Dentogist: MCQs in DentistryDentogist: MCQs in Dentistry—Clinical Sciences

41 C. Because attachment of genioglossus is laxed

and support of tongue is altered in this fracture,

therefore tongue falls back blocking respiration.

42 B. Bleeding from ear occurs because displaced

fractured condyle tears the external auditory

meatus.

43 C. Classical picture of anterior open bite is in

bilateral subcondylar fracture.

44 C. It is the direction of view which marks the angle

fracture. If looking from above it is vertical if

looking from side it is horizontal (see answer 45).

45 C. A. Vertically unfavourable fracture

B. Horizontally favourable fracture.

46 D. Submentovertex is for zygomatic arches

Reverse Town's view is for subcondylar region.

47 A. Lateral oblique 30° for horizontal favourable and

unfavourable fractures of angle

Lateral oblique 15° for ramus and body of mandible!.

48 B. This is known as jug-handle view best to show

zygomatic arches.

For zygoma-occipitomental view

Horizontal placement of mandibular fracture-

Lateral oblique 39°

Nasoethmoid Occipitomental

True lateral face

CT scan.

49 D. In other cases tooth should be retained

50 D.
51 D. In subcondylar fractures in children less than 14

years of age;

If occlusion' is disturbed slightly or occlusion is

normal—no immobilization is required and

active movement should be instituted to prevent

reankylosis.

If occlusion is grossly deranged IMF for 10 days

and then active movement should be instituted

(Row and Williams).

52 B. Anterior open bite cannot be corrected by simple

IMF and distraction stoppers should be placed

with anterior traction with elastics.

53 B. The posterior wires are placed in region of 1st

molars. While passing these on buccal aspect of

mandible the facial vessels may be injured

leading to bleeding haematoma formation.

54 C. Such a incision is below the marginal mandibular

nerve a branch of facial nerve, thereby it

is not injured.

55 C. Simple superior borders or peralveolar wiring in

wall of socket of 3rd molar and IMF is sufficient

to reduce and fix such a fracture.

31 C. This movement is pathognomonic of LF III fractures

along with its movement at nasofrontal

area. This fracture causes complete disjunction

of middle 3rd of face at these two points and

therefore, the movements are felt at these areas.

32 B. LF III would not involve (IOM) infraorbital

margins, nor there would be movement at infraorbital

margin.

33 A. Ethmoid is involved in LF III and fracture

zygoma.

34 C. In unilateral fracture LF II the half maxilla moves

down causing open bite on contralateral side,

with steps at infraorbital margin and nasal

bones.

Fracture zygoma would prevent opening of

mouth, unilateral subcondylar fracture would

not have a tendency for open bite, but on

opening mandible moves to the affected side.

35 C. If tooth has a crown root fracture then it would

require extraction unless the root part of the

fracture is not below the level of the alveolar

bone. If pulp is exposed: post crown if not

exposed: simple jacket crown should be given.

36 C. Whereas if root fracture is in the coronal twothird

of the root the crown, root and fractured

apical portion should be removed.

37 C. When replanting a tooth no attempt should be

made to sterilize the tooth, but should be washed

with normal saline. All attempts should be

aimed at maintaining the vitality of the periodontal

membrane or cemenfum. In apicoectomy,

etc handling of tooth damages the periodontal

membrane and no better prognosis has been

seen with this. Outer limit of reimplantation

from time of avulsion is 48 hours.

38 B. Long canine roots and impacted 3rd molars

make the bone in the respected areas weak.

Whereas the forces of impactare concentrated at

subcondylar neck region. Therefore rate of

fracture is high in

Subcondylar 33.4% and

Canine/Body 33.6%.

39 C. Though all signs are indicative of injury but

sublingual haematoma is pathognomonic of

fracture of mandible.

40 C. Coronoid process is such a deep structure with

surrounding temporalis attachment on its

—Clinical Sciences

41 C. Because attachment of genioglossus is laxed

and support of tongue is altered in this fracture,

therefore tongue falls back blocking respiration.

42 B. Bleeding from ear occurs because displaced

fractured condyle tears the external auditory

meatus.

43 C. Classical picture of anterior open bite is in

bilateral subcondylar fracture.

44 C. It is the direction of view which marks the angle

fracture. If looking from above it is vertical if

looking from side it is horizontal (see answer 45).

45 C. A. Vertically unfavourable fracture

B. Horizontally favourable fracture.

46 D. Submentovertex is for zygomatic arches

Reverse Town's view is for subcondylar region.

47 A. Lateral oblique 30° for horizontal favourable and

unfavourable fractures of angle

Lateral oblique 15° for ramus and body of mandible!.

48 B. This is known as jug-handle view best to show

zygomatic arches.

For zygoma-occipitomental view

Horizontal placement of mandibular fracture-

Lateral oblique 39°

Nasoethmoid Occipitomental

True lateral face

CT scan.

49 D. In other cases tooth should be retained

50 D.

51 D. In subcondylar fractures in children less than 14

years of age;

If occlusion' is disturbed slightly or occlusion is

normal—no immobilization is required and

active movement should be instituted to prevent

reankylosis.

If occlusion is grossly deranged IMF for 10 days

and then active movement should be instituted

(Row and Williams).

52 B. Anterior open bite cannot be corrected by simple

IMF and distraction stoppers should be placed

with anterior traction with elastics.

53 B. The posterior wires are placed in region of 1st

molars. While passing these on buccal aspect of

mandible the facial vessels may be injured

leading to bleeding haematoma formation.

54 C. Such a incision is below the marginal mandibular

nerve a branch of facial nerve, thereby it

is not injured.

55 C. Simple superior borders or peralveolar wiring in

wall of socket of 3rd molar and IMF is sufficient

to reduce and fix such a fracture.

31 C. This movement is pathognomonic of LF III fractures

along with its movement at nasofrontal

area. This fracture causes complete disjunction

of middle 3rd of face at these two points and

therefore, the movements are felt at these areas.

32 B. LF III would not involve (IOM) infraorbital

margins, nor there would be movement at infraorbital

margin.

33 A. Ethmoid is involved in LF III and fracture

zygoma.

34 C. In unilateral fracture LF II the half maxilla moves

down causing open bite on contralateral side,

with steps at infraorbital margin and nasal

bones.

Fracture zygoma would prevent opening of

mouth, unilateral subcondylar fracture would

not have a tendency for open bite, but on

opening mandible moves to the affected side.

35 C. If tooth has a crown root fracture then it would

require extraction unless the root part of the

fracture is not below the level of the alveolar

bone. If pulp is exposed: post crown if not

exposed: simple jacket crown should be given.

36 C. Whereas if root fracture is in the coronal twothird

of the root the crown, root and fractured

apical portion should be removed.

37 C. When replanting a tooth no attempt should be

made to sterilize the tooth, but should be washed

with normal saline. All attempts should be

aimed at maintaining the vitality of the periodontal

membrane or cemenfum. In apicoectomy,

etc handling of tooth damages the periodontal

membrane and no better prognosis has been

seen with this. Outer limit of reