C. Atelectasis
D. Hypotension

86
189. According to Gate control theory of pain, large fiber impulses tend
to:
A. By pass the central control process
B. Inhibit the effect of painful stimuli transmitted by small fibers
C. Transmit severe .chronic pain only
D. Potentiate the effect of painful stimuli

190. In case of mild lidocaine toxicity, the first clinical sign is:
A. Nervousness
B. Lethargy
C. Convulsions
D. Tachycardia

191. Which of the following is the cause of allergies to local anesthetics?

A. Slow elimination
B. Improper technique
C. Slow detoxification
D. Antigen and antibody reactions
192. The following drugs potentiates the action of sedative drugs:
A. Phenothiazines
B. Propanol
C. Methyldopa
D. Digitalis

87
193. Each cartridge contains how many ml. of anesthetic solution:
A. 0.9 ml
B. 1.2 ml
C. 1.8 ml
D. 2.2 ml

194. How many mg of 2% lidocaine present in the cartidge?

A. 36 mg
B. 18 mg
C. 180 mg
D. 360 mg

195. How many mg of adrenaline are in each cartridge of 2% lignocaine

with adrenaline:
A. 0.36 mg
B. 0.036 mg
C. 0.018 mg
D. 0.15 mg
196. Among the following in which patient GA is contraindicated?
A. An adult male over 65 years of age
B. Patient with acute respiratory infection
C. Child under 6 years of age
D. Patient with wheel compensated heart disease

88
197. The following two laboratory tests should be considered before
deciding whether to use general anesthesia or not?
A. Total WBC count and prothrombin time
B. Total WBC count and urine analysis
C. Bleeding time and clotting time
D. Complete blood count and urine analysis

198. Nerve membrane stabilization action of local anesthetic agents is

due to:
A. Increasing conductance of potassium ions
B. Creating negative after potentials
C. Preventing conductance of Na ions from the exterior of the nerve to
the interior
D. Preventing conductance of Na ions from the interior to the exterior of
the nerve

199. Thirty seconds after the injection of 1.8 ml of local anesthetic

containing 2% lidocaine with adrenaline patient loses consciousness.
The most probable diagnosis is:
A. Toxic reaction to the adrenaline
B. Cerebral hypoxia
C. Tachycardia
D. Toxic reaction to the lidocaine

89
200. In which conditions N O - O sedation in contraindicated?
A. Emphysema
B. Upper respiratory obstruction
C. Emotional instability
D. All of the above

201. Members of the sterile professional team include

A. Surgeon, assistants and scrub nurse
B. Surgeon, scrub nurse, and circulating nurse
C. Surgeon, scrub nurse, circulating nurse and anesthesiologist
D. A and B

202. One wants to anesthetize the inferior alveolar nerve at the point at
which it exists from the mandibular canal, so the injection site most
often located in
A. Between first and second molars inferior to the root apices
B. Between first and second molar superior to root apices
C. Between first and second premolars inferior to root apices
D. Between first and second premolars superior to root apices

90
203. Accidental intravenous injection of LA which contains a
vasoconstrictor may cause:
A. Convulsions and palpitations
B. Unconsciousness and depressed respiration
C. Increased respiration
D. Any of the above may occur

204. Compared to inhalation, IV sedation:

A. Produces more; predictable amnesia
B. May produce more serious complications
C. May result in deeper sedation
D. All of the above are correct

205. Among the following which is least likely to block reflexes for
surgery completely when used alone?
A. Nitrous oxide
B. Halothane
C. Ethane
D. Thiopentone sodium
206. Likely cause of trismus after inferior alveolar block anesthesia is:
A. Damage to medial pterygoid muscle during injection
B. Myositis of the external pterygoid muscle
C. Submandibular cellulitis
D. Stretching of the pterygomandibular raphe
91
207. Most common cause of death occurring under GA is due to:
A. Reflex cardiac standstill
B. Over dosage of anaesthetic agent
C. Excessive carotid sinus stimulation
D. Airway obstruction with improper ventilation

208. Three common symptoms indicating the correct level of sedation

after diazepam administration is:
A. Blurring of vision, slurring of speed and loss of GAG reflex
B. 50% ptosis eyelids, blurring of vision, slurring of speech
C. Paresthesia of lips, tongue and fingers
D. Sweating over the face, itching of the nose and loss of gag reflex

209. Preferable patient position in recovery room after ambulatory

general anesthesia is:
A. Supine
B. Sitting
C. Prone
D. Lateral

92
210. Among the following which nerve innervates the buccal gingiva of
the maxillary second premolar?
A. Anterior palatine nerve
B. Buccal nerve
C. Middle superior alveolar nerve
D. Posterior palatine nerve

211. Paresthesia during a mandibular nerve block is due to:

A. Sodium conductance through the nerve
B. Acid pH of the anaesthetic solution
C. Contact of the needle with the nerve trunk
D. Poor technique

212. Of the following in which condition local anesthesia is ineffective?

A. Edema
B. Localized infection
C. Hematoma
D. Anemia
213. The following anatomical land marks are useful in the closed
mouth approach of mandibular nerve block except:
A. Occlusal plane of occluding teeth
B. Anterior border of ramus
C. Mucogingival junction of the mandibular teeth
D. A and B
93
214. A contraindication to local infiltration technique:
A. Hypertension
B, Diabetic patient in whose urine sugar is present
C. Infection in the arch
D. Kidney problems

215. The purpose of gas filled bubbles in anesthetic cartridge is:

A. Indicate the level of anaesthetic agent
B. Prevent deterioration of the vasoconstrictor
C. Formed during the manufacturing process
D. A and C

216. Anterior palatine nerve is anaesthetized by anterior palatine nerve

block. The subjective symptoms include:
A. Feeling of numbness in posterior palate
B. Feeling of numbness in the anterior part of the palate near the incisors
C. Feeling of numbness of whole palate
D. Little or no subjective symptoms
217. The primary site of local anaesthetic action is:
A. Medulla oblongata
B. Substantia gelatinous
C. Nerve membrane
D. Nodes of ranvier

94
218. Which is best monitor of the level of analgesia?
A. Eye movements
B. Respiratory movements
C. Muscle tone
D. Verbal response

219. When comparing to the nonmyelinated nerve, myelinated nerve

requires:
A. Higher concentration of anaesthetic agent
B. Lower concentration of anaesthetic agent
C. Same concentration of anaesthetic agent
D. None of the above because no correlation

220. Local anaesthetic cartridges contain small bubbles.

These bubbles contain:
A. Oxygen gas
B. Carbon dioxide gas
C. Nitrogen gas
D. Carbon monoxide gas

95
221. Which of the following statements is true?
A. More concentration of H+ ions in an area potentiate anaesthetic agent
action
B. Less concentration of H+ ions in an area potentiate anaesthetic agent
action
C. A little is known about the relation between H+ ion concentration and
anaesthetic activity
D. No correlation between H+ ion concentration and anaesthetic activity

222. A surgical procedure required bilateral block. A bi- lateral inferior

alveolar nerve block is:
A. Not contraindicated
B. Should rarely be performed
C. May cause space infection
D. Dangerous because patient may swallow the tongue

223. Risk of death in more in some patients with the use of local
anesthesia with adrenaline. Which of the following group of patients are
called as walking time bombs?
A. Cocaine abusers
B. Hypertensive
C. Hyperthyroidism patients
D. Patients under MAOI (MAO inhibitors) treatment

96
224. Subjective symptom of buccal nerve block is:
A. Numbness and tingling sensation of the buccal mucosa
B. Numbness of the lingual mucosa near molars
C. No subjective symptoms
D. A and B

225. Ester group of local anaesthetics mainly inactivated

A. Hydroxylation
B. Oxidation
C. Hydrolysis
D. None of the above

226. Among the following, which condition is a contraindication to the

use of local anaesthetic agent?
A. Parkinson's disease
B. Liver damage
C. Pregnancy (3rd trimester)
D. Hypersensitivity to the drug
227. Amide type of local anaesthetic agents undergo biotransformation
primarily in the:
A. Kidney
B. Liver
C. Plasma
D. No biotransformation occurs excreted in all unaltered form
97
228. Ester type local anaesthetic agents undergo biotransformation in
the:
A. Kidney
B. Liver
C. Plasma
D. B and C

229. Of the following in which condition general anaesthesia is

contraindicated?
A. Hemoglobinopathy
B. Allergy
C. Diabetes mellitus
D. All of the above

230. The following is least toxic of all local anaesthetics:

A. Tetracaine
B. Mepivacaine
C. Prilocaine
D. 2-chloro procaine
234. Cocaine is:
A. Vasodilator in action
B. Vasoconstrictor in action
C. Synthetic
D. Synthetic and vasodilator in action
98
232. Adrenaline is added to local anaesthetic agents because it:
A. Potentiate the action of all local anaesthetic agents
B. Increases the rate of destruction of the local anaesthetic agent
C. Decreases the rate of absorption of the local anaesthetic at the
injection site
D. Prevents deterioration of the anaesthetic solution

233. Sedation by which of the following routes can be reversed rapidly?

A. Intravenous
B. oral
C. Inhalation
D. Intramuscular

234. Only nitrogen oxide alone is not used as a general anaesthetics

agent because of the:
A. Poor analgesic properties
B. Expense of the agent and its explosive hazard
C. Difficulty in maintaining an adequate oxygen concentration
D. Hepatotoxic nature

99
235. After the general anesthesia, vomiting may occur.
The immediate postoperative complication following aspiration of liquid
vomitus into trachea and bronchi is:
A. Lung abscess
B. Bronchitis
C. Pleurisy
D. Atelectasis

236. Which of the following side effects is seen commonly with the
administration of nitrous oxide and oxygen?
A. Hallucinations and dreams
B. Tachycardia
C. Tremors
D. Nausea

237. In which stage of general anesthesia surgery is performed?

A. Stage I
C. stage III
B. stage II
D. stage IV

100
238. The following areas are anaesthetized by the anterior palatine nerve
block:
A. Part of the upper lip, lateral surface of nose and lower eyelid
B. Posterior portion of hard palate and overlying tissues up to the first
premolar
C. Incisors canine and first premolar
D. Both hard and soft palates completely

239. The following deep bony landmarks is important in performing a

block of the II and Ill divisions of the trigeminal nerve from the lateral
approach:
A. Temporal surface of sphenoid
B. Perpendicular plate of the palatine bone
C. Lateral plate of the pterygoid process
D. Styloid process

240. For a therapeutic procedure bilateral mandibular nerve block is

required. Bilateral mandibular nerve block is:
A. Should perform rarely
B. Not contraindicated
C. Dangerous because tongue may fall back and patient
D. May cause severe trismus due to space infection

101
241. Facial paralysis after inferior alveolar nerve block is due to:
A. Injection into the parotid gland
B. Aberent facial nerve
C. Sympathetic stimulation
D. All of the above

242. Among the following items in the past medical history, which
would most affect the choice of local anaesthetic agent?
A. RHD
B. Hyperthyroidism
C. Adrenal insufficiency
D. Asthma

243. The main function of atropine in preoperative medication is to:

A. Depress gastro intestinal mobility and relieve anxiety
B. Reduce the salivary secretion and sedation
C. Reduce secretions and depress vagal reflex
D. Reduce bronchial secretions and enhance vagal reflex
244. In the extraoral infraorbital nerve block the following nerve is not
involved:
A. Anterior superior alveolar
B. Middle superior alveolar
C. Sphenopalatine
D. Lateral nasal
102
245. After giving an inferior alveolar nerve block patient develops
paralysis of the muscles of the forehead, eyelids and upper and lower
lips on the same side of the face. This is probably due to:
A. Anesthesia of the motor branches of the mandibular nerve
B. Diffusion of the anaesthetic solution involving the ophthalmic
division of the trigeminal
C. Injection of the solution into the capsule of the parotid gland and
consequent block of the facial nerve
D. Diffusion of the solution through the inferior orbital fissure and
anaesthetized the oculomotor nerve

246. Among the following which of the following are potential

immediate post extraction complications for a surgical patient treated
under GA?
A. Respiratory embarrassment
B. Circulator depression
C. Aspiratory of blood or gastric contents
D. All of the above

247. The fate of nitrous oxide when administered for analgesia is:
A. Detoxified in liver
B. Exhaled by lungs
C. Excreted by kidney
D. Chemically changed into NO and CO

103
248. Of the following in which nitrous oxide-oxygen sedation is
contraindicated?
A. Mental retardation
B. Sickle cell anemia
C. History of congestive heart failure 3 months previously
D. None of the above

249. The sensation of "tissue tearing" during inferior alveolar nerve

block indicates:
A. Passage through buccinator muscle
B. Passage through an area of infection
C. Barb on the needle
D. Large bore needle such as 19 no. needle

250. Of the following which is main cause of toxic manifestations

following injection of a vasoconstrictor is?
A. Intramuscular injection
B. Intravascular injection
C. Injection into a nerve trunk
D. Allergic reaction

104
251. Of the following which is most common postoperative
complication of outpatient of general anesthesia?
A. Pneumonia
B. Lung abscess
C. Nausea
D. Atelectasis

252. In a dental clinic after the administration of local anesthesia

depression of respiration occurred. It is a manifestation of:
A. Trauma to a nerve trunk by the syringe needle
B. Toxic effects of the solution
C. Puncture of a blood vessel
D. Use of an isotonic solution

253. Among the following which is most common complication

associated with nitrous oxide sedation?
A. Vomitus aspiration
B. Behavioral problem
C. Respiratory depression
D. Vomiting

105
254. Among the following which is advantage of oral administration of
drugs to achieve conscious sedation?
A. It is highly reliable in producing sedation
B. It is easiest to administer
C. Over dosage is unlikely
D. None of the above

255. Which of the following is immediate post-operative complication

of aspiration of liquid vomitus into the trachea and bronchi?
A. Atelectasis
B. Pneumothorax
C. Chemical pneumonia
D. Pleuricy

256. The following factors play a role and cause variations in

susceptibility of sensory nerve fibers to local anesthesia:
A. Diameter of the nerve fiber
B. Distance between nodes or Ranvier
C. Length of nerve fiber
D. All of the above

106
257. Which of the following are contraindications to nitrous oxide
oxygen sedation?
A. Emotional instability
B. Upper respiratory tract obstruction
C. Emphysema
D. All of the above

258. Which of the following would be indicated if one expected a long

surgical procedure and a general anaesthetic to be administrated?
A. Sodium thiopental
B. Vinyl ether, open drop method
C. Intubation with individually selected anaesthetic agent
D. None of the above

259. Intraoral injection to block second division of the trigeminal nerve

should be given in the:
A. Foramen spinosum
B. Foramen ovale
C. Pterygopalatine fossa
D. Infraorbital foramen

107
260. Which is the main route of elimination of nitrous oxide?
A. Kidneys
B. Liver
C. Lungs
D. Skin

261. Frequently which of the following in amide type local anesthesia

causes allergic reaction?
A. Lignocaine hydrochloride
B. Methyl paraben
C. Adrenaline
D. Contaminants in the solution

262. Usually hydrolysis of amide type of local anaesthetic salts is

facilitated by:
A. Tissue pH above 7.0
B. Tissue pH between 5.0 and 7.0
C. Tissue pH below 5.0
D. There is no relationship between pH and hydrolysis in amide type
local anesthesia

108
263. Respiration in stage IV general anesthesia is characterized by:
A. Thoracoabdominal in nature
B. Abdominothoracic in nature
C. Deep and irregular
D. Absent

264. A patient is allergic to PABA Most probably he will also be allergic

to:
A. Lignocaine
B. Carbocaine
C. Prilocaine
D. Tetracaine

265. Nitrous oxide cylinders are usually in colour:

A. Black
B. White
C. Blue
D. Red
266. Which of the following should be included in the preoperative
orders?
A. NPO from mid night
B. Take written informed consent
C. Void on call to the OR
D. All of the above
109
267. In which stage of anesthesia patient becomes hyperactive?
A. stage I
C. stage III
B. stage II
D. stage IV

268. Toxic dose of lignocaine with adrenaline is:

A. 5 mg/kg body weight
B. 10 mg/kg body weight
C. 15 mg/kg body weight
D. 20 mg/kg body weight

269. In gate control therapy of pain. Pain is mainly modulated by:

A. Substantia gelatinosa
B. 'B' fibers
C. 'C' fibers
D. Transmission system

270. Morphine scopalamine premedication produces:

A. Amnesia and decreased salivation
B. Psychic sedation
C. Additive effects with anaesthetics
D. All of the above

110
271. The following which produces an unconscious state?
A. Regional analgesia
B. Nitrous oxide and oxygen
C. Neuroleptic analgesia
D. None of the above

272. Maximum recommended dosage of lignocaine with adrenaline

subcutaneously is:
A. 100 mg
B. 30 mg
C. 500 mg
D. 700 mg

273. Among the following which stage of anesthesia describes the level
of conscious sedation?
A. Stage I
B. Stage II
C. stage III plane 1
D. stage III plane 2
274. The initial stage of paralysis of facial nerve:
A. Tongue deviate to the same side on protrusion
B. Tongue deviate to the opposite side on protrusion
C. No deviation of the tongue
D. None of the above
111
275. "Tic douloureux" treatment includes:
A. Dilantin sodium in all cases
B. Carbamezapine in all cases
C. Mandibular nerve block in all cases
D. Trichloroethylene in all cases

276. Risus sardonicus is one the sign of the tetanus.

This involves:
A. Spasm of the glottis causing altered voice
B. Spasm of the facial muscle causing a fixed smile
C. Spasm of the pterygoid muscles causing trismus
D. Spasm of the chest wall causing difficulty in breathing

277. Which of the following structure is associated with

Bell's palsy"?
A. Submandibular gland
B. Seventh cranial nerve
C. Temporomandibular joint
D. Glossopharyngeal nerve

112
278. A decrease in the pH of interstitial fluid will:
A. Increase the effectiveness of a local anaesthetic block
B. Have no effect on the effectiveness of a local anaesthetic block
C. Decrease the effectiveness of the LA solution
D. Initially increases than decreases the effectiveness of LA solution

279. Maximum recommended dosage of lignocaine and adrenaline

subcutaneously is:
A. 100 mg
B. 300 mg
C. 500 mg
D. 700 mg

280. The following clinical disease process affect the

TMJ directly:
A. Ankylosis
B. Arthritis
C. Dislocation
D. All of the above

113
281. Best treatment for a small opening of a disease free maxillary sinus
is:
A. Not treating socket but advising the patient proper home care
B. Packing tile socket with a hemostatic agent to encourage clotting
C. Leaving the socket undisturbed but prescribing nasal vasoconstrictor
and antibiotics
D. Employ primary closure of the socket using sutures.

282. Among the following which factors influence the pain perception
threshold?
A. Emotional state.
B. Apprehension and fear
C. Age
D. All of the above

283. The drug of choice to counteract the central nervous system

stimulation caused by accidental IV injection of local anesthesia:
A. Adrenaline
B. Pentobarbital
C. Caffeine
D. None of the above

114
284. Under GA, hemolysis resulting from a transfusion reaction will
exhibit which of the following symptoms?
A. Chills, fever, dyspnoea, headache, pain in the back
B. Hypotension, skin flush, tachycardia, abnormal hemorrhage,
hyperpyrexia
C. Urticaria, angioneurotic edema, asthma
D. Utricaria and pruritus

285. Following group of drugs used for premedication produce a

detached serenity without clouding consciousness. Can you identify
them?
A. Antiemetics
B. Ataractics
C. Analeptics
D. Psychodissociates

286. Among the following which results in sudden swelling in the area
of a dental injection?
A. Drug incompatibility.
B. Paravascular injection
C. Infection
D. Vascular penetration

115
287. Among the following which has least hypnotic action?
A. Chloral hydrate
B. Pentobarbital
C. Phenobarbital
D. Codeine

288. Which of the following is not a transmitter substance and it has no

role in impulse transmission?
A. Dopamine
B. Noradrenaline
C. Succinyl choline
D. GABA

289. Pre-anesthetic medication commonly used to achieve the following

goals except:
A. Decreasing nervous irritability
B. Decreasing secretions
C. Providing analgesia
D. Desensitizing tile respiratory center to CO2

116
290. When is the appropriate time to administer an analgesic to control
postoperative pain?
A. Only after the return of sensation
B. When pain becomes moderate to severe
C. Before the anesthetic effect wears off
D. None of the above

291. Sedation by which of the following routes can be reversed most

rapidly?
A. Inhalation
B. Intravenous
C. Intramuscular
D. Oral

292. Among the following which drug is drug of choice in management

of the acute allergic reaction involving hypotension?
A. Aminophylline
B. Dexamethasone
C. Diphenydramine
D. Adrenaline

117
293. One cannot determine the level of N20 per tank with
N20 pressure gauge on a sedation machine because:
A. The gas is explosive
B. The pressure drops in a sporadic fashion
C. The pressure remains constant until the tank
D. It is nearly empty

294. Toxic effects seen after administration of a local anesthetic with

epinephrine are probably due to anesthetic agent if the following sign is
present:
A. Tachypnoea
B. Tachycardia
C. Drowsiness
D. Sweating

295. While receiving IV diazepam, patient has upper eyelid ptosis

(verrill's sign) the dentist should immediately
A. Assist respiration
B. Consider the patient is adequately sedated
C. Place the patient in Trcndelenberg position.
D. Consider the anesthesia is not complete and administer one more
dose of diazepam

118
296. Among the following which way best protect from the toxic aspects
of a local anesthetic?
A. Take a thorough medical history
B. Have oxygen available
C. Use an aspirating technique
D. Use the lowest possible concentration of the local anesthetics

297. Trigeminal neuralgia is characterized by:

A. Paralysis of the one side of the face due to paralysis of facial nerve
B. Dull pain when pressure is applied over the affected area (Trigger
zones)
C. Sharp pain when pressure is applied to the affected area
D. Prolonged episodes of the pain which is constant in nature

119
Chapter 3: Sterilization and Instruments
1. Scrub technique refers a method of scrubbing the:
A. Surgical instruments after a contaminated case
B. Patient body surface before placing surgical incision to decrease
bacterial flora.
C. Operating room.
D. Operator's hands and forearms before donning gown and gloves.

2. The sterilizing units should be monitored at which of the following

intervals?
A. Daily
B. Weekly
C. Bi weekly
D. Monthly

3. Scrub technique refers to the proper method of:

A. Washing hands and arms before gloving for surgery
B. Cleaning the operating room after a contaminated case
C. Washing the patient's body surface prior to incision
D. Washing the instruments prior to sterilization

120
4. Bi-beveled chisels are used primarily to:
A. Remove bone
B. Split teeth
C. Make purchase points
D. All of the above

5. Chromic catgut sutures are packed in alcohol to prevent:

A. Atmospheric contamination
B. Enzymatic degradation
C. Loss of tensile strength
D. All of the above

6. Catgut sutures are packed in this type of alcohol:

A. Ethyl alcohol
B. Methyl alcohol
C. Isopropyl alcohol
D. Absolute alcohol

7. The typical "railroad track" scar is the result of:

A. Inadequate approximation of wound edge during suturing
B. Delayed removal of sutures
C. Delayed wound closure
D. Excessive fibrous tissue formation

121
8. The "Wicking" effect will be more commonly seen when the
following suture material is used:
A. Nylon
B. Plain catgut
C. Silk
D. Polypropylene

9. Steam autoclaving:
A. Kills microorganisms by RNA and DNA breakdown
B. Destroys cotton or cloth products
C. Is non corrosive to carbon steel instruments?
D. Utilizes 249.80F at 5 psi and 15 to 30 minutes

10. Glutaraldehyde is activated to achieve its full antimicrobial

capability by adding:
A. Sodium sulphate
B. Sodium hypochlorite
C. Sodium bicarbonate
D. Sodium hydroxide

122
11. A vertical mattress suture is used in wound Closure:
A. To prevent ischemic necrosis of wound edges in areas with poor
blood supply
B. To close flaps that are one tissue layer thick
C. To Evert the wound margins
D. To provide a water tight closure

12. Single use hypodermic needles have coloured hubs for ease of
identification of the needle gauge. 25'G needle hubs are:
A. Blue
B. Red
C. Yellow
D. Green

13. To reduce thrombophlebitis in patients on parenteral fluid therapy,

IV catheter made up of the following materials are used:
A. Silicone
B. Stainless steel
C. Teflon
D. Plastic

123
14. The main objective for efficacy of sterilization practice is destruction
of:
A. Cocci
B. Viruses
C. Bacteria
D. Spores

15. Most postoperative infection results from:

A. Faulty surgical technique
B. Inadequate asepsis and disinfection
C. None of the above
D. Both of the above

16. _____________ is a chemical, applied to living tissues, such as skin

or mucous membrane to reduce the number of microorganisms present,
by inhibition of their activity or by destruction.
A. Antiseptic
B. Disinfectant
C. Antiseptic and disinfectant
D. Cleaning agent

124
17. _____________ is the process of destruction or removal of all
microbial forms:
A. Antisepsis
B. Sterilization
C. Disinfection
D. Cleaning

18. The mechanism by which the disinfectant and anti-sepsis act on

microorganisms?
A. Coagulation of bacterial protein
B. Alteration in properties of bacterial wall
C. Binding of sulphydryl groups
D. All of the above

19. Alcohol shows maximum antiseptic activity at:

A. 10%
B. 50%
C. 70%
D. 99%

125
20. In autoclave at 15 psi pressure and 121 degree C temperature time
required to kill all living organisms is:
A. 3 min
B. 6 min
C. 15 min
D. 60 min

21. Organisms used for test of efficiency for heat sterilization

A. S sanguis
B. T pallidum
C. Beta hemolytic streptococci
D. Bacillus sterothermophyllus

22. Basic action of Dry Heat sterilization is

A. Dehydration
B. Oxidation
C. Reduction
D. A and B
23. Which of the following relation of temperature and time is for dry
heat sterilization?
A. 60C - 2hrs
B. 100 – 1, 1/2hrs
C. 170C - 1hr
D. 200C - 15mins
126
24. Glass bead sterilizer is used for sterilization of:
A. Glass instruments
B. Plastic instruments
C. Endodontic files and burs
D. Long metal instruments

25. The operation theatres are disinfected by:

A. Alcohol
B. Heat sterilization
C. Fumigation
D. None of the above

26. Excretions and secretions should be disposed by:

A. Buried in deep pit'
B. Powder and lime
C. Incineration
D. Deep burial

27. Laboratory specimen should be kept in:

A. 10% formalin
B. 10% phenol
C. 100% alcohol
D. 0.2% Chlorhexidine

127
28. Plaque from gingival crevice contains around how many bacteria:
A. 1000
B. 2500
C. 2.5 x 1011
D. 2.5 x 1017

29. At birth oral cavity contains:

A. S. sanguis
B. S. hemolyticus
C. M. tuberculae
D. Oral cavity is sterile

30. Most commonly detected organisms in mouth of new born is:

A. S. sanguis
B. T. pallidum
C. S. salivarius
D. C. albicans

31. Shape of treponema is:

A. Spiral
B. Cocci
C. Bacilli
D. Dumb-bell

128
32. Candida albicans is:
A. Virus
B. Bacteria
C. Fungi
D. Yeast

33. A hot air oven cannot be used for sterilization of:

A. Glassware
B. Talcum powder
C. Cotton
D. Culture media

34. A gas compound used in special autoclaves for sterilizing materials

that cannot be taken to higher temperatures is:
A. Water vapor
B. Ethylene oxide
C. Hydrogen
D. Cyanide
35. Criteria that have been used to distinguish pathogenic from non-
pathogenic bacteria are known as:
A. Gram stains
B. Koch's postulates
C. Randolph's rules
D. Pasteur's principles
129
Chapter 4: Exodontia \ Impaction
1. A patient develops facial edema one day after removal of a tooth.
Instructions to the patient should be to use:
A. Warm, wet applications outside and inside the mouth
B. Cold applications outside and inside the mouth
C. Intraoral cold applications only
D. Intraoral hot applications only

2. Of the following the most common postoperative complication after

surgical removal of mandibular teeth
A. Myositis
B. Paresthesia
C. Loss of the blood clt
D. Postoperative hemorrhage

3. The most serious complication which may occur following surgery

about the maxillary canine is:
A. Iritis
B. Cellulitis
C. Localization of pus
D. Cavernous sinus thrombosis

130
4. The elevators used in exodontia are functionally:
A. Class I levers only
B. Class I and II levers
C. Class Ill levers only
D. Only wedge-shaped

5. To extract a tooth the following type of grip is most desirable:

A. The whole of the inner surface of the forceps blade should fit the root
surface
B. Only edges of the forceps blade should contact the tooth (Two point
contact)
C. Only single lever contact between forceps blade and root surface (one
point contact)
D. Grip plays little role in extraction

6. Exodontia elevators are based on principle of:

A. Levers
B. wedge
C. Wheel and axle
D. All of the above

131
7. While removing mandibular 3rd molar which part of bone should be
used as a fulcrum?
A. Lingual cortical bone
B. Mesial inter-radicular bone
C. Buccal alveolar bone
D. Distal surface of adjacent crown

8. Mechanical advantage would be maximum for an elevator when:

A. Effort arm is greater than resistance arm
B, Resistance arm is greater than effort arm
C. When fulcrum is in the center
D. When fulcrum is near the point of effort

9. When maxillary lateral incisor has to be extracted the first movement

of forceps should be:
A. Labially then apically
B. Palatally then apically
C. Labially or palatally
D. Apically then palatally
10. Mead forceps are used for extraction of:
A. Maxillary molars
B. Mandibular incisors
C. Maxillary canines
D. Maxillary premolars
132
11. To extract mandibular premolars the first movement of forceps
should be:
A. Apical and labial
B. Apical and lingual
C. Apical and mesial
D. Labial and no apical movement

12. When maxillary and mandibular teeth are to be extracted

simultaneously the order of extraction should be:
A. Maxillary teeth followed by mandibular teeth
B. Mandibular teeth followed by maxillary teeth
C. It does not matter which teeth are removed first
D. For anterior region mandibular first and for posterior region maxillary
first

13. When simultaneous extractions have to be carried out in one

maxillary segment the order of extraction should be:
A. Incisors, canine, premolars, molars
B. 3rd molar, second molar, 2nd premolar, 1st molar,
1st premolar, incisors, canine
C. Molars, premolars, canine, incisors
D. Molars, premolars, incisors, canine.

133
14. The Stobis method of extraction is indicated when:
A. Two adjacent teeth have to be removed
B. When central incisor is to be extracted
C. When isolated molar is to be extracted and adjacent teeth are absent
D. Upper and lower 3rd molars have to be extracted simultaneously

15. 'White line' described by George Winter is a line

A. Along occlusal surfaces of erupted mandibular molars extending to
impacted third molar region
B. From crest of bone lying distal to third molar to crest of the
interdental septum between 1st and 2nd molar
C. From perpendicular to 'amber line'
D. From perpendicular to 'red line'

16. 'Red Line' as described by George Winter is demarcated as a line:

A. Drawn from bone distal to third molar to crest of the interdental
septum between 1st and 2nd molar
B. Which is a perpendicular dropped from 'amber line' to point of
application of elevator
C. Which is a perpendicular dropped from 'white line' to point of
application of elevator
D. None of the above

134
17. If in a mesioangular mandibular impaction there is apical notch
visible on a radiograph the tooth should:
A. Not be removed
B. Be removed by lingual split technique
C. Be removed by splitting the tooth
D. None of the above

18. Which type of mandibular impactions are most commonly associated

with 'apical notch' formation:
A. Mesioangular
B. Distoangular
C. Vertical
D. A and B

19. The disadvantage of lingual split technique is\are:

A. Injury to lingual nerve
B. Opening up of facial spaces on lingual side and floor of mouth
C. Chances of dislodging tooth or root in sub- lingual space
D. All of the above

135
20. The basic advantage of lingual split technique for extraction of
mandibular impacted teeth is\are:
A. Bone loss is minimal
B. Easy and quick method
C. Tissue trauma is minimal
D. All of the above

21. Lateral trepanation technique of Bowdler Henry is indicated for:

A. Extraction of impacted canines
B. Removal of impacted premolars
C. Removal of partially formed un-erupted third molars
D. Treating dentigerous cysts with enclosed third molars

22. The chisel should be used with:

A. Bevel towards the bone which is to be saved
B. Bevel towards the bone which is to be sacrificed
C. Bevel direction is not important
D. Flat surface parallel to direction of grains of bone
23. While making vertical incision for flap for mandibular third molar
impactions one can injure:
A. Buccal pad of fat
B. Branches of lingual nerve
C. Branches of facial nerve
D. Branches of facial artery/ vein
136
24. Dry socket commonly occurs after:
A. 24 hours
B. 2 days
C. 3-4 days
D. 10-15 days

25. The treatment of localized osteitis is:

A. Debridement, curettage and sedative packing
B. Curettage, irrigation and sedative packing
C. Irrigation and sedative packing
D. None of the above

26. In case of extraction of maxillary molars if maxillary tuberosity also

fractures the fractured bone:
A. Should be removed
B. Should be replaced and allowed to heal by secondary intention
C. Should be replaced and retained by primary suturing of soft tissues
D. Should be fixed by transosseous wiring or bone plating
27. The complication of using air rotor at 30,000 RPM for impacted
molars is:
A. Necrosis of cone
B. Dehiscence
C. Tissue laceration
D. Emphysema
137
28. The most important suture while closing Ward's incision for
impacted mandibular third molar is:
A. Suturing of vertical limb
B. Suturing of retromolar limb
C. Suture of area immediately distal to 2nd molar
D. None of the above

29. Dull ache in the jaw and ear three days after a dental extraction may
indicate:
A. Pulpitis of an adjacent tooth
B. Need for a stronger prescription for discomfort
C. Need for an antibiotic
D. Loss of the alveolar clot

30. The scalpel blade most commonly used for oral surgical procedures
is:
A. No. 22
B. No. 12
C. No. 11
D. No. 15

138
31. The "red line" in winter’s classification of impacted teeth represents:
A. The depth at which the impacted tooth is located
B. The angulation of the 2nd molar
C. The summit of the alveolar bone covering the impacted tooth
D. Relation of the 3rd molar to the ramus

32. The most serious complication of an abscess of the maxillary

anterior teeth is:
A. Pain
B. Paresthesia
C. Cavernous sinus thrombosis
D. Orbital cellulitis

33. The beaks of an extraction forceps should be placed:

A. On the anatomical crown
B. At the junction of the clinical and anatomic crowns
C. On the root surface as far apically as possible
D. At the junction of the apical and middle thirds of the root
34. A mucoperiosteal flap can be repositioned accurately because the:
A. Periosteum is inelastic
B. Periosteum is very elastic
C. Periosteum contains sharpey's fibers
D. All of the above

139
35. The root most likely to be pushed into the maxillary sinus during a
tooth extraction is:
A. Palatal root of the maxillary second molar
B. Palatal root of the maxillary first premolar
C. Palatal root of the maxillary first molar
D. Mesiobuccal root of the maxillary first molar

36. A 55-year-old lady has aIone standing carious maxillary first molar
tooth on the right side. The tooth has served as an abutment, and now
has to be extracted. Proper care is to be taken during extraction to
prevent:
A. Alveolar osteitis
B. Pushing the palatal root in the maxillary sinus
C. Removing the floor of the maxillary sinus with the tooth
D. Displacement into the infratemporal fossa

37. Which of the following muscles is pierced by the needle while

giving an inferior alveolar nerve block?
A. Medial pterygoid
B. Superior constrictor
C. Temporalis
D. Buccinator

140
38. Primary healing of a mandibular fracture is seen following fixation
with:
A. Gunning splints
B. Compression plates
C. Trans-osseous wires
D. Champy plates

39. In the maxilla, a compression bone plate can be safely applied along
the:
A. Infraorbital margin
B. Anterolateral wall of the maxillary sinus
C. Fronto-zygomatic suture
D. Zygomaücomaxillary suture

40. To provide 'absolute stability' of the fractured ends by a compression

bone plate, the minimum number of screws that have to be placed on
both side of the fracture line is:
A. Six
B. Two
C. Three
D. Four

141
41. A potential complication following tooth extraction from areas,
having undergone irradiation is:
A. Excessive bleeding
B. Alveolar osteitis
C. Osteoradionecrosis
D. Fracture of the underlying bone

42. A straight elevator is property used to advantage when the?

A. Buccal cortical plate is used as a fulcrum
B. Adjacent tooth is not to be extracted
C. Interdental bone is used as a fulcrum
D. When the bone surrounding the tooth to be extracted is sclerosed

43. The ideal order of extraction of teeth is:

A. First molar, canine, lateral incisor, second molar, first premolar and
third molar
B. Third molar, second molar, second premolar, first molar, first
premolar, lateral incisor and canine
C. Lateral incisor, canine, first premolar, second premolar, first molar,
second molar and third molar
D. Canine, first molar, third molar, second molar, 2nd premolar, 1st
premolar and lateral incisor

142
44. The 'cow-horn' (no. 16) forceps should not be used for the extraction
of mandibular deciduous molars as the:
A. Sharp beaks can damage the un-erupted premolar teeth
B, Beaks cannot engage the furcation area properly
C. Forcep is not intended for extraction of deciduous molars
D. None of the above

45. Prophylactic removal of an erupted third molars in a teenager should

ideally be carried out:
A. When crowding/ rotation occurs in the anterior teeth
B. When the root is one-third formed
C. When the root is two-thirds formed
D. Before the root formation

46. The most common contributing factor to pericoronitis of an impacted

mandibular third molar is:
A. Bacterial infection
B. Trauma from the opposing maxillary third molar
C. Trauma from the eruptive forces exerted by the tooth
D. Food impaction

47. A palatal flap for the removal a maxillary impacted canine near the
midline should be:

143
A. Reflected around the necks of the teeth
B. Started with vertical incisions in the opposite canine region
C. Started with a vertical incision in the midline
D. Semilunar in design

48. Epinephrine packs are to be avoided in controlling bleeding from

extraction sockets as:
A. It interferes with the coagulation process
B. It causes vasoconstriction with resultant alveolar osteitis
C. It causes reflex vasodilatation with severe post- operative bleeding
D. It can be lead to a hypertensive crisis

49. In the open beak technique of extraction, the tip of the forceps is
placed at:
A. The cementoenamel junction
B. 2/3rd on the root surface
C. Marginal alveolar bone
D. Two mm apical to the DE junction
50. While removing an impacted mandibular third molar buccal leverage
is applied when?
A. Tooth is inclined mesially
B. Tooth tapers towards the root
C. Tooth is very close to the 2nd molar
D. Space exists between the neck of the tooth and the second molar

144
51. The extraction of an impacted upper third molar with SA is best
carried out using:
A. A straight elevator
B. Miller's elevator
C. Cryer's elevators
D. Apexo elevators

52. Blood loss during full mouth extractions of teeth and alveoplasties,
can be expected to be in the range of:
A. 50-200 ml
B. 200-800 ml
C. 800-1000 ml
D. 1000-1200 ml

53. Facial oedema following surgical extraction of an impacted

mandibular third molar, can be best reduced
A. Postoperative administration of dexamethasone
B. Preoperative administration of diclopfenace sodium
C. Careful retraction and manipulation of the soft tissue flap during
surgery
D. Regular use warm saline mouth rinses after surgery

145
54. Generally, the treatment of choice for cementoma is:
A. Extraction of all teeth
B. Endodontic treatment of involved teeth
C. No treatment
D. Block resection of involved area

55. The healing process that takes place following the non-surgical
extraction of a mandibular 1st molar may be described as:
A. 'Healing by first intention
B. Healing by second intention
C. Granulomatosis
D. A and C

56. Best treatment for pericoronitis associated with impacted mandibular

third molar is:
A. Irrigating under the operculum
B. Antibiotic and analgesic therapy
C. Extraction of impacted third molar
D. Operculectomy

146
57. A palatal flap is required for removal of a maxillary impacted canine
near the midline. Palatal flap should be:
A. Started with a vertical incision in the midline
B. Reflected from the necks of the teeth
C. Made with a semilunar incision
D. None of the above palatal flap should be avoided

58. During the tooth extraction a known cardiac patient experienced

angina. This was most likely precipitated
A. Allergy to the anesthetic agent
B. The stimulus of pain and anticipation
C. Adrenaline in the drug
D. The upright position in the chair

59. Three days after the extraction of maxillary first molar patient
developed a fluctuant palatal abscess. The treatment of choice is:
A. Caldwell-Luc procedure
B. Heat and cold therapy
C. I and D and antibiotic therapy
D. Only antibiotic therapy after culture and sensitivity tests

147
60. Early sign of syncope is:
A. Epistaxis
B. Pupillary constriction
C. Pallor
D. Rapid pulse and increased BP

61. Among the following, the factor of least importance in alveolar flap
design is:
A. Linear incision
B. Closure over the bone
C. Tension free closure of the flaps
D. Base relationship to length

62. The following are indication for suturing following exodontia

except:
A. Blood clot protection
B. Reapproximation of mucoperiosteal flaps
C. Immobilisation of tissues
D. Hemostasis

148
63. In the extraction of mandibular third molars, the main reason why
the posterior incision should be placed more buccally is:
A. To prevent damage to lingual nerve
B. Incision should be on the sound bone
C. To prevent damage to retromolar artery
D. All of the above

64. In multiple extractions, the order of extraction usually:

A. Maxillary before mandibular and posterior before anterior
B. Mandibular teeth before maxillary
C. Maxillary teeth before mandibular
D. Anterior teeth before posterior

65. Limited accessibility is one of the most disadvantage of the

following flap:
A. Envelop flap
B. Semilunar flap
C. Three cornered flap
D. Four cornered flap

149
66. According to Nitzin's theory, the following microorganisms are
responsible for dry socket:
A. Treponema denticola
B. Leprospira pyrogen
C. Pseudomonas
D. Bacillus subtilus

67. Most common site for dry socket:

A. Lower incisor area
B. Upper incisor area
C. Lower molar area
D. Upper molar area

68. Few days after a dental extraction patient came with marked pyrexia
and complaining of impairment of labial sensation and marked
tenderness on extra oral palpation. Most probable diagnosis is:
A. Dry socket
B. Acute osteomyelitis
C. Postoperative haematoma
D. None of the above

150
69. Advantage of chisel and mallet over bur in removing bone is:
A. Less skill is needed
B. Psychologically more acceptable
C. No coolant is necessary
D. Chisel and mallet are good instruments to remove dense bone

70. The following design parameters should follow to prepare a

mucoperiosteal flap except:
A. Flap should provide adequate visibility and accessibility
B. Free margin broader than base
C. Ragged margins should be avoided
D. Flap should be a full thickness mucoperiosteal flap

71. Most common cause of post-extraction bleeding is:

A. Bleeding disorders
B. Failure of the patient to follow post extraction instructions
C. Due to the analgesics such as aspirin
D. Patient with the anticoagulant therapy
72. A deep level of general anesthesia is enhanced by a:
A. Muscle relaxant like d-tubocurarine
B. Non-irritating drug
C. Loose fitting mask
D. High alveolar concentration of anaesthetic agent

151
73. "Postage stamp" method is:
A. A method of bone removal in transalveolarextraction
B. A method of extraction of maxillary canines by intra- alveolar
method extraction
C. A method of bone grafting
D. None of the above

74. "Line of withdrawal" of a tooth is mainly determined

A. The size of the crown
B. The root pattern
C. Shape of the crown
D. Size of the roots

75. "Odontectomy" is synonymous to:

A. Transalveolar extraction
B. Intra-alveolar extraction
C. Extraction under local anesthesia
D. Extraction under general anesthesia
76. The best example of an elevator which works on wheel and axle
principle?
A. Howartli's periosteal elevator
B. Winter cross bar elevator
C. Millers apexoelevator
D. None of the above
152
77. Impacted mandibular third molar classification is usually based on:
A. Relation of the tooth to the ramus of the mandible
B. The position of the tooth in relation to the long axis of the second
molar
C. The relative depth of the third molar in bone
D. All the above

78. Ten teeth have been removed for a patient who was “J”
premedicated. The proper position of the patient in Pfy the recovery
room is:
A. Head elevation 300 with patient on his back
B. Trendelenburgts position patient head is almost parallel to the floor
C. Reverse Trendelenburg's position
D. Supine position

79. A swelling over lies an extraction wound and it crackles on

palpation. Most likely diagnosis is:
A. Ecchymosis
B. Cellulitis
C. Emphysema
D. Empyema

153
80. During reflecting a palatal mucoperiosteal flap for removal of an
impacted canine structures passing through the incisive canal are
averted. The sequela to this is:
A. Of no clinical significance
B. Loss of a triangular mucosal flap behind the incisors and canine due
to loss of blood supply
C. Resorbption of bone around the canal
D. Anesthesia of the anterior palate

81. Which of the following is the principle action of ammonia in

syncope?
A. Respiratory stimulant
B. Vagal stimulant
C. Vasomotor stimulant
D. Inhibitor of vasomotor tone

82. After the surgical removal of chronically infected teeth in a

controlled diabetic patient, which of the following is of utmost
importance?
A. Postoperative check of patient for bleeding
B. Return of patient to diet of a normal individual
C. Revaluation of insulin dosage being taken by the patient
D. Medication for marked post-operative pain and discomfort

154
83. The following nerves should be anesthetized for the removal of
maxillary first molar:
A. Posterior palatine, anterior palatine
B. Anterior palatine, Middle superior alveolar, posterior superior
alveolar
C. Anterior superior alveolar
D. Posterior superior alveolar

84. During the maxillary teeth extraction, a patient developed severe

pain and purulent discharge from the nose. The following conditions and
tooth are most probably involved:
A. Perforation of the maxillary sinus, first molar
B. Hematoma with in a facial plane, second molar
C. Injury to buccinators muscle, canine
D. Perforation of the maxillary sinus, central incisor

85. Extraction of mandibular first molars in an 8-year-old child is also

known as
A. Premature extraction
B. Serial extraction
C. Orthodontic extraction
D. Wilkinson's extraction

155
86. Etiology of "localized alveolitis" (drysocket) includes:
A. Trauma
B. Vascular supply to regional bone
C. Infection
D. All of the above

87. When mandibular teeth are to be extracted, the patient should be

positioned in such a way that the occlusal plane of the mandibular arch
is:
A. Parallel to the floor when the teeth are closed together
B. Parallel to the floor when the mouth is wide open
C. Perpendicular to the floor when the teeth are closed together
D. Perpendicular to the floor when the mouth is wide open

88. A 75-years-old woman whose weight is approximately 100 pounds

requires multiple extractions under local anesthesia. For premedication,
the fol. lowing dose of diazepam is enough to allay the apprehension?
A. 20 mg
B. 30 mg
C. 10 mg
D. 5 mg

156
89. The beak of an extraction forceps is designed such away that the
extraction pressure is transmitted to the:
A. Crown of the tooth
B. Alveolar bone
C. Root of the tooth
D. Cementoenamel junction of the tooth

90. During the extraction of mandibular third molar it is noted that the
distal root is missing. The root tip is most probably in the:
A. Submental space
B. Submandibular space
C. Pterygomandibular space
D. Parapharyngeal space

91. A 45-year-old women insists on extraction of painful mandibular

first molar. She has not rested for 2 days and nights because of pain. Her
medical his- tory reveals she took 30 mg of prednisone daily for one
year but stopped taking the medication three months age. The dentist
should:
A. Relieve the symptoms by giving antibiotics and analgesics
B. Give steroid supplements and extract the tooth under local anesthesia
C. Avoid procaine anesthetic
D. Extract the tooth under local anesthesia in a usual manner

157
92. Recontouring of the residual ridge in the early part of extraction of
period occurs primarily by resorption of the:
A. Buccal-lingual cortical bone
B. Labial-buccal cortical bone
C. Lingual cortical bone
D. Crestal bone

93. Three days after extraction of teeth for an immediate denture, patient
complains of a diffuse, non-painful yellow, submandibular and supra
sternal discoloration of the skin. The dentist should:
A. Advise antibiotics
B. Apply heat and advice analgesics
C. Apply cold compressions
D. None of the above

94. Of the following which tooth is most difficult to anesthetize by

infiltration technique alone:
A. Maxillary canine
B. Maxillary central incisors
C. Maxillary first molar
D. Maxillary first premolar

158
95. To luxate a tooth with a forceps the movements should be:
A. Finn and deliberate primarily to the facial surface with secondary
movements to the lingual surface
B. Sharp and definite so periodontal ligament tears easily
C. Gentle wiggles so patient get used to the pressure
D. Figure of "eight" motion

96. When a root is accidentally displaced into the maxillary antrum, the
dentist should?
A. Enlarge the socket to gain access
B. Place a drain into the socket
C. Refer to an experienced surgeon for root removal
D. Pack the socket with gel foam to prevent fistula formation

97. The left hand of the operator should serve the following purpose
when extracting a mandibular tooth?
A. Support the mandible
B. Protect other teeth
C. Retract soft tissues
D. All of the above

159
98. Patients with end-stage renal disease are of increased risk when
undergoing extraction of teeth because they?
A. Have an increased tendency to bleed
B. Are susceptible to infections
C. Are often on steroid therapy
D. All of the above

99. During extraction of maxillary third molar the maxillary tuberosity is

fractured and remains attached to periosteum with an intact blood
supply. The treatment of choice is to:
A. Refer the case to an oral surgeon
B. Remove the fractured tuberosity
C. Reposition and Stabilize loss of the tuberosity
D. Send the patient to preventive dentistry with instructions to prevent

100. Among the following which is most common complication after

surgical removal of a mandibular tooth?
A. Post extraction hemorrhage
B. Paresthesia of lingual nerve
C. Loss of blood clot
D. Difficulty in swallowing

160
101. A severe dull ache in the jaw three or four days after an extraction
of tooth usually indicates:
A. Exposure of cementum of an adjacent tooth
B. Acute pulpitis of an adjacent tooth
C. Prescription of an antibiotic agent
D. Loss of alveolar blood clot

102. Hemorrhage after dental extraction procedure can be prevented by:

A. Applying pressure
B. Ligating bleeding major vessels
C. Properly designing and carefully reflecting mucoperiosteal flaps
D. All of the above

103. Trismus after extraction most likely results from:

A. Passing the needle through medial pterygoid muscle while injecting
B. Injecting the solution near a branch of facial nerve
C. Injecting the solution near a branch of trigeminal nerve
D. Systemic administration of LA
104. Local factor for postponing tooth removal is:
A. Periodontitis
B. Hemangioma in the region of the tooth
C. Hypercementosis
D. Malignancy

161
105. Number 16 cowhorn forceps are specifically designed to extract:
A. Maxillary first and second premolars
B. Mandibular central incisors
C. Mandibular molars
D. Maxillary molars

106. A small opening is made into the maxillary antrum during

extraction, immediate treatment is:
A. Pack the socket with gauge
B. Allow the clot to form No special treatment is necessary
C. Place the patient on antibiotics
D. Raise a big mucoperiosteal flap and close the antrum

107. 'Rubber band extraction' is a method of extraction in patient having:

A. Hemangioma and heamophilia
B. Periocoronitis and impacted molars
C. Super numerary teeth and ankylosed teeth
D. Myocardial infraction and angina pectoris
108. A straight elevator is properly used to advantage when the:
A. Adjacent tooth is the fulcrum
B. Tooth is isolated tooth
C. Interdental bone is fulcrum
D. Adjacent tooth is not to be extracted

162
109. Contributing factor to pericoronitis of an impacted mandibular third
molar is:
A. Trauma by opposing tooth
B. Previous radiation therapy
C. Systemic disease
D. Infected follicular cyst

110. After the posterior superior nerve block patient should experience:
A. Numbness of the lip
B. Numbness of the palate till the first premolar
C. Few symptoms of anesthesia
D. Numbness of that side efface

111. The tips of anatomic forceps should be placed:

A. On the crown portion
B. At the junction of clinical and anatomical crowns
C. Near junction of apical and middle thirds of clinical crown
D. On the root surface as far apically as possible
112. In designing the flap the following is correct:
A. The flap should be as small as possible
B. Free margins should be wider than the base
C. Sutured margins should be supported by a blood clot
D. It should be a mucoperiosteal flap

163
113. Appropriate time to administer analgesic to reduce postoperative
pain associated with removal of two mandibular molars:
A. When pain becomes severe
B. Before the effect of LA wears off
C. The morning of surgery
D. Only after the return of sensation

114. While extracting mandibular teeth the patient should be positioned

so that the occlusal plane of the mandible should be:
A. Parallel to the floor when jaws are closed
B. Form some angle to the floor when the mouth is wide
C. Parallel to the floor when the mouth is wide open
D. Perpendicular to the floor when the mouth is wide open

115. While extracting a multi-rooted tooth, the crown fractures, the

prudent next step is to?
A. Divide the roots with a bar
B. Reflect a flap
C. Reapply the forceps in a more apical direction
D. Leave the roots in place and observe

164
116. During the extraction of mandibular third molar, it is noted that
distal root of the mandibular third molar, the root is most probably in
the:
A. Submandibular space
B. Submental space
C. Inferior alveolar canal
D. Pterygomandibular space

117. A patient came for extraction of his four anterior teeth all with
grade 3 mobility. He is under prednisone 25 mg for the past three
months. The dentist should:
A. Take the patient off prednisone therapy
B. Consult the physician who will probably take the patient off
prednisone therapy for at least five days before the procedure
C. Be concerned with adrenal insufficiency
D. Proceed normally

118. The following maxillary third molar impaction is most likely to be

displaced in to the infratemporal fossa the antrum if improper technique
is used:
A. Mesioangular
B. Vertical
C. Distoangular
D. Mesiolingual

165
119. The most common complication after surgical removal of a
mandibular tooth is:
A. Paresthesia of lingual nerve
B. Paresthesia of inferior alveolar nerve
C. Postoperative hemorrhage
D. Loss of blood clot

120. Which maxillary impactions are most likely to be displaced into the
antrum or the infratemporal fossa with incorrect technique during the
extraction?
A. Distoangular
B. Mesioangular
C. Vertical
D. Faciolingual

121. Paresthesia of the lower lip is most commonly the result of:
A. A benign tumor of the mandible
B. Removal of mandibular third molar
C. Periapical abscess of first molar
D. Fracture of the mandible

166
122. Following may cause postoperative hemorrhage:
A. Liver disease
B. Aspirin and other salicylates medication
C. Prolonged use of broad spectrum antibiotics
D. All of the above

123. The difficult tooth to be anesthetized by infiltration technique is the

maxillary:
A. Central incisor
B. First molar
C. Third molar
D. Canine

124. Infiltration in maxillary first molar region is not effective because:

A. Of zygomatic buttress bone in the region
B. Of the presence of parotid opening in that region
C. Of three roots
D. It is supplied by two nerves
125. The following mandibular teeth can be removed without pain after
the inferior alveolar and lingual nerve block:
A. All molars and second premolars
B. First molar and premolars
C. Canine and first premolar
D. All teeth in that quadrant
167
126. The following history and laboratory value contraindicate
extraction of mandibular first molar:
A. Hb% is 15 gm% and hematocrit value is 42 percent
B. Five months pregnant lady without any complications
C. Rheumatic patient taking penicillin
D. Prothrombin time is 45 seconds

127. A 48-year-old, diabetic patient wants extraction of 2 teeth which

are in grade I mobility. He takes 40 units of NPH insulin daily. Which of
the following management procedure in indicated to remove the teeth?
A. Defer treatment, have him take breakfast, but not take insulin to avoid
hypoglycemia
B. Defer treatment, have the patient take his insulin but tell him to avoid
breakfast
C. Treat the patient in the usual manner without much alteration in the
diet and drugs
D. Admit the patient into a hospital for the procedure

128. A 20-year-old patient requires extraction of all erupted teeth

because of extensive decay. He has two maxillary third molar
impactions. X-ray film shows bony impactions. The molars should be:
A. Extracted along with other teeth
B. Retained because no changes of eruption
C. Retained under a denture until they erupt
D. Exposed surgically and can be used for prosthetic retention

168
129. Four days after multiple dental extractions, an elderly fair skinned
women complains of black and blue marks over her neck. The most
probable diagnosis is:
A. Polycythemia
B. Leukemia
C. Postoperative ecchymosis
D. Manifestation of basal cell carcinoma

130. A 45-year-old man requires a tooth extraction. His medical history

indicated myocardial infarction two years ago. This patient is receiving
anticoagulant drugs. The dentist should:
A. Never operate on this patient
B. Avoid performing surgery until the anticoagulant had been
discontinued for at least three days
C. Perform surgery if prothrombin time is 18 seconds
D. To avoid postoperative hemorrhage advice vitamin

131. A patient who is receiving anticoagulants requires extraction of a

tooth. Laboratory data indicating prothrombin time is 21 seconds with a
control time of
15 seconds. The treatment should consist of:
A. Regulation of the anticoagulant level with heparin
B. Injection of vitamin K and immediate extraction
C. Injection of vitamin K and extraction after half an hour
D. Extraction of the tooth and use of sutures and local hemostatic agent

169
132. Persistent pyrexia after full mouth extraction results from:
A. Wound infection
B. Dehydration
C. Endocarditis
D. Any of the above

133. Prophylactic antibiotic coverage before dental extraction is

indicated for patients with each of the following conditions except:
A. Kidney damage needing hemodialysis
B. Prosthetic aortic valve
C. Rheumatic heart disease
D. Coronary artery bypass

134. A mandibular molar was extracted because of advanced caries.

After one month patient developed an extra oral indurated swelling near
the previous extraction site. Multiple draining sinuses appeared and
drained pus with yellow granules. The most probable diagnosis is:
A. Histoplasmosis
B. Tuberculosis
C. Actinomycosis
D. Streptococcal infection

170
135. Most serious potential complication after extraction from areas
previously irradiated is:
A. Osteoradionecrosis
B. Alveolar osteitis
C. Prolonged healing
D. Prolonged suppression of salivary secretion

136. A patient complains of persistent bleeding five hours after the

extraction. Initial treatment is to:
A. Advise bleeding time and clotting time and other laboratory
investigations
B. Inject a local anesthetic solution into the area to provide
vasoconstriction
C. Remove clots and examine the area to locate the source of bleeding
D. Have the patient bite on a gauge socked with adrenaline

137. After a tooth extraction under local anesthesia, a patient with a

known cardiac problem experiences angina. This is most likely
precipitated by:
A. Allergy to the anaesthetic agent
B. Allergy to preservative agent in the anaesthetic solution
C. The stimulus of pain and anticipation
D. The epinephrine in the anaesthetic solution

171
138. During the extraction of maxillary first molar, the palatal root tip of
molar slipped into the maxillary sinus. Proper way to approach to
recovery is through the:
A. Same socket by enlarging the opening through which the root entered
the sinus
B. Maxillary incisive fossa
C. Maxillary incisive fossa medial to canine
D. Lateral nasal wall in the middle meatus of the nose

139. A mandibular left second molar is un-erupted in a 14 year-old boy.

Radiological examination reveals a dentigerous cyst surrounding the un-
erupted tooth. The treatment of choice is:
A. Observe for at least 2 years
B. Aspirate and send the contents of the cyst to biochemical analysis
C. Uncover the crown and keep it exposed
D. Extract the tooth under local anesthesia

140. The prime purpose of Bibevel chisel is:

A. Split teeth
B. Sharpen the angles
C. Remove bone
D. Engage point establishment

172
141. Ammonia inhalation in the treatment for syncope acts by
producing:
A. Bronchodilatation
B. Vasoconstriction
C. Sedation
D. Mucosal irritation

142. Osteotome is:

A. Monobeveled
B. Bibeveled
C. Tetrabeveled
D. Not contain any bevels

143. The following nerves should be anaesthetized for extraction of a

maxillary lateral incisor:
A. Posterior superior alveolar
B. Nasopalatine
C. Anterior palatine
D. Anterior superior alveolar

173
144. During the administration of an inferior alveolar nerve block which
of the following muscles is usually penetrated with the needle:
A. Buccinator
B. Medial pterygoid
C. Lateral pterygoid
D. Masseter

145. For the removal of root apex from the maxillary sinus, one should
block the following nerves:
A. First division of trigeminal nerves
B. Second division of trigeminal nerve
C. Third division of trigeminal nerve
D. Infraorbital nerve

146. Treatment of choice for a localized osteitis or dry socket following

extraction of a tooth is:
A. Topical antibiotic application in the socket
B. Systemic antibiotic administration
C. Debridement of the wound by irrigation and placement
D. Curetting the bony walls of the socket to induce bleeding and clot
formation

174
147. A patient returns several days after extraction of three adjacent
mandibular molars and complains of pain similar to dry socket. The first
step is to:
A. Currete the three socket area thoroughly in an attempt to establish
new blood clot
B. Explore the sockets gently with curet
C. Irrigate the socket and place the dressing
D. Radiographic examination of the area

148. The following muscle is most frequently encountered in an

incorrect infraorbital nerve block:
A. Orbicularis oris
B. Triangularis
C. Quadratus labi superiors
D. Risorious

149. A patient who is under steroid therapy and has need for extraction
of chronically infected teeth. Premedication includes:
A. Antihypertensive drugs to prevent shock
B. Atropine to prevent cardiac arrest by vagal stimulation
C. Antihistamines
D. Antibiotics

175
150. Forty eight hours after the extraction of impacted mandibular third
molar patient returns to your office complaining of moderate pain
radiating to the ear. His temperature is 990 F and swelling is minimal.
The most probable diagnosis is:
A. Trauma to the inferior alveolar nerve during the injection
B. Postoperative infection of parotid space
C. Postoperative infection of masticatory space
D. Post-extraction alveolitis

151. The elevator can be used to advantage when?

A. Multiple adjacent tooth are to be extracted
B. The interdental bone is used as a fulcrum
C. The tooth to be extracted is isolated
D. The adjacent tooth is not to be extracted

152. Post-extraction localized alveolitis or "dry socket" is usually

characterized clinically by:
A. A brawny, indurated swelling with hyperpyrexia over 100" F
B. Continuous dull pain with little or no adjacent swelling
C. Attacks of sharp, lancinating pain with swelling
D. Local tenderness and ecchymosis of the skin and mucous membrane

176
153. Extraction of an isolated residual maxillary molar offers the
technical hazard of:
A. The development of maxillary sinusitis
B. Displacement into the infratemporal fossa
C. Fracture of the tuberosity or floor of the antrum
D. Producing a nasal oral fistula

154. Prophylactic removal of unerupted teeth is accomplished with best

results at certain stage of tooth development. The best time to remove
such a tooth
A. When two-thirds of the root is formed
B. When the root is completely formed
C. Before any of the root is formed
D. When the crown of the tooth is above the cementoenamel junction of
adjacent tooth

155. Following a maxillary tuberosity injection, within a few seconds,

patient face becomes extremely distended and swollen on the injected
side treatment is:
A. Incision and drainage
B. Antibiotic administration
C. Use of cold packs and pressure on the side
D. Antihistamine administration

177
156. The maxillary first molar is extracted by forceps method. The
healing of the socket can be described as:
A. Healing by primary intention
B. Granulomatosis
C. Healing by secondary intention
D. Epithelialization

157. The healing process that takes place following approximation of the
flaps are described as:
A. Healing by first intention
B. Healing by second intention
C. Healing by granulomatosis
D. Hematoma formation followed by organization

158. A tooth is resistant to luxation with forceps. Its removal is best

achieved by:
A. Fracture the crown with forceps
B. Fracture the crown with chisel and roots with forceps
C. Transalveolar method
D. Split tooth technique

178
159. The immediate step following the forceps extraction of a maxillary
central incisor with a periapical radiolucency is:
A. Examine the root apex for soft tissues pathology
B. Pack the socket with a medicament
C. Currets the alveolus, if tissue was not removed with extraction
D. A and C

160. "Ash forceps" is commonly used for:

A. Extraction of lower incisor
B. Extraction of upper canines
C. Holding tissues prior to biopsy
D. Holding vascular areas during surgery

161. If there is visible bleeding from an isolated major vessel, it is best

controlled by:
A. Systemic administrations of Vitamin K
B. Electrocoagulation
C. Clamping and ligation
D. B and C
162. Of the following most difficult impaction to extract
A. Mesioangular
B. Vertical
C. Distoangular
D. Horizontal
179
163. Rongeur is commonly used to:
A. Cut the bone
B. Extract third molars
C. Place the sutures in the areas where access is limited
D. None of the above

164. Under general anesthesia patient needs oropharyngeal:

A. Lap pad
B. 4 x 4 gauge
C. Ferguson mouth gag
D. Pick up forceps

165. One decided to use forceps for removal of a tooth.

The first direction for the force to be applied is:
A. Buccally
B. Lingually or palatally
C. Apically
D. Occlusally

180
166. After the extraction of maxillary first molar, a communication is
found between the palatal socket and a disease free maxillary sinus
which measure 0.2 cm. The best treatment 'is:
A. Allow the clot to form advice proper home care
B. Primary closure and antihistamine
C. Gold foil closure
D. Caldwell-Luc operation

167. An approach to an impacted mandibular molar is achieved by:

A. Envelop flap
B. Bayonet flap
C. L shaped flap
D. All of the above

168. The muscles that aid in displacement of maxillary fractures are:

A. Masseter
B. Temporalis
C. Upper part of orbicularis and lower part of orbicularis occuli
D. None of the above

181
169. A bony opening in the canine fossa Caldwell-Luc procedure is
commonly used to:
A. Expose canine root for apicoectomy
B. Enter the maxillary sinus
C. Uncover and marsupilize a cyst
D. Establish drainage of an alveolar abscess

170. Ankylosis of the TMJ is best treated with:

A. Exercise and massage
B. Sclerosing solutions
C. Antibiotics
D. Condylectomy

171. Alveolectomy is one of the commonly used procedure. It is:

A. Closure of an oroantral fistula
B. Removal of alveolar bone
C. Reconstruction of mucoperiosteum and alveolar bone
D. None of the above
172. Which is best treatment for pericoronitis involving an impacted
mandibular third molar?
A. Antibiotic and analgesic therapy
B. Operculectomy
C. Extraction of the involved third molar
D. Gently irrigating under the operculum
182
173. Postoperative edema can be minimized by:
A. Careful surgical manipulation of hard and soft tissues
B. Administration of antihistamines preoperatively
C. Application of heat immediately after the procedure
D. Application of heat and cold simultaneously

174. During the dental procedure suddenly patient became "light headed,
diaphoretic" then became conscious. The most diagnosis is:
A. Shock
B. Syncope
C. Cerebrovascular accident
D. Hyperventilation

175. One day after the extraction, patient came with the complaint of a
rubbery, non-tender midfacial swelling. The most likely diagnosis:
A. Abscess
B. Fibroma
C. Hematoma
D. Inflammatory edema

183
176. Among the following which is most appropriate preoperative
instruction for a diabetic patient undergoing extraction of his teeth:
A. Maintain normal diet and normal medication
B. Increase medication preoperatively
C. Increase sugar intake prior to surgery
D. Do not eat or take any medication before the surgery

177. A patient who is a grand mal epileptic requires emergency

extraction. One should:
A. Advise the patient that procedure require admission to the hospital
B. Proceed with extraction using xylocaine without adrenalin
C. Proceed with extraction if anti-convulsive medication is employed by
patient
D. Inform the patient that in his condition no extraction should be
performed

178. Which of the following medication require preoperatively for a

patient with mitral valve replacement?
A. Ampicillin
B. Cloxacillin
C. Benzathine penicillin
D. Procaine penicillin

184
179. A 30-year-old female patient with a BP of 150/80 requires
treatment. You would:
A. Recommend general anesthesia
B. Seek medical treatment to lower BP
C. Refer the patient to an oral surgeon
D. Use sedation preoperatively

180. Among the following which condition will require specific

management prior to emergency extraction?
A. Hemophilia
B. Glaucoma
C. Carcinoma tongue
D. Mixed tumor of parotid

181. Elective dental extractions and minor oral surgical procedures on a

patient who has had a myocardial infarct two months prior are best?
A. Performed using an adrenaline free local anaesthetic, because of
adrenaline action on heart muscle
B. Performed under oral diazepam
C. Postponed until at least six months have elapsed
D. Performed with normal

185
182. Among the following, which is true about mucoperiosteal flap
design?
A. Flaps should be narrower at the base
B. Flap margin should not rest on sound bone
C. Flap should be wider at the base
D. Flaps should be avoided

183. Among the following which condition is contraindicated to the use

of local anesthesia?
A. Pregnancy
B. Hypersensitivity to the drug
C. Hepatic damage
D. Parkinson's disease

184. Post extraction complications are most often caused by:

A. Inadequate diet
B. Inadequate preoperative testing
C. Inadequate patient instructions
D. Poor surgical technique

186
185. Among the following which is most important in prevention of post
extraction bleeding problems?
A. Transfusion of blood
B. Tight suturing of flaps
C. Ice to face
D. Local pressure

186. Five days after extraction of an impacted mandibular third molar,

your patient presents with hard, painful swelling of 12 hours duration
near angle of the mandible. This is most likely due to:
A. Angioneurotic edema
B. Hematoma
C. Infection
D. Surgical trauma

187. Inadvertent displacement of the teeth into inaccessible areas of head

and neck and be effectively prevented by:
A. Use of prudent surgical technique
B. Use of gauze pharyngeal curtain
C. Evaluation of radiography prior to surgery
D. All of the above

187
188. A mandibular second molar is extracted. It is found that the distal
root is fractured and the tip is missing. When the dentist attempts to
recover it and finds that his instrument will pass downward and into the
lingual soft tissue, the tip is most likely to be in the:
A. Submental space
B. Sublingual space above the mylohyoid muscle
C. Submandibular space below the mylohyoid muscle
D. Parapharyngeal space

189. 48-72 hours after extraction patient developed fever. The problem
may result from:
A. Wound infection
B. Endocarditis
C. Cellulitis
D. Any of the above are corrected

190. Wilkinson extractions are:

A. A type of extractions done with Wilkinson elevator
B. Done in order to permit eruption of 3rd molars in the proper position
C. Usually done in the patients above 45 years
D. None of the above

188
191. The best time of extraction in pregnancy:
A. First trimester
B. Second trimester
C. Third trimester
D. None of the above

192. Of the following which teeth need primarily tory movement to

extract when?
A. Maxillary first premolar
B. Mandibular second premolar
C. Mandibular central incisor
D. Mandibular lateral incisor

193. Bone removal with aeroter is usually contra indicated because of

the danger of developing:
A. Hematoma
B. Emphysema
C. Abscess
D. Edema

189
194. Which of the following nerves should be blocked to remove a root
tip from the antrum?
A. Anterior superior alveolar nerve
B. Posterior superior alveolar nerve
C. Second division of the trigeminal nerve
D. Third division of trigeminal nerve

195. Which of the following procedures eliminate hemorrhage after

dental extraction procedures?
A. Ligating bleeding vessels
B. Applying pressure and carefully reflecting mucoperiostema
C. Eliminating systemic bleeding disorders
D. All of the above

196. Cavernous sinus thrombosis following infection of maxillary and

anterior teeth most often results from spread of infected emboli along
the:
A. Pterygoid plexus
B. Ophthalmic vein
C. Facial artery
D. Angular artery

190
197. Among the following which muscle is most frequently encountered
in an incorrect infraorbital nerve block?
A. Quadratus labi superioris
B. Mentalis
C. Rizorius
D. Orbicularis oris

198. Management of dry socket (localized alveolar osteitis) include all

of the following except:
A. Curetting the socket and Promote bleeding
B. Normal routine irrigation to flush out the debris
C. Placing a sedative dressing to protect the exposed bone
D. Advising analgesics as an adjunctive treatment

191
Chapter 5: Minor Surgical Procedure
1. Repeat biopsies are indicated:
A. For blastomatoid conditions
B. When ulcers fail to heal in four days
C. In bone defect lesions that fail to heal in six weeks
D. When clinical course differs from a reported benign process

2. Hyperplastic palatal tissue known as papillomatosis is seen often

beneath dentures. This condition is best treated by:
A. Supraperiosteal dissection or electro-surgery
B. Not allowing the patient to wear his denture
C. Radical excision because it is premalignant
D. Chemical cautery

3. A soft tissue flap consisting of mucosa and periosteum can be

repositioned accurately because the:
A. Periosteum is very elastic
B. Mucosa is mostly collagen fibers
C. Periosteum sends filiform-like projections into the haversian canals
D. Periosteum is relatively inelastic

192
4. Treatment of a mucocele on the lower lip is by:
A. Incision
B. Excision
C. Electro-surgery
D. Excision, including adjacent minor salivary glands

5. An excisional biopsy is characterized by:

A. Using a trephine
B. Exfoliative cytologic techniques
C. Including normal tissues and most of the lesion
D. Including normal tissue and all of the lesion

6. In oral surgery, cold pac Epulis Fissuratum is most commonly due to:
A. Ill-fitting dentures over resorbed ridges
B. Infection by Candida albicans
C. Poorly performed 'Z' plasty
D. None of the above

7. The recurrent ranula is best treated by:

A. Electro-surgery
B. Cryosurgery
C. Marsupialization
D. Sub-lingual gland excision

193
8. Incisional biopsy of an ulcer is taken:
A. At the center of the lesion
B. Edge of the lesion
C. Edge of the lesion along with normal tissues
D. At any part of the lesion

9. Which one of the following should not be done during in incisional

biopsy of soft tissue?
A. Place suture through the intended specimens before removing it
B. Infiltrate local anaesthetic solution around the intended site
C. Place the specimens in saline if 10% formalin is unavailable
D. Obtain some adjacent normal tissue if possible

10. The purpose of aleveoloplasty is to

A. Eliminate the undercuts that interfere with seating of the denture
B. Avoid rounding off the sharp bony projections as they will round off
in a few days during the healing process
C. Retain the width of the alveolar ridge even though undercuts exists
D. None of the above
11. Packs are applied:
A. Immediately prior to surgery
B. Immediately after surgery
C. To prevent the spread of infection
D. To produce vasodilation
194
12. During full mouth extraction of teeth and alveloplasties, blood loss
can be expected to be in the range of:
A. 0-100 ml
B. 200-800 ml
C. 800-1000 ml
D. 1000-1500 ml

13. The most frequently used approach to temporomandibular joint

surgery is:
A. Endural
B. Submandibular
C. Preauricular
D. Postauricular

14. The primary intent of an extra-oral surgical dressing is to:

A. Support the incision
B. Protect the surgical site from trauma
C. Absorb drainage
D. Keep the surgical field free from infection

195
15. How long should one wait before obtaining a biopsy of an oral
ulcer?
A. 4 days
B. 7 days
C. 14 days
D. 30 days

16. To prevent tearing of the mucosal edges during wound closure, the
following needle should be used:
A. Round bodied
B. Cutting
C. Reverse cutting
D. Five edged

17. The following principles should be adhered to when performing

alveoplasties after extractions?
A. Conservation of bone
B. Use only absorbable sutures
C. The soft tissue margins should be tightly approximated
D. All of the above

196
18. Damage to the following structure should be avoided while
performing an apicectomy on tooth no. 7 (12):
A. Nasal floor
B. Inferior alveolar canal
C. Anterior superior nerve
D. Incisive canal

19. A suitable fixative for a routine biopsy specimen is:

A. 10 % formalin
B. 40 % formalin
C. 20 % formalin
D. 10 % alcohol

20. To achieve surgical hemostasis in a patient suffering from

Hemophilia A, preoperative administration of the following blood
product should be preferred:
A. Whole blood only
B. Fresh frozen plasma
C. Factor VIII cryoprecipitate
D. Factor VIII concentrates

197
21. A skin graft vestibuloplasty prevents relapse by:
A. Physically maintaining the depth of the vestibule
B. Preventing the reattachment of the muscle to the periosteum
C. Causing an inhibitory effect on fibroblasts in the underlying tissue
D. All of the above

22. Pre-prosthetic surgery on the mandible requires the preservation of

the:
A. Labial frenum
B. Palatal tori
C. Mylohyoid ridge
D. Genial tubercles

23. Chromic catgut sutures are preferred over plain catgut as they
exhibit:
A. Greater strength
B. Less tissue inflammatory response
C. Delayed resorption
D. Ease of manipulation

198
24. Removal of mylohyoid ridge is planned in an edentulous patient.
Which of the following nerves should be protected?
A. Mental
B. Mylohyoid
C. Lingual
D. Inferior alveolar

25. Among the following which is logical explanation that explains how
an abscessed maxillary canine causes swelling beneath the eye?
A. Lymphatics drain upward in this region
B. Apex of canine lies above the attachment of the canines and levator
labi superioris mucles
C. Infection spread through the angular vein which has no valves
D. Bone is less porous above the apex of the canine which facilitates the
spread of infection

26. Most tuberosity reductions before denture construction requires:

A. Primarily soft tissue or fibrous tissue removal
B. Large amount of bone removal
C. Relief from pterygoid hamulus
D. Some bony reductions in all instances

199
27. Incision and drainage (I and D) in an area of acute infection should
be performed when?
A. Induration has occurred
B. Localization has occurred
C. Acute pain is present
D. There is fever which is above 1020 F

28. During the apicectomy on a maxillary lateral incisor, one should take
care not to perforate or damage the:
A. Maxillary sinus
B. Labial frenum
C. Floor of the nose
D. Contents of the incisive canal

29. A mucocele of the lower lip should be treated by:

A. Incision
B. Electro-cautery
C. Excision including adjacent minor salivary gland
D. 'Incision and drainage followed by antibiotics

200
30. Among the following which definite sign/symptom indicate infection
of masticator space
A. Difficulty in swallowing
B. Trismus
C. Decreased salivary secretion (Xerostomia)
D. Fever above 100F

31. Antibiotic medication for pericoronitis should be advised:

A. If extraction is delayed or postponed
B. Before surgery
C. Routinely to treat pericoffcnitis
D. If trismus and fever present

32. Among the following which stage of anesthesia describes the level
of conscious sedation?
A. stage I
B. stage II
C. stage III plane 1
D. Stage Ill plane 2
33. Alveolectomy for prosthetic reasons should be performed:
A. During the time of extraction of teeth
B. One month after the extraction
C. 2 months after the extraction
D. At the time when the complete dentures are to be constructed
201
34. Irritational fibroma which is asymptomatic is best treated by:
A. No treatment is necessary because it is asymptomatic
B. Simple excision
C. Radiation therapy
D. Wide excision followed by chemotherapy

35. Commonly employed approach for the removal of foreign body or

root tip from the maxillary antrum is:
A. Through the canine fossa
B. Through the socket by enlarging it
C. By nasal antrostomy
D. Palatal approach

36. Nasal antrostomy usually done from this:

A. Middle concha
B. Inferior concha
C. Middle meatus
D. Inferior meatus
37. Commonest complication with Risdon and submandibular incision
is:
A. Damage to marginal mandibular nerve
B. Damage to cervical branch of facial nerve
C. Damage to inferior alveolar nerve
D. Damage to lingual nerve
202
38. To remove an undercut maxillary tuberosity, the following flap
design criteria is true:
A. Incision should be made at the crest of the ridge
B. A "wedge" should be done first
C. Incision may extend to premolar canine area
D. All of the above

39. In sutured skin incisions of the face, the edges of the skin should be:
A. Everted
B. Inverted
C. Edge to Edge
D. Separated

40. The following methods are commonly used methods of ridge

extension procedure of the mandible:
A. Secondary epithelialization
B. Mucosal graft vestibuloplasty
C. Skin graft vestibutoplasty
D. All of the above
41. Maxillary tori are usually removed by:
A. Burs and chisels as indicated to section and remove tabulation
B. Bone forceps to hold torus while it is being sectioned
C. Rongeurs to crush bone
D. All of the above
203
42. The 'Z' plasty procedure is commonly used to correct:
A. Oro-antral fistula
B. Ankyloglossia
C. Interfering labial frenum
D. B and C

43. At the time of extraction of upper third molar, the tuberosity is

fractured, but still attached to the periosteum. Which of the following
treatment should be employed?
A. Remove the tuberosity and file the area and suture the soft tissue
B. Remove the tuberosity and fill the defect with osteogen and suture it
C. Leave the tuberosity and stabilize it
D. None of the above

44 To drain pus from an abscess, the surgeon should:

A. Cut an eclipse from the abscess surface to allow for a drain
B. Aspirate the contents
C. Penetrate into abscess cavity and probe with an artery
D. Cut only the mucosa and skin

204
45. Two cm highly suspicious lesion of the floor of the mouth is to be
studied microscopically. A specimen is best obtained:
A. Incisional biopsy
B. Excisional biopsy
C. FNAC
D. None of the above

46. The severe complication of the canine space infection is:

A. Erosion of internal carotid artery
B. Erosion of external carotid artery
C. Cavernous sinus thrombosis
D. Respiratory paralysis

47. The treatment of choice for traumatic bone cyst is:

A. Marsupialization and leaving the cyst lining
B. Opening the cavity and inducing bleeding
C. Enucleation of the cyst lining
D. Packing with BIPP and prevent bleeding and clot formation
48. Treatment of choice to a localized infection with pus
A. Antibiotic administration
B. Establish drainage
C. Apply cold to the area
D. Advise hot mouth washes

205
49. Of the following which is most frequently indicated treatment for
odontogenic cysts:
A. Fulguration
B. Enucleation
C. Marsupialization
D. Incision and drainage

50. A patient came to dental clinic with a growth on the inside of the
cheek that is approximately 0.5 cm in diameter and not painful. He
noticed the swelling 3 months back. The best treatment is to:
A. Remove all of growth and send for biopsy
B. Observe periodically
C. Start antibiotic medication
D. Remove part of the growth and send for biopsy

51. Among the following which is treatment of choice for infection with
fluctuation in an afebrile patient?
A. Administration of antibiotics
B. Application of hot packs to the area
C. Incision and drainage
D. Antibiotics administration followed by I and D

206
52. Among the following which is a problem with reconstruction of the
atrophic ridge with hydroxy apatite granules:
A. Displaced material
B. Mental nerve dysesthesia
C. Poor ridge form
D. Any of the above

53. Which muscle should be detached to lower the floor of the mouth?
A. Mylohyoid
B. Geniohyoid
C. Genioglossus
D. A and C

54. Of the following in which condition a biopsy should not be

performed on a tissue. When the tissue?
A. Responds to local treatment
B. Is associated with paresthesia
C. Suddenly enlarges
D. B and C

207
55. Marsupialization is a surgical procedure which commonly used to
treat a\an?
A. Cystic odontoma
B. Periapical cyst
C. Large cyst
D. Oro antral fistula

56. Of the following movement should be employed to reduce a

dislocation of the mandible:
A. Downward and forward
B. Downward and backward
C. Upward and backward
D. Upward and forward

57. Papillomatosis or hyperplastic palatal tissues most often seen

beneath dentures. This condition is best treated by:
A. Not allowing the patient to wear the dentures
B. Supraperiosteal dissection or electro-surgery
C. Chemical cautery
D. Radical excision because this has malignant potential

208
58. Which of the following represent excisional biopsy?
A. Exfoliative cytologic technique
B. Including normal tissue and all of the lesion
C. Including normal tissue and most of the lesion
D. Removing a representative section of the pathological tissue or lesion
and some adjacent normal tissue for comparison

59. Of the following conditions where acrylic splints are advisable

during the postoperative phase of management:
A. Torus palatinus reduction
B. Mental tubercle reduction
C. Mandibular alveoplasty
D. None of the above

60. During the removal of a maxillary torus, the mid portion of the
palatine process of the maxilla is accidentally removed. One might see:
A. Vertical fracture of the maxilla
B. An opening into the nasal cavity
C. Opening into the maxillary antrum
D. Horizontal fracture of the maxilla

209
61. In the usual approach to mandibular tori the incision is usually
placed:
A. Parallel to the internal oblique ridge
B. Over the alveolar crest
C. Over the prominence of the tori
D. Below the mylohyoid line

62. Of the following, where antrostomy is commonly used?

A. To remove high maxillary third molars
B. To expose a tooth root for apicectomy
C. To treat an alveolar abscess
D. Following closure of an oroantral fistula

63. Which of the following may cause paresthesia of the lower lip?
A. Malposed maxillary third molar
B. Removal of a mandibular third molar
C. Removal of torus mandibularis
D. None of the above
64. of the following which is best method to treat a large radicular cyst
of the maxilla with apical involvement
A. Marsupialization
B. Aspiration
C. Enucleation and primary closure
D. Enucleation and packing the cavity with BIPP
210
65. All of the following are safely excised in preparing
A. A pendulous tori
B. Genial tubercles
C. Feather edged ridges
D. Mylohyoid ridge is best to restore a missing mandibular portion.

