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Endodontics (Medical Entrance)

Description: pulpal diseases periradicular tissues diagnosis
Number of Questions: 20
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Tags: pulpal diseases periradicular tissues diagnosis Endodontics
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Which of the following types of traumatized teeth have a better rate of survival?

  1. Teeth with closed apices

  2. Teeth with open apices

  3. Primary teeth

  4. Apices of teeth are not related to their survival.

  5. None of these


Correct Option: B
Explanation:

Open apex has more circulation and the tooth is still in developmental stage. There are viable cells as well in the connective tissue, which can differentiate accordingly. Thus, there is better prognosis.

Which of the following is the most important factor in necrosis of inflamed pulpal tissue?

  1. Virulence of bacteria

  2. Ability to release inflammatory fluids to avoid marked increase in inflammatory fluids

  3. Host resistance

  4. Amount of circulation

  5. Lymph drainage


Correct Option: E
Explanation:

Lymph drainage is the most important factor as it removes the toxins from pulpal tissues. Thus, it prevents the necrosis of inflamed pulpal tissues.

Which of the following is not a result of excessive orthodontic forces on pulp tissue?

  1. Disruption in blood supply

  2. Altered nerve supply

  3. Hyperemia

  4. Atrophy of cells

  5. Alteration of nerve axons


Correct Option: C
Explanation:

This is not a result of excessive forces. Blood supply is decreased.

Which of the following is most likely to lead to pulpal necrosis?

  1. Lateral luxation

  2. Extrusion

  3. Intrusion

  4. Concussion

  5. Chipping of enamel


Correct Option: C
Explanation:

This is the most common reason. As a result of intrusion, pressure is there on the underlying tissues. Thus, chances of disruption of circulation are more.

Which of the following supports cell viability of stem cells?

  1. 17% EDTA

  2. NaOCl

  3. Chlorhexidine

  4. Calcium hydroxide

  5. None of these


Correct Option: A
Explanation:

In a study by Trevino et al, it was found that EDTA had 89% cell survival. It also had beneficial effects on pulp cells, when used as dentin conditioner.

Which of the following cells are master regulators of the immune system in pulp?

  1. Odontoblasts

  2. Dendritic cells

  3. Mast cells

  4. Preodontoblasts

  5. All of the above


Correct Option: B
Explanation:

Dendritic cells are the master regulators of immune system in pulp. When pulp is irritated, odontoblastic processes sense invasion and elicit requirement of dendritic cells which phagocytose invaders and present antigens to stimulate T-lymphocytes.

Phagocytes are released in pulpal inflammatory reaction due to caries, when

  1. RDT > 2 mm

  2. RDT < 2 mm

  3. RDT < 1 mm

  4. caries and pulp are in direct contact

  5. None of these


Correct Option: D
Explanation:

Phagocytes are released only when caries and pulp come in direct contact.

The diagnosis and classification of pulpal pathosis are based on which of the following?

  1. Histologic findings

  2. Signs and symptoms

  3. Radiographs

  4. Both (1) and (2)

  5. None of these


Correct Option: B
Explanation:

In pulpal diseases, the signs and symptoms of conditions make the basis for classification.

Which of the following responses results in an uninflamed pulp when heat test is done?

  1. Immediate

  2. Normal

  3. Delayed

  4. No response

  5. None of these


Correct Option: C
Explanation:

The response of normal uninflamed pulp is delayed when heat test is done.

Sensory neuropeptide CGRP is responsible for which of the following?

  1. Increase in blood flow during pulpal inflammation

  2. Regulation of immune system

  3. Delayed hypersensitivity

  4. Reparative dentin formation

  5. Both (2) and (3)


Correct Option: A
Explanation:

Recent research has shown that sensory neuropeptide CGRP is responsible for an increase in blood flow during pulpal inflammation.

In tooth with necrotic pulp, pain provoked with heat application is attributed to

  1. direct stimulation of fibres by heat

  2. increased intrapulpal pressure

  3. remnants of nerve fibres

  4. thermal expansion of gases

  5. None of these


Correct Option: D
Explanation:

This is the most probable reason as with the application of heat, gases expand and cause pain.

Which of the following cells are absent in normal pulp?

  1. Mast cells

  2. Plasma cells

  3. Preodontoblasts

  4. Dendritic cells

  5. None of these


Correct Option: A
Explanation:

Mast cells are cells of connective tissue. They release histamine in time of inflammation. But in normal pulp, unlike other connective tissues, mast cells are not there and appear only during inflammation.

What happens to the response in a normal pulp when cold test is done and stimulus is maintained?

  1. It increases.

  2. It remains the same.

  3. It decreases.

  4. There is no response at all.

  5. None of these


Correct Option: C
Explanation:

If the temperature is maintained, response to cold decreases.

Which of the following may be considered in differential diagnosis of condensing osteitis?

  1. Periapical granuloma

  2. Osteomyelitis

  3. Enostosis

  4. Radicular cyst

  5. None of these


Correct Option: C
Explanation:

This is a radiopaque condition resulting in bone deposition and is considered as differential diagnosis of condensing osteitis.

Which of the following is not a part of pulpal disease classification?

  1. Odontoclastoma

  2. Pulp polyp

  3. Previously initiated root canal therapy

  4. Pulpal necrosis

  5. None of these


Correct Option: E
Explanation:

All of the above are parts of pulpal classification.

Pulpal damage is

  1. directly proportional to the amount of dentin removed

  2. not related to the amount of dentin removed

  3. inversely proportional to the amount of dentin removed

  4. related to the diameter of opened dentinal tubules

  5. None of these


Correct Option: A
Explanation:

Dentin is the protective casing of the pulp. Dentin removal will cause damage to the pulp.

Pulpal necrosis and periapical pathosis may be attributed to which of the following?

  1. Increased tissue pressure

  2. Inability of pulp to expand

  3. Lack of collateral circulation

  4. Low compliance system

  5. All of the above


Correct Option: E
Explanation:

Increased tissue pressure, inability of pulp to expand, lack of collateral circulation and low compliance system are the factors leading to pulp necrosis and periapical pathosis.

Which of the following statements is/are true?

Statement 1: In cases of acute apical abscess, drainage is usually not through accessed tooth.

Statement 2: The abscess often does not communicate directly with apical foramen.

  1. Statement 1 is trues but statement 2 is false.

  2. Statement 2 is true, but statement 1 is false.

  3. Both statements are usually true.

  4. Both statements are usually false.

  5. None of these


Correct Option: C
Explanation:

In acute apical abscess, the communication is not yet established with apical foramen and thus, drainage is usually not through the accessed tooth. Hence, both the statements are correct.

Which of the following statements is/are correct regarding bone resorption in periapical lesions?

  1. It is a destructive process.

  2. It prevents osteomyelitis.

  3. It prevents bacterial invasion of alveolar osseous tissues.

  4. It is associated with matrix metalloproteinases.

  5. All of the above


Correct Option: E
Explanation:

All of the above statements are correct about bone resorption in periapical areas. 

Which of the following viruses has/have been attributed to symptomatic periapical lesions?

  1. Cytomegalovirus (CMV)

  2. Epstein-Barr virus ( EBV)

  3. HIV

  4. Herpes virus

  5. Both (1) and (2)


Correct Option: E
Explanation:

Both CMV and EBV are reported in symptomatic periapical lesions.

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