Dental OSCE Exam 2023 with complete solutions

Immunosuppresant drug used in Transplant Patients that causes Gingival Hyperplasia - Answer- Cyclosporine How is Perio disease related to diabetes? - Answer- Glucose levels are increased. Cause for cement failure? - Answer- increased SOLUBILITY of the cement Before trimming teeth on a stone cast for an immediate denture, you must first... - Answer- mark a line 3 mm above the free gingival margin. ** Which analgesic(s) is safe for a Patient with kidney disease? - Answer- Tylenol (acetaminophen) ONLY. NOT NSAIDS OR ASPIRIN ** For Patients on dialysis, where do you take their blood pressure? - Answer- On the arm opposite of the shunt. How do you prevent syncope? - Answer- Trendlenburg position. (feet higher than head) How do you treat syncope if breathing? How do you treat syncope if not breathing? - Answer- Place the patient in the trendlenburg position. (flat/feet higher than head) If breathing? Use crushed ammonia under nose and pure oxygen. Not breathing? start BLS. Treatment of a child with Fibrous Dysplasia? - Answer- for kids, prolong surgical intervention as long as possible. some lesions will stabilize & some lesions will grown. Only surgically remove if esthetics are a concern. *Note: Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This can weaken the affected bone & cause deformations or fractures. *Radiographic appearance: orange peel if late stage. ** Treatment of barbiturate allergic reaction. - Answer- antihistamine (synergic reaction to barbituate) ** look at this. **Can you treat a patient who had Hepatitis A, one year ago? - Answer- yes. they can be treated "1 week after having jaundice" -- the exam referred to it as jaundice. At what intervals are intermediate dentures evaluated? - Answer- 24- hrs. 72- hrs. 1 week 1 month Every 3 months **How long to keep a dressing on after periodontal treatment? - Answer- Pack is kept in for 1 week after surgery. TX for Primary herpetic gingivostomatitis? - Answer- Palliative only - you only treat for fever and pain. Eagles Syndrome symptoms - Answer- Pain while swallowing, turning head, or mouth opening. may include dysphagia, dysphonia, otalgia, headaches, dizziness. * The elongation of styloid process// mineralization of the stylohyoid ligament. ** Epinepherine//vasoconstrictors are contraindicated in patients with ____________. They would exacerbate the symptoms. - Answer- hyperthyroid - My exam asked which anesthetic to use on someone with hyperthyroid patients. ** ** "Opalescent hue" - Answer- dentinogenesis imperfecta -- my exam showed a pic of eyes (blue sclera) and stated this patient had brittle bones. this exam intertwines osteogenesis imperfecta with DI, I think. OI was not an option. Radiographic findings of Dentinogenesis Imperfecta. - Answer- Bulbous crowns. Obliterated canals & Pulp chambers. Cervical Constrictions amelogenesis imperfecta heredity - Answer- dominant/recessive/x-linked. ** hypomaturation amelogenesis imperfecta manifests clinically as.... showed an image but it wasn't quite textbook - Answer- "Snowcapped" Pattern. Showed an image. this is due to the matrix not forming well. crystals are weird. hypoPLASTIC amelogenesis imperfecta manifests clinically as... - Answer- a generalized/localized pitted pattern on enamel typically. can be smooth/pitted/or rough. can be AD, AR, X-linked. Best TX for tetracycline stain - Answer- Veneers. ** Facial reduction for a PFM crown? - Answer- 1.5 mm. (( 1.0-1.5 mm)) * This is the same for lingual reduction* ** If a Traumatic ulcer is formed after extraction. What is the treatment? - Answer- Observe// Re-evaluate (2 weeks) ***Patient with tenderness anterior to ear lobe? - Answer- Inflammed Stenson's duct (Parotid duct). *** asked about this MANY TIMES ***After SRP, a patient notices more spaces between teeth. why? - Answer- decreased swelling of the gingiva. Radiograph with herringbone effect. Why? - Answer- film was placed backwards. "a reverse exposure of x-ray film" film that requires least amount of radiation? - Answer- e-speed. d-slowest-"dumb" e & f = fastest. How much epi can be given to a patient with BP of 160/110? - Answer- None. Don't treat this patient. Refer to physician. *** Patient with history of slow-growing mandible for 10 years, this is indicative of... - Answer- Hyper Pituitarism. ** Patient with history of weight gain, deepening voice, dry skin - Answer- hypothyroidism hashimoto's- autoimmunethyroiditis. exophthalmos is a sign of - Answer- Bulging eyes. Graves disease -- hypERthyroidism. Patient with diffuse pigmentation on the FOM & Ventral of tongue - Answer- addison's disease hypOadrenalism TX of Addison's (or of adrenal crisis)? - Answer- Corticosteroid replacement therapy. 