66. _____________ is best to restore a missing mandibular portion.

A. Homogenous bone
B. Autogenous bone
C. Silastic
D. Tantalum

67. Which of the following criteria should be considered before a third

molar transplantation?
A. The root is at least half formed
B. The width of the crown approaches the width of the extracted tooth
C. A and B
D. None of the above
68. Most objective way to detect sharp ridges of bone while performing
alveoloplasty is:
A. Place a finger over the body ridge and palpate
B. Place a finger over the soft tissue flap and palpate
C. See the area for sharp bony projections
D. None of the above
211
69. Minimum volumes of local anaesthetic agent is advised for
infiltration when excising frenum because larger volumes may?
A. Cause tissue slough
B. Distort the tissues
C. Cause rebound bleeding
D. Cause toxic effects

70. Of the following conditions, where an incisional biopsy is indicated?

A. 4 cm hemangioma of the tongue
B. 3 cm leukoplakia of the soft palate
C. 0.5 cm papillary fibroma of the gingiva
D. 1.5 cm exostosis of jaw

71. A negative histopathology report of a highly suspicious oral lesion

suggest?
A. No malignant potential of the lesion
B. Lesion should be stained with toludine blue like stains
C. Periodical recalls are necessary to assess the nature of the lesion
D. That another biopsy is necessary in view of the clinical impression
72. Skin graft vestibuloplasty prevents relapse by:
A. Causing an inhibitory effect on fibroblasts
B. Forms a barrier to reattachment of muscle to periosteum
C. Promoting osteogenesis and bony barrier is established
D. Relapse is common in skin graft vertibuloplasty
212
73. Among the following, where excisional biopsy is indicated?
A. 2 cm hemangioma of the tongue
B. 3 cm leukoplakia of the left palate
C. 0.5 cm fibroma of the gingiva
D. 3.5 cm area of Fordyce spot of the check

74. The soft tissue incision used to remove mandibular torus should be
placed:
A. Directly over the torus
B. Inferior to the torus in the area of the floor of the mouth
C. Over the edentulous alveolar crest in the gingival crevice aroung the
dentition
D. A and B

75. After the incisional biopsy of a lesion in the floor of the mouth and
placement of sutures, the patient experiences severe bilateral swelling of
the sub mental and submandibular spaces. This is caused by:
A. Ludwig's infection
B. Too much fluid intake postoperatively
C. Injury to lingual artery with hemorrhage
D. Extravasation into these compartments

213
Chapter 6: Cyst\Tumor\Surgical Pathology
1. Marsupialization is a surgical procedure which may be used in
treating?
A. A large cyst
B. A cystic odontoma
C. A periapical cyst of 1 cm
D. On oral antral fistula

2. A painless, fluid-filled retention cyst appearing in the area of recent

dental treatment may be the result of:
A. Failure of absorption of the anesthetic agent
B. Allergic reaction to some agent employed
C. Infection incurred during treatment
D. An injury obstructing or blocking a minor salivary gland

3. A swelling on the anterior floor of the mouth is soft and painless. It

has been present for several months. The overlying mucosa has a bluish
tingue. The most likely diagnosis is:
A. A retention cyst
B. A mixed salivary gland tumor
C. An infected periodontal abscess
D. A carcinoma of the floor of the mouth

214
4 Sialoliths are most commonly found in the:
A. Parotid duct
B. parotid gland
C. Sublingual gland
D. Submandibular duct or gland

5. Bifid mandibular canal is somewhat common in the following disease:

A. Paget’s disease
B. Fibrous dysplasia
C. Neuro fibromatosis
D. A and B

6. Of the following which nevus has the maximum potential to become

melanoma?
A. Junctional nevus
B. Blue nevus
C. Hairy nevus
D. Intradermal nevus
7. Of the following which group of lymph nodes one most commonly
involved in tubercular lymphadenitis?
A. Axillary
B. Cervical
C. Submental
D. Submandibular
215
8. Which of the following is correct regarding rodent ulcer?
A. Common site of occurrence is lateral border of the tongue
occasionally seen on the ventral surface of the tongue
B. More common in blacks
C. Antibiotics particularly penicillin is effective in the treatment of the
disease
D. None of the above are correct

9. Of the following areas, where retention cysts commonly occur?

A. Floor of the mouth
B. Upper lip
C. Lower lip
D. Buccal mucosa

10. Marsupialization is associated with the treatment for:

A. Abscess
B. Pericoronal infection
C. Cyst
D. Cellulitis

216
11. Mixed tumors of major salivary glands are most frequently found in
the:
A. Tip
B. Palate
C. Tongue
D. Parotid gland

12. The swelling of bone usually seen with a cyst is due to:
A. Ballooning of cortical plates
B. New sub periosteal deposition
C. Soft tissue reactive swelling
D. Cortical plates being reabsorbed and cystic lining causes the swelling

13. In an otherwise asymptomatic cystic swelling there is sudden

neurapraxia in inferior alveolar nerve region it can be due to:
A. Infection of cyst
B. Expansion of periosteum due to cyst
C. Neuritis
D. Neuralgia

217
14. A patient presents with a non-vital and swelling in the labial sulcus.
On aspiration straw coloured fluid is present a tentative diagnosis would
be:
A. Nasopalatine cyst
B. Solitary bone cyst
C. Keratocyst
D. Periapical periodontal cyst

15. With infected large cyst the adjoining teeth give a negative vital
response, it is:
A. Non reversible
B. Reversible after decompression
C. Extraction of the teeth is a must
D. None of the above

16. In following situations an artefact may simulate a cystic lesion

(except in):
A. Radiolucent area in periapical region of central incisors
B. Radiolucent area apical to mandibular premolars
C. Radiolucent area apical to maxillary canines
D. Radiolucent area in ramus of the mandible below sigmoid notch

218
17. To obtain better informative radiographic view of a cyst which has
eroded the cortex considerably:
A. Exposure time should be reduced
B. Exposure time should be increased
C. Voltage should be increased
D. Milliampere should be increased

18. Partsch operation is same as:

A. Marsupialisation
B. Decompression with enucleation
C. Only enucleation
D. Enucleation with marsupialisation

19. Fissural cysts should be ideally treated by enucleation because:

A. The cysts are smaller in size
B. They never enlarge to a size where enucleation cannot be done
C. The bone does not always regenerate from margins and fissural areas
D. Marsupialisation would leave the cavities open and these areas are
more susceptible to infection

219
20. Bohn's nodules are:
A. Cystic swellings in neonates
B. Cysts associated with soft palate
C. Cysts of gingiva in growing children
D. Warts on the tongue

21. The choice of treatment for keratocyst should be:

A. Marsupialisation
B. Marsupialisation with secondary closure
C. Enucleation
D. Marsupialisation with primary closure

22. The high recurrence rate of keratocysts is incriminated to:

A. Its fragile thin lining
B. Presence of daughter cysts in the cystic lining
C. Presence of daughter cysts in the capsule of the cyst
D. All of the above

23. The protein content of periapical and dentigerous cysts is:

A. 5-11 gm/dl
B. Less than that of serum
C. More than that of serum
D. Less than 4 gm/dl

220
24. The window for marsupialisation shows maximum contracture
when:
A. It consists of sulcus mucosa supported by loose connective tissue
B. It consists of sulcus mucosa with firm periosteal bed loosely adherent
to bone
C. It consists of mucoperiosteum firmly adherent to underlying bone
D. Cyst is large

25. Complete enucleation of cyst in palatal area carries danger of:

A. Excessive bleeding from nasopalatine artery
B. Severing of nasopalatine nerve
C. Tear of nasal mucosa
D. Alteration of speech

26. In cysts of maxilla involving maxillary sinus marsupialization pack

should be changed from:
A. Nasal antrostomy
B. Caldwell-luc operation
C. Palatal opening
D. From tooth socket

221
27. In a 48-year-old patient the treatment of dentigerous cyst with
impacted molar lying near lower border of mandible, would be:
A. Enucleation with primary closure and IMF
B. Marsupialization with extraction of molar
C. Marsupialization with IMF
D. Enucleation with secondary closure

28. In which of the situation(s) the cystic lining would have become
thick and adherent?
A. Infection
B. Already decompressed earlier
C. Tooth has been extracted without treating the cyst
D. All of the above

29. During enucleation the incision should be placed on:

A. Firm bony base
B. Mucosa only
C. Cystic lining
D. Cystic capsule

222
30. If during enucleation of a cyst the apices of adjacent normal teeth
become exposed:
A. Retrograde filling should be done with calcium hydroxide
B. They should be treated endodontically with apicectomy
C. Dressing and secondary closure should be done
D. If vital they should be observed for three months

31. One of the main reasons for break-down of suture line after primary
closure is:
A. Dead space
B. Hematoma formation
C. Saliva seepage
D. Retaining adjacent teeth

32. The best material to be packed in large bony cavity after enucleation
of cyst is:
A. Allogenic bone
B. Hydroxy apatite crystals
C. Autogenic medullary bone chips
D. Autogenic cortical pieces

223
33. Cysts from the following teeth usually expand palatally (except):
A. Maxillary lateral incisors
B. Roots of maxillary premolars
C. Upper molars
D. Upper central incisors

34. An early stage cementoma may be erroneously diagnosed as a

periapical cyst but for the:
A. Position of lesion
B. Vitality of tooth
C. Radiopacity of the margin
D. Age of the patient

35. Lateral developmental periodontal cyst is typically present:

A. In relation to vital teeth
B. In relation to submental space
C. In relation to pulpless maxillary teeth only
D. Supernumerary non vital teeth
36. Eruption cysts should be treated:
A. immediately with enucleation
B. By marsupialization
C. With no active treatment
D. With antibiotics.

224
37. The protein content of keratocyst is found to be:
A. < 4 gm\dl
B. 6 gm\dl
C. Equal to serum protein
D. More than serum protein

38. Treatment of keratocyst is:

A. Marsupialisation
B. Enucleation
C. Excision
D. Enucleation with secondary closure

39. A 36-year-old patient presented with an asymptomatic swelling on

left side of body of mandible, radiograph shows small radiopaque specks
within the bone cavity and on aspiration straw colored fluid was present.
It is a typical picture of:
A. Amaeloblastic adenomatoid tumour
B. Calcifying epithelial odontogenic cyst
C. Keratocyst
D. Cystic odontoma

225
40. A 26-year-old male patient presented with multiple keratocysts,
basal cell carcinoma on right cheek and Dyskeratosis with bifid rib.
Diagnosis would constitute:
A. Gorlin's cyst
B. Gorlin's syndrome
C. Marfan's syndrome
D. Pierre Robin syndrome

41. Globulomaxillary cyst occupies bony region between:

A. Maxillary central incisor and lateral incisor
B. Maxillary lateral incisor and canine
C. Maxillary canine and premolar
D. 1st and 2nd premolar of maxilla

42. 18-year-old boy presented with swelling in labial sulcus, difficulty in

breathing, skiagram shows no radiolucent lesion of the bone and on
aspiration straw coloured fluid was present. It could be:
A. Medial palatine cyst
B. Nasoalveolar cyst
C. Nasal polyp
D. Nasopalative duct cyst

226
43. A patient 14 years of age presented with swelling on right mandible,
the adjacent teeth were vital. Radiologically there was an extensive
radiolucent lesion with scalloped margin extending between the roots
and lamina Dura was intact. On aspiration golden yellow coloured fluid
was present, a tentative diagnosis can be:
A. Aneurysmal bone cyst
B. Hemorrhagic bone cyst
C. Stafne's bone cyst
D. Static bone cyst

44. Traumatic bone cyst is also known as:

A. Solitary bone cyst
B. Hemorrhagic bone cyst
C. Static
D. A and B

45. Stafne's bone cyst is a:

A. True cyst
B. Bony depression above inferior alveolar canal
C. Bony depression below inferior alveolar canal
D. Radiolucent area below inferior alveolar canal

227
46. The static bone cyst should be treated by:
A. Enucleation
B. Marsupialisation
C. No active treatment
D. Exploration and closure

47. An example of retention cyst is:

A. Mucocele
B. Ranula
C. Dermoid cyst
D. Branchial cyst

48. Mucocele should be treated by:

A. Marsupialisation
B. Enucleation of cyst
C. Enucleation of the cyst and the minor salivary gland
D. Decompression only

49. Trauma to the excretory ducts of sublingual salivary glands causes:

A. Ranula
B. Mucocele
C. Solitary cyst
D. Sialolithiasis

228
50. Following cysts occur on lateral side of neck:
A. Dermoid cyst
B. Thyroglossal cyst
C. Branchial cyst
D. Epidermoid cyst

51. A patient presented with a small cystic swelling in anterior region of

neck which moved on swallowing and on protrusion of tongue, it could
be:
A. Dermoid cyst
B. Thyroglossal cyst
C. Epidermoid cyst
D. Branchial cyst

52. A 33-year-old patient reported with an extensive ameloblastoma of

mandible but the lower border was not involved, the treatment should
be:
A. Curettage
B. En-block resection
C. Segmental resection
D. Hemimandibulectomy

229
53. The recommended treatment modality for Pindborg's tumour is:
A. Curettage
B. Enucleation
C. Excision/ resection
D. Marsupialisation with secondary closure

54. Adenoameloblastoma should be managed by:

A. Enucleation
B. En-block resection
C. Segmental resection
D. Hemi/ partial mandibulectomy

55. When performing curettage in aggressive tumours such as

ameloblastoma or Pindborg's tumour, one
A. Not sacrifice vital structures present in the area
B. Sacrifice the vital structures present in the area
C. Both tumours are not aggressive
D. None of the above
56. The surgical management of Brown's tumour of mandible is:
A. En-block resection
B. Segmental resection
C. Parathyroidectomy
D. No treatment

230
57. A patient presented with a radiolucent lesion and biopsy report
shows giant cells the lesion could be:
A. Giant cell granuloma
B. Brown tumour
C. Cherubism
D. All of the above

58. 8-year-old boy presented with bilateral swelling of mandible which

was asymptomatic and slowly progressive in nature, radiologic picture
had extensive bilateral multilocular radiolucencies in posterior
mandibular angle and body, this is a characteristic picture of:
A. Hand-Schüller-Christian disease
B. Letterer-Siwe disease
C. Cherubism
D. Eosinophillic granuloma

59. A hypertensive patient having cafe au lait spots, hypoplastic maxilla

and signs of mental deficiency presented with a soft tissue mass on
buccal mucosa, this should insist surgeon to investigate for:
A. Neurofibromatosis
B. Neurilemoma
C. Down syndrome
D. Pierre Robin syndrome

231
60. A 35-year-old patient with history of trauma complained of
intermittent pain in mandible with areas of paresthesia. X-ray picture
revealed a radiolucent area extending into the inferior alveolar canal, on
aspiration no fluid/ gas was present, one can suspect:
A. Hemorrhagic bone cyst
B. Aneurysmal bone cyst
C. Traumatic neuroma
D. None of the above

61. Incision for removal of a palatal torus should be placed:

A. In the midline
B. Paramedian
C. From crevices of teeth
D. As an envelope flap

62. Following method/methods can be used for treating oral leukoplakia:

A. Excision
B. Cryotherapy
C. Fulguration
D. All of the above

232
63. Treatment of pyogenic granuloma consists of:
A. Antibiotics and analgesics
B. Excision with removal of teeth
C. Excision without removal of teeth
D. None of the above

64. Peripheral giant cell granuloma should be treated by:

A. En-block resection
B. Excision with removal of teeth
C. Excision without removal of teeth
D. Segmental resection

65. If after extracting a mandibular tooth, one encounters bleeding due to

an underlying haemangioma the first step in treatment would be:
A. Carotid artery ligation
B. Inferior alveolar artery ligation
C. Replacing the tooth in the socket
D. Pressure packing
66. Chondromas are:
A. Radiosensitive
B. Radiopaque
C. Radioresistant
D. Only present in condylar area

233
67. The management of ossifying fibroma consists of:
A. En-block resection
B. Curettage / enucleation
C. Segmental resection
D. Cryotherapy

68. A 14-year-old female patient presented with swelling on (right) side

of face in maxillozygomatic area. The swelling has been slowly
progressive in nature, radiograph shows diffuse radiopaque mass
involving maxillary sinus and zygoma, with a typical 'ground glass'
appearance this is characteristic picture of:
A. Osteoma
B. Ossifying fibroma
C. Fibrous dysplasia
D. Osteosarcoma

69. The recommended treatment for fibrous dysplasia is:

A. Curettage for contouring
B. Resection en-block
C. Radiotherapy
D. Excision

234
70. The tumors which are poorly differentiated are:
A. Radiosensitive
B. Radioresistant
C. Radioatropic
D. Radiorefractive

71. A protein level between 5-11 g/dl in a cystic fluid is:

A. A dentigerous cyst
B. A keratocyst
C. A radicular cyst
D. A mucocele

72. The Reharmann flap is used to:

A. Close an oronasal fistula
B. Gain access to the TM Joint
C. Close an oro-antral fistula
D. None of the above
73. The commonest etiological factor in the development of T M Joint
ankylosis in children is:
A. Infection
B. Tetanus
C. Trauma
D. Rheumatoid arthritis

235
74. The preferred treatment of a giant cell lesion 2.5 cm in diameter, in
the mandibular anterior region is:
A. Electrocauterization
B. Wide radical excision
C. Curettage
D. Block excision

75. The following cyst has the highest rate of recurrence:

A. Radicular cyst
B. Primordial cyst
C. Keratocyst
D. Dentigerous cyst

76. Radiographic examination is useful in detecting all the following

cysts, except the:
A. Follicular cyst
B. Nasopalatine cyst
C. Residual cyst
D. Nasoalveolar cyst
77. "Partsch No. Il operation" is the name given to:
A. Enucleation
B. Marsupialization
C. Excision of a ranula
D. Combination of (A) and (B) above
236
78. A 25-year-old lady reports to you with a diffuse, non-progressive
and a non-tender swelling of the right maxilla, approximately 2 x 1.5
cm, extending from the canine to the first molar region. The X-ray
shows a ground glass" appearance of the bone in the concerned area.
The surgical treatment will be:
A. Total excision of the lesion
B. Curettage of the area with extraction of the involved teeth
C. Surgical cosmetic recontouring only
D. Surgical excision followed by radiotherapy

79. "T3" in the TNM staging of the oral malignant lesions represents:
A. Carcinoma in situ
B. Tumour 2 cm or less in greatest diameter
C. Tumour > 2 cm but < 4 cm in greatest diameter
D. Tumour > 4 cm in greatest diameter

80. While performing a submandibular sialography the cannula is

inserted in the following direction to the Wharton's duct:
A. Upward and medical
B. Medial to lateral
C. Lateral to medial
D. Lateral and downward

237
81. Factors leading to difficulties in cannulation while performing
sialography are, except:
A. Short or blunt bevel on tubing
B. Rough bevel on tubing
C. Too large a caliber tubing
D. Excessive dilation of the duct orifice

82. In trans-oral sialolithotomy of the submandibular duct the incision

for removal of an anterior sialolith should be placed:
A. Medial to the plica
B. Lateral to the plica
C. Directly over the duct
D. Lateral to the duct

83. "Ageusia" refers to the:

A. Loss of hearing
B. Excessive sensitivity to touch
C. Lowered pain sensitivity
D, Loss of taste

238
84. A patient with an adenoid cystic carcinoma of the parotid will
present with all the following symptoms except:
A. Swelling of the parotid region
B. Fixation to the underlying tissues
C. Iritis
D. Drooping of the oral commissure

85. Steven-Jonson syndrome, a variant of erythema multiform, involves:

A. Oral lesions
B. Cuteneous genital lesions
C. Nephritis
D. Oral lesions & Iritis

86. Hormonal disturbance is the primary cause of jaw deformity in

patients suffering with:
A. Paget's disease
B. Achondroplasia
C. Acromegaly
D. None of the above

239
87. Ground glass appearance in X-rays may suggest the patient is
suffering with:
A. Hyperparathyroidism
B. Fibrous dysplasia
C. Paget's disease
D. None of the above

88. Which of the following condition associated with EB virus?

A. Common cold
B. Measles
C. Burkitt's lymphoma
D. Poliomyelitis

89. 16-year-old patient has a painful swelling which is firm in

consistency in the mandibular premolar area. Teeth near the swelling are
vital. X-ray reveals a discrete radiolucency in the premolar area. The
next diagnostic step is:
A. Aspiration
B. Biopsy
C. Complete RBC and WBC count
D. Bone scans

240
90. Bifid ribs, multiple radiolucent lesions of the jaws, multiple basal
cell nevi and falx cerebri calcification are found in:
A. Basal cell nevus syndrome
B. Sturge-Weber syndrome
C. Horners syndrome
D. Hereditary intestinal polyposis

91. Fordyces disease is due to:

A. Hyperkeratosis
B. Capillary fragility
C. Aberrant sebaceous glands
D. Cholesterol deposits

92. Rodent ulcer or basal cell carcinoma is usually present in the:

A. Intraorally lateral border of the tongue
B. Upper third of the face
C. Middle third of the face
D. Lower third of the face
93. Needle aspiration of a central bone lesion is useful to:
A. Rule out a vascular lesion
B. To determine thickness of buccal plate
C. To diagnose traumatic bone cyst
D. Feel for root surfaces

241
94. 60-year-old women with a past history of adenocarcinoma of the
breast complaining of an ulcer on the right lateral border of her tongue.
Fractured cusp on the mandibular right molar which exposes a sharp
margin of dental amalgam is found during routine clinical examination.
Treatment of choice is:
A. Immediate biopsy of the lesion
B. Restoration of the tooth with biopsy in 2 weeks if necessary
C. Restoration of the tooth
D. Restoration of the tooth with biopsy in 2 months, if the lesion does
not heal

95. Of the following regions where ameloblastoma frequently occur?

A. Mandibular molar region
B. Maxillary molar region
C. Mandibular premolar region
D. Maxillary premolar region

96. During routine radiographic examination one found pear shaped

radiolucency maxillary canine and lateral incisors region. The teeth are
vital most probable diagnosis is:
A. Radicular cyst
B. Incisive canal cyst
C. Globulomaxillary cyst
D. Primordial cyst

242
97. The best treatment for cementoma is:
A. No treatment
B. Endodontic treatment
C. Extraction of the teeth
D. Resection of the involved area

98. During the examination of radiograph of a 60-year- old male patient,

one finds periapical radiolucencies near mandibular incisors. The
diagnosis include:
A. Periapical cyst
B. Early cementomas
C. Paget's disease
D. A and B

99. In the clinical evaluation, the most significant finding of a parotid

mass may be accompanying:
A. Slow progressive painless enlargement
B. Nodular in consistency
C. Submental and preauricular lymphadenopathy
D. Facial paralysis

243
100. In a radiograph radiopaque line around the pathology:
A. Slow growing pathology
B. Rapidly growing pathology
C. No correlation to the growth
D. Malignant lesion with rapid growth

101. During the radiographic examination of maxillary central incisors

one notices a radiolucency between the two central incisors. It is most
likely:
A. Nasopalatine cyst
B. Primordial cyst
C. Globulomaxillary cyst
D. Lateral periodontal cyst

102. A which of the following condition one might see multiple

odontogenic cysts?
A. Cleido cranial dysostosis
B. Paget's disease
C. Craniofacial dysostosis
D. Marfan's syndrome

244
103. During examination of a panoramic X-ray of 65-year old patient,
one noticed 1cm Lytic lesion in the mandible. Which of the following is
the possible diagnosis?
A. Hyperparathyroidism
B. Ca prostate
C. Aneurysmal bone cyst
D. All of the above

104. Large soft swelling noticed in the floor of the mouth.

It could be:
A. Thyroglossal duct cyst
B. Mucous retention cyst
C. Dermoid cyst
D. All of the above

105. Nikolsky's sign helps in the diagnosis of:

A. Herpetic stomatitis
B. Erythema multiforme
C. Pemphigus vulgaris
D. Drug allergy

245
106. Which of the following is most common site for sialoliths?
A. Parotid duct
B. Submandibular duct
C. Minor salivary gland
D. Parotid gland

107. Of the following where sialoliths are most common?

A. Parotid gland
B. Parotid duct
C. Submandibular duct
D. Sublingual gland

108. Of the following which is true? "Port wine stain" is a:

A. A type of stain occasionally used by histopathologist
B. Commonly used contrast media for better image by
C. A type of hemangioma
D. None of the above are correct
109. Which of the following is correct regarding Bowen's disease of the
skin?
A. A type of dermatitis, sometimes affects the eye
B. A pre malignant condition/ lesion
C. Is due to some abnormalities in sweat gland
D. Occur in mercury poisoning

246
110. Which of the following may cause a painless fluid filled retention
cyst appearing in the area of recent dental treatment?
A. Allergic reaction to some agent employed
B. Infection
C. An injury obstructing a minor salivary gland
D. Failure of absorption of the anaesthetic gland

111. A bluish soft and non-tender swelling on the anterior floor of the
mouth is noted. It has been present for several months. Most likely
diagnosis is:
A. Mixed salivary gland tumor
B. An infected periodontal abscess
C. A retention cyst
D. Carcinoma of the floor of the mouth

112. All of the following are seen in cleidocranial dysostosis except:

A. Absence or hypoplasia of clavicles
B. Pseudo or false prognathism
C. Premature eruption of teeth
D. Bulging forehead and prominent cranial bones

247
113. One might see Cafe au lait spots in the following conditions except:
A. Tuberous sclerosis
B. Sjögren's syndrome
C. von Reckling Hausen's disease
D. Albright's syndrome

114. Most likely cause of tender swelling in the submandibular triangle

is:
A. Obstruction to stenen's duct
B. Lipoma
C. Lymphadenopathy
D. All of the above

115. Of the following which denotes the inflammation of the salivary

duct?
A. Pulmonary embolism
B. Acute myocardial infarction
C. Thrombophlebitis
D. All of the above

248
116. A patient is under oral anticoagulants such as warfarin therapy.
Most probably he have:
A. Pulmonary embolism
B. Acute sialadenitis
C. Chronic sialadenitis
D. Sialodochitis

117. Of the following which is characteristic of the traumatic

(hemorrhagic) bone cyst?
A. It causes root resorption
B. Rarely expands cortices or displaces teeth
C. Devitalized involved teeth
D. Is usually found in the maxilla

118. Ameloblastoma is commonly seen in which of the following areas?

A. Antrum and floor of the nose
B. Symphysis area of the mandible
C. Molar area of the ramus of the mandible
D. Mandibular premolar area

249
119. In a routine examination of an IOPA one noticed the following,
Ground glass appearance of bone, complete loss of lamina Dura, Loss of
trabecular pattern of bone
The most probable diagnosis is:
A. Hypercalcemia
B. Hyperparathyroidism
C. Fibro-osseous lesion
D. Hypocalcemia

120. A 60-year-old man complaining some loss of hearing, some loss of

visual acuity and enlargement of his maxilla. The above findings suggest
he is most probably suffering with:
A. Paget's disease
B. Multiple myeloma
C. Ossifying fibroma
D. Ameloblastoma

121. In routine radiological examination one notices a pear shaped

radiolucency located between the maxillary lateral incisor and canine.
Most probably it would be:
A. Nasoalveolar cyst
B. Median palatine cyst
C. Globulo maxillary cyst
D. Naso palatine duct cyst

250
122. Which of the following may cause fixation of a non-tender soft
tissue mass to surrounding tissues?
A. Benign tumor
B. An inflammatory process
C. Malignancy
D. Lesion arising from bone

123. In routine radiological examination one found radiolucency near

angle of the mandible and below the inferior alveolar canal. Most
probably it is:
A. A cyst
B. A developmental defect
C. A cavernous hemangioma
D. Granuloma

124. Globulomaxillary cyst is a type of:

A. Dentigerous cyst
B. Idiopathic
C. Fissural cyst
D. Primordial

251
125. Radiographs of the maxillary central and lateral incisors disclose a
heart shaped radiolucency in the midline. Teeth next to the radiolucency
are vital, this is most probably:
A. Nasopalatine duct cyst
B. Globulomaxillary cyst
C. Nasoalveolar cyst
D. Median palatine duct cyst

126. Fibrous dysplasia can be treated by:

A. Irradiation of the lesion
B. Surgical excision
C. Conservative surgery
D. Removal of the adjacent teeth

127. Among the following which is most frequent complication of sub

apical orthodontic surgery?
A. Nonunion of segments
B. Devitalization of teeth
C. Avulsion effect
D. Vertical fracture of the roots

252
128. Ameloblastoma of the jaw can best be treated by:
A. Excision
B. Surgical resection followed by cauterization
C. Enucleation
D. Irradiation

129. Which of the following lesion has no epithelial lining?

A. Nasopalatine cyst
B. Nasolabial cyst
C. Aneurysmal bone cyst
D. Follicular cyst

130. Among the following which is fissural cyst and entirely located in
soft tissue?
A. Nasoalveolar cyst
B. Globulomaxillary cyst
C. Median alveolar cyst
D. Primordial cyst
131. Osteitis deformans is the condition in:
A. Which roots have hypercementosis
B. Which anodontia seen
C. Which supernumerary roots are more common?
D. None of the above

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Chapter 7: Facial Space Infection\Osteomyelitis
1. The hard, firm condition of the tissues is termed:
A. Cellulitis
B. Purulence
C. Coagulum
D. Abscess

2. Treatment at the first appointment for patient with cellulitis should

include:
A. Antibiotics and heat only
B. Extraction of the offending tooth
C. Antibiotics, heat and fluids
D. Incision and drainage

3. The patient with cellulitis after giving heat, antibiotics, and fluids
returns 24 hours later. On palpation, the area is soft painful to touch, and
the tissue rebounds when palpated. This condition is termed:
A. Abscess
B. Cellulitis
C. Resorption
D. Induration

254
4. Treatment for the patient with abscess should include:
A. Aspiration
B. Antibiotics and heat only
C. Incision and drainage
D. Antibiotics, heat and fluids

5. If one treats an abscess with antibiotics without I and D it may cause:

A. Non-suppurative inflammatory reaction
B. Formation of antibioma
C. Healing with scar formation
D. None of the above

6. Of the following which organism is commonly associated with sub-

acute bacterial endocarditis of dental origin?
A. Staphylococcus aureus
B. Streptococcus viridans
C. Beta hemolytic streptococcus
D. Lacto bacillus acidophilus

255
7. Usually acute pyogenic bacterial infection produce
A. Neutropenia
B. Lymphocytic leukocytosis
C. Neutrophilic leukocytosis
D. Eosinophilia

8. Koplik's spots are oral manifestations of

A. Smallpox
B. Rubeola
C. Rubella
D. Scarlet fever

9. Classical Ludwig's angina has bilateral involvement of the following

spaces except:
A. Submandibular
B. Sublingual
C. Submental
D. Lateral pharyngeal
10. Osteoradionecrosis occurs due to damage to which of the following
structures?
A. Blood vessels
B. Salivary glands
C. Muscle
D. Nerves
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11. In a 19-year-old patient with a swelling over the left angle of the
mandible, temperature 380 C and negative history of trauma, one should
suspect:
A. Spontaneous fracture of the mandible
B. Pericoronal infection
C. Parotid tumor
D. Submaxillary gland tumor

12. Infection from a maxillary first molar spreads most often to which
space:
A. Infratemporal
B. Retropharyngeal
C. Submandibular
D. Buccal

13. Cavernous sinus thrombosis following extraction of acutely infected

maxillary anterior teeth is most often due to spread of infection along:
A. The anterior facial, angular, ophthalmic veins
B. The pterygoid plexus and inferior ophthalmic vein
C. The pterygoid plexus and superior ophthalmic vein
D. Not likely by any of these routes

257
14. The greatest deterrent to normal wound healing is:
A. Trauma
B. Infection
C. Metabolic disease
D. Nutritional deficiency

15. Facial spaces are filled by:

A. Loose connective tissue
B. Elastic fibres
C. Loose adipose tissue
D. Dead space

16. The characteristic features of infection of masticator space is:

A. Swelling
B. Draining pus intraorally
C. Trismus
D. High grade fever
17. The infections of masticator space do not enter into neck because:
A. The fascia is tenaciously adherent to mylohyoid line
B. The fascia is firmly adherent to periosteum lower border of mandible
C. Before it reaches the neck it follows path of least resistance to open
extraorally or intraorally
D. Masticator space is not continuous with spaces in neck

258
18. The infection of masticator space can spread to except:
A. Temporal pouches
B. Lateral pharyngeal space
C. Sublingual space
D. Submandibular space

19. Swellings of masticator space and lateral pharyngeal space are

similar. The distinctive difference is that masticator space infection:
A. Is of dental origin
B. Is not pushed towards the midline
C. Is more diffuse and visible from outside
D. Has a tendency to spread to temporal pouches

20. Incision and drainage of masticator space should be attempted:

A. At region anterior to masseter muscle
B. Intraorally from buccal sulcus
C. Extraorally in subangular region
D. From pterygomandibular raphe
21. Infections from mandibular 1st molar would travel to:
A. Submandibular space
B. Sublingual space
C. Masticator space
D. Digastric space

259
22. The major structures present in the submandibular space are:
A. Deep part of submandibular gland, branches of facial artery, lingual
nerve
B. Superficial part of submandibular gland, branches of facial artery and
lingual nerve
C. Superficial part of submandibular gland, branches of facial artery,
mylohyoid nerve
D. Submandibular duct, lingual nerve and hypoglossal nerve

23. In Ludwig's angina the classical sign is:

A. Tongue is raised and falls back causing respiratory embarrassment
B. That submandibular, sublingual and submental spaces are involved
though tongue may not be raised
C. That submandibular, sublingual and sub-mental spaces are involved
bilaterally
D. Board-like brawny induration of mandible with tongue falling back
and causing respiratory embarrassment

24. In Ludwig's angina the incision should be placed deep up till:

A. Mylohyoid muscle
B. Anterior belly of digastric
C. Geniohyoid
D. Mucous membrane of floor of mouth

260
25. Infections of lateral pharyngeal space travel usually from:
A. Temporal pouches
B. Masticator space
C. Sublingual space
D. None of the above

26. Infections of lateral pharyngeal space are life-threatening because

there may be dangers of:
A. Thrombosis of IJV
B. Erosion of ICA
C. Oedema of larynx
D. All of the above

27. Infections from lateral pharyngeal space can traverse

A. Anterior mediastinum
B. Middle mediastinum
C. Posterior mediastinum
D. Only superior mediastinum

261
28. Infections from submandibular space and sub-mental space usually
traverses to:
A. Anterior mediastinum
B. Middle mediastinum
C. Posterior mediastinum
D. Only superior mediastinum

29. Infections which travel from masticator space to parotid space are
very painful because:
A. Facial nerve is irritated
B. The capsule of parotid does not give way for the developing infection
to spread
C. Auriculotemporal nerve is irritated by infection
D. None of the above

30. While giving an inferior alveolar nerve block, infection is transposed

to:
A. Pterygopalatine fossa
B. Pterygomandibular space
C. Submandibular space
D. Masticator space

262
31. While giving posterior superior alveolar nerve block, infection may
be instituted into:
A. Pterygomandibular space
B. Infratemporal fossa
C. Temporal pouches
D. Pterygopalatine fossa

32. A patient, presented with ophthalmoplegia and signs of meningitis

after extraction of upper central incisor, could be diagnosed as due to:
A. Tumour of pituitary
B. Tuberculous meningitis
C. Cavernous sinus thrombosis
D. No relation

33. The diagnostic sign/s which Eagleton characterized for cavernous

sinus thrombosis is/are:
A. Known site of infection
B. Paresis of Ill, IV, VI nerves
C. Proptosis of eye and (B)
D. All of the above

263
34. Dissecting subperiosteal abscess develops:
A. Immediately after 3rd molar extraction on lingual side
B. Several weeks later and distant to site of 3rd molar extraction
C. In association of post extraction infection in buccal area of extracted
3rd molar
D. When extensive dissection is done while extracting an impacted tooth

35. An acute alveolar abscess should be treated with:

A. First antibiotics for three days and then incision and drainage
B. Incision and drainage with broad spectrum antibiotic
C. Broad spectrum antibiotics and analgesics
D. Antibiotics and proteolytic drugs as chymotrypsin

36. Osteomyelitis begins as an inflammation of:

A. Cortical bone
B. Periosteum
C. Medullary bone
D. Periosteum and inner cortex
37. Which of the following conditions are susceptible to osteomyelitis?
A. Paget's disease
B. Fibrous dysplasia
C. Radiation
D. All of the above

264
38. Osteomyelitis is more common in:
A. Maxilla
B. Mandible
C. Zygoma
D. Nasal complex

39, Osteomyelitis is caused most commonly by:

A. Streptococcus
B. Staphylococcus
C. M. tuberculosis
D. E. coli

40. In osteomyelitis how much bone should have been destroyed before
it manifests radiologically:
A. 10-12%
B. 15%
C. 30-60%
D. 80%
41. Moth eaten appearance so characteristically seen in the radiographs
of osteomyelitis is due to:
A. Presence of sequestrum
B. Enlargement of medullary spaces
C. Reduced medullary spaces
D. Narrowing of Volkmann's canals
265
42. Treatment of chronic osteomyelitis consists of:
A. Culture sensitivity and prolonged antibiotic therapy
B. Culture sensitivity with antibiotic therapy and hyperbaric oxygen
therapy
C. Sequestrectomy, surgical exploration and prolonged antibiotic
therapy after culture sensitivity
D. Sequestrectomy, antibiotics after sensitivity and hydrocortisone
therapy

43. Saucerisation as a surgical treatment for osteomyelitis connotes:

A. Complete removal of decayed bone with primary closure of wound
B. Trimming or excision of margins of necrotic bone overlying focus of
osteomyelitis and allowing secondary healing
C. Creating a saucer shaped defect by excision of the defect with
primary closure
D. None of the above

44. In treating osteomyelitis with hyperbaric oxygen:

A. 30% oxygen is used at 1 atm
B. 70% oxygen is used at 2 atm
C. 100% oxygen is used at 3 atm
D. 80% oxygen is used at 2 atm

266
45. A40-year-old patient presented with multiple extraoral sinuses with
yellowish discharge and with history of intermittent remission after
antibiotics treatment two months ago. The disease started after
extraction of 2nd mandibular premolar. It is suggestive of:
A. Tubercular osteomyelitis
B. Actinomycosis
C. Subperiosteal Garre's osteomyelitis
D. Dissecting subperiosteal abscess

46. Treatment of "alveolar osteitis" consists of:

A. Curettage of the socket to induce fresh bleeding in the socket
B. Prescription of antibiotics specific for gram-negative microorganisms
C. Gentle removal of debris, irrigation of the socket and placement of an
obtundent dressing
D. Irrigating the socket with 5% povidone-iodine

47. Surgical management of Ludwig's angina includes:

A. Incision and drainage
B. Incision and decompression
C. Drainage through closed dwelling catheters
D. None of the above

267
48. When a canine space infection has proceeded from cellulitis to
fluctuance, which is apparent visibly and digitally, and the patient is in
great pain, the initial treatment should be:
A. Administering parentral antibiotics
B. Application of hot packs over the region
C. Incision and drainage
D. Giving an infraorbital nerve block to provide pain relief

49. Management of ecchymosis following oral surgery includes:

A. Application of cold packs over the area
B. Administration of steroids and enzymes
C. Aspiration with a wide bore needle
D. None of the above

50. The major local factor that predisposes mandibular bone to

osteomyelitis is:
A. Reduced cellular proliferation
B. Reduced lymphatic circulation
C. Reduced vascular supply
D. Reduced antibody formation

268
51. Complications of lateral pharyngeal space infection include:
A. Thrombosis of the internal jugular vein
B. Erosion of the internal carotid artery
C. Respiratory paralysis
D. All of the above

52. Infection from a horizontally impacted mandibular third molar will

initially involve the:
A. Submandibular space
B. Sublingual space
C. Pterygomandibular space
D. Masseteric space

53. While draining a submandibular abscess, the surgeon should:

A. Increase the overlying tissues with a no. 10 blade
B. Aspirate the contents, and put in a vacuum drain to evacuate the
remaining pus
C. Use the Hilton's method to completely evacuate the pus
D. Always perform the procedure under general Anesthesia

269
54. In Marx's protocol for the management of osteoradionecrosis of the
mandible using hyperbaric oxygen if tissue dehiscence occurs after the
initial 30 dives and then:
A. The mandible is resected and 30 more dives are given
B. The mandible is resected and the dives are discontinued
C. The full course of 60 dives is given followed by the resection of
mandible
D. The full course of 60 dives is given followed by additional 20 dives
after 10 weeks

55. According to BIRN's hypothesis the severe pain associated with dry
socket is due to:
A. Release of plasmin
B. Release of kinin from the degenerative clot
C. Thermal irritation of the exposed nerve ending of the alveolar bone
D. B and C

56. Which is the potential primary hazard to a patient under

propylthiouracil therapy and whose laboratory data indicates hematocrit
value of 45 percent, reverse neutropenia, reduced myeloblasts in bone
marrow, clotting time of 8 min?
A. Thyroiditis
B. Hemorrhage
C. Hypoxia
D. Infection

270
57. The following are the characteristic features of
Ludwig's angina:
A. Raised tongue
B. Bilateral submandibular swellings
C. Dysphagia
D. All of the above

58. A teenage girl presents with pain, trismus swelling associated with a
partially erupted lower third molar.
The most likely diagnosis is:
A. Peritonsillar abscess
B. Pericoronitis
C. Ameloblastoma
D. Fracture of the mandible near angle region

59. Which of the following may result from acute pyogenic bacterial
infections?
A. Lymphopenia
B. Leukopenia
C. Lymphocytosis
D. Leukocytosis

271
60. After radiotherapy bone is more prone for infection.
This is probably related to:
A. Decalcification
B. Anaemia
C. Invasion by malignant cells
D. Endarteritis of small blood vessels

61. Of the following which is not a component of masticator space?

A. Submandibular space
B. Sub masseteric space
C. Deep temporal pouch
D. Superficial temporal pouch

62. Dental infection from the mandibular first molar spreads to the:
A. Submental space
B. Buccal vestibular space
C. Infratemporal space
D. Pterygomandibular space

272
63. Specimen for bacteriologic examination and diagnosis should be
collected:
A. Prior to the development of the symptoms
B. One or two days after the antibiotic treatment
C. During the acute stage of the disease
D. During the convalescence

64. Local factors that predispose bone to osteomyelitis are related

mainly to:
A. Reduced antibody formation
B. Potent endotoxins
C. Reduced blood supply
D. Increased lymphatic circulation

65. Osteomyelitis of the TMJ can be treated by:

A. Condylectomy
B. Irradiation
C. Incision and drainage, if needed condylectomy
D. None of the above

273
66. Among the following which anaerobic organism is frequently
responsible for oral and facial infection?
A. Staphylococcus aureus
B. Staphylococcus albus
C. Bacteroids fragilis.
D. Streptococcus viridans

67. Among the following which variable has the greatest significance in
antibiotic management of dental infection?
A. Susceptibility of the organism
B. Route of administration
C. Antigenicity of the antibiotics
D. Specific antibody titer of the host

68. All the spaces mentioned below are involved in classic Ludwig's
angina except:
A. Submandibular
B. Space of the body of the mandible
C. Submental
D. Sub lingual

274
69. To drain pus from an abscess of the pterygomandibular space from
an intraoral approach, the muscle most likely to be incised is the:
A. Buccinator
B. Temporal
C. Medial pterygoid
D. Lateral pterygoid

70. Contamination from a patient with a recent serum hepatitis?

A. Wear gloves
B. Wear a mask
C. Sterilize all instruments and drapes after treatment
D. All of the above

71. pterygomandibular space infection may lead to involvement of the:

A. Submaxillary space
B. Parapharyngeal space
C. Infratemporal space
D. All of the above
72. Which of the following sign/symptom does not suggest
postoperative infection?
A. Firm, tender swelling
B. Localized pitting oedema
C. Temperature elevation
D. Increasing or persisting pain
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73. After I and D of an abscess, the infectious process has failed to
regress inspite of the patient being on high doses of an antibiotic, it
would be wise to:
A. Repeat culture and sensitivity tests
B. Insert a large drain
C. Augmenting antibiotic action by administration of parenteral
proteolytic enzymes
D. Debride and irrigate the area with a fibrinolylic agent

74. Teeth in line of fire means:

A. Teeth in the area of planned therapeutic radiation
B. Teeth in the line of fracture
C. Teeth within the cancerous lesion
D. None of the above

75. Scrub technique refers to the proper method of scrubbing the:

A. Operator's hands and forearms before donning gown and gloves
B. Patients body surface before surgical incision
C. Operating room after each infected operation
D. All of the above

276
76. Acute pyogenic bacterial infections produce:
A. Leukopenia
B. Lymphopenia
C. Neutropenia
D. Leukocytosis

77. The tendency to infection of bone after radiotherapy is probably

related mainly to:
A. Anaemia
B. Decalcification
C. Invasion by malignant cells
D. Endarteritis of small blood vessels

78. A patient has received a tumoricidal course of cobalt therapy for a

'lesion of the pharynx. His mandibular first molar has developed a
periapical abscess related to caries. This tooth would be treated by:
A. Administering an antibiotic and extracting
B. Performing root canal therapy if at all possible
C. Prescribing an analgesic compound plus an antibiotic
D. Incising the patient to the radiotherapist

277
79. Forty eight hours following the removal of a left impacted
mandibular third molar, the patient returns to your office complaining of
moderate pain radiating to the left ear. His temperature is 99F and
swelling is minimal. The most probable diagnosis is:
A. Traumatic injury to the inferior alveolar nerve during the injection
procedure
B. Postoperative infection involving the masticator facial space
C. Postoperative infection involving the parotid space
D. Post extraction alveolitis

278
Chapter 8: TMJ And Maxillary Sinus
1. Paranasal sinus view (or) Water's view is advised for sinusitis
patients. Features of sinusitis include:
A. Fluid levels.
B. Clouding of the antra
C. Clouding and fluid levels
D. Erosion of the bone

2. Of the following which method is commonly used to treat ankylosed

TMJ?
A. Steroid injection into the joint.
B. Muscle relaxants and occlusal equilibration
C. Surgical procedure involving condylectomy
D. Systemic steroids

3. Of the following which is not a structural element of the TMJ?

A. Joint cavities.
B. Condylar process
C. Sigmoid notch
D. Articular disc

279
4. The Al-kayat and Bramley approach to the TM joint is a modification
of the:
A. Hemicronal approach
B. Retroauricular approach
C. Preauricular approach
D. Risdon's approach

5. Mention the blood supply to the flap that has used to close an
oroantral fistula in the area of tooth:
A. Nasopalatine
B. Greater palatine
C. Posterior superior alveolar
D. Facial

6. The treatment of unilateral TMJ ankylosis in an 8-year old child

would be:
A. Simple gap arthroplasty
B. Condylectomy
C. Gap arthroplasty with costochondral grafting
D. High condylotomy with costochondral grafting

280
7. The ideal surgical approach to TMJ ankylosis is:
A. Endaural
B. Submandibular
C. Postauricular
D. Preauricular

8. Interposition of temporal muscle and fascia in treatment of TMJ

ankylosis is advocated:
A. To prevent reankylosis
B. To prevent erosion of glenoid fossa due to movement of ramal end
C. To provide soft pad for easy movement of ramal end
D. None of the above

9. Which of the following is\are cause/s of TMJ ankylosis?

A. Trauma
B. Middle ear infection
C. Rheumatoid arthritis
D. All of the above
10. In surgical management of TMJ ankylosis, one can encounter
excessive bleeding from:
A. Inferior alveolar artery
B. Internal maxillary artery
C. Pterygoid plexus of veins
D. All of the above
281
11. In unilateral TMJ ankylosis the chin is deviated to:
A. The affected side
B. The contralateral side
C. No deviation seen
D. Side where growth is occurring

12. In a bilateral TMJ ankylosis case the chin would be deviated to:
A. Side of intense ankylosis
B. Side where more movement is present
C. No deviation
D. None of the above

13. Dautrey procedure is a treatment modality for:

A. TMJ clicking
B. TMJ dislocation
C. TMJ arthritis
D. TMJ ankylosis
14. A patient complains of pain in TMJ area on mastication, his muscles
of mastication are tender and an audible click is there, these features are
characteristic of:
A. MPDS
B. Traumatic subluxation
C. Rheumatoid arthritis
D. Rheumatic arthritis
282
15. The hypertonic saline or sclerosing solution is used for conservative
management of TMJ sub-luxation and dislocation. These injections are
given:
A. In superior compartment
B. In inferior compartment
C. Paracapsular
D. In the articular disc

16. In TMJ osteoarthritis which medicament is injected in TMJ?

A. Sodium morrhuate
B. Hydrocortisone
C. Sodium salicylate
D. Hypertonic saline

17. Myofacial pain dysfunction syndrome can be precipitated by:

A. High filling or malocclusion
B. Psychogenic factors
C. Bruxism
D. All of the above

283
18. Arthroscopy is a technique by which:
A. The inside of joint can be seen from outside but for treatment open
surgery is required
B. The inside of joint can be seen and operated from outside, without
any open surgery
C. Dye is injected into the joint and serial radiographs are taken to see
movement of disc in the joint
D. Dye is injected into the joint and outline of joint cavity is delineated
to see any bony erosion spur formation, etc.

19. A patient who reports with bilateral dislocation of TMJ should be

managed:
A. Manually without LA
B. Manually with LA
C. Under GA only
D. Surgically under GA

20. The management of recurrent TMJ dislocation is:

A. High condylotomy
B, Eminectomy
C. Dautrey procedure
D. All of the above

284
21. A patient of MPDS with typical psychosomatic etiology should be
prescribed:
A. Carbamethaxamol
B. Diazepam
C. Fomentation and cold compresses
D. All of the above

22. Berger's flap for OAF closure utilizes a:

A. Palatal flap
B. Buccal flap
C. Only a mucosal mobilization
D. None of the above

23. A palatal flap has high success rate in management of OAF because:
A. Abundance of tissue
B. Branch of palatal artery is also mobilized
C. It is resistant to infection
D. Of fatty layer there are less chances of tear
24. If nasal antrostomy is planned after OAF closure Opening should be
made in:
A. Middle meatus
B. Inferior meatus above nasal floor level
C. Inferior meatus at nasal floor level
D. Just above middle concha
285
25. OAF should never be closed if:
A. Palatal mucosa is deficient
B. Signs of infection are present
C. Opening is too large
D. Patient is to have a complete denture

26. If on removing a tooth, one realizes that a large OAF has been
formed:
A. Immediate primary closure should be done
B. Closure should be done after 7 days
C. The sinus should be irrigated, lavage for 2/3 days then closed
D. None of the above

27. Nasal decongestants are prescribed in management of OAF to:

A. Allow drainage
B. Shrink antral lining
C. Prevent infection
D. Make breathing easier
28. Sialoangiectasis denotes:
A. Salivary gland and duct system as vastly dilated
B. A sialolith is present
C. A stricture in duct is present
D. Chronic inflammation of salivary gland

286
29. The treatment of parotid abscess is:
A. Antibiotics only
B. Dilation of duct and (A)
C. Incision parallel to facial nerve branches and drainage with (A)
D. Fomentation with (A)

30. The stone in anterior submandibular salivary gland duct should be

removed by placing the incision:
A. Medial to plica sublingualis
B. Lateral to plica sublingualis
C. Never in anterior region
D. Just superficially in 2nd-3rd molar region

31. Once the stone in submandibular salivary gland duct has identified
the incision should be placed:
A. Longitudinally and duct sutured
B. Transversely and duct sutured.
C. Longitudinally and surgical wound closed without suturing the duct
D. Transversely and surgical wound closed without suturing the duct

287
32. While removing a submandibular gland one encounters:
A. Facial artery, facial vein, cervical branch of facial nerve
B. Facial artery, facial vein, cervical branch of facial nerve
C. Facial artery, facial vein, hypoglossal nerve only
D. Facial artery, facial vein, marginal mandibular branch of facial nerve
only

33. The early manifestation of sialadenitis on a sialogram

A. Terminal acini are dilated
B. The acinar system is dilated
C. The ductal system is dilated
D. Constriction of ductal and acinar system

34. Warthin's tumour is:

A. Malignant parotid tumour
B. Benign submandibular tumour
C. Benign parotid tumour
D. Any tumour of salivary glands which can be benign or malignant
35. Mucoepidermoid tumour is:
A. Malignant
B. Benign
C. Squamous cell tumour of salivary gland
D. Same as adenocarcinoma

288
36. Cylindroma:
A. Is malignant tumour
B. Is slow growing but metastases
C. Shows extensive invasion
D. All of the above

37. Ankylosis of the temporomandibular joint is best treated via:

A. X-ray therapy
B. Arthroplasty
C. Cortisone injection
D. Exercises

38. Early movement following surgery for temporomandibular joint

ankylosis is:
A. Harmful
B. Desirable
C. Unimportant
D. Indicated only when ankylosis is limited to one side
39. To reduce a dislocation of the mandible, the movement employed is:
A. Downward and backward
B. Downward and forward
C. Upward and backward
D: Upward and forward

289
40. The most common disorder causing pain about the masticatory
apparatus including the TMJ, is:
A. Myofacial-pain-dysfunction
B. Trigeminal neuralgia
C. Degenerative arthritis
D. Traumatic arthritis

41. Radiographic features of sinusitis include:

A. Fluid levels
B. Erosion of bone
C. Clouding of the antra
D. Clouding and fluid levels

42. Extraction of a maxillary second molar has resulted in a perforation

of the maxillary antrum 0.5 cm in diameter. An acceptable procedure
would be:
A. Caldwell-Luc procedure
B. Creation of a nasal antrostomy window for proper aeration and
drainage
C. Smoothing bone margins of the socket and placement of sutures
across the socket
D. Insertion of iodoform gauze packing into the socket to allow healing
by second intention

290
43. The most common cause of temporomandibular joint ankylosis is:
A. Infection
B. Rheumatoid arthritis
C. Trauma
D. Congenital malformations

44. The "hanging drop" appearance in the maxillary sinus radiograph

indicates:
A. A nasal polyp
B. A blow out # of the orbit
C. A radiographic artifact
D. An antrolith

45. The most critical period for a child after having a condylar fracture
would be the age group between:
A. Five to ten
B. Ten to twelve
C. One to five
D. Twelve to fifteen

291
46. The following movement is used to reduce an anterior dislocation of
the condyles:
A. Downward, forward and upward
B. Downward, backward and upward
C. Upward, forward and medial
D. Upward, backward and lateral

47. The Denker's procedure is an approach to the:

A. Pterygomandibular space
B. Ethmoid sinus
C. Maxillary sinus
D. Medial wall of the orbit

48. Hydrocortisone acetate is injected in a painful arthritic

TM Joint to:
A. Increase the blood supply
B. Lubricate the synovial lining
C. Anaesthetize the nerve supply
D. Decrease the inflammation

292
49. A fractured mandibular condyle is displaced forward and medially
by the action of the following muscle:
A. Temporalis
B. External pterygoid
C. Internal pterygoid
D. Masseter

50. Following an oral surgical procedure the surgical site is covered with
a gauze dampened with saline because the:
A. Saline promotes haemostasis at the site
B. Saline decreases the tendency of the clot to become embedded in the
gauze mesh
C. Saline has localized anti-inflammatory action
D. Saline accelerates the healing of the wound

51. "Drum splints" are used in the management of patients with:

A. Myofacial pain dysfunction syndrome
B. Non displaced mandibular angle fractures
C. Fibrous TMJ ankylosis
D. Atypical facial pain

293
52. The amount of dye that can be injected into ductal system of the
parotid glands during sialography varies between:
A. 0.5 to 0.75m1
B. to 1.5 ml
C. 1.5 to
D. to 2.5 ml

53. The following agent is now commonly used for chemical

capsulorrhaphy in patients with recurrent dislocation of the TMJ:
A. Carnoy's solution
B. Sodium psylliate
C. Sodium tetradecyl sulphate
D. Sodium mourrhate

54. According to Sawhney's classification of TM joint ankylosis, type II

cases present:
A. A bridge of bone between the remus and the zygomatic arch
B. A joint entirely replaced by a mass of bone
C. Flattening of the condyles with no joint space seen on the radiograph
D. Bony fusion of the outer edge of the articular surface of the joint

294
55. A rib harvested for growth center transplantation following TMJ
arthoplasty, should have at least the following amount of cartilage
attached to it:
A. 5 mm
B. 10 mm
C. 15 mm
D. 25 mm

56. A reciprocal click occurring during movement of the

TM joint is indicative of:
A. Anterior disc displacement with reduction
B. Complete anterior disc dislocation of the disc
C. Disc displacement with perforation
D. Normal joint function

57. The canfiled operation to explore the maxillary sinus utilizes assess
through:
A. Inferior angle of the anterior-inferior angle of the antrum
B. The canine fossa above the premolar teeth
C. An opening created by removal of lower portion of the angle formed
by the junction of antral and nasal walls
D. An opening made below the inferior turbinate

295
58. The clinical sign of acute maxillary sinusitis are all
A. Mucopurulent exudates
B. Tenderness over the anterolateral sinus wall
C. Tenderness to percussion of maxillary molar teeth
D. Loss of vitality of maxillary molar teeth

59. Among the following which is best radiograph to examine maxillary

sinuses is:
A. Orthopantamogram
B. Intraoral periapical films
C. Occlusal view
D. Water's view

60. Commonly advised extra oral radiograph to see the maxillary sinuses
is:
A. AP skull
B. Submentovertex
C. Occipitomental
D. Lateral skull
61. Hypertrophy of the mandibular condyle may cause the following:
A. An anterior cross bite
B. Ipsilateral posterior open bite
C. Unilateral class Ill malocclusion
D. All of the above
296
62. Of the following which is most common disorder causing pain about
the masticatory apparatus including the TMJ?
A. Traumatic arthritis
B. Trigeminal neuralgia
C. Myofacial pain dysfunction syndrome
D. Degenerative arthritis

63. Early movements of TMJ following surgery for TMJ ankylosis is:
A. Desirable
B. Harmful
C. Contraindicated
D. B and C

64. Which of the following incisions best exposes TMJ:

A. Submandibular
B. Preauricular
C. Risdon
D. Intraoral
65. The following clinical disease process affect the TMJ directly:
A. Ankylosis
B. Arthritis
C. Dislocation
D. All of the above

297
66. Best treatment for a small opening of a disease free maxillary sinus
is:
A. Not treating socket but advising the patient proper home care
B. Packing tile socket with a hemostatic agent to encourage clotting
C. Leaving the socket undisturbed but prescribing nasal vasoconstrictor
and antibiotics.
D. Employ primary closure of the socket using sutures

298
Chapter 9: Maxillofacial Injury
1. Of the following which view is best to visualize zygomatic arches?
A. Submentovertex or jug handle view
B. Occipitomental view
C. Orthopantamogrum
D. Skull PA view

2. Open reduction and internal fixation of fracture fragments in the older

patients is risky because:
A. Of their old age, they less likely tolerate the major procedure under
general anesthesia
B. Fixation is difficult because bone will become denser as age advances
C. Delayed or non-union may occur because of overall decrease in
reparative abilities of the body
D. None of the above are correct

3. Of the following which is the best method of treating a green stick

fracture of the mandible?
A. Allow normal masticatory movements
B. Bringing the teeth into occlusion with interdental wiring
C. Extra skeletal fixation
D. None of the above

299
4. Radiographic examination following chin trauma to a patient
discloses a unilateral fracture of the mandible. Clinical examination
discloses a deviation of the jaw to the right side on opening. One would
suspect fracture of the:
A. Symphysis
B. Left condyle of the mandible
C, Right condyle of the mandible
D. Left body of the mandible

5. The most common site of fracture of the mandible is the:

A. Angle
B. Symphysis
C. Coronoid process
D. Midbody

6. Fat embolism may result following:

A. Nephrosis
B. Burn
C. Crush injury
D. Diabetes

300
7. A LeFort I fracture is a:
A. Transvers fracture of the maxilla
B. Pyramidal fracture of the maxilla
C. Craniofacial dysjunction
D. Fracture of the zygomatic arch

8. A patient with maxillofacial injuries should be carried

A. Supine position
B. Lateral position
C. Prone position
D. Sitting position

9. Immediate management of nasal bleed in facial injuries is:

A. Reduction of nasal bones manually
B. Paraffin gauze packing
C. Positioning the patient in supine position
D. Positioning the patient in prone position
10. Placing a nasal pack during nasal bleeding and CSF leak carry the
danger of:
A. Fracture of ethmoidal plates
B. Redirecting the CSF to oropharynx
C. Meningitis
D. Redirecting CSF to orbit

301
11. Hypovolemic shock develops after loss of:
A. 10% blood
B. 20% blood
C. 30% blood
D. 40% blood

12. Facial wounds can be considered for primary closure when they
report within:
A. 24 hrs
B. 72 hrs
C. 36 hrs
D. 48 hrs

13. Failure of primary suturing occurs in facial wounds when:

A. Fine silk had not been used
B. Catgut has been used
C. Dead space develops
D. Continuous suturing is done
14. Diplopia would result if fracture line around zygomaticofrontal
suture passes:
A. Below the Whitnall's tubercle
B. Above the Whitnall's tubercle
C. Through zygomaticofrontal suture
D. Tearing the periosteum of orbital surface of zygomatic bone
302
15. Battle's sign is associated with:
A. Fracture zygoma
B. Fracture anterior cranial fossa
C. Fracture middle cranial fossa
D. Fracture nasoethmoid

16. The differentiating feature of bleeding due to black eye and that due
to fracture of orbit is\are:
A. Circumorbital ecchymosis in black eye develops rapidly
B. Posterior limit of subconjunctival haemorrhage cannot be seen in
black eye
C. Posterior limit of subconjunctival haemorrhage can be seen in black
eye
D. None of the above

17. Guerin type fracture is same as fracture:

A. Le Fort I
B. Le Fort II
C. Suprazygomatic
D. Le Fort Ill

303
18. 'Moon face' appearance is not present in fracture:
A. LeFort I
B. LeFort II
C. Zygomatic complex
D. Le Fort Ill

19. 'Dish face' deformity commonly seen with fractures of middle third
of face is because of:
A. Posterior and downward movement of maxilla
B. Anterior and forward movement of maxilla
C. Anterior and downward movement of maxilla
D. Nasal complex fracture

20. In a crown-root fracture of the tooth, if fracture is not below alveolar

bone and pulp is not exposed the tooth should be:
A. Endodontically restored
B. Extracted
C. Only jacket crown given
D. Observed for 3-6 weeks
21. In replanting an avulsed tooth:
A. It should be thoroughly made sterile
B. Root filling with apicoectomy should be done
C. There is failure due to external resorption
D. All of the above
304
22. Pathognomonic sign of fracture mandible is:
A. Deranged occlusion
B. Tenderness and swelling at site
C. Sublingual haematoma
D. Inability to open mouth

23. Fracture of coronoid process can occur due to:

A. Trauma at chin region
B. Trauma from posterior region
C. Reflex muscular contraction
D. Lateral trauma

24. The term vertical in 'vertical favorable' fractures connotes:

A. The fracture line running in vertical direction
B. The displacement of fracture is in vertical plane
C. The direction of view of the observer is in vertical direction
D. Fracture can be reduce vertically

25. Submentovertex view is an ideal view for diagnosing fracture of:

A. Zygoma
B. Zygomatic arch
C. Horizontal fracture of mandible
D. Nasoethmoid region

305
26. Gunning type splints are used when patient is:
A. Edentulous in one jaw
B. Edentulous in both jaws
C. When vertical relation is not known
D. All of the above

27. A 32-year-old female patient reported with bilateral subcondylar

fracture with anterior open bite, the treatment would constitute:
A. Intermaxillary Fixation for 6 weeks
B. Distraction with rubber stoppers and anterior traction followed by
Intermaxillary fixation for 4-6 weeks
C. Intermaxillary fixation for 4 weeks
D. Distraction with rubber stoppers and posterior traction followed by
intermaxillary fixation for 4-6 weeks

28. If fracture angle result following extraction of mandibular impacted

3rd molar the immediate treatment should be:
A. IMF only
B. Bone plating (under GA)
C. Superior border transosseous wiring and IMF
D. Transosseous wiring at the lower border and IMF

306
29. Walsham's forceps are used for:
A. Disimpaction of maxilla
B. Reduction of maxilla fractures
C. Reduction of fracture nasal bones
D. Ash septal force

30. Indirect reduction of fracture zygoma can be done by:

A. Gillies approach
B. Intraoral approach
C. Percutaneous approach
D. All of the above

31. The optimum length of screw, for fixation of plate in mandible is:
A. 2 mm
B. 3 mm
C. 4 mm
D. 6 mm
32. The most commonly injured tooth during the placement of miniplate
for the fracture of mandible in anterior region may be:
A. Central incisor
B. Lateral incisor
C. Canine
D. 1st premolar

307
33. In fractures of mandible in elderly patients, fixation of plate is:
A. Submucosal
B. Supraperiosteal
C. Subperiostal
D. None of the above

34. The contraindication to miniplate along the line of osteosynthesis

would be:
A. A comminuted fracture
B. An infected fracture site
C. A fracture in a 10-year-old
D. When more than one fracture site exists in mandible

35. Stress shielding effect is seen in:

A. Miniplating
B. Compression bone plating
C. Lag screw
D. Transosseous wiring
36. During compression bone plating which type of healing would be
observed:
A. Contact healing
B. Gap healing
C. Primary healing
D. Secondary healing
308
37. In Luhr system of plating, the two individual compression screws
move through:
A. 1 mm
B. 1.6 mm
C. 3.2 mm
D. 4 mm

