AIIMS NOV. 2011 DENTAL/MDS Question Paper

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 All India Institute of Medical Sciences Conducted Post Graduate Dental entrance exam on 13th Nov.,2011.


 Here are few Questions and tentative answers for the same.





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Free Dental Clinic Management Software.... Full Version : DentSuite 1.0

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Freeware : Free to download and use.

Publisher's Description

DentSuite 1.0 is just the right software you need to manage your dental clinic, with all the facilities to maintain patient history, manage appointments, store pictures of pre and post operative images taken through an intra-oral camera and to print patient detailed report with pre and post operative images




Size: 1.22MB
Publisher:
Release Date:2006-06-08

OS: Win 2000/XP






 Source: http://soft.ddctvm.com/
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Free software for NBDE I (Part 1) aspirants

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Rx Dentistry has come up with a free Online/Offline application for all National Board Dental Exam students .
Here is a free Online trial software.





 
 
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  • password: rxdentistry

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Bitten By a Snake : Things you should know

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►    3500   SPECIES
►    300     VENOMOUS
►    30000  - 40000 DEATHS ANNUALLY


POISONOUS SNAKES

INDIAN SCENARIO
►    5 DANGEROUSLY POISONOUS SNAKES
          KING COBRA
          COMMON COBRA
          COMMON KRAIT
          RUSSELL’S VIPER
          SAWSCALED VIPER
MOST COMMON POISONOUS SNAKE IS COMMON KRAIT

►    216  SPECIES

►    52  VENOMOUS



SNAKE VENOM

►    Toxic saliva secreted by modified parotid glands of a venomous snake
►    Amber coloured when fresh
►    Constituents               Toxins
                                       Enzymes
                                       Miscellaneous : neurotoxins
                                                                cardiotoxins
                                                                hemolysin


VENOM CLASSIFICATION

►    Neurotoxic              elapids(cobra,krait)
►    Hemotoxic               viperidae
►    Myotoxic                  sea snake
►    Krait and russell’s viper is much more toxic than that of cobra


SYMPTOMATOLOGY OF NON VENOMOUS SNAKES

►    Universal fear associated induce a state of shock
►    Bite site may demonstrate multiple teeth impressions
►    Lack of significant local pain or swelling
►    Adequate reassurance and symptomatic treatment measures lead to full recovery


SYMP..VENOMOUS SNAKE BITES

►    ELAPID BITE
►    Local features :
►        indistinct fang marks ,
►        burning pain,
►        swelling and discolouration,                                                                        
►        serosanguinous discharge

       
Systemic features

►    preparalytic stage  :     emesis,
                                             headache,
                                              LOC.
      paralytic stage      : ptosis,
                                           ophthalmoplegia
                                           drowsiness,
                                           dysarthria,
                                           dysphagia,
                                           convulsions,
                                           bulbar paralysis,
                                           resp failure .

     

VIPERID BITE

Local features:
                         rapid swelling,
                         discolouration,
                         blister formation,
                         bleeding from bite site,
                         severe pain
    
Generalised bleeding manifestations.                       
                          epistaxis,
                          hemoptysis,
                          bleeding gums
                          hemauria
                          purpuric spots
 Renal failure

      

HYDROPHID BITE

►    Local features: minimal swelling and pain
►    Systemic features: myalgia muscle stiffness
                  myoglobinuria , renal tubular
                  necrosis                  


DIAGNOSIS OF SNAKE BITE
►    FANG MARKS:classically, two puncture                wounds seperated by a distance varying from 8mm to 4cm, depending on the species involved.
►    However a side swipe may produce only a single puncture,while multiple bites could result in numerous fang marks.
►    Baileys method
  
      



Management of snake bite


FIRST AID


►    DELAY ENRY OF VENOM
►    TOURNIQUET
►    ABOVE KNEE
►    ABOVE ELBOW


CLINICAL ASSESMENT
►    VITAL SIGNS—PULSE
                           --B P
                           --RESPIRATION –SBC
OBSERVE – BITE MARK
                   --LOCAL REACTION
                   --PAINFUL LNE
►               