3 uses of Corticosteroids? - Answer- 1. Anti-inflammatory: for allergic rxns like swelling, redness, arthritis, asthma, 2. Autoimmune 3. Adrenal crisis. also -- SLE or lichen plans. ** recurrent ulcers that heal with scarring** - Answer- major apthous ulcers -- if SCARRING is mentioned *** Treatment of major apthous ulcers - Answer- corticosteroids. *when in doubt always choose corticosteroids* Supernumerary teeth disease: if clavicles are present? if clavicles not present? - Answer- Gardners- with clavicles. Cleidocranial dysplasia - without clavicles. Best type of denture teeth to oppose natural dentition? - Answer- acrylic. 14 y.o. with inflamed gingiva - Answer- leukemia -- but will determine this from the CBC #'s they give. Ideal amount of undercut required for a circumferential clasp - Answer- 0.01 inch. Treatment of an extra-oral abscess which is non-odontogenic in origin? - Answer- hot compress ** showed an image and asked the tx of ranula? - Answer- surgical removal (excision) tx of mucocele - Answer- surgical removal Patients with no hair or teeth - Answer- ectodermal dysplasia ** (showed image) tx for geographic tongue - Answer- none. if pain exists - corticosteroids Be able to identify varicose in tongues. Is this normal? - Answer- This is a normal sign of aging and they're normally seen on the ventral and lateral surfaces of the tongue *** Patient has a short crown. Which cement is best? - Answer- Resin cement *** ** How often is an autoclave checked? - Answer- 1x/week ** Reason sealants fail - Answer- contamination *** my exam asked about composite failure and asked In the form of "micro leakage" tx of candidiasis - Answer- Nystatin *** TX of lichen planus - Answer- corticosteroids When a Pt becomes unconscious, what do you check first? - Answer- breathing. CPR—placement of palm and fingers - Answer- Palm on lower sternum, fingers on xiphoid process **** Ameloblastomas, are teeth vital or non-vital? - Answer- Vital ! radiograph appearance -- soap bubble pattern. tx -- resection/full or marginal. Disease that shows increased fatigue, increased bone marrow space, and decreased trabeculation. - Answer- Sickle cell anemia. Type of collimation to reduce radiation dose? - Answer- rectangular collimation. Does a higher or lower kV reduce radiation dose? - Answer- higher. *** Static on the film prior to processesing can result in - Answer- dark spot or lines on the x-ray. *exam showed a pano with crazy liens* identify thrombocytopenia. what is this indicative of? - Answer- indicates a low platelet count (150k + is the normal. How do you identify and treat a mucus retention cyst? - Answer- it is a RO lesion, usually in the sinus but does not have to be. these are caused by obstructions. these are treated with surgery. Normal blood values: Platelets - Answer- 150,000-400,000 Normal Blood values: RBC - Answer- 4.6-6.2 million (~ 5 million) Normal Blood Values: WBC - Answer- 9,700 (10k) Normal Blood Values: HBG - Answer- 12-16 mg Why might a patient be taking lovastatin & vasotec (Enalapril)? - Answer- statin = lowers cholesterol. "il" = lowers blood pressure Patient faints and is unconscious in chair. What do you do? - Answer- ensure open airway - check and maintain breathing. o2 is always first. radiograph view best to visualize sinus? - Answer- waters view *** Purpose of try in for immediate dentures - Answer- VDO (to establish vertical dimension) ***** When is a reline of an immediate denture performed by a LABORATORY (hard)? - Answer- 6 months.