38. The whole of middle third of face can be approached by:

A. Infraorbital incisions
B. Bicoronal flap
C. Alkayat and bramley approach
D. Transconjunctival approach

39. Acceptable treatment modality for fracture mandible in an 8-year-old

is:
A. Transosseous wiring since IMF cannot be done
B. IMF for 3 weeks
C. Circum-mandibular splinting
D. AO bone plating

309
40. A patient with maxillofacial injuries should be carried in a supine
position only when there is:
A. Spinal, cervical injury
B. Bilateral parasymphysis fracture
C. Unconsciousness
D. Excessive mobility of fractured maxilla

41. Tongue-tie is indicated in:

A. Bilateral parasymphysis fracture
B. Unconscious patient
C. Chin has been destroyed in gunshot
D. All of the above

42. Glasgow coma scale is used:

A. To ascertain motor responsiveness
B. Verbal responsiveness
C. Eye response
D. To ascertain level of consciousness
43. Examination of pupils is of paramount importance in maxillofacial
injuries because it indicates:
A. Trauma to brain
B. Trauma to optic tract
C. Progress of patient after trauma
D. All of the above
310
44. The method commonly used to differentiate nasal discharge from
CSF in fracture of middle third of face:
A. Examining level of glucose
B. Examining level of chlorides
C. Drying the discharge on a piece of cloth
D. Examining the level of proteins

45. Patient with maxillofacial injury complains of regurgitation, absence

of gag reflex and weakening of voice, he may have:
A. Laryngeal trauma
B. Injury to middle cranial fossa
C. These symptoms are due to acute pain
D. Paralysis of IX N

46. Treatment of choice of a linear non-displaced fracture of the body of

the mandible with a full complement of teeth is:
A. Kirchner's wire
B. Circumferential wiring
C. External pin fixation
D. Closed reduction with intermaxillary fixation

311
47. Following a bilateral fracture of the mandible in the canine region,
the anterior fragment of the mandible is displaced posteriorly by the
action of the:
A. Anterior belly of the digastric muscles, geniohyoid and genioglossus
muscles
B. Thyrohyoid, genioglossus and geniohyoid muscles
C. Mylohyoid, genioglossus and geniohyoid muscles
D. Mylohyoid, geniohyoid and thyrohyoid muscles

48. The best radiographic view for evaluation of fracture of the middle
face is:
A. PA skull
B. Lateral skull
C. Towne's view
D. Water's view

49. The most important step in suturing lacerated lip:

A. Apposition of muscular layer
B. Apposition of vermilion border
C. Apposition of mucosal layer
D. All of the above

312
50. A patient presents with lateral subconjunctival haemorrhage.
Infraorbital step and diplopia on right side with inability to open mouth,
he can be having:
A. Fracture subcondylar right side
B. Fracture zygoma right side
C. Fracture Le Fort Il right side
D. Fracture of floor of the orbit

51. Apatient presents with bilateral infraorbital step, paraesthesia on left

cheek region, with posterior gagging, and mobility of maxillary complex
at nasal bones, it indicates:
A. Bilateral fracture zygoma
B. Bilateral fracture Le Fort Il
C. Fracture zygoma left side with bilateral Le Fort Il
D. Fracture bilateral subcondylar and fracture zygoma left side

52. A patient complains of diplopia following fracture zygoma, this is

because of:
A. Fracture of orbital floor
B. Entrapment of medial rectus
C. Entrapment of superior oblique
D. All of the above

313
53. Traumatic telecanthus is associated with:
A. Bilateral Le Fort Il fracture
B. Nasoethmoidal injury
C. Fracture nasal bones
D. Bilateral fracture zygoma with enophthalmos

54. Guerin sign is presence of:

A. Ecchymosis at mastoid area
B. Ecchymosis at greater palatine foramen area
C. Ecchymosis in zygomatic butress area
D. Ecchymosis in sublingual area

55. The typical 'cracked pot' sound on percussion of upper teeth is

indicative of fracture:
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. A and B
56. In Le Fort I fracture infraorbital rim is:
A. Bilaterally involved
B. Not involved
C. Involved medially
D. May or may not be involved

314
57. Ecchymosis at zygomatic buttress would indicate fracture:
A. LeFort I
B. Le Fort II
C. Zygoma
D. All of the above

58. On palpation there is a step at bilateral infraorbital margins and

mobility of midface is detectable at nasal bridge a possible diagnosis
would be fracture:
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. Le Fort III and II

59. There is tenderness at zygomatico-frontal suture, with hooding of

eyes and step at zygomatic arches with disturbed occlusion, a possible
diagnosis would be:
A. Fracture zygoma and zygomatic arch
B. Fracture zygoma with paralysis of III nerve causing hooding
C. Fracture Le Fort II and fracture zygoma
D. Fracture Le Fort III

315
60. On moving the maxilla bimanually, movement is felt at zygomatico-
frontal suture area in a case of middle third fracture of face, it is
indicative of fracture:
A. Le Fort I
B. Le Fort II
C. Le Fort III
D. Zygoma

61, Step and mobility at infraorbital margin and step at

Zygomatico-frontal region would indicate fracture:
A. Le Fort 111 and Le Fort 11
B. Le Fort Il and zygoma
C. Le Fort Ill and zygoma
D. None of the above

62. Fracture Le Fort Il involves the following bones:

A. Frontal process of maxilla, nasal, lacrimal
B. Frontal process of maxilla, lacrimal, ethmoidal
C. Frontal, maxilla and nasal
D. Maxilla, frontal process of zygoma, nasal and lacrimal

316
63. A patient presents with open bite on left side and with tenderness at
nasal bones, it could be fracture:
A. Unilateral Le Fort I on right side
B. Subcondylar on left side and zygoma on right side
C. Le Fort Il on right side
D. Zygoma on right side and subcondylar on right side

64. If there is root fracture in apical third of tooth without mobility:

A. Tooth should be extracted
B. Treated endodontically
C. No treatment and periodic review
D. None of the above

65. High rate of fractures at canine region of mandible is

A. Change of direction of forces occurring here
B. Long canine root
C. Lower border is thin in this area
D. Alveolus is thin in this area
66. Respiratory embarrassment can occur in fracture:
A. Angle
B. Parasymphysis
C. Bilateral parasymphysis
D. Bilateral subcondylar

317
67. A patient reported with deviation of jaw to the right side on opening
and bleeding from the right ear, is a typical picture of:
A. Left-subcondylar fracture
B. Right-subcondylar fracture
C. Right-subcondylar with fracture of anterior cranial fossa
D. None of the above

68. A patient with bilateral subcondylar fracture presents with:

A. Inability to open mouth
B. On opening mandible moves forward
C. Anterior open bite
D. Closed bite

69. A horizontalIy unfavorable fracture of angle of mandible runs from:

A. Lingual plate anteriorly backward through buccal plate posteriorly
B. Upper border downward and forward
C. Upper border downward and backward
D. None of the above
70. Best radiograph for fractures of middle third of face:
A. Submentovertex
B. Reverse Towne's view
C. OPG
D. Occipitomental view

318
71. To find if fracture of angle mandible is vertically favourable or
unfavourable the radiograph advised:
A. PA view mandible
B. Lateral oblique 300 mandible
C. Occipitomental view
D. Lateral oblique 150 mandible

72. There is absolute indication for extraction of a tooth which is present

in the fracture line when there is:
A. Longitudinal fracture of tooth involving the root
B. Infected fracture line
C. Dislocation of tooth from its socket
D. All of the above

73. A 7 -year-old boy presented with fracture of left subcondylar region

with occlusion undisturbed, the treatment would be:
A. Immobilisation for 7 days
B. Immobilisation for 14 days with intermittent active opening
C. No immobilisation with restricted mouth opening for 10 days
D. No immobilisation and active movement

319
74. While doing circum-mandibular wiring there are chances of injuring:
A. Facial nerve
B. Facial artery, vein
C. Epiglottis
D. Lingual nerve

75. The submandibular incision for approaching angle fracture is placed

one finger breadth below the lower border of mandible:
A. To keep the incision line masked
B. To prevent injury to facial vessels
C. To prevent injury to marginal mandibular nerve
D. Access becomes easy

76. In old patients, open reduction and fixation should be done with
great care to:
A. Prevent iatrogenic fracture of atrophic mandible
B. Detach minimum of periosteum
C. Prevent dislocation of condyle
D. None of the above
77. Following are the examples of rigid fixation:
A. Lateral Fontal suspension
B. Extra skeletal pin fixation
C. Bone plating
D. B and C
320
78. To fix a zygomatic fracture by open reduction following sites have to
be approached:
A. Zygomatic, frontal and infraorbital
B. Infraorbital and zygomaticotemporal
C. A and B
D. Zygomaticofrontal, zygomatic prominence and, floor of orbit

79. Tetanus immunization of patients with facial injuries includes:

A. Administration of antibiotics
B. Administration of 0.5 ml of absorbed toxoid
C. Administration of 250 units of TIG
D. (B) and (C) above

80. The 'Golden Hour of Trauma' refers to:

A. The period of time between minutes and hours after the trauma
B. The period of time in seconds or minutes after the traumatic incident
C. The period of time exactly one hour after the trauma is sustained
D. The period of time during which the patient regains consciousness
after trauma

321
81. A true open bite is seen in which of the following fractures:
A. Horizontal fracture of the maxilla
B. Fracture of the angle of the mandible
C. Unilateral condylar fracture
D. Fracture of the zygomatic bone

82. Which of the following mouth guards are most recommended for
high impact sports such as rugby?
A, Type I (stock) mouth guards
B. Type II (boil and bite) mouth guards
C. Type Ill (custom) mouth guards
D. All are equally effective

83. The "Epi-Tek" catheter is used for:

A. Drainage of pus from a fascial space
B. Administration of fluids
C. Sialography
D. Control of nasal haemorrhage
84. Endotoxic shock is seen in patients of maxillofacial trauma with
related:
A. Abdominal injuries
B. Cardio-thoracic injuries
C. Crush injuries
D. Spinal cord injuries
322
85. Indications for neurosurgical referral in a patient with maxillofacial
trauma include all, except:
A. Meningitis
B. Large aerocoele
C. Excessive oral/ nasal bleeding
D. Young patient with CSF leak

86. As per the Glasgow Coma Scale, motor responsiveness score 3

denotes:
A. Obeying
B. Localizing
C. Extending
D. Flexing

87. Acrylated arch bars are also known as:

A. Krupps arch bars
B. Winter's arch bars
C. Wipla arch bars
D. Schuchardt arch bars

323
88. Contraindications for use of gunning splints in patients with fractures
of the mandible include all, except:
A. Grossly comminuted fractures
B. Fractures of the atrophic mandible
C. Bilateral fractures of the edentulous mandible where proximal
fragments can be controlled by IMF
D. Posterior displacement of the anterior part of the mandible

89. Following intermaxillary fixation, a patient can lose weight on an

average up to:
A. 5kg
B. 5.5 kg
C. 6.5 kg
D. 7 kg

90. Log rolling a trauma patient into the recovery position minimizes the
risk of:
A. Damage to the spinal cord
B. Aspiration of blood or foreign bodies
C. Obstruction of the airway from the displaced tongue
D. None of the above

324
91. The "parade-ground" fracture refers to:
A. Bilateral fractures of the mandibular angles
B. Midline symphyseal and undisplaced bilateral condylar fracture
C. Bilateral fracture dislocation of the condyles
D. Midline symphyseal and bilateral fracture dislocation of the condyles

92. A patient with severe maxillofacial trauma has a systolic pressure

less than 100 mm Hg. The expected amount of blood loss should be in
the range of:
A. 500 ml
B. 750 ml
C. 1000 ml
D. 1250 ml

93. Replantation technique of avulse mature teeth requires:

A. Removal of any soil contamination by rinsing with water followed by
sterilization
B. Leaving the pulp tissue intact but sealing the apex with an alloy prior
to replantation
C. Removal of any blood clot in the socket by curettage
D. None of the above

325
94. "Matchbox" injuries of the maxilla-mandibular region refer to:
A. Burns of the soft tissues overlying the facial skeleton
B. Fracture of the nasal bones
C. Fractures of the middle third of the facial skeleton
D. Crush injuries of the maxillary sinus

95. Paresthesia is one of the commonest finding in which of the

following fractures?
A. Subcondylar fracture of the mandible
B. Zygomatico maxillary complex fracture
C. Fractured coronoid and displacement of the fracture
D. Symphysis fracture associated with bilateral subcondylar fracture
(parade ground fracture)

96. Clinical findings of a subcondylar fracture on the right side include:

A. Trismus and crepitus bilaterally
B. Inability to deviate the mandible to the left
C. Deviation of the mandible on protrusion towards the left side
D. Bleeding intraorally most of the times moderately sometimes
severely

326
97. Clinical findings of a subcondylar fracture on the left side include:
A. Trismus and crepitus bilaterally
B. Inability to deviate the mandible to the left
C. Deviation of the mandible on protrusion towards the left side
D. Bleeding intraorally, most of the times moderately sometimes
severely

98. After reduction of a mandibular dislocation that occurred for the first
time, treatment should be to:
A. Inject sclerosing solution into the joint, so further dislocation is less
likely
B. Inject corticosteroids into the joint which reduces the inflammation
C. Immobilize with IMF for 5-6 weeks
D. Advise the patient to limit opening of the mouth for
2-3 weeks

99. Among the following which is the least common site of mandibular
fracture?
A. Body
B. Coronoid
C. Condyle
D. Angle

327
100. CSF rhinorrhoea commonly seen in patient with:
A. Le Fort I fracture
B. Zygomatic complex fracture
C. Le Fort Ill fracture
D. Bilateral condylar fracture with symphysis fracture of mandible

101. Forward displacement of the condyle in condylar fractures is due

to:
A. Medial pterygoid
B. Lateral pterygoid
C. Masseter
D. Temporalis

102. The movement employed in the reduction of displaced mandible is:

A. Downward and backward
B. Upward and forward
C. Upward and backward
D. Downward and forward

328
103. After a blow to the chin, patient has pain and tenderness over the
right TMJ. Open bite, and deviation of the chin to the right side. This
suggests:
A. Fracture mandible right angle region
B. Fracture mandible left angle region
C. Fracture mandible right condyle
D. Fracture mandible left condyle

104. Fractures of mandible where full complement of teeth are present is

best treated by:
A. Intraoral open reduction
B. Circumferential wiring
C. Full cast splints
D. Closed reduction and intermaxillary fixation

105. In which of the following anterior open bite Occur?

A. Bilateral condylar fractures
B. Symphysis fracture on one side and angle fracture on the other side of
the mandible
C. Horizontal fracture of the maxilla
D. A and C

329
106. For an oral surgery patient undergoing closed reduction of a
fractured mandible which of the following procedures should be
performed?
A. Medical history and physical examination
B. CBC
C. Urine analysis
D. All of the above

107. Bones usually fracture at the sites of:

A. Compressive strain
B. Tensile strain
C. Rich blood supply
D. Thin periosteal covering

108. Energy range required to fracture the mandible is in the range of:
A. 44.6 - 74.4 kg/m
B. 79.2 - 98.1 kg/m
C. 10.1 - 28.5 kg/m
D. 100.2 - 150.9 kg/m
109. In case of subcondylar fracture, the condyle moves
A. Anterior lateral direction
B. Posterior medial direction
C. Posterior lateral direction
D. Anterior medial direction
330
110. Geurin's fracture is synonymus to:
A. Le Fort I level fracture
B. Le Fort Il level fracture
C. Le Fort Ill level fracture
D. Le Fort IV level fracture

111. The following fracture is usually pyramidal in shape:

A. Le Fort I fracture
B. Le Fort Il fracture
C. Le Fort III fracture
D. Mandibular symphysis fracture

112. Cranio facial dysjunction commonly occurs in:

A. Le Fort I fracture
B. Le Fort 111 fracture
C. Mandibular symphysis fracture
D. Mandibular condyle

113. Gilli's approach is:

A. Used to block inferior alveolar nerve
B. Used to reduce the fractured zygoma
C. Placed just anterior to the ear
D. One of the frequent approach for condylar surgery

331
114. Lowering the pupillary level of eyeball occur if:
A. The orbital volume increases
B. Detachment of suspensory ligament of lockwood occurs
C. In case of blow out fracture
D. None of the above

115. How many weeks of fixation are required for fracture mandible?
A. 8 - 10 weeks
B. 6 - 8 weeks
C. 4 - 6 weeks
D. 2 - 4 weeks

116. During the Gillies approach, the structure of anatomic significance

is:
A. Superficial temporal artery
B. Marginal mandibular nerve
C. Internal jugular vein
D. Inferior alveolar nerve
117. An unfavorable displaced fracture of the mandibular angle is
difficult to treat because of:
A. Muscle pull causes distraction
B. Malocclusion secondary to the injury
C. Injury to nerves and vessels
D. Bone in that region is very thick
332
118. Among the following which may produce respiratory obstruction?
A. Bilateral condylar fracture
B. Symphysis fracture of mandible
C. Bilateral fracture of mandible in the second premolar area
D. Fracture of the angle of the mandible

119. In a patient with bilateral dislocated fractures of the necks of the

mandibular condyles one can expect the following clinical signs:
A. Anterior open bite
B. Inability to protrude the mandible
C. Inability to bring posterior molars into contact
D. A and B

120. Of the following which facial bone is most frequently fractured?

A. Mandible
C. Nasal
B. Maxilla
D. Zygomatic
121. Ecchymosis in the post auricular region over the mas-
A. Battle's sign
B. Murphy's sign
C. Guiren's sign
D. None of the above

333
122. "Hanging drop" sign in radiograph usually indicate:
A. Nasal bone fracture
B. Orbital floor fracture
C. Isolated coronoid fracture fragment hanging by temporalis muscle
D. Condylar fracture

123. Of the following which is almost pathognomonic of a mandibular

fracture?
A. Deep laceration near the area of trauma
B. Ecchymosis in the lingual sulcus
C. Anterior open bite
D. None of the above are correct. There is no pathogenic feature of
mandibular fracture

124. Among the following where one might see "Bucket handle"
displacement of fracture segments:
A. Bilateral mandibular body in a 60-year-old
B. Isolated nasal bone fracture in a 35-year-old female who is pregnant
C. Unilateral zygomatic maxillary complex in a 40-year- old patient who
is wrestler by occupation
D. Pure blow out fracture of floor of the orbit in a 20-year- old tennis
player

334
125. A patient came to the trauma center who had a blow over his lower
jaw. Intraoral examination reveals hematoma near lingual side of lower
second molar. The proximal fragment is medially displaced. Which of
the following might explain the above findings?
A. Vertically favorable fracture of angle of the mandible and
displacement is due to masseter action
B. Vertically unfavorable fracture of angle of the mandible and
displacement is due to internal pterygoid action
C. Horizontally favourable fracture at the angle and displacement is due
to medial pterygoid action
D. Horizontally unfavourable fracture at the angle and displacement is
due to masseter action

126. In case of pure symphysis fracture of mandible, fracture segments

are usually displaced:
A. Lingually and downward by the pull of genioglossus mylohyoid
muscles
B. .Mainly lingually and lingual and downward movement due to the
pull of geniohyoid and myohyoid musle
C. Mainly upwards movement. Lingual and upward movement due to
the pull of geniohyoid and mylohyoid muscle
D. None of the above are correct. A little or no displacement occur

335
127. Excessive muscular contraction is one of the frequent cause of:
A. Unilateral condylar fracture
B. Cornoid fracture
C. Fracture of angle of the mandible
D. Bilateral condylar fracture

128. Which of the following is right regarding Guardsman

A. It is nasal fracture associated with unilateral zygomatic maxillary
complex fracture
B. CSF rhinorrhoea is severe in this cases
C. Commonly seen in epileptics
D. It is a type of comminuted fracture due to bullet or missile injures in
the war field

129. "Panda Facies" is one of the term to describe the patient face after
mid face trauma. The appearance is due to:
A. A-gross swelling of the face
B. CSF rhinorrhoea and bleeding from the nose and laceration results in
red and white streaks on the face
C. Edema and ecchymosis around the eyes
D. Sub conjunctival hemorrhage (Bilateral)

336
130. Tram line pattern on the face is due to:
A. Sutures placed with tension
B. CSF rhinorrhea
C. Circumorbital ecchymosis
D. Sub conjunctival hemorrhage

131. Of the following which is weakest part of orbit:

A. A Medial wall
B. Lateral wall
C. Floor of the orbit
D. Roof of the orbit

132. Posterior displacement of the fractured anterior segment in the

bilateral fracture of the mandible in the canine region is due to the action
of the:
A. Thyrohyoid, genioglossus and geniohyoid
B. Mylohyoid, genioglossus and geniohyoid
C. Geniohyoid and genioglossus and anterior belly of digastric muscles
D. Mylohyoid, geniohyoid and thyrohyoid muscle

337
133. Which of the following is complication often open fracture?
A. Malunion
B. Nonunion
C. Infection
D. Crepitation

134. A patient with suspected cervical fracture should, be kept in:

A. Body and neck extended
B. Prone position
C. Body extended and neck flexed
D. Both body and neck flexed

135. Principles in treating fractures include:

A. Reduction of fracture
B. Fixation of fracture and restoration of occlusion
C. Immobilisation
D. All of the above
136. Depressed fracture of the zygomatic area may be clinically
recognized by:
A. Concavity of the overlying tissue in the zygomatic arch area
B. Interference with movements of the mandible
C. Subluxation of condyles
D. A and B

338
137. Which of the following is characteristic of Le fort fracture
A. CSF rhinorrhoea
B. Bleeding from the ear
C. Bleeding into the antrum
D. A and B

138. Most common anatomic site of fracture mandible is:

A. Angle
B. Condyle
C. Coronoid
D. Body

139. Of the following, which is the immediate treatment for a patient

with comminuted fracture and in the state of shock?
A. Ringer's lactate solution by IV route
B. Normal saline by IV route
C. Blood transfusion
D. Plasma expanders
140. A Gunning's splint is used in the treatment of:
A. Fracture of the condylar neck of a child
B. Fracture of the edentulous mandible
C. Anterior dentoalveolar fracture
D. None of the above

339
141. Presence of ecchymosis in the sulci, the floor of the mouth and hard
palate usually suggest there is a:
A. Laceration
B. Fracture
C. Abrasion
D. None of the above

142. Among the following which is not used in the fixation of bone
grafts?
A. A Bone plates
B. Titanium mesh
C. Gut
D. Tranosseous wires

143. Which is most frequently performed to correct a skeletal

mandibular retrognathia?
A. 'C' type osteotomy
B. Horizontal osteotomy or the ramus
C. Oblique sub condylar
D. Sagittal split osteotomy of the ramus

340
144. Which of the following procedure best suited to correct bi-
maxillary protrusion?
A. Extraction of four premolars and anterior alveolar segment
repositioning
B. Mandibular body osteotomy and posterior maxillary osteotomy
C. Subcondylar osteotomy
D. None of the above

145. What are the principles in the treatment of mandibular fractures to

ensure rehabilitation of jaw function?
A. Reduction of the fracture
B. Fixation of the fracture
C. Restoration of occlusion
D. All of the above

146. Among the following which muscle plays least role to displace
fractured mandibular angle?
A. Temporalis
B. Triangularis
C. Medial pterygoid
D. Lateral pterygoid

341
147. The proximal segment of mandibular angle fracture usually
displaced in which direction?
A. Anterior and superior
B. Posterior and inferior
C. Inferior only
D. Posterior and superior

148. After a depressed fracture of zygomatic arch mandibular movement

is restricted. The most probable rea-
A. Disruption of TMJ
B. Spasm of the lateral pterygoid muscle
C. Mechanical impingement of the fracture fragment on the coronoid
process
D. Splinting action of masseter and medial pterygoid muscle

149. Among the following which is compound fracture?

A. Fracture with many small fragments
B. Fracture in a "star" shaped appearance
C. Fracture with commination with the oral cavity
D. Fracture with bleeding into the masticator space

342
150. Most common disorder causing pain about the masticatory
apparatus including the TMJ is:
A. Trigeminal neuralgia
B. MPDS
C. Degenerative arthritis
D. Traumatic arthritis

151. Among the following which extra oral radiograph best

demonstrates the subcondylar fracture?
A. Towne's projection
B. AP Mandible
C. Submento vertex
D. Occipitomental

152. The mini-bone plate system is a:

A. Gompressive bone plating system
B. Monocortical system
C. Bicortical system
D. None of the above

343
153. The best and most effective position (in mandible) of miniplate as
proved by various experimental studies is:
A. Lower border of mandible
B. Buccoalveolar region
C. Linguoalveolar region
D. Ata height midway between superior alveolar region and lower
border of mandible

154. The minimum number of miniplates required in fractures anterior to

canine in mandible is:
A. No plate is required since anterior region develops less amount of
tension forces than in molar region
B. Only one plate as in molar region
C. Two plates
D. Three plates

155. Minimum number of screws required for fixation of miniplate are:

A. One screw on each side of fracture site
B. Two screws on each side of fracture site
C. Three screws on each side of fracture site
D. Two screws in smaller fragment and three screws in larger fragment

344
156. In a fracture of mandible at the angle-region the placement of
screws in proximal segment is in:
A. Sagittal plane
B. Horizontal plane
C. Such a close relation to teeth that injury to molar invariably occurs
D. No relation to teeth

157. To prevent injury to the apices of the teeth in mandible, the

placement of miniplate is:
A. At the lower border of mandible
B. At a distance; twice the height of the clinical crown below the
alveolar crest
C. Below the inferior alveolar canal
D. Not possible since alveolar bone bears the apices of the teeth

158. The spherical gliding principle is a feature of:

A. Miniplates
B. Luhr plating
C. ASIF plating
D. Lag screws

345
159. Epiphora results due to:
A. Blockage of lacrimal gland canaliculi
B. Blockage of nasolacrimal duct
C. Over activity of lacrimal glands
D. Evulsion of palpebral conjunctiva

160. The most common site of mandible, which shows non-union or

delayed union after IMF is:
A. Angle
B. Body
C. Symphysis
D. Ramus

161. Risdon wiring is indicated for:

A. Body fracture
B. Angle fracture
C. Symphysis fracture
D. Subcondylar fracture
162. Facial paresis following maxillofacial fractures is most common
in:
A. # of the condylar neck
B. # of the nasal bones
C. # of the zygomatico-maxillary complex
D. # of the mandibular symphysis
346
163. The most common complication of maxillofacial injuries requiring
immediate attention is:
A. Haemorrhage
B. Airway obstruction
C. Infection
D. Shock

164. The safest initial approach to opening the airway of a patient with
maxillofacial trauma and suspected neck injury is:
A. Head tilt-chin lift
B. Jaw thrust technique
C. Head lift-neck lift
D. Heimlich procedure

165. The Gillies approach is used to gain access to the following bone:
A. Nasal bone
B. Zygomatic bone
C. Maxilla
D. Temporal bone

347
166. Ecchymosis in the mastoid region seen after a fracture of the
petrous bone is known as:
A. Chovstek's sign
B. Battle's sign
C. Guerin's sign
D. Tinel's sign

167. Direct interdental wiring is also known as:

A. Risdon's wiring
B. Gilmer's wiring
C. Eyelet wiring
D. Col. Stout's wiring

168. The "2.7" in the 2.7 mm plating system denotes:

A. The bone plate thickness
B. The bone screw diameter
C. The diameter of the plate hole
D. The distance between the plates
169. The proximal segment of a horizontally unfavourable mandibular
angle fracture is displaced:
A. Inferiorly
B. Posteriorly and medially
C. Anteriorly and superiorly
D. Anteriorly and laterally
348
170. The outermost holes of an "eccentric dynamic compression plate"
are angled at:
A. 75 Degree
B. 85 Degree
C. 60 Degree
D. 55 Degree

171. CSF rhinorrhea following a Le Fort Ill frontal bone fracture is

because of:
A. # of the cribriform plate of the ethmoid
B. # of the posterior wall of the frontal sinus
C. # of the roof of sphenoid air sinus
D. All of the above

172. 'Panda facies' is commonly seen after:

A. Le Fort I fractures
B. Le Fort Il fractures
C. Zygomatic arch fractures
D. Orbital blow-out fractures

349
173. A subconjunctival haemorrhage remains bright red in colour for a
long time because of the:
A. Permeability of the conjunctiva to oxygen
B. Natural colour of blood
C. Lack of drainage of the pooled blood
D. None of the above

174. The following structures are divided when the angle of the
mandible is exposed through a submandibular incision:
A. Skin and superficial fascia only
B. Skin, superficial fascia, platysma, deep cervical fascia and medial
pterygoid muscle
C. Skin, superficial fascia, deep cervical fascia and masseter muscle
D. Skin, superficial fascia, platysma, deep cervical fascia and masseter
muscle

175. The most common pathognomonic sign of a mandibular fracture is:

A. Malocclusion
B. Trismus
C. Deviation of the jaw on opening
D. Paraesthesia of the mental nerve

350
176. A protein supplement is provided for a 70 kg adult patient who has
been treated with intermaxillary fixation following a non-displaced
mandibular angle fracture. The amount of protein that he requires per
day is:
A. 100 mg/kg/ day
B. 100 gm/kg/day
C. 1000 mg/kg/ day
D. 500 mg/kg/ day

177. Clinical union of fractures occurring in the region of the middle

third of the facial skeleton takes place, on an average within:
A. 3 to 4 weeks
B. 4 to 6 weeks
C. 6 to 8 weeks
D. 2 to 4 weeks

178. Reduction of a fractured malar bone is best carried out after:

A. Teri-orbital oedema has subsided
B. Three to five days after injury
C. Chemosis has subsided
D. All of the above

351
179. A Class Ill fracture of the tooth is:
A. A fracture of only the enamel portion of the crown of the tooth
B. An injury extending into the dentin but with no pulpal exposure
C. An extensive injury to the coronal portion of the tooth with pulp
exposure
D. A fracture occurring at or below the cement-enamel junction of the
tooth

180. Elastic traction used commonly to reduce facial fractures, does so

by overcoming:
A. The active muscular pull that distracts the figments
B. The organized connective tissue at the fracture site
C. The malposition caused by the direction and force of trauma
D. All of the above

181. The gap created between the base of the skull and the ramus of the
mandible during a TMJ arthroplasty to prevent reankylosis should be at
least:
A. 05. To 1.0 cm
B. 1.0 to 1.5 cm
C. 1.5 to 2.5 cm
D. 2.5 to 3.5 cm

352
182. Gunshot fractures of the facial bones should not be treated via open
reduction because:
A. Infection will definitely occur
B. Closure of the wound due to soft tissue loss is difficult
C. The numerous small fragments will lose their vitality when the
periosteum is reflected
D. All of the above

183. While doing circumferential wiring around a mandibular gunning

splint, care must be taken not to damage the:
A. Mandibular branch of the facial nerve
B. Facial artery as it crosses the antero-inferior of the masseter
C. The lingual nerve
D. The submandibular gland and its duct

353
Chapter 10: Reconstructive And Orthognathic
Surgery
1. A transplant of bone from one human to another's is termed:
A. Autogenous
B. Homologous
C. Heterogenous
D. Alloplastic

2. Which of the following surgical procedures are commonly used for

treatment of maxillary retrognathia?
A. Le Fort I osteotomy
B. C-osteotomy
C. Inverted L osteotomy
D. Anterior maxillary osteotomy

3. Which of the following materials is best to restore a missing portion

of the mandible?
A. Silastic
B. Tantalum
C. Chrome cobalt
D. Autogenous bone

354
4. A patient with class Il div I malocclusion is operated for genioplasty
his anterior teeth after the operation would be:
A. In edge to edge bite
B. Without any change
C. Having normal overjet of 2 mm
D. Having no overbite

5. Jumping genioplasty is a term which connotes:

A. Movement of chin posteriorly
B. Double step genioplasty
C. Single step advancement
D. Advancement after set back of mandibular body

6. Sagittal split osteotomy is a procedure carried out for:

A. Mandibular deformities
B. Maxillary deformities
C. Deformities in which occlusion in not involved
D. Condylar repositioning
7. Sagittal split osteomy was first advocated by:
A. Obwegesser
B. Dai Pont
C. Wunderer
D. Moose

355
8. Apertognathia is a condition in which there is:
A. Retrogenia
B. Maxillary hypoplasia
C. Open bite deformity
D. Maxillary and mandibular prognathism only

9. During genioplasty there are chances of injuring:

A. Inferior alveolar nerve
B. Marginal mandibular nerve
C. Mental nerve
D. Lingual nerve

10. Wassmund and Wunderer procedures are:

A. Mandibular segmental osteotomies
B. Maxillary segmental osteotomies
C. Maxillary subapical osteotomies
D. Multiple subapical osteotomy procedure of maxilla and mandible
respectively
11. White graft are:
A. Nerve rejected
B. Are immunologically biocompatible
C. Are rejected without evidence of vascularization
D. Behave in same manner as autogenous grafts

356
12. The best bone graft which can be utilized for reconstruction of large
mandibular defect is:
A. Chostochondral graft
B. Calvarial graft
C. Iliac crest graft
D. Metatarsal bone graft

13. Iliac crest graft should ideally be taken from:

A. Lateral aspect
B. Medial aspect
C. Posterosuperior aspect
D. Anteroinferior aspect

14. A patient in whom iliac crest graft has been taken for mandibular
reconstruction, should be kept nil orally postoperatively:
A. For 6hr
B. Till bowel sounds appear
C. For 12 hours
D. Till patient is ambulatory

357
15. The graft of choice in a 30-year-old patient of ameloblastic resection
would be:
A. Free iliac crest graft
B. Free vascularized iliac crest graft
C. Medullary bone graft
D. 6th rib

16. Alveoplasty should be carried out:

A. When multiple extractions are done in one quadrant
B. When entire arch extraction is there
C. To remove undercuts
D. All of the above

17. The Kazanjian's technique of vestibuloplasty leaves:

A. Lip surface to re-epithelialize
B. Alveolar surface to re-epithelialize
C. Depth of sulcus periosteum to re-epithelialize
D. None of the above

358
18. The Lipwitch procedure is used for:
A. Ridge augmentation
B. Sulcoplasty
C. Tuberoplasty
D. Chiroplasty

19. When there is high crestal attachment of muscle and tissue the
indicated method of vestibuloplasty is:
A. Kazanjian's
B. Clark's
C. Obwegesser's
D. Howe's lipwitch

20. In a patient with class Ill facial profile one would think of which type
of genioplasty:
A. Reduction G
B. Advancement G
C. Straightening G
D. Rotational G

359
21. A patient reported with class Ill skeletal deformity the ideal choice
would be:
A. Inverted L osteotomy
B. Segmental osteotomy
C. Reverse sagittal split osteotomy
D. Sagittal split osteotomy

22. The basic advantage of sagittal split osteotomy is/are:

A. It is carried out intra-orally as well as extra-orally
B. No bone grafting is required when defect is less than 8 mm
C. There are no chances of paresthesia
D. All of the above

23. In a patient in whom SNA is 820 and SNB is 960 indicates he would
require:
A. Maxillary surgery with setback
B. Mandibular surgery
C. Mandibular advancement
D. Maxillary advancement
24. Allografts are grafts taken from:
A. Same species and individuals are genetically related
B. Different species
C. Same species but individuals are genetically not related
D. Same species and between genetically identical individuals
360
25. Composite grafts consist of:
A. Bone only
B. Medullary bone only
C. Bone and soft tissue
D. Particulate bone mixed with resins

26. Intercortical alveoloplasty is done by:

A. Removing margins of cortical plates
B. Removing interseptal bone entirely and collapsing labial and palatal
cortical plates
C. Removing septa till upper third of socket compressing the cortical
plates
D. None of the above

27. The principle problem with tuberosity reduction is:

A. Poor access
B. Formation of OAF
C. Infection
D. Damage to posterior superior alveolar nerve
28. Incision for operation of tongue-tie should be placed:
A. Transversely on lingual frenum
B. Longitudinally along lingual frenum on both sides
C. On crest of frenum longitudinally
D. None of the above
361
29. Surgical treatment of bimaxillary protrusion consists of:
A. Le Fort I osteotomy with sagittal split osteotomy in the mandible
B. Subcondylar osteotomy with Le Fort Il osteotomy
C. Vertical ramus osteotomy only
D. Anterior maxillary osteotomy with anterior sub apical osteotomy of
the mandible

30. The ideal time for repair of a cleft lip is:

A. Immediate after birth
B. 3 weeks to 3 months
C. 3 months to 3 years
D. After puberty

31. The blind sub condylar osteotomy for the correction of mandibular
prognathism
A. May damage the internal maxillary artery and cause profuse
hemorrhage
B. May damage the branches of the facial nerve
C. May be used for cases requiring less than 7 mm correction
D. All of the above

362
32. The extraoral subcondylar ramus osteotomy is indicated for the
following, except:
A. Major setback of the mandible 10 mm)
B. Minor setback of the mandible (K 10 mm)
C. Vertical shortening of the mandibular ramus
D. Asymmetrical mandibular setback

33. The disadvantage of a full thickness graft is:

A. Pigmentary changes
B. Lack of depth for contour
C. Decreased survival chance
D. Marked tendency to contract

34. The scalpel blade that should be preferred for incision and drainage
of abscess is:
A. No. 15
B. No. 12
C. No. 11
D. No. 10

363
35. The following are the basic indications for anterior sub apical
mandibular surgery, except:
A. To correct a mandibular dentoalveolar protrusion
B. To alter the lower third facial height and increase chin projection
C. To level an excessive curve of Spee
D. To correct mandibular dental arch asymmetry

36. The medial bony cut given while performing a modified sagittal
ramus osteotomy extends:
A. 15 to 20 mm posteriorly from the anterior border of the ramus
B. 5 mm above the inferior alveolar neurovascular bundle
C. Through the entire length of the medical ramus up to the posterior
border
D. 5 mm below the sigmoid notch and 10 mm posterior to the anterior
border

37. A-50-year-oId male is undergoing radiotherapy for carcinoma left

mandibular body. He requires hemi-mandibulectomy and radical neck
dissection. The ideal time for the surgery would be:
A. Six months after radiotherapy
B. Immediately upon completion of radiotherapy
C. Four to six weeks after completion of radiotherapy
D. Any time during the course of radiotherapy

364
38. Among the following which is advantage of sagittal split osteotomy
over transoral vertical subcondylar osteotomy?
A. Greater mandibular movement is achieved
B. Because it is intraoral procedure. No external scar is produced
C. Alone may be used to correct a mandibular retrognathism and
prognathism.
D. Less chance of injuring the inferior dental canal

39. Goals of orthognathic surgery includes:

A. Improve periodontal stability and periodontal prognosis.
B. Shorten orthodontic treatment time and improve orthodontic results.
C. To correct jaw relationships prior to major restorative procedures
D. All of the above

40. Generally bone marrow for grafting the defects is obtained from:
A. The iliac crest
B. The mandible
C. Maxillary tuberosity
D. Rib
41. Among the following which are characters of an ideal graft?
A. It should withstands mechanical forces.
B. It should produce no immunological response
C. It should actively assist osteogenic process of the host
D. All of the above
365
42. Advantage of sharp dissection over blunt dissection is:
A. Less traumatic
B. Permits muscle splitting rather than muscle tearing
C. Less likely to severe important nerves
D. A and B

43. Which of the following can be treated with a sagittal osteotomy of

the mandible?
A. Mandibular retrognathism
B. Mandibular prognathism
C. Open bite
D. All of the above

44. Bone transplant from one human to another is termed:

A. Allogenous
B. Autogenous
C. Homologous
D. Heterogenous
45. Which of the following bone graft has the greatest osteogenic
potential?
A. Autogenous cortical graft
B. Autogenous cancellous graft
C. A freeze-dried bone graft
D. Xenograph
366
46. To get the best long term results, which of the following procedures
for augmentation genioplasty are recommended?
A. Injection of silastic gel
B. Onlay bone graft
C. Pedicled horizontal sliding osteotomy
D. Insertion of silastic rubber implant

367
Chapter 11: Medical Emergency
1. The surgical risk for a patient with organic heart disease depends upon
his:
A. Cardiac reserve
B. Blood pressure
C. Respiration
D. Pulse rate

2. When a localized clot forms intravascular at the site of operation or

injury, it is called:
A. Embolus
B. Thrombus
C. Coagulated hematoma
D. Platelet agglutination

3. A patient is wide-eyed, very nervous with an increased systolic

pressure (with widening of the pulse pressure), increased pulse rate, fine
skin and hair and loss of body weight. He is probably suffering from:
A. Diabetes
B. Hypothyroidism
C. Hyperthyroidism
D. Hyperpituitarism

368
4. Preoperative sedation with short-acting barbiturates
(Numbutal@, Seconal @) is valuable because it:
A. Prevents respiratory depression
B. Produces drowsiness and amnesia
C. Is easily administered and has no side effect
D. Is without hazard and is compatible with narcotics

5. A patient who is on a regimen of steroid therapy and has need for

extraction of chronically infected teeth requires premedication with:
A. Atropine to reduce the hazard of vagal stimulation and cardiac arrest
B. Antihypertensive to combat tendency toward shock
C. Antihistamines to prevent allergic reactions
D. Antibiotics

6. Differential white blood cell counts in the laboratory are useful in the
diagnosis of:
A. Anemia
B. Eosinophilia
C. Spherocytosis
D. Vitamin deficiency

369
7. Postoperatively, a patient may develop serum sickness as a reaction to
a non-protein drug or to a bio- logic product. The reaction occurs after a
sensitization period of:
A. 1 day
B. 3 days
C. 4 days
D. 1-3 weeks

8. Complete respiratory obstruction is first manifested

A. Prolonged expiration
B. No movement by the patient
C. Information given by the patient
D. Pronounced retraction of the intercostal and supraclavicular spaces

9. The immediate postoperative complication following aspiration of

liquid vomitus into trachea and bronchi is:
A. Pleurisy
B. Bronchitis
C. Atelectasis
D. Lung abscess

370
10. In administering artificial ventilation, it is recommended that the
rescuer deliver a resting tidal vol.
A. Normal
B. Twice the normal
C. Three times the normal
D. Four times the normal

11. A patient who is currently taking Coumadin may recently have had:
A. Thrombophlebitis
B. A pulmonary embolism
C. Acute myocardial infarction
D. Any of the above

12. Patients suffering from uncontrolled juvenile onset diabetes mellitus

are usually poor candidates for oral surgery because of:
A. The high incidence of wound infection and poor healing
B. Their inability to follow postoperative instruction
C. Their tendency to hemorrhage profusely
D. Abnormal protein metabolism

371
13. Which of the following always indicated obstruction to the airway?
A. Slow pounding pulse
B. Stertorous breathing
C. Increase in pulse rate
D. Decrease in blood pressure

14. Which of the following procedures is correct for treating an

unconscious patient with no pulse and dilated pupils?
A. Start closed chest massage at once
B. Start artificial ventilation at once
C. Start closed chest massage in conjunction with artificial ventilation
D. Start closed chest massage if the pupils do not constrict with light

15. Hemostasis depends upon each of the following except:

B. Prothrombin
A. Vessel wall
C. Blood platelets
D. Albumin
16. The earliest sign of hemorrhagic shock is
A. Dyspnea
B. Hypotension
C. Tachycardia
D. Vasoconstriction

372
17. In shock, vasopressor drugs are preferably given:
A. Sublingually
B. Intravenously
C. Intracardially
D. Subcutaneously

18. The prothrombin time that would cause the practitioner the greatest
concern before a surgical extraction is:
A. 20 percent of normal
B. 40 percent of normal
C. 50 percent of normal
D. 80 percent of normal

19. Two minutes following cessation of a two-hour treatment session

using 80 percent nitrous oxide, 20 percent oxygen and local anesthesia,
the patient becomes cyanotic and tachycardia:
A. Over-oxygenation
B. Under-oxygenation
C. Diffusion hypoxia
D. Malignant hyperthermia

373
20. In order to carry cardiac compression effectively, the sternum should
be depressed:
A. 2 inches every second
B. 5 inches every second
C. 2 inches every 5 second
D. 1 inch every 10 second

21. Which of the following drugs used for premedication produce a

detached serenity without clouding consciousness?
A. Ataractics
C. Analeptics
B. Antiemetics
D. Anesthetics

22. Which of the following laboratory studies would be expected to be

abnormal in a patient with hemophilia
A. Partial thromboplastin time
B. Prothrombin time
C. Platelet count
D. Bleeding time

374
23. Narcotics are used primarily:
A. To control anxiety
B. To counteract depression
C. For the treatment of pain
D. For their ataractic effect

24. A patient with a history of ankle edema, shortness of breath and

orthopnea is probably suffering from:
A. Asthma
B. Emphysema
C. Rhinophyma
D. Cardiac decompensation

25. Ultra short-acting barbiturates produce loss of consciousness by

depression of the:
A. Thalamus
B. Spinal cord
C. Limbic system
D. Ascending portion of the reticular activating system

375
26. Use of which of the following antibiotics is most restricted because
of its side effects?
A. Penicillin
B. Tetracycline
C. Cephalexin
D. Chloramphenicol

27. Abnormal coagulation time will occur in a patient with which of the
following conditions?
A. Hemangioma
B. Hemophilia
C. Thalassemia
D. Pernicious anemia

28. When vasoconstrictors produce constriction of afterioles, the site of

action is at which receptor?
A. Alpha
B. Beta
C. Gamma
D. Delta

376
29. External cold application to achieve hemostasis causes:
A. A transient/ vasoconstriction
B. Increased chemotaxis
C. Active component which assist in hemostasis
D. B and C

30. Hepatitis that commonly occur with multiple transfusion due to:
A. Hepatitis A
B. Hepatitis B
C. Non A: Non B
D. All of the above

31. Which of the following condition can be diagnosed by differential

white blood?
A. Anemia
B. Spherocytosis
C. Thrombocytopenic purpura
D. Eosinophilia
32. After intravenous administration of a short acting barbiturates which
tissue is saturated last as a result of re-distribution:
A. Liver
B. Brain
C. Muscle
D. Fat
377
33. After the injection of a test dose of IV sedation a patient complains
of immediate severe burning pain at the site of injection, radiating
distally in the involved arm. Simultaneously the colour of the arm
appears blackly with several blanched areas. The pulse is regular but
weak compared to the opposite side likely diagnosis is:
A. Injection into the radial nerve
B. Injection into biceps tendon
C. Injection into an artery
D. Impeding anaphylactic reaction

34. Which of the following is best treatment for hypoglycemia in an

unconscious diabetic patient?
A. Intravenous administration of 50% dextrose in water
B. Administration of oral carbohydrates
C. Sublingual injection of 50% dextrose
D. None of the above. No treatment is necessary

35. Which of the following may occur due to hyperventilation in an

anxious patient?
A. Acidosis
B. Elevated pC02 M
C. Carpopedal spasm
D. Cyanosis

378
36. Of the following which is treatment of sustained convulsive reaction
to a local anesthesia?
A. Oxygen and IV fluids
B. Diazepam and oxygen
C. Phenytoin
D. Slow acting barbiturates and oxygen

37. Of the following which nerve is affected in Saturday night palsy?

A. Ulnar
B. Lingual
C. Radial
D. Median cephalic

38. A patient came to the emergency ward who needs immediate

transfusion of blood. There is no time for blood grouping and cross
matching which of the following group of blood can be transfused?
A. Rh positive
B. ABRh positive
C. Rh negative
D. ABRh negative

379
39. Risus sardonicus is a sign of:
A. Rabies
B. Tetanus
C. Poliomyelitis
D. Diphtheria

40. All of the following tissues contain alkaline phosphates except:

A. Bone
B. Muscle
C. Prostate
D. Kidney

41. Which of the following indicates a localized clot formation

intravenously at the site of injury?
A. Thrombus
B. Platelet agglutination
C. Embolus
D. Organized hematoma
42. In artificial ventilation it is commonly recommended that the rescuer
deliver a resting tidal volume that is:
A. Four times the normal
B. Three times the normal
C. Twice the normal
D. Normal
380
43. In an elective tracheostomy the entry should be made:
A. Above the cricoid
B. Below the cricoid
C. Through the cricothyroid membrane
D. Laterally below the thyroid cartilage

44. Patients who are suffering with uncontrolled juvenile onset diabetes
mellitus are usually poor candidates for surgical procedure because of:
A. Their inability to follow postoperative instructions
B. The high incidence of wound infection and poor healing
C. Their tendency to bleed profusely
D. Their oral hygiene

45. All of the following play a role in hemostasis except:

A. Vessel wall
B. Blood platelets
C. Albumin
D. Prothrombin
46. Universal distress signal, characterizing the obstructed airway in a
conscious adult is:
A. Rapid heavy breathing
B. Victims’s hand at his throat
C. Violent choking
D. Violent thrashing of the victim's arm
381
47. Hemophilia-A is:
A. X-Linked recessive
B. X-Linked dominant
C. Autosomal recessive
D. Autosomal dominant

48. Normal factor VIII levels in the blood is:

A. 5.0-6.5 1.u/ml
B. 3.0-4.5 1.u/ml
C. 1.5-2.5 1.u/ml
D. 0.5-1.5 1.u/ml

49. Epsilon amino caproic acid (EACA) is one of the agent useful in the
treatment of hemophilia. A mechanism of action of EACA is:
A. It is rich in factor V fll, which is deficient in hemophilia
B. Antifibrinolytic activity
C. It accelerates the coagulationprocess which is usually delayed in
hemophilia
D. By unknown mechanism
50. Because of many side effects of (EACA) it is largely replaced by:
A. Desmopressin
B. AC A (Amino caproic acid)
C. Tranexamic acid
D. Cryoprecipitate
382
51. All of the following conditions characterized by neutrophil
leukocytosis (increased neutrophils) except:
A. Neonatal period
B. Corticosteroid therapy
C. Typhoid
D. Periapical abscess

52. Of the following which condition is characterized by decreased

eosinophil’s?
A. Aplastic anemia
B. Periarteritis nodosa
C. Amoebiasis
D. Psoriasis

53. Which is factor IV?

A. Thromboplastin
B. Calcium
C. Christmas factor
D. Fibrinogin

383
54. of the following which is present in both intrinsic and extrinsic
pathway?
A. Factor Vlll
B. Factor Xll
C. Factor V
D. None of above

55. of the following which is screening test for scurvy?

A. Tourniquet test
B. Immunoassay for total body Vitamin C
C. Melkerson – Rosenthal test
D. None of the above

56. Prolonged prothrombin time is seen in all of the following except:

A. Factor VII deficiency
B. In patient with coumarin therapy
C. Factor V deficiency
D. Factor XI deficiency
57. Serum Alkaline phosphatase increase in all of the following
conditions except:
A. Scurvy
B. Hyperparathyroidism
C. Paget's disease
D. None of the above
384
58. Of the following what would be the WBC range in mild infections:
A. 4000 - 8000 cells/mm3
B. 24,000 - 30,000 cells/mm3
C. 15,000 – 20,000 cells/mm3
D. None of the above

59. Of the following which is earliest sign of hemorrhagic shock?

A. Vasoconstriction
B. Hypotension
C. Tachycardia
D. Dyspnoea

60. Near accurate body temperature can be obtained if one measures:

A. Orally
B. Axillary
C. Rectally
D. Temperature over forehead

61. Of the following which indicates early oxygen want?

A. Cyanosis
B. Increased pulse rate
C. Bradycardia
D. A and B

385
62. Among the following where is tetanus likely to occur?
A. Avulsive wounds
B. Perforating wounds
C. Deep puncture wounds
D. Contaminated laceration

63. Cold packs commonly used:

A. To produce local vasodilation
B. Immediately after surgery
C. To increase permeability
D. To prevent the spread of infection

64. Which of the following is a constant finding in systemic infection:

A. Fever
B. Swelling
C. Bacteremia
D. Lymphadenopathy
65. Immediate post-surgical swelling can be best reduced by:
A. Gentle manipulation of soft and hard tissue and early application of
cold packs
B. Judicious administration of antihistamines
C. Judicious administration of non-steroidal anti-inflammatories
D. None of the above

386
66. Surgical risk for a cardiac patient depends upon his:
A. Blood pressure
B. Respiration
C. Pulse rate
D. Cardiac reserve

67. Hemorrhagic shock is characterized by:

A. Hypotension
B. Low blood volume
C. Increased pulse rate
D. All of the above

68. Of the following which is most useful in evaluating a patient for an

abnormal bleeding tendency?
A. History
B. Bleeding time
C. Prothrombin time
D. Rumple-Leede test

387
69. Treatment: Syrup Brufen 2 teaspoon TID for 2 days.
What is the volume of teaspoon and what is the meaning of TID?
A. 5 ml and twice in a day
B. 5 ml and thrice in a day
C. 15 ml and thrice in a day
D. 15 ml and twice in a day

70. Which of the following is first manifestation of complete respiratory

obstruction?
A. Pronounced retraction of intercostal and supraclavicular spaces
B. Prolonged expiration
C. Cyanosis
D. None of the above. No changes in the patient

71. On examination it is noted that a patient requires 5 to 6 seconds to

rapidly and completely exhale after a deep inspiration. He may be
suffering with:
A. Upper air way disease
B. Advanced pulmonary disease
C. Severe cardiovascular disease
D. Normal exhalation time

388
72. Which of the following may result in interruptions in cardiac
compressions?
A. Little changes in blood flow and blood pressure
B. A reduction of the blood flow and blood pressure to zero
C. Carbon dioxide buildup in the lungs
D. None of the above

73. Which of the following is true of cardiopulmonary resuscitation?

A. Compression to ventilation ratio in two person CPR is 5:1
B. Compression to ventilation ratio in single person CPR is 15:2
C. Compression should be 60-80/minute in adults
D. All of the above

74. In a patient presenting for dental surgery with the history of chest
pain upon exertion, which is relieved by rest and nitroglycerin, one
would suspect:
A. Pneumothorax
B. Fractured rib
C. Myocardial infarction
D. Angina pectoris

389
75. A patient on dicumerol therapy should have which of the following
prior to dental surgery?
A. Vitamin K
B. A sedative
C. Prothrombin time test
D. An antibiotic

76. In Pierre-Robin syndrome, a complete upper airway obstruction may

occur when the infant is in a supine position or during feeding. Due to
the nature of this obstruction, it may be handle by putting the patient into
a prone position. If this fails, the next procedure should be:
A. Intubation
B. Nasal airway
C. Tracheostomy
D. Displacing mandible forward

77. A patient in shock should:

A. Be placed in Trendelenburg's position
B. Be placed in reverse Trendelenburg's position
C. Have his legs elevated 20 degrees with trunk and head remaining
level
D. Have his arms elevated 20 degrees with trunk and head remaining
level

390
78. In Pierre-Robin syndrome, a complete upper airway obstruction may
also occur when the patient is in a prone position. This may be handled
by:
A. Intubating the patient
B. Performing a tracheotomy
C. Displacing the mandible forward
D. Inserting a nasal catheter with oxygen under pressure

79. Before any oral surgical procedure is carried out, prophylactic

antibiotic cover is indicated for patients with the following conditions,
except:
A. Rheumatic heart disease
B. Chronic renal failure
C. Prosthetic heart valve
D. Coronary artery bypass

80. A patient requiring tooth extraction is taking anti-coagulant drugs for

the past six months. His prothrombin time is 21 seconds and the control
is 15 seconds.
The treatment under these circumstances should include:
A. Preoperative administration of vitamin K
B. Postoperative administration of vitamin K
C. Discontinuation of the anticoagulant drugs for one week prior to the
extraction
D. Extraction of the tooth with proper local care to control bleeding

391
81. When two rescuers are performing cardiopulmonary resuscitation on
an adult, how many compressions are to be given per minute?
A. 20
B. 40
C. 60
D. 80

82. Inhaled aromatic spirits of ammonia act against syncope by:

A. Direct stimulation of the respiratory center
B. Direct stimulation of the vasomotor center
C. Irritating the sensory endings of the olfactory nerves
D. All of the above

83. The minimal acceptable value for a hematocrit for elective oral
surgery is:
A. 20
B. 30
C. 40
D. 50

392
84. For the ligation and exposure of the external carotid artery in the
carotid triangle, the incision is made from:
A. The angle of the mandible to the cricoid cartilage
B. The tip of the mastoid process to one inch below the mandibular
angle
C. The angle of the mandible to the hyoid bone
D. The level of the hyoid bone to the cricothyroid cartilage

85. Intraoperative venous haemorrhage can be controlled by the

following methods except:
A. Electrocoagulation
B. Ligation with haemostats
C. Bone wax temponade
D. Pressure packing with gauze

86. In order to carry out cardiac compression effectively, the sternum

should be depressed:
A. 1 inch every second
B. 1.5 to 2 inches per second
C. 2 inches per five seconds
D. 1 inch every ten seconds

393
87. A pregnant woman in her third trimester loses consciousness on the
dental chair, she should immediately be:
A. Placed in the Trendelenburg's position
B. Lowered in the horizontal position and turned toward her right side
C. Placed in the supine position with the feet elevated slightly
D. Lowered in the supine position and turned toward her left side

88. The importance of chronic alcoholism prior to oral

A. Predispoistion to syncope
B. Relative contraindication to local anaesthesia
C. Prolonged bleeding secondary to liver dysfunction
D. Contraindication for use of NSAIDs

89. An odour of acetone in one's breath should direct suspicion to:

A. Heart disease
B. Liver damage
C. Diabetes mellitus
D. Kidney disease

394
90. Extraction of four teeth is required in a 65-year-old diabetic female
who has had her morning insulin, pre- operative instruction should
include:
A. Do not eat or take any medication by mouth prior to surgery
B. Increase sugar intake prior to surgery
C. Maintain normal diet
D. Increased premedication

91. A patient on recent prolonged steroid therapy may have:

A. Relative adrenal insufficiency
B. Intolerance to sedatives
C. Prolonged post extraction haemorrhage
D. Relative analgesic potential

92. Normal bleeding time by Duke's method:

A. 1 to 5 min
B. 3 to 5 min
C. 3 to 8 min
D. 10 to 30 sec
93. Treatment required for post-operative cutaneous ecchymosis is:
A. Aspiration of blood
B. Use of topical steroids
C. Application of cold
D. None
395
94. The rate of infusion of intravenous diazepam is:
A. 3 ml/ min
B. 1 mg/ min
C. 1 ml/ min
D. 3 mg/ min

95. The following elements interfere with the activity of tetracycline:

A. Ca and Bi
B. Na and K
C. Mg and Na
D. Mg and Ca

96. Class of drugs are currently, the best oral sedative drugs for
dentistry:
A. Narcotics
B. Barbiturates
C. Benzodiazepenes
D. Ethanols
97. Among the following which is contraindicated in patients taking
sodium warfarin therapy?
A. Acetaminophen
B. Diphenhydramine
C. Ibuprofen
D. Codeine
396
98. Intravenous diazepam administration sometimes causes phlebitis.
This usually attributed to the presence of:
A. Ethyl alcohol
B. Benzoic acid
C. Propyleneglycol
D. Methyl paraben

99. Which of the following are symptoms of digitalis toxicity:

A. Resting pulse less than 60 beats/mm
B. Arrhythmias and mental disturbances
C. Nauseas
D. All of the above

100. Which drug is contraindicated in patients taking so-

A. Aspirin
B. Morphine
C. Benadryl
D. Pentobarbital
101. But mainly in the liver, procaine reduces the effectiveness of the
following drug group:
A. Sulfonamides
B. Penicillin
C. Aminoglycosides
D. Cephalosporin
397
102. One of your patient stated that he is narcotic addict. After the
extraction which of the following analgesics are contraindicated?
A. Aspirin
B. Pentazocin
C. Acetaminophen
D. None of the above

103. Prophylaxis for tetanus in a previously immunized person involves

the use of tetanus toxoid as a booster in which manner?
A. 5 ml subcutaneously
B. 5 ml orally
C. 1 ml intramuscularly
D. 3 ml intravenously

104. A RHD patient requires preoperative prophylaxis with penicillin.

An appropriate regimen is:
A. 2 gm penicillin V 1 hour before surgery
B. 600,000 unit procaine penicillin 1M 12 hourly day before surgery
C. 250 mg phenoxymethyl penicillin 6 hrs day before surgery
D. All of the above are correct

398
105. Glucocorticoids:
A. Decreases inflammation
B. Decreases pain threshold
C. Increases the rate of wound healing
D. Enhances the repair

106. Among the following which analgesic is contraindicated in patients

with G6PD deficiency?
A. Aspirin
B. Paracetemol
C. Opioid analgesic
D. None of the above

107. How many postoperative days one should continue antibiotic

coverage for sub-acute bacterial endocarditis?
A. One
B. Two
C. Three
D. Four
108. Among the following which is "Broad spectrum" antibiotic:
A. Sulphanamides
B. Penicillin
C. Tetracycline
D. None of the above
399
109. Mechanism of action of penicillin is due to:
A. Damage to the cytoplasmic membrane
B. Interference with cell wall synthesis
C. Antimetabolite action
D. None of the above

110. Which of the following antibiotic mainly effective against gram-

negative bacteria:
A. Lincomycin
B. Vancomycin
C. Kanamycin
D. Clindamycin

111. Among the following which drug is commonly administered to a

patient with an allergic reaction who is demonstrating urticaria and
wheezing?
A. Steroid
B. Atropine
C. Dexamethasone sodium
D. Adrenalin

400
112. The following drugs can be used for conscious sedation:
A. Diazepam
B. Phenobarbital
C. Chloral hydrate
D. All of the above

113. Among the following which drug is least rapidly acting in treatment
of anaphylaxis?
A. Adrenaline
B. Hydrocortisone
C. Diphenhydramine
D. Aminophyline

114. Among the following which is correct regarding oral route of drug
administration?
A. Its effect is most predictable
B. Quickest way to administer drug
C. It is usually a pleasant route
D. A and C

401
115. Of the following which group of drugs commonly cause respiratory
depression?
A. Antihistamines
B. Tranquilizers
C. Synthetic narcotics
D. Non barbiturate sedative hypnotics

116. In which of the following conditions corticosteroid administration

is contraindicated?
A. Peptic ulcer
B. Psychosis
C. Tuberculosis
D. All of the above conditions

117. Administration of short acting barbiturates for preoperative

sedation is valuable because it:
A. Is easily administered and has no side effect
B. Produces drowsiness and amnesia
C. Prevents respiratory depression
D. Is compatible with narcotics and has no hazards

402
118. Of the following which is effective agent for the treatment of
respiratory depression which is the result of over dosage of barbiturates?
A. Caffeine
B. Oxygen
C. Metronidazole
D. None of the above

119. Al of the following are important in the management of a patient

depressed from known over dose of morphine except:
A. Assistance of ventilation
B. Provision of a patent airway
C. Narcotic antagonist
D. Tranquilizer

120. Which of the following is the drug of choice for treatment of an

infection which is caused by a gram-positive, non-penicillin’s
staphylococci organism?
A. Clindamycin
B. Erythromycin
C. Penicillin G
D. Cephalosporin

403
121. Usual adult dosage of oral codeine is:
A. 0.5 - 1.0 grains
B. 0.5- 1.0 grains
C. 1.0-2.0 grains
D. 2.0 grains

122. Intra articular injections of steroids into painful joint such as

arthritic TMJ, have palliative effects from:
A. Providing an analgesic effect
B. Providing better lubricating effect
C. Providing an anti-inflammatory action
D. Increasing the blood supply

123. Penicillin is not effective against certain organisms because the

causative organism:
A. Produces an enzyme inhibiting the activity of the drug
B. Produces catalase
C. Is not a gram-negative organism
D. None of the above are correct. Penicillin works on almost all the
organisms

404
124. Which of the following drug administration produces the most
rapid relief of the symptoms of angina pectoris?
A. Pentobarbital
B. Amyl nitrate
C. Oxygen
D. Phenobarbital

125. History of bruising easily, nocturia, excessive thirst and low

resistance to infections indicate the patient is most likely suffering from:
A. Diabetes mellitus
B. Glomerulonephritis
C. Lupus erythematous
D. Thrombocytopenic purpura

126. Spider telangiectatic spots on the skin of a patient are noted. He

should have an examination to determine the condition of his:
A. Kidneys
B. Liver
C. Lungs
D. Gallbladder

405
127. A 13-year-old girl has a history of severe sore throat, migratory
type of joint pains and swollen joints of the extremities. This history is
suggestive of:
A. Gout
B. Serum sickness
C. Rheumatic fever
D. Osteoarthritis

128. Laboratory data of patient indicates white blood cell count more
than most likely the patient is suffering from:
A. Leukopenia
B. Polycythemia
C. Leukemia
D. Anemia

129. Clinical hemophilia is characterized by (BT - bleeding time, CT -

clotting time, PT- Prothrombin time, PTT- Partial thromboplastin time:
A. Prolonged PT and normal BT
B. Prolonged BT, PT and PTT
C. Normal BT and PT and prolonged PTT
D. Prolonged BT and normal CT; PT and PTT

406
130. Severe liver disease may cause the following:
A. Decreased quality of circulating platelets
B. Decreased prothrombin production
C. Increased drug detoxification and decreased drug effects
D. None of the above

131. Characteristic featured of hypovolemic shock include:

A. Hypotension
B. Low pulse pressure
C. Tachycardia
D. All of the above

132. "Vital signs" include which of the following?