NEUROTOXICITY
►    PTOSIS
►    OPHTHALMOPLEGIA
►    MYASTHENIA LIKE SYMPTOMS
►    ASSES SBC



HEMATOTOXICITY

►    PURPURA
►    ECHYMOSIS
►    GINGIVAL SULCUS BLEED
►    HEMATURIA

CAPILLARY LEAK SYNDROME
►    PUFFINESS
►    CHEMOSIS
►    PAROTID SWELLING




Lab. Investigations

  
Haematological-
                             leucocytosis(>20,000-
                                     severe envenomation)                          
                            elevated PCV
                             thrombocytopenia
                             evidence of hemolysis
                             prolonged CT,PT,PTT
                             elevated FDP



►    CT     >    20 MINUTES

►    SURE SIGN OF ENVONOMATION

►    PITVIPER   > 2 WEEKS

►    ECG: bradycardia
             ST    /
             Twave inversion
             QT Prolongation
             changes due to hyperkalemia
             

►    Metabolic
         hyperkalemia
         hypoxemia with resp.Ac
         met.Ac or lactic Ac
►    Urine
         hematuria,proteinuria,Hburia
         Mburia
        


►    Renal : ARF -- BU S.Cr   S E
►    CXR :  pulm.edema
               intrapulm.Hgs
               pleural effusion
►     Immunodiagnosis: by ELISA….
     highly sensitive but specificity inadequate to diff b/w diff species of snakes



SPECIFIC MANAGEMENT  ASV

►    HORSE SERUM
►    ASV IN INDIA
                        COBRA
                        KRAIT
                        RUSSEL’S VIPER
                        SAW SCALED VIPER
 1 mi ASV     ---    0.6m6 cobra R viper
                     ---    0.45mg krait S viper
                       


Indication ---- systemic manifestaiton
►    NEUROTOXICITY
►    REPEATED VOMITING
►    HAEMOTOXICITY
►    NEPHROTOXICITY
►    CARDIOTOXICITY
►    RHABDOMYOLYSIS


►    PROLONGED  CT  ALONE

                       PIT VIPER  --  NO
                       SNAKE NOT IDENTIFIED


NEUROTOXIC ENVONOMATION
►    INITIAL DOSE  10  -  15 VIALS
►    REASSESS
►    IMPROVEMENT   30  --  60 MIN
►    REPEAT  5 VIALS AFTER 60  -- 90 MINS
►    SUPPORTIVE – NEOSTIGMINE AFTER ATROPINE


HAEMOTOXIC ENVONOMATION
►    MILD            CT  <  30 MINS
                        CLOT SIZE  =  50% blood col
                        initial dose  = 5 vials
►    MODERATE   CT   >  30 MINS
►                           CLOTS ONLY SPECKLES
►                           intial dose   = 10 vials
►    SEVERE      INCOAGULABLE
►                         initial dose  = 15 vials


►    REPEAT  CT  AFTER 6 – 9 HOURS
►    IF CT PRONGED REPEAT 5- 10  VIALS
►    LOW DOSE INFUSION – FOLLOWING
                                            DAYS


SUPPORTIVE CARE


  ANTIBIOTICS
  METHYL PREDNISOLONE
  FFP,FRESH BLOOD
  PREVENTION AND Rx OF HYPOTENSION
  PRVENTION OF SHOCK



PREVENTION OF ARF

►    PROPER FLUID ADMINISTRATION
►    CORRECT MYOCARDIAL DYSFUNCTION
►    MONITOR OUTPUT BU S.Cr SE
►    AVOID  NEPHROTOXIC DRUGS
►    PROTEIN RESTRICTION



Management of local reactions

►    BULLAE   - LEFT INTACT
►    NECROSIS  - DEBRIDEMENT
►    COMPARTMENT SYNDROME – FASCIOTOMY
►    MOST COMFORTABLE POSITION


REACTIONS TO ANTIVENOM

►    ANAPHYLACTOID  10 – 90 MINS

►    PYROGENIC 2 HOURS

►    SERUM SICKNESS  5 – 21 DAYS
►    Rx  local anaesthetic ice pack













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5 Common Dental Problems (for a layman)

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  • DECAY: The most common problem, often seen as blackish or brownish spots and can cause a lot of sensitivity and pain too!