A. TPR (temperature, pulse, respiration)
B. BP (blood pressure)
C. All of the above
D. None of the above
133. Among the following in which condition one might see
Hutchinson's incisors?
A. Acquired syphilis
B. Congenital syphilis
C. Secondary syphilis
D. Tertiary syphilis

407
134. Among the following which is absent in an asthmatic patient?
A. Hyperactive bronchi
B. Inspiratory wheezes
C. Bronchi that rapidly and spontaneously change caliber in response to
various stimuli
D. History suggestive of allergy

135. Oral examination reveals unilateral lesions along the distribution of

nerve, localized hyperemic and vesicle formation vesicles filled with
yellow fluid and when it ruptures, it leaves an eroded area surrounded by
a red areola. The lesion most likely is:
A. Lichen planus
B. Herpes zoster
C. Pemphigus
D. Fordyce diseases

136. Acetone odour in one's breath usually indicate the person is

suffering with:
A. Heart disease
B. Diabetes mellitus
C. Kidney disease
D. Liver damage

408
137. A patient came to oral surgery department who has bleeding from
the gums, acute gingival hyper trophy, along with complaining of
weakness and anorexia. His blood picture showing the:
HBO/0 14 gm, RBC count: 4.5 million/mm3, WBC 1, 10,000, DC
Neutrophils-88% Lymphocyte - 10%, Monocytes - 0%, Eosinophil’s -
2%
Likely diagnosis of the above findings
A. Infectious mononucleosis
B. purpura
C. Myelogenous leukemia
D. Marked gingivitis due to local cause

138. Which of the following preoperative hematological analysis may

reflect von Willebrand disease?
A. Bleeding time
B. Factor X level assay
C. Platelet count
D. Factor IX level assay

139. Among the following which is absolute contraindication to the teeth

extraction?
A. Heart murmur
B. Patient on anticoagulant therapy
C. Patient taking steroids
D. None of the above

409
140. One patient states he has recently become excessively thirsty
(polydipsia), hungry (polyphagia) and arises at night several times to
urinate (polyuria). The most probable diagnosis -is:
A. Acute dehydration
B. Congestive heart failure
C. Diabetes mellitus
D. Renal failure

141. Among the following in which condition eosinophilia is not seen?

A. Parasitic infection
B. Allergy
C. Hodgkin's disease
D. Cushing's syndrome

142. Among the following which physical sign would deter you from
proceeding with multiple extraction and alveoloplasties without further
evaluation?
A. Hepatomegaly
B. Seleral icterus
C. Ascites
D. All of the above

410
143. If one consider BT (bleeding time), PT (prothrombin time) PTT
(partial thromboplastin time) which of the following represent vascular
hemophilia?
A. Normal BT PTT and prolonged BT
B. Prolonged BT, PT and PTT
C. Prolonged PT, moderately prolonged PTT and normal
D. Prolonged BT, moderately prolonged PTT and normal

144. Macroglossia seen in all of the following conditions except:

A. Cretinism
B. Von Reck Linghausen's disease
C. Scurvy
D. None of the above

145. Patient history reveals dyspnea, orthopnoea, edema of the ankle and
palpitation most likely diagnosis is:
A. Respiratory problem
B. Hepatic failure
C. Uremia
D. Congestive heart failure

411
146. An anxious, nervous patient states that he has had recent weight
loss and is easily fatigued. Tremors, tachycardia and tremors, sweaty
palms are noted in physical examination most likely diagnosis is:
A. Renal disease
B. Hyperthyroidism
C. Diabetes
D. Cushing's disease

147. Of the following which represent complete respiratory obstruction?

A. Prolonged expiration
B. No movement by the patient
C. Pronounced retraction of the intercostal and supraclavicular spaces
D. Cyanosis

148. Of the following which is a feature of acromegaly?

A. Micrognathia
B. Hypoglycemia
C. Crowded teeth
D. Large tongue
149. In which of the following conditions one can see neck swelling?
A. Hodgkin's disease
B. Infectious mononucleosis
C. Tuberculosis
D. All of the above
412
150. Among the following which bone lesion is most fatal?
A. Paget's disease
B. Osteochondroma
C. Multiple myeloma
D. Odontogenic myxoma

151. Increased Bence-Jones proteinuria and multiple radiolucent areas in

the skull indicate which of the following conditions?
A. Hodgkin's lymphoma
B. Burkitt's lymphoma
C. Multiple myeloma
D. Adeno carcinoma

152. All of the following are signs of thyrotoxicosis except:

A. Slow pulse rate
B. Exophthalmos
C. Tremor
D. Temperature elevation
153. Cyanosis of the lip may suggest:
A. Carbon monoxide poisoning
B. Anemia
C. Congenital heart disease
D. All of the above

413
154. The asthmatic patient is characterized by:
A. Recurrent pulmonary infections
B. Multiple pulmonary emboli which may be life threatening
C. Hyperactive bronchi, that rapidly and spontaneously change calibre in
response to various stimuli
D. None of the above

155. An obese patient falls while jogging and is unconscious which of

the following should be considered to differentiate between cardiac
arrest and other causes:
A. Pulse (carotid (or) femoral)
B. Pupil constriction/ dilatation
C. Respirations present (or) absent
D. All of the above

156. Of the following which is possible sign of sub-acute bacterial

endocarditis?
A. Enlarged tongue
B. Discharge from the ear
C. Splinter hemorrhage
D. Intestinal obstruction

414
157. Which is the minimal acceptable value for a hematocrit for elective
surgery?
A. 30
B. 25
C. 15
D. 5

158. If one uses normal cuff of Sphygmomanometer on an adult obese

patient it will yield diastolic pressure readings that are:
A. Falsely high
B. Falsely low
C. Accurate but systolic pressure readings are falsely high
D. Accurate but systolic pressure readings are false

159. Among the following which is true regarding phlebitis:

A. High doses of antibiotics are necessary to accelerate resolution
B. Application of ice packs to the area during the first 2 days is indicated
C. Local application of heat and immobilisation for several days is
indicated
D. Abscess formation is quite common

415
160. The primary airway hazard for an unconscious patient in a supine
position is:
A. Tongue obstruction
B. Bronchospasm
C. Laryngospasm
D. Aspiration

161. The best blood product administered preoperatively to patients with

hemophilia A is:
A. Fresh frozen plasma
B. Factor IX concentrate
C. Whole blood
D. Factor V Ill concentrate

162. Cardinal symptom of dehydration due to disturbance of fluid and

electrolyte balance is:
A. Hypothermia
B. Nausea
C. Polydipsia
D. None of the above

416
163. Emotional stress affect the rate of absorption of oral medication.
Which of the following is correct?
A. It decreases the rate of absorption
B. It increases the rate of absorption
C. The above statement is wrong there is no effect on the rate of
absorption
D. It increases the rate of absorption of few drugs and decreases the rate
of absorption of few drugs

164. If efforts in cardiopulmonary resuscitation are effective there will

be
A. Constriction of pupils
B. Dilatation of pupils
C. Hypertension immediate
D. None of the above

165. Patient with idiopathic thrombocytopenic purpura (ITP) is most

likely to have which of the following post- operative complication?
A. Infection
B. Hemorrhage
C. Edema
D. Localized alveolar osteitis (dry socket)

417
166. Complete blood count does not include:
A. Haemoglobin
B. Haematocrit
C. Total WBC
D. ESR

167. All of the following are various methods to control intraoperative

hemorrhage except:
A. Gauze sponge pressure
B. Artery application to the open vessels
C. Infiltration with lidocaine
D. Bone compression for surface bleeders

168. Pin point haemorrhages on skin are called as:

A. Purpura
B. Hematoma
C. Petechiae
D. Ecchymosis
169. When one suspects tetanus organisms in a wounded patient. Anti-
tetanus prophylaxis given in the form of:
A. Tetanus antitoxin (if the patient is previously not immunized)
B. Penicillin (if there is no allergy)
C. Tetanus toxoid
D. All of the above
418
170. Al patients admitted to the hospital for surgery must
A. Give verbal permission
B. Sign an operative permit after receiving premedication
C. Sign an operative permit before the discharge
D. Sign an operative permit at the time or admission to the hospital

171. One suspected rheumatoid arthritis of the TMJ helpful positive

laboratory study would be:
A. Hematocrit elevation
B. GTT
C. Increased erythrocyte sedimentation rate
D. Tourniquet test or hess test

172. Which of the following is early sign of want of oxygen?

A. Tachycardia
B. Cyanosis
C. Sternal relaxation
D. Constricted pupils

419
173. Treatment of syncope is most effectively accomplished by which of
the following?
A. Administering 100% oxygen for five minutes
B. Lowering the chair to place the patient's head lower than his feet
C. Bending the patients head forward between his knees and asking the
patient to raise his head against hand pressure
D. It requires treatment by a physician

174. Which of the following causes postoperative infection:

A. Lack of asepsis
B. Failure to remove pathology
C. Inadequate debridement
D. Any of the above

175. Among the following, which is best hemostatic agent for control of
local hemorrhage?
A. Gel foam
B. Surgical
C. Bone wax
D. Vit. K

420
176. Among the following which causes the practitioner the greatest
concern?
A. 80% of normal PTT
B. 50% of normal PTT
C. 30% of normal PTT
D. 20% of normal PTT

177. During CPR sternum should be depressed:

A. Two inches every 5 seconds
B. 2 inches every second.
C. 1 inch every 10 seconds
D. 3 inches every 5 seconds

178. Which of the following agent should be administered to a patient

with moderate liver disease who has an abnormal prothrombin time and
bleeds excessively after surgery?
A. Packed red cells
B. Platelet accelerator
C. Vitamin K
D. Fresh whole blood

421
179. After administration of inferior alveolar nerve block to an addict,
the needle accidentally pricks the dentist's finger. Subsequently the
dentist developed malaise weakness, and elevated SCOT and SGPT.
Most probably he contacted which of the following disease?
A. Serum hepatitis
B. Infectious hepatitis
C. Infectious mononucleosis
D. Primary syphilis

180. Is common to all forms of shock:

A. Hypovolemia
B. Hypertension
C. Impaired tissue perfusion
D. Vasoconstriction

181. Which of the following may result due to the prolonged use of
phenytoin sodium?
A. Jaundice
B. Yellow pigmentation on teeth
C. Gingival hypertrophy.
D. It is a safe drug with absolutely no side effects

422
182. In patients on artificial ventilators the cycle of exhale air ventilation
should be repeated every:
A. 20 seconds
B. 10 seconds
C. 5 seconds
D. 1 second

183. The following factors influence the sedation dosage of intravenous

agents:
A. Weight of the patient
B. Age of the patient
C. Type of agent used
D. All of the above

184. Among the following which steps, followed in completing physical

examination?
A. Inspection
B. Palpation and percussion
C. Auscultation
D. All of the above

423
185. Which of the following antibiotics is commonly prescribed for
penicillin allergic patients?
A. Tetracycline
B. Erythromycin
C. Chloramphenicol
D. Cephalosporin

186. Which cardiac condition require antibiotic prophylaxis before

surgery?
A. Coronary insufficiency
B. Angina pectoris
C. Rheumatic carditis
D. Congestive heart diseases

187. Frequent site of occurrence for ameloblastomas:

A. Mandibular premolar area
B. Maxillary molar area
C. Antrum and floor of the nose
D. Molar and ramus area of the mandible
188. Among the following which is short acting barbiturate?
A. Pentobarbital
B. Phenobarbital
C. Valium
D. Codeine
424
189. Site of action of valium (Diazepam) is:
A. Cerebellum
B. Limbic systems
C. Cerebral cortex
D. Pyramidal system

190. Among the following which drug is contraindicated in hyperthyroid

patients, because the subjects are extra-ordinarily sensitive to the drug?
A. Salicylates
B. Barbiturates
C. Adrenaline
D. Digitalis

191. Among the following which frequently causes infective

endocarditis?
A. Staphylococcus aureus
B. Streptococcus viridans
C. Staphylococcus pyogens
D. None of the above

425
192. The emergency, most frequently encountered during outpatient
general anesthesia is:
A. Anaphylaxis
B. Bradycardia
C. Respiratory obstruction
D. Hypotension

193. A patient came to dental clinic who has a pulse rate of 72, a
respiratory rate of 15, a BP of 120\80, warm pink extremities and pupils
that constrict during near accommodation. What is the most likely
diagnosis?
A. Normal patient
B. Acute anxiety syndrome
C. Coronary artery disease
D. Myopia

194. An inhaled foreign body most probably enters:

A. Left bronchus
B. Right bronchus
C. Esophagus
D. None of the above

426
195. Among the following which is an advantage of IV administration of
a drug?
A. Minimal skill is necessary
B. Sedative drugs are compatible with IV solution
C. It eliminates side effects
D. It allows titration of the drug

196. Among the following which factor is strongest stimulators to

increase the respiration?
A. Decrease in venous oxygen
B. Increase in blood pH
C. Increase in arterial carbon dioxide
D. Decrease in arterial oxygen

197. During the treatment of shock jugular venous pressure (JVP) should
be maintained in the range of:
A. 15-20 mm Hg
B. 5-10 mm Hg
C. 10-15 mm Hg
D. 0.2-5 mm Hg

427
198. The average daily adult fluid intake should be:
A. Approx. 4000 ml
B. Approx. 1800 ml
C. Approx. 1200 ml
D. Approx. 500 ml

199. The following space infection may cause severe respiratory

difficulty and tracheostomy may require:
A. Pterygopalatine space
B. Canine space
C. Temporal space
D. Parapharyngeal space

200. Of the following which is most common site of metastasis from

mandible:
A. Heart
B. Liver
C. Lung
D. Pancreas
201. After prolonged steroid therapy patient may have:
A. Prolonged post extraction bleeding
B. Analgesic potentiation
C. Relative adrenaline insufficiency
D. Not tolerable to sedatives
428
202. Prophylactic antibiotic coverage for a patient with rheumatic heart
disease is required prior to:
A. Scaling and curettage
B. Extraction of maxillary first molar (Single tooth extraction)
C. Open reduction and internal fixation (ORIF)
D. All of the above required

203. The significance of chronic alcoholism prior to oral surgical

procedure is:
A. Prolonged haemorrhage secondary to liver disease
B. Intolerance to LA
C. Predisposition to syncope
D. Contraindication for N2O analgesics

204. Which of the following is significant in a patient with renal

transplant?
A. Hematocrit 37%
B. Cholesterol -200 mg%
C. WBC -2000
D. BUN -21%

429
205. At what diastolic pressure do you consider the patient to have
significant hypertension?
A. 110
B. 90
C. 85
D. 65

206. Most important single aspect of a patient's surgical experience is:

A. Family history
B. Past medical history
C. Complete blood count
D. Suture technique

207. The hematocrit serves as an index for:

A. Monocyte volume
B. Patient red blood cell volume
C. Patient total blood cell volume
D. Patient white blood cell volume
208. Among the following all are important measures to prevent
emergencies except:
A. Monitor the patient intraoperativelly
B. Assess your patient's medical status preoperatively
C. Weigh your patient
D. Keep emergency kit up to date
430
209. Treatment of choice for postoperative cutaneous ecchymosis is:
A. Aspiration of blood
B. Application of cold
C. Use of topical steroids
D. None

210. After the administration of penicillin patient reports itching in

various areas of the body. One should:
A. Ignore the itching
B. Discontinue all medication
C. Call an ambulance and meet patient in hospital
D. emergency room

211. Allergic reactions may be characterized by:

A. Bronchospasm
B. Cardiovascular collapse
C. Angioneurotic edema
D. All of the above
212. Continuation of antibiotic medication in gram negative soft tissue
infections is required:
A. At least 2 days after all clinical signs of infection subside
B. Until acute symptoms of infection subside
C. for a minimum of 7- 10 days
D. For a period of 21 days
431
213. Which of the following values should be taken if there is excessive
blood loss after a surgical procedure?
A. Hematocrit and platelet count
B. WBC and RBC count
C. Hemoglobin and Hematocrit
D. Platelet and RBC count

214. Among the following which patient will probably have bleeding
problems postoperatively?
A. Leukemic patient
B. Hypertensive patient
C. Thrombocytopenic patient
D. All of the above arc correct

215. If a normal patient losses approximately 1000 cc of blood during

surgery, the necessary colloid fluid replacement should be:
A. 1000 cc
B. 2000 cc
C. 3000 cc
D. 6000 cc

432
216. Blood transfusions may cause complications. Which of the
following are possible complications associated with blood transfusions?
A. Circulatory overload
B. Thrombophlebitis
C. Immediate and delayed hemolytic reactions
D. All of the above

433
Chapter 12: Implant
1. Osseo integrated implants have the following features:
A. They form junctional epithelium with the surrounding tissues
B. They are anchored directly to living bone as determined by radio
graphic and light microscopic analyses
C. They have direct structural and functional connection with bone only
at the radiographic level of detection
D. They form a pseudo-periodontal ligament

2. Osseo integration implies:

A. The process of inserting implants in bone
B. Integration of the bone and implant with fibrous tissue between them
C. At least some direct contact of living bone and the surface of the
implant at the light microscopic level of magnification
D. None of the above

3. An endo-steal implant is an implant inserted in:

A. Periosteum
B. Bone
C. Root canal
D. None of the above

434
4. Endosteal implant can be:
A. Root form implant only
B. Plate form implant only
C. Can be either root form or plate form
D. Combination of both

5. The transfer coping in an implant is used:

A. To position an analog in the impression
B. To transfer the position of the implant in the mouth to the cast
C. To gain exact implant positioning
D. All of the above

6. In case of endosseous implant:

A. A seal between implant surface and soft tissue is not required
B. A permucosal seal of the soft tissue at the implant surface is very
essential
C. Whether the seal is established or not it does not really make a
difference to the success
D. None of the above
7. A permucosal seal in case of a dental implant is:
A. Possible
B. Absolutely impossible as tissue will not stick to the implant surface
C. Not necessary at all
D. None of the above
435
8. Lack of Osseo integration can be due to:
A. Premature loading of the implant system
B. Placing the implant with too much pressure
C. Overheating the bone during preparation
D. All of the above

9. While inserting an implant a gap is observed between the implant and

the prepared site the implant will most probably:
A. Fail
B. Be a success
C. The gap does not affect the success of the implant
D. None of the above

10. the most common types of implant in use today are:

A. Subperiosteal implant
B. Transosteal implants
C. Endosteal implants
D. All of the above
11. Which of these is an indication for implant placement?
A. Inability to wear a removable or complete denture
B. Unfavorable number and location of natural tooth abutments
C. Single tooth loss which would necessitate preparation of undamaged
teeth for FPD
D. Any of the above
436
12. Ideal amount of bone under soft tissue is:
A. 8 mm vertical and 4 mm horizontal
B. 10 mm vertical and 6 mm horizontal
C. At least 12 mm vertical and 6 mm horizontal
D. Depends from patient to patient

13. The minimum space between implant should be:

A. 2 mm
B. 5 mm
C. 3 mm
D. 4 mm

14. This distance between the implant and the superior aspect of the
inferior alveolar canal should be:
A. 1 mm
B. 3 mm
C. 2 mm
D. 4 mm
15. The distance between the implant and the mental foramen should be:
A. 2 mm
B. 3 mm
C. 1 mm
D. 5 mm

437
16. What should the distance between the implant and the post ligament
of the adjacent teeth be?
A. 2 mm
B. 1 mm
C. 5 mm
D. 3 mm

17. Time taken for integration of implants in the maxilla

A. 4 months
B. 2 months
C. 6 months
D. 8 months

18. With respect to anatomic limitation the most straightforward area for
implant placement is:
A. Anterior mandible
B. Posterior mandible
C. Anterior maxilla
D. Posterior maxilla

438
19. A surgical guide template is used in implant dentistry for:
A. Delineate the embrasure
B. Locate the implant within the restoration contour
C. Align implants along the long axis of the completed restoration and
identify the level of the CEJ or tooth emergency profile
D. All of the above

20. The recommended time interval between surgery and placing load in
the posterior mandible is:
A. 2 months
B. 3 months
C. 4 months
D. 6 months

21. The recommended time interval between surgery and placing load in
the maxilla is:
A. 2 months
B. 3 months
C. 4 months
D. 6 months

439
22. Internal irrigation is used for implant surgery:
A. To clear the operative field
B. To cool the rotating bur so that the temperature in bone does not
increase
C. So that bone can absorb the water
D. None of the above

23. Whenever implants are placed in the posterior mandible they should:
A. Engage the superior cortical bone and medullary bone
B. Engage the superior cortical, medullary bone and inferior cortical
bone
C. Engage only the superior cortical bone
D. None of the above

24. Implants placed in the posterior maxilla should:

A. Leave 1 mm of bone between the floor of the sinus and the implant
B. Leave 2 mm of bone
C. Can go into the antrum if required as long as lining is not punctured
D. None of the above
25. Probing under local anesthesia is used:
A. To check if any sharp bony edge is there
B. To check for caries
C. To check the length of the implant
D. To judge soft tissue thickness at the planned implant site
440
26. The transfer coping in an implant is used:
A. To position an analog in the impression
B. To transfer the position of the implant in the mouth to the cast
C. To gain exact implant positioning
D. All of the above

27. The minimum safe distance between an endosteal implant and any
adjacent anatomical structure should be:
A. 2 mm
B. 2.5 mm
C. 3 mm
D. 1.5 mm

28. Advantage of root form implants over plate forms include:

A. Greater surface area
B. Fewer pontics
C. Greater bone density
D. All of the above
29. The decrease in bone width within the first one to three years after
tooth extraction is:
A. 25%
B. 30%
C. 35%
D. 40%
441
30. The following division provides bone in all dimensions for implant
placement:
A. Div. A
B. Div. B
C. Div. C
D. Div. D

31. Among the following which indicates successful allogeneic tooth

implant?
A. The tooth survives for 12 months
B. The periodontal ligament is re-established
C. Both the pulp and periodontal ligament survive
D. Ankylosis occur

32. Which of the following is true in regard to reconstruction of an

edentulous mandible with implants?
A. Subperiosteal implant requires only single surgery
B. Staple implant is most useful for the posterior mandible
C. Both blade and the osteointegrated cylinder are useful as posterior
abutments in patients with high mental foramen
D. Osteointegrated concept of implant. Stabilisationhas the best
documentation of long term success

442
33. Angle SNA in a cephalogram indicates:
A. Mandible - cranial bone relationship
B. Mandible - maxilla relationship
C. Maxilla - cranial bone relationship
D. Maxillary teeth to cranial bone

443
Chapter 13: Miscellaneous
1. Purpose of taping the eyes shut before surgery is to:
A. Prevent lacrimal secretions which may contaminate the field
B. Prevent corneal abrasion
C. Limit ocular motility
D. None of the above

2. Of the following which is correct? Thiersch graft is in:

A. Full thickness graft
B. Pedicle graft
C. Partial thickness graft
D. None of the above

3. Of the following which is the best method of treating a green stick

fracture of the mandible?
A. Allow normal masticatory movements
B. Bringing the teeth into occlusion with interdental wiring
C. Extra skeletal fixation
D. None of the above

444
4. Which one of the following disorders responds favorably during using
an occlusal separator?
A. Capsular fibrosis
B. Muscle spasm
C. Chronic dislocation
D. Unilateral condylar hyperplasia

5. Visible bleeding of an artery is best controlled via:

A. Pressure
B. Tea bag plus pressure
C. Tourniquet
D. Clamping and ligation

6. The purpose of giving antibiotics prior to oral surgery in patients with

a history of rheumatic heart disease is to help:
A. Eliminate all bacteria from the blood stream
B. Prevent recurrence of rheumatic fever
C. Prevent rheumatoid arthritis
D. Prevent sub acute bacterial endocarditis

445
7. A graft that has been detrived from another species
Of a different genetic disposition is also known as a:
A. Allograft
B. Isograft
C. Homograft
D. Heterograft

8. Vitamin K is used in the management of post-extraction bleeding

when the cause is determined to be due to:
A. Lowered platelet count
B. Thrombocytopenic purpura
C. Prothrombin deficiency
D. Factor VIII deficiency

9. Site selection for intravenous fluid therapy in an outpatient should be

the:
A. Dorsal vein, at the back of the hand
B. Median cubital vein
C. Femoral vein
D. Cephalic vein

446
10. 'Eagle's syndrome' is associated with the elongation of the:
A. Mastoid process
B. Odontoid process
C. Styloid process
D. Palatine process

11. Dental laser technology is now available for:

A. Soft tissue surgery
B. Treatment of hard tissues
C. Non-surgical applications
D. All of the above

12. Viral infection which can be seen in oral cavity of patients with HIV
is/are?
A. Hairy leukoplakia
B. Herpetic stomatitis
C. Papilloma warts
D. All of the above

447
13. The major criteria of WHO guide line for diagnosing
AIDS consists of all except?
A. Weight loss more than 10%
B. Prolonged fever for more than 1 month
C. Chronic diarrhea for more than 1 month
D. Generalized lymphadenopathy

14. The main target cells of HIV are:

A. Plasma cells
B. T4 cells
C. T8 cells
D. B cells

15. The cells from which HIV can be isolated:

A. Langerhans’s cells
B. Dendritic follicles
C. Alveolar macrophages
D. All of the above
16. Body fluids can be responsible for transmission of
A. Blood
B. Cervical secretions
C. CSF
D. Tears

448
17. The facial development seen in HIV positive children is
characterized by:
A. Normal facial profile
B. Microcephalic
C. Ocular hypotelorism
D. Narrow palpebral fissure

18. Detection of HIV antigen is:

A. Positive after 2 to 4 weeks of infection and then becomes negative till
the clinical disease sets in
B. Positive after 4 to 6 weeks till clinical disease sets in
C. Only positive when clinical disease sets in
D. Positive only after 1 week of infection

19. When blood of HIV patients is analyzed it would show:

A. Leukocytosis
B. Decreased ratio of T4/T8 cells
C. Decreased level of IgG
D. Decreased level of IgA
20. The immunodeficiency characteristic of HIV infection is due to:
A. Decreased humoral immunity
B. Decreased cellular immunity
C. Both of the above
D. None of the above
449
21. When T cell subset assay is done in HIV positive patients there is:
A. Increased ratio of T helper/ T suppressor cells
B. Decreased ratio of T helper/ T suppressor cells
C. Increased ratio of T4/T8 cells
D. Decreased production of T8 cells

22. Besides autoclaving, simple method of inactivating HIV is all

except:
A. Dry heat at 100 degree C
B. Boiling for 20 min
C. 1% sodium hypochlorite
D. 6% Hydrogen peroxide

23. WHO guide lines for suspected HIV patients suggests that they
should:
A. Be excluded from the main stream
B. Remain integrated within the society
C. Be excluded to isolation
D. None of the above
24. HIV crosses:
A. Blood-brain barrier
B. Placental and vitreous humour
C. Both of the above
D. None of the above
450
25. The impression material recommended for taking impression for
maxillofacial prosthesis in AIDS patient:
A. Alginate
B. Silicone
C. ZnOE
D. Plaster of Paris

26. Aspirator used for suction should be disinfected after using for HIV
patient by:
A. Flushing with 2% glutaraldehyde and washing with fresh water after
10 min
B. Flushing with 2% glutaraldehyde and leaving overnight
C. Flushing with savlon and washing after 12 hours
D. None of the above

27. Impressions for maxillofacial trauma should be disinfected by:

A. Thorough rinsing with water
B. Immersing in 2% glutaraldehyde for 3 hours after rinsing in water
C. Immersing in 2% glutaraldehyde for minimum of 10min after rinsing
in water
D. Immersing in 2% glutaraldehyde for 12 hours

451
28. The dental infections commonly seen in ADS patient:
A. Necrotizing ulcerative gingivitis
B. Rapidly progressive periodontitis
C. Horizontal bone loss
D. All of the above

29. Body fluid in which HIV is highly concentrated:

A. Semen, cervical fluids
B. Blood
C. Saliva
D. Tears

30. The most common pathogen isolated from pulmonary system of HIV
patient is:
A. Mycobacterium tuberculosis
B. Mycobacterium avium intracellulare
C. Pneumocystis carinii
D. None of the above
31. HIV virus is a:
A. DNA virus
B. Retrovirus
C. DNA, RNA virus
D. None of the above

452
32. Diagnosis of pediatric AIDS can be done by:
A. ELISA test
B. Western blot test
C. Virus culture
D. None of the above

33. The first antibody to HIV antigen appears in blood after:

A. 1-2 weeks of infection
B. 2-4 weeks of infection
C. 4-6 weeks of infection
D. 4-6 months of infection

34. ELISA test demonstrates:

A. HIV antigen
B. HIV antibodies
C. HIV
D. None of the above

35. The confirmatory test used for HIV infection is:

A. ELISA
B. Immunodot test
C. RIPA test
D. Western blot test

453
36. HIV can be inactivated by (except):
A. Autoclaving
B. 2% glutaraldehyde
C. Boiling for 20 minutes
D. Gamma radiation

37. Following chemicals are used for inactivating HIV (ex.

A. 2% glutaraldehyde
B. 50% ethanol
C. 1% sodium hypochlorite
D. 2.5% cetamide

38. World's ADS day is observed on:

A. 22nd November
B. 26th February
C. 1st December
D. 29th November

454
39. The recommended method for sterilizing impressions for
maxillofacial prosthesis is:
A. Impression in silicone and autoclaving
B. Impression in alginate and soaking in 2% glutaraldehyde for 10
minutes
C. Impression in silicone and soaking in 2% glutaraldehyde for 20
minutes
D. Impression in silicone and soaking in 2% glutaraldehyde for three
hours

40. The working surface in operation theatre should be disinfected

especially for HIV, by using:
A. Savlon
B. Gamma radiation
C. Hypochlorite solution
D. UV light

41. Best way to palpate submandibular gland is:

A. Bimanual extraloral palpation with the patient head tipped forward
and towards the same side
B. Monomanual extraoral palpation with patient's head tipped forward
and toward the same side
C. Bimanual, simultaneous intraoral and extraoral palpation
D. Intraoral palpation with the patient head tipped forward

455
42. In an irradiated field, the optimal time for a surgical procedure is:
A. A Immediately after completion of radiotherapy
B. Any time during radio therapy
C. 6 months to 1 year after the completion of radiotherapy
D. 4-6 weeks after radiotherapy

43. Commonly used suture material for closure of intraoral wound is:
A. Nylon
B. Black silk
C. Cat gut
D. Chromium catgut

44. The following is one of the advantage of chromic gut over plain gut
suture:
A. Greater ease of use
B. Non absorbability
C. Greater strength
D. Less expensive
45. Vertical mattress sutures are frequently used in closure:
A. To Evert margins
B. In one tissue layer thick flaps
C. Because of the lack of sufficient blood supply
D. None of the above

456
46. Virus which causes ADS is a:
A. Retrovirus
B. DNA virus
C. Reovirus
D. None of the above

47. The following suture material has the memory prop-

A. Silk
B. Catgut
C. Nylon
D. Linen

48. Which of the following is non resorbable suture material?

A. Dacron
B. Catgut
C. Polyglycolic acid
D. Polyglactin
49. Presence of suture usually increase the susceptibility to infection by
a factor of:
A. 10 times
B. 100 times
C. 1000 times
D. 10,000 times

457
50. Langer's lines usually run:
A. Parallel with skin creases and parallel to the action of underlying
muscles
B. Perpendicular with skin creases and parallel to the action of
underlying muscles
C. Parallel with skin creases and perpendicular to the action of
underlying muscles
D. Perpendicular with skin creases and perpendicular to the action of
underlying muscles

51. Among the following suture material which one elicit more tissue
reaction:
A. Catgut
B. Silk
C. Nylon
D. Linen

52. Which of the following is commonly used as preservative for Gut

sutures:
A. Ethyl alcohol
B. Isotonic saline
C. Hypertonic saline
D. Isopropyl alcohol

458
53. Surgical needle and sutures are usually sterilized in manufacturing
units by:
A. Gamma radiation
B. X-rays
C. Boiling
D. Dry heat sterilization

54. A patient admitted to the hospital for dental treatment by a dental

staff member is the responsibility of the:
A. Family physician
B. Admitting dentist
C. Kesident physician
D. Physician consultants

55. Completed patient hospital records or charts are the legal property of
the:
A. State
B. Patient
C. Hospital
D. Doctor in charge

459
 Answers
Chapter 1: Surgical Anatomy
1. D
2. A
3. D
4. D
5. C
6. B
7. C
8. A
9. B
10. B
11. A
12. D
13. A
14. D
15. D
16. C
17. B
18. D
19. A
20. C
21. D
22. C
23. C
24. A
25. C
460
26. C
27. B
28. D
29. C
30. A
31. A
32. D
33. B
34. A
35. B
36. C
37. D
38. A
39. A
40. B
41. A
42. D
43. C
44. A
45. C
46. C
47. A
48. D
49. C
50. A
51. D
52. A
53. D
54. B
461
55. C
56. A
57. C
58. D
59. C
60. C
61. B
62. D
63. D
64. A
65. D
66. B
67. C
68. A
69. C
70. B
71. A
72. C
73. B
74. A
75. D
76. D
77. C
78. D
79. D
80. B

462
Chapter 2: LA\GA\Pain Control
1. A
2. B
3. C
4. A
5. A
6. A
7. A
8. D
9. B
10. D
11. C
12. A
13. D
14. D
15. A
16. C
17. A
18. A
19. D
20. A
21. D
22. A
23. C
24. B
25. B
26. A
27. B
463
28. A
29. D
30. C
31. C
32. C
33. B
34. C
35. C
36. B
37. A
38. C
39. D
40. B
41. C
42. A
43. C
44. C
45. C
46. B
47. A
48. A
49. A
50. B
51. B
52. C
53. D
54. B
55. C
56. A
464
57. C
58. A
59. A
60. C
61. B
62. A
63. C
64. B
65. A
66. B
67. C
68. D
69. B
70. B
71. B
72. C
73. D
74. D
75. B
76. A
77. A
78. C
79. D
80. C
81. A
82. C
83. B
84. B
85. C
465
86. B
87. B
88. D
89. A
90. D
91. B
92. C
93. A
94. D
95. B
96. B
97. B
98. C
99. C
100. B
101. B
102. A
103. B
104. B
105. C
106. D
107. C
108. A
109. C
110. B
111. C
112. A
113. B
114. B
466
115. C
116. C
117. B
118. A
119. D
120. B
121. C
122. D
123. C
124. A
125. B
126. D
127. A
128. B
129. B
130. B
131. D
132. C
133. A
134. A
135. D
136. D
137. A
138. B
139. B
140. B
141. C
142. C
143. C
467
144. D
145. A
146. A
147. B
148. B
149. C
150. C
151. C
152. C
153. B
154. B
155. C
156. C
157. B
158. B
159. C
160. C
161. C
162. D
163. D
164. B
165. B
166. A
167. C
168. C
169. D
170. C
171. A
172. B
468
173. A
174. D
175. A
176. C
177. B
178. C
179. D
180. B
181. A
182. B
183. C
184. A
185. D
186. B
187. C
188. C
189. B
190. A
191. D
192. A
193. C
194. A
195. C
196. B
197. D
198. C
199. B
200. D
201. A
469
202. C
203. D
204. D
205. A
206. A
207. D
208. B
209. D
210. C
211. C
212. B
213. C
214. C
215. B
216. A
217. C
218. D
219. A
220. C
221. B
222. A
223. A
224. C
225. C
226. D
227. B
228. D
229. A
230. D
470
231. B
232. C
233. C
234. C
235. B
236. D
237. C
238. B
239. C
240. B
241. D
242. B
243. C
244. C
245. C
246. D
247. B
248. D
249. C
250. B
251. C
252. B
253. B
254. B
255. C
256. D
257. D
258. C
259. C
471
260. C
261. B
262. A
263. D
264. D
265. C
266. D
267. B
268. A
269. A
270. D
271. C
272. C
273. A
274. A
275. B
276. B
277. B
278. C
279. C
280. D
281. A
282. D
283. B
284. B
285. B
286. D
287. D
288. C
472
289. D
290. C
291. A
292. D
293. C
294. C
295. B
296. C
297. C

473
Chapter3: Sterilization and Instruments
1. D
2. B
3. A
4. B
5. B
6. C
7. C
8. C
9. A
10. C
11. A
12. A
13. C
14. D
15. D
16. A
17. B
18. D
19. C
20. C
21. D
22. D
23. C
24. C
25. C
26. B
27. A
474
28. C
29. D
30. C
31. A
32. D
33. D
34. B
35. B

475
Chapter 4: Exodontia \ Impaction
1. A
2. C
3. D
4. B
5. A
6. D
7. C
8. A
9. D
10. B
11. B
12. A
13. B
14. A
15. A
16. B
17. C
18. D
19. D
20. D
21. C
22. B
23. D
24. C
25. C
26. C
27. D
476
28. C
29. D
30. D
31. A
32. C
33. C
34. A
35. C
36. C
37. D
38. B
39. A
40. D
41. C
42. C
43. B
44. A
45. C
46. B
47. A
48. C
49. C
50. C
51. B
52. B
53. C
54. C
55. B
56. C
477
57. B
58. B
59. C
60. C
61. A
62. A
63. D
64. A
65. B
66. A
67. C
68. D
69. C
70. B
71. B
72. D
73. A
74. B
75. A
76. B
77. D
78. A
79. C
80. A
81. A
82. C
83. B
84. A
85. D
478
86. D
87. B
88. B
89. C
90. B
91. B
92. B
93. D
94. C
95. A
96. C
97. D
98. D
99. C
100. C
101. D
102. D
103. A
104. B
105. C
106. B
107. A
108. C
109. A
110. C
111. D
112. D
113. B
114. C
479
115. A
116. A
117. C
118. C
119. D
120. A
121. B
122. D
123. B
124. A
125. C
126. D
127. C
128. C
129. C
130. C
131. D
132. D
133. D
134. C
135. A
136. C
137. C
138. C
139. C
140. A
141. D
142. B
143. B
480
144. A
145. B
146. C
147. B
148. C
149. D
150. D
151. A
152. B
153. C
154. A
155. C
156. C
157. A
158. C
159. D
160. A
161. D
162. C
163. A
164. B
165. C
166. A
167. D
168. D
169. B
170. D
171. B
172. C
481
173. A
174. B
175. C
176. A
177. C
178. D
179. D
180. A
181. C
182. C
183. B
184. D
185. D
186. C
187. D
188. C
189. D
190. B
191. B
192. B
193. B
194. C
195. D
196. B
197. A
198. A

482
Chapter 5: Minor Surgical Procedure
1. D
2. A
3. D
4. D
5. D
6. A
7. D
8. C
9. C
10. A
11. B
12. B
13. C
14. D
15. C
16. A
17. A
18. A
19. A
20. D
21. A
22. D
23. A
24. C
25. B
26. A
27. B
483
28. C
29. C
30. B
31. D
32. A
33. A
34. B
35. A
36. D
37. A
38. D
39. A
40. D
41. A
42. D
43. C
44. C
45. A
46. C
47. B
48. B
49. B
50. C
51. C
52. D
53. D
54. A
55. C
56. B
484
57. B
58. B
59. A
60. B
61. B
62. D
63. B
64. A
65. B
66. B
67. C
68. B
69. B
70. B
71. D
72. B
73. C
74. C
75. D

485
Chapter 6: Cyst\Tumor\Surgical Pathology
1. A
2. D
3. A
4. D
5. C
6. A
7. B
8. D
9. C
10. C
11. D
12. B
13. A
14. D
15. D
16. D
17. A
18. A
19. C
20. A
21. C
22. D
23. A
24. A
25. C
26. A
27. C
486
28. D
29. A
30. D
31. B
32. C
33. D
34. B
35. A
36. C
37. A
38. C
39. B
40. B
41. B
42. B
43. B
44. D
45. C\D
46. C
47. B
48. C
49. A
50. C
51. B
52. B
53. C
54. A
55. B
56. C
487
57. D
58. C
59. A
60. C
61. A
62. D
63. C
64. B
65. C
66. C
67. B
68. C
69. A
70. A
71. C
72. A
73. C
74. C
75. C
76. D
77. A
78. C
79. D
80. B
81. D
82. A
83. D
84. C
85. D
488
86. C
87. B
88. C
89. A
90. A
91. C
92. C
93. A
94. B
95. A
96. C
97. A
98. D
99. D
100. A
101. A
102. D
103. D
104. D
105. C
106. B
107. C
108. C
109. B
110. C
111. C
112. C
113. B
114. C
489
115. D
116. D
117. B
118. C
119. B
120. A
121. C
122. C
123. B
124. C
125. A
126. C
127. B
128. B
129. C
130. A
131. A

490
Chapter 7: Facial Space Infection\Osteomyelitis
1. A
2. C
3. A
4. C
5. B
6. B
7. C
8. B
9. D
10. A
11. B
12. D
13. A
14. B
15. A
16. C
17. B
18. D
19. B
20. C
21. B
22. C
23. C
24. D
25. B
26. D
27. C
491
28. A
29. B
30. A
31. A
32. C
33. D
34. B
35. B
36. C
37. D
38. B
39. B
40. C
41. B
42. C
43. B
44. C
45. B
46. C
47. B
48. C
49. A
50. C
51. D
52. C
53. C
54. A
55. D
56. D
492
57. D
58. B
59. D
60. D
61. A
62. B
63. C
64. C
65. C
66. C
67. A
68. B
69. A
70. D
71. D
72. B
73. A
74. B
75. A
76. D
77. D
78. B
79. D

493
Chapter 8: TMJ And Maxillary Sinus
1. C
2. C
3. C
4. C
5. B
6. C
7. D
8. A
9. D
10. D
11. A
12. C
13. B
14. A
15. C
16. B
17. D
18. B
19. B
20. D
21. D
22. B
23. B
24. C
25. B
26. A
27. B
494
28. A
29. C
30. A
31. C
32. A
33. A
34. C
35. A
36. D
37. B
38. B
39. A
40. A
41. D
42. C
43. C
44. B
45. C
46. B
47. C
48. D
49. B
50. B
51. A
52. B
53. C
54. D
55. B
56. A
495
57. A
58. D
59. D
60. C
61. D
62. C
63. A
64. B
65. D
66. A

496
Chapter 9: Maxillofacial Injury
1. A
2. D
3. B
4. C
5. A
6. C
7. A
8. B
9. B
10. C
11. D
12. A
13. C
14. B
15. C
16. C
17. A
18. C
19. A
20. C
21. C
22. C
23. C
24. C
25. B
26. D
27. B
497
28. C
29. C
30. D
31. C
32. C
33. B
34. C
35. B
36. C
37. B
38. B
39. C
40. A
41. D
42. D
43. D
44. C
45. B
46. D
47. A
48. D
49. D
50. B
51. B
52. A
53. B
54. B
55. D
56. B
498
57. D
58. B
59. D
60. C
61. B
62. A
63. C
64. C
65. B
66. C
67. B
68. C
69. C
70. D
71. A
72. D
73. D
74. B
75. C
76. B
77. C
78. C
79. D
80. C
81. A
82. C
83. D
84. A
85. C
499
86. D
87. D
88. C
89. C
90. A
91. C
92. C
93. D
94. C
95. B
96. B
97. C
98. D
99. B
100. C
101. B
102. A
103. C
104. D
105. D
106. D
107. B
108. A
109. D
110. A
111. B
112. B
113. B
114. B
500
115. C
116. A
117. A
118. C
119. D
120. D
121. A
122. B
123. B
124. A
125. B
126. D
127. B
128. C
129. C
130. B
131. C
132. C
133. C
134. A
135. D
136. D
137. C
138. A
139. A
140. B
141. B
142. C
143. D
501
144. A
145. D
146. B
147. A
148. C
149. C
150. B
151. A
152. B
153. C
154. C
155. B
156. A
157. B
158. C
159. B
160. C
161. C
162. C
163. B
164. B
165. B
166. B
167. B
168. B
169. C
170. A
171. D
172. B
502
173. A
174. D
175. A
176. C
177. A
178. D
179. C
180. D
181. B
182. C
183. B

503
Chapter 10: Reconstructive And Orthognathic
Surgery
1. B
2. A
3. D
4. B
5. B
6. A
7. A
8. C
9. C
10. B
11. C
12. C
13. B
14. B
15. B
16. D
17. A
18. B
19. C
20. A
21. D
22. B
23. B
24. C
25. C
26. B
504
27. B
28. B
29. D
30. B
31. B
32. B
33. B
34. C
35. B
36. A
37. C
38. C
39. D
40. A
41. D
42. D
43. D
44. C
45. B
46. C

505
Chapter 11: Medical Emergency
1. A
2. B
3. C
4. B
5. D
6. B
7. D
8. D
9. B
10. B
11. D
12. A
13. B
14. C
15. D
16. C
17. B
18. A
19. C
20. A
21. A
22. A
23. C
24. D
25. D
26. D
27. B
506
28. A
29. A
30. B
31. D
32. D
33. C
34. A
35. C
36. B
37. C
38. C
39. B
40. C
41. A
42. C
43. B
44. B
45. C
46. B
47. A
48. D
49. B
50. C
51. C
52. A
53. B
54. C
55. A
56. D
507
57. A
58. C
59. C
60. C
61. D
62. C
63. B
64. A
65. A
66. D
67. D
68. A
69. B
70. A
71. B
72. B
73. D
74. D
75. C
76. D
77. C
78. C
79. D
80. D
81. C
82. C
83. B
84. A
85. C
508
86. B
87. D
88. C
89. D
90. C
91. A
92. A
93. C
94. C
95. D
96. C
97. C
98. C
99. D
100. A
101. A
102. B
103. C
104. A
105. A
106. A
107. B
108. C
109. B
110. C
111. D
112. D
113. B
114. C
509
115. C
116. D
117. A
118. B
119. D
120. C
121. A
122. C
123. A
124. B
125. A
126. B
127. C
128. C
129. C
130. B
131. C
132. C
133. B
134. B
135. B
136. B
137. C
138. A
139. D
140. C
141. D
142. B
143. D
510
144. D
145. D
146. B
147. C
148. D
149. D
150. C
151. C
152. A
153. C
154. C
155. D
156. C
157. A
158. A
159. C
160. A
161. D
162. C
163. A
164. A
165. B
166. D
167. C
168. C
169. D
170. D
171. C
172. A
511
173. B
174. D
175. B
176. D
177. B
178. C
179. A
180. C
181. C
182. C
183. D
184. D
185. B
186. C
187. D
188. A
189. B
190. C
191. B
192. C
193. A
194. B
195. D
196. C
197. C
198. B
199. D
200. C
201. C
512
202. D
203. A
204. D
205. A
206. B
207. B
208. C
209. D
210. D
211. D
212. C
213. C
214. D
215. C
216. D

513
Chapter 12: Implant
1. B
2. C
3. B
4. C
5. A
6. B
7. A
8. D
9. A
10. C
11. D
12. B
13. C
14. C
15. B
16. B
17. C
18. A
19. A
20. C
21. D
22. B
23. B
24. A
25. D
26. A
27. A
514
28. D
29. D
30. A
31. D
32. D
33. C

515
Chapter 13: Miscellaneous
1. B
2. C
3. B
4. B
5. D
6. D
7. D
8. C
9. A
10. C
11. D
12. D
13. D
14. B
15. D
16. D
17. B
18. A
19. B
20. B
21. B
22. A
23. B
24. C
25. B
26. B
27. C
516
28. D
29. B
30. C
31. B
32. C
33. C
34. B
35. D
36. D
37. D
38. C
39. D
40. C
41. C
42. D
43. B
44. C
45. A
46. A
47. C
48. A
49. D
50. C
51. A
52. D
53. A
54. C
55. C

517
 Oral surgery 2nd term exam

Q/ Choose the best answer

1. .An anterior open-bite relationship (apertognathia), results from excessive downward growth of :
a. mandible
b. maxilla
c. both a and b
d. neither a nor b
2. Contraindications for dental implants:
a. bruxism
b. osteoporosis
c. a& b
d. neither a nor b
3. Primary stability is the initial mechanical lock between the screw implant and the
bone , it depend on :
a. the thread design
b. the preparation of the surgical site
c. a and b
d. neither a nor b
4. In order to avoid an irreversible bone damage that can lead to failure of
osseointergartion , use:
a. low-speed handpiece
b. high-torque handpiece
c. copious saline irrigation
d. all of the above
5. Indications of endodontic surgery :
a. ledging
b. gross overfills
c. Teeth with deep periodontal pockets
d. a & b

Nasolabial angle: is measured between the columella of the nose

and the upper lip,this angle should be
a. 90 ± 10°
b. 60 ± 10°
c. 160 ± 10°
d. None of the aboved

6. Carcinoma of tongue is most common in:

a. lateral edge of tongue
b. tip of tongue
c. dorsum. of tongue
d. all of the above

1
7. Conditions of definite premalignant potential:
a. Leukoplakia
b. Erythroplakia
c. Chronic hyperplastic candidisis
d. All of the above
8. Psychogenic orofacial pain include :
a. facial arthromyalgia
b. atypical facial pain
c. acute pulpitis
d. a & b

10. Treatment of trigeminal Neuralgia include :

a. carbamazepine
b. Antidepressant
c. peripheral neurectomy
d. a & c
11. Ankylosis of the T.M.J can be a sequel to :
a. intracapsular fracture of the condyle
b . sever infection of the joint
c. long standing active rheumatoid arthritis
d. all of the above
12. The best radiographic view of tempromandibular joint is given by :
a. transorbital view.
b. reverse towen,s view.
c. transpharyngeal view
d. panoramic view .
13. If the root fracture in apical third of tooth without mobility :
a. tooth should be extracted.
b. treated endodontically.
c. no treatment & periodic review.
d. non of above.

14. Patient present with lateral subconjunctival hemorrhage. Infra orbital step &diplopia on right side
with in ability to open mouth he can have :
a. fracture sub condylar right side .
b. fracture zygomatic right side.
c. fracture lefort II right side.
d. fracture of the floor of the orbit.

15.Respiratory embarrassment can occur in fracture :

a-angel.mandible
b-para symphysis.
c-bilateral para symphysis .

2
 d-bilateral subcondylar.
16.The treatment of localized osteitis is:
a-Debridement, curettage & sedative packing .
b-Curettage ,irrigation &sedative packing .
c-Irrigation &sedative packing.
d-None of above .
17.Benign tumor of glandular epithlium is called as:

a. lipoma b. fibroma
c. adenoma d. myxoma
18. The best radiographic technique for demonstration of internal derangements of the T M J is:
a- MRI .
b- CT scan.
c- Athrography.
d- OPG
19. Submandibular salivary gland is separated into superficial and deep portions by :
a. .Buccinator muscle
b. .Mylohyoid muscle
c. Digastric muscle
d. Sternomastoid muscle
20. The parotid gland is divided into superficial and deep portions by:
a. Cartilagenous portion of external auditory canal
b. Facial nerve branches
c. Mandible
d. Internal maxillary artery
21. All major salivary glands arise from
a. Ectoderm
b. Endoderm
c .Mesoderm
d. All three embryonal tissue
22. Submandibular salivary gland swelling is differentiated from submandibular
lymphadenitis clinically by
a .Bidigital palpation
b. Presence of transillumination in submandibular salivary gland
c. Movement during swallowing
d. Palpation from behind the patient
23 . When a tooth is displaced in the posterior portion of the mouth, The tooth may be
removed by means of :
a. Magill forceps
b. Rowe forceps
c. allis forceps

3
 d. All of the above

24.You notice that your patient's submandibular lymph nodes are enlarged. You would
look for potential infection sites in the

a. hard palate.
b. hard palate and upper lip.
c. hard palate, upper lip and upper central incisor.
d. hard palate, upper lip, upper central incisor and lower first molar.
25 .Most common complication of condylar injuries in children
a. Pain
b. Ankylosis
c. Osteoarthritis
d. Fracture of glenoid fossa
26.Battle's sign is :
a. Sub-conjunctival ecchymosis.
b. Sub-lingual ecchymosis.
c. Palatal ecchymosis.
d.. Ecchymosis in the mastoid region.

27. Osteomyelitis in adult most commonly occur in:

a. maxilla b. mandible c. lip d. none of the above

28. Treatment of choice of a linear non-displaced fracture of the body of the mandible,
with full complement of teeth is
a). Kirschner wire
b). Circumferential wiring
c) External pin fixation
d) Simple wiring
29 The extraoral X-ray view required for a fracture mandible is :
A. Submento vertex
B. Posterio anterior
C. Water's view
D. Towne's view
30. The weakest point of the mandible where fracture occurs is

A. Neck of the mandible

B. Angle of the mandible
C. Symphysis menti
D. Oblique ridge near mental foramen
31 . A fracture mandible should be immobilized for an average of

A. 3 weeks B. 6 weeks C. 9 weeks D. 12 weeks

4
 32. Le Fort III fracture is the same as
A. Craniofacial dysjunction
B. Guerrin's fracture
C. Pyramidal fracture
D. None of the above
33 . Which is the immediate danger to a patient with severe facial injuries
A. Bleeding
B. Associated fracture spine
C. infection
D. respiratory obstruction.
34. A cyst occurring under the tongue, caused by blockage of the salivary gland duct
is called:
a. Follicular cyst
b. Dentigerous cyst
c. Ranula
d. Dermoid cyst
35. CSF rhinorrhea is found in :
A. Frontal bone structure B. Zygomatico maxillary fracture

C. Naso ethmoidal fracture D. Condylar fracture

36. A pear-shaped radiolucency causing displacement of roots of vital maxillary lateral

and cuspid teeth is characteristic of:
a. globulomaxillary cyst
b. apical periodontal cyst
c. primordial cyst
d. nasoalveolar cyst

37 .Incedence of sialolethsis is very high in :

a. parotid gland

b. submandibular gland

c. sublingual gland

d. minor salivary gland

38. The following are Disadvantage of CT scan except

a .Ionizing radiation b .Expensive c. Require cooperative patient d. Non invasive

5
 39 .Which of the following condition is associated with anterior open bite
A. Unilateral condylar # B. Bilateral condylar #
C. Maxillary # D. Coronoid #
40 . When subcondylar fractures , mandible it deviates to :

A. Same side B. Opposite side C. Does not move D. Retrudes

41 . Battle's sign is :
A. Sub-conjunctival ecchymosis. B. Sub-lingual ecchymosis.
C. Palatal ecchymosis D. Ecchymosis in the mastoid region.

42. Fracture of body of mandible with full arch of teeth (undisplaced) is treated by :
A. IMF . B. Open reduction and internal fixation
C. Close reduction and internal fixation D. External pin fixation

43. Surgical procedures used in closure of oroantral fistula:

a.buccal advancement flap

b. palatal rotational flap

c. both a& b

d. none of the above

44. Localization of fractured needle as a foreign body by :

a. CT scan b. MRI

c .both a & b d.neither a nor b

45. The weakest point of the mandible where fracture occurs is :

A. Neck of the mandible B. Angle of the mandible
C. Symphysis menti D. Oblique ridge near mental foramen

46 . The most (common ) sign mandibular fracture is :

A. Malocclusion B. Trismus
C. Deviation of the jaw on opening D. Paraesthesia of the mental nerve

47. Green stick fractures are most common with :

A. Older people B. Adult C. Children D. Soldiers

48. The fracture of the tooth bearing segment of the mandible is :

6
 A. Simple B. Complex C. Compound D. Comminuted
49. Vestibuloplasty is :
a. the deepening of the vestibule b. most commonly done in maxilla
c. most commonly done in mandible d. both a & c

50 . Dermoid cysts are :

a. relatively uncommon in oral cavity

b. Congenital cysts

c. contain hair, sebaceous and sweat glands

d. all of the above

51 .Torus palatinus commonly occur in:

a. anterolateral part of the hard palate
b. posterolateral part of the hard palate
c. on the mid line of the hard palate

52.The first step in management of maxillofacial injury is :

A. Secure airway B. I.V mannitol
C. I.V dexamethasone D. Blood transfusion

53. A fracture result from trauma to the eye by a ping pong ball is :
A. Blow out fracture B. Orbital fracture
C. Blow in fracture D. Compound fracture
54. Panda faces is commonly seen after :
A. Le fort I fractures B. Le fort II fractures
C. Mandible fractures D. None of the above
55. Torus mandibularis most commonly occur in :
a. buccal side of central incisors
b. lingual side of central incisors
c. lingual side of maxillary premolar
d. lingual side of mandibular premolar

7
56. Ranula: is a cyst forming in the floor of the mouth :

a. from sublingual gland

b. from submandibular gland

c. it forms in a manner similar to the mucocele

d. a & c

57. In depressed zygomatic arch fracture, difficulty in opening the mouth is caused
by impingement of:
A. Condyles B. Ramus
C. Petrous temporal D. Coronoid process

58. Le Fort II fracture is called

A. Guerin B. Pyramidal C. Floating D. Cranial disjunction
59 .Maxillary sinus is usually involved in fractures:
A. Lefort I fracture B. Lefort III fracture
C .Zygomatic arch fracture D. Symphyseal fracture

60 Most common complication of condylar injuries in children

A. Pain B. Ankylosis
C. Osteoarthritis D. Fracture of glenoid fossa

Best wishes Assis.Prof. Dr. Yahya A. Al

8
M C Q Oral Surgery

Ahmed Azher
2o19
 Review in
Oral and
Maxillofacial
Surgery
Sachin Dev Sachdeva
Rajat Misurya
Samprati Badjate
Archana Sachdeva |

Foreword
_ Rajiv Borle JAYPEE |
 Basic Principles of
Oral Surgery

Excisional biopsyis donein lesion ofsize:

A. Less than 2 cm in diameter
_ B. More than 4 cm in size
Cc. None of the above
D. All of the above
Incisional biopsy includes:
A. Only pathologic tissue
B. Pathologic and normaltissue
C. Only normal tissue
D. Noneof the above
3. Requirements offlap are:
A. Flap must be designed to provide an adequate exposure of
the surgical site
B. Broad base and good vascular supply
C. Whenplaced back should rest on healthy bone
D.All of the above
Surgical incision should be made:
A. 45 degree to epithelial surface
B. Right angle to epithelial surface
C. Can be doneat any angle
D. Noneof the above
Fixer used for biopsy specimen:
A. 10 percent formalin
B. 10 percent benzoin
C Toluidine blue
D. None of the above
 2 Review in Oral and Maxillofacial Surgery
Basic Principles of Oral Surgery 3
6. All of the following are absorbable suture material except:
A. Catgut B. Polyglycolic . In periodontal surgeries needle usedis:
C. Polyglactin D. Silk A. 1/4th, round body
7. All of the following are non absorbable suture except: B. 3/8th, reverse cutting
A. Silk B. Stainless steel C. 1/2, flat needle
C Nylon D. Chromiccatgut PD, 3/4th, atraumatic needle
8. Which number scalpel blade is universally useful for oral . Poor accessibility is main disadvantageof:
surgical procedure? « A. Trapezoid flap B. Envelope flap
A. 15 B. 12 © Semilunar flap D. Anyof the above
& 17 D. 10 . Vieryl is an:
9. Local factors predisposing bone to osteomyelitis are related A. Absorbable natural suture
mainlyto: B. Absorbable synthetic suture
A. Reduced antibody formation © Nonabsorbable silk suture
B. Reduced blood supply PD. Nonabsorbable synthetic suture
C. Potent endotoxin . Incisional biopsyis indicated in:
D. Increased lymphatic circulation A. 2cm hemangiomaof tongue
10. Normally a dressing should be changedafter every: B. 3 cm leukoplakia of cleft palate
A. Atleast 24 hr B. 3-4 days ©. 0.5cm fibroma of gingiva
C 24-48 hr D. 4-5 days D. 3.5 cm area offordyces spot of cheek
11. Presenceof suture increases the susceptibility of infection by a . Amongthe following which factor influences pain perception
factorof: threshold:
A. 100 times B. 1000 times A. Emotionalstate B. Apprehension
C. 10000 times D. 100000 times C Age D. All ofthe above

~12. Which of the following material is not used for packing of . Complete blood count does not include:
wounds? A. Haemoglobin B. Haematocrit
A. Iodoform gauze €, Total WBC count D. ESR
B. Gauze soakedin antibiotic paste
. Amongthe following which causes practisioner the greatest
C Betadine
concern:
D. Gauze soaked in hydrogen peroxide
A. 80 percent of normal partial prothrombin time
13. Drains are usedfor: B. 50 percent of normal prothrombintime
A. Providing exit for pus and infection outside C. 30 percent of normal prothrombin time
B. Prevent formation of haematomas 1D. 20 percent of normal prothrombintime
C. Prevent formation of seromasin hard andsoft tissues
D. All of the above 1, Whichof the followingis early sign of need of oxygen?
A. Tachycardia B. Cyanosis
C. Sternal relaxation D. Constricted pupil

14.86 15. B 16. B 17. B 18. D 19.D

20, D 21. A
 facial Surgery

lowing which anaerobic organism is frequently Basic Principles of Oral Surgery 5

for oral infection?
locoecus aureus Preanesthetic medication is commonly used to achieve the
Wlococcus albus following goalsexcept:
Bacteroides fragilis A. Decrease nervous irritability
D. Streptococcus viridans B. Decrease secretions
23. In patient on artificial venti C. Provides analgesia
lation the cycle of exhale air D. Desensitise the respiratory center of CO,
ventilation should be repeated of
every:
A. 20 secs
B. 10 secs 41. Whatis the time to administer analgesic for controlling post-
C 5 secs operative pain?
+ D. 1sec
24. The following factors influence A. After the regain of sensation
the sedation procedure with B. Pain becomes moderate to severe
IV agents:
A. Weightofpatient C. Before the anesthetic effect wears off
B. Age D. Noneof the above
C Type of agent used D. Allof the above
be
[ 25. Frequentsite for occurrence of 32. The soft tissue incision used to remove mand. Tori should
ameloblastomais:
A. Mandibular premolar area placed:
B. Max molar area A. Directly over torus : 1
; ior to torus in floor of mouth /
C Max antrum andfloorof nose
D. Mandibular molar and ramus C on the edentulous crest or gingival crevice around the
area dentition
26. Amongthe following which
is short acting barbiturates: D. Noneof the above
A. Pentobarbital
B. Phenobarbital
C Valium 33. Which of the following bonegraft has the greatest osteogenic
D. Codeine
potential?
27. Site of action of valium
is: A. Autogenouscortical bone
A. Cerebellum B. Autogenouscancellous graft
B. Cerebral cortex
C Limbicsystem D._ Pyramidal system Cc. A freeze dried bonegraft
28. Among the following which D. Xenograft
has least hypnotic action:
A. Chloralhydrate B. Pentobarbital 34. Among the following which is an advantage of IV
C Phenobarbital D. Codeine administration of drug?
29. Which of the followinglesio A. Minimalskill
n has no epithelial lining?
A. Nasopalatine cyst B. Sedative drugs are compatible with IV solution
B. Nasolabial cyst
C Aneurysmal bone cyst Cc. Iteliminates side effects
D. Follicular cyst D.It allowstitration of the drug
35. Sedation by which of the following routes can be reversed most
rapidly?
A. Inhalation B. Intramuscular
C. Intravenous D. Oral

30. D SB Cc 32. C 33. B 34.D 35.A

a
~ ; .
Basic Principles of Oral Surgery 7
Surgery
6 Review in Oral and Maxillofacial
F :
of catgut over plain
body most robably enters: 44. The following is one of the advantage
36. An inhaled foreign Right seeds
‘A Leftbronsue
— B. Nonabsorbable
C. Oesophagus D. Noneofthe above A. Greater ease of use
D. Cheap
Cc Greater strength
who has pulse rate of 72 euite cand cae
37. A patient came to dental clinic pink extremities and
45. Theav.
should be:
respiratory rate of 15 bp of120/80 warm
then what is or anat aily adult fluid intake -
= oe
pupils thatconstrict during near accommodation C. 1200 nat
: a
the diagnosis:
B. Acute anxiety syndrome best demonstrates the
A. Normal patient . 46. Among the following which radiograph
C Coronary artery disease D. Myopia 8 Ol
' oeae.
submandibular gland is: si - a-pmandible
38. Best wayto palpate D. Occipito mental
A. Bimanual extraoral C Submentovertex
site of metastatis from
B. Monomanual extraoral 47. Of the following which is most common
extraoral
C. Bimanual simultaneous intra and mandible?
D. Noneof the above - ae
B. Liver
is strongest stimulator to increase D. Pancreas
39. Among the following which ung
the respiration:
A. Decrese IV oxygen B. Increase blood pH
C. Increase in arterial CO, D. Increase in arterial oxygen
has the memory property:
40. The following suture material
A. Silk B. Catgut
D. Linen
_c Nylon
oneelicit more tissue reaction?
41. Among the following which
A. Catgut B. Silk
Cc Nylon D. Linen
in
res are usually sterilised
42. Surgical needle and sutu
manufact urin g units by:
B. X-rays
A. Gammaradiation
Cc Boiling D. Dry heatsterilisation
parallel with:
43. Langer lines usually runs
underlying muscle
A. Parallel with skin creases and on of
B. Perpendicular to skin creases and parallel to acti
underlying muscle
perpendicular to action of
C. Parallel with skin creases and
underlying musc le
D. Noneof the above
39.C 40.C 41.A 45. B 46.A 47.C
36. B 37.A 38. C 44.C
42.A 43.C
 Sterilization and Disinfection 9

how muchtimeto kill the

6. Boiling watersterilization requires
bacteria:
Sterilization and A. 120 degree Celsius for 5 min
B. 100 degree Celsius for 10 min
Disinfection C. 100 degree Celsius for 5 min
D. 120 degree Celsius for 10 min
to elevate the boiling point
7. Which of the following can be used
of water?
A. 4 percent NaOH B. 2 percent KI
uding their
all micro-organisms incl D. 4 percent NaCl
. Complete destruction of ctio ns: C 2 percent Na,CO,
caus ing, infe
sporesthat are capable of
A. Antisepsis
B. Disinfection 8. Disadvantageof repeated boiling:
C. Sterilisation
D. Fumigation A. Spores are notkilled
on mucous membraneto redu
ce B. Cutting instruments lose their sharpness
. Chemical applied to the skin
ent is: C. Cutting instruments lose their luster
smsp res
the No. of micro-organi D. Microbes becomeresistant
B. Disinfectant
A. Antiseptic laving?
Cc. Antibiotics
D. Allof the above 9. Which ofthe followingis true for autoc
pressure-10 Ib
A. Temp-160 degree F, time-15-20 min,
used: ure-15 Ib
_ Disinfectant is a chemical
surface vegetative organism
s but B. Temp-250 degree F, time 20-30 min, press
A. Onnonvital objectsto kill pressure-15 Ib
C Temp-250 degree F,time-1 5-20 min,
not necessarily their spores ure-10 Ib
brane to reduce the number
of D. Temp-160 degree F, time-20-30 min, press
B. On the skin or mucous mem
microbes 10. Whatis autoclaving?
C. To dehydrate and oxidate micr
obes A. Moist heat above 100 degree Celsius
D. On the spores B. Moist heat below 100 degree Celsius
ired for hot air oven is:
C. Moist heat above 180 degree Celsius
. Temperature and time requ D. Noneof the above
s
A. 160 degree Celsius for 2 hour urisation by Flash method?
B. 160 degr ee Celsi usfo r 6 hour s 11. Whatis the temperature for paste
15 sec and cooling to 13 degree Celsius
C. 175 degree Celsius for 30
minutes A. 72 degree Celsius for Celsius
ng to 10 degree
D. 175 degree Celsiusfor 2 hour
s B. 66 degree Celsius for 20 sec and cooli
ng to 5 degree Celsius
lization kills by: C. 58 degree Celsiusfor 30 sec and cooli
. Hot air oven used for steri D. Noneo f the above
n
A. Reduction and hydratio ized by:
B. Oxidation and hydrogenatio
n 12. Endodontic instruments are steril
n B. Fumigation
Cc. Dehydration and oxidatio A. Autoclave
D. Dry heat
D. Dehydration and reductio
n Cc Hotsalt steriliser

8. B 9.C 10. A 11. A

2. A 3.A 4.A §,'C 6. B 7
1.C
1IZ.<
10 Review in Oral and Maxillofacial Surgery Sterilization and Disinfection 11

13. Cidexis: 20. Whatis Clean Case:

A. 5 percent glutaraldehyde A. Onein which pusis present
B. 2.5 percent glutaraldehyde B. One in which pusis not present
C 5 percent H,O, C Both AandB
D. 2 percent glutaraldehyde D. Noneof the above
14. Cold sterilization is done by: 21. The methodof sterilization of metal instrumentsis by:
A. Glutaraldehyde B. Benzalkonium chloride A. Infrared radiation
Cc Ethylene oxide D. Ethyl alcohol B. Sintered glassfilters
15. Spores of are used for testing the efficiency of C. 3 percentlysol solution
dry heat. , D. Soap and water
A. Staph. aureus 22. Catgutis sterilized by:
B. Clostridium tetani A. Autoclave B. Boiling
C. Treponema denticola C UVradiation D. Ethylene oxide
D. Streptococci
23. Minimum timerequired forsterilization of surgical instruments
16. At what temperature ethylene oxide is used for gas by moist heat at 134 degree Celsiusis:
sterilization? A. 3 min B. 13 min
A. 20 degreeCelsius Cc 30min D. 60 min
B. 6.8 degree Celsius
C 11.8 degree Celsius 24. Which of the following is recommended methodforsterilizing
D. 108° degree Celsius metal dental instruments? .
A. Boiling water for 30 min
17. The main objective for efficacy of sterilization practice is B. Chlorhexidine for 24 hr
destructionof: C Steam at 100 degree Celsius for 5 min
A. Cocci B. Viruses D. Steam at 134 degree Celsius for 3 min
_C. Bacteria D. Spores
25. Which ofthe following is most commonlyusedfor disinfecting
18. Scrub techniquerefers a method of scrubbing: dental handpiece? in
A. Surgical instruments after contaminated case A. Chlorox B. Glutaraldehyde
B. Patient body surface before placing surgical incision to Cc Betadine D. Ethyl alcohol
decrease bacterial flora
C. Operating room 26. Whatis the fastest safest and mosteffectiveto sterilize metal
D. Operator's hands and forearms before donning gown and impression tray with solder that melts at temperature above
gloves 175 degree?
A. Filtration B. Autoclave
19. Of the following which is most commonlyusedas fixative? Cc Dryheat D. 2 percent glutaraldehyde
A. 10 percent alcohol B. 10 percent formalin
C 20 percent formalin D. 20 percent alcohol 27. Ethyl alcoholis effective against spores:
A. 70 percent B. 60 percent
C. 50 percent D. 100 percent
13. D 14. B 15. B 16. D 17.D 18. D 20. B 21. A 22. D 23. A 24.D 25.B
26. B 27. A
12 Review in Oral and Maxillofacial Surgery
Sterilization and Disinfection 13
28. Heat sensitive instruments are dipped in:
A. 1:1000 solution of benzylkonium chloride 37. What is used for washing skin wounds and skin preparation
B. Hexachlorophene prior to surgery?
C. Ethylene oxide A. Povidine iodine
D. Formalin B. Glutaraldehyde
C Formalin and ethyl!alcohol
29. Hexachlorophene compoundskill all vegetative bacteria if D. Cetrimide and isopropylalcohol
instruments are kept submergedfor:
A. 6hrs ‘ B. 3 hrs 38. Disinfectant action of halogensis:
Cc 10hrs D. 8 hrs A. Directly proportional to their atomic weight
B. Inversely proportional to atomic weight
30. Heat sensitive and water sensitive instrumentsare sterilized ¢ Equalto atomic weight
by: D. Noneof the above
A. Gassterilization B. Moist heat
C Dry heat D. None 39. Halogen havinggreatest disinfectant action:
A. Fluorine B. Chlorine
31. Needles, suture material, dressings are sterilised by: Cc Bromine D. Iodine
A. Autoclave B. Moist heat
C Gas D. Ionising radiation 40. Preoperative skin preparation are done by using:
A. Glutaraldehyde B. Isopropyl alcohol
32. is most commonly usedto purify air in operation theatre: D. Chlorhexidine
C. Povidine iodine
A. Beta rays B. Gammarays
Cc UVrays D. None 41. Purpose of hand scrubis:
A. Removesuperficial contaminants
33. Three percent hexachlorophene solution gives good result B. Lossen epithelium
against: C Reduce bacterial count
A. Gram-—ve organism B. Gram +ve organism D. All ofthe above
Cc AandB D. Noneof the above
42. Hand scrub is donefor:
34. Whatis used for application on oral wounds? A. 15 min B. 10 min
A. Savion B. Spirit C 5min D. 2 min
C 2percentiodine D. Ethyl alcohol
43. Alcoholacts by:
35. Three Percent H,O,is: A. Oxidation B. Reduction
A. Oxidizing agent B. Reducing agent D. Hydrogenation
C. Denaturationof proteins
Cc AandB D. Halogenating agent
44. Phenols act by:
36. Which chemical is added to glutaraldehydefor activation? B. Precipitating proteins
A. Denaturating proteins
A. Sodium chloride B. Sodium bicarbonate Cc Reducing D. Oxidising
C Sodiumhydroxide D. Sodium nitrate

39. A 40. C 41.D 42.B

BS
w
a
AD
aw
eN
 14 Review in Oral and Maxillofacial Surgery

45. Benzalkoniumchloride mainly destroys: ~

A. Gram +ve bacteria B. Gram —vebacteria
Cc AandB D. None of the above
46. For fumigation minimum how muchpercent of relative
humidity is used:
A. 80 percent B. 100 percent Exodontia
C. 50 percent D. 70 percent
47. For hand disinfection Which of the following chemicals are
used?
A. Hibiscrub and phisored 1. All of the following, ts aboutinhaled tooth fragr
B. Betadine are true except:
C Soapcontaining disinfectant like hexachlorophene A. It usually enters the right bronchus
D. All of the above B. It may cause lung abscess _
48. Alcoholsarenoteffective against: Cc Itmay cause bronchiostasis
A. Gram +vebacteria B. Gram —ve bacteria D.It willbe coughedout spontaneously. No treatment necessary
C Spores and viruses D. Allof the above 2. Rotatory movementis used for the extraction of:
49. Nonionizing radiation includes: A. Mandibular canine
A. X-rays B. UV rays B. Maxillary central incisors
C Gamma rays D. Infrared light C Maxillary lateral incisors
D. Allof the above
50. To check the efficiency for heat sterilization which test is used: during
A. Thermocouple B. Brown’stest 3. A pregnantpatient in 2nd trimester falls into syncope
C Autoclave D. All of the above extraction of upper molars, she should be keptin:
A. Trendelenburg position
B. Head down towardsherfeet
C. Rightlateral position
D. Left lateral position

4, Reactionary haemorrhageoccurs after extraction becauseof:

A. Broken roots
B. High BP
Cc. Sharpinterdental septum
D. Gingivallaceration

§. Mechanical advantage obtained from wheel and axel principle

of elevator is:
A. 2.5. B. 3
Cc. 4.6 D. 6

45.A 46.D 47.D 48. C 49.B 50. D

 16 Reviewin Oral and Maxillofacial Surgery Exodontia 17

6. The extraction of which of the following is most difficult ip

extraction after 4 weeks will
maxillary arch? 14. Trismus following a lower molar
:
A. Lateral incisor B. 1st premolar be dueto:
bular space
C 2nd premolar D. Canine A Breakage of needle in pterygomandi
B. Haematoma of TMJ
7. Displacementof root in maxillary sinus is most likely to happen
C Submassetric space abscess
during extraction of maxillary: D. Root stumpin socket
A. Canine B. Deciduous Ist molar that
is haemorrhageafter surgery
C 1st molar D. 2nd molar 15. Reactionary haemorrhage
occurs:
8. Which of the followingis relatively difficult tooth to extract? B. After 24 hours
A. Within 24 hours
A. Maxillary canine B. Maxillary central incisor C. After 72 hours D. After 7 days
C Mandibular premolar D. Mandibular canine and
ich of the following elevators fit well in operators hand
9. A patient who is on dicoumarol therapy required a tooth thumb and finger?
extraction. Whichlaboratory test is most valuable in evaluating
- pees rotated quickly by between
A. Couplan elevator ;
the surgical risk?
B. Hospital pattern elevation
A. Clotting time B. Bleeding time C Winter's elevator
C. Prothrobin time D. Complete blood cell count
D. Warwick james elevator
10. A male is taking 60 mg of hydrocortisone daily on day of for extraction of teet!h is:
17. Anabsolute contraindication
extraction the dose should be: B
; A. Hypertension
A. Remain unchanged B. Reduced to% Cc. Thyrotoxicosis D. Central haemangioma
C Double D. Reduced to % 2
on patient whohas had a M-I,
18. Elective dental rin on
11. Use of medical history in extraction patientis: ;
months priorare bes'
A. In medicolegal cases ve. =
A. Performed underoral sedati
injection.
B. Performed using epinephrine free
B. To assess the growth stage of patient
C To determine bleeding disorders
C. Performed using both of above
D. To determine communicable disease s have relapsed.
D. Postponed untilatleasttill 6 month
12. In patient of liver disease, possible complication during which principle:
19. Roottip elevat orutil izes
extractionis:
A. Wedge B. Pulley
A. Dry socket B. Facial space infection C Wheel and axel D. Noneof these
C Bleeding D.Lossofclot
extraction blue black spots are
13. Dry socket: 20. One dayafter complete mouth
spots indicate:
, seen on neck ofpatient. These
A. Results from lossof blood clotin socket
B. Is treated by reinducing bleeding in socket
A. Therombocytopenic purpura
C Isa form of osteomyelitis B. Postoperative ecchymosis
© Impaired blood circulation
D. Is commonin extraction of anterior teeth
D. Cellulitis

6. B TE 8. A 9.C 10. C 1.c¢

17.D 18. 19.A
4256 13. A 15. A 16.D
 18 Review in Oral and Maxillofacia
l Surgery

21. In extraction b ‘est time

i to administer a nal ici 7 Exodontia 19
A. Before anaesthesia wearsoff ~
Fe
B. Prior to extraction 27. Basic principles of extraction are all except:
C Whenpain is moderate to severe A. Notraumato bone and mucosa
D. After anaesthesia wears off
B. Expansion of bony socket
22. oe of a tooth durin © Application of lever and fulcrum
g acuteinfection:
a = extensive spread D. Insertion of wedge
of infection ;
- Helps drainage and relieves painif
ibiotic is gi 28. Duringextraction it is seen that the tuberosity is fractured but
a its adequate blood level is remains attached to mucoperiosteum. The treatment is:
ae nea
. oe a sudden death
due to pulmonary embolism A. Removethe tuberosity
Ns eadto trigeminal neuralgia in
postoperative of period B. Refer to oral surgeon
23. 7. important principle C Elevate frap and do transosseous wiring
during extraction:
; ie am = bone while D. Reposition fragments and stabilize sutures
extracting whole tooth out—
\ a to mucosa while extracti 29. No. 16 cowhorn forcep are specially designed to extract:
C AandB while extracting tooth
pate A. Maxillary Ist and 2nd premolar
D. Noneof the above
B. Mandibular central incisor
24. Whena
Vhen forcepis to be utiliz © Mandibular molar
utili ed
direction for tooth to be appli
ed ms iniunt D, Maxillary molar
& ooh s
B. Buccally . Diagnosis of dry socket is done by:
gually D. Apically A. History B. Clinical examination.
25. _
Theideal treatatmen
m tof alveolar osteit ©. Radiographs D. Noneof the above
itiis after dental extraction
. Whichteeth are extracted standing behind the patient?
A. Topical antibiotics A. Maxillary left molars B. Mandibularleft side
= eremanic antibiotics
©. Maxillary right side D. Mandibular rightside
ridement of socket and sedati
ti %
D. Curettageto induce fresh bleeding:
Se . Bleeding caused in extraction socket due to wound sepsis after
26. Elevator can be used to few daysis called as:
advantage when? A. Primary haemorrhage B. Reactionary
A. Tooth to be extractedis
isolated C. Secondary D. Systemic
B. Adjacent tooth boneis used
as fulcrum
C Adjacenttooth is not to be extrac . For a patient undergoing anticoagulant therapy who requires
ted
D. Multiple adjacent teeth
are to be extracted unavoidable dental surgical treatment the dental surgeon
should:
A. Nottakepatient until therapyis over
B. Bring down dosage and proceed further
C Adjust dosage before andafter dental treatment
D, Consult physician of patient for joint decision

VA 28. D 29..C 30. A 31.D $2.:C

 20 Review in Oral and Maxillofac
ial Surgery
34. 2
The only y tooth t 0 be extracted Exodontia 21
by primary rotatory move
ments
be:
A. Mandic bular central al
inci or and maxil
incis 40. Chair position during extraction of maxillary teeth should
- peered central incis A. 16cm below elbow of operator
ors and nianoa
I ary central incisor and t B. Cm below shoulderlevel of operator
mandiibul
D. Mandibular central
incisor and maxillary
i C 16cmbelow shoulderof operator
ie a‘olar D. 8 cm below elbow of operator
35. i.
Princ
V ipleeacti tte ia In
i syncope is as:
41, During multiple extractions,it should be done in sequence of:
B. Respiratory stimulant A. Maxillary before mandibular anterior before posterior
C Vagal stimulant B. Mandibular before maxillary post before anterior
D. Inhibition of vasomoto
r tone © Maxillary before mandibular, posterior before anterior
36. :
Bestt
aai n= D. Mandibular before maxillary anterior before posterior
ion i pregnancy is:
in
42, During extraction priorities should be givento all except:
B. 2nd trimester A. Roots before whole teeth
C. 3rd trimester B. Painful teeth before loose tooth
D. Noneof the above © Anteriors before posterior
37. ta
Rubbe
er bandextracti D. Lower before upper
xtracon
tion is
i method of extraction
is patients
. Beaks of mandibular tooth forceps are at an angle of
A. Bleeding disorder to handle:
B. MJ and angina A.
C 45 deg
deg B. 60 deg
C Upernumerary teeth D. Odeg
D. Impacted teeth
. While usingelevators, fulcrum is taken from:
38. unde
Hyporgoi
glyc
y ng
emia
Tor me. A. Adjacent tooth
ay occur
a i patii ent taki
i ng insul
i in and B. Finger
xtraction is done on em Cc. Interdental bone
f
aes hadinfection ae D. Tooth to be extracted
atien
i t had noexercis
e j nmo min
D. Patient had breakfast . Expansion of bony socket causes:
before eetiata A. Tear of PDL
B. Multiple small fractures of buccal plate and interradicular
39. Elevators shou
ld be forced dow
n the PDL at an
— tolong axis an & le of
of tooth: septum
A. 60 deg C. Elevation oftooth from socket
C 90 deg D. All ofthe above
5 Fe ace
. Radiographs are useful in following cases except:
A. Impacted
B. Abnormal shape of roots
C. Tooth with deep PD pocket
34. B 35. B D. Ankylosis
36. A 37. A 38. A
B 42. C 43. C 45.B
ee
22 Review in Oral and Maxillofacial Surgery

47. Which conta 2

~*
A. Idealfit ct of tooth and forcep is not permissible?
B. 2 point contact
C. 1 point contact
D. All of the above
Impaction

s seen in:
1, Bulls eye type of appearance in IOPAi
molar
A. Lingually placed mandibular third
lly place d mand ibul ar third mola r
B. Bucca
C. Inver ted mandi bular thir d mola r
PD, Distoangular impaction
r at 30,000 rpm for impacted
The complication of using airoto
molar is: B. Tissue laceration
A. Necrosis of bone D. Emphysema
Tissue necrosis
is noted thatdistal
ile extracting mandibular third molar,it
y in the:
is missing. The roottip is most likel
Submental space
Submandibular space
Parapharyngeal space
Pterygomandibular space
of mandibular third
monest complication after removal
ar
Lingual nerve damage B. Dry socket
‘# mandible D. Bleeding
acted canine:
Mostlikely to be ankylosed
They may damageroot of other teeth
Goodfunction is impossible without them
complete
They will not erupt until root function is

47..C.
[= : view in Oral and Maxillofacial Surgery :

6. Radiogra
Phic appearanceofthe
'
j Impaction 25
of mandibular thi the inferior de ntal canal
~ and ro: :
A. Tram line
rd mol
ar:
0
need
1.A dentist planning to remove an impacted tooth will
whichis grooved which of the following radiographs?
C Winters lin
tu. A. A periapical film will be all thatis rsquired
e
D. Tram line enha
a. B. A bite wing will oflittle or no use
nced © lateral view will be all that is required
D. Ananteroposterior viewis all thatis required
can cause: 3rd molar?
12. Which ofthe followingis mostdifficult impaction of
A. Stoppa ge in
in | ki
A. Mesioangular B. Vertically impacted
B. #of angle evel pons D. Distoangular
= nave haemorrhage ©, Partially impacted
mouth
A 23-year-old female patient complains of decreased
8 one opening since 4 days. This could be dueto:
The‘red line’ in Winter's cl
represents: Classification of impacted tee A. Impacted 3rd molar
A. Depth at which ij m fi, Oral submucous fibrosis
<
5 Angulation of 2nd ei teeth is located Oropharyngeal fibrosis
pie 1D. Bony ankylosis of TMJ
D. Relate of alveolar bone covering the s:
j
ation of 3rd molar to the rama € impacted teeth Whe direction of bevelof the chisel during bone cuttingi
9. re
Duri
o me ‘
ng extraccti
ti on ; Awayfrom boneto be sacrificed
: of lower im
pacted right mo
lar b one I Towards the boneto be sacrificed
: td expose ma Independentof the boneto be sacrificed
ximum dimensio
- Upto CE junction Parallel to stress lines
= Upto furcation making
area Winter War lines, amberline represents:
- Upto half of roots Relative depth of 3rd molar
- 10. ma
Whnd
icib
h is
ulne acya Pointof application of the elevator
n for pericoron
itis involving imp Bone level covering the impacted tooth
acte molar
= aie and Axial inclination of the impacted tooth relative to 2nd
analgesic therapy
on chin is
a ¢ surgery of 3rd molar, patches of anaesthesia
e
Cc Bitn
raction,ofi
i inv ea
olved 3rd molar to damageof:
Pp'cation of hea
t and col . Lingual to B. Inferior alveolar nerve
d simultaneously D. None of the above
Mental nerve
of the
hift tube’ technique is used to determine the position
Impacted maxillary molars
Impacted mandibular molars
Impacted canines
6. B 2.B “Tiipacted premolars
8. A 9A 10. C
12. D 13.A 14.A 15.C 16. B
 26 Review in Oral
and Maxillofacia
l Surgery
e. Impaction
18. Classie e
fication ‘ 27
of impacted 3r
d molars (mandi: : Most desirable inc ing of a flap is:
bular mo lars) is ae
isi
A. Relation of on whil
ilee designing
. oy
tooth to ramus of mand
B. Relative dept ible and 2nd mo
h of 3rd molar in lar ee aad
D. Elliptical
C Based on Pos the bone © Curved
ition of long axi
relation to long axi s of impacted ra
traindication for placement of incision lines
s of second molar 3rd molar in
D. Allof the ab Bove: the canine prone
ove
19. The most co fi. Throughtheincisive papilla
mmon impacted
A. Mandibular teeth is: © Over me
3rd molars _
B. Maxillary ca . All of the above
nine
Cc Maxillary cen \ ile ede
tral incisors designing intraoralincision for flap thin
-Mandibular ca Convenience and access jaad oer
nine
20. Amongthe
following whic Bi. Avoidance of injury to vita a :
teeth? h are the local Integrity of interdental papi
causes of impa
A. Obstruction for cted
eruption BA of the abov
B. Ectopic position eories of impacteion
. <
are:
C Ankylosis of Primof tooth bud Phylogenic theo
B. Mendelian th
eory
ary or permanenttee ry D. None of the ab
D. Allofthe abov th Both A and B ove
e
War lines white lin
21. Injury to lin
gua l ner es representé:
A. Maxillary 3rd mo veis Possible during extraction of: Winter's Wa
Occlusal plane
Cc Maxillary ca
lar B. Mandibular ca
nine nine Bonelevel
.
D. Mandibular 3r Point of applicationo alaatie
22. Maximum Perc d molar f ele
entage of maxillary im . None of the ab
A. Horizontal pacted 3rd molars are ov e
: a eie
S Mesioangul
ar
B. Distoangular lines in Winter's — eitiate
D. Vertical Perpendicularto am =
" 23. Pell and Gr berlin
egory cla
A. Based on Positi ssification: Parallel to ambe
rline
on of
of the second mola the impacted 3rd molar to the lo From thecrest of interdental septum
B. Based on relati r ng axis
onship to the occlus , At the occlusal plane
al surface of the
adjoining Longerthe root the extracti
tion is:iOhesicicpaal
A. Moredifficul
t
t) Less difficult D. Less easy

Young patients have:

Sclerosed bone Faas .
.. Spongyelastic pliable bone
€, Cancellous bone
18. D 1), Dense bone
19. A .20. D 21.D 22:'C 23. C
273:
 28 eview in
Review i Oral and Maxillofacial
Surgery 29
impaction
32. The most diff i
ifficult im
= ee pacted coors tp removeis: pacted man dibular 3rd molarpa
tient
orizontal - Vertical 48 hrafter extraction of im of moderate pain radiatin
g,
D. Distoangular r returns to your office c omplaining
mini mal.The
degree F. Swelling is
33. es
Distoan gular impac
i tion nis
i most diff i to the ear. His temp is 99
. se nitniay of delivery into ea :
se
moe most probable diagnosisis during injection
ae ge amount of distal bone
is rem ee ese A, Traumatoi nferior alveolar nerve
parotid space
= ccess to the rootsis difficult
a fi. Postoperativei nfection of space
- All of the above C. Postoperative i nfection of masticatory
34. m
Duria
n & refl
eecti i ng of D. Postextraction alveolitis
f a palatal mucoperiosteal ieved by:
ed ma ndibular molaris ach
=P ed caninestruct
ures Passing th ee
e
). An approach toa impact B. L shap ed flap
es averted.The sequela to thisi: A. Envelope flap
as no clinical importance
, the amenr D. Allof the above
F C Bayonet flap
Se n,
- Loss of tri riangular mucosalflap behind the impacted mandibular3
rd molar,
a tption of bone aroundthecanal inci § days after extracti on of an swelling after 12 hrs
hard, painful
- Anaesthesi Sainiwt your patient presen ts with dueto:
aof the anterior palate ° ible.This is most likely
deviation near ange of mand
35. x
ai
Contrpiasi
ibutoerv
ry f.actor to periicoroniti Angioneurotic oedema
iti s of an impacted mand A.
ular
ibul
B. Haematoma
é seus by opposing tooth C. Infection
- Previousradiation thera PD. Surgical trauma
C Systemic disease
Wilkinson extraction are:
ey
D. Infected follicular cyst e wi th Wilkinson elevator
A. Atype of extraction don eru ption of 3rd molars in proper
36. The followin . , Done in orde r to per mit
_ & maxilla
be disPlaced into Mary 3rd molari ioni
i the infratemporal f mpaction is mostlikely to position
above 45 years
niqueis used: ossa the antrum if impro © Usually done in patients
A. Mesioangular lest
B. Vertical D. Noneof the above
dica te
labora tory values contrain
D. Mesiolingual The following history and molars:
37. ee
A 20-year-old pati ent requ n of man dib ula r 3rd
ires extracti extra ctio 42
an d haematocrit value is
Pei Soe deca
y. He banae it da
ce A. Hb percent is 15 gm percent
ca - The molars should be:
4s
percent
eaeeee without any complications
. ane with the
other tooth B. 5 months pregnant lady
ae ecause no changes penicillin
of eruption C, Rheumatic patient taking
D. Exposed surgicalauylyaand ndccananebe usedf
45 sec
PD. Prothrombin time is
nor sprosthetic retentio n _Paresthesia of lower lip
is most commont y the resu
lt of:
mandible
A. Abenign tumour of
ar 3rd molar
B. Removal of mandibul
molar
C. Periapical abscess of 1st
1D. # of mandible
41. B 42.D 43. B
39.D 40. C
44, D
 30 Review in Oral an
d Maxillofacial Surgery
;
44. In extractio
n of mandibular
3rd molars the
Main reason wh
y

Temporomandibular
C To prevent da
ma geto retromola
D. All ofthe abov r artery
e
45. Best treatm
ent for Pericoron
mandibular mol
ar is:
itis associated
with impacted Joint Disorders
A. Irrigating unde
r
B. Antibiotic And the operculum
analgesic therapy
C Extractionof impacted 3rd
D. Operculect molar
omy TMJis a which typeofjoint ?
46. Systemic ca A. Ginglimus
uses of impactio
A. Rickets n of tooth are: iarthroidia F ,
Cc Hypothyroi B. Tuberculosis e Batis of hinge and gliding movemen
dism
D. Allofthe ab PD. Allof the above a
47. Impacted su ove
pernumerary tee
A. Gardener's sy th is feature of:
ndrome The articular surface of TMJ consist of ?
B. Plummer Vi A. Concavearticular glenoid fossa
nson syndrome
C Marfan’s sy i, Convex articular tubercle
ndrome
D. Klinefelter sy © Both A and a
ndrome
D. Noneof the above
The ea articulating surfaces of TMJ are covered by
A. Lateral ligament
<¢ Maxillary mola i. Retrodiscal lamina
rs
D. Mandibular Fibrocartilage
molars
49. If ina 48-yea 5 Loose connective tissue
r-old Patient low
carious and 3r erleft Second
d molar of sa molar is 8rossl
y Thearticular disc is all except:
impacted with me region is me
out any sympto sioangularly A. Biconcave
extracted: ms then which
tooth is to be
c thine in its central portion than periphery
C oth
Both anc
A and B
one of the above 1), Thinnerat the periphery than central po rtion
D.N >tOf > ab 7e
Theglen ae i . a
ee = D Nonetab ‘ i arti
Thews glenoid fossa terminated at posterior rticular lip whic
.

A. Posterior displacemen -
i. Impingement of tympanic = az
C Anterior displacement of condy
44.D 45. C 46. A 47. A 48. B 49.C PD. Allof the above
= — —
=
32 Review in Oral and Maxillofac
ial Surgery
Temporomandibular Joint Disorders 33
6. The posterosuperior aspect
/ of condyle and anterior to bifa
zoneis called as: minar
A. Jokey’s cap
Hood supply of TMJis from:
B. Temporodiscal compartment _ A. Superficial temporalartery
C Genu vasculosa fi, Deep temporalartery
D.
© Maxillary artery
Retrodiscal tissue 7
1D, Facial artery
7. The fossa continued ante
fs riorly to the articular tubercle
which Commonest cause of TMJ ankylo sisis:
is:
| A. Trauma
Concavoconvex undersurface
B. Convex anteroposteriorly and .. Developmentdisturbances
C Concave anteroposteriorl
concave mediolaterally ©, Infections
y and concave mediolaterally 1D, Atropy
D. Concave on uppersurface
8. Thearticular disc divides Prequentdislocation of TMJis dueto:
the joint into ?
A. Superior andinferior compartm A. Spasm of muscles of mastication
B. Anterior and posterior comp
ents fi. Articular eminence being smaller
C Postero, intermediate and
artments © Decreased free way space
anterior 1), Allof the above
D. Noneofthe above
9. The discis attached ante gmusis dueto the inflammationof:
rior ly and post Facial pterygoid
A. Tendonoflateral pterygoid andre eriorly respectively to ?
trodiscal pad Facial nerveirritation
B. Retrodiscal pad and tendon oflat
C eral pterygoid Superior constrictor
Sphenomandibular ligament and
D. tendonoflat. Pterygoid . Buccinator
Tendonof lat. pterygoid and sphe
nomandibular ligament
10. Rees described shape of Pinto’s ligamentis:
the meniscule as: Anterior maleolar ligament
A.
Germsvasculosa B. Jokey’s cap . Posterior maleolarligament
C Vascular knee
D. Genu avasculosa Stylomandibular
11. The volumeof upperjoi . son
nt space is: . Lateral ligament
A. 2.1 ml
B. 1.9m] ny aes: wie
C 09m! eated dislocation of condyle can be pen
D. 1.2m] the Zygom atic arch and reuni on P
actu re of
act
12. Accessory ligaments of galled as:
TMJare:
A. Stylomandibular and spen
omandibular A. Stobes method B. Dautery procedure
B. Stylomandibular and stylohyo D. Weber's procedure
\ id (, Denkel’s method
- Sphenomandibular and
stylohyoid
D. Stylohyoid and mylohyoid Common least cause of TMJ ankylosis is:
A, Trauma :
fi, Developmental disturbances
€. Infections
1), Atrophy

15.A 16.A 17. A 18 -B

A 14.A
D
 34 Review
(ew in
i Oral and Maxillofacial
Surgery rders 35
Temporomandibular Joint Diso
20. Inverted hock e :
y stick incision was proposed by:
st es sos

A. Blair ible:
cs bits Dislocationis treated by forcing, mand
C Dingmann
. Crane A, Upwards and backwards
21. The tem poral branchoffacial nerve 1), Upwards and forwards
lies can away from anterior ©, Downwards and forwards
cancavity of external auditory canal: 1D, Downwards and backwards
A. lcm
C 2cm . 1.5cm dueto inflammation of:
‘ - 3.8cm Trismus is
3 i
22. Which surgi
rgical roced .
9 eae ee
A. Arthroplasty alan = out to treat TMJ ankylosis?
D. ay coy . Interior constrictor
C._ Discoplasty D :
- Capsuloraphy 1D, Buccinator
23. In dislocation of j jaw,diispla
cementof artic
i ular disc beyond
articular tub ercle of TMJ results Co ia galmaa
a
an of following muscle ?
from spasm ore xcessive A, TMJ ankylosis aa a

id . TMJdislocation
ee ao B. Lat. Pte Coconsid treatment
rygor
D - Temporalis
oe . All of these
24. Double contra st phase contract arthroscopy submandi bular incision is:
A. Clicking of TMJ
is usedto study: erve that may be confined in
Hs ao of TMJ Marginal mand branch of facial nerve
C Joint space
vl nes. eocloscal nerve
ie ypoglossal
25. All are features of TMJ di ° Mylohyoid nerve
A. Deafness J dislocation excépt: }, Lingual nerve
B. Ant. - displ
displacement of with following features
3 i openbite nilateral TMJ ankylosis is associated
eee
- Can be reduced by applyingflence. pt:
Multiple carious teeth
normal side of mandible
26. araenent of ankylosis is: . Facial asymmetry with fullness on
. clean Chin deviated towards affected side
B. Physiothera affected side
ylectomy D. Noneofthe above . Prominent antegonial notch on
27. a
Alkayat
e and TMJ ankyl osis, treatment of choiceis:
e Bramao
le sppseach of TMJis modi
fication of: ur years child with
Gaparthroplasty
B. Retroauricular approach Wi, Condylectomy
C Preauricular approach © Gap arthroplasty with costochondral
graft
D. Resdon’s approach ,
1), Notreatment
of TMJ is:
The most common dislocation
B. Posterior
A. Anterior
D. Lateral
{. Medial

30. B 31. A 32. B

29.A
>So
 36 —
Review in Oral and
Maxillofacia l Surgery
Temporomandibular Joint Disorders 37
35. The joint cavi
vity can be examined ed in
Surgical exposu ; detail with
reis: ouf“muc
A. Sialography urrence of TMJ ankylosis may be dueto:
Ee Tropy B. Arthroscopy Inadequate gap created
36. D. Endoscopy Hi, Fracture of costochondralgraft
e: e TM)is ‘ Inadequate coverage of glenoid fossa surface
inter-related to:
o
é to
Ical spi
pine 1D, Allof the above
B. Occlusion of teeth
D. Noneof the abo
ve In unilateral ankylosis duration of mandible and chin is on:
37. Capsulorrhaphy Affected side B. Unaffected side
is a form of:
= eer tightenin Equal on both sides D. No
g procedure
ze ae a mechanica
l obstacle One expected rhumatoid arthritis of TMJ helpful positive
cs ctrestrant of
condyle boratory study would be:
~ Creation of new min
ds balance Hematocrit investigation
38. Hind’s a .
w, GIT
A. Submandibular
Pproachis thea
PPy ‘.TMI through: Increase ESR
C Postrenal S tenia
1D, Tourniquettest
- Endamal.
39. All are
re tyypes of preauricu
i lar a ost commoncause of TMJ ankylosis is:
= a approa B. Trauma
ch. gig ae Osteoarthritis
sdon’s approach
D. Blan’s : Rheumatoid arthritis D. Childhood illness
ost common disorder causing pain about the masticatory
A. Receded chin pparatus including TMJis:
em ig face appear Trigeminal neuralgia B. MPDS
ance
Oe
Via,
tion of mandib
i le on affect Degenerative arthritis D. Traumatic arthritis
ed side
slowing clinical disease affect the TMJ directly:
41. ate
i :of TMJ ankylosis B. Arthritis
was Siven by:: Ankylosis
Chan Dislocation D. All ofthe above
B. Lindermama
: D. Sowhney
42. Frey’ss:yndrom MY the following which is commonly used to treat'ankylosed
eis
i syn dro me.a y?
A. Auriculotemp i i
oral nerve wea ee Steroid injection into joint
B. Facial nerve
i, Muscle relaxant
¢ Temporal nerve
(. Surgical procedure
D. Superioralveolar
ner ve [)), Systemic steroid
Ankylosis of TMJ is beet treated with:
A, Sclerosing solution
Wi, Active mouth exercise
€, Condylectomy
1). Intra-articulator injection of hydrocortisone
39. C 40. B
.d 44.A 45.C 46. B 47.B 48. D
,C 50. C
 Maxillary Sinus 39

during extraction:
oro-antral communication

Maxillary Sinus @ Immediate prolapse of

diately
Requires no treatment imme lining into mouth
antra l
ty while drinking
Reflux of fluids into nasal cavi diately
Mustbe closed surgically imme
ly from:
| antrostomy is done usualB. Inferior concha
| 1. Followin 'g Symptomsar inusitie. Middle concha
to maxill ary sinusitis D. Inferior meatus
ové
A. Tendernesss overthe ie related xcept: Middle meatus
B. Postnasal drip e involved area
adult:
Mary sinus drains into in an Inferior meatus
B ceange int phooation fold
Middle meatus
B.
Nasolacrimal duct
iteration of Nasolabiali
; D.
SgDuring extractio n
- aS e molar a root tip is displace
d eppesior meats
llar y sinu s alwa ys lies directly above the:
inside the Stldeen Bare ult maxi
tmentis: Incisors B. Canines
A. Caldwell Luc Operati 5, trea D. Mola rs
B. Hemi-maxillectom SHOn f
Premolars
C Refer surgical mxpi
oreti llary sinus:
of whichtooth lies close to maxi
weekstill socket beals
10n for 6 =
completely B. 2nd premolar
Ist molar
D. Canine
D. Notreatmentindicated Qnd molar
i Fi e extracting maxillary Ist molar
root is displaced into
ice into sinus in Caldwell Luc Operation nis
4. . .
3. Entran
. made through: :
B.: Canineie ffossa illary sinus, managementis
aity D. Z SP Leave it
;
: ygomatic ridge Retrieve through socket
; 4. Bestradio; is:
A. OPG. graphto view maxill
ary sinus Ask patientto blow nose fossa to remove
uf window in canine
C Occlusal view
B. IOPA Raise a flap and create a
\ : s view
D. PA Water' ;
the root
graph to view maxillary
monly advise d extraoral radio
during extraction of: i
———.-

Maxillary 1st premolar us 1S:

B. Submento-vertex
S Maxillary 2nd premolar AP skull
D. Lateral skull
. Maxillary Ist molar Occipito-mental
lary sinus
ing of disease free maxil
- Maxillary 3rd molar t treatmentfor small open

Not treating it but adv rice

proper homecare,
urage clotting
tatic agent to enco
Packing socket with h aemos l
Leaving sock et un dist urbed but prescri bing nasa
vasoconstrictor
, Em ploy primary closure
with sutures
9.D
 40 Revi(Ow ew
in
i Oraland Max
illofacias
Surgery
14. .
In PNS
Midsiibs
yj Sinusitis Patient,
C bon. ai i features see
Maxillary Sinus 41
eae, B. Clouding
= ele @ capacity of average antrum is:
- None ofthe 3
-= following abo 5-10 ml B. 30-35 ml
bones contain
air sinuses 20-25 ml D. 10-15 ml
© Sphenoia except:
ptomsof acute maxillary sinusitis are:
D neeoid
a Suppression
» Severe constantlocalized pain
Fetid odur
, Allof the above
Chronic sinusitis is produced by:
A. Repeated attacks of sinusitis
17. Nasal antro stom B, Insomnia
A. Inferior zaeaihieg “fer Caldwell Luc, © Allergic conditions, endocranial imbalance
© Middle Meatus D. Allof the above
Sub-acute sinusitis is:
A. Stage before acute sinusitis
8, Severe form of acute sinusitis
C. Intermediate stage between acute and chronic sinusitis
Cc Bridgefla D. Stage after chronic sinusitis
dD. Palatal isl
and flap Mucous membraneasa result of chronic inflammation may
19, ]Displacem
,ent of roots
int,
undergo:
e e
18 mos tlie
: n to happ maxill
i ary A. Hyperplasia B. Atrophy
i en en du ri
in eng extractio Urine extra
- nof see C Multiple polyp D. Anyof the above
5
B. Decidu
meous fj ue
bei mosi
laer . Closure of large chronic oro-antral fistula is best accomplished
- Antrum is
line by:
4 Highmore’sd byciliated ep; i A. Caldwell-Luc procedure _B. Palatal flap
= membrane s cae as:
alsocalled
Pchneiderian me e ta C Buccal flap D. Both B and C
: ehermann’s
mbrane
membrane 28. The direct visual examination of maxillary antrum is made by
- Ashley’s me
mb rane a cutting a window in:
21. oetion
s of parana A. Lateral wall of antrum B. Roof of antrum
- =Bive sal sinuses
resonance to are: C Posterior wall D. Antero-lateral wall
en > the voice :
Inspired air
Dan e P in reduci 29. During apicectomy of maxillary lateral incisor, one should take
ng weight of sku care not to perforate or damage the: 4
e above ll
A. Maxillary sinus B. Labial frenum
14.¢ 15,
; .B
C. Floor of nose D. Contents of incisive canal
20. B 16. 17.A
1D = 18. B 19
LC
24.D 25.C 26. D 27.B
 sre 11 ural
and Maxillofacial Surg
ery
30. Commonly appl
ied approach for
root tip from maxi removal of foreig
n bodies or Maxillary Sinus 43
llary antrumis:
A. Thro
ughcanine foss
B. Throughthe socket a i istulais all excep
ic sinusitis associated with oro-antral fis
ic
i t
C Nasal antrosto
by enlargingit
my Becinmact of sense of melt pened
D. Palatal approach Foul smell of muco-purulen facil
31. Of the followin c Mild tenderness overinfra-orbi
g conditio
A. Toremove high maxi ns, antrostomy is common:
B. To expose toot
llary 3rd molars l communicationis made
h root for apicecto * rmationof presence of oro-antra
C To treat alveolar my
abscess by:
Dz. Following clos an Schirmer'’s test
ure of oro-antral fist
ula
32. Autogenous inte B. Nose blowing si
rpositional 8rafts Rose Bengal tes
A. Costo-chondral are all except:
© Temporal muscle B. Bovine cartilag . Excessive rinsing of mouth
e
D. Auricular cart
33. MPDSis also ilage Osteumis situated in:
knownasall of t he
following except: A. Inferior meatus
: mea tus
B. Superior
A. TMJ syndrome
B. TMJ dysfunction D. Noneof the above
syndrome
C Frey’s syndro ara-nasal sinuses
me Inflamma tion of most or all of the p
1, soeraene
D. Costen’s syndro *
me simultaneously is known as: B. Odo anak
ntogenic —itis
34, Maxillary sinu A. Pan-sinusitis
sitis is odontogen D. Maxillary sinusi'
A. Close Proximit ic in origin becaus Cc Rhinitis
y with e of: .
B. Close relation with maxillary teeth . sc cnitia pay De
nasalfloor 42. Acute maxillary sinusitis :
C Presence of Pseu A. Catarrhal may B. Suppurative
dostratified ciliated
D. Noneof the abo
ve
epithelium
C Non-suppurative
D. Allo f the above
35. Maxillary sinu mmation of antral mucosa is
sis also 43. Maxillary sinusitis = infla
» A. Antrum of Rehrma known as: t "
B. Schneiderian
nn : ifi lexcept:
antrum eae maxillary sinus
C Antrum of Highmo fected drainage
re
D. Ashley’s antrum
a Pennie ek a
36. Whitehead varn relation to roots o'
ish contains benzoi
A. 10 n in _ —__ Parts: to m
Be 7:5 Most common cause of spread of oral infection
44. via
¢ 15
D. 20 inus is:
37. Frontal sinus can . A Neoplasm and ——
be viewedin:
A. Occipital-mental Extraction
i of too! t ‘
10° B. Lateral oblique
Cc, Caldwell projecti
on 15° e Peach of antral floor and wa
D. Reverse towne’s D. Periapical abscess
30. A 31.D 32. B 33. C
36. A 37.C 34.A 35.C

42.D 43.C
38. D
44.D
 C
D. Antral pathogens
Removethe eti: olo Diseases of
Salivary Glands
gy ofsinusitis
46. In chroni
c si nusiti
itis, transi
Thickened lining lluminat;
4s pene air sp membtese.
ace
resence of tooth
D. All of the ab
ove e e
1. A lesion wasexcised from the lowerlip of a 14-year-old boy.It
e. consists of a central cavity filled with clear fluid and lined with
Cc 2 Ww eeks granulation tissue only. Surface epithelium was extremely thin
D 4 weeks butinfact. A few collections of salivary gland acini and bundles
of skeletal muscle fibres were found deep to the lesion. The
diagnosisis:
B. Trocar A. Ranula B. Fibroma
= Periosteal elev C Mucoule D. Sebaceouscyst
at or
- Rongeur’s fo 2. The etiology of Mikulicz’s diseaseis
rc eps
A. Genetic B. Autoimmune
Cc Viral D. Bacterial -
ntrostomy was
Siven by: 3. A condition of the mouth whichincreasesthe caries activity in
B. Geor:ge Ca
ld theoralcavity is:
D. Re
hrmann ae A. Xerostomia B. Malignancy
50. Mention th
e blood Supply to
Pe fis flap that h C. Thin saliva D. Hair tongue
tula in the ar used to clos
- ea of tooth No. e
INaso-palatine = 4. Sialoliths are most commonly found during radiographic
Cc PSA B. Gre
e examination ofthe:
A. Parotid gland B. Maxillary sinus
C Submandibular duct D. Sublingual gland duct
5. Pleomorphic adenomasof parotid gland origin are mostlikely
to exhibit:
A. Rapid growth with early death of the patient
B. Early metastasis to distant organs
C Slow growth but a tendency to local ,recurrence after
incomplete removal
D. Local metastasis after local removal
45.B 46. D 47.C 48. B 49.B
ls 50. B
 46 Review in Oral and Maxillofacial Surgery
Diseases of
6. Of the following salivary AY
gland lesions, which is usua
characterized by by
lof the foll owingles.ions are
associated with the Sicca synd lly
rome:
A. Mixed tumour livary glands except:
B. Adenoid cystic Ca i Sjogren's syndrome
C Mucoepidermoid Ca §, Diabetes mellitus. —
D. Benign lymphoepithelial lesio
n ©. Ectodermal dysplasia
7. Adenopathy is clinically manifested PD. Uveoparotid fever
is
igna nt salivary gland tumour
by:
A. Hypersalivation
B. Swelling Which of the following mal
C Hyposalivation . _D. Swelling of the tongue common is children?
8. Branch less fruit laiden tree A. Pleomorphic adenoma
or cherry blossom appearanceis
radiographically seenin: B. Cylindroma
- Serouscell adenoma
A. Adenomacysticcell Ca oma
B. Mucoepidermoid carcinoma ©. Mucoepidermoid carcin
C Clear cell carcinoma : affected by tumours a nd
§, Usually major salivary glands Tue tumouraffect palatal
D. Sjégren’s syndrome malignances but w hich of the fo
salvery glands? :
9. Most common salivery glan
d tumo : sarin
tic carcin
A. Basalfcell Ca urs:
B. Mixed cell Ca A. Adenai aEceiatk
C Pleomorphic Ca D. Pleomorphic adenoma e: Mucoepidermoid carcinoma
10. Congenital occlusion or absenceof one or more major salivary C
D Mucoep ey i:
_ipaga
: gland duet is known . Clear cell carcinoma
as:
tionsof p
A. Atresia 16. All except one are complica
B. Abberancy
C Aplasia or agenesis es mad Paresis thrombosis /
D. Noneof the above c ate meningeal artery apt
D. Frey’s syn dro me
11. Papillary cyst adenoma lymphamatosum
or adenolymphoma e mos t com mon ly volves:
is a type of monomorphic adenoma 17. Salivary gland ston
name:
commonly known bythe
A. Submandibular gland
A. Mixed tumour B. Parotid
i gland
B. Cylindroma C. Sublingual glands
C Warthin’s tumour D. Lingual glands
a
nt finding, of the
mo Ss t Sl gn ific
evaluation the
18 - In the clinical
12. Which of the following sites of minor salivary glands i ay be accompanying:
is more ement
prove for the ocurrence of tumo
eatin
s k: n pain
oaasen
i .arg
ss less enl cqutadesied
urs?
A. Palate B. Cheek
C Lowerlip Cc Supramental and presseicu
D. Tongue
D. Facial paralysis
=
6. D 7.B 8. D 9D 10.A 11.¢€ m6 14. D 6.C 17.A 18.
12.A
: 15. *

eee
Yr 48 Reviewin
jew i Oral and Maxillofacial Surgery
s 49
Diseases ofSalivary Gland
| aex 19. Whichof
Whi the following statements is False ?
A A salivary duct obstruction queis carried out for:
can cause a unilateral swellin
. Bimanual palpation techni ngual gland
ing subli
' or of th
smallest after a meal
ut is
‘
| rg
an A. Submandibularg land swell
B. Ranula
they are enlarged due to
C Cervical lymph nodes when
B. The lesion termed as ranula
Is associated with the subling
f sali ual
inflammation
Cc Thesublingual saliva ty gland is the most common site of
L D. Both A and B
ivary gland neoplasia
| | plastic enlarg; t of the salivary
D. clea adenons is the most c 26. Non-infl tory, non
‘ommonsalivary gland
glandis called as:
B. Sialosis
A. Sialodenitis
20. Warthin’s tumouris: D. Sialorrhea
a aoo of the parotid
Cc Phylanni
gland glands:
of parotid
s ele ihemer of parotid
gland 27. Most common tumour
A. Pleomorphic adenoma
D. Noneof the oo oe B. Adenoid cystic carcinoma
21. Thec 5t Cc Cylindroma
tizi z 5 ‘
A. Cheeks Se sialometapl D. Epidermoid carcinoma
B. Dorsum of tongue one weekon
cm ulcer develops within
Cc Palate D. Gingival 28. A painful craterlike 15 female. The mostlikely
22. Pleomorphic the hard palate mucosa 0: f a40-year-old
h ad. nomaarises from:
| A. Myoepithelial cells .
B.Ad
diagnosis is:
A. Actinomycosis
Connectivetissue D. Sahaeue B. Squamous cell carcinoma
;= 23. + Th{he most commonsaliv, glan li C. Pleomorphic adenoma
A. Pleomorphic edaneane . gnant neoplasm in bones: D. Necrotiozing sialometapla
sia
sional
i Adenoid cystic carcinoma
ngin floor of mout h increases during meals provi
Mucoepidermoid carcinoma 29. Swelli
diagnosis:
, D. Adenolymphoma
A. Sialolim of Whartons duct
24. Milkulicz’s disease is: B. Sialolim of ducts of rivinus
- An inflammatory disease C Oral sub mucous fibrosis
) - Neoplastic disease D. Sjégren’s syndrome
perineural
S An autoimmune disease perotid malignancy shows
D. Viral infection 30. Which of the following
spread:
B. Adenoid cystic carcinoma
A. Pleomorphic adenoma papilloma
D. Ductal
C. Warthin’s tumour
of sal ivary gland origin:
31. Which of the followingis
B. Granular cell myoblastoma
A. Acinic cell carcinoma D. Allof the above
Cc Chond rosar coma
19... C 20.A
- 21: 22.A
23. C 24.C
28. D 29. A 30. B
25.D 26. B 27. A

QS —
 50 Review in Oral and Maxillofacia
l Surgery
s 51
Diseases ofSalivary Gland
32. Reductionin flow of saliva
is not generally seen in:
A. Elderly diabetics a ae f: _——
=
B. Patient undergoing radiation thera % Patty change in parotid is sign
C Patients suffering from parkinsoni py
sm kee
C Malnutrition D. Noneof the above
D. Patients on phenothiazine drugs
i
minorsalivary gland ?
33. Sialographyis used to detect ich tumour does not occ ur in
A. Salivary duct only
anomalyof:
, Irreoniayics adenoma
denocarcinoma /
B. Salivary gland
C Salivary gland and duct c ‘dinoepeternchl carcinoma
D.Salivary gland tumours D. Warthin’s tumour
sialogram:
34. Acute non-suppurativesiala Ball-in-hand appearance ona
denitis is seen in: , A. Benign tumour
A. Acutebacterial sialadenitis
B. Mumps B. Sjégren’s syndrome
© Chronic bacterial sialadenitis C Normal gland
D. Necrotising sialometapla D. Noneof the above
sia —
; nitvi tl
i es all
BOexcept"cejan
35. A cyst occurs underthe 43. Sjégren’s syndrome includ
tongue, caused by obstructio & ugh
salivary gland. Such a cystis n ofa A. Xerostomia
called:
A. Mucocele Cc Arthritis
B. Ranula :
C Dermoid cyst
D. Dentigenous cyst 44. Tender subman dibul
i ar swelling is mostly dueto
E ; ‘ie
36. Mucocele most commonlyar ig’s an;
ise as a résult of: induced sialadeni
A. Rupture of a salivary gland . Lae = sialolithiasis
B. Partial or complete compr
ession of the salivary acini
c Enlarged lymph nodes
C Inflammatory changes in the D. Allof the above
glandular interstitial tissue known syndrome
alsoCiing
D. Partial or complete obstruction is a as:
of the salivary duct by calculus 45. Austculctempore!em
37. The most Itz s
complication of ips is: D. Frey’s syn
« A. Myochorditis e culver syndrome
B. Orchitis
C Cheilitis D. Conjunctivitis pause ares
46. Saliva is increased by:
38. Adenoid cystic carcinomais
also known as:
C. Adrenergic drugs D. Noneof the above
A. Cylindroma B. Adenolymphoma 5 ne
C Warthin’s tumour i
i adenoma isatt riibuted to:
D. Pleomorphic adenoma rrence of pleo morphic
39. Sialolith in the excretory duct
will resultin: ” paee of an incomplete capsule
A. Chronic sialadenitis B. Mixed origin
B. Mucousretention cyst C Absenceof capsule
© Pleomorphic adenoma D. Rupture of the duct D. Perineural spread

43.D 44.C 45.D

42. A
 52 ;
Review in Oral and Maxillofacial Surgery

48. -
Xerostomia,, enlargement
enl of salivary and lacrimal glands is see

Cysts and Tumours

A. Sicca syndrome
B. Sjogren's syndrome ;
C Mikulicz’s disease
49. ak
One might see café
caf au lait
i spots in
i the following condition of Oral Cavity
A. Tuberous sclerosis
- Sjogren’s syndrome
von Recklinghausen’s s di
D. Albright’s syndrome not a type of dentigerous cyst?
joa 1. Which ofthe following is
B. Periapical
A. Central
D. Circumferencial
Cc. Lateral
unction that may giverise to lesions
2. Metabolic or systemic dysf
of cystic appearances?
A. Osteitis fibrosa cystica
B. Histiocytosis
Cc Both AandB
D. Noneof the above
lt of
esterol crystals as a resu
3. Cystic fluid contains chol
breakdown products of:
cells
A. RBCs and exfoliated epithelial
B. WBC andplasmacells
c Lymph
D. Platelets
d osmotic pressure because:
4. Cystic fluid have increase r weight
cula
A. It contains proteins with high mole
cont ains prot eins with low mole cular weight
B. It
Cc Cholesterol
D. Carbohydrates
5. Nasoalveolar cyst is lined by:
ed or squamous epithelium
A. Transitional columnar relat
dost rati fied citra ted colu mnar epithelium
B. Pseu ,
C Oral mucous membrane
D. Stratified columnar epithelium

48. A 49. €
 Reviewin Oral and Maxillofacia
l Surge Cysts and Tumours of Oral Cavity 55
y
Type of biopsy done for small cyst:
* oSmed palatine ner A. Incisional B. Excisional
e a se Superior pada
ve
C Punch biopsy D. Noneof the above
lveolar
diameter can be treated
. The bonecysts thatare less than 2 cm in
pod € superioralveolar ner
- ve
Nasopalatine nerve
by: B. Marsupialization
7. oe canal cys A. Enucleation
t is removed:
> ee by raisin Cc. No-treatment D. None of the above
g labial flap
oa y byraising palatal fla 15. If the cyst has invol ved maxil lary antrum it should be
tmentrequired approached through:
D. Allof the above ;
A. Palatal pedicle flap
8. Cyst common!y found betw. B. Caldwell luc approach
inci
is: een lateral upperPer incisor and canine C. Buccal flap advancement
A. Incisive canal cyst D. Combination of buccal orpalatal flap
c Globulomaxillary cyst B. Ranula
D. Median palatalcyst 16. Partsch’s operationis also called as:
9. co arise as a A. Marsupilisation
resulto
7 truction of Saliva f: B. Enucleation
ry duct
* ‘traumato salivary duct C. Enucleation with primary closure
C Congenital atresia D. Combined marsupilisation and enucleation
D. All of the above
17. Comb ination of marsupilisation and
enucleation is called as:
3
3
A. Partsch Il B. Waldron’s operation
A: Gentging ranula
10. In plun
the extravasated mucu

B. Myleyoidmuneandcosenubgland
Cc. BothAandB D. None of the above
ated for removal of 3 cm
18. Which of the following surgery is indic
collects ;in subliingua:l gland
C Mylohyoi: d muscle and colle ameloblastoma involving inferior borde
r of mandible?
cts
D. B. Fulguration
le and colle cts in a gland A. Enucleation
11. Mylohyoid musc e Cc. Cryosurgery D. Resection
€ver an erupting tooth an
* =o e :
rous or erupti 19. Ameloblastomais best managedby
B. Primordialcyst
ntige ,
A. Chemotherapy B. Radiotherapy
C OKC . Cc. Gene therapy D. Surgical excision
D. Periodontal cyst
20. Redicular cyst is treated by:
12. Cream
:
:
y white suspensi ; A. Excision B. Resection
ee keratin that a PPears ears li :
without an olfenates smell
e is found j like pus Cc Curettage D. Radiotherapy
A. Dent ai
ntigerous cyst
C OKC i B. Primordial cyst
D.Periapicalcyst

6. D 7 10.¢ v7.c. IAD

2¢ a ac .D 13. B 14.A 15. B 16. A
: 11. A
19.D 20. C
 56

Review in Oral
: .

and Maxill ofacial Surgery Cysts and Tumours of Oral Cavity 57

|

21. Whichofthe
f,ollowi i is not . The most appropriate method to differentiate between a
- Exposure of ve ng an advantage of
marsup
ry little bone upjl
iljization? dentigerouscyst and an ameloblastomais through:
: Preservation
Of vital structur A. Radiographic examination
= Rapid healin
g re
B. Spiration cytology
Onserve surgical C Microscopic examination
structures
22. avedle aspi
ration of a cent D. Clinical features
~ BS out a va ral bon € lesion
scular lesion is useful: 29. Treatmentof fibrous dysplasiais:
e eae
thickness of buc A. Radical resection of lesion
. 1agnose traumati cal plat
B. Radiation therapy
- To fee] root su c bone t
rface Cc. If the lesion is small dissection is done, if lesion is large
a
cosmetic surgery hasto be carried out
D. Cryosurgery
30. A man has 1 x 1.5 cm pedunculated lesion on the soft palate
C Cholesterol cry
stal which has or rough, warty surface but is the same colour as
D. Inflammatory
cells adjacent mucosa appropriate managementof this lesion is to:
24. An empt
y caviity ty in A. Perform an incisional biopsy
i the mandib
to be:3 le with no lini B. Perform excisional biopsy
n & 1s
i most like]
A. Aneurysmal bo C. Scrape for exfoliative cytology
© DentigeZ ne cyst ; . " D. Observe for two weeks
rous cyst of 2 Ramee bone cavity
: s 31. Whentreated with simple curettage which odontogenic tumour
is mostlikely to recur?
A. Complex odontoma
B. Compound odontoma
B. Aspira
c = tion of C Odontogenic myxoma
the cyst D. Ameloblastic fibroma
- Expose the crowna
nd ke epit ex
posed
32. Odontomaistreated by:
26. Expected
Surgical proc A. Excision B. Resection
odontogenic cys edu most frequently Cc. Curettage D. Radiotherapy
tis: - indicated for
A. Incision dr
ainage 33. Treatment of ameloblastoma:
Marsup'ilisatio . Soleealtig so
n lution A. Excision of tumour
> Enucleati
27. The cyst is
deroofed and
B. Resection of mandible along with tumour
Margins of the the s C Marsupilization
cyst wall in: .
D. No active treatment is necessary
Decortication
© Saucerization - 7tiotherapy
- Enucleation

24.1.
27. B 22.4 23. A 24. B 25.D
° 26.D

Eee
 Cysts and Tumours of Oral Cavity 59
Oral and Maxillofacial Surgery
old patient
M. Best treatmentof al 42. Treatmentfor fibrous dysplasia in or young 25-year-
A. Enucleation ads involving maxilla is best treated by:
a niareupilization A. Enbloc resection B. Cosmetic contouring
arsupilization followed b C Maxilla ry resecti on D. Radiation therapy
D. Enucleation followed i by:
by eta 43. Submandibularcalculus can be removed
35. A5 cm, suspici ‘
Picious looking lesi
A. Dilatation of the duct
= Incised sent for Scr esion of oral mucosa should be: B. Incision of opening of duct
- Excised sentfor biopsy C Removal of gland
C. Irradiated ; D. Incision of duct and removal ofcalculus
following
D. Offered palliative treatment 44. During surgical excision of parotid gland the
structures may be damaged:
i
placedin: A. Lesser occipital nerve, hypoglossal, chorda tympan
A. 10 percent ethanol B. Facial nerve and auriculotemporal nerve
B. 10
© Hydrogen peroxide eeee C. Submandibular
: : duct
37.- Protei - percent formalin D. Cervical fascia
Protein content of <4mwhite desk; '
-
~ Denteecoup
nin:
B. Polini 45. During removal of a parotid tumour the auriculotemporal nerve
eratocyst D. Periodontal is injured. This result in:
ahcyst A. Facial paralysis
38. ee of palatal tumo B. Ingeminal neuralgion
urresults in:
a cessive bleeding from C. Gustatory sweating
nasopalatine vesse
2 ene of nasal mucosa D. Ovolingual paraesthesia
amage to nasopalatin "
approach by
D.Alteration of peck a 46. Submandibular ductis exposed via intraoral
a incising:
39. Adenoameloblastoma A. Buccinator
is managedby:
A. En bloc resection of maxi B. Mucous membrane
lla . *
B. Marsupilization C Masseter
Enucleation D. Allof the above
D. No treatment
or tumours is
47. Excision of submandibular gland for calculus
l care should
40. Odontogenictumours urs just
j 1 cm away from lower border: doneby incision below angle of the jaw. Specia
A. En blocresectio be taken to avoid damage to:
C Enucleation " Nomimandibulectomy A. Ansacervicalis
- None of the abo ve
mpegis procedure donein:
41. gin pilization B. Mandibular branch of facial nerve
B. Patisdo tal C. Posterior auricular nerve
= ee cyst
D. Stafne coal on D. Submandibular ganglion
neurysmal bonecyst

42. B 43. D 44. B 45.C 46.B 47.B

34. C
as 35.A
cig 36. B we rey
 60 Review in Oral and Maxillofacial Surgery

48. Treatment of pleomorphi

rphic ade: id i
- — parotidectomy with inane a
i

Mid-face Fractures 9
- Superficial parotidectomy
Perea
C Deepparotidectomy
D. Radical parotidectomy
49. oe~
Treatm ~of mucocele on lower lip is:

B. Excision ’
C Excision with adj . LeFort fracture is sameas:
D. Biopsy 1th adjacent glands A. Craniofacial dysfunction |
B. Fracture
50. Which ofthe followin ig, detects salivary gland duct C. Pyramidal fracture |
diverticuli:
A. Ultrasonography B. Plain radiography ; D. None of the above
C. Sialography |
D. Xeroradiography included in glassgow coma scale?
. Which of the followingis not
B. Motor response
A. Eye opening
D. Pupil response
C. Verbal response
_ CSF rhinorrhoeais found in: |
A. Frontal bone fracture |
B. Zygomatico maxillary fracture
C. Naso ethmoidalfracture
D. Condylar fracture
in:
_ CSF rhinorrhoeais not seen |
B. Lefort2
A. Lefort1
Lefort 3 D. Ethmoidal #
C
is
l fossa there is epiphora this
. After fracture of middle crania
due to damageof:
y
A. Ciliar gangli on B. Greater palatine nerve
Cc. Infraorbital nerve D. None of the above
of head injury is:
6. The first step in management
B. TV mannitol
A. Secure airway
D. Blood transfusion
Cc. IVdexamethasone
 62 Review in Oral and Maxillofacia Mid-face Fractures 63
l Surgery
of
7. Which of the following is ia is seen with which of the following types
~
nota feature of LeFort II fracture? . Paraesthes
Para
A. Enophthalmos B. Malocclusion fracture?
C. Paraesthesia D. CSFrhinorrhoea A. Subcondylar
B. Zygomaticomaxillary
8. Guerin fracture is:
A. Maxillary fracture C. Coronoid process
B. Maxillary and zygomatic D. Symphyseal
fracture
C Maxillary and nasal bone 6, Diplopia is most common with:
fracture
D. Nasal bonefractute only A. Mandibular fracture —
9. Gillie’s approach for reduct B. Craniofacial dysfunction ‘
ion of zygomatic fracture is C Zygomaticomaxillary complex
done
ugh: D. Nasal fracture
A. Temporal fossa B. Infratemporal fossa
C Infraorbital fossa Palle be done within:
D. All of the above 17. Suturingin facial wound ee
A. 2 hours
=. ;
10. A fracture of eye by ping D. 8 hours
pongball results in: Cc 4hours
A. Blow out fracture :
B. Orbital fracture 18. The hanging drop appearanc e in the maxillary sinus radiograph
C Blowin fracture indicates: .
D. Compound fracture
z nea kates of the orbit
11. Pandafacies is commonlyse
en after: C Radiograph artifact
A. LeFortI fracture
D. Antrolith
B. LeFort II fracture
C Mandible fracture 19. LeFort I fracture is characterised by:
D. Noneofthe above A. Bleeding from ear
12. Walshams forceps are usedto B. Bleeding fromantrum
: Cc Angle'sclassII classification
~ A Removeteeth
B. Remove roots D. None ofthe above
C Clampblood vessels D. Reduce nasal bonefracture ‘ ‘ severe facial
ial
20. Which - the immediate dangerto a pa tient with
13. A patient is in shock
with gross comminuted injuries?
immediate treatment is to give: fracture,
A.Bleeding
A. Normal saline B. Associated fracture spine
B. Ringer'slactate solution C. Infection
C Whole blood
D. Plasma expanders . = C63 act . :
in opening the
21. In depressed zygomatic arch fracture difficulty
14. Forceps used for maxillary fracture disimpaction: a apa
A. Rowe's mouthis caused by impingement os ar
B. Bristow’s
C Ashe’s C. Petrous temporal
D. Walsham’s i
D. Coronoid pre
cess

7A 8. A
B 16.D 17.B 18. B B
19. 20. D
9A, 10. A 15. s
11.B 12.D
21.D
 64 Review in Oral and Maxil Mid-face Fractures 65
lofacial Surgery
~
22. Thesafest initial appr i
Which of the following always indicates obstruction to th e
oach to open airway of
maxillofacial traumais: patient with airway?
A. Headtilt-chintilt A. Slow pounding pulse
B. Jaw thrust technique B. Stertorous breathing
C Headlift-necklift C. Increase in pulse rate
D. Heimlich procedure D. Decrease in blood pressure
23. True open biteis caus . Moon faceis seen in:
ed by:
A. Horizontal fracture ofthe A. LeFortI B. LeFortII
maxilla
B. Unilateral fracture of C LeFort Il D. Orbital fracture aecatia
mandibular angle
C Fracture of coronoid
D. Fracture of mandibul
process ofleft side of mand
ible 40. . White
1 head varnishin gauzeis used to arrest bleeding
ar symphysis A. Gingival crest
24. Allof the following B. Bleeding from pulp
statements of nasal fract
A. Even if minor ures are true except: C Bleeding frombone :
they may be followed bybilateral
andfacial oedema ecchymosis D. Bleeding from capillaries i .
B. They may need to be
reduced hich of the followingis seen?
C They need not be complicate for a few weeks
r iL oan
n ee, “ B. comceeonical
D. They maylead to telescopin d by traumatic telecanthus D. Noneof the a “sae
g of the nasal complex into the Se: Buller Haemnocttiags
frontal sinus
25. Fixation with pack in 2. An a average patient with maxillofacial trauma requires
32.
maxillary sinusis: muchof daily sodium:
A. To support comminut B. 50-60 mmol
ed fracture of the body A. 100 mmol
complex of zygomatic
Cc 10mmol D. 1000 mmol
B. Tosupport and recon ;
stitute comminuted orbita
C Toprotect mucosal cover l fracture illi’s approachis used in: /
ing of maxillary sinus
D. Both A and B a Aookrluiction of zygomatic fracture
ible ;
26. Floating maxilla is typic
al in: eS toed reduction of zygomatic fracture
A. LeFortI
D. Noneof the above
B. LeFort II
© Craniomandibular dysfu 34. Lefort 2 fracture is called: a padi }
nction
D. Allof the above
-
C. we
Floating D. Cranial dysfunction
27. In a patient of head
injury which is more impor
first? tant to note i i eat res! ults from
35. Diplopia entrapment
= ren o f:
oblique
A. Papillary light refle
x B. Papillary size
C Cornealreflex C Caan D. Superior oblique
D. Ability to open eye

22.A 23. A B 30. C 31.A 32.A 33. A

24.B 25.A 26.A 27.D
 Wd Maxillofacial Sur
gery
Mid-face Fractures 67
C Fracture at fron
Whichofthe follow ingis right about Guar
dman’s fracture?
D. None of the abo tog oma ti A. Itis nasalfracture
ve *BOmatic sutu B. CSF rhinorrhoea is severe
re in this case
_ Commonly seen in epileptics
A. Ma: D. Type of comminuted
fracture dueto bullet or
c Orbicularis missle injuries
oculli . Tramline pattern on the
; oeoie face is due to:
38. i.
Hoodin
pie.of A. Sutureplaced in tension
: eyes is
i seen in abo
- i ae
i Fined B. CSF rhinorrhoea
Le-Fort 3 5. . C Circumorbital ecchymosis
"O)
D. Nasal bone D. Subconjunctival haemorrhage
46. Which is weakest part of
orbit amongthe following?
B. Zygomati A. Medial wall
c co B. Lateral wall
c LeFort3 fra m lex fr, © Floorof orbit
cture, ae D. Roof of orbit
. Bilateral con 47. The immediate treatment
mandible dylar £ for a patient with comminuted
Ylar fracture i fracture and in state of shock:
wit h symphysis fra
40. Lowering cture of A. Ringer's lactate solution .
the Pupi i
B: Ofbital volume incres
lary |} B. Normal saline by IV
by IV route

. tachment of sus
eee °f*Yeball occurit
k
C. Blood transfusion
route

© Incase of blo . Dd: Plasma expanders

w out Pen sornsy ligamentsof |Ocu 1
fra chu
None ofthe above les occur 48. Depressed fracture
of the zygomatic area
41. si
Duri
gn recognised by: may be clinically
n if
thican
illte’ 5 approach A. Concavity of the overlying
the Struct tissue
in the zygomatic arch area
A Superfici ure of anat B. Interference with movements
al temporal omic of mandible
~ 5. Marginal mand arte © Subluxation of condyles
Cc Internal ju ibular nerv D. Both A and B
gu e
D. Inferior la r vein
alveolar 49. Principle of treating
fracture includes:
42. Which A. Reduction of fracture
facial bone
A, Mandib j S fre B. Fixation offracture and
le restoration of ocelusion.
ele e © Immobilization
a
D. All of the above
50. Complication of an o
pen fracture reduction:
A. Malunion
C Infection B. Nonunion
D. Crepitation

44.C 45.B 46.C 47. A 48.D

50. C 49.D
 Mandibular Fractures 69

In case of sub-condylar fracture, the condyle moves in which

direction

Mandibular Fractures
A. Anterolateral B. Posteromedial

r
©. Posterolateral D. Anteromedial

n 10 Pieacase
. The fracture of the tooth-bearing segment of the mandibleis:
A. Simple
C. Complex
B. Compound
D. Communited

1. For the fracture . The proximal segmentof mandibular angle fracture is usually
of man
a dible, all are true displaced in which direction:
exce;pe:
=
A. Antero-superior B. Postero-inferior
C. Onlyinferior D. Postero-superior
© Theyares characteri
Cterised b: *
D. CSFrhinorrhoea isa common 9. A displaced mandibularfracture ina child should be managed
fanee
by:
A. Circum-mandibular wiring
B. Early mobilisation ’
Cc IMF
C Platiing onlateral
side
i of th D. Trans-osseous wiring
D.Plating at infe
rior border ie
10. A fracture of the mandible in the canine region ina 6-year-old
3. 7-year-old
. bo'Y presented with f, child should be managedby:
—
re;
with
i
occlusion
3*
undisturbed. The of left sub-condylar
racture
A. Capsplint fixation B. IMF
B anion for 7 days he treatment would be: C Risdon’s wiring D. Trans-osseous wiring
. _Immobilisation for 14d. ue
C Noimmobilisat; * days with intermittent act; i 11. The most commonsite of fracture of mandibleis:
D. No ‘tesbbien
isationwith restricted
andactive Geetmouth
ate opening
ee for ten days A. Body B. Symphysis
Cc Angle D. Condyle
a eture
4. as
Frac oed mandib
i le should be imm
_s obi
_ lia foran averageo 12. A patient with unfavourable fracture of the angle of mandible
- f:
ors wee is best treated by:
D. 12 weeks :
i pees mmon
A. Closed reduction with IMF
co mpliicati
cation of condylar
injuries in children
B. Closed reduction with cap splint
is: C Open reduction with inter-osseous wiring
B. Ankylosis
D. Openreduction with rigid fixation
© Osteoarthritis
-
D. Fracture of glen 13. Bucket handle type of fracture is seen in:
oid fossa
A. Children B. Soldiers -
C Edentulous patients D. Young adults

1.D 2.D 3.D 4B = 9.B 10. A 11.D

an
oo

Qn
Noa

_
_
 70 ald
Reviewi n Oral andMaxillofacial Sur Mandibular Fractures 71
gery
14.A fractured mandibular
i ~
cond yle is
is displaced
di dibular fracture is:
medially by the acti fo rward and Mostc pathog ic sign of
on of:
A. Temporalis A. Malocclusion
Cc Interior pterygoid = Macrior Plerygoid B. Trismus
15. Primary heali - Masseter C. Deviation of the jaw while opening
ing of a mandibular fr. 1D. Paraesthesia of mental nerve
fixation with: acture is seen follow;
wing
A. Gunning i spli
Splint , Direct interdental wiring is also called as:
C Trans-osseous B. Compression plat A. Risdon’s wiring B. Eyelet wiring
wiring es
D. Champy’ C Gilmer’s wiring D. Essig’s wiring
16. Eburnationis
seen in:
A. Malunion taht . An adultpatient sustained a sub-condylarfracture on the left
c Osteomyeliti B. * N Nonunion side. Clinically it is seen that thereis:
s
D. Osteor adionecr A. Moderate intraoral bleeding
17. Allare the fe osis
atures of i B. Trismus andbilateral crepitus
A. Malocclusion mandibular fractures except: C. Deviation of the mandibleto the right on protrusion
e =‘araesthesia of lower lip D.Inability to deviate the mandibleto the right
ractured end a
muiselas re prevented from dislocation by 25. The weakest point of mandible where fracture occurs is:
masticato
D. Are usually compound A. Neck
7
18. Greenstick frac B. Angle
tures are common C Symphysis
A. Older people in
D. Oblique ridge near mental foramen
© Child
iii ae ;
B. Adults
D. Soldiers 26. Clinicalsign thatis always positive in bone fracture is:
$ A Risdon’s
A ‘ent for mandib:
wiring A. Crepitus B. Tenderness
i a
the incisors is: C Abnormal mobility D. All of the above
P sp’ int . Essig’s wirin;
D. Trans-osseour wiring 27. The extraoral radiograph required for a fractured mandibleis:
20. Compression A. SMV B. PA view
- ee ‘ osteo-synthesis heal
Soe without callous eae Cc PNS D. Towne’s
ene by:
- Seco} unio: i
© Compression "without callousformation 28. Posterior auricular ecchymosis in case of fracture of cranial
D. Allofthe above baseis:
A. Battle’s sign B. Tinel’s sign
21. Which of the fi
ollowing is nota rig} C Coleman’s sign D. Nikolsky’s sign
A. Osteo-synthesis oonthetic fixation?
C Screw plating D. Wes oplating 29. Direct impact on the bone will produce:
. Wiring A. Transverse fracture
B. Oblique fracture
C Spiral fracture
D. Comminutedfracture

23. B 24.D 25.B 26. B

 7 Sih
2 Review in Oral
and Maxillofacia
l Surgery
Mandibular Fractures 73
30. A deviation
of mandible to the
A. Fractureofleft ri ght side may
con suggest: 6. Fracture of mandible not involving dentalarchis treated by:
= Lyperplasia ofri dyle ~™
ght condyle A. Open reduction
> ypoplasia ofleft con B. Closed reduction
- Fracture of right dyle
condyle C Notreatmentindicated
31. a
If frae
cturew
of th
D. Noneof the above
i re dis
i tal to the last
tooth, the 37. Treatmentof choice of a linear non-displaced fracture of body
- Closed reduct
ion with IMF of mandible with full complement of teethis:
Oe reduction Wit A. Kirschner wire
5 Se uct
h bone plating
ion with inter-osseou B. Circumferential wiring
reduction with cap s wirin
splint Cc Ext. pin fixation
32. Following g : D. Inter-dentalfixation
bil
bi ateral mandib
te
whirch of the follow ul
Owii ng muscle~wil 38. Which of the following condition is associated with anterior
e l ten
e d to
C pulle
the man
e ctibic open bite?
A. Geniogi lossus and ant A. Unilateral condylar fracture 7
e Genioglossus belly of di i
and mylohyoid B. Bilateral condylar fracture
= Genioglossus and een C Maxillary fracture
- Genioglossus and thyrohyoid D. Coronoid fracture
masseter
33. ii
Treen
atm
aeent of choOic
i e fora Symphysis 39. When sub-condylarregion fractures, on protrusion of mandible,
fracture in an 8-y
ear-old it deviatesto:
A. IMF A. Sameside B. Opposite side
B. Capspli
ent ewit
t h cir
ci cumferential
; C Does not move D. Retrudes
i wir ing
D. Notreatment 40. Battle’s sign is:
ind icated A. Sub-conjunctival ecchymosis
34. In Ost
< A eosynthesis,
i f,followiing
1s, are used except
B. Sub-lingual ecchymosis
: C Palatal ecchymosis
B. Wires D. Ecchymosis in mastoid region
© Champy’s bon
e
D. Eyelet Wiring plate 41. Risdon’s wiringis indicated for fracture of:
A. Body B. Angle
35. he
Fractureof b ody
d of mandib
i le with full arch of
Cc Symphysis D. Sub-condylar area
teeth is treated
A. IMF 42. The optimum length of screw for fixation of plates in mandible
= on reduct is: .
ion and interior
a Osed reduct fixation A. 2mm B. 3mm
ion andinteriorfi
- Exteriorpinf xatio C 4mm D. 6mm -
ixation
.
30.D 31. B 32.A 33. B 34. D 35. A 36. A 37::D 38. B 39.A 40. D 41.C
42.C

rrr
 74 Review in Oral and
Maxillofacial Surgery Mandibular Fractures 75
ai
43. The splint most comm i occurs??
only used in dentulous In which of the following anterior open bite
fractures is: mandibular
i dylar fracture
A. Gunning splint 4 Bcohoslntcteoure on one side and angle fracture on other
B. Capsplint
C Ribbonsplint : side of mandible :
D. Allofthe above
44. A displaced, unfavourable © Horizontal fracture of maxilla
in the mandibular an:
potentially difficult to gle regionis D. Both A and C
treat because of:
A. Injury to neurovascular
bundle
B. Malocclusion secondary
to injury
C Distraction offractured
Segments by muscle pull
D. Increased density of bonein
the region
45. For a patient unde
rgoing closed reduction
mandible, which of the of fractured
following procedures
performed: should be
A. Medicalhistory and physi
cal examination
B. CBC
C Urineanalysis
D. Allofthe above
46. In case of sub-condyl
ar fracture, the condyle
irection: moves in which
A. Anterolateral
B. Posteromedial
C. Posterolateral
D. Anteromedial
47. Forward displacement
of condyle in condylar
to: fracture is due
A. Medial pterygoid
C Masseter
B. Lateral pterygoid
D. Temporalis i
48. Among the following,
which is the least common
fracture? site of
A. Body of mandible
B. Coronoid
C Condyle
D. Angle of mandible
49. Fractures of mandible
where full compliment
Present is best treated of teeth are
by:
A. Intraoral open reduc
tion
B. Circumferential wirin
g
C Cap splint
D. Close reduction and
intermaxillary fixation

43.B 44.C 45.D 46.A 47.B

48. B 49.D
 Infections of Head and Neck Region 77

Retropharyngeal space infection is mainly due to spreadof:

A. Cervical tuberculosis B. Meningoencephalitis
Infections of Head C Mumps D. Odontogenic infections
The distinguishing feature of masticatory space infection is:
and Neck Region A. Pain
C Trismus
B. Dysphagia
D. Swelling
9, The greatest barrierto infection is:
A. Connective tissue B. Epithelium
a igieane: responsible C. Muscle D. Fascia
for acute osteomyelitis is:
0. Osteoradionecrosis is due to:
B. Treponema denticola A. Infection
C Staphylococcus aureus B. Endarteritis of blood vessel
D. Streptococcus viridans Cc Sepsis
2. Ree Picture of a case of D. None of the above .
an acute osteomyeliti s shows:
et ucopenia _ B. Leukocytosis 11. A mandibulardental infection which exits the buccalcortical
ymphocytosis D. Neutrophilia plate above the muscle attachmentwill cause abscessof:
3. Trismu
1 sassociated with infecti on A. Buccal space B. Masseter space
of C Vestibular sulcus D. Masticatory space
is related to irritation of the:
sl marr ee enace
A. Buccinator 12. Which ofthe followingis not a primary mandibular space?
B. Masseter
C Lateral pterygoid A. Buccal B. Sublingual
D. Medial pterygoid
4. Garre’s osteomyelitis is: C Submandibular D. Pterygomandibular
* ae focal sclerosis and nonsu 13. Treatmentof Garre’s osteomyelitis is:
ppurative osteomyelitis
i onic focal sclerosis and suppu A. Incision and drainage B. Sequestromy
rative osteomyelitis
Sc Suppuration and acute pain C Saucerisation D. Surgical recontouring
D. Chronic diffuse sclerosing osteom
yelitis 14. Odontogenic infections are mostly caused by:
5. Death in Ludwigs angina occur A. Mixed bacteria B. Anaerobic bacteria
s due to:
A. Sepsis C Aerobic bacteria D. Viruses
B. Respiratory obstruction
C Cavernoussinus thrombosis 15. The infection from a lower 3rd molar pericoronal area spreads
D. Carotid blow out mostly to:
A. Submandibular space B. Submental space
6. oes of pterygomandibul C Pterygomandibularspace D. Buccal space
ar spaceis formed by:
Es ae
B. Medial pterygoid
‘ranial base D. Lateral pterygoid

en
Ie 2. B 3.D 4.A
 Infections of Head and |
78 Review in Oral and Maxillofacial Surgery

Ss
ad boneis seen on the X-ray as:
16. Involucrum is: A. Moreradiolucent
A. Dead bone B. New live bone , More radio-opaque
C. Previouslive bone D. Sclerotic bone © With osteophyte growing out
17. The fascial space that is divided by the styloid process into an D. Soap bubble appearance
anterior and posterior compartmentis: The most dangerous type of spread of infection from
A. Pterygomandibular B. Lateral pterygoid abscessis to:
C. Retropharyngeal D. Infratemporal A. Infratemporalfossa
18. The mostdefinite clinical sign indicating odontogenic infection B. Pterygoid
into the masticatory space: Cc Parapharyngeal space
A. Trismus D. Submandibular space
B. Xerostomia . Hyperbaric oxygenis indicated for:
C. Difficulty in swallowing A. Obstructive lung diseases
D. Swelling in submental area B. Osteoradionecrosis
19. Which of the following does not suggest postoperative Cc. Cardiac failure
infection? D. Renal diseases .
A. Increase in temp B. Swelling i thrombosis ing
i following infection
in :
D of anterior
6. Cavernous sinus
along:
C Pain D. Pitting oedema , measilinny teeth most often from spread ofinfection
A. Facial artery B. Angular artery
20. Hilton’s method deals with:
A. Decompressionof cyst C Ophthalmic vein D. Pterygoid plexus
B. Drainage of an abscess . Trismus is most commonin infection of: ;
C. Biopsy removal i A.Subenantal space B. Submandibular space
D. Pre-anaesthetic check-up C Submassetric space D. Buccal space
most likely
21. In a 19-year-old patient with a swelling overthe left angle of 28. A tender swelling in submandibular triangle is
the mandible, temp of 38 degree Celsius and negative history diagnosedas: a /
~ of trauma one should suspect: hadenopath B. Ludwig's angina
A. Spontaneousfracture of mandible S Haeon wy D. Noneofthe above
B. Pericoronal infection
29. Ludwigs angina involves spaces.
C Mumps
dibular B. Submental
D. Sjogren’s syndrome
C Sublingual
ae cual D. Allof the above
22. Osteomyelitis:
A. Neveroccurs in infants
B. Inacutecases fracture mandible is very common
C Of mandible can show symptomsoflip paraesthesia
D. Produce no lymphadenopathy

25. B 26. C 27.D 28.A

23. B 24.C
16. B 17.B 18.A 19.D 20. B 21.B 29.D
22.C
 Infections of Head and Neck Region 81
80 Review in Oral and Maxillofacial Surgery
process
Afterincision and drainageof an abscess the infectious
30. aS
A diagnosi i
gnosis of cavernoussinus isi madeon the b.
thrombosisis dose
has failed to regress in spite of the patient being on high
of an antibiotic. It would be wise to:
- Knownsite of infection

SNR PAYFYNe
. Septicaemia
A. Insert a large drain
B. Repeat culture andsensitivity
- Venousobstructionin
v retina , conjunctiva
j i o} i
©. Debride andirrigate the area with fibrinolytic agent
Paresis of 3rd, 4th and 6th nvs ae D. Begin parenteral administration of proteolytic
enzymes to
Abscess formation in neighbouring soft tissue augmentthe antibiotics
Nuchalrigidity 2
os

‘ cis :
1, 2, 3, 4, . Which of the following is not present in pterygomandibular
3,4 : : 2 Space?
125 ;
1, 2,5, 6 A. Auriculotemporal nv
. All of the abovearé correct B. Lingual nv
C Mandibular nv
31. Osteomyelitis of jaw can be cu red by:
D. Mylohyoid nv
A. Resection -
with acute
B. Physiotherapy 47. Whichof the following features is not associated
C. Sequestromywithantibiotic treatment osteomyelitis of mandible: -
D. Drainage A. Severe pain
B. Purulent exudates
32.A periapical infection o; e
sossk conasonty ita Om r abscessof a mandibular molar spreads Cc. Paresthesia of lowerlip
D. Radiographic evidence of bone destruction
A. Submandibular space
B. Temporal space 38. Theincision for drainage in ludwig’s angina extends:
S Sublingual space A. Upto the neck
D. Infratemporal space B. To the angle of mandible
C. Floor of mouth
33. fig aeangamuci
Palatal abscess most common! y results from infectionof:
i i D. Allof the above
.
B. Maxillary laterals 39. A patient has a localised infection with pus formation
C Maxillary canine Treatmentof choiceis to:
D. i A. Wait for drainage B. Establish drainage
Maxillary premolars C Administer antibiotics
34. Infections from maxillary first molar drainsinto:
Pileso
incisor, patient
lce ae develops
= Submandibular space B. Infratemporal space 40. After extraction of upper central
paralysis.The
Buccal space D. Infraorbital space ophthalmoplegia, meningitis and lateral rectus
diagnosisis:
A. Cavernous sinus thrombosis
B. Notrelated
C Cellulites
D. Ludwig's angina
36. A 37.D 38. D 39. B 40. A
35. B
 Infections of Head and Neck f n 83
82 Reviewin Oral and Maxillofacial Surgery
aig
7. The severe complication of canine space infectionisi
41. Pericoronitis is seen in relation to: A. Erosionof internal carotid artery :
A. Impacted 3rd molars only B. Erosion of external carotid artery
B. Around incompletely erupted crowns only C Cavernoussinus thrombosis
C Completely erupted crowns only D. Respiratory paralysis :
D. None of the above
48. Treatmentof choiceto a localised infection with pus is:
42. Subperiosteal abscess penetrating deepis seen after extraction A. Antibiotic administration
of: B. Establish drainage
A. Maxillary 3rd molars C. Apply cold to that area
B. Mandibular 3rd molars, D. Advise hot mouth washes
C Maxillary 1st molars
D. Mandibular 1st molar
43. In infection involving the submandibular space when extra
oral incision drainage are necessary which of the following
structures should be divided:
A. Skin only
B. Skin, superficial fascia only
C Skin, superficial fascia, platysma and masseter muscle
D. Skin, superficial fascis, platysma and deep cervicalfascia
. Incision and drainage in an areaofacute infection should be
performed when:
A. Induration has occurred
B. Localization has occurred
C Acute pain is present
D. Fever above 102 degree fahrenheit
45. Amongthe following which definite sign/symptom indicate
infection of masticator space?
A. Difficulty in swallowing
B. Trismus
C. Decreased salivary secretions
D. Fever above 100 degree fahrenheit
46. Antibiotic medicationfor pericoronitis should be advised:
A. If extraction is delayed or postponed
B. Before surgery
C Routinely to treat pericoronitis
D.If trismus andfever present

47.C 48. B
41. B 42.B 43.D 44.B 45.B 46.D
 Medical Emergencies 85

7. In medical emergency easiest technique for opening airway is

to:
A. Turn his head back

Medical Emergencies 42 B. Turn headto one side

C Clear mouth,throat
D.Strike his back
8. In CPR,if one incorrectly apply pressure over xiphoid process
the following may be injured:
1. one
Whichis th e best method
} to counteract severe A. Heart B. Liver
acidosis following
C Spleen D. Lungs
A. Administration of adrenaline by IV
routes 9. Instead of respondingto treatmentfor syncope,patients pulse
B. Administration of sodium bicarbonate
IV and respiration become weak and irregular with attendant
C Administration of adrenaline IM
cyanosis. Thefirst resuscitative measure should beto:
D. Notreatment necessary
A. Support circulation by injecting 1:1000 adrenaline
2. Amongthe following
i whichi
ich s
i the rescue breathing in adult ? B. Begin closed chest cardiac message
" /min
A. 6times B. . 18 tii C BeginCPR
C 12times/min
i D. Place paper bag over patient's face and risk blood CO,
D. 24 nae
3. ie perform tracheoctomy entry
should be madeat the: 10. If efforts in CPRareeffective there will be:
ee ligament B. Thyroid membrane ' A. Constriction of pupils
yroid notch D. Cricoid cartilage B. Dilatation of pupils
C Hypertension immediate
4. The
= primar
primary y h hazard for unconscious
i patient
ient in
i supineposition D. Noneof the above
A. Tongueobstruction H B.- Bronchospa: 11. Patient with idiopathic thrombocytopenic purpura (ITP) is most
C Lanyngospasm likely to have which of following postoperative complication:
D. Aepirition m
A. Infection
5. The best blood product admini
with haemophilia A is:
d ivel ti B. Haemorrhage
—— =e C Oedema
A. Fresh frozen plasma D. Localised alveolar osteitis
B. Factor [IX concentrate
C Whole blood 12. All of the following are various methods to control intra
D. Factor VIII concentrate operative haemorrhage except:
é A. Gauge sponge pressure
6. ee
Cardinal sympto
e ms e
of dehydr
ydratio :
ati n due to disturb ; B. Artery application to open vessels
anceof fluid
A. Hyperthermia
C Infiltration with lidocaine
B. Nausea D. Bone compressionfor surface bleeding
© Polydipsia D. None ,
 Medical Emergencies 87
in Oral and Maxillofacial Surgery

13. Whichof the following factor does During CPR sternum should the depressed:
not play rolein haemostasis@ A. 2 inches every 5 second
is:
A. Prothrombin B. 2 inches every second
B. Vessel wall calcium C linch every 10 seconds
Cc VitK D. Vit.B og
D. 3 inches every 5 seconds
14. Which isthe earliest sign of haemorr
hagic shock ? obstruction
A. Hypotension 2. Amongthe following which always indicate
B. Vaso constriction airway? /
© Tachycardia D. Dyspnoea A. Increase respiratory rate
15. Preoperativevit K is indicated in patients B. Increase pulse rate
with:
A. Diabetes mellitus * B. Chronic pneumonitis C. Stertorous breathing
C Liver disease _ a
D. Accuracy D. Decreased blood pressure
16. The main cause of bleeding in patients ly i Lti
lting - =fusion reaction w
is thrombocytopenic 23. Under GA,h
purpurais deficiencyof: exhibit which of the oe symp ~ ae
A. VitB .
B. Prothrombin ills, fever, dyspnea, headache p
Cc VitK D. Platelets B Hipoeuion aaflush, tachycardia abnormal haemorrhage,
17. During shock vasopressor drugs
are preferably given:
hyperpyrema -
A. Sublingually Cc. Urticaria, angioneurotic oedema, asthma
B. Intracardially D. Urticaria and pruritus
dint
C Intramuscularly D. Intravenously
i up of drugs used for preme dication
i pro:
18. Drug of choice to counter act CN’s can you
stimulation caused by = endoan without clouding consciousness
accidental IV injection of LA:
A. Adrenaline B. Phenobarbital A as B. Ataractics is
C. Caffeine D. Noneof the above Ps Aoakegtica D. Psychodissociated
19. Treatment of syncope is mosteff
ectively accomplished by 25. Is commontoall forms of shock:
which of the following ?
A. Administer 100 percent O, for 5 A. Hypovolemia
min rtension
~ B. Loweringchair to phase patient's head
lower
C Bending patient’s head forward betwee than his feet C cLaren tissue perfusion
stats
n his knees and D. Vasoconstriction
askingpatientto raise his head against
hand pressure
D. It requires treatment by physician 26. Amongthe following with results in sudden
swelling
20. Amongthe following which is best of dentalinjection:
haemostatic agentfor control A. Drug in competitively
of local haemorrhage ?
A. Gel foam B. Paravascular injection
B. Surgical C. Infection ;
Cc Bone D. VitK D. Vascular penetration