  • GUM PROBLEMS: Red, swollen gums can hurt a lot, can bleed when you brush, cause your teeth to become lose and can be a major cause of bad breath

  • CROWDED / PROTRUDED TEETH: An extremely unaesthetic scenario with difficulty in maintaining oral hygiene.

  • MISSING TEETH: Can cause ugly looking gaps when you smile and makes chewing difficult. Also causes loss of adjacent teeth over time, if not replaced soon.

  • DISCOLORED TEETH: Can arise from a variety of reasons, resulting in a totally unaesthetic appearance.

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Lecture notes in Dentistry

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Oral Pathology Powerpoint Lectures


SOURCE:utechdmd2015.wikispaces.com/
and :
Cabrillo Community College
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Lectures In Oral & Maxillofacial Surgery

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Biopsy in oral surgeryUse SHIFT+ENTER to open the menu (new window).
Edit
bone graftUse SHIFT+ENTER to open the menu (new window).
Dento-alveolar fracturesUse SHIFT+ENTER to open the menu (new window).Edit
Differential Diagnosis of Head and SwellingUse SHIFT+ENTER to open the menu (new window).Edit
Emergency - Allergic reactionsUse SHIFT+ENTER to open the menu (new window).
Emergency Kit Part -2Use SHIFT+ENTER to open the menu (new window).Edit
Emergency-CardiacUse SHIFT+ENTER to open the menu (new window).
Emergency-EndocrineUse SHIFT+ENTER to open the menu (new window).Edit
Emergency-Respiratory emergUse SHIFT+ENTER to open the menu (new window).
Hemorrage in oral surgeryUse SHIFT+ENTER to open the menu (new window).
MALIGNANT LesionsUse SHIFT+ENTER to open the menu (new window).Edit
Management of maxillofacial traumaUse SHIFT+ENTER to open the menu (new window).Edit
Mandibular fractresUse SHIFT+ENTER to open the menu (new window).Edit
Mandibular Nerve block (Other techniques)Use SHIFT+ENTER to open the menu (new window).Edit
Mandibular Nerve blockUse SHIFT+ENTER to open the menu (new window).
Maxillary Anesthesia -1Use SHIFT+ENTER to open the menu (new window).
Maxillary Anesthesia -2Use SHIFT+ENTER to open the menu (new window).Edit
Maxillary Anesthesia -3Use SHIFT+ENTER to open the menu (new window).
Maxillary Anesthesia -4Use SHIFT+ENTER to open the menu (new window).
MaxSinus lecture 1Use SHIFT+ENTER to open the menu (new window).
MaxSinus lecture 2Use SHIFT+ENTER to open the menu (new window).
Medical emergency kit Part -1 Use SHIFT+ENTER to open the menu (new window).
Medical emergency-Medical HistoryUse SHIFT+ENTER to open the menu (new window).
Mid-face injuryUse SHIFT+ENTER to open the menu (new window).
Radical Neck DissectionUse SHIFT+ENTER to open the menu (new window).
TUMOURS OF THE HEAD AND NECKUse SHIFT+ENTER to open the menu (new window).
Unerupted and impacted IUse SHIFT+ENTER to open the menu (new window).Edit
Vascular Anomalies presentationUse SHIFT+ENTER to open the menu (new window).Edit
zygomatio-frontal FractureUse SHIFT+ENTER to open the menu (new window).

SOURCE:Dr. Hesham Khalil
BDS, MSc, OMF Prosth Certi, MFDSRCS (England), PhD

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