13. D 21. B 22.C 23. B

14.C 15.C 16.D 17.D 18. B
 Medical Emergencies 89
88 Reviewin Oral and Maxillofacial Surgery
tly encountered during
33. The emergency, most frequen
27. A
Diazepam
Me issecu=
contraindi i patient
for use in i i history
with i of: outpatient general anaesthesia is:
A. Anaphylaxis
B. Psychic depression psychic B. Bradycardia
C Severe hypertension C. Respiratory obstruction
D. Coronory artery disease D. Hypotension
ntly encountered during
28. ooo
Whi i may result due to prolonged use of 34. The emergency, most freque
outpatient general anaesthesiais:
A. Jaundice A. Anaphylaxis
B. Yellow pigmentation on teeth B. Bradycardia
C Gingival hypertrophy C. Respiratory obstruction
D.Itis safe drug absolutely noside effects D. Hypotension
29. Whi A se : go as drug is drug of choice in
Nid fae condition require antibiotic prophylaxis before 35. Among the following which
n involving bronchospasm
managementof acute allergic reactio
°
A. Recovery insufficiency and hypotension?
A. Aminophylline B. Dexamethasone
B. Angina pectoris
C Rheumatic carditis Cc. Diphenhydramine D. Adrenaline
D. Congestive heart disease has uppereyelid ptosis
36. While receiving IV diazepam patient
ately:
30. Among the following with drug is contraindicated in (verill’s) the dentist should immedi
hyperthyroid patients b the subject <traordinari A. Assist respiration
sensitive to drug: . 3 us a B. Considerpatientis adequately sedated
n
A. Salicylate B. Barbiturates C Place patient in Trendelenburg positio
te and administer one more
C. Adrenaline D. Digitalis D. Consider anesthesiais not comple
dose of diazepam
31. All spaces
atses ae menti i
tioned below are involved i classic
in i Ludwig’s is strongest stimulator to
37. Amongthe following which factor
A. Submandibular increase the respiration?
B. Space of body of mandible A. Decrease in various O2
C Submental B. Increase in blood patients
D. Sublingual C Increase in arterial CO,
D. Decrease inarterial O,
32. peep
Among the followi
ollowing which
i frequently causes infective
i i endo ly involved in stroke?
38. Of the following withartery is common
A. Lenticulostriate artery B. Cerebral artery
A. Staph. aureus B. Strep. viridans
C Ophthalmic artery D. Noneof the above
C. Staph. pyogens D. Noneof the above

33. C 34.C
 Medical Emergencies 91
90 Reviewin Oral and Maxillofacial Surgery
_ In external cardiac compressions, compression relation cycle
39. Anylaceration of scalp bleeds profusely because: should be repeated: ; ‘
A. Because of less blood supply ~ A. 100 times/min B. Twice/min
B. Because vessels are bound loosely in connective tissue and Cc 60times/min D. 80 times/min
retract readily . suo is : i f complete
C Allofthe above 46. Which of the fo i owing is let manifestation of comp
D. Abo i respiratory destruction: .
j RROne statement is wing A. Pronouncedretraction of intercostals and supraclavicular
40. Which of the followingis best treatmentfor hyperglycaemia in spares
an unconscious diabetic patient: B. Prolonged expiration
A. IV administration of 50 percent dextrose in water C Cyanosis
B. Administration of oral carbohydrates D. None of the above
C. Sublingual inj of 50 percent dextrose
D. Noneof the above 47. Haemorrhagic shockis characterised by:
A. Hypotension B. Low blood volume
41. Which of the following may occur due to hyperventilation in Cc. Increased pulse rate D. Allof the above
answer patient?
A. Acidosis B. Elevated PCO, 48. Surgicalrisk for a cardiac patient depends uponhis:
A. IP B. Respiration
C Carpopedal spasm D. Cyanosis
C Pulse rate D. Cardiac reserve
42. Which ofthe followingis true of CPR, compressionto:
A. Ventilation ratio in 2 persons CPRis 5:1 49. Of the following which is earliest sign of haemorrhagic shock?
B. Ventilation ratio in single person CPRis 15:2 A. Vasoconstriction B. Hypotension
C Should be 60-80/ min in adults C Tachycardia D. Dyspnoea
D. Should be 100/min in children 50.In elective tracheostomythe entry should be made:
E. Allofthe above A. Above cricoid
43. Of the following which is thefirst step when initiating CPR? B. Below cricoid
A. Establish responsiveness C Through cricothyroid membrane
B. Toestablish airway D. Laterally below thyroidcartilage
« C Precardial thumbs
D. Noneof the above
44. Which ofthe following mayresult in interruptions in cardiac
compressions:
A. Little changesin blood flow and BP
B. Reduction of blood flow and BP to zero
C CO,buildup in lungs
D. Noneof the above

39. D 40.A 41.C 42.5 43.A 44.B

 Antibiotics and Analgesics 93

Metronidazole:
A. Hasnosideeffects
Antibiotics and B. Is used in management of ANUG
©. Is mainly concentratedin saliva

Analgesics D. Is active against gram +ve aerobes

. Drug to be avoided ina patient allergic to penicillin

is:
A. Sulphonamide B. Tetracycline
Cc Ampicillin D. Chloramphenicol

1. ape
The most c
Pca side
i effect of oral administrat 0). Mechanism of action penicillin is by:
ini ion of
A. Protein denaturation
A. Anaphylactic shock B. Diarrhoea B. Inhibitionof cell wall formation
C Oral candidiasis D. Renal failure C Alteration in metabolic pathway
D. Mitotic inhibition
2. Whichofthe following is primarily bactericidal drug?
A. Chloramphenicol B. Gentamicin 11. Mechanism ofaction of Chlorotetracycline:
© Sulphadiazine D. Tetracycline A. Interfere with metabolism
B. Inhibition of protein synthesis
3. The antibiotic of choice in patients sensitive to penicillin C. Inhibitionof cell wall formation
is:
A. Erythromycin B : D.Interfere with DNA function
C Tetracycline Dz See

ra eae
indications for metronidazole except:

a
ires intensive the: sds 12. The following are
4. Dessiminated candidiasi 4 : rapy with:
3 EAE
A $

D. Thiabendazole C. Trichomonasinfection
5ildentity h D. Streptococcal sore throat
. A. ad nf drugs used against pseudomonas infection:
B. Ceftazidime 13. Metronidazole is a type of:
= Arnceséillin D. Allof the above A. Broad spectrum antibiotic
6. True about
é amoxicillin in compari
parison to ampicillin is: B. Quinolone
A. Highoralbioavailability anes C Imidazole derivative
B. Loweroral availability D. Antidepressant
C Equal bioavailability activity of
14. The following elements interfere with the
. D. Can
/ begiven parenterally as etracycline:
tet li
Which of the
spectrum?
spectrum?
following penicillins has the best gram —
C Mgand Na
eeal
D. Mgand Ca
D wemae
. vs
- ethicillin B. Ampicillin
© Penicillin V D. Cefixime
|
os = am 8.B 9.C 10. B 11. B 12. D 13. C
oe 4.B 5.D 6.A 14.C
 94 Reviewin Oral and Maxillofacial Surger Antibiotics and Analgesics 95
y
15. Among the following what is contrain 23. Whichofthe following is not contraindicated in therapy with
dicatedin patients taking opioids
sodium Warfarin therapy:
A. Acetaminophen A. Usein headinjury patients
B. Diphenyl hydramine B. Use in impair pulmonary function }
C. Ibuprofen D. Codeine C Use of agonist with mixed agonist antagonist
16. One of your patient stated that D. Use in severe constant pain
he is narcotic addict then after
extraction which of the follow
ing analgesics are 24. Which of the following can be given safely to a patient of
contraindicated:
A. Aspirin congestive heart failure?
B. Pentazocine A. Aspirin B. Paracetamol
C Acetaminophen D. All of the above C. Diclofenac sodium D. Ibuprofen
17. How manypostoperative days one should
continue
antibiotic 25. Acommon side effect associated with all NSAIDsdrugsis:
coverage for subacute bacterial
endocarditis? A. Drowsiness B. Gastricirritation
A. B. 2
G3 C Xerostomia D. Constipation
D. 4
18. Among the following whichis 26. Which of the following is an NSAIDagent with tendency to
broad spectrum antibiotic: produceblood dyscrasias: '
A. Sulphonamides B. Penicillin
C Tetracycline A. Indomethacin B. Ibuprofen
D. Noneof the above C. Ketoroloc D. Acetaminophen
19. Which of the following antibio
tic is mainly effective against 27. Nausea and vomiting are associated with administration of
gram —ve bacteria?
A. Lincomycin - opioid analgesicis the result of stimulation of:
B. Vancomycin A. Limbic system
C Kanamycin D. Oleandomycin B. Emetoc system
20. Antibiotic thatinterferes with C. Chemoreceptortrigger zone
DNAfun ctionis:
A. Metronidazole B. Nystatin D. Opioid receptors in git
C Tetracycline D. Sulphonamides 28. Narcotic overdose can be antagonised by:
21. Morphineis contraindicated in A. Diphenhydramine B. Atropine
all of the following except:
A. Pulmonary oedema B. Emphysema C Naloxane D. Nalorphine
C Bronchial asthma -
D. Head injury - Less gastrointestinal bleedis seen in the following NSAID:
22. Aspirin producesall of the followi
ngeffects except: A. Meloxicam
A. Frank gastric bleeding B. Naproxen
B. Prolonged prothrombin time C. Cox 2 specific inhibitors
C Platelet dysfunction D. Ibuprofen
D. Constipation
- Aspirin is contraindicated in:
A. MI B. Angina
C Peptic ulcers D. Hyperterision

15. C 23. D 24.B 25.B 26. A 27.C 28. C

16. B 17.B 18. B 19.:C 20.A
 Antibiotics and Analgesics 97
96 Review in Oral and Maxillofacial Surgery

31. The most prominent toxic effect associate Aspirin is usedin treatment of myocardial infarction:
d with acetami- A. It inhibits thromboxanes
nophenis: >
A. Respiratory alkalosis B. It stimulates prostacyclins
B. Haemorrhage
C Hepatic necrosis C Itisavasodilator —
D. Gastric ulceration
D. Ithelps in reducing inflammatory aggregate
32. Aspirin is avoidedin children with influenza
infection because
of associationof: 40, Prolonged use of aspirin causes:
A. Reye’s syndrome A. Hypoprothrombinemia
B. Nausea
C Diarrhoea B. Hyperprothrombinemia
D. Acid base imbalance
Cc Hypophosphatemia
33. Pregnantpatients canbe safely given: D. Hypercalcemia
A. Tetracycline B. Paracetamol causes least git
C Metronidazole D. Barbiturates 41. The anti-inflammatory analgesic drug that
symptomsis:
34. Which of the following anti-inflammatory
drug is Cox 2 A. Aspirin B. Phenylbutazone
inhibitor? Cc Paracetamol D. Indomethacin
A. Aspirin B. Ketoprofen in pregnancy
C. Rofecoxib » 42. Salicylate administration is contraindicated
D. Sulindac because: He
35. All of the following statements are true about It delays onset of labou /
pain except:
A. Analgesia is associated with U and K receptors eaaee pulmonary hypertension of new born
B. Dysphoriais associated with K receptors C. Readily crosses placental barrier
C NSAIDS benefit by preventing prostaglandin synthesis D. Allof these
D. Naloxane is a non-competitive antagonist
and irreversibly IDs have adverseeffect on: /
Opposes opioids
= eo B. Kidney
36. Paracetamolis contraindicatedin: Cc Liver D. Stomach
A. Nephritis
B. Chronic hepatitis 44. Aspirin causes:
A. Agranulocytosis _
C. Bleeding disorders
B. Haemolytic anaemia
D. Pregnancy
Cc Aplastic anaemia /
37. A patient on 300 mgofaspirin will show all the D. Hypoprothrombinemia
followingexcept:
A. Irreversible inhibition of cyclo-xygenase pathway
B. Prolonged bleeding time 45. Platelet aggregation is inhibited by all except:
A. Indomethacin B. Salicylate —
C Inhibition of thromboxane TXA2 D. Phenobarbitone
D. Inhibition of prostaglandin PGI2 Cc. Dipyridamole
t gitsymptoms
38. Salicylate overdosein children causes: 46. The anti- inflammatory analgesic that causesleas
;
A. Crystalluria is:
B. Reye’s syndrome B. Phenylbutazone
C Kernicterus spiri
D. Noneof the above D. Indometha cin
. e Deca
41.iC 42.C 43. B 44.D
31.C 39. A 40. A
32. A 33. B 34. C 35. D 36. B 45.D 46. C
98 Review in Oral and Maxillofacial Surgery

Local and General

47. Which ofthe following isa
i NSAID i
produce blood syacasias! ee

44
A. Ibuprofen

Anaesthesia
B. Ind i
C Acetaminophen Dz. i
48. oo should be avoidedin all conditions except:
5 ee ventricular failure B. Bronchial aun :
onstipation D. Pancreatitis
administrationis:
49. Tetracycline in children.causes: 1. The most commonly usedroute of drug,
A. Calcification B. Missing teeth A. Oral B. Rectal
C. Discolored teeth D. Peg teeth Cc. Intranasal D. Intramuscular
children is:
50. Which off the following g, is
i a 4th generation cephalo in? 2. The most valuable route to sedate young
a Ceftriaxone B. Cefador " rs A. Intravenous B. Intramuscular
Cefepime D. Cefuroxime D. Sublingu al
Cc Rectal
of the following local
3. In peripheral nerve block, which
of action?
anaesthetics has the longest duration
A. Bupivacaine B. Lignocaine
D. Prilocai ne
Cc Cocaine
c local anaesthetic
4. The longest acting, mostpatent and mosttoxi
is: .
B. Dibucai ne
A. Lidocaine
Cc Bupivacaine D. Tetracaine
ed local anaesthetic
5. Which of the following is the preferr
technique for haemophiliacs:
B. Supraper iosteal
A. Nerve block
Cc Intraligamentary D. Field block

6. Local thetic with ad line is absolutely contraindicated

in:
A. First trimester of pregnancy
B. Hyperthyroidism
C Haemophilia
D. Hypertension

47.D 48.A 49.C 50. C

 Local and General Anaesthesia 101
Review in Oral and Maxillofacial Surgery
. LA acts on nerve membraneby:
a en is an exampleof an: to exterior
A. Blocking conductanceof Na+ from interior
c and B. Ester * B. Blocking conductance of Na+ from exterior
to interior
le D. Aldehyde C. Blocking conducta nceof K+ from interior to exterior
o interior
Vhi
8. Whichof i followin;ig muscles is
the is pierced
pi i D. Blocking conductance of K+ from exteriort
giving an inferior alveolar nerve heck: oa 2 percentlignocaine
A. Medial pterygoid 5 6. How muchlignocaineis presentin 20 ml of
B. Superior constrictor ;
: re B. 200
C Temporalis D. Buccinator : mg
i used to prevent laryngospasm due to ne D. 120 mg
Whichofthe following
9. pain ollowingis Cc 300mg
of all
B. Epinephrine 17. The action of adrenaline is potentiated in the presence
= He
AHalt B. Ethyl chloride
10. Theeffect of local anaestheti R: pacdnyichdline Cc. Cyclopropane D. Ether
ae: esthetic can be increased by the addition
B. Isoprenaline 18. When blocking a nerve containing both molar and sensory
A. Adrenaline
D. Felypressin fibres, the last functional property lostis:
C Dopamine B. Pain
_. A. Temperature
11. Which ofthe followi Cc. Proprioception D. Touch
A: Lidocaine ollowing local — is a vasoconstrictor?
; i D.. Ropivacaine
Procaine 19. eeoe local anaesthetic is greater in:
C Bupivacaine
ype res
12. ce <See
The dose i i i
given i anaphylaxis:
in B. Type C fibres
C Type delta fibres
B. 0.5 mgin 1:10,000 im/sc D. Fibres supplying the musclefibres
C 0.5 mgin 1:500 im/sc a topical LA?
20. Which ofthe following is not used as
D. 0.5 mg in 1:100 im/sc B. Tetracaine
A. Procaine
13. Mostdifficult maxill ary toothto anaesthe' C. Lidocaine D. Benzocaine
thetise b: y infiltrationis: °
- A. First molar with compromised
B. First premolar
21. The safe dose of adrenaline in patients
Cc Canine D. Third molar cardiac conditionis:
14. hte
Which of ee
th i symptoms is i seen in a patient
A. 0.2mg/kg body wt
a Tage a
0-40 percent ;
nitrous ;
oxide? Cc 0.4mg/kg body wt D. 0.04 mg
ch e

22. A bilateral mandibular block:

B. Floating sensation tongue
A. Is dangerous because patient may swallow
C Sweating B. May leadto spaceinfection
D. Noneof the above Cc. Isnot contraindicated
D. Should rarely be performed
 Local and General Anaesthesia 103
102 Review in Oral and Maxillofacial Surgery
31. In systemic LAtoxicity thereis:
23. Surgery is carried in which stage of GA: A. Postdepression convulsion
A. Plane 1 B. Plane 2 ~ B. Post convulsion depression
C Plane 3 D. Plane 4 C Convulsions
24. Whichof the following general thetic techniques be used D. Depression
for anaesthesia in oral surgery: 32. A patient whofaints during extraction should be positioned in
A. Open drop method
the:
B. Anaesthesia with nasopharyngeal airway A. Lateral position
C Nasoendotracheal tube with throat pack B. Trendelenburg position
D. LV. anaesthesia with nitrous oxide and oxygen
C. Reverse Trendelenburg,
25. The onsetofaction oflidocaineis: D. Dorsosacral position
A. 1-2 minutes B. 5-10 minutes 33. Which of the following is not a theory for local anaesthetic
C 3-5 minutes D. 7-8 minutes action?
26. Sedation by whichofthe followingroutes can be reversed A. Membrane expansion theory
most
rapidly: B. Calcium displacementtheory
; :
C Electrical : theory
potential .:
A. Oral B. Inhalation
C. Intravenous D. Specific receptor theory
D. Intramuscular
E. Noneof the above
aaaitaiss
A. 2 percent B. 5 percent
34. Itis difficult to obtain local infiltration anaesthesiain presence
‘ ; n becauseof:
of inflammatio
C 8 percent D. 10 percent A. Adecreased pH
28. The action of long acting muscle relaxants used during GA B. Increased vascularity
maybe terminated by: C Oedema
A. Neostigmine B. Atropine D. Pain
C Ketamine D. Succinylcholine 35. Maximum doseof lignocaine without adrenaline that can be
29. The role of sodium metabisulfite in LA agentis: admittedto a patientis:
A. Preservative B. Fungicide
ich
A. 4mg/kg body weight
C. Reducing agent D. Vasoconstrictor Cc 7mg/kg body weight
B. 5mg/kg body nents
D. 9mg/kg body weight
30. Inferior alveolarnerve blockis givenin: 36. In case of Gow Gates techniquetarget areais:
A. Retomolar area A. Neck of condyle B. Head of condyle ;
B. Pterygomandibular space C Medialside of ramus D.Lateral side of ramus
© Submandibular space 37. With overdose of LA agent, one should observe for:
A. Hypertension B. Hypotension ;
—
C No changein BP D. Cardiac arrhythmia

31. B 32.C 33,:C 34. A 35, C 36.A

23..C 24.C 25. C 26. B 27.A 28. A 37.B
 104 Review in Oral and Maxillofacial Surgery Local and General Anaesthesia 105

38. In which condition local anaesthesiais . Preferable patient position in recovery room after ambulatory
ineffective: %
A. Oedema B. Localised infection GA is:
C Haematoma D. Anaemia A. Supine B. Prone
C Sitting D. Lateral
39. In dentistry which sedatives are generall
y used:
A. Benzodiazepines B. Morphine 7, Comparedto inhalation, IV sedation:
C NSAID D. Pethidine A. Produces morepredictable amnesia —
B. May produce moreserious complication
40. Improper direction of insertion
of needle during inferior C. Mayresult in deeper sedation
alveolar nerve blockresults in:
D. All of the above
A. Facial nerve paralysis B. Paresthesia
C Hematoma 48. Each cartridge contains how many ml of anaesthetic solution:
D. Trismus
A. 0.9 ml B. 1.2ml
41. Inferior alveolar nerve block in absolute
ly contraindicated in Cc 18ml D. 2.2ml
patients suffering from one of the followin
g:
A. Thrombocytopenia 49. Ester type LA agents undergobiotransformationin the:
B. Haemophilia ; A. Kidney B. Liver
C Hypoprothrombinemia C Plasma D. Both B and C
D. Von Willebrands disease
50. In case of mild lidocainetoxicity, the first clinical sign is:
42. Excess of plasmalevel of lignoci A. Nervousness B. Convulsions
ne can cause CVS collapse
dueto: Cc. Lethargy D. Tachycardia
A. Myocardial depression B. Syncope
C Vagal stimulation D. CNS excitability
43. Increased incidence of reaction to
LA will occurby:
A. Rapid rateof injection
B. Using an aspirating technique
C Additionof vasoconstrictor —
D. Premedication with barbiturate
44. Concentration of epinephrine addedto LA
is!
A. 0.0005 mg/ml B. 1mg/ml
C 0.005 mg/ml D. 10mg/ml
45. Common anaesthetic complication
occurring within first day
after surgery under GA is:
A. Cardiacfailure B. Renal failure
Cc Atelectasis D. Hypotension
 Neurological Disorders 107

. Maxillary nerve gives branchesin all except:

A. Cranium B. Infraorbital canal
Neurological C Ear D. Onthe face
Hardandsoft palate are innervated by:
Disorders

©
A. Greater palatine nerve
B. Middle palatine nerve
C. Posteriorpalatine nerve
D. Allof the above

1. Trigeminal nerveis attachedto: . Infraorbital nerve includes:

A. Medial aspect of pons A. Maxillary and mandibular
B. Lateral aspect of pons near middle cerebellum B. Middle and anterior superior alveolar
C Lateral aspect of medulla oblongata C Middle and posterior superior alveolar
D. Noneof the above D. Ophthalmic and mandibular

2. Trigeminal ganglionis present in: 11. Superior dental plexus is composedof:

A. Sella turcica B. Nasal floor A. Dental nerves
C Meckles cave D. Noneof the above B. Interdental branches
Cc. Inter-radicular branches
3. Whichdivision of trigeminal nerve contains motorfibres? D. All of the above
A. Maxillary B. Mandibular
C Ophthalmic D. None of the above 12. Mandibular nerveis the nerveof:
A. 1st branchial arch
4. Motorrootof trigeminal nerve supplies: B. 2nd branchial arch
A. Skin of entire face C. Both Ist and 2nd 4
B. Muscles of mastication and other muscles D. Noneof the above
C Oral cavity
D. Mucous membraneof cranium 13. 1st branchial arch givesrise to:
A. Precursor of mandible
5. Which is shortest branch of trigeminal nerve? B. Spine of sphenoid
A. Ophthalmic B. Maxillary ‘C Sphenomandibular ligament f
C Mandibular D. Noneof the above D. Allof the above
6. Frontal, maxillary, lacrimal are branchesof: 14. Meningeal branch and nerve to medial pterygoid are branches
A. Maxillary nerve B. Mandibular of:
Cc Facial D. Ophthalmic A. Temporalis nerve B. Maxillary
7. Maxillary nerve innervatesall except: C Mandibular D. Ophthalmic
A. Lowereyelid B. Side of nose
C Uppereyelid D. Upper lip

1B 2.C 3.B 4.B 5. A 6.D

ToS
 Neurological Disorders 109
108 Aeview in Oral and Maxillofacial Surgery
23. When carbamazepineis contraindicated drug of choice is:
15. Which fibres conduct pain fast which is sharp and localised A.
B. Clonazepam
Normal saline1.5 mg/day
5 percent
are large and myelinated: . Norm
A. B delta fibres B. A delta fibres Cc Janneincroae units
C C fibres D. None of the above D. Noneof the above
16. Small, polymodal, unmyelinated, nociceptive, afferent conducts 24. Surgical treatmentfor trigeminal neuralgia includes:
slow carry touch sensationare the fibres: A. Peripheral neurectomy
A. Adelta B. Bdelta B. Thermocoagulation :
C C fibres D. All of the above C Microvascular decompression ofthe sensory root
§ ; D. Allofthe above
17. Once pain impulse reaches thalamusit is sent not only to ae si ee ia
: i
25. Tinels sign is an indication o f: :
b
ROR rh B. Hypothalamus A. Nerve degeneration B. Nerve regeneration
C BothAandB D. Co pons C Neuropraxia D. Neurotemesis

18. Trigeminal neuralgia is defined as pain which: 26. Trigeminal neuralgia is characterised by:
A. Suddenusually bilateral severe recurring pain A. Paralysis of one side of face due to paralysis of facial nerve
B. Often usually unilateral dull intermittent pain B. Dull pain whenpressure is applied overthe affected area
C Sudden usually unilateral severe recurring pain C. Sharp pain whenis stimulated the affected area
D. Sudden unilateral dull recurring pain D. Prolonged episodesof the pain which is constant in nature
; : scato:
_19. Tic Doloureuxis the term usedfor: 27. Cogad of lingual nerve suppliesto:
A. Migtaine :
B. Trigeminal neuralgia B. Lingual surface of mandible
C Vascular headache C. Floor of mou! th
D. Neuropraxia D. Allof the above
20. Whichdivision oftrigeminal nerve is most commonly affected 28. Which nerveis affected in SeesileSn
i ia: A. Ulnar . Lingua ;
i‘ Medien B. Mandibular Cc Radial D. Median cephalic
[eae D.Allof the above 29. Composition of Talbot's solutionis:
21. In extreme cases of trigeminal neuralgia patients face is A. Iodine, Znl, glycerine and water
described as: B. Chlorine, ZnCl, glycerine and water
A: Frozen or mask face B. Dish type C F, ZnF,glycerine and water
3 gl A e and and water
te, glycerine wate
C Moons face D.Bird facies D. Chlorate, Zn chlorate,

22. Drug of choicefor trigeminal neuralgia is:

A. Phenytoin B. Normal saline
C Carbamazepine D. Xylocaine

23. A 24.D 25. B 26.D 27.D 28. C

15.B 16. C 17.C 18.C 19.B 20.B 29. A
 110 Review in Oral and Maxillofacial Surgery Neurological Disorders 111

30. Ptosis may be caused bya lesion of: 9. Neuromasof inferior alveolar nerveare:
A. Oculomotor nv B. Trigeminal nerve A. Lateral exophytic B. Stellate neuroma
C Superior oblique D. Trochlear nerve © Medial exophytic D. Both A and B
31. Which muscle has a dual nerve supply? 40. Neuropraxia is: ‘
A. Digastric B. Lateral pterygoid A. No axonal degeneration, temporary sensation loss
C Masseter D. Temporalis B. Mild temporal injury due to compression
C. Spontaneousrecovery within 4 weeks
32. In Trigeminal neuralgia 90 percent alcoholis
injected in D. All of the above
Trigeminal ganglion through:
A. Foramen ovale B. ForamenLacerum 41. Nerve sheath in neuropraxia:
C. Foramen Rotundum D. Foramen Spinosum A. Remains intact B. Gets interrupted
Cc. Destroys completely D. Noneofthe above
33. Sensory nerve supplyofface is by:
A. Trigeminal nerve B. Cervical plexus 42. Cryosurgery utilises which of the following:
C Both A and B D. Greateroccipital nerve A. N,O B. CO,
Cc Liquid O, D. N;O,
34. Vertical wrinkles are caused by:
A. Frontalis B. Corrugator supercilli 43. During cryosurgery:
C BothAandB . D. Noneof the above A. Cells get evaporated ,
B. Cells will not die only freeze
35. Middle Meningeal artery is a branch of which part
of Maxillary C. Cell death occurs when temperature falls below —20 degree
artery?
Celsius
A. Ist B. 2nd
D. Patient Needs GA
C 3rd D. 4th
- 44. Axonotemesisis a condition in which:
36. Commonfacialvein is formed by:
A. Loss of continuity of some axons
A. Anterior division of retromandibular vein
B. Recovery is often less and appears after 1-3 months
B. Anterior division of retromandibular and posterior auricular
C Nerve remainsintact
vein
D. Allof the above
* C Jugular vein
D. Noneof the above 45. Neurotmesisis:
A. Complete severenceof all layers of the nerve
37. Dangerousareaof scalpis:
B. No recovery is expected
A. Deepfascia B. Superficial fascia C Permanent conductionblockof all impulses
C. Loose areolar tissue D. Pericardium of scalp D. All of the above
38. Only cranial nerve emerging from dorsal aspect
of brainstem
is:
A. 3rd B. 4th
C 6th D. 12th

30.A 31. A 32. A 33. C 34.B 35.A

 112 Review in Oral and Maxil
lofacial Surgery
46. Contraindications for
,

microneurosurgery
A. Central neuropathic
pain
B. Dysesthesia not abolished
are: - Orthognathic
by LA nerve block
C Improving sensation
D. Aand B
Surgery, Distraction
E. Allof the above
47. Paroxysmal lacrimat
ion
Osteogenesis and
is term
A. Melkerson-Rosenthal synd ed as:
B. Crocodile tear synd
rome
rome +
Implantology
C Facial palsy
D. Noneofthe above
48. Idiopathic paresisof
facial nerve of sudden onset
anyother diseaseelse where not related to ioplasty i used to change/modify:
procedureis :
in body, is known as: * Papen of genioglossus muscle in preprosthetic
A. Trigeminal neuralgia
B. Bell's palsy procedure -
C Crocodile tear synd
rome
B. The procedureofgenial tubercles
D. Noneof the above C Position of chin : /
D. Attachmentofanteriorbelly of digastric
49. Bells sign represents:
A. Inability to open eye i ill rotrusion
i may be surgically
i correcte d by:
ye)
: = A Mea body osteotomy and posterior maxillary
B. Inability to close
© Inability to do eyeaffec tedieye
movements
teotom:
i RonaoS premolars and anter 3
D. Allof the above 5 repositioning ior alveolar segmental
C. Step osteotomy of mandibular body
D. Subcondylar osteotomy
3. Sagittal split osteotomyis a procedure done in the mandibular:
A. Ramus B. ree
C Symphysis D. Angle
4. To obtain best long-term result, which of the following
k procedures for augmentation genioplasty is recommended:
A. Onlaybonegraft
B. Injectionof sialastic gel
C._ Insertionof silastic rubber implant
D. Pedicled horizontal sliding osteotomy

46.C 47.B 48. B 49. B

 114 Review in Oral and Maxil
lofacial Surgery
Orthognathic Surgery, Distraction Osteogenesis 115
5. Augmentation Seni
opla sty is done by:
A. Sliding horizontal oste 12. Goals of orthognathic surgery includes:
otom y
B. Bone graft A. Improve PDL stability and PDL prognosis
C Silicone implant B. Shorter orthodontic time and improve orthodontic results
D. Allof the above C Tocorrect jawrelationship prior to major restorative
6. a
Sagito procedure
tal split
n ie osteotom
ne y 1S
i a proc edure done for: D. All ofthe above
B. Mandibular defo 13. Amongthe following which is most frequent complication of
rmities
C Condylar deformit subapical orthodontic surgery?
ies
D. Deformities in occl A. Nonunionof segments
usion
7. ae
In a patien B. Devitalisation of teeth
oi tBo wi nao ? facia
i l profiile one woul C. Avulsioneffect
d think of
A. Reduction genioplast D. Vertical fracture of roots
y
B. Advancement genio 14. Which is the most frequently performed surgery to correct
plasty
Cc Straightening genioplast skeletal mandibular retrognathia?,
D. Rotational genioplast
y
y A. Ctype osteotomy ¢
8. Isograftis also call B. Horizontal osteotomy of ramus
ed as: C Oblique subcondylar
A. Heterograft
C Autogenous graft B. .S graft D. Sagittal split osteotomy of ramus
D. Homeok 15. Generally bone marrow forgrafting the defects is obtained
9. Identical twin ordiffere
nti divi i mi:
Pes e is also called ae. i i
egies Rareirn A. Iliac crest B. Mandible
C. Heterograft
Homograft
Bi deren
B. I:
a ae
C Maxillary tuberosity D. Rib

10. Disadvantages of 16. Followingare the characters ofan ideal graft, it should:
auto geno A. Withstand mechanicalforce
A. Extensive resorptionaft us bone excep:
er grafting ian B. Produce no immunological response
B. Need for
donorsite surgery ci C. Actively assist osteogenic potential of host
C Twosites of surgery
D. All of the above
D. Rejection of the graft
11.A 17. Among the following which is not used in fixation of bone
vw the followin i g whic ich h is
i advantage of sagit grafts:
az Z omy over tran tal split
soral vertical subcondy A. Boneplates B. Titanium mesh
; etal lar osteotomy?
movement is achieved C Catgut D. Transosseous wires
- im
Becauseit
a is an intra oral =
procedure, no external
scar is
© SlAloneommay
a be
anused
"d to correct a mand ndib
i ular retr
zt ognathis
i m
; Less chance of injur
y to inferior dental canal
-D .
6.B 7A
1L.¢ 8.B 9.B 12.D 13. B 14.D 15. A 16.D 17.C
10.D
ET Orthognathic Surgery, ©
116 Review in Oral and Maxillofacial Surgery
25. Which of the following can be
7 .
osteotomy of mandible? ,
18. nae — vertical
Subcondylar Seiin oat wasfirst
i proposed by: ~ A. Mandibularretrognathism
B. Schuchardt in 1959
B. Mandibular prognathism
C Openbite
C Profitt and White in 1968
D. Allof the above
D. Caldwell-Letterman in 1954
19. Bonetransplant from one human to anotheris termed as: 26. Technique thatwasfirst described by Tra’
= eisasbay B. Autogenous and later modified by Dalpont, Hunsuck and)
A. Ctype osteotomy
omologous D. Heterogenous B. Horizontal osteotomy of ramus
Which is minimal
20. seguir: .
mal acceptable value for ahaematocrit for elective C Oblique subcondylar
D. BilateralSagittal split osteotomy
A. 30 5 B.
C28 | rao 27. Subsigmoid oblique subcondylar osteotom
y was ad
A. Caldwell-Letterman in 1954
21. Advantage of sharp dissection over blunt dissectionis: B. Robinson and Hinds in 1955
C. Profitt and White in 1968 ‘
D. Fish and Epker in 1980 ’
B. Permits muscle splittir v4 rather than muscle tearing
Cc Less likely to severe impor tant nerves and vessels was advocated
28. Intraoral Vertical Ramus Osteotomy (IVRO)
by:
22. i.aan
Whi i
the following bone graft has greater osteogenic A. Caldwell-Lettermanin 1954
B. Robinson and Hindsin 1955
A. Autogenouscortical graft C. Winstanley in 1968
B. Autogenouscancellous graft D. Fish and Epker in 1980
C freeze dried bonegraft by:
D. Xenograft 29. First anterior maxillary setback was performed
A. Rene LeFort in 1945 B. CohnStock in 1921
23.
aan ceei analysis
i for orthognathic surgery) was Cc. Salzmanin 1964 D.Bell in 1968
positioning of
30. All except one are the indications of superior
A. Fish and Epker in 1980
entire maxilla — LeFort I osteotomy.
B. Charles J. Burstone in 1978
A. Superior movement less than5mm
C. Profitt and White in 1968 excessively large
B. Existing functional nasal septal deviation or
D. Caldwell-Letterman in 1954 inferior tubinates
as a single unit or minor movementof
24. First anterior mandibular osteotomy was performed by: C. Movementof maxilla
A. Hullihen in 1849 B. Craige in 1894 * multiple segments.
C Salzmanin 1964 D. Bell in 1968 D. Vertically deficient maxilla

27.B 28. C 29. B 30. D

25. D 26. D
 Mn Oraland Maxillofacial Surgery
Orthognathic Surgery, Distraction Osteogenesis
119
. The concept of distraction osteo
genesis for the treatmentwf 38. Four identifiable stages of mature bone formation in order
fractures and nonunion of the are:
long bones was given by: i. Stage of extending bone formation
A. Mac Lennan in 1925
B. Ilizarov in 1950 li. Stageoffibrous tissue
© Schuchardt in 1959 ili. Stage of mature bone formation
D. Kosteca in 1965 iv. Stage of bone remodeling
A. (i), (ii), (iii), (iv)
32. The feasibility of distractio B. (ii), (iv), (i), (iii)
n osteogenesis on membrano
bonesofthe craniofacial us © (ii), (), (iv), (iii)
skeleton was reported by:
A. Mac Lennanin 1925 D.(ii), (i), (iii), (iv)
B. Kosteca in 1965
C McCarthyin 1992 39. All the advantages of intraoral distractors are
true except:
D. Obwegeslor in 1975 A. Theyare simplerto apply and use
B. Devices are concealed so better patient compliance
33. All are the indications of C Allow multidirectional forces for lengthening
distractio i
A. Mandibular microsomia D. Noextraoral scars
B. Mandibular prognathism POmecerrtaanes
C Cleft palate 40. Extraoral distractor device can be of:'
D. Apertsyndrome
A. Unidirectional appliance
B. Bidirectional appliance
34. The latency period of distr C Multidirectional appliance
action osteogenesis in an adult
A. 5-7 days is of: D. Allof the above
B. 15-17 days
C 25-27 days
D. 3 months 41. Term osseointegration wascoined by:
35. Thetensile stress that A. Obwegeser B. Clark
is applied when the bone
separated by: ends are C Branemark D. Snyder
A. 1mm per hour
B. 1mm per day 42. According to Ante’s law:
C 1mm perweek
D. 1mm per month A. Sum ofperiodontal surfaces of abutmentteeth must
more or
36. In youngerpatient the laten equalthan thatofthe teeth to be replaced
cy period is of:
A. 6 hours B. Sum of periodontal surfaces of abutmentteeth must less or
B. 1-2 days
C 14-15 days equalthan thatof the teeth to be replaced
D. 21 days
37. Consolidation phase C Sum of periodontal surfaces of abutment teeth must
is of: more
A. 1 week thanthatof the sum oftotal teeth present
C 4-6 weeks
B. 1-3 weeks D. Noneof the above
D. 8-10 weeks
43. An implantis considered successful if it does not lose horizontal
bone morethan: ’
A. 3.5mm infirst year B. 1.5 mm in first year
C 3.5mm in three years D. Noneof the above

38. C 39. C 40.D 41.C 42.A 43.B

 120 Review in Oral and Maxillofacial Surgery

44. The light microscopié direct functional and

structural bond
between organised vital bone and surface of an
intimate,
alloplastic material is known as:

Cleft Lip and Palate 47

A. Osseoinduction B. Osseodehiscence
Cc Osseointegration D. Osseoconduction
45. Ideal gap of the implant from all important structures
is:
A. 5mm B. 0.5mm
C 2mm D. 2cm
46. The maximum sped of standardised steel drill at 1. Which is more common?
which the A. Left sided unilateral cleft
preparation of implant bedis done:
A. 200 rpm B. 2000 rpm
B. Left and right unilateral are equal
C 20,000 rpm D. 200,000 rpm
C. Right sided unilateral cleft
D.Bilateralclefts
47. Ina twostage implant, the second surgical procedure :
to uncover through
the implant after healing in phase is done usually 2. Hereditary transformation of cleft is
about:
A. 3 monthsin mandible and 6 months in maxilla A. Male, sex linked dominated gene
B. Male, sex linked recessiv e gene
B. 6 monthsin mandible and 3 months in maxilla
C. 3 monthsin both mandible and maxilla C Female, sex linked recessive gene
D. Noneof the above D. Female,sex linked dominated gene
incidence of cleft lip and
48. Failure of an implant will show the following 3. Environmentalfactors influencing :
symptomsexcept: .
signs and
palate during pregnancy are:
A. Loss of bone around the implant body A. Viral infections
B. Horizontal mobility greater than 5 mm B. Exposure to radiation
C Anaemia and anorexia
C Radio-opaque shadow around implant
D. Pain during percussion D. All of the above
to have:
49. Which ofthe following are requirements for successful 4. Consanguineous marriages are believed
placement?
implant
: A. Significant influence on clefts
B. Not any influenc ing change
A. Mucosal seal B. Adequate transferof force
C Biocompatibility Cc Achance of defective zygote
D. Allof the above D. Very lesseffect on clefts
50. Approximate force applied to check implant mobility
is: takes place between:
A. 500 grams 5. Embryologic development of face
B. 900 grams
C 1200 grams D. 200 grams
“A. 4th and 8th weeks of gestation
B. 6th and 10th weeksof gestation
C 10th and 12th weeksof gestation ‘
D. 8th and 12th weeks of gestation

44.C 45.C 46. B 47. A 48.C 49.D

 122 Review in Oral and Maxillofac
ial Surgery
6. Limbs of placodes beco Cleft Lip and Palate 123
me:
A. Mediannasal proce
ss
B. Lateral nasal Process
C Both of the above
ior porti
14. In Kernahan’sclassification anterior portions of ae dep ” depicts:
:
B. Li :
D. None of the above
e iveies
veo! D. Allof the above
i:
7. Lowerlip and mand
ible develop from: . iated with:
Cleft palate may be associated with: , ,
A. Mandibulararch
C Stomodeum
B. Maxillary arch ie ihacked underdeveloped maxilla
D. Ectodermal plates B. Ineffective sucking :
8. Following are deti C Airwayobstruction
ved from maxillary proce
A. Cheek and maxilla ss:
D. Allofthe above
B. Zygoma and seco
ndary palate
C Both ofthe above 16. Cleft palate patients shows problem in:
D. None of the above A. Vision and ‘mastication 4
B. Hearing and deglutination
9. In cleft lip and palat
e, the main problemis
: C Smelling Rua 6
A. Failure oflateral nasa
l Process to make cont
act with median
D. Taste sensation amg
nasal process
B. Formation of secondar 17. First surgical intervention for repair of cleft lip is carried
y palate
C Growth of nasal septum
D. Noneofthe above ox B. 6-12 months
10. Median nasal Processe e ee D. 10-12 months
s form the foll owing:
A. Middle portion of nose 18. Before 1 year to 18 months,repair of:
B. Midd le portion of upperlip A. Cleft lip only
and premaxilla
C Entire primary palate B. Cleft palate only
D. Allofthe above Cc. Both simultaneously
11. Lateral nasal processe
+

s forms: nies ice

. of:
ae

A. Nasal septum carri tat theageof:

C Prem
B. Ala of nose 19. ee me ‘4
axilla B. 16-18 years
D. Allof the above A. 14-18 ye
12. In Veau’s classificati D. 10-12 years ~
on of cleft lip and palate group C 18-20 years
d by mostof
:
A. Prealveolar clefts Lis: ‘ mi
the surgeons for surg
ery of
© Complete alveolar cleft B. Postalveolar clefts + 20. Which rule is —
s D. Noneofthe above .
cleft palate and lip: -
13. Complete bilateral A. William’srule often B. Millard’s rule of six
alveolar cleft is group
classification. in Veau’s C. William’s rule of six D.Millard’sruleof ten
m4 A 21. Millard’s ruleof ten
includes:

<i
Sea
g At iOmocks ofspe, 10pounds
in f weight
weight, 10 inchhelght ofhead
Se
6.C 7.A
: 10 gmeeks
of Hb,10
of age,
weeks of age, 10 pounds weigh:t
8.C 9A
12.D 13. D 10.D 11.B f the above
eee

14. B 15.D 16. B 17.A 18. D 19.B

 a bw &
124 Review in-Oral and Maxillofacial Surgery

22. Rhinoplasty is:

A. Final lip andpalate revision
B. Final lip revision
C. Final palate revision
D.Final nose and lip revision
23. Surgical repair of unilateral cleftlip:
A. Millard’s procedure B. Langenback’s procedure
C Rhinoplasty D. Cumin’s procedure
24. In Pierre Robin syndrome following featuresare seen:
A. Cleft palate :
B. Mandibular micrognathia
C. Glossoptosis
D. All of the above
25. Breastfeeding or suckingis difficult for cleft palate patients
becauseof:
A. Air in oral cavity
B. Absence of negative pressure in mouth
C. Tongueobstruction
D. Allof the above

2D .23.A- 24D25.8
 Basic Principles of
Surgical Technique

1. The scalpel grasp commonly used in oral surgery is:

A Modified pen grasp B. Pen grasp
C Table knife grasp D. Palm and thumb grasp
2. The scalpel should be gripped:
A Rigidly or firmly B. Lightly
C Firmlybutlightly D. Firmlybutrigidly
3. The incision must be made:
A With a sharp scalpel
B. Perpendicular to the skin surface
C Preferably in the natural skin creases
D. All of theabove
4. When suturing the skin incision of the face, the skin edges
should be:
A Inverted B. Everted
C Both A and B D. None of the above
5. The massive outgrowth of scar tissue invading the normal
surrounding skin is called as:
A Lipoma B. Fibroma
C Keloid D. Papiloma
6. Which of the following is/are absorbable suture materials?
A Catgut B. Nylon
C Polyglycolic acid D. A and C
7. Which of the following is/are nonabsorbable suture materials?
A Polyesters and propylenes
B. Dacron
C Nylon
D. All of the above
 2 MCQs in Oral and Maxillofacial Surgery

8. The gauze pads usually used for extraoral wound dressing

are:
A. 2 by 2 and 4 by 6 em
B. 3 by 3 and 6 by 6 em
C 5 by 5 and 10 by 10 em
D. 6 by 6 and 8 by 8 em
9. The germ theory of disease was developed by:
A. Lister B. Moss
C Pasteur D. Miller
10. The scalpel blade most commonly used for oral surgical
procedure is:
A. 12 No. B. 10 No.
C 15 N o. D. 13 No.
11. Which part of surgical glove is considered sterile?
A. Only interior of the glove
B. Only exterior of the glove
C Both of the above
D. None of the above
12. The study of the tissues removed from the living organisms to
confirm diagnosis through histopathological study is called
as:
A. Autopsy B. Biopsy
C Cytology D. AandC
13. The refrigerant media used in cryosurgery units is/are:
A Carbon dioxide B. Nitrous oxide
C Freon D. All of the above
14. Electrofulguration is also called as:
A. Electrocoagulation B. E1ectrocutting
C Electrodesiccation D. Electrocautery
15. Histopathological study of tissue removed after death of
individual is called as:
A. Biopsy B. Punch biopsy
C Au topsy D. Aspiration biopsy
16. A flap based on a particular blood supply is:
A. Semilunar flap B. Envelop flap
C Ped icle flap D. Rhomboid flap
 Bas1c Pnnc1ples of Surg1cal Technique 3

17. Which of the following incisions provides excellent access to

temporomandibular joint?
A Submandibular incision
B. Risdon's incision
C Gillie's incision
D. Alkayat-Brarnl ey incision
18. In which of the following conditions, incisional biopsy is
indicated?
A 4 ern hemangioma of the tongue
B. 3 em leukoplakia of the soft palate
C 0.5 ern papillary fibroma of the gingiva
D. 1.5em exostosis of jaw
4 MCQs in Oral and Maxillofacial Surgery

Answers
l.B. Th e "pen grasp", commonly used in oral maxillofacial
surgery, permits the grasping of the scalpel handle between
the thumb and first two fingers. The third and fourth fingers
prov id e a rest position (fulcrum) on a firm base from which
short, skillful, incising strokes may be safely instituted.
2.C. rt should not be grasped too rigidly or in such a manner as to
produce digital tremors and otherwise influence the
unrestricted movement that is required in producing a clean
and atraumatic incision.
3.0. Pla nning the surgical scar for best esthetic results demands
tha t the incision be placed into one of the creases of skin
relaxation or, as a second choice,into an immediately parallel
area.
4.8. This will compensate for anticipated swelling and permit the
leveling out of the eversion without loss of the edge contact of
lhe skin incision.
S.C. Kel oids occur only in suspected individuals, most often in the
pigmented races. They have great chances for recurrence when
excised.
6.0. Pol yglycolic acid sutures are easier to handle, less tissue
reactive, and considerably less expensive.
7.D. Their greatest advantage is superior tensile strength, but they
also have minimum capillary action within the wound and
therefore induce less inflammatory reaction . But they are
difficult to handle and hard to tie.
S.C. Su ch ga u ze pad s are maintained in position by adhesive or
t'l astic band age.
9.C. This concept provided a basis for und erstanding wound
sepsis.
lO.C. I ncision should be made bone deep and with firm and
continuou s stroke without damaging the vita l structures.
n.B. Th e surgeon is helped into the gloves in such a ma nner that
onl y the interior of the gloves is touched by the hand s.
 Bas1c Princ1ples of Surgical Technique 5

12.8. Autopsy is the histopatl1ological study of tissue removed after

the death of individua L
13.0. These can produce temperature in the range of -20''C to
-90°C. The cryosurgery is useful for brain tumors vascular
anomalies, premalignant lesions and in the treatment of
benign and malignant neoplasms.
14.C. Fulguration or carbonization is a superficial bum produced
as a result of spark if the electrode is held slightly away from
the tissue.
15.C. Biopsy is the study of tissues removed from living organism
to confirm diagnosis though histopathological stud y.
16.C. Such a flap is designed in the palatealong the length of grca ter
palatine artery making use of this vessel.
17.0. Alkayat-Bramley incision isa modification of the preauricular
incision where the upper part of the incision is extend ed in a
question mark fashion over the temporal area to gain better
access.
18.8. An incision biopsy is performed by removing a wedge-shaped
segment of the pathological tissue along with surrounding
normal zone.
St erilization and Asepsis

1. Which of the following is most efficient method for destruction

of microorganisms including spore formers?
A. Boiling wa ter sterilization
B. Chemica l sterilization
C. Cold sterilization
D. Autodaving
2. Which of the following is true about autoclaving?
A. Temperature 121 c,pressure 20 Psi, time 15minutes
B. Temperature 1so c, pressure 20 Psi, time 40 minutes
C. Temperature 134 c, pressure 30 Psi, time 3 minu tes
0. Both A and C
3. Cidex is:
A. 2% H202
B. 4% glutaraldehyde
C. 2% glutaraldehyde
D. 2% formaldehyde
4. The heat sensitive and water sensitive instruments are best
sterilized by:
A. Formaline B. Ethylene oxide
C. Formaldehyde D. H202
5. Which of the following is used in gas sterilization?
A. Chlorhexidine
B. Cetrimid e
C. Sodiumhypochlorite
D. Ethylene oxide
6. The agents used to kill pathogenic organisms but not
n ecessarily the spores of bacteria on non-livin g objects are
ca lled :
A. Antisepti cs B. Antibiotics
C. Di siJ1fectants D. Antibioma
 Stenlization and Asepsis 7

7. Which of the following is used as antiplaque agent?

A 20% chlorhexidine gluconate
B. 0.2% chlorhexidine gluconate
C 10% formaline
D. 10% chlorhexidine glucona te
8. The ultimate test for efficiency of sterilization is provided by:
A Bacteria B. Virus
C Fungi D. Spore forming pathogens
9. Which of the following isnot a physical method of sterilization?
A Filtration B. Irradiation
C Cold sterilization D. Ultrasonics
10. The organisms most difficult to eradicate by sterilization are:
A Fungi B. AIDS virus
C Hepatitis B virus D. Spore forming bacteria
 8 MCQs in Oral and Maxillofacial S urgery

Answers
1.0. Autoclaving is the most effective, time efficient and practical
method of sterilization since it provides moist heat inthe form
of saturated steam under pressure .
2.0. The 3-minute"flash cycle" is best indicated for unwrapped
instruments. When wrappings are used for instruments or
surgical pa cks, a longer sterilizing cycle is required to permit
adequate penetration of steam tmder pressure.
3.C. Compound s of glutaraldehyde in 2% aqueous solution have
found some favor in cold sterilization. They are marketed in
either alkaline solution or in potentiated acid solution, each
considered equally effective.
-!.B. Ethylene oxide in concentrations exceeding 3% of room air
could be explosive. Therefore it is necessary that the room
where gas sterilization is practiced be properly vented .
5.D. Ethylene oxide sterilizers are relatively economical for large­
scale sterilization, but when the gas is supplied in cartridge it
is expensive and not reu sable.
6.C. If a chemica l is sporicidal it is called as sterilant, but if the
chemical used is not sporicidal it is called a disinfectant.
7.8. 20% solution of chJorhexidine gluconate is used for rapid
hand disinfection prior to surgery. Whereas 0.2% solution is
used as an antiplaque agent.
8.0. A process cannot be called a sterilization process unJess it
has shown to be capable of kiUing high numbers (preferably
all) of bacterial spores, the most difficult of microorganisms to
kiJJ .
9.C. The effectiveness of cold sterilization is d oubtful against
spores.
10.1. A process ca nnot be called a steril ization process unJ ess it
has shown to be capable of killing high numbers (preferably
all) of bacterial spores, the most difficult of microorganisms to
kill.
 Extraction of
Teeth-Exodontia

1. Extraction of a tooth during pregnancy is safely carried out

during:
A First trimester B. Middle trimester
C Last trimester D. None of the above
2. Which of the following is absolute contraindication for
extraction of a tooth?
A Hypothyroid ism
B. Hypoparathyroid ism
C Hyperthyroidism
D. Hyperparathyroidism
3. Transalveolar extraction is also called as:
A Closed extraction
B. Intra-al veolar extraction
C Ope:n extraction
D. All of the above
4. Dry socket usually forms during which postoperative day?
A 1stpostoperati ve day
B. 3rd or 4th postoperative day
C 5th postoperativ e day
D. 6th postoperative day
5. The order of extraction of teeth is:
A 3rd molar,2nd molar, 1st moJ ar,2nd premolar, 1st premol ar,
canine, lateral incisor, central incisor
B. 2nd molar, 1st molar,3rd molar, 1st premolar, 2nd premolar,
canine, lateral incisor, central incisor
C 3rd molar,2nd mola r,2nd premolar, 1st molar, 1st premola r,
lateral incisor, canine, central incisor
D. None of the above
 10 MCQs in Oral and Maxillofacial Surgery

6. Which of the following teeth is in close approximation to

maxillary sinus?
A. Maxillary canine
B. Maxillary 2nd premolar
C Maxillary 1st molar
D. Maxillary 2nd molar
7. Ash forceps are used for extraction of:
A. Maxillary molars
B. Mandibular molars
C Maxillary incisors
D. All the teeth
8. Mead forceps are used for extraction o.£:
A. Maxillary posterior teeth
B. Mandibular posterior teeth
C Mandibular anterior teeth
D. Maxillary anterior teeth
9. Cowhom No. 16forcep is used for extraction of:
A. Mandibular anterior teeth
B. Maxillary anterior teeth
C Mandibular molars
D. Maxillary molar
10. Allies forceps is used for:
A. Tissue cutting
B. Tooth extraction
C For grasping tissue
D. None of the above
11. The beak of an extraction forcep is designed so that most of
the extraction pressure is transmitted to the:
A. Cementoenamel junction
B. Crown of the tooth
C Root of the tooth
D. Alveolar bone
12. Odontectomy is synonymous with:
A. Extraction under general anethesia
B. Extraction under local anethesia
C Intra-a!veolar extraction
D. Transalveolar extraction
 Extract1on of Teeth-Exodont1a 11

13. 'Rubber band extraction' is a method of extraction in patients

having:
A. Myocardial inf arction and angina pectoris
B. Supernumerary teeth and ankylozed teeth
C Pericoroniti s and impacted molars
D. Hemangioma and hemophil ia
14. Prophylactic antibiotic coverage before dental extraction is
indicated for patients with each of the following conditions,
except
A. Coronary artery disease
B. Rheumatic heart disease
C Prosthetic aortic valve
D. Kidney damage needing hemodialy sis
15. The primary purpose of bibevel chisel is:
A. Engage point establishment
B. Remove bone
C Sharpen the angles
D. Split teeth
16. The elevator can be used to advantage when:
A. The tooth to be extracted is isolated
B. The interdental bone is used as a fulcrum
C The adjacent tooth is not to be extracted
D. The adjacent teeth are to be extracted
 12 MCQs in Oral and Maxillofacial Surgery

Answers
1.B. There is massive nausea and vomiting in the first trimester of
pregnancy whereas there is risk of premature delivery in the
last trimester.
2.C. l'ntients with toxic goiter can pose the problem of thyroid
crisis. No extractions should be performed on patients of toxic
goiter.
3.C. Transalveolar extraction is also known as surgica l extraction
of tooth by reflection of an adequate mucoperiosteal flap and
removal of the bone followed by tooth removal.
4 .B. Dry socket is a very painfu l condition that follows faulty
healing after tooth extraction.
S.C. The most posterior teeth are removed first and the canines are
removed last. Even first molars have strong bony framework
and are extracted following the extraction of adjoir"ring teeth.
6.C. Maxillary sinus can be accidentally opened while extracting
:: maxillary molar or premolar tooth.
7.0. Ash forceps are used for the extraction of all the teeth.
S.C. Forceps No. 151 or Mead forcepsmay be used for extraction of
mandibular anterior teeth.
9.C. forces exerted during extraction of mandibu lar molars are
bucca l and lingual rocking with remova l to buccal side.
1O.C. Allies forceps is used for grasping tissue.
ll .C. In English pattern forceps the upper forceps have thebeaks in
the same line as handles whereas in the lower forceps beaks
n re at right angle to the long axis of the handl es.
12.0. This is also known as surgical extraction of tooth by reflection
nf an adequate mucoperiosteal flap and removal of the bone
followed by tooth removal.
13.0. Car diac disease, su ch as coronary a rter y disease,
hypertension, a nd cardiac decompensation can complicate
cxodontiR s. Ma n agement may require the help of physician.
 Extraction of Teeth-Exodontia 13

14.A.
15.0. Bibeveled chisel is called as osteotome.
16.0.
 Impacted and
Supernumerary Teeth

1. The impacted mandibular 3rd molars are classified on the

basis of:
A. Relation of tooth to ramus of mandible and second molar
B. Relative depth of 3rd molar in the bone
C Position .of long axis of impacted 3rd molar in relation to
long axis of 2nd molar
D. All of the above
2. Which of the ,following is most difficult impaction?
A Vertical
B. Mesioangular
C Distoangular
D. Noneoftheabove
3. Red line is:
A. The linejoining the buccal cusps of erupted mqlars and going
posteriori y over 3rd molar region
B. The line running at the 1eve1of the crest of interdental bone
between molars
C The line drawn perpendicular from amber line to an
imaginary point of elevation
D. All of the above
4. Which of the following teeth is more commonly impacted?
A. Mandibular canine
B. Maxillary canine
C Maxillary central incisor
0. Mandibular central incisor
5. Canine impacted in the edentulous maxilla represents:
A. Class I impaction B. Class IV impaction
C Class V impaction 0. Oass ID impaction
 Impacted and Supernumerary Teeth 15

6. The impacted supernumerary teeth are most commonly found

in:
A. Maxillary posterior region
B. Maxillary anterior region
C Mandibular posterior region
D. Mandibular anterior region
7. Which nerve can be damaged during the removal of impacted
mandibular 3rd molar?
A. Facial nerve B. Optic nerv e
C Lingual nerve D. Olfactory nerve
8. Which of the following is bibeveled?
A. Chisel B. Bone gouge
C Osteotome D. Bone rongeur
9. Ideal ridge is:
A Ushaped
B. Vshaped
C Both A and B
D. None of the above
10. Bone resorption in diabetic patient is:
A. Normal
B. Slow
C Rapid and extensive
D. Cannot be predicted
11. The single supernumerary tooth occurring between maxillary
central incisors is called as:
A. Mesiodente s B. Paramolar
C Mesiodens D. Distomolar
12. The double supernumerary teeth occurring between maxillary
central incisors are called as:
A. Mesiodens
B. Me5iodentes
C Both of the above
D. None of the above
13. The supernumerary anterior maxillary teeth are usually
removed by:
A Buccal approach B. Palatal approach
C Labial approach D. Both A and C
16 MCQs mOral and Maxlllofacaal Surgery

14. The impacted mandibular supernumerary premolars are

difficult to remove because of:
A. Presence of compact bone
B. Contents of mental foramen on buccal side
C Salivary gland on lingual side
D. None of the C).bove
15. Which of the following is most common complication after
extraction of mandibular molars:
A Ecchym osis
B. Osteomyelitis
C Edema
D. Loss of blood dot
16. Treatment of choice of dry socket is:
A. Curettage
B. Antibiotics
C Obtundent, antiseptic dressing locally and analgesics
D. All of the above
17. Osteomyelitis is characterized by:
A Pus discharge from bone
B. Granulation tissue extruding from bone
C Small radiopaque pieces of bone lying loose
D. All of the above
18. Based on the relation of toQth ramus of mandible and second
molar, class Ill impaction is:
A. When highest portion of 3rd molar is above occlusal line
B. When highest por-tion of 3rd molar is at occlusal line
C When highest portion is below the level of occlusal line
D. When 3rd molar is located within the ramu s of mandible
19. Based on relative depth of 3rd molar in the bone, position B
impaction is:
A. When 3rd molar is located within ramus of mandible
B. When highest porti on of3rd molar is above level of occlusal
line
C When highest portion of 3rd molar is at the level of occlusal
line
D. When highest portion of 3rd molar is below the occlusal line
but above the cervical line of second molar
 Impacted and Supernumerary Teeth 17

20. Which of the following is best treatment for pericoroniti s

associated with impacted mandibular third molar?
A Operculectomy
B. Extraction of impacted molar
C. Antibioti c and analgesic therapy
D. Irrigating under the operculum
21. An approach to an impacted mandibular molar is achieved
by:
A 'L' shaped flap
B. Bayonetflap
C. Envelop flap
D. All of the above
18 MCQs mOral and Maxillofacial Surgery

Answers
J.D. lt is advised to identify the tooth position always on the basis
of all the three classifications as only then the exact position
of the tooth can be explained or conveyed for any reference .
2.C. The distoangular impaction is difficult to remov e because its
buJ k lies in the vertical ramus.
3.C. It indicates the amount of resistance and cUfficulty encountered
during removal of impacted third molar.
4.8. The bone of the hard palate offers more resistance than the
alveolar bone on the ridge for a lingually erupting canine.
S.C. Vertically impacted canine between lateral incisor and first
premolar comes under class IV impaction.
6.B. The supernumerary teeth can be encountered in any region of
the jaw. Howev er, these are most commonly found in the
ma xillary incisor region especia11y on the palatal side.
7.C. The nerve repair is difficult once the nerve is cut .Care should
always be taken to save this nerve from chisels. They may slip
on to lingual side while doing bone cutting.
S.C. A chisel is a monobeveled instrument, wherea s,osteotome is
a bibeveled instrument.
9.A. When the multiple extractions are perform ed, the contours of
alveolar ridge should be considered in the light of future
prosthetic needs.
10.C. Therefore one should remove only the teeth and not sharp
bone or piece of bone so as to save every bit of bone.
11.C. Supernumerary teeth may occur singly between the central
incisors (mesiodens) or they may be double (mesiodentes).
12.H. Although supernum erary teeth may be found impacted m
any area of the alveolar ridges. The most common onesoccur
in the maxillary anterior region.
 Impacted and Supernumerary Teeth 19

13.B. When radiographs are incol)clusive in establishing the

location of the supemuinerary teeth anterior or pQsterior to
the no:t:irull :teeth, a palatal approach is made, since few are
located in an anterior position.
14.0. Occlusal radiograph s will lqcate the tooth as being on the
buccal side or on the lingual side or midway betWeen the
plates{the last is most frequent).
15.0. Hemorrhage can be controlled by packing gelfoam or oxycel
packed in the socl<et. Adr naline pack kept for sometime irt
the socket wl.ll also stop 'the hemorrhage.
16.C. In dry socke.t blood clot is disintegrated leaving ruiked bone
behind. There is severe neuralgic pain sensitive to any food
that the p Hent will take..
17.0. Extensive osteomyelitis is rarely encountered with the advent
of newer antibiotics.
18.0. InclaSs ll impaction,space between the distal surface of second
molar and ramus is less than mesiodistal ·diameter of the
crown of third molar.
19.0. Inposition C impaction, the highest portion of the tooth is
below the cervical line of the second molar.
20.B. An aeute pericoronitis arol.llld a mandibular third molar
usually,responds to the extraction of the maxillary third molar
if the latter is impinging on the infected mandibul!!tr tissue.
21.0. The mdst commonly practiced incision is the L-shaped flap.
HoweveJ", an envelope flap or bayonet-shaped flap is also
practiced as per convenience of the surgeon.
 Preprosthetic Surgery
and Postoperative
Compli- cations

1. Reactionary hemorrhage occurs:

A. After 2-4 days
B. After7-14day
C Within 24 hours
D. Within 48-72 hours
2. Most common site for dry socket is:
A. Lower incisor area
B. Upper incisor area
C Upper molar area
D. Lower molar area
3. The most common cause of postextrac.tion bleeding is:
A. Patient with the anticoagulant therapy
B. Bleeding disorders
C Failure of the patient to follow postextracti on instructions
D. Due to the analgesics such as aspirin
4. Extraction of mandibular first molars in a lh years old child is
also known as:
A. Orthodontic extraction
B. Wilkinson's extraction
C Premature extraction
D. Serial extraction
5. Etiology of localized osteitis inclu es:
A. Trauma
B. Decrease in vascular supply to regional bone
C Infection
D. All of the above
 Preprosthet1c Surgery and Postoperative Complications 21

6. Hemorrhage aft er dental extraction procedure can be

prevented by all of the following, except
A. By applying pressure
B. Ligating bleeding bl ood vessels
C Properl y designing and carefully reflecting mucoperiostea l
flap
D. By giving anticoagulant
7. Paresthesia of lower lip most commonly occurs due to:
A A benign tumor of mandible
B. Fracture of the mandible
C Periapical abscess of first molar
D. Removal of mandibular 3rd molar
8. The most serious complication which may occur folJowing
surgery about the maxillary canine is:
A Cellulitis
B. Cavernous sinus thrombosis
C Iritis
D. Localization of pu s
9. Which of the following does not suggest postoperative
infection?
A Swelling
B. Pain
C Temperatureelevation
D. Pitting edema
10. Mucoceles are mostly caused by:
A Tooth extraction ·Trauma
C Infection D. Sialolithiasis
11. When root of tooth is displaced into maxillary antrum, it is
removed by which approach?
A. Nasal antrostomy
B. By Weber-Frugsion incision
C Through the socket
D. Through canine fossa
12. Treatment of choice for postoperative cutaneous ecchymosis
is:
A Application of cold B. Use of topica l steroid s
C Aspiration of bl ood D. N one of the above
 22 MCQs in Oral and Maxillofacia l Surgery

13. Ecchymosis means:

A. A lesion of bone
B. Fracture of bone
C Discoloration of the soft tissue
D. Tu mor ofkidney
14. What are the objectives of ridge augmentation?
A. To increase the ridge-height and width
B. Protection of neurovascular bundles
C Restoration of proper maxillomandibular arch relationship
D. All of the above
15. Which of the following is/are used for ridge augmentation?
A. Tantalum gauze filled with bone chips
B. Hydroxyl apatite
C Acrylic implants
D. All of the above
16. Autogenous rib graft for ridge augmentation is usually
harvested from:
A. First rib B. 2nd-4th rib
C 6th-9th rib D. 11th-Uth rib
17. Resorption of the alveolar bone of the mandible results in all
of the following, except
A. Brings the mental foramen close to upper border of mandible
B. Brings the mental foramen close to the lower border of the
mandible
C Wearing of denture causes discomfort to the patient
D. Paresthesia of lower lip
18. Vestibuloplastyis:
A. The deepening of the vestibule
B. Most commonl y done in maxilla
C Most commonly done inmandible
D. Both A and C
19. The bony enlargement of the maxillary tuberosity usually
occurs in:
A. Upwa rd direction
B. Anterior direction
C Mesial direction
D. Downward and lateral direction
 Preprosthet1c Surgery and Postoperative Complications 23

20. Torus palatinus commonly occurs in:

A Anterolateral part of hard palate
B. Posterolateral part of hard palate
C On the midline of the hard palate
D. None of the above
21. Torus mandibularis most commonly occurs in:
A Buccal side of mandibular incisors
B. Lingual side of mandibular incisors
C Lingual side of maxillary premolars
D. Lingual side of mandibular premolars
22. Which of the following is true about the excision of torus
palatinus?
A It should be excised with the help of burs and rongeurs
B. Itshould not be excised with chisel and mallet
C It should be excised with chisel and mallet
D. Both A and B
23. All of the followings are objectives of alveolectomy, except
A To correct the premaxillary excess
B. To increase the interm axillary gap
C To correct sharp knif e-edged bony ridge
D. To decrease the intermaxillary gap
24. Hyperplasia of the crest of the alveolar ridge is most commonly
found in:
A Maxillary posterior region
B. Maxillary anterior region C
Mandibular anterior region
D. Mandibul ar posterior region
25. On the basis of oral and radiographic examination, the alveolar
ridge deficiency is classified into:
A II classes
B. IV classes
C VI classes
D. VIII classes
26. Class II alveolar ridge is:
A. Deficient in height only
B. Deficient in width only
C Deficient in width and height
D. Does not show an deficiency in height and w idth
24 MCQs mOral and Maxlllofac1al Surgery

27. Recontouring of the residual ridge in the early part of extraction

period occurs primarily by resorption of the:
A. Crestal bone
B. Lingual cortica l bone
C. Labial-buccal cortical bone
D. Buccal-lingual cortical bone
28. During the removal of mylohyoid ridge, which of the following
nerves should be protected?
A. Mental nerve B. Mylohyoid nerve
C. Lingual nerve D. Inferior alveolar nerve
29. During the apicoectomy on a maxillary lateral incisor, one
should take care not to perforate or damage the:
A. Maxillary sinus B. Labial frenum
C. Floor of the nose D. Contents of the incisive canal
30. Which of the following methods is/are commonly used for
ridge extension of the mandible?
A. Secondary epithelialization
B. Mucosal graft vestibuloplasty
C. Skin graft vestibuloplasty
D. All of the above
 <?p rosthetic Surgery and Postoperative Complica tiOn s 25

Answers
l.C. Intermediate hemorrhage or reactionary hemorrhage occurs
within 24 hourspostoperatively. It is generally because of rise
in blood pressure or slipping of the ligature.
2.0. Dry socket isencountered even after least traumatic remov al
of tooth in experienced hands where utmost care has been
taken regarding sterilization and asepsis.
3.C. The patient should be given instructions to get as uneventful
postoperative healing. Faithful compliance of the instructions
will help prevent post-extraction complications.
4.B.
S.D. Dry socket (localized osteitis) is one of the most perplexing
postoperative complications. The etiology of the dry socket is
unknown, but the following factors increase the incidence of
this painful post-extraction sequela: trauma, infection,
decreased vascular supply of the surrounding bone, and
generalsystemiccondition.
6.0. Use of anticoagulants like heparin, dicumarin and hirudin,
etc. will prevent dotting of blood.
7.0. Injury to lingual nerve is also possible during extraction of
mandibular third molar.
S.B. Cavernous sinW? thrombosis is the infectious thrombosis of
the cavernous sinus. In the beginning it may be
thrombophlebitis,i.e. inflanunatory aspect of intima of vessels,
followed by thrombus formation, which is infected.
9.0. In postoperative infection, pain ma y continue as severe,
lancinating and neuralgic in character. It should be treated by
providing drainage by opening the sutures and patient should
be given appropriate a ntibiotics and analgesics.
lO.B. Mucocysts or mucoceles result from the obstruction of a
glandular duct and are commonly located in the lip, cheek,
and the floor of the mouth.
 26 MCQs m Oral and Maxillofacial Surgery

11.0. A small root tip may remain asyrnptometic. A small op.. ...llg
into maxillary sinus normally repairs with the organization
of blood clot that fills the extraction socket. A large opening
should always be dosed by plastic repair.
12.0. Ecchymosis are large extravasations of the blood into the
subcutaneou s tissue with facial discoloration ranging from
light red to deep bluish or purple in color .
13.C. Ecchymosis is discoloration of the soft tissues bene.ath the
eye,in the cheek, under the mandible, floor of the mouth, etc.
14.0. Ridge augmentation is a surgical procedure, whicll involve
replacement of bone that has beenlost through excessive bone
resorption .
15.D. Ridge augmentation has beeri tried with bone transplants,
autogenous and homogenous c:artilage, hydroxylapatite,
acrylic implants as well as tantalum gauze rolled on itself
and filled with bone chips.
16.C. It is important that the rib oriliac crest graft should beplaced
lingual to the alveolar crest in case of mandible and labial to
the alveolar crest in case of maxilla because of their resorption
pattern.
17.B. Resorption of the alveolar bone of the mandible may bring the
ridge down to the level of the mental foramen. Patient may
experience paresthesia or anesthesia of the lower lip or a
constant neuralgic pain during mastication .
18.0. The denture bearing area isincr-eased by shifting the soft tissue
attachments deeper.
19.0. During this operation,care must be exercised not to open the
maxillary antrum. For this preoperative study of X-ray is of
utmost importan .
20.C. Torus palatinus may interfere with the insertion of a denture
since a denture rocks over it and breaks over a period of time.
The treatment lies·in excision.
21.0. The treatment of torus manibul1'tr lies in itssurgical removal.
22.0. Torus palatinus should not be excised enmass with the help
of chisel because of fear of nasal perforation.
 Preprosthet1c Surgery and Postoperative Complications 27

23.0. Alveolectomy refers to surgical removal of the alveolar process.

24.8. Hyperplasia on the crest of the alveolar ridge is seen in patients
most commonly in the maxillary anterior region in the form of
mobile unsupported soft tissu e on account of ill-fitting
dentures or in patien ts who have used the same set of dentures
for many years.
25.8. Inclass I, alveolar ridge is adequate in height but inadequate
in width, usually with lateral deficiencies or und ercut areas.
Inclass IV, there is resorption of the basilar bone producing
p ncil -thin, flat mandible or maxilla.
26.C. Inclass n, alveolar ridge is deficient in both height and width
and presents a kni fe edge appearance.
27.C. Any attempt to prepare the ridges that will disturb the
muscular balance or compromise the area for the denture on
the ridge will lead to failure as far as the success of the denture
is concerned and the very purpose of providing a successful
denture will be defeated.
28.C. The lingual nerve and Wharton's duct are protected with a
Lane retractor.
29.C. Roots of maxillary lateral incisor lies close to the floor of the
nose.
30.0. Secondary epithelialization vestibuloplasty is the procedur e
of choice for patients with extensive scarring or epulis
fissuratum in the sulcus or who have good quality mucosa
cover available without sufficient height.
 Cysts of the Oral Cavity

1. Which of the following is not true about ranula?

A. It is a retention cyst
B. There is no pitting on pressure
C There is pitting on pressure
D. Tense cmd fluctuant on palpation
2. Globulomaxillary cyst occurs:
A. In between maxillary canine and 1stpremolar
B. ln between mcmdibular canine and 1st premolar
C In between mandibula,r canine and lateral inCisor
D. Inbetween maxillary canine and lateral indsor
3. Which of the followings is not a congenital cyst?
A. Dermoid cyst
B. Epidermoid cyst
C Thyroglossal cyst
D. Periapical cyst
4. All of the followings are fissural type of cysts, except.
A. Median cyst
B. Nasoalveolar cyst
C Nasolabial cyst
D. Dermoid cyst
5. Which of the followings is not a non-odontogenic cyst?
A. Mucocele
B. Gingival cyst
C Median cyst
D. Incisive canal cyst
6. Which of the following is not an odontogenic cyst?
A Lateral periodontal cyst
B. Gingiva l cyst
C Median cyst
D. Follicular cyst
 Cysts of the Oral Cavity 29

7. Which of the following is most common type of dentigerous

cyst?
A. Central type B. Multiple type
C Latera l type D. Grcumferential type
8. Which of the following cyst has·highest rate of recurrence?
A. Dentigerous cyst B. Keratocyst
C Primordial cyst D. Follicu lar cyst
9. Ruston bodies are not present in:
A. Apical periodontal cyst
B. Infected dentigerous cyst
C Primordial cyst
D. Gingival cyst of neonate
10. Nasoalveolar cyst is also known as:
A. Branchiogenic cyst B. Epstein's pearls
C Klestadt's cyst D. Bohn's nodules
11. Which of the following cysts is not seen in radiographs?
A. Globulomaxillary cyst
B. Dentigerous cyst
C Klestadt 's cyst
D. Primordial cyst
12. Botryoid odontogenic cyst is a type of:
A. Nasolabial cyst
B. Gingival cyst
C Lateral periodontal cyst
D. Primordial cyst
13. Dental lamina cysts of newborn are also known as all of the
following, except
A. Gingival cyst of newborn
B. Epstein's pearls
C Bohn's nodules
D. Bohr's nodules
14. Bohn's nodules are most commonly found :
A. Inanterolateral region of hard palate
B. In posterolateral region of hard palate
C At the junction of hard and soft plate
D. In soft palate only
30 MCQs 111 Oral and Maxlllofacral Surgery

15. Which of the following cysts moves upwards during

swallowing?
A. Dentigerous cyst B. Dermoid cyst
C TI1yroglossal cyst D. Epidermoid cyst
16. Osteitis fibrosa cystica is also known as:
A. Hypoparathyroidism
B. Hypothyroidism
C Hyperthyroidism
D. Hypetparathyroidism
17. All of the following have radiolucent radiographic appearance,
except
A. Ameloblastoma
B. Giant cell tumor
C Fibrous dysplasia
0. Condensing osteitis
18. Which of the following is not a retention cyst?
A. Ranula B. Gingival cyst
C Mucocele D. Extrava.sation cyst
19. Which of the following cysts is associated with a non-vital
tooth?
A. Globulomaxillary cyst
B. Nasoalveolar cyst
C Periapical cyst
D. Nasolabial cyst
20. Marsupialization is also called as:
A. Caldwell-Luc operation
B. Waldron's operation
C Partsch's operation
D. None of the above
21. Primordial cyst is lined by:
A. Simple cuboidal epithelium
B. Simple columnar epithelium
C Stratified squamous epithelium
D. Pseudostratifie d squamous epithelium
22. Dentigerous cyst is most commonly associated with a:
A. Non -vitaJ tooth B. Impacted tooth
C Erupted tooth D. Missing tooth
 Cysts of the Oral Cavity 31

23. Dentigerous cyst is most commonly found in:

A. Maxillary anterior region
B. Maxillary posterior region
C. Mandibular anterior region
D. Mandibular posterior region
24. Which of the following has the greatest potential to undergo
transformation into an ameloblastoma?
A. Primordial cyst B. Keratocyst
C. Dentigerous cyst D. Follicular cyst
25. Which of the following cysts is not lined by epithelium?
A. Hemorrhagic bone cyst
B. Dentigerouscyst
C. Follicular cyst
D. Periodontal cyst
26. Treatment of choice for hemorrhagic bone cyst is:
A. Incision
B. Excision
C Surgical exploration followed by curettage toestablish fresh
bleeding
D. Caldwell-Luc operation
27. The protein content of cystic fluid less than 4 gm/100 ml of
soluble protein is diagnostic feature of:
A. Dentigerous cyst B. Keratocyst
C Periodontal cyst D. Radicular cyst
28. Which of the following is the most common cause of recurrence
of keratocyst?
A. Absence of epithelial lining
B. Presence of thick epithelial lining
C Presence of thin and fragile epithelial lining
D. Presence of a thick connective tissue lining
29. Brick red fluid is aspirated from:
A. Follicular cyst B. Primordial cyst
C. Hemorrhagic cyst D. Epstein's pea rls
30. The cysts less than 2 em in size are best treated by:
A. Incision B. Marsupialization
C. Enucleation D. Aspiration
32 MCQs in Oral and Maxillofacial Surgery

31. Paetsch's operation is indicated for treatment of:

A. Small cysts B. Large cysts
C Solid tumors D. White lesions
32. Branchiogenic cyst is charactetistically located:
A. In the midline of neck
B. Along the posterior border of sternocleidomastoid muscle
C Along the anterior border of sternocleidomastoid musde
D. ln the floor of mouth
33. Which of the following cysts appears as pear-shaped
radiolucency in radiographs?
A. Gingival cyst
B. Lateral periodontal cyst
C Globulomaxillary cyst
D. Nasoalveolar cyst
34. Multiple keratocysts are found in:
A. Marfan syn rome
B. Basal cell nevus syndrome
C Paget's disease of bone
D. Marble bone disease
 Cysts of the Oral Cavity 33

Answers
l.C. Ranula is a cyst in the floor of the mouth present between the
root of the tongue and mandible. Generally the sublingual
gland is the contributing factor .
2.0. Globulomaxillary cyst is formed at the junction of globular
and maxillary processes between the lateral incisor and the
canine tooth. As it grows in size, it causes divergence of the
roots of these teeth .
3.0. Periapical cyst is a developmental cyst.
4.0. Dermoid cyst is a congenital cyst. As the name suggests, a
dermoid cyst contains everything present in skin as its
contents namely hair, sebaceous and sweat glands.
5.8. Non-odontogenic cyst are of two types namely fissural type
and retention type. Incisive canal cyst and median cyst comes
under fissural type whereas mucocele comes under retention
type.
6.C. A median cyst is a non-odontogenic cyst. It is a rare cyst
encountered in the midline of the alveolar processes of maxilla
and mandible or even as a mid palatal cyst.
7.A. Central type cyst more or lesssymmetrically envelops the tooth .
Tooth appears as a flame of a candle in the radiograph.
8.8. The recurrence can be attributed to very thin and fragile lining
part of which can be left behind during enucleation .
9.C. Rushton bodies are peculiar linear,after curved,hyaline bodies
with variable stainability, which are of uncertain origin.
lO.C. A nasoalveolar cyst forms at thejunction of theglobular, latera l
nasal, and ma xillary processes. It produces a swelling at the
attachment of the ala of the nose, and as it expand s, it
encroaches on the nasal cavity.
ll.C. Since these cysts are not central bony lesions, X-ray findings
arenegative .
 34 MCQs mOral and Maxtllofac1al Surgery

12.C. A periodontal cyst is formed from epithelial restsor remnants

in the periodontal membrane . When periodontal cyst are
formed along the lateral surface, they are termed as lateral
cyst.
13.0. Dental lamina cystsof the newborn are multiple, occasionally
solitary, nodules or the alveolar ridge of newborn which
represent cysts originating from remnant of dental lamina.
14.C. Boh.n 's nodules are keratin filled cysts scattered over the
palate, most numerou s along the junction of the hard and soft
palate and apparently derived from palatal salivary gland
structures.
15.C. Thyroglossal duct runs from foramen caecum in tongue to
ultimate position of thyroid gland in the neck. TI1e cyst arises
from any portion of this duct.
16.0. Hyperparathyroidism leads to bone resorption. Fibrous
replacement occurs in that area. The hemorrhage may occur
into the replacement tissue. Organization occurs with
formation of delicate osteoid trabeculae and osseous material.
17.0. Condensing osteitis has radiopaque radiographi c appearance,
as there is condensation of bone.
18.B. Gingival cyst is a periodontal cyst.
19.C. Periapical cyst is most common odontogenic cyst associated
with non-vital tooth.
20.C. Ma rsupialization involves deroofing of the cyst along with
adjoining bone and mucoperiosteum so that the cystic lining
becomes continuous with the lining of the oral cavity.
21.C. Primordial cyst arises from the enamel organ epithelium before
any calcified tooth structure is formed .
22. B. These cysts interfere with normal eruption of teeth. Enlarged
dentigerou s cysts can cause a marked displacement of teeth.
23.0. Dentigerous cysts may be found anywhere in the mandible or
the maxilla but are more frequently located at the angle of the
j nw, the cuspid regions, maxilliuy third molar areas, the antral
cavity, and also in the floor of the orbit.
 Cysts of the Oral Cav1ty 35

24.C. Primordial or dentigerous cyst is a potential ameloblastoma .

The formation of budsat the basal layer of the epithelium and
papillary outgrowth into the lumen may be the beginning of
this dental tumor.
25.A. Access to the bone cyst must be gained by incising and
reflecting the mucoperiosteum .
26.C. The concave side of the curet is usually placed against the
bone as the thin blade is teased in between the cyst wall and
the bone cavity.
27.B. The aspirated cystic fluid is analyzed for the estimation of
soluble protein content.If the protein level is less than 4 mg /
100 ml then it is diagnostic of a keratocyst.
28.C. The recurrence can be attributed to very thin and fragile lining
part of which can be left behind during enucleation .
29.C. Light straw colored fluid containing cholesterol crystals
confirm the diagnosis of a cyst keratocyst shows a creamy
white suspension of keratin.
30.C. Enucleation involves complete removal of the cystic lining
and primary closure of the wound .
31.B. Partsch operation or marsupialization is indicated if the cyst
is very large and placed in an inaccessible area from where
complete enucleation is not possible .
32.C. Branchiogenic cyst contains a mucoid or milky fluid . The
extent of cyst in the neck is confirmed radiographically after
injecting some radiopaque dye in the cyst.
33.C. Globulomaxillary cysts usually cause a divergence of the roots
of these teeth and appear as pear-shaped radiolucanci es on
the X-ray film.
34.B. The basal cell nevus syndrome is a hereditary compl ex
embracing various manifestations of cutaneous and skeletal
abnormalities.
 Peri osteitis,
Osteomyelitis and
Necrosis of the Jaw

1. Osteomyelitis in adults ismost commonly found in:

A. Maxilla B. Mandible
C Lip D. None of the above
2. Osteomyelitis is commonly caused by:
A. Staphylococcus alb s
B. Staphylococcus aureus
C Streptococcus mutans
D. Streptococcus sanguis
3. Necrosis of jaw can be caused by:
A. Radiation B. Chemicals
C Electrocoagulation D. All of the above
4. Acute osteomyelitis in infants can caused by:
A. Birth trauma
B. Inf ection from contaminated feeding bottles
C Wection from unclean nipple of the mother
D. All of the above ·
5. Chronic osteomyelitis may be associated with:
A. Tuberculosis ·bf the jaw
B. Syphilis of the jaw
C Actinomycosis of the jaw
D. All of the above
6. Seqllestrum appears:
A. Radioleucent
B. More radioleucent than surrounding·bone
C More radiopaque than surro ding bone
D. All of the above
 Penostettts. Osteomyelitts and Necrosis of the Jaw 37

7. Treatment of chronic osteomyelitis consists of:

A Sequestrectomy B. Saucerization
C Both of the above D. None of the above
8. Saucerization means:
A Removal of soft tissue
B. Removal of sequestrum
C Removal of bony cavity
D.Sequestrum
9. Immature bone surrounding the sequestrum is called as:
A Cloacae B. Involucrum
C Gumma D. Operculum
10. Which of the following is not true about Carre's osteomyelitis?
A It is a non-suppu ra tive productive d isease
B. It is a suppurati ve productive disease
C It occurs in response to a mild irritation
D. There is periphera l subperiosteal bone deposition
11. Discharge of which of the following diseases contains sulfur
granules:
A Tuberculosis B. Syphilis
C Actinomycosis D. Measles
12. Osteoradionec rosis of the jaw bone occurs as a complicati on
of: -
A Chemotherapy 8. Physiotherapy
C Radiotherapy D. All of the above
13. How much bone should be destroyed in osteomyelitis bef ore
it manifests radiologically:
A 10-15% B. 15-20%
C 30-60% D. 80-100°/.,
38 MCQs 111 Oral and Max111ofac1al Surgery

Answers
1.8. Osteomyelitis is more common in males than females and
more common in mandible than maxilla.
2.B. Different varieties of Streptococcus haemolyticus and Streptococcus
pneumoniae are also seen. Gram-negative bacilli may be found
that may complicate the picture.
3.0. Necrosis of the jaw can also follow surgery or trauma when
vascularity of bone is compromised.
4.0. Acute osteomyelitis in infants is a rare condition and usually
starts two weeks after birth. Majority of the times, the
involvement is of maxilla .
S.D. Osteomyelitis is the inflammation of the soft tissue of the bone
namely marrow spaces of the spongiosa and the Haversian
system of the cortex.
6.C. The sequestrum appears whiter than the surrounding bone
because of its higher calcium ion contents.
7.C. The treatment of chronic osteomyelitis consists of
sequestrectomy (removal of sequestrum) and saucerization
(removal of bony cavity).
S.C. Saucerization consists of elimination of bony cavity in the
jaw bone to avoid coll ction of blood and formation of large
hematoma which is liable to get infected and liquified.
9.B. When the sequestrum is large, pus may discharge through
small perforations in the involucrum .These perforations are
called cloacae.
l 0.8. Garre's osteomyelitis may be due to mild toxic stimulation of
the periosteal osteoclasts by attenuated microorganisms.
ll.C. Actinomycosis is a very slow developing infection rarely seen
in man,caused by Actinomyces (A. bovisand A. israelii).
12.C. When the jaws are exposed to overdosage of radiotherapy,
the normal tissues of the mouth and the jaws are adversely
affected although the carcinoma rna y be treated .The normal
bone cells lose their repair and regeneration potential.
 Penoste1t1s , Osteomyelitis and Necrosis of the Jaw 39

13.C. A confirmatory radiographic diagnostic test is bone scan

taken after infecting intravenous radionuclides that are
known to concentrate in the pathological areas in the
skeleton. Such spots are labeled as '' Hot Spots" and
indicate areas of increased vascularity and osteoblastic
activity.
 Acute and Chronic
Odontogenic Infections
of the Oral Cavity

1. The most common site of pericoronitis is:

A. Maxillary 3rd molar region
B. Mandibular 3rd molar region
C Mandibular 1st molar region
D. Mandibular 1st premolar region
2. Facial spaces are filled with :
A. Bundles of collagen fibers
B. Loose areolar connective tissue
C Ligaments
D. All of the above
3. Hyaluronidase is an enzyme that helps in:
A. Synthesis of the collagen fibers
B. Synthesis of the intercellular cementing substances
C Breakd own of the intercellular cementing substances
D. Digestion of carbohydrates
4. Acute cellulitis is characterized by all of the following, except
A Increased erythrocytic sedimentation rate
B. Decreased erythrocytic sedimentation rate
C Increased WBC count
D. Both A a nd C
5. Wh ich of the following is not a content of the carotid sheath?
A. Comm on carotid artery
B. Va gus nerve
C Internal j ugu lar vein
D. External ju guJar vein
 Acute and Chron1c Odontogemc lnfect1ons of the Oral Cavity 41

6. The apices of mandibular third molar usually:

A. Lie above the mylohyoid muscle
B. Lie below the mylohyoid muscle
C Lie below the leva tor anguli oris muscle
D. Lie below the caninus muscles
7. The floor of which of the following spaces is formed by
mylohyoid muscle?
A. Sublingual space
B. Submental space
C Submandibular space
D. All of the above
8. The contents of the sublingual space is/are:
A. Sublingual gland B. Hypoglossal nerve
C Lingual nerve D. All of the above
9. The lymph from which of the following orreas does not drain
into the submental lymph nodes?
A. Tip of the tongue
B. Median part of the lower lip
C Mandibular premolars
D. Mandibular central incisor
10. Which of the followings is not a content of submandibular
space?
A. Deep portion of the submandibular gland
B. Facial artery
C Nerve to mylohyoid muscle
D. Mylohoid vessels
11. Which of the following are/is cause/s of submandibular space
infection?
A. Needle infection
B. Pericoronalinfection
C Dentoalveolar abscess
D. All of the above
12. The characteristic feature of the Ludwig's angina is/are:
A. Bilateral involvement of the submandibular, sublingual and
submental spaces
B. Typical open mouth appearance
C Swelling of the floor of the mouth
D. All of the above
42 MCQs mOral and Maxlilofac1al Surgery

13. Buccal space is present between :

A. Skin and buccinator muscle
B. Buccinator and mylohyoid musde
C Buccinator and masseter muscle
D. Masseter and mylohyoid muscle
14. Which of the following is/are contents of the infratemporal
space?
A. External pterygoid muscle
B. Internal maxillary artery
C Pterygoid plexus
D. All of the above
15. Pterygopalatine fossa communicates with the nasal cavity
through:
A. Foramen ovale
B. Mental foramen
C Sphenopalatine foramen
D. Greater foramen
16. Which of the following is/are causes of infratemporal space
infection?
A. Needle infection
B. Dentoalveolar abscess inl'elation to mcixillary third molar
C Ascending inf ection from pericoronitis around the
mandibular third molar ·
D. All of the above
17. Cavernous sinus thrombosi is characterized by which of the
following?
A. Proptosis B. Edema in the eyelids
C Lacrimation D. All of theabove
18. The drug of choice for the treatment of cavernous sinus
thrombosis is:
A. Pencillines
B. Streptomycin
C Chloramphenicol
D. Ciprofloxacin
19. Characteristic features of the meningitis is/are:
A. Vomiting · B. Stiffness of the neck
C Headache D. All of the above
 Acute and Chron1c Odontogenic Infections of the Oral Cavity 43

20. Which of the following is true about cyst?

A lt is also known as gumboil
B. It is a pathological cavity containing fluid or semjfluid
C A true cyst is not lined by epithelium
D. A false cyst is Lined by epithelium
21. Which of the following materials is most commonly used as a
retrofilling material?
A Glass ionomer cement
B. Composites
C Amalgam
D. Resins
22. Which of the following is/are microscopic feature/s of the
granuloma?
A Consists of organizing connective tissue
B. Numerou s bloOd capillaries
C Evident inflammatory exudates
D. All of the above
23. Stylomandibular ligament separates:
A Parotid space from sublingual space
B. Parotid space from submandibular space
C Sublingual space from submental space
D. Parotid space from submental space
24. Cellulitis is also known as:
A Periodontitis B. Phlegmon
C Gustatory sweating D. Glaucoma
25. Which of the following spaces is not involved in classic
Ludwig's angina?
A Submental space
B. Sublingual space
C Submandibul ar space
D. Space of the bod y of the mandible
26. Which of the followings is not a component of masticator
space?
A Deep temporal pouch
B. Submasseteric space
C Submandibular space
D. Pterygomandibular space
44 MCQs rn Oral and Maxillofacial Surgery

Answers
1.8. In case of impacted third molar that has not reached to the
occlusal level there is supraeruption of the maxillary third
molar which often traumatizes the flap over the lower molar
ca using inflammation.
2.B. Normally facial spaces are occupied by the loose areolar tissue,
adipose tissue and neurovascular structures.
3.C This allows infection to spread rapidly. The tissues become
swollen, red and very tender to touch.
4.8. Patient shows severe systemic reaction in the form of high
grade fever, rapid, irregular and feeble pulse, increased
respiration rate, raised white cell count and erythrocytic
sedimentation rate.
S.D. The carotid sheath is a condensation of the cervical fascia
around the common and internal carotid arteries, the internal
jugular vein,the vagus nerve and the constituents of the ansa
cervicalis.
6.8. Mylohyoid muscle is the separating barrier between the
sublingual and submental spaces.
7.0. Infections of sublingual space spread to the submental space
by a lymphatic spread or by a direct perforation of the
mylohyoid muscle.
S.D. Sublingual space contains the sublingual gland, the
su bmandibuJar duct, the deep portion of the submandibular
gland, the lingual and hypoglossal nerves,and the terminal
branches of the lingual artery.
9.C The submental space is most commonly involved because of
infection of lymph nodes via lymphatic.spread from the lower
incisors, lower lip and chin, tip of tongue and floor of the
mouth.
lO.A. The submandibular space contains as its major structure. The
superficial part of the submandibular gland,the deep portion
of the gland continuing around the posterior border of the
mylohyoid into the sublingual space.
 Acute ancl Chron1c Odontogenic lnf ect1ons of the Oral Cav1ty 45

11.0. The commonest source of infection comes from the mandibular

molars. The other sources are related to lymph nodes and
submandibular gland .
12.0. Intraorally the floor of the mouth is raised, because of the
distension by the inflammatory exudates, which forces the
tongue against the palate and into the orophanynx.The floor
of the mouth is raised to the level above the occlusal table of
the mandible.
13.C. The buccal space is bounded anteromedially by the buccinator
muscle, posteromedially by the masseter muscle and the
anterior border of the ramus of mandibular and covered
laterally by the platysma together with an extension of the
deep fascia forwards the parotid capsule.
14.0. The important contents of the space are pterygoid plexus of
veins with its emissary veins connecting to cavernous sinus,
the maxillary artery and its branches, the mandibular nerve
and its branches and the chorda tympani nerve, a branch of
the seventh cranial nerve.
15.C. The pterygopalatine fossa communicates with the
infratemporal fossa through the pterygomaxillary fissure.
16.0. Most of the times infratemporal space infection is the sequelae
of the pterygomandibular space infection extending upwards
and causing the masticator space infection.
17.0. Ptosis of the upper lid occurs due to the involvement of the
occulomotor nerve.Severe headache, pain behind the eye is
due to pressure onto the ophthalmic nerve.
18.C. Inj. ceftrioxone upto 6-8 gm a day with inj chloramphenicol
upto 2-4 gm in a day with inj. metronidazole 2 gm in a day
with inj.arnikacin 1-1.5 gm in a day is suggested regimen for
the disease.
19.0. Movement of the maxilla in the presence of cerebrospinal
rhinorrhea is dangerous.Infectious organisms can be pushed
up into dura, and a meningitis may result .
20.B. A cyst is a sac like pathological structure occurring either in
hard or soft tissue of the body, containing liquid or semi solid
which is surrounded by a wall of connective tissue and is
usually lined by epithelium.
46 MCQs mOral and Max1llofac1al Surgery

21.C. Amalgam is most commonly used as retrofilling material.

22.0. A dental granuloma denotes the presence of lesion in the
periapical region in which an abscess or localized area of
osteolysis is replaced by granulation tissue on account of
body's attempt to repair.
23.B. Inferiorly the parotid fascia is reinforced, presenting a strong
band called the stylomandibular ligament, which very
effectively separates the parotid from the submandibular
space.
24.B. A massive cellulitis that does not go to suppuration proceeds
towards fast inflammatory infilteration of the subcutaneous
tissue. Such a fast spreading cellulites is known as
'phlegmon' .
25.0. Ludwig's angina is a strange condition characterized by the
massive cellulitis occurring bilaterally, simultaneously
involving the submandibular and sublingual spaces
extending to the submental space as well.
26.C. The masticator space includes the subperiosteal region of the
mandible and a facial sling containing the ramus of the
mandible and the muscles of mastication.
 Maxillary Sinus and
Disease of Maxillary
Sinus

1. Which of the foJlowings is/are also called as antrum of

Highmore?
A. Frontal sinus B. Maxillary sinus
C Ethmoidal sinus D. All of the above
2. The opening of the maxillary sinus is present in:
A. Superior meatus
B. Inferior meatus
C Middle meatu s
D. None of the above
3. The shape of maxillary antrum in adults is:
A. Triangular B. Pyramidal
C Square D. Rectangular
4. The capacity of the average adult antrum is:
A. 5-10 ml B. 10-15 ml
C 20-25 ml D. 25-30 ml
5. The posterolateral wall separates the maxillary antrum from:
A. Nasal cavity
B. Oral cavity
c Orbit
D. Infratemporal fossa
6. The level of the floor of the maxillary sinus in adolescence
and old age is:
A. Below the level of the nasal floor
B. Above the level of the nasal floor
C At the level of the nasal floor
D. None of the above
 48 MCQs m Oral and Maxillofacial Surgery

7. Schneiderian membrane is:

A. Also called as periodontal membrane
B. The epithelial lining of the frontal sinus
C The epithelial lining of the maxillary sinus
D. Both A and C
8. The function/s of paranasal sinuses is/are:
A. Helps in reducing the weight of the skull
B. Helps to give resonance to the voice
C Conditions the inspired air
D. All of the above
9. Which of the following radiographs is important for diagnosis
of maxillary sinusitis?
A. Panoramic radiograph
B. Cephalometric radiograph
C Water's view
D. Bitewing radiographs
10. Antrolith means:
A. Stone in the salivary gland
B. Stone in the tooth
C Stone in the maxillary antrum
D. All of the above
11. Intranasal antrostomy is done through:
A. Superior meatus B. Middle meatus
C Inferior meatus D. Superior conchae
12. Which of the following flaps is/are used for closure of an
oroantral fistula?
A. Palatal pedicle flap
B. Buccal sliding flap
C Both of the above
D. None of the above
13. Which of the following operations is done for the removal of
the epithelial lining of the maxillary sinus, cysts and polyps
from the maxillary sinus?
A. Caldwell-Luc operation
B. Waldron 's operation
C Partsch's operation
D. Marsupialization
 Maxrlla ry Srnus a nd Drsease of Maxr llary Srnus 49

14. Which of the followings is/are indications for the Caldwell-

Luc operation?
A For lifting the floor of the orbit in case of the btow out fracture
B. For removal of cysts from the antrum
C For removal of the antroliths from the sinus
D. All of the above
15. Which of the following is/are symptoms of acute maxillary
sinusitis?
A Severe, constant and localized pain
B. Teeth in relation to maxillary antrum are extremely sore and
painful
C Difficulty in breathing
D. All of the above
16. Which of the following is/are etiological factors of chronic
maxillary sinusitis?
A Repeated attacks of acute antritis
B. Altered metabolism
C Overindulgences and lack of sleep
D. All of the above
17. Which of the following is/are used for the closure of the oro-
antral fistula?
A Buccal pad of fat
B. 24 carat gold disks
C Berger flap
D. All of the above
18. Which of the following is the largest sinus?
A Frontal sinus
B. Ethmoid sinus
C Maxillary sinus
D. ·Sphenoid sinus
19. The development of the maxillary sinus starts during:
A 1st fetal month
B. 2nd fetal month
C 3rd fetal month
D. 4th fetal month
50 MCQs 111 Oral and Max1llofac1al Surgery

20. The integrity of the floor of the antrum is at greatest risk with
surgery involving removal of :
A. A maxiU ary third molar
B. Torus palatinus
C A nasopala tine cyst
0. A single remaining maxillary molar
21. Radiographic features of sinusitis include:
A. Fluid levels
B. Erosion of bone
C Clouding of the antrum
0. Cloud ing and fluid levels
 Max1llary Sinus and Disease of Max1llary Smus 51

Answers
1.8. Maxillary sinus is also known asantrum of Highmore because
this antrum, meaning a cavity or hollow space especia ll y
found in bone, wa s first described by Nathaniel Highmore,
an English anatomi st of the seventeeth century.
2.C. Maxillary sinus or antrum of Highmore is small recess in the
lateral wa ll of middle meatu s of the nose.
3.8. The maxillary sin us is py ramidal in shape with its base at the
nasoantral wa ll and its apex in the root of the zygoma .
4.8. The capacity of the average adult antrum is from 10 to 15 ml.
and its complete absence is rare.
S.D. The anterolateral wall of the antrum is formed by the canine
fossa.
6.A. It is at lower level than the nasal floor in an adult and at a
higher level in infants and children.
7.C. The antrum is lined by ciliated epithelium also called as
'Schneiderian membrane.'
8.0. There are in total four groups of paranasa l sinuses namely
maxillary , fronta l , ethmoidal and sphenoidal. Paranasal
sinuses condition tl1e inhaled ai r. In very cold climate they
warm the inhaled air.Invery hot climate they cool the inhaled
air to body temperatu re.
9.C. Posteroanterior v iew of maxilla in Water's position is fue usual
radiograph ta ken for d iagnosis.
lO.C. Antroliths appear opaque in fue radiograph.
ll.C. Explora tion and l avage of the antrum throu gh the inferior
meatus with the hel p of a troca r and cannula is carried out.
12.C. Cl osure of the large chr onic oro-ant ra l fistula is best
accomplished by palata l pedicle flap operation beca use of
thickness of the fla p, its high vascul arity and suffici ent
amount of the ava ilability of the tissue.
 52 MCQs rn Or<JI and M<Jxrllofacral Surgery

13.A. The direct visual examination of the maxillary antrum is best

made by cutting a window in the anterolateral wall of the
maxillary antrum and this approach is called Caldwell-Luc
approach.
14.0. Removal of tooth or root from the antrum that has been
accidently pushed up during course of extraction and the
removal through the socket could not be achieved , is also an
indication for Caldwelll-Luc operation.
15.0. Pain increases on bending forward and by putting pressure
on zygomatic bone.
16.D. Chronic sinusitis is produced by repeated attacks of acute
sinusitis or prolonged acute attack, a persistent dental focus,
chronic rhinitis, chronic infection in frontal or ethmoidal
sinuses,overexertion, dietary deficiencies,insomnias, allergic
conditions, etc.
17.0. Preserved cartilage, 24 carat gold disks or tentalum gauze
have been used to fill the defect prior to closure. Buccal pad of
fat and split thickness buccal and palatal mucosal flaps are
also used for closure of the oro-antral fistula.
18.C. The maxillary sinus is generally larger than any of the other
sinuses and lies chiefly in the body of maxilla.
19.C. The development of the maxillary sinus starts. during 3rd fetal
month.
20.0. The integrity of the floor of the antrum is at greatest risk with
surgery involving removal of a single remaining maxillary
molar.
21. D. A diseased sinus with thickened lining looks hazy or cloudy.
 Diseases of
Salivary Glands

1. Which of the following is the largest salivary gland:

A. Submandibular gland
B. Parotid gland
C Sublingual gland
D. Labial mucus gland
2. The salivary glands develop from:
A. Endoderm B. Ectoderm
C. Mesoderm D. All of the above
3. Sublingual gland develops during:
A. 2nd week of intrauterme lif e
B. 4th week of intrauterine life
C. 6th week of intrauterine life
D. 8th week of intrauterine life
4. Which of the following is/are the pu re serous gland?
A. Submandibular gland
B. Parotid gland
C. Sublingual gland
D. All of the above
5. The parotid gland is covered by which of the following?
A. True capsule
B. False capsule
C. Both of the above
D. None of theabove
6. The duct of the parotid gland is also kn own as:
A. Stensen's d uct
B. Wharton 's duct
C. Barthol in's duct
D. Sjogren's duct
54 MCQs 111 Oral ancl Maxrllofac,al Surqcry

7. The Stensen's duct opens opposite to the:

A Maxillary 2nd premolar
B. Maxillary 1st molar
C Maxillary 2nd molar
D. Mandibular 2nd molar
8. The submandibular gland is a:
A Pure mucus gland
B. Pure serous gland
C Predominantly mucus gland
D. Predominantly serous·gland
9. The duct of which of the following gland opens on the
sublingual papilla at the side of the lingual frenum:
A Parotid gland
B. Sublingual gland
C Submandibular gland
D. Lacrimal gland
10. Wharton's duct is the duct of which of the following gland?
A Sublingual gland
B. Submandibular gland
C Parotid gland
D. Lacrimal gland
11. The duct of the sublingual gland is also called as:
A Stensen's duct B. Wharton's duct
C Bartholin's duct D. Lacrimal duct
12. Which of the following is not a non-invasive investigation?
A. Computerized tomography
B. Ultrasound scanning
C Magnetic resonance imaging
D. Biopsy
13. The inflammation of the salivary glands is called as:
A Peritonitis B. Sialadenitis
C Sialolithiasis D. Agenesis
14. Acute bacterial sialadenitis is caused by:
A. Streptococcus salivarius
B. Diplococcus pneumoniae
C Streptococcus viridans
D. All of the above
 01seases of Salivary Glands 55

15. Sialogogues are used to:

A Decrease the salivary flow
B. Increase the gastric secretion
C Increase the salivary flow
D. Decrease the gastric secretion
16. The most common form of the acute viral parotitis is:
A Measles
B. German measles
C Mumps
D. Orchitis
17. The incubation period of mumps is:
A 5-8 days B. 8-12 days
C 12-21 days D. 35-45 days
18. The congenital absence of the major salivary glands is
called as:
A Gemination B. Agenesis
C Hypoplasia D. Metaplasia
19. The presence of stone in the salivary gland is called as:
A Sialadenitis B. Sialolithiasis
C Antrolithiasis D. Odontolithiasis
·20. The sialolithiasis are most commonly found in:
A Sublingual gland
B. Parotid gland
C Submandibular gland
D. Lacrimal gland
21. Xerostomia refers to:
A Normal salivary flow
B. Increased salivary flow
C Salivary flow is less than normal
D. Increased gastric secretion
22. Which of the following is/are characteristic/s of the Sjogren's
syndrome:
A Dry eyes
B. Drymouth
C Rheumatoid arthritis
D. All of the above
 56 MCQs rn Oral and Maxrllofacral Surgery

23. Mikulicz's disease is characteriz_ed by:

A. Symmetrical arge;ment oi the salivary glands
8. Enlargement of the lacrimal gland
C. Both of the above·
D. None of the above
24. According to WHO which of the following is/are epithelial
tumor:/s of the salivary glands?
A Pleomorphic adenoma
B. Adenolymphoma
C. Oxyphilic adenoma
D. All oftheabove
25. Pleomorphic adenoma is most cQmmonly found in:
A Parotid gland
B. Sublingual gland
C Submandibular gland
D. Lacrimal gland
26. Warthln's tumor is also called as:
A. Ad nocystk carcinoma
B. Papillary cystadenoma lymphomatosum
C. Adenolymphoma
D. Oxyphilic adenoma
27. Which of the following salvary gland tumors spread (s) along
the perineural lymphatics? -
A. Adenoeystic cardnom
B. Warthin's tum0r
C. Cylindroma
0. Both A and C
28. Frey's syndrome is characteri ed by:
A. Gusta'tory sweating
B. Flushmg of the skin of temporal region
C. Sweating of the skin of the upper cheek
D. Allef the above
29. Signs and symptoms - of malignancy is/are:
A. Persistent pain
B. Pacial nerve paralysis
C. Fixation to underlying tissues
D. Allo'ftheabove
 Diseases of Salivary Glands 57

30. Which of the following is/are autoimmune diseases:

A. Sjf>gren's syndrom e
B. Mikulicz's disease
C. Rheumatoid arthritis
0. AJJ of the above
31. Stafne's cyst is found:
A. Between the mandibular canal and the superior bord er of
the mandible
B. Between the mandibular canal and the inferior bord er of the
mandible
C. In the maxilla
D. In the soft palate
32. Which of the following is a connective tissue tumor?
A. Pleomorphic adenoma
B. Oxyphilic adenoma
C. Adenolymphoma
0. Fibroma
33. Which of the following is the cause of tender swelling in the
submandibular triangle:
A. Fibroma
B. Lipoma
C. Obstruction ofStensen's duct
0. Lymphadenopath y
 58 MCQs 111 Oral and Maxdlofac 1al Surgery

Answers
1.B. Parotid gland is the Largest of the three-paired salivary glands.
[t is a bilobular serous gland overlying the masseter muscle.
2.B. Salivary glands developed from proliferating buds of ectoderm
that differentiate to form a glandular structures.
3.D. Parotids develop during the 4th week of intrauterine life while
submandibular glands during the 6th week, sublingual glands
during the 8th week and minor glands after the development
of these glands.
4.B. ·The salivary secretions are serous in nature and discharged
into the oral cavity via the Stenson's duct.
S.C. The parotid gland is covered by inner true capsule and outer
false capsule.
6.A. Stenson's duct emerges out from the anterior aspect of gland,
crosses the masseter, pierces the buccinator muscle and opens
opposite to the maxillary second molar.
7.C. The accessory part of the gland is drained by a small duct that
opens into the upper border of the parotid duct.
8.0. Submandibular gland is composed of mixture of serous and
mucous acini, former predominating.
9.C. The duct emerges from the anterior end of the deep part of the
gland .
1O.B. Wharton 's duct passes from the gland at the posterior boder
of the mylohyoid muscle, turns upwards entering into the
sublingual space and runs in an anterior direction to open on
the sublingual papilla.
ll.C. Bartholin duct, the duct of sublingual gland occasionally
communicates with the submandibular duct.
12.0. Biopsy is u sed in diagnosis of any neoplasm by the
histopathological examination.
13.8. Sialadenitis may be acute or chronic.
14.0. Occasionally yeast forms are also found.
 DISC<tses of S<tlivary Glands 59

15.C. Use of sialogogues to increase the salivary flow and produce

a washing action is beneficial.
16.C. Mumps usually occurs inchildren primarily involving parotid
gland while submandibular gland may be involved later in a
few cases.
17.C. Fever, malaise and swelling develop.Childremains irritable
due to the pain experienced .
18.B. This is an uncommon condition .Ifany gland is absent,it ma y
lead to the development Qf xerostomia and consequently high
caries rate as the flushing action of saliva is compromi sed.
19.B. Sialolithiasis is generally due to an accretion of mineral salts
in and around a soft plug of mucus, bacteria or desquamated
epithelial cells.
20.C. Sialolithiasis are four times more common insubmandibular
gland than in the parotid.
21.C. Xerostomia leads to high caries rate as the flushing action of
saliva .is compromised.
22.0. It has n found that some patients present only with dry
eyes and dry mouth, known as sicca complex or primary
Sjogren'ssyndrome.
23.C. A nodular enlargement of a gland occurs resembling
neoplastic disease where a more uniform, symmetrical
enlargement of the salivary and lacrimal glands is found .
24.0. Monomorphi c adenoma also comes under epithelial tumors
of salivary gland s.
25.A . The parotid gland is the most commonly involved followed
by submandibul ar gland and lastly the sublingual gland.
26.B. Warthin's tumor is a benign tumor, which is smooth,sof t and
rounded and ma y well be fluctuant. Itaffects men more often
than women.
27.0. Adenocystic carcinoma or Cylindroma grow comparatively
slower and can penetrate suprising distances away from the
main mass, particularly along the perineural lymphatics.
28.0.The only effective cure is to divide the parasympath etic fibers
from the glossopharyngeal nerve.
60 MCQs in Oral and Maxillofacial Surgery

29.0. Twnorsof salivary glands form 1-2percent of the total twnors

occurring in all parts of the body.
30.0. Rheumatoid arthritis is reported in about 15 percent cases of
Sj ogren's syndrome.
31 .B. In Stafn e's cyst, X-ray picture appears as an ovoid
radiolucency generally situated between the mandibular canal
and the inferior border of the mandible, commonly in the
second or third molar region or just anterior to the angle.
32.0. Other connective tissue tumors are fibrosarcoma, lipoma,
hemangioma , melanoma, lymphoma, etc.
33.0.
 Oral Cavity Tumors and
their Surgical Aspects

1. Which of the following is not a bening ectodermal tumor?

A Ameloblastoma
B. Adenoid odontogenic tumor
C Calcifying epithelial odontogenic tum or
D. Cementoma
2. Which of the following is/are bening mesodermal tumor/s?
A Cementoma
B. Odontogenic fibroma
C Odontogenic myxoma
D. All of the above
3. Which of the following tumor/s arises from both ectodermal
and mesodermal elements?
A Odontogenic fibroma
B. Ameloblastoma
C Ameloblastic fibroma
D. Odontogenic myxoma
4. Which of the following is/are giant cell tumor/s?
A Osteoclastoma
B. Reparative granuloma
C Eosinophilic granuloma
D. All of the above
5. The benign tumor of the glandular epithelium is called as:
A Lipoma B. Fibroma
C Adenoma D. Myxoma
6. The benign tumor of the smooth muscles is called as:
A Rhabdomyoma B. Rhabdomyosarcoma
C Leiomyosarcoma D. Leiomyoma
62 MCQs 111 Oral ilfld MilXIIIofZ!CILJI Surgery

7. The benign tumor of the skeletal muscle is called as:

A. Rhabdomyoma B. Rhabdomyosarcoma
C Leiomyosarcoma D. Leiomyoma
8. The malignant tumor of the blood vessels is called as:
A Hemangioma B. AngiOsarcoma
C Leiomyoma D. Lymphar\gioma
9. The malignant tumor which arises from nerve sheath ·is called
a:
A. Neurilemmoma B. Neurofibroma
C Neurqgenicsarcoma D. Allofthe<J.bove
10. Which of the following tumors arises form the surface
epithelium?
A Squamous cell carcinoma
B. Malignant melanoma
C Basal cell carcinoma
D. Adenocarcinoma
11. Which of the following tumors has neuroectode.nnal origin?
A. Adenocarcinoma B. Malignant melanoma
C Basal cell carcinoma D. Squamous cell carcinoma
12. Which of the following is/are pre-malignant lesionls:
A. Leukoplakia
B. Erythroplakia
C Oral submucous fibrosis
D. Alloftheabove
13. Ameloblastoma is also called as:
A. Odontoma B. Adam<J.Otinoma
C Cementoma D. Myxoma
14. Ameloblastoma most commonly occurs in:
A. Mandibular anterio_r region
B. Mandibular molar region
C Maxillary anterior region
D. Maxillary molar region
15. Ameloblastoma most commonly occurs between:
A. 10-20 years of age B. 20-40 years of age
C 40-60 years of age D. 60-SO years of age
 Or<J, C<Jvrty Tumors and t11err Surgrcal Aspects 63

16. Which of the following is/are histological type/s of

ameloblastoma?
A. Follicular type B. Plexiform type
C Acanthomatus type D. All of the above
17. 'Camoy solution contains which of the following:
A. Absolute alcohol-6 ml
B. Chloroform.-3 ml
C Glacial acetic acid-1 ml
D. All of the above
18. Adenomatoid odontogenic tumor is also called as:
A. Ameloblastoma
B. Adamantinoma
C Adenoameloblastoma
D. All of the above
19. Calcifying epithelial odontogenic tumor is also called as:
A. Adenomatoid odontogenic tumor
B. Pindborg tumor
C Wa.rthin's tumor
D. Ameloblastoma
20. Which of the following is/are characteristic feature/s of the
pindborg tumor?
A. More common in mandible than maxilla
B. Most common in molar and ramus region
C Usually occurs between 3040 years of age
D. All of the above
21. Which of the following is/are histological feature/s of the
pindborg's tumor?
A. Honeycomb multilocular appearance
B. Driven snow appearance
C Leisegang ring
D. All of the above
22. Compound composite odontome most commonly occurs in:
A. Anterior maxilla B. Posterior maxilla
C Anterior mandible D. Posterior mandible
23. Complex composite odontome most commonly occurs in:
A. Anterior maxilla B. Posterior maxilla
C Anterior maxilla D. Posterior mandible
 64 MCQs mOral and Maxillofac•al Surgery

24. Multiple osteomas of the jaws, long bones and skull occws in:
A. Gardner's syndrome B. Down's syndrome
C Sjogren's syndrome D. Marfan's syndrome
25. Ghost cells are present in:
A Papilloma
B. Myxoma
C Compound odontome
D. Fibroma
26. 'Sun-ray' appearance in radiograph is characteri tic feature
of which of the following:
A. Ewing's sarcoma B. Osteogenic sarcoma
C Multiple myeloma D.Pleomorphicadenoma
27. Presence of bence jones bodies in the urine is a diagnostic
sign of:
A Pleomorphic adenoma
B. Ewing's sarcoma
C Multiple myeloma
D. Osteogenic sarcoma
28. Cafe au lait spots are present in:
A Monostotic fibrous dysplasia
B. Polyostotic fibrous dysplasia
C Both of the above
D. Ewing's sarcoma
29. The painless symmetrical .swelling of the jaws producing a
typical chubby face appearance is called as:
A. Paget's disease B. Cherubism
C Marble bone disease D. Osteoclastoma
30. Peripheral giant cell tumor is also known as:
A. Reparative granuloma
B. Osteoclastoma
C Brown tumor of hyperpar athyroidism
D. Teratoma
31. A tumor which is made up of different types of tissues which
are not native to the area in which tumor occurs is called as:
A Hamartoma B. Teratoma
C Chembism D. Gumma
 Oral Cavity Tumors and the ir Surgical Aspect s 65

32. The malignant tumor of mesodermal origin is called as:

A. Carcinoma B. Sarcomr
C Both A and B D. None of the above
33. Which of the following is/are complication/s of th e
radiotherapy:
A. Xerostomia
B. Mucositis
C Necrosis of soft and hard tissues
D. All of the above
34. Which of the followings is/are characteristic feature/s of the
hyperparathyroidism?
A. Increased density of bone
B. Absence of lam ina dura
C Increased resorption and exfoliation of teeth
D. All of the above
35. Cherubism usually manifests in which age group:
A. 15-20 years of age B. Below 7 years of age
C 20- 30 years of age D. 30-40 years of age
36. Which of the following is most common type of
amelof:?lastoma?
A. Extraoral ameloblastoma
B. Extraosseous amelobla stoma
C Intraosseous am eloblastoma
D. None of the above
37. Needle aspiration of a central bone lesion is used to:
A. Determine the thi ckness of the bu ccal plate
B. Make a diagnosis of traumatic bone cyst
C Rule out a diagnosis of vascular lesion
D. Feel for root surface
38. Which of the following bone lesions is most likely to be fatal :
A. Multiple myeloma B. Giant cell tum or
C Paget's disease D. Odontogenic myxoma
39. Endocrine disturbance is the primary cause of jaw deformity
in patient with :
A. Acromega ly B. Achondroplasia
C Pa get's disease D. Albright's syndrom e
66 MCQs 111 Orai anrl Maxtflofactal Surgery

40. The tumors which are poorly differentiated are:

A. Radioresistant B. Radiorefractiv e
C Radioatrophic D. Radiosensitiv e
41. Fordyces disease is due to:
A. Cholesterol deposits
B. Aberrant baceous glands
C Capillary fragility
D. Hyperkeratosis
42. Basal cell carcinoma (BCC) most commonly occurs in which of
the following sites:
A. Lateral border of tongue
B. Upper third of the face
C Middle third of the face
D. Lower third of the face
43. Which of the following is a feature of acromegaly:
A. Micrognathia B. Hypoglycemia
C Crowded teeth D. Large tongue
44. Fibrous dysplasia can be treated by:
A. Irradiation of the lesion
B. Surgical excision
C Conservative surgery
D. Removal of the adjacent teeth
 Oral Cav1ty Tumors and the 1r Sur9 1ca: Aspects 67

Answers
1.0. Cementoma is a benign mesodermal tumor.
2.0. Cementoma, odontogenic fibroma and odontogenic myxoma
are benign mesodermal tumors.
3.C. Ameloblastic fibro-odontoma and odontoameloblastoma also
arises from both ectodermal and mesodermal elements (Mixed
tumors}.
4.A. Focal lesions of hyperparathyroidism are also giant cell
tumors.
S.C. Adenocarcinoma is malignant tumor of glandular epithelium .
6.0. Leiomyosarcoma is malignant tumor of smooth muscles.
7.A. Rhabdomyosarcoma is malignant tumor of skeletal muscles.
8.8. Hemangioma is benign tumor of blood vessels.
9.C. Neurilemmoma and neurofibroma are benign tumors, which
arises from nerve sheath.
10.A. Squamous cell carcinoma occurs on the vermilion borders
and mucosa of the mouth.
11.8. Pigmented cellular nevus is benign tumor of neuroectodermal
origin.
12.0. Carcinoma in situ and invasive type of lichens planus, are
also pre-malignant lesion.
13.8. Ameloblastoma is true neoplasm of enamel organ known
earlier as "Adamantinoma."
14.8. Ameloblastoma is more common in mandible in molar and
ramus region.
15.8. Ameloblastoma is slow growing tumor seen at age of 20 to 40
years.
16.0. Follicular type contains cerboidal I columnar cells with
polarized nuclei as pre-ameloblastic cellS.Plexiform type is
meshwork like and Acanthomatous type undergoes squamous
metaplasia in stellate reticulum with keratin pearls.
68 MCQs in Oral and Maxillofacial Surgery

17.0. Use of "camoy solution "is recommended for fixing the tissue
in the tumor bed.
18.C. Adenoameloblas toma is characterized by formation of duct
like structures by the epithelial component .
19.ll. ln Pindborg tumor,mandible is more commonly involved .than
maxilla and the average ratio is 2:1
20.0. Unlike ameloblastoma it does not invade inter-trabecular
spaces.
2l.C. Characteristic histological feature is homogenic eosinophilic
substance, which is interpreted as amyloid. Calcifications in
large amounts 'form "Lesisegang Ring."
22.A. Odontomes are more commonly reported in males and also
more in maxilla than mandible.
23.B. The common complaint presented by the patient is delayed
eruption of permanent teeth.
24.A. Gardner's syndrome consists of (1) multiple polyposis of the
large intestine. (2) osteomas of the bones including long bones,
skull and jaws, (3) multiple epidermoid or sebaceous cysts of
the skin, (4) occasional occurrence of desmoid tumors, and (5)
impacted supernumerary and permanent teeth .
25.C. Ghost cells are pale, eosinophilic, swollen epithelial cells that
have lost the nucleus but show a faint outline of the cellular
and nuclear membrane.
26.B. Sunray appearance results from the radiating speculesofbone
extending outwardly from cortex.
27.C. Multiple myelom a is a malignant tumor usually showing
multiple or diffuse bone involvement and characterized by
round cells related to plasma cells.
28.8. Fibrous dysplasia of bone is a benign, self -limiting but not
encapsulated lesion. Inpolyosteotic type there is involvement
of many bones.
29.B. Usually the lesion appears at 2 to 4 years and grows rapidly
unti17 years. It tends to regress after puberty.
30.8. Osteoclastoma is seen more commonly in m;mdible around
30 yea rs of age.
 Oral Cavity Tumors and their Surg1cal Aspects 69

31.8. Teratoma is also known as teratoblastoma or teratoid tumor .

32.8. Typical examples of sarcoma are chondrosarcoma and
osteosarcoma.
33.0. The severity of damage is directly related to the type of
radiation used, tota I dosage, fractionization ,extent of disease
and its location, the patient 's age and nutritional status.
34.0. Fibrous tissue with evidence of haemorrhage is a seen
alongwith giant cells, which are characteristically small and
bunched together.
35.8. The children are normal at birth; usually the lesion appears at
2 to 4 years and growsrapidly until7 years. It tends to regress
after puberty.
36.C. It is slow growing tumor seen at age of 20 to 40 years.
37.C. Its drawbacks are that there is possible risk of seeding tumor
cells along the needle track.
38.A. The tumor is usually fatal in approximately 3 to 4 years time;
however,cytotoxic drugs may delay the same.
39.A. An increase in the number of granules in the acidophilic cells
or an adenoma of the anterior to be of the pituatony is
associated with gigantism or acromegaly.
40.0. The more differentiated the tumor the less is radiation
response.
41.8. Fordyce's granules appear as small yellow spots, either
discretely separated or forming relatively large plaques, often
projecting slightly above the surface of the tissues.
42.C. Basal cell carcinoma does not arise from oral mucosa and
thus is never seen in the oral cavity W"lless it arrives there by
invasion and infitration from a skin surface.
43.0. In cases of acromegaly due to hyperpituitari sm in the adult,
an enlarged tongue is a common finding and probably occurs
as a result of the muscles concomitant wi th the growth of the
mandible.
44.C. Fibrous dysplasia of bone is a benign, self-limiting but nol
encapsulated lesion.
 Cleft Lip and
Cleft Palate

1. The oral cleft problem occurs between:

A 2nd-4th weeks of fetal life
B. 6th-10th weeks of fetal life
C 1Oth-14th weeks of fetal life
D. 14th-18th weeks of fetal life
2. The cleft lip deformity most commonly occurs during which
period of embryo-fetal life?
A 2nd-4th week B. 4th-t;th week
C 6th-8th week D. 8th-10th week
3. The deft palate deformity usually occurs between :
A 2nd-4th week of fetal life
B. 4th-8th week of fetal life
C 8th-10th week of fetal lif e
D. 10th-14th week offetallife
4. The occurrence of cleft lip and cleft palate is:
A. 1in every 800 live births
B. 1 in every 1200 live births
C 1in every 1400 live births
D. 1in everv 1600 live births
'
5. Cleft lip most frequently occurs on:
A. Left side B. Right side
C Both of the above D. None of the above
6. Which of the following is/are etiological factor/s of the oral
clefts?
A Chromosomal abnormalities
B. .Increased maternal age
C Radiation and hyp()xia
D. A ll of the above
 Cleft L1p and Cleft Palate 71

7. Davis and Ritchie classified clefts into how many groups?

A ll groups B. illgroups
C. N groups D. V groups
8. The surgical repair of cleft lip according to "ruleof 10" should
be done when the child:
A Weights 10 lbs
B. Has hemoglobin concentration of 10 gm/ dl
C. Is about 10weeks old
D. All of the above
9. The surgical repair of the cleft palate should be done during
which period of life?
A months B. 6-18 months
C. 18-24 months D. 24-30 months
10. Which of the following is/are true?
A Cleft lip is more common in males
B. Cleft palate is more common in females
C. Cleft lip is more common on left side than on right side
D. All of theabove
11. Which of the following is/are problem/s associated with deft
palate?
A Difficulty in swallowing
B. Difficulty in speech
C Nasal regurgitation
D. Allof the above
12. Which of the following is/are types of clefts of secondary
palate?
A Submucous type B. Total type
C Subtotal type D. All of theabove
13. The secondary palate is made up of:
A Soft palate only B. Hard palate only
C Alveolar ridge D. Both soft and hard palates
14. Oeft lip and cleft palate are associated with which of the
fQllowing deformity/deformities?
A Hypoplastic ala on the cleft side
B. Deviation of nasal septum to the noncleft side
C. Hypoplastic maxil la on the cleft side
D. All of the above
72 MCQs mOral and Maxlllofacral Surgery

Answers
l.B. A combination of failure in normal union and inadequate
development may affect the soft tissue and bony components
of the upper lip, alveolar ridge and hard and soft palates
2.C. Rea sons for the formation of cleft lip are as follows.
(i) Failure of fusion of maxillary process with the median
nasal process .
(ii) Incomplete penetration of the mesoderm into the epithelial
membranes of maxillary and median nasal process.
3.C. Cleft palate occur if palatal shelves fail to fuse together. It
occurs in following conditions.
(i) If the tongue fails to deseent due to underdevelopment of
mandible.
(ii) lncomplete penetration of the mesoderm into the palatal
shelves.
4.A. Combineq clefts of the lip and palate .are more frequent tban
the isolated involvement of either region.
S.A. Clefts of the lip are more frequent in males, whereas isolated
clefts of the palate are more frequent infemales.
6.0. Several autosomal trisomy syndromes include oral de&along
with other congenital anomalies.
7.8. Group 1-Prealveolarclefts (unilateral, bilateral)
Group Jl-Post-alveolardefts
Group ITI-Complete alveolar clefts (unilateral, bilateral)
8.0. Itis better to wait until the end of six months at which time the
upper deciduous incisors are better developed qr even
erupting. This timing is physiologically logical and was
adopted byTean Delaire.
9.B. ·me deft palate should be closed as early as possible toget the
best speech results.
 Cleft L1p and Cleft Palate 73

10.0. In about 3 to 5 percent of cases cleft lips and palates are

associated with congenital deformities affecting other parts
of the body.
11.0. Clefts of the palate may be associated with considerable
underdevelopment of the mandible, resulting in the tongue
protruding into the oropharynx and interfering with breathing
in newborn child-the Pierre Robin syndrome.
U.O. Kernahan and Stark gave this classification.
13.0. Formation of deft tip and alveolus (primary palate) occurs in
between 4 to 8 weeks in utero and clefts of soft and hard
palate (secondary palate) occur in between 8 to 12 week in
utero.
14.0. Inbilater al cases, the premaxilla may be protuberant and the
columella is extremely short.
 Injuries of
the Facial Area

1. The bony union of the two halves of the mandible at symphysis

takes place at the end of:
A. First year of life B. Second year of life
C Third year of life D. 4th year of life
2. Which of the following is most common site of the fracture of
the mand_ible?
A. Coronoid process
B. Angle of the mandible
C Symphysis of the mandible
D. Body of the mandible
3. The fracture in which there is break in continuity of the bone
without any break in mucosa or skin is called as:
A. Compormd fracture
B. Comminuted fracture
C Simple fracture
D. Alloftheabove
4. The fracture in which bone is fractured into more than two
fragments is called as:
A. Simple fracture
B. Compormd fracture
C Comminuted fracture
D. Green stick fracture
5. Which of the following is the pathognomonic feature of the
body of the mandible:
A. Malocclusion
B. Hematoma inthe floor of the mouth
C Openbite
D. Battle's sign
 lnJunes of the Fac1al Area 75

6. Which of the following is the rare site of fracture of the

mandible?
A. Neckofthecondyl e
B. Angle of the mandible
C Coronoid process of the mandible
D. Canine region of the mandible
7. According to AO classification of mandibular fractures - F3
stands for:
A. Single fracture
B. Comminuted fracture
C Fracture with a bone defect
D. Multiple fractures
8. Which of the following muscles doles not play any role in the
displacement of the fractured segments of the mandible?
A. Muscles of ma stication
B. Muscles of facial expression
C Accessory muscles of mastication
D. All of the above
9. Leakage of CSF through nose is called as:
A. CSF otorrhea B. CSF rhinorrhea
C Both of the above D. Epistaxis
10. The formation of the primary callus takes about
A. 5-10 days B. 20-30 days
C 40-50 days D. 60-70 days
1L Which of the following is/are type/s of the primary callus?
A. Anchoring callus B. Bridging callus
C Sealing callus D. All of the above
12. Which of the following is also called as endosteal callus?
A. Anchoring callus B. Uniting callus
C Bridging callus D. Sealing callus
13. lnjuty to which of the following cranial nerve/s leads to ocular
palsies?
A. Third cranial nerve (oculomotor)
B. 4th cranial nerve (Trochlear)
C 6th cranial nerve (abducent)
D. All of the above
76 MCQs in Oral and Maxillofac ial Surgery

14. Which of the following is/are characteristic feature/s of shock?

A. Cold skin B. Hypotension
C Increase in pulse rate D. All of the above
15. Transient loss of consciousness occurs in:
A. Mild concussion of the brain
B. Moderate concussion of the brain
C Severe concu ssion of the brain
D. All of the above
16. The incomplete type of bone fractures in children is called as:
A. Simple fracture
B. Compound fracture
C Comminuted fracture
D. Green stick fracture
17. Anterior open bite occurs in:
A. Body fracture of mandible
B. Fracture of angle of mandible
C Fracture of coronoid process
D. Bilateral condyla r fracture
18. Guerin fracture is also called as:
A. Green stick fracture B. LeFort I fracture
C Le Fort ll fracture D. LeFort llifracture
19. LeFort II fracture is also called as:
A. Guerin fracture
B. Floating maxilla
C Pyramidal type of fracture
D. Horizontal fracture of maxilla
20. Ecchymosis in the mastoid region is called as:
A. Guerin sign B. Colman's sign
C Battle's sign D. Panda's sign
21. The characteristic dish face deformity occurs in which type of
fracture?
A. Lc Fort I B. LeFort IT
C Le Fort ID D. All of the above
22. Hematoma formation inthe region of greater palatine foramen
is called as:
A. Battle's sign B. Guerin sign
C Colmnn's sign D. Panda's sign
 lnjunes of the Facial Area 77

23. Anosmia means:

A. Loss of vision
B. Loss of taste
C Loss of sense of smell
D. Diplopia
24. Anosmia occurs due to damage to which nerve?
A. Optic nerv e
B. Occulomotor nerv e
C Olfactory nerve
D. Trigeminal nerve
25. Damage to nasolacrimal duct results in:
A. Diplopia B. Anosmia
C Amnesia D. Epiphora
26. Which of the following does not occur when there is damage
to infraorbita) nerve?
A. Paresthesia of lower eyelid
B.·: Paresthesia of.lhe side of the nose
C Paresthesia of the upper lip
D. Paresthesia of the lower lip
27. Which of the following forcep/s is/are used for reduction of
fracture?
A. Rowe's disimpaction forceps
B. Walsham 's forceps
C Asch's septal forceps
D. All of the above
28. Which of the following is/are true about arch bar wiring?
A. The arch bar is adapted by starting from the distal most
point in the arch
B. It is indicated when there are not enough teeth in the arch for
conventional Risdon's wiring
C It is indicated when all teeth in arch cannot be secured to the
base wire due to poor periodontal health of certain teeth
D. All of the above
29. Which of the following is the strongest stimulus to respiration ?
A. Increase in arterial oxygen
B. Decrease in arterial oxygen
C Increase in arterial carbon dioxid e
D. Decrease in arteria l carbon dioxide
 78 MCQs in Oral and Max1llofac1al Surgery

30. The proximal segment is usually displaced in which direction

in the fracture of angle of edentulous mandible?
A. Posterior only
B. Inferior ?nlY
C Anterior and inferior
D. Anterior and superior
31. The typical 'cracket pot' sound on percussion of upper teeth is
indicative of fracture:
A. Le Fort I B. Le Fort II
C LeFort III D. All of the above
32. Respiratory embarrassment can occur in fracture of:
A. Angle
B. Parasymphysis
C Bilateral parasymphysis
D. Bila teral subcondylar
33. The mini-boneplate system is a:
A. Monocortical system
B. Bicortical system ·
C Compressive bone plating system
D. Noneof the above
34. The impression material recommended for taking impression
for maxillofacial prosthesis is:
A. Plaster of Paris
B. Alginate
C Zinc oxide-eugenol
D. Silicone
35. The muscles that aid in displacement of maxillary fractures
are:
A. Masseter
3. Ternporalis
C Upper part of orbicularis and lower part of orbicularis oculi
D. None of the above
36. Paresthes·ia is one of the commonest findings in which of the
following fracture?
A. Su bcondylar fracture of mandible
B. Zygomaticomaxillary complex fracture
C Fractured coronoid process
D. Symphysis fracture
 InJuries of the Fac1al Area 79

37. Forward displacement of the condyle in condylar fracture is

due to:
A Temporalis muscl e
B. Masseter muscle
C Lateral pterygoid muscle
D. Medial pterygoid muscle
38. In which of the following conditionls, anterior open bite occur:
A Bilateral condylar fracture
B. Symphysis fracture on one side and angle fracture on other
side of mandible
C Horizontal fracture of the maxilla
D. AandC
39. Gill's approach is:
A Used to block inferior alveolar nerve
B. Used to reduce the fractured zygoma
C Placed just anterior to the ear
D. One of the frequent approaches f<?r condylar surgery
40. How many weeks of fixation are required for fracture of
mandible?
A 2-4 weeks B. 4-6 weeks
C 6-8 weeks D. 8-10 weeks
41. Excessive muscular contraction is one of the frequent causes
of:
A Unilateral condylar fracture
B. Coronoid fracture
C Fracture of angle of the mandible
.D. Bilateral condylar fracture
42. Which of the following splintls is/are commonly used for
fixation of the fractured mandible in children?
A Ca.st metal splints
B. Acrylic cap splints
C Gunning splints
D. All of the above
4,3. Which of the following splint/sis/are used for the fixation of
fractured edentulous mandible?
A Gunning splint B. Cast metal splint
C Acrylic cap splint D. All of the above
 80 MCQs in Oral and Maxlllofac1al Surgery

44. External pin fixation is indicated in which of the following

conditionls?
A. In comminuted fractures of the mandibl e
B. Tn fractures of theedentulous mandible where open reduction
is to be avoided
C In pathol ogical fractures when there is collapse of fragments
D. A ll of the above
45. Bleeding from the nose associated with CSF rhinorrhea
indicates the fracture of:
A. Anterior cranial fossa
B. Middle cranial fossa
C Posterior crania l fossa
D. None of the above
46. A bruise ca used by an impact from blunt object without any
rubbing of the skin is called as:
A. Abrasion B. Contusion
C Laceration D. Incision
47. In radiographs,fracture line appears:
A. Radiopaque B. Radiod ense
C Radiolucent D. None of the above
48. The fracture communicating with the external environment
through the wound is called as:
A. Simple fracture
B. Compound fracture
C Green stick fracture
D. All of the above
49. Which of the following is the best method to treat mandibular
fractures in children?
A. Cast metal spl in t
B. Open reduction
C Interm axillary fixation
D. Acry lic cap splint
50. Green stick fractures should be treated by:
A. Open reduction
B. Ex ternal pin fixa tion
C By use of haloframe
D. By interma xillary fixation followed by active functioning
 Injuries of the Facial Ar ea 81

51. Rowe's disimpaction forcep is:

A One pronged forcep
B. Two pronged forcep
C Three pronged forcep
D. Four pronged forcep
52. Hanging drop appearance in the radiographs occurs in:
A Mandible fracture
B. Dentoalveolar fracture
C Blow out fracture of the orbit
D. Subcondylar facture
53. Blow out fracture of the orbit may be associated with which of
the following?
A Enophthalmos
B. Diplopia
C Hanging drop appea rance
D. All of the above
54. Intem31 skeletal suspension, which is a type of internal method
of fixation, was introduced by:
A Angle B. Adam
C Moss D. Sicher
82 MCQs mOral and Maxtllofactal Surgery

Answers
l.A. The complete bony union takes place at the end of the first
year of life but this line of fusion remains relative!y weak point
in the structure.
2.B. The angle of mandible is an anatomically as well as
physiologically weak structure.
3.C. In simple fracture, fracture segments are not exposed to the
external environment.
4.C. These are high impact injuries on account of major trauma.
S.B. Resultantly, patient cannot swallow anything. There is fetid
odor and excessive salivation as the patient can't clean the
oral cavity.
6.C. Fracture of the coronoid process is very rare and difficult to
diagnose.
7.B. AO classification isbased on clinical and radiological findings
and describes mandibular fractures along with soft tissue
involvement.
8.B. To displace the bone muscle should have attachment on fixed
ends, i.e. a bone only.
9.B. CSF is cerebrospinal fluid.
10.8. Primary callus cannot be detected radiographically.
11.0. Depending upon the location and function, the primary cells
is divided into four varieties: (1) Uniting callus, (2) Bridging
ca Uus, (3) Anchoring callus and (4) Sealli).g callus.
12.0. Sealing callus develops on the inside sur face of the bone
adjacent to uniting callus.
13.0. lnjury to 3rd,4th and 6th cranial nerve lead to ocular palsies.
14.0. Shock in maxillofacial injuries can be a hemorrhagic or
neurogenic shock.
15.A. In moderate concussion, patient may be unconscious for a
period ranging from few to 24 hours. In severe concussion,
pa tient may be unconscious for more than 24 hours.
 lnJunes of the Fac1al Area 83

16.0. These appear as a crack in the bone in which only one cortex
of the bone is fractured whereas other cortex is bent only as in
the case of green stick of a tree.
17.D. In bilateral condylar fractures, a posterior premature occlusion
and anterior open bite is seen.
18.B. It is also called as floating maxilla aswhole of the tooth bearing
part of maxilla becomes detached and mobile.
19.C. Violent force usually from anterior direction sustained by
central region of the middle third of face may result in
pyramidal type of fracture.
20.C. Ecchymosis in the mastoid region in place of posterior auricular
artery is known as Battle's sign. Itis seen in Lefort II fracture.
21.C. The patient presents with characteristic dish face because the
middle third of face is pushed back.
22.B. Hematoma formation in the region of greater palatine foramen
is called as Guerin sign.
23.C. Anosmia means absense of sense of smell. It occurs due to
defect in a damage to olfactory nerve.
24.C
25.0. Damage to nasolacrimal duct results in epiphora.
26.0. Damage to infraorbital nerve leads to paresthesia of lower
eyelid, paresthesia of the side of the nose and paresthesia of
the upper lip.
27.0. Rowe's disimpaction forceps is a two pronged forceps where
one prong fits into the nasal cavity and the other fits on the
hard palate.
28.0. As a general rule, the arch bar should not cross the fracture
line except in few undisplaced fractures or green stick fracture.
29.C.
30.0. Fractures of the angle of the mandible are influenced by the
pull of the medial pterygoid, masseter and temporalis muscles
that tend to displace the ramus in an upward and medial
direction.
 84 MCQs in Oral and Maxillofacial Surgery

31.0.
32.C. Airway obstruction is attributed to tongu e fa lling back on
account of unfavorable bilateral parasymph ysea l fracture of
the mandible, when the fragment is pulled backwards and
downwards due to the muscular attachments.
33.A. Miniplates have 0.9 mm thickness and the screws used are
monocortical screws holding the plate and the jaw involving
only the outer cortex.
34.0.
35.0. In a low-Level fracture, muscular displacement is not a factor
if the fracture is at a higher level, the pterygoid muscle
attachments are included in the loose fragment, which is
consequently retruded and depressed at the posterior end,
resulting in an anterior open bite.
36.8. If infraorbital nerve is involved in the fracture, the patient
may complain of anesthesia of upper lip, side of nose and
upper teeth.
37.C. As soon as the condyle is pulled from its pla ce, the ramus of
the mandible is pulled up by the elevator muscles.
38.0. Inbilateral condylar fractures, a posterior premature occlusion
and anterior open bite is seen.
39."8. Gille's approach or temporal fossa approa ch.
40.C. Fixation is the procedure by which the fractured bone ends
are held together in reduced position .
41.8. Fracture of the coronoid process is very rare and difficult to
diagnose.
428. Acrylic ca p splints are easy to make and are frequently used
in children, as it is difficult to place wires on the deciduous
teeth due to their anatomic structure.
43.A . Gunning splint is ind ica ted in fra ctures of edentulou s
ma ndible when the patient has lost his denture or is not
bearing a denture.
44.0. External pin fixa tion is also used in cases where intermaxillary
fixation cannot be done because of wounds in the oralcavity.
 InJuries of the Facial A rea 85

45.A. 'Ibisoccurs as a result of fracture of cribriform plate of ethmoid

bone.
46.B. Contusion is hemorrhage in the brain tissues. So, an area of
necrosis appears in the brain tissue resulting in deficit in
corresponding part of the body, which is involved in the brain.
47.C. In radiographs, ordinarily fracture line appears radiolucent.
It appears radiopaque if the ends are over-riding each other.
48.B. As a rule, fractures involving the tooth bearing area are always
compound fractur s becauSe they communicate with the oral
environment through gingival sulcus and periodontal
ligament.
49.0. Acrylic cap splint is used, as it is difficult to place wires on the
deciduous teeth due to their anatomic structure.
50.0. In green stick fracture, only one cortex of the bone is fractured
whereas other cortex is bent only.
51.B. Rowe's disimpaction forceps is a two-pronged forceps where
one prong fits into the nasal cavity and the other fits on the
hard palate.
52.C. In hanging drop appearance, inferior oblique and inferior
rectus muscle has got caught inthe fracture, the movements of
the eyeball are restricted leading to diplopia.
53 D. The orbital fat and muscles herniate into the maxillary antrum
and enophthalmos is produced .
54 B.
 Temporomandibular
Joint Disorders

1. The articulating surfaces of the temporomandibular joint are

covered by:
A. Hyaline cartilage B. Elastic cartilage
C Connective tissue D. Fibrocartilage
2. The upper surface of the articular disk in anteroposterior
direction is:
A. Convex B. Biconvex
C Concave D. Concavo-convex
3. Which of the following is not true about articular disk?
A. It is oval in shape and is fibrous
B. It is thinner in central portion than its periph ery
C Its undersurface is concave in anteroposterior direction
D. Itsundersurf ace is convex inanteroposterior direction
4. Which of the following is/are not accessory ligamentls of the
TMJ?
A. Sphenomandibular ligament
B. Temporomandibular ligament
C Stylomandibular ligament
D. BothAandC
5. The maximum biting load occurs in which of the following
areas?
A. Incisor area B. Canine area
C Premolar area D. Molar area
6. The temporomandibular joint arthralgia is caused by:
A. Bruxism and muscular spasm
B. Rheumatoid arthritis and osteoarthritis
C Occlusal disharmony
D. All of the above
 Temporomandibular Jo1nt D1sorders 87

7. The hypermobility of temporomandibular joint is known as:

A. Dislocation B. Luxation
C. Subluxation D. Ankylosis
8. The dislocation of temporomandibular joint usually occurs in:
A. Medial direction B. Lateral direction
C. Anterior direction D. Posterior direction
9. Temporomandibular joint arthroscopy is used for:
A. Diagnosis of interna l pathologies of TMJ
B. BiopsiesofTMJ
C. Joint lavage and lysis
D. All of the above
10. Arthrocentesis means:
A. Gastric lavage
B. Lavage of the joint
C. Biopsy of the joint
D. Inflammatory condilion of the joints
11. Which of the following is not true about sclerosing solution
used for temporomandibular joint?
A. Sclerosing solution should be injected into the joint space
B. Sclerosing solution should not be injected into joint space
C Sodium psylliate is used as a sclerosing agent
D. Sclerosing solution causes fibrosis of the capsule
12. The surgical management of the temporomandibular joint
dysfunction includes which of the following?
A. Menisectomy and em.inectomy
B. Condylectomy and high condylectomy
C. Condylotomy
D. All of the above
13. Which of the following is not a complication of condylectomy?
A. Shortening of height of the ramus
B. Deviation of jaw in unilateral condylectomy
C. Anterior open bite in bilateral condylectomy
D. Deep bite in bilateral condylectomy
14. The acute pyogenic arthritis is usually caused by:
A. Staphylococcus albus B. Staphylococcus aureus
C Streptoccccu s mutans D. Streptococcus viridans
88 MCQs in Oral and Max illofacial Surgery

15. Osteoarthritis is characterized by:

A. It occurs in old age
B. lt generally involves the large joints
C Pain and stiffness of the joint
D. All of the above
16. Myofascial pain dysfunction syndrome is also known as:
A. Cowden's syndrome B. Gardner's syndrome
C Costen'ssyndrome D. Eaglesyndrom e
17. Eagle syndrome is characterized by:
A. Elongation of spine
B. Elongation of styloid process
C Elongation of radius bone
D. Elongation of cervical vertebrae
18. Which of the following is/are used as sclerosing solutions?
A. Ringer's lactate B. Sodium psylliate
C Sodium morrhuate D. Both Band C
19. Inability to open the mouth due to fusion of head of the condyle
of the mandible with the articulating surface of the glenoid
fossa in known as:
A. True ankylosis B. False ankylosis
C Trismus D. Muscular spasm
20. False ankylosis may be caused by:
A. Muscular trismus B. Muscular fibrosis
C Myositis ossi.ficans D. All of the above
21. Tetany occurs when blood calcium level is:
A. Abov e 12 mg/100 ml
B. Above 15 mg/100 m.l
C Between 9-12 mg / 100 ml
D. Below 6-8 mg/100 ml
22. Tetanus is caused by:
A. Clostridium welchi B. Clostridium tetani
C S taphylococcus aureus D. None of the above
23. True ankylosis of TMJ is caused by:
A. Trauma
B. Birth injuries
C Middle ear infection and mastoiditis
D. All of the above
 Temporomandibular Jomt D1sordcrs 89

24. Which of the following is/are true about TMJ ankylosis?

A Inability to open the jaw
B. Deviation of midline towards the affected side
C Asymmetrical facial appearance in unilateral TMJ ankylosis
D. All of the ·above
25. Which of the following materials is/are used to prevent
recurrence of TMJ ankylosis?
A Tantalwn foil
B. Teflon blocks
C Silastic blocks
D. All of the above
26. Excessive growth of the mandibular condyle is known as:
A Condylar hypoplasia
B. Condylar hyperplasia
C Condylar metaplasia
D. None of the above
27. Which of the following is not a characteristic feature of the
condylar hyperplasia?
A. Deviation of chin away from the affected side
B. Deviation of the chin towards the affected side
C Open bite on the affected side
D. Cross bite on the unaffected side
28. Bilateral condylar hyperplasia is characterized by:
A Prognathic mandible
B. Retrognathic mandible
C. Retruded mandible
D. All of the above
29. Underdevelopment of the condyle is .known as:
A Condylar hyperplasia
B. Condylar hypoplasia
C Condylar metaplasia
D. All of the above
30. Which of the following is/are true about condylar hypoplasia?
A Reduced lower facial height
B. Facial asymmetry in unilateral cases
C Retrognathic mandible inbilateral cases
D. All of the above
90 MCQs in Oral and Maxtllofac1a l Surgery

31. Which of the following is most common diso.rder causing pain

about the masticatory apparatus including the temporo-
mandibular joint?
A. Traumatic arthritis
B. Degenerative arthritis
C Trigeminal neuralgia
D. Myofacial pain dysfunction
32. The most common cause of TMJ ankylosis is:
A. Rheumatoid arthritis
B. Childhood illness
C Osteoarthritis
D. Trauma
33. Dautrey procedure is used for treatment of:
A. TMJ ankylosis B. TMJ clicking
C TMJ arthritis D. TMJ dislocation
34. Early movement following surgery for temporomandibular
joint ankylosis is:
A. Harmful
B. Unimportant
C Desirable
D. Indicated only when ankylosis is limited to one side
35. Ankylosis of the TMJ is best treated with:
A. Condylectomy
B. Antibiotics
C Sclerosing solutions
D. Exercise and massage
36. Which of the following movements should be employed to
reduce a dislocation of the mandible?
A. Upward and forward
B. Upward and backward
C Downward and forward
D. Downward and backward
 Temporomandibular Jomt 01sorders 91

Answers
1.0. Temporomandibular joint is a ginglymoarthroidal joint
meaning th reby it has both hinge and sliding action.
2.0. The disk in its anteroposterior direction is concave on the
undersurface and concavo-convex on the upper surface.
3.0. The meniscus or articular disk is positioned between the
glenoid fossa above and mandibular condyle below.
4.8. The capsule of the joint is reinforced by strong
temporomandibular ligament extending from zygomatic arch
to condylar neck . The accessory ligament s are
sphenomandibular and stylomandibular ligaments.
S.C. The size, shape, position of the teeth in jaws and occlusion
influence the joint.
6.0. Temporomandibular joint arthralgia is a painful condition of
the joint that can be attributed to multiple etiological factors.
7.C. Hypermobility is suggestive of subluxation.
S.C.
9.0. Temporomandibular joint arthroscopy permits xamination
of the interior of the joint with the help of fiberoptic telescope .
10.8. Arthrocentesis is the least invasive procedure of the joint and
is best carried out with the help of an arthroscope.
ll.A. The injection should not be injected to the joint space but
should be restricted to the capsule for obtaining fibrosis and
tightening of the capsule.
· 12.0. The joint is approached through the conventional
preauricular approach for an easy access,direct exposure and
relatively complication free aesthetically acceptable incision.
13.0. Incondylectomy, condyle is resected for 6 to 8 :n'Un of length
below the superior border and removed after freeing from the
attachment of the lateral pterygoid muscle .
14.8. Acute pyogenic arthritis is very painful. Movement of the jaw
is restricted .
 92 MCQs in Oral and Maxillofacial Surgery

15.0. Symptoms of osteoarthritis increase in wet and cold weather.

16.C. In Costen's syndrome, there is painful TMJ with associated
symptoms on account of reduced vertical height.
17.B. Eagle syndrome is characteri?:ed by elongation of styloid
process .
18.0. Injection of sclerosing solution is given for the joint that shows
evidence of hypermobility .
19.A. The fusion can be inthe form of a fibrous union or bony union.
20.0. Inability to op n the mouth on account<>£ muscular spasm or
trismus is labeled as false ankylosis as the cause here is extra-
articular.
21.0. When there is hypocalcemia, the spasms in the muscles are
produced hampering the op g of the mouth.
22.B. Tetanus is also known as lock jaw because of persistent tonic
spasm of the muscles.
23.0. True ankylosis of the TMJ is an intra-articular problem on
account of fusion of fhe artitul ting surfaces of head of the
condyle with the glenoid ossa.
24.0. In bony ankylosis, interincisal opening is invariably less than
5mm.
25.0. Tentalum foil, acryli<; balls, teflon and silastic blocks, Delrin
and condylar stell implants have been used with varied,
success.
26.B. Excessive growth of the mandibular condyle even after the
skeletal maturity h s been reached is labeled as condylar
hyperplasia.
27.8. The mandible is bowed downward leading to open bite on
the affected side and cross bite on the other side.
28.A. The treatment lies in reducing the size of the condyle.
29.B. The treatment lies in reconstruction of the condyle and ramus
using autogenous costochondral graft. ·
.30.0. Condylar hypoplasia can be congenital or acquired.
 Temporomandibular Jomt D1sorders 93

31.0. It includes those conditions affecting the joint in its

musculature that produce painful joint with limitation of
movement and clickin g in the joint but it excludes all those
conditions where organic lesions can be diagnosed .
32.0. Birth trauma inthe fonn of wrong application of forceps on
the joint can produce the so-called congenital ankylesis.
33.0.
34.C. The jaw is vigorously mobilized after intermaxillary fixation
for about 2 weeks time.
35.A. Condylectomy involves the excision of the condyle in cases of
partial fibrous ankylosis where some articular space is still
persisting .
36.0.
 Hemorrhage and
Shock

1. Arterial hemorrhage is characterized by:

A. Oozing of bright red blood from minute vessels
B. Bright red colored blood that is pulsating in flow
C Dark red colored blood that is non-pulsating in flow
D. Dark red colored blood that is pulsating in flow
2. Secondary hemorrhage occurs:
A. During surgical procedure
B. Within 24 hours of postoperative phase
C Within 48 hours of the postoperative phase
D. After 7-14 days of the postoperative phase
3. Thromboplastin is released by:
A. Macrophages B. Mast cells
C Neutrophils D. Platelets
4. Total number of blood clotting factors are:
A. 6 B. 9
C 12 D. 13
5. Which of the following is number IV clotting factor?
A. Fibrinogen B. Prothrombin
C Calcium ion D. Christmas factor
6. Plasma thromboplastin ant cedent is:
A. FactorY B. FactoriX
C Factor X D. Factor XI
7. Blood clotting factor XII is also known as:
A. Stuart factor
B. Christmas factor
C Laxi Lorland factor
D. Hagemann factor
 Hemorrhage and Shock 95

8. Hemophilia occurs due to deficiency of:

A. Factor XI B. Factor IX
C Factor Vll1 D. Factor Vll
9. Deficiency of factor IX causes:
A. Classical hemophilia B. Christmas disease
C Hageman disease D. Stuart disease
10. Parahemophilia a caused by the deficiency of:
A. Factor V B. Factor VII
C Factor IX D. Factor XI
11. Prothrombin is synthesized in:
A. Kidney B. Stomach
C Liver D. Gallbladder
12. The normal bleeding time is:
A. 1-2 minutes B. 2-5 minutes
C 8-10 minutes D. 10-15 minutes
13. Which of the following is/are used as anticoagulantls:
A. Heparin B. Dicumarin
C Hirudin D. All of the above
14. The most common site of severe hemorrhage of dentoalveolar
origin is:
A. Inferior dental vessels
B. Greater palatine arteries
C Incisive canal vessels
D. All of the above
15. Hemophilia is characterized by:
A. Normal coagulation time
B. Prolonged coagulation time
C Prolonged bleeding time
D. Decreased coagulation time
16. Which of the following astringents can be used to control
hemorrhage?
A. Tannic acid B. Carbolic acid
C Ferric sulfate D. All of the above
17. Which of the following is/are complication/s of blood
transfusion?
A. Hypothermia B. Simple pyrexial reaction
C Thrombophlebitis D. All of the above
 96 MCQs mOral and Maxillofactal Surgery

18. The advantage/s of the autotransfusion is/are:

A. It eliminates the risk of viral hepatitis
B. Iteliminates the risk of HIV infection
C It avoids blood incompatibility
D. All of the above
19. Which of the following is/are true about syncope:
A. It isa transient loss of consciousness due to cerebral ischemia
B. It is a permanent loss of consciousness due to cerebral
ischemia
C. Also caused as common fainting attack
D. Both A and C
20. Which of the following is/are signls of syncope:
A. Hypotension B. Dilatation of pupil
C Cold perspiration D. All of the above
21. Shock is·characterized by:
A. Decreased cardiac output
B. Hypotension
C Acute circ'ulatory failure
D. All ofthe above
22. Oligemic shock is also called as:
A. Cardiogenic shock B. Septic shock
C Anaphylactic shock D. Hypovolemic shock
23. Which of the following is/are etiological factor/s of shock?
A. Acute circulatory failure·
B. Increase in volume capacity of the vasd.tlar tree
C Reduction in circulating blood volume
D. All of the above
24. Which of the following is/are signls and symptom/s of shock?
A. The skin is cold and clammy
B. Dilated pupils
C Pulse is fast and irregular
D. All of the above
25. Differential white blood cell counts inthe laboratory are useful
in the diagnosis of:
A Anemia B. Eosinophilia
C Spherocytosi s D. lhrombocytopenic purpura
 Hemorrhage and Shock 97

26. A patient has had a dental infection for five days. His white
blood cell count is probably in the range of:
A. 4000-9000 Icu m.m
B. 15000-20000lcu nun
C 25000-30000 Icu mm
D. Noneoftheabove
27. Which of the following is common to all fonns of shock?
A. Sepsis B. Hypovolemia
C Hypertension D. Impaired tissue perfusion
28. The proper rate of rescue breathing in an adult is:
A. 5times per minute B. 12times per minute
C 20 times per minute D. 28 times per minute
29. Which of the followings may cause postoperative hemorrhage:
A. Prolonged use of broad spectrum antibiotics
B. Salicylate therapy
C Hepatic disease
D. All of the above
30. A complete blood count does not include:
A. Total erthrocytes
B. Totalleukocytes
C Hemoglobin
D. Erythrocyte sedimentation rate
31. Hypovolemic shock develops after loss of:
A. 10'% blood B. 20% blood
C 30% blood D. 40% blood
32. Which of the following is most important in prevention of post-
extraction bleeding problems?
A. Localpressure
B. Ice to face
C Tight suturing of flaps
D. Transfu ?ion of blood
33. Which of the following is true about hemophilia?
A. Normal BT,P1T and prolonged PT
B. Prolonged BT, PT and PTT
C Prolonged PT, moderately prolonged P1T and normal BT
D. Prolonged BT, moderately prolonged P'IT and normal PT
98 MCQs 1n Oral and Maxillofacial Surgery

34. The best blood product administered preoperatively to patient

with hemophilia A is:
A. Fresh frozen plasma B. Factor IX concentrate
C Whole blood D. Factor VITI concentrate
35. Pin-point hemorrhage on skin are called as:
A. Purpura B. Hematoma
C Petechiae D. Echymosis
36. Among the following which causes the practitioner the
greatest concem?
A. 20% of normal PIT B. 40% of normal PIT
C 60% of normal PIT D. 80% of normal PIT
37. Hematocrit serves as an index of £
A. Monocyte volume
B. Patient 's white blood cell volume
C Patient's total blood cell volume
D. Patient's red blood cell volume
38. When a localized clot forms intravascularly at the site of
operation or injury, it is called:
A.'Embolus B. Thrombus
C Coagulated fibrin D. Organized hematoma
39. Hemostasis depends upon each of the following, except
A. Vessel wall B. Prothrombine
C Blood platelets D. Albumin
40. Postoperative bleeding in thrombocytopenic purpura results
from a deficiency of :
A. Platelets B. Vitamin C
C VitaminK D. Prothrombin
 Hemorrhage and Shock 99

Answers
1.B. VenotiS hemorrhage is characterized by nonpulsating, dark
red color of the blood exhibiting steady flow.
2.D. Secondary hemorrhage occurs as a result of breaking down of
the clot on accoWlt of infection.
3.0. When blood is shed, the platelets disintegrate to liberate
thrombopl tin.
4.0. Out of these thirteen factors, twelve are proteins and one is
ionic calcium.
S.C. Calcium, number IV clotting factor is required in very minute
amounts in coagulation and its deficiency is not known to
cause any haemorrhagic disorder.
6.0. Plasma thrombopla stin antecedent produce hemophilia like
condition but unlike classical hemophilia as it occurs both in
males and females.
7.0. Clotting factor XII is also known as Hagem factor and
tissue contact factor.
S.C. Deficiency of factor V1II or AHG is a sex linked recessive
disorder.
9.B. This disease clinically and .genetically resembles classic
hemophilia.
10.A. Factor Vis called proaccelerin or labile factor.
ll.C. Prothrombin is synthesized in liver in the presence of vitamin
K
12.B. Bleeding time is the time taken from the moment of injury and
extravasation of blood to the stoppage of hemorrhage in a
puncture wound.
13.0. Also adding oxalate and citrate in the blood facilitates
precipitation of calcium that in tum prevents clotting.
14.0. Other common sites of hemorrhage are osseous tissue,
periosteum,muscular and glandular tissue, etc.
lS.B. The co gulation time is abnormally prolonged whereas
bleeding time is normal .
100 MCQs in Oral and Maxlllofac1al Surgery

16.D. By precipitating the proteins using electrocoagulation or

astringents like-ferric-sulfate, carbolic acid or tannic acid lead
to cont:I:olofhemorrhage.
17.D. The ad've_rse rea tions of transfusion vary frdm ina:pparent
hemolysis to post-transh!.sion jaundice and severe renal
failure.
18.0. Autotransfu ·sion ensures th availability of blood especially
when no donor is available. ·
19.0. The predisposing causes of syncopeare emotio stress, lack
of sleep,excess.ive heat, sight.ofher l(>rrhage, etc.
20.0. Qther signs of syncope includes pallor of skin, feeling of
nausea, vomiting and in case patient is sitting or standing,
there is tendency to (all on ac:ctmnt of unconsdousness.
21.D. Shock is also associated with subnormal temperature,
sweating, fall in blood press1,1 ;e as well as loss of
consciousness.
22.0 In oligemic shock, there is reductio_n in blood volume on
account of external or internal hemorrhage.
23.0. In acute circulatory failure, thl:lre is sudden loss of pumping
action of heart i:lS. .in myocardial infarction, which l¢ad,s to
anoxia of the brain along with peripheral vasodilatation.
24.0. Respiration is. shallow rapid and irregular. Temperature is
subnormal. Blood pr.essure (alls very low.
25.8. Eosin0philia is increase in ·eosinophil count.
26.8. White blood cell c0unt increases in dental infections .
::?7.0. Shock ts the disparity between the blood v61ume in the body
and volume capacity of the vascular tree.
28.8. Good oxygen exchange is mandatory, and ways to assure it
may range from relief of obstruction to oxygen therapy t9
assisted ventilation by way of an endotracheal tube.
29.D. Postoperative hemorrhage results as a result ofprofonged use
of broad-sp trum antibiotics, salicylate therapy and hepatic
disease.
30.0. A complete blood ·countdoesnotindude ESR.
 Hemorrhage and Shock 101

31.0. Hypovolemic shock occurs as a result of reduction in blood

volume on account of external or internal hemorrhage.
32.A. For an extraction socket a 10 x 10em gauze pack or a bolus of
cotton damped with saline is moulded over the surgical site.
33.C. Normal BT is 2.5 to 9.5 minutes Normal PT is 11 to 12.5
seconds. Normal P1T is 30 to 45 seconds.
34.0. The best blood product administered preoperatively to patient
with hemophilia A is factor VIII concentrate .
35.C. Petechial hemorrhage is a type of submucosal or subcutaneous
hemorrhage occurring in minute spots not larger than the
size of a pinhead.
36.A.
37.0. Serial hematocrit determinations are most useful in assessing
the progress of shock and monitoring for continuing blood
loss.
38.8. Embolus is clot formed at different site·from its occurance site.
39.A. Hemostasis is spontaneous or induces cessation of flow of
blood from rupture in the integrity of the vascular system.
40.A. Thrombocytopenia is deficiency of platelete.
 Neurological Disorders
of Maxillofacial Region

1. Trigeminal nerve is:

A Only sensory nerv e
B. Only motor nerve
C Both sensory and motor nerves
D. None of the above
2. Loss of taste is known as:
A Anesthesia B. Analgesia
C Ageusia D. Paresthesia
3. Lesion of lower motor neuron of the facial nerve is
characterized by:
A. Paralysis of few muscles on the opposite side of face
B. Paralysis of all facial muscles on opposite side
C Paralysis of all facial muscles on the same side
D. Paralysis of lower facial muscles
4. Which of the following nerves supplies muscles of
mastication?
A. Hypoglossal nerve B. Glossopharyngeal nerve
C Trigeminal nerve D. Faciall nerve
5. Which of the following lesion/sis/are usually painful?
A. Periapical granuloma
B. Periapical cyst
C Periapical abscess
D. All of the above
6. Which of the following lesion/sis/are usually a sociated with
a non-vital tooth?
A. Periapical granuloma
B. Periapical cyst
C Periapica l abscess
D. All of the above
 Neurolog1ca l Disorders of Maxillofac1al Reg1on 103

7. Pain in the ear is also known as:

A. Odontalgia B. Otalgia
C Glossitis D. Sialadenitis
8. Which of the following is/are true about migraine?
A. Itoccurs most commonly in women
B. It is spasmodic and throbbing type of head ache
C Usually unilateral
D. All of the above
9. Cluster headache is also known as:
A. Periodic migranous neuralgia
B. Histamine cephalgia
C Shingles
D. Both A and B
10. Herpes zoster is also known as:
A. Tic doulourex B. Alarm clock headach e
C Shingles D. Frey's syndrome
11. Which of the following divisions of the trigeminal nerve is
most commonly involved in herpes zoster?
A. Mandibular division ·
B. Maxillary division
C Ophthalmic division
D. Facial division
12. Which of the following is also known asTic doulourex?
A. Trigeminal neuralgia
B. Sphenopalatine neural gia
C Glossopharyngeal neuralgia
D. Hypoglossal neuralgia
13. Which of the followings is not true about trigeminal neuralgia?
A. It has definite trigger zone
B. Pain is bilateral and crosses the midline
C Pain is unilateral and does not cross the midline
D. Most commonly occurs in old age and in females
14. Which of the following drugs is the treatment of choice for
trigeminal neuralgia?
A. Phenytoin B. Carbamazepine
C Amoxycillin D. Phenobarbital
 104 MCQs mOral a nd Maxillofacial Surgery

15. Which of the followings is characterized by presence of trigger

zone in the pharyngeal mucous membrane?
A. Trigeminal neuralgia·
B. Sphenopalatine neuralgia
C Tic douloureux
D. Glossopharyngeal neuralgia
16. Geniculate neuralgia is characterized by which of the
following?
A. Itinvolves sensory or intermedius portion of the facial nerve
unilaterally
B. Also known as Ramsey-Hunt syndrome
C Most common in young females
D. All of the above
17. Sphenopalatine neuralgia is also known as:
A. Trotter'ssyndrome B. Eaglesyndrome
C Sluder'ssyndrome D. Frey'ssyndrome
18. Which of the following syndromes occurs due to iron
deficiency anemia?
A. Eagle syndrome
B. Gardner'ssyndrome
C Plununer-Vinsonsyndrome
D. Costen'ssyndrome
19. Which of the following can cause stomatitis and peripheral
neuritis?
A. Mercury B. Lead
C Arsenic D. All of the above
20. Which of the following disorder/sis/are associated with neural
problem?
A. Lupus erythematosus B. Diabetes mellitu s
C Scleroderma D. All of the above
21. The traumatic nerve injury inwhich only the myelin sheath of
the nerve is affected is known as:
A. Neurotmcsis B. Axonotmesis
C Neuropraxia D. None of the above
22. Which of the following nerve palsies is also known as Bell's
palsy?
A. Optic nerve palsy B. Facial nerve palsy
C Lingual nerve palsy D. Trigeminal nerve palsy
 Neurological Disorders of Maxillofacial Regton 105

23. Which of the following is/are characteristic fracture/s of the

Bell's palsy?
A Inability to wrink le the forehead
B. Mouth is drawn to opposite side
C Aff ected side of face is expressionless
D. All of the above
24. Post-traumatic herpes zoster may involve which of the
following nerve/s?
A Sensory nerve distribution of trigeminal nerve
B. Facial nerve
C Glossopharyngeal nerve
D. All of the above
25. The inflammation of the nerve is known as:
A Glossitis B. Neuritis
C Sialadenitis D. Tonsilliti s
26. The mechanism of pain is best explained by:
A Calciwn gate theory
B. Plasma membrane expansion theory
C Reversible coagulation theory
D. Gate control theory
27. Definite trigger zones are present in:
A Trigeminal neuralgia
B. Sphenopalatine neuralgia
C Frey's syndrome
D. Sluder'ssyndrome
 106 MCQs 111 Oral and M<Jxillofac1al S11rgery

Answers
l.C. Motor part mainly supplies the muscles of mastication. The
sensory part has three divisio pthalmic, maxilla.ry and
mandibular .
2.C. Paresis is incomplete paralysis 'denoting neuromuscular
deficit.
3.C. Lesions of the upper motor neurons of the facdal nerve cause
palSy of the lower facial muscles anly.
4.C. Trigeminal nerve carries motor fibers to mu5cles of mastication.
S.C. The g·ranuloma and cyst are painless 1,mless otherwise
infected.
6.D. Other associated symptoms inclu.de pus under the muco­
periosteum and $Welling of the lip or cheek.
7.B. Pain in the ear can also be neuritic type and can produce
facial pain at the onset by referring along th branches of
trigeminal nerve.
S.D. Migraine is found in per.sons who are anxious, rigid,
perfectionists and work hard to f tigue themselves.
9.D. In cluster headache, the pain is throbbing type that begins
deep inthe midface inthe retrobulbar region.and then migratE$
to forehead or temporal region andeven to the lower face.
lO.C. Itoccur insensory nerve distribution of trigeminal, facial and
glassopharyngeal nerves.
U.C. Herpes zoster affects the optha.lmio division more commonly
followed by miilXillary and mandibular divisions.
12.A. Trigeminal neuralgia is one of the most c;qmmonly known
neuralgia of maxillofacial region.
13.B. It has a definite trigger zone meaning. Thereby an area of on
the mucous membrane or the skin from where the pain is
elicited throughout the course of the nerve once this area is
touched.
 Neurolog1cal Disorders of Max1llofac1al Reg1on 107

14.8. Carbamazepine(Tegretal) 100 to 200 mg tablets three times a

day afford significant or even total pain relief and is the
treatment of choice in medicinal therapy for trigeminal
neuralgia.
15.0. Glossopharyngeal neuralgia closely resembles trigeminal
neuralgia and patient experiences same type of pain but in
the distribution of ninth cranial nerve.
16.0. The trigger zone is in pinna of the ear:
17.C. In this type of neuralgia, sphenopalatine ganglion is believed
to be irritated.
18.C. Itcauses atrophy of the mucosa and pain in the tongue.
19.0. Mercury, bismuth,lead, cadmium and arsenic, etc. are known
to cause stomatitis, necrosis of the mucosa,peripheral neuritis,
anemias, encephalopathy, agranulocytosis, etc.
20.0. Itisbelieved that there occurs a segmental demyelination due
to ischemia of the vessels supplying the nerve.
21.C. Neuropraxia occurs some days after trauma and disappears
spontaneously and completely .
22.8. There is inability to wrinkle the forehead and raise the
eyebrow. There may alsohe slight drop of the eyebrow when
the patient closes the eye, the globe turns upward and there is
slight movement of the upper eyelid. This is known as Bell's
sign.
23.0. Patient is unable to maintain oral hygiene. There is food
lodgement and halitosis.
24.0. Pain is experienced during the acute stage. Itmay be followed
by post-herpetic neuralgia exhibiting severe and lancinatin g
pain.
25.8. Traumatic neuritis occurs if the nerve is tom, impinged or
lacerated. The viral infection like herpes zoster can also lead
to neuritis.
26.0. Pain may be defined as an unplea sant sensation perceived by
the patient.
108 MCQs 111 Oral and Maxtllofacial Surgery

27.A. Trigeminal neuralgia has definite trigger zon ;? meaning thereby

an area on the mucous membrane or the skin from where the
pain is elicited throt1ghout the course of the nerve once this
area is touched.
 Tissue Transplantation

1. A tissue graft taken from the same individual is known as:

A. Allograft B. Xenograft
C Autogenous graft D. Isograft
2. Which of the following grafts is also known as
syngenesioplastic grafts:
A. Autogenous graft B. Allogenic graft
C Isogenic graft D. Xenogenic graft
3. A graft taken from a donor of another species is known as:
A. Xenograft B. Allograft
C Autogenous graft D. Isogenic graft
4. Transplantable, synthetic materials of non-animal origin are
called as: ·
A. Allogenic materials
B. Alloplastic materials
C Isogenic materials
D. All of the above
5. Which of the following is/are used as alloplastic materiaVs:
A. Ceramic hydrox ylapatite
B. Tricalcium phosph ate
C Plaster of Paris
· D. All of the above
6. The invading agent causing initiation of the immune response
is called as:
A. Antibody B. Antigen
C Immunebody D. All of the above
7. The specific protein developed in the body in response to an
antigen is called as:
A. Heptan B. Antigen
c Antibody D. Toxin
 110 MCQs mOral and Max 1llofac 1al Surgery

8. Antibodies are released by:

A Plasma cells B. Fibroblasts
C Erythroblasts D. Platelets
9. Which of the following grafts is used in treatment of TMJ
ankylosis to provide future growth center to the mandible?
A Tibia graft
B. lleum graft
C Costochondral juncti on graft
D. Calvariwn graft
10. The first successful autogenous bone graft was reported by:
A VanMeekren B. Hunter
C Merrem D. Krug r
11. Which of the following is the most successful allogeneic bone
storage method?
A Thimerosal coagulation method
B. Merthiolate coagulation method
C Cryobiological methods
D. None of the above
12. The thickness of the split-thickness type of skin graft ranges
from:
A O.l-0.2 mm B. 0.3-0.Smm
C 1-2 mm D. 2-4 mm
13. Which of the following is/are universal sequelae of tooth
transplantation?
A Periapical cyst formation
B. Progressive root resorption
C Ankylosis
D. Both Band C
14. Which of the following is used for the surface decalcification
of the root of the tooth to be transplanted?
A Carbolic acid B. Sulfuric acid
C Citric acid D. Glycerine
15. Which of the following grafts has high success rate?
A. Autogenous graft
B. Allogenic graft
C Isogenic graft
D. Xenograft
 T1ssue Transplantation 111

16. Bone blend is a mixture of:

A. Bone and sulfuric acid
B. Bone and sterile saline
C Bone and sodium hypochlorite
D. Bone and blood
17. Osseous coagulation is a mixture of:
A Bone dust and sterile saline
B. Bone dust and blood
C Bone dust and H202
D. Bone dust and hydrogen
18. Boplant is a xenograft obtained from:
A. Cow bone B. Calf bone
C Horsebone D. Oxbone
19. Which of the following non-bone material/s can be used as
graft?
A Sclera B. Cartilage
C Plaster of Paris D. All of the above
20. Which of the following grafts has the greatest osteogenic
potential:
A A xenograft
B. A freeze-dried bone graft
C An autogenous cortical graft
D. An autogenous cancellous graft
21. White grafts:
A Behave in same manner as autogenous grafts
B. Are rejected without evidence of vascularization
C Are immunologically biocompatible
D. Never rejected
22. Iliac crest graft should ideally be taken from:
A Anteroinferior aspect
B. Posterosuperior aspect
C Lateral aspect
D. Medial aspect
23. Limited accessibility is one of the disadvantages of which of
the following flap?
A. Four cornered flap B. Three cornered flap
C Semilunar falp D. Envelop flap
112 MCQs mOral and Max1llofac1al Surgery

Answers
l.C. Grafts taken from the same individual from one anatomical
site to the other is known as autogenous graft.
2.C. In isograft graft is deri-ved from an individual having same
genetic disposition. ·
3.A. When the graft has been derived from a donor of another
species it is called heterograft or xenograft.
4.8. Examples of alloplastic material include ceramic
hydroxylapatite implants, tricalcium phosphate implants as
well as plaster of Paris.
S.D. The term graft is usually reserved for the true transplantation
of living tissue with success of grafting procedure depending
on the survival of the transplanted cells.
6.B. The foreign body or the graft material that causes the initiation
of an immune response is called an antigen.
7.C. Antigen antibody reaction plays a role in the rejection of the
graft.
8.A. The plasma cells and large lymphocytes are known to produce
antibodies which are released into the body fluids.
9.C. A costochondral or sternoclavricular joint is used in place of
TMJ in order to provide future growth to the mandible as in
cases of TMJ ankylosis and condylar hypoplasia.
10.C. Autogenous grafts are taken from the same individual from
one anatomical site to the other.
ll.C. The most successful tissue storage method s used in the
banking of allogenic bone have been cryobiological in nature,
i.e.by use of cooling, freezing or freeze drying environments.
12.8. Split skin grafts are described as thin, intermediate or thick
according to the thickness of dermis included.
13.0. Progressive root resorption and ankylosis are universal
sequelae of tooth transplantation .
14.C. Citric acid causes demineralization of root surface, thus
inducing cementogenesis and attachment of collagen fibres.
 T1ssue Transplantation 113

15.A. When material to be grafted is obtained from same person it is

called as autogenous graft.
16.B. The bone blend technique uses an autoclaved plastic capsule
and pestte. Bone is removed from a predetermined site,
triturated in the capsule to a workable, plastic like mass, and
packed into bony defects.
17.B. Osseous coagulum tedmique uSes small particles ground from
cortical bone.
18.B. Calf bone (Boplant), treated by detergent extraction, sterilized,
and freeze dried, had been used for treatment of osseous
defects.
19.C. These are known as alloplastic material.
20.0. Marrow with accompanying cancellous bone taken from the
iliac crest can be transplanted autogenously to effect new bone
formation, as they are capable of actively inducing
osteogenesis.
21.B. Inwhite graft vascularization do not occur which causes graft
rejection.
22.0. Inmajority of the cases inner cortex and medulla is harvested.
23.C. Semilunar flap do not have vertical releasing incision so have
limited accessibility.
 Implants in Dentistry

1. Which of the following materials is most commonly used as a

dental implant?
A. Polymers B. Ceramics
C Titanium D. Steel
2. The direct structural and functional conta between bone and
implant is called as:
A. Fibro-osseous integration
B. Fibrous integration
C Osseointegration
D. All ofthe above
3. Which of the following types of implant tissue interface is
most important for the success of the implant?
A. Osseointegration B. Fibro-osseous integration
C Fibrous integration D. Connective tissue integration
4. Which of the followings is most common type of implant used
in dentistry?
A. Endosteal implant B. Subperiosteal implant
C Transosteal implant D. Two piece implant
5. Endosteal implant is integrated into:
A. Soft tissue B. Periosteum
C Bone D. Root canal
6. With regard to anatomic limitations which of the following
sites is most ideal for implant placement? ·
A. Anterior of maxilla
B. Posterior of maxilla
C Anterior of mandible
D. Posterior of mandible
7. Time required fo.r osseointegration in maxilla is:
A. 2 months B. 4 months
C 6 months D. 8 months
 Implants 111 Dent1stry 115

8. Time required for osseointegration in mandible is:

A 2 months B. 4 months
C 6 months D. 8 months
9. Which of the followings is not a metal and alloy type of
implant?
A Titanium B. Cobalt-chromium
C Stainless steel D. Tricalcium phosphate
10. Which of the following is/are type/s of the ceramic implants?
A Hydroxylapatite
B. Aluminium oxide
C Tricalcium phosphate
D. All of the above
11. Which of the following is not a type of endosseous implants?
A Pintype
B. Blade type
C Screwtype
D. Two piece implant
12. Which of the following is not a type of subperiosteal implant?
A Single pin staples
B. Two piece implants
C Complete arch implants
D. Unilateral one piece implants
13. According to shape, implants can be classified into:
A Mucosal inserts and blade vent implants
B. Mandibular staples and hollow basket implants
C Screw implants and plasma sprayed screw implants
D. All of the above
14. Which of the following is/are indication/s for the dental
implants?
A Single missing tooth replacement
B. Multipl e missing teeth replacement
C Poor oromuscular coordination
D. All of the above
15. Contraindication/s for the dental implants is/are:
A Lack of expertise on the part of the dentist
B. Hypersensitivity to dental implant
C Lack of maintenance of good oral hygiene by the patient
D. All of the above
 116 MCQs 1n Oral and Max1llofac1al Surgery

16. The stability of the dental implant depends on:

A. Quantity of the bon e
B. Quality of the bone
C Both quantity and quality of the bone
D. None of the above
17. The minimum healing time period required before the loading
of the dental implants is:
A 1-2 months B. 3-6 months
C 9-12 months D. 15-18 months
18. The min imum distance kept between two adjacents implants
should be:
A lmm B. 2m.m
C 3mm D. 4m.m
19. The minimum distance kept between dental implant and
maxillary sinus should be:
A. 1mm B. 2.m.m
C 3mm D. 4mm
20. The minimum distance between dental implant and superior
border of the inferior alveolar canal is:
A. 3mm B. 4rrun
C 2mm D. 5mm
21. The minimum amount of bone required around the perimeter
of dental implant is:
A. 2mm B. lmm
C 4 mm D. 3mm
22. Which of the following sites should be avoided for implantation
in order to save the contents of the incisive canal?
A. Anterior of mandible
B. Anterior of maxilla
C Posterior of maxilla
D. Posterior of mandible
23. Which of the following implants is mainly used in atrophic
mandible?
A. Mucosal inserts
B. Subperiosteal implant dentures
C Blade vent implants
D. Screw implants
 Implants m Dentistry 117

24. Which of the followings is recommended when there is

inadequate bone for the placement of implaJ1l intQ the bone?
/L Endosteal implants -
B. Subperiostepl implants
C Tran&osteal implants
D. S<_:r w type of implants
118 MCQs 111 Oral and Maxillofacial Surgery

Answers
l.C Titanium is the most acteptable material in terms of
biocompatibility .
2.C. The success of the implant is directly related to the amount of
contact between the bone and the implant.
3.A. Osseointegration is comparable to ankylosis of a tooth as it
involves direct connection between the bone and a load
carrying implant.
4.A. Endosteal implants are placed into the bone and engage
endocortex for fixation.
S.C. Endosteal implants are surgically placed within the alveolar
and basal bone.
6.C Trans.osteal implants are combination of subperiosteal and
endosteal implants. These are especially used in the anterior
part of the mandible.
7.C. Midlin of maxilla is always avoided for implantation in order
to save the contents of the incisive canal.
S.B. Because of dense bone in mandible the time required for
osseointegration in mandible is less than maxilla.
9.0. Tricalcium phosphate is an implant made of ceramics.
10.0. Implants made of carbon .are made up of vitreous carbon
implants and low temperature isotropic pyrolitic carbon
implants.
11.0. Cylindrital type also comes under endosseous implants.
12.A. Single pin staples comes under transosseous implants.
13.0. According to functional performance,implants are classified
into retentive·,and supportive implants.
14.0. In the present circumstances, it is an elective procedure
recommended for patients who are incapable of wearing a
removable denture prosthesis.
15.0. Unmotivated patients· are not good candidates for dental
implants. ·
 Implants m Dentistry 119

16.C. The success of implant depend upon a variety of factors like

biocompatibitity, implant tissue interface, quality of bone,
surgical techniqu e, undisturbed healing pha se and infection,
etc.
17.8. After 3 to 6 months (3 months in mandible and 6 month in
maxilla) overlying mucosa is excised to expose the healing
cap.
18.C. A gap of 2 mm mu st be maintained between inferior alveolar
canal and apical end of implant.
19.A. An implant exhibit better initial stability if both superior and
inferior cortical plates are use for stabilization.
20.C. For an endosseous implant to deliver the desired results, a
minimum implant length of 6 mm is required.
21.8. An osseointegrated implant can be stress loaded in terms of
masticatory function equivalent to the natural dentition.
22.8. Incisive caraJ is present in anterior region of maxilla so implant
placement is avoided here.
23.8. Maxillary subperiosteal implants are normally not used due
to poor success rate.
24.8. Subperiosteal implants rest on thebone under the periosteum.
 Local and Gen---
Anesthesia in
Oral Surgery

1. Analgesia means:
A Loss of consddusness
B. Loss of pain sensation and loss of consciousness
C Loss of pain sensation without loss of consciousness
D. All of the above
2. Cocaine was first discovered by:
A. Koller B. Niemann
C Hall D. Einhom
3. Which of the following local anesthetic agents is
vasoconstrictor?
A Procaine
B. Cocaine
C Xylocaine
D. Benzocaine
4. Which of the following is true about local anesthetic agents?
A All local anesthetic agents are vasodilators
B. All local anesthetic agents are vasoconstri ctors
C All local anesthetic agents are vasodilator s except cocaine
which is a vasoconstrictor
0. All local anesthetic agents are metabolized in liver
5. Which of the following local anesthetic agents is not synthetic?
A Procaine
B. Cocaine
C Xylocaine
D. Tetracaine
 Local and General Anesthes1a 111 Oral Surgery 121

6. Which of the following is/are the advantage/s of adding

vasoconstrictor with local anesthetic agent?
A. Itdecreases the absorption of local anesthetic agent from the
site of injection
B. It decreases the bleeding
C It decreases the systemic toxicity of the LA
D. All of the above
7. Which of the followings is most commonly used local
anesthetic solution in oral surgery?
A. Procaine B. Lidocaine
C Chloroprocaine D. Cocaine
8. Which of the followings is an amide type of local anesthetic
agent?
A. Procaine B. Chloroprocaine
C Tetracaine D. Lidocaine
9. Amide type of local anesthetic agents are metabolized in:
A. Liver B. Plasma
C Kidney D. Lung
10. Ester type of local anesthetic agents are metabolized in:
A. Liver
B. Plasma
C Liver and plasma
D. Liver and kidney
11. Which of the following sensations is lost first under local
anethesia?
A. Pain B. Touch
C Pressure D. Thermal
12. Which of the following is true about local anesthetic agents?
A. All are vasoconstr ictors
B. All are myocardial stimulant
C All are myocardia l depressants
D. All of the above
13. Which of the following local anesthetic agents is used as an
antiarrhythmic agent?
A. Tetracaine B. Benzocaine
C Lidocaine D. Cocaine
122 MCQs mOral and Max•llofacial Surgery

14. Which of the following is most commonly used vasoconstrictor

in present day practice?
A. Dopamine B. Felypressin
C Adrenaline D. Noradrenaline
15. The standard American cartridges contain:
A. 1ml of the anesthetic solution
B. 1.5ml of the anesthetic solution
C. 1.8ml of the anesthetic solution
D. 2 ml of the anesthetic solution
16. A solution containing adrenaline as 1:100,000, contains how
many milligrams of adrenaline per ml?
A. 0.0001 mg/ml B. 0.001 mg/ml
C. 0.01 mg/ml D. 0.1 mg /ml
17. Which of the followings is used as a reducing agent in local
anesthetic solution?
A. Thymol B. Methyl paraben
C Sodium metabisulfite D. Clove oil
18. Which of the followings is used as a preservative in local
anesthetic solution?
A. Adrenaline
B. Sodium metabisulfite
C Methylparaben
D. Thymol
19. Which of the following is/are contraindication/s of local
anesthetic with adrenaline?
A. Allergy to local anesthetic solution
B. Acute infection
CHyperthyroidism
D. All of the above
20. The length of a needle required for a nerve block is:
A. 30mm B. 38mm
C 42mm D. 48mm
21. The infiltration anesthesia is not effective in anesthetizing
which of the following teeth?
A. Maxillary anterior teeth
B. Maxillary posterior teeth
C Mandibular anterior teeth
D. Mandibular posterior teeth
 Local and General Anesthesia mOral Surgery 123

22. The nervus tentorii is the branch of which of the following

division of trigeminal nerve?
A. Ophtha lmic division
B. Maxillary division
C. Mandibula r division
D. Inferior alveolar nerve
23. The mesiobuccal root of maxillary first molar is supplied by:
A. Posterior superior alveolar nerve
B. Middle superior alveolar nerve
C Anterior superior alveolar nerve
D. Inferior alveolar nerve
24. Greater palatine foramen is situated between which of the
following teeth?
A. Maxillary first and second premolars
B. Maxillary first molar and second premolar
C Maxillary first and second molar
D. Maxillary second and third molar
25. Which of the following stages of general anesthesia is the stage
of surgical anesthesia?
A. Stage I B. Stage II
C Stage Ill D. Stage IV
26. Respiration is absent in which of the following stages of general
anesthesia ?
A. Stage I B. Stage II
C Stage Ill D. Stage IV
27. Which of the following is known as laughing gas?
A. Halothane
B. Ether
C Nitrous oxide
D. Thiopentonesodium
28. Which of the following general anesthetic agents is used for
induction of anesthesia?
A. Nitrous oxide B. Thiopentone sodium
C Ketamine D. Ether
29. Which of the following is most commonly used general
anesthetic agent?
A. Ether B. Chloroform
C Halothane D. Ethyl chloride
 124 MCQs in Oral and Maxtllofacial Surgery

30. Which of the following sensitizes myocardium to adrenaline

causing arrhythmias?
A. Tiuopentone sodium
B. Nitrous oxide
C Halothane
D. Ketanline
31. Which of the following is/are complicationls of the general
a nesthesia?
A. Respiratory depression
B. Laryngcalspasrn
C Bronchospasm
D. All of the above
32. Which of the following is used for the treatment of malignant
hyperthermia?
A. Halothane B. Dantrolene sodium
C Ketamine D. Adrenaline
33. The semilunar ganglion is related to which nerve?
A. Facial nerve B. Trigeminal nerve
C Vagus nerve D. Optic nerve
34. Thymol in local anesthetic solution is used as:
A. Preservative B. Reducing agent
C. Oxidising agent D. Fungicide
35. Which of the following is/are systemic complicationls of local
anesthetic solution ?
A. Hypersensitivity B. Toxicity
C Fa inting D. All of the above
36. The primary cause of toxic manifestation following injection
of a vasoconstrictoris:
A. Allergic reaction
B. Intramuscular injection
C Intravascular injection
D. Injection into a nerve truck
37. The most common postoperative complication of outpatient
general anesthesia is:
A. Lung abscess
B. I 'reuamonkia
C Nausea
D. Carpopedal spasm
 Local and General Anesthesia in Oral Surgery 125

38. The most common emergency seen after the use of local
anesthetics is:
A. An allergic reacti<.m 'B. A toxl.c reaction
C. Trismus D. Syncope
39. Hydrolysis of anesthetic salts is facilitated by:
A. A tissue pH above 7.0
B. A tissue pH below 5.0
C A tissue pH between 5.0-7.0
D. Upophilic properties of the nerve fiber
40. After giving a posterior superior alveolar nerve block, the
patient should experienc::e:
A. Numbness of the palate·
B. Numbness of the side of his face
C Numbness of .the infraorbital nerve
D. Few subjective signs of anesthesia
41. The best" monitor oJ the level of analgesia:
A. Respiration B. Verbal re$ponse
C Muscle tension 0. Eye movements
42. Which of the following maxillary teeth is most difficult to
anesthetize by infiltration technique?
A. Canine B. First molar
C Third .molar D. First premolar
43. WhiCh of the following muscle is most frequently involv d in
an incorrect anterior superior alveolar nerve block?
A. Quadratus labii supetioris
B. Mentalis
C Risorius
D. Orbicularis oris
44. Which of the followings is/are contraindication/s for nitrous
oxide-Qxygen sedation:
A. Emphysema
B. Emotional instability
C Upper respiratory obstro tion
I;>. All of the above
4_5. Sedation by which of the following routes can be reversed
mosttapidly?
A. Oral B. lntt"amuscular
C Intravenou s D. Inhalation
 126 MCQs in Oral and Maxtllofactal Surgery

46. Trismus seen the day after a mandibular block usually means
injury to which of the following muscles?
A. Medial pterygoid B. Lateral pterygoid
C Temporalis D. Masseter
47. The maximum dose of adrenalin which can be given to a
patient with history of cardiovascular disease is:
A. 4 mg/ ml B. 0.4 mg/ml
C 0.04mg/ml D. 0.0004mg/ ml
48. Which of the followings is the safest local anesthetic agent?
A. Propoxycaine B. Chloroprocaine
C Procaine D. Cocaine
49. Entonox is:
A. SO% ether + 20% 02 mixture
B. 50% N20 + 20% 02 mixture
C N20 +halothane mixture
D. 50% N20 + 50% 02 mixture
50. Which of the following muscles ismost frequently encountered
in incorrect infraorbital nerve block?
A Risorious
B. Quadratus labii superiors
C Triangularis
D. Orbicularis oris
51. Most reactions following injection of LA are caused by:
A Over dosage B. Toxicity
C Anxiety D. Allergy
52. How many mg of 2% lidocaine is present in the cartidge?
A. 18mg B. 36mg
C 180 mg D. 360 mg
53. Preferable patient position in recovery room after ambulatory
general anesthesia is:
A Supine B. Sitting
C Prone D. Lateral
54. The primary site of action of local anesthetic agents is:
A NodesofRanvier
B. Nerve membrane
C Substantia gelatinous
D. Medulla oblongata
 Loca l a nd General Anestl1es1a m Oral Surgery 127

55. lntraoral injection to block second division of the trigeminal

nerve should be given in the:
A Foramen spinosum
B. Foramen ovale
C Pterygopalatine fossa
D. Infraorbital foramen
56. Which of the following is the main route of elimination of
nitrous oxide?
ASkin B. Lungs
C Liver D. Kidneys
51. Which of the following innervates the buccal gingiva of the
maxillary second premolar? ··
A Buccal nerve
B. Anterior palatine nerve
C Posterior palatinenerve
D. Middle superior alveolar nerve
58. Local anesthetics are most effective in tissues that are:
A Acid B. Neutral
C Slightly alkaline D. Inflammed
59. In the gate theory of pain, pain is modulated primarily by:
A. "B" .fibers
B. "C"fibers
C The transmission system
D. The substantia gelatinosa
60. Which of the following methods can be used to control pain
except
A Psychosomatic methods
B. Removing the cause
C Raising the pain threshold
D. Preventing the pain reaction by causing depression of the
autonomic nerves system
128 MCOs in Oral and Maxillofac ial Surgery

Answers
l.C. Anesthesia can be defined as loss of all sensations either due
to a neurological disorder, or by administration for drugs or
other medical interventions. ·
2.8. Cocaine was discovered in 1859 by Niemann and was used
and demonstrated by Karl Koller on 15 Sept. 1884, who
instilled the drug into the eye.
3.B. Vasoconstrictors are added to the local anesthetic solutions
for counteracting their vasodilatory effect.
4.C. Since all local anesthetic agents but for cocaine are
vasodilators, they are rapidly absozt,ed. into blood stream from
the point of injection. ·
S.B. Procaine, Xylocaine and Tetracaine are synthetic nitrogenous
compounds.
6.0. Vasoconstrictors also helps in minimizing the dose
7.B. Lidocaine 2% is most commonly used local anesthetic in oral
surgery.
8.0. Procaine, chloroprocaine and Tetracaine are ester type of local
anesthetic agent.
9.A. The agents with amide type linkage are metabolized in liver
by a hydrolytic process .
lO.C. Those with ester type linkage (procaine) are metabolized by a
pseudocholinesterase found in liver as well as plasma.
ll.A. After giving LA somatic afferent sensations are lost in the
order of pain, temperature, touch and deep pressure.
12.C. Almost all local anesthetic agents with the expecption of
cocaine produce hypotension.
l3.C. Local anesthetics are myocard ia l depressants. The heart rate
and force of contraction is decreased.Therefore, conduction
is slowed down.Cardiac output is reduced. Itis for this reason
lidocaine is also used as antiarrhythmic agent.
14.C. The most commonly used vasoconstrictor in present day
practice is adrenaline in the concentration of 1:100,000 to
1:200,000 .
 Local and Gene ral Anesthesia mOral Surgery 129

15.C. The standard American cartridges contain 1.8 ml of the

anesthetic solution.
16.C. Since the safe d ose of adrenaline is approximately 0.25 mg,
not more than 20 ml of the solution should be used in a normal
healthy adult patient.
17.C. Reducing agent competes for the available oxygen in the vial.
18.C. Preservatives a re added to maintain the stability of the
solution.
19.0. Other contraindic a tions include liver disorders, rena l
disord rs, very fearful and apprehensive patients, etc.
20.C. The length of needle required is 42 mm for a nerve block and
25 mm for submu cosal and subcutaneous infections.
21.0. Infiltration anethesia is not effective in case of mandibular
premolars and molars because of the thick cortical plate in the
posterior region .
22.A. Inthe middle cranial fossa,ophthalmic division gives nervus
tentorii to supply the dura.
23.B. Middle superior alveolar nerve is sensory to lining of maxillary
antrum and maxillary bicuspids as well as mesiobuccal root
of maxillary first molar.
24.0. Greater palatine nerve (anterior palatine nerve) emerges on
hard palate through greater palatine foramen.
25.C. Stage of surgical anesthesia is commonly divided into four
planes indicatin g increa sing depth of anesthesia a nd
progressive loss of reflexes.
26.0. Pupils are wid ely dilated. Blood pressure is very low and
pulse is extremely feeble. The skin is cold and ashen grey.
27.C. Nitrous oxide is a sweet smelling, non-irritating and colorless
gas and is heavier than air it is neither inflammable nor
explosive .
28.B. Disadvantages of thi opental sodium are respiratory and
circulatory depression and tendency to laryngospasm.
29.C. Halothane is a potent anesthetic agent, pleasant to smell and
non-irritant.
 130 MCQs m Oral and Maxillofacial Surgery

30.C. Halothane causes hypotension and bradycardia and

predisposes to arrhythmias under light anesthesia,
hypercarbia or hypoxia especially when there is endogenous
or exogenous catecholamine increase.
31.0. General complications of thiopental sodium are respiratory
depression, circulatrory collapse, laryngospasm, coughing,
postoperative vertigo, drowsiness, euphoria, anaphylaxis and
cutaneous allergy.
32:8. Malignant hyperpyrexia is a genetically inherited condition
of ryanodine 1receptor mutation leading to calcium channel
abnormally resulting in heat production.
33.8. Maxillary division of trigeminal nerve arises from middle of
semilunar ganglion.
34.D. To be on the safer side, a small quantity of thymol is added to
the local anestheic solution.
35.0. Other systemic complications include idiosyncrasy, malignant
hyperthermia, hyperventilation ,drug interaction, etc.
36.C. Local anesthetic agents are known to produce toxic reactions
especially following intramuscular injections of large doses.
37.C. Postoperative nausea and vomiting is due to anesthetic agent
and technique, patients factors, condition of stomach and
surgical factors.
38.0. The common causes of fainting are anxiety, long wait in the
dental office, empty stomach, sight of blood, fear of infection,
tension of operation and cries of other patients.
39.A. Anesthetic salts are hydrolysed in alkaline medium
40.D. Few subjective symptoms are reported with this injection and
instrumentation is required to demonstrate absence of pain.
41.8.
42.8. In infiltration technique anesthetic solution is injected to
anesthetize the terminal branches or nerve endings in the area
of surgery generally under the mucosa or the skin.
43.A. Infraorbital nerve block is a block of anterior and middle
superior alveolar nerves.
 Local Llnd General Anesthes ia mOral Surgery 131

44.0. Nitrous oxide is a sweet smelling, non-irritating, colorless

gas and is heavier than air.
45.0. Inhalation anesthesia is achieved using gases and anesthetic
vapor, the partial pressure of these agents exerted in the brain
determines the depth of anesthesia.
·46.A. While giving inferior cheolar nerve block injury to medial
pterygoid muscle causes trismus.
47.C. The vasoconstrictor agents are contraindicated in
hyperthyroidism, diabetes mellitus, hypertension, coronary
insufficiency, cardiac illness and internal hemorrhages.
48.B. Chlorprocaine has ester type of linkage and are metabolized
in liver as well as plasma.
49.0.
SO.B.
Sl.C. Local anesthesia is not recommended for fearful and
apprehensive patients who refuse for in:jection.
52.B. 9.2 Grains of lignocaine in roughly one fluid ounce of water
make 2% solution.
53.0. Lateral position (perhaps with slight head, c,lown tilt) is safest
for the airway, with one or other knee drawn upto prevent
rolling.
54.B. Local anesthetics inhibit the propagation of nerve impulses
along fibers at sens6ry endings at myone.ural junctions and at
synapses, etc.
55.C. After passing through foramen rotundwn maxillary nerve
enters into pterygopalatine fossa where LA solution block
the nerve.
56.B. Nitrous oxidehas a very rapid onset and offset of action because
of its low blood gas partition coefficient (0.47) .
57.0. Middle superior alvecJlar nerve is sensory to lining of maxillary
antrum and maxillary bicuspids as well as mesiobuccal root
of maxillary first molar. ·
58.C. The best results of local anesthetic solutions are achieved in
normal body pH that is slightly basic innature. These solutions
do not work in highly acidic atmosphare.
132 MCQs mOral and Maxillofactal Surgery

59.0. In Gate control theory, it is contested that a painful stimulus

excites T-cells in the spinal cord that activate the ascending
neural path.
60.D. While diagnosing and treating a case of pain in maxillofacial
region, psychological and physical factors must be taken into
consideration .
 Orthognathic Surgery

1. The fine tooth movements can be achieved by:

A. Orthognathic surgery B. Orthodontic methods
C Orthopedic surgery D. All of the above
·2. The orthognathic surgery is usually done:
A. During normal facial growth
B. During accelerated facial growth
C After facial growth is completed
D. All of the above
3. By the age of fourteen years how much of facial growth is
completed:
A. 5-10% B. 25-35%
c 55-65% D. 85-95%
4. When the masticatory load is increased, the vertical growth of
maxilla :
A. Remains same B. Is increased
C Is decreased D. None of the above
5. When the mandible is advanced the masticatory forces:
A. Remain same B. Are decreased
C Are increased D. None of the above
6. Which of the following force/s on condyle can stimulate the
mandibular growth?
A. Tensile force B. Compressive force
C BothAandB D. None of the above
7. Which of the following is characteristic feature of the
dolichocephalic person?
A. Broad face
B. Short face
C Long and narrow face
D. U shaped arch
 134 MCQs mOral and Maxillofacial Surgery

8. The nasolabial angle may vary from:

A. 2o -4o· B. 3o·-so·
c ss -7s· D. 90·
-no·
9. The normal value of gonial an,gle is:
A so· B. 75·
c 1oo· D. 125·
10. The ratio of maxillary length to mandibular length is:
A 1:2 B. 1:3
C 1:1.3 D. 1:4
11. Apertognathia means:
A. Deepbite B. Openbite
C Crossbite D. Posterior cross bite
12. The person who has undergone cleft palate surgery is
characterized by:
A Normal maxilla
B. Maxillary retrusion
C Maxillary protrusion
D. Straight profile
13. The person who has undergo_ne cleft palate surgery has a:
A. Straight profile
B. Convex profile
C Concave profile
D. Maxillary protrusion
14. Which of the followings is/are common surgical procedure/s
done on the maxilla?
A. Lefort osteotomy
B. Anterior segmental osteotomy
C Posterior segmental osteotomy
D. AU ofthe above
15. Anterior segmental osteotomy can be used for correction of:
A Maxillary protrusion
B. Dentoalveolar protrusion of the upper arch
C Deepbite
D. All of the above
16. Posterior segmental osteotomy can be used for correction of:
A Anterior cross bite B. Posterior cross bite
C Anterior open bite D. Both Band C
 OrthognathiC Surgery 135

17. Sagittal split osteotomy can be used for correction of:

A.. Mandibtilar prognathism
B. Mandibular retrognathism
C Apertognathia
D. All of the above
18. Which of the followings is/are indicationls for the anterior
maxillary segmental osteotomy?
A. Decreased nasolabial angle
B. Increased overjet
C Class IImalocclusion
D. All of the above
19. Which of the following procedure/s can be used for the
correction of maxillary excess?
A Wassmund technique
B. Wunderer technique
C. Epker's technique
D. Allof the above
20. Which of the following procedure/s can be used for
advancement of the mandible?
A. 'C'osteotomy
B. Extraoral vertical ramus osteotomy
C. Inverted f L' osteotomy
D. BOth A and C
21. The sagittal split osteotomy procedure was devt!loped by:
A. Wassmund
B. Wunderer
C Epker .
D. Obwegeser
22. Which of the followings is/are advantage/s of the sagittal split
osteotomy?
A It avoids an external scar
B. It avoids injury to themarginal mandibular nerve
c. cbe used for oorrection of open bite
D. All of the above
23. Genioplasty is the procedure which is used for the correction
of deformities of the:
A Nose B. Genial tUbercle
C Chin D. Cheek
136 MCQs mOral and Maxillofacral Surgery

24. The first and second arch syndrome is characterized by:

A. UnderdeveJopmentofTMJ
B. Underdevelopment of muscles of mastication
C Underdevelopment of maxilla
D. All of the above
25. Bilateral ankylosis ofTMJ results in:
A. Macrognathia
8. Micrognathia
C Protrusion of mandible
D. Retrusion of maxilla
 Orthognath1c Surgery 137

Answers
1.8. Tooth movements like rotation and tilting, correction of
crowding.and spacing, etc..arebetter managed by orthodontic
modalities.
:Z.C. It is>accepted generally that sllz'g ry is done usually after the
facial growth is c9mpleted 9the ise the chances of relapse
are higher.
3.0. tween 14-arid 18 years an -average female·exhibits only 3
t;n.rr!. of
manibular growth.
4.C. When the mesticatory load are increased the v rtical growth
of maxilla is decreased .
5.8. If the mandible is advanced, the masticatory force is- reduced
-and vice vers.a.
6.A. Compressive force can retard the mandibular growth.
7.C. The dolichocephalic person has got a long narrow face with a
'V' shaped dental arch.
8.0. Inmaxillary protrusion the angle isreduced.·
9.1). Gonial angle is- the angle formed at the angle of the mandible
betweea tbe IM.Jldibular plane and posterior border of the
mandible.
lO.C. The measurements are taken from condylion to point A
(maxillary length) and from con¢lylion to gnathion
(¢andibular length). ·
11.8. Open bite deformity is also called as Apertognathia.
12.8. This also may be assOciated with certain syndromes of the
head and neck.
13.C. Maxillary retrusion is seen in. almost all persons who had
und 6n cleft palatesurg .
14.0. LeFort osteotomy-is mainly used for the correction.of vertical
-excers of the·m:a.xiila .
15.0. Anterior segmentel osteo.tomy of the maxiUa is usually
performed on the patients having decreased nosolabial angle,
close II malo<;clusion, pronourtced overjet and overbite. -
 138 MCQs 111 Oral and Maxillofacial Surgery

16.0. Posterior segmental osteotomy is used for correcting posterior

cross bite and anterior open bite.
17.0. Sagittal splitosteotomyisa versatile procedure, which can be
used for both prognathism and retrognathism.
18.0. Anterior segmental osteotomy of the maxilla is usually
performed on the patients having horizontal excess of the
maxilla .
19.0. The major difference between the Wundercer technique and
the Wassmund technique is that in the former the palatal flap
i s raised completely instead of tunneling as in the later.
20.0. The bony cut is fashioned as a 'C' or inverted 'L' shape.
21.0. Sagittal split osteotomy is a versatile procedure, which can be
employed for the correction of retrognathism and prognathism.
22.0. However, th e chances of injury to the mandibular
neurovascular bundle is greater and the surgery demands
more expertise and precision than the extraoral one.
23.C. It is possible to reposition the chin in all the three dimensions
of space.
24.0. This syndrome is characterized by the underdevelopment of
th e temporomandibular joint , mandibular ramu s and
associa ted muscles of mastication.
25.B. This is known as bird face appearance.
 Emergencies and
Complications in
Oral Surgery

1. HypeiVe_ntilation is characterized by:

A. Hypoxia
B. Hypercapnea
C Increase in level of C02 inblood
D. Hypocapnea
2. Which of the followings can cause hypotension?
A. Shock
B. Adrenal crisis
C Hypoglycemia
D. All of the above
3. Tachycardia is characterized by:
A. Nonnalheartrate
B. Heart rate below 60 beats/minute
C Heart rate below 70 beats Iminute
D. Heartrateabove lOObeats/minute
4. Which of the following is not a sign or symptom of
hypoglycemia?
A. Pallor
B. Sweating
C Tremors
D. Dryskin
5. Hyperglycemia is characterized by which of the foilowings?
A Polydipsia
B. Polyurea
C Polyphagia
D. All of the above
 140 MCQs mOral and Maxillofacial Surgery

6. The fracture of floor of nasal cavity can occur during the

extraction of which of the following teeth?
A. Maxillary third molar
B. Maxillary second molar
C Maxillary first molar
D. Maxillary premolars and canine
7. Emphysema is characterized by:
A. Collection of pus in interstitial connective tissue
B. Collection of blood in interstitial connective tissue
C Collection of air in interstitial connective tissue
D. Collection of lymph in interstitial connective tissue
8. A maxillary third molar during extraction can be accidentally
pushed into which of the following space/s?
A. Pterygomaxillary fossa
B. Maxillary antrum
C Infratemporal space
D. All of the above
9. An internal approach can be used for the removal of a tooth
displaced into which of the following space/s?
A Submandibular space
B. Pterygomandibular space
C Parapharyngeal space
D. All of the above
10. Collection of blood in the tissues resulting in a tumor like mass
is called as:
A. Ecchymosis B. Emphysema
C Hematoma 0. Melenoma
1I. The stone present in nose are called as:
A. Antroliths B. Rhinoliths
C. Sialoliths D. Odontoliths

12. A foreign body aspirated by a patient usually goes into:

A. Left lung B. Right lung
C Liver D. Kidney
13. A tooth which is completely displaced out of its socketis called
as:
A. Luxated B. Intruded
C Avulsed D. Extruded
 Emergencies and ComplicatiOns 111 Ora l Surgery 141

14. A fracture of tooth involving enamel and dentine without

exposure of pulp is called as:
A. Class I fracture
B. Cl<t$S II fracture
C Class illfracture
D. Class IV fracture
15. Anaphylactic shock can occur in which type of allergic reaction?
A. Type!
B. Typell
C Typeffi
D. TypeiV
 142 MCQs mOral and Max 1llofae al Surgery

Answers
l.D. Hyperventilation results in lowered level of C02 in the blood
or hypocapnea, which in turn cause reduction in cerebral
blood flow, decreases in peripheral resistance le ding to
hypotension.
2.D. The systolic blood pressure that was previously normal if
drops below 80 mm of Hg denotes·hypotension.
3.0. Abnormally fast heart .rate (tachycardia) or irregular beats
and missing beats (arrhythmias) are conditions that may lead
to an emergency in the dental office.
4.0. Dry skin is seen in hyperglycemia .
S.D. Patient has typical acetone breath with a rapid deep breathing.
6.0. Oronasal communications are also Seen following fractures
of middle third facial skeleton involving the palate..
7.C. Emphysema can be seen following an injection of local
anesthetic incase the air from the syringehas not been·removed
prior to injection.
8.0. A blind searcll for the tooth and root pieces in the antrum,
spaces of neck and in the inferior dental canal should never
be done.
9.D. The position should be localized with the help of radiographs
like PA view of mandible, true lateral ·view of the skull and .
mandible and lateral oblique view of mandible.
lO.C. Hematoma can be formed as a result of blunt trauma or an
injury to a vessel as during injection of local anesthetic .agent.
ll.B. Antroliths are calcareous bodies or s'tones found in the
maxillary antrum.
12.B. Because the bronchus Qf right lung lies almost in straight line.
with trachea . Foreign bodies should be removed in case they
are lodged in vicinity of vital structures like.a major vessel or
a nerve especially when it has got sharp edges.
13.C. Tooth avulsion is displacement of tooth out of its socket.
 Emergenc•cs and Complications 111 Oral Surgery 143

14.B. A fracture of tooth involving enamel and dentine with

exposure of pulp is called as class III fracture.
15.A. For anaphylaxis to develop, an initial exposure to an antigen
is necessary to produ ce specific antibodies which in tum
attach themselves to cell walls of the tissues, mast cells and
circulating basophils .These sensitized antibodies are capable
of initiating anaphylactic reaction on subsequent exposure to
antigens.
 Acquired Defects of
the Hard and Soft
Tissues of
the Face

1. Which of the followings is/are disadvantage/s of the split

thickness graft:
A. Lack of depth for contour problems
B. Pigmentary changes
C Marked tendency to contract
D. All of the above
2. Full thickness graft is also known as:
A. Esser graft B. Waldron graft
C Wolfe'sgraft D. Obwegesergraft
3. Z- plasty is a:
A. Single rotation flap
B. Double rotation flap
C Triple rotation flap
D. None of the above
4. Which of the following method/s is/are most effective in
releasing tension on a linear contracture?
A. Z- plasty
B. V-Yprocedures
C Y-V procedures
D. V procedures
5. Which of the following is/are disadvantage/s of the bone and
cartilage filling materials?
A. Resorption
B. Distortion
C Difficulty of shaping
D. All of the above
 Acqu1red Defects of the Ha rd and Soft T 1ssues of F ace 145

6. Which of the following materials can be used for the surgical

repair of the facial defects?
A Vitallium and tantalum
B. Polyethylene and teflon
C Rubber silicone
D. All of the above
7. Which of the following is not a characteristic feature of the
proplast?
A Itis a polymer of tetrafluoroethylene
B. Itexhibits microporosity
C Ithas high tensile modulus
D. Itis thermostable
8. Which of the following is not an indication for bone grafting of
the mandible?
A Non-union of fractures of mandible
. Extreme atrophy of mandible
C Full thickness loss of mandibular segments due to truma,
infection,etc
D. Both A and B
9. Which of the following grafts is most widely used and isgraft
of choice for repairing facial defects?
A Homogenous graft
B. Xenograft
C Heterogenous graft
D. Autogenous graft
10 The split thickness graft can be used for restoring defects f:
A Oral cavity B. Nasal cavity
C Orbit D. All of the above
 146 MCQs in Oral and M<Jxlllofaclal Surgery

Answers
l.D. Grafts do not take well in infected areas,-overexposed cartilage
or bone, or in avascular area.
2.C. The only disadvantage of the full thickness graft is the
decreased chance of graft survival as compared with split
thickness graft.
3.B. Z-plasty is the most effective method for releasing tension on
a linear contracture.
4.A. The rotation of the flaps allows the direction of tension to be
changed, with consequent relaxation of the tension of the
original axis.
S.D. Bone continues to be popular for correcting contour defects,
particularly fresh autogenous bone.
6.0. Tantalum has been used in the form of plates for cranioplasty
and is easily adapted to defects, although it tends to leave a
dead space on the undersurface .
7.C. Proplast has been used successfully in contour correction,
otological reconstruction, as an interface for metallic
mandibular condyles, and laminated to Teflon as a
temporomandibular joint cushion.
S.C. Bone grafts are indicated incases of nonunion of fractures of
the mandibular in which freshening of the fractured ends
would result in foreshortening of the mandible. Bone grafts
may be indicated inof e><;treme atrophy of the mandible.
9.0. Autograft is graft taken from the same individual. This graft
give best result.
10.0. Spl.itthicknessgraftsmaybeusedtoconvertprimarytraumatic
wounds into dosed wound if there is not enough local tissue.
 Miscellaneous

All India PGDEE 2004

1. In Winter's WAR line, Amber line represents the:

A Relative depth of the Illrd molar
B. Point of application of th.e elevator
C. Bone level covering the impacted tooth
D. Axial inclination 9f the impacted tooth relative to lind molar
2 Unilateral TMJ ankylosis is associated with the following
features, except
A Multiple carious teeth
B. Facial asymmetry with fullness on the normal side of
mandible
C. Chin deviated towards the affected side
D. Prominent antegonial notch on the affected side
3. In dislocated condylar fractu.res, the condyle is dislocated:
A Medially due to the attachment of medial pterygoid
B. Laterally due to the attachment of lateral pterygoid
C. Laterally due to the attachment medial ptergyoid
D. Medially due to the attachment of lateral pterygoid
4. Ostectomy procedure is indicated in:
A Physiologial architecture of alveolar bone
B. Correction of tori
C. Reverse architecture bony defects
D. Correction of bone ledges
148 MCQs in Oral and Maxillofacial Surgery

Answers
1.A. Amber line runs at the level of the crest of interdental septum
behveen the molars and represents the bone level covering the
i mpacted tooth.
2.A. lf the ankylosis is unilateral some degree of movement is
possible because of the normal joint on the opposite side.
3.0. As soon as the condyle is pulled from its place, the ramus of
the mandible is pulled up by the elevator muscles.
4.C. Ostectomy includes the removal of tooth supporting bone. It
is not done in case of torus removal and physiological alveolar
bone architecture. Bony ledges are corrected by osteoplasty so
the answer is reverse architecture bony defects.
 All India PGDEE 2005

1. Amide-type local anesthetics are metabolized in the:

A. Serum B. Liver
C Spleen D. Kidneys
2. The rate of injection of intravenous valium is:
A. lml/min. B. 2.5ml/min.
C 1mg/ min. D. 2..5 mg/ min.
3. The most common site of leak in CSF rhinorrhoes is:
A. Sphenoid sinus
B. Frontal sinus
C Cribriform plate
D. Tegmen tympani
4. The longest acting local anesthetic is:
A. Prilocaine B. Lignocaine
C Bupivacaine D. Ropivacaine
5. InGillies temporal approach for reduction of Zygomatic arch
fracture Rowes Zygomatic elevator is placed between :
A. Superficial fascia and the temporal fascia.
B. Between the temporal bone and the temporalis muscle.
C Between the temporal fascia and the temporalis muscle.
D. Skin and superficial fascia.
6. Mucoperiosteal flaps:
A. When raised do not cause postoperative swelling and pain .
B. Are raised whenever bone removal is desired to facilitate
extraction.
C Are rountinely raised during extraction .
D. When raised will cause trauma and injury to underlying
osseous tissues.
7. The agent of choice to reverse status ep.ilepticus induced by
local anesthetic overdose is:
A. Oxygen B. Diazepam
C Epinephrine D. Phenobarbital
8. Abbey-Estlander flap is used inthe reconstruction of:
A. Buccal mucosa B. Lip
C Tongue D. Palate
150 MCQs mOral and Max1llofac1al Surgery

9. A dermatome is used:
A. To remove scar tissue.
B. To harvest skin grafts.
C To abrade skin which is pigmented.
D. For pairing of lacerated soft tissue.
10. In which one of the following conditions the sialography is
contraindicated?
A. Ducatal calculus B. Chronic p<Uotitis
C Acute parotitis D. Recurrent sialadenitis
 All lnd1a PGDEE 2005 151

Answers
l.B. The metabolism of local anaesthetic agents is chiefly
concerned with liver. The agents with amide type are
metabolized in liver where as ester type are metabolized by
pseudocholinesterase found in liver as well as plasma .
2A.
3.C. Fractures of cribriform plate of ethmoid and involvement of
anterior cranial fossa result in CSF rhinorrhoea.
4.C. Longest acting local anesthetic is Dibucain but among the
given options duration of action of bupivacaine is longest.
S.C. The attachment of temporalis muscle to the coronoid process
and temporal fascia allow space between the two for the
placement of Rowe's elevator. When the zygomatic bone is
engaged it can be lifted by elevator to reduce the fracture.
6.B. Mucoperiosleal flap is raised with the help of curet for access
to the bone. Now bone can be removed with the help of chisel
and mallet or with bur.This is used in extraction apicoectomy
etc.
7.B. Toxic dose of LA on CNS causes stimulation followed by
depression stimulation produces excitement and even
convulsions. For ,treatment o.f status epilepticus LA injection
should be immediately discontinued and diazepam is injected
intravenously very slowly along with oxgene inhalation .
8.B.
9.B. Skin graft in the form of full thickness or partial thickness are
used for the lost skin or mucosa. Dermatoma is used to harvest
split skin grafts after preparing the site with betadine .
lO.C. Sialography is a radiographic procedure after injecting radio-
opaque dye for detection of salivary gland diseas
Cont;raindications of sialography
(i) Inacute inflammation of gland
(ii) When patient is allergic to iodine.
 All India PGDEE 2006

1. The most common reason for the removal of impacted

mandibular tffird molars:
A. Referred pain
B. Orthodontic treatment
C Recurrent pericoronitis
D. Chronic periodontal disease
2. The antibiotic cover is mandatory before extraction in the
following condition of the heart:
A. Ischemic hert disease (IHD)
B. Hypertension
C Congestive cardia failure
D. Congenital heart disease
3. Anterior open bite occui'S in fracture of :
A. Symphysis B. Bilateral angles
C Bilateral condyles D. Unilateral condyle
4. Zygomatic arch fractures are best seen in:
A. Submentovertex view B. Occipitoxnental view
C Lateral view of skull D. Posteroanterior view of skull
5. Bilateral subconjectival ecchymosis is not associated with:
A. Le-Fort II fracture
B. Le-Fortillfracture
C Naso ethemoidal complex fracture
D. Le-Fort Uracture
6. Dacron cascular graft is a:
A. Nontextile synthetic B. Textile synthetic
C Nontextile biologic D. Textilebiologic
 All lnd1a PGDEE 2006 153

Answers
l.C Pericoronitis in relation to mandibular third molar is a
common feature. Its treatment includes irrigation with dilu ted
hydrogen peroxide,antibiotics anti-inflammator y analgesics.
Its definitive treatment is extraction of third mola.r or excision
of pericoronal flap.Incase of recurrent pericoronitis extraction
of teeth is only treatment of choice.
2.0.
3.C. In case of bilateral condylar neck fractures open bite occur
because condyle is pulled antero-medially and overriding of
the fragments occur b y ·elevator groups of muscle of
mastication .
4.A. Submentovertex (Jug handle) view of skull is advised to see
zygomatic arch and base of skull.
S.D. Bilateral subconjuctival echymosis is not a feature of Lefort I
fracture.As here fracture line is at low level and do not involve
the orbit.
6.B. Dacron graft is polyester coated with .teflon or silicon. These
are synthetic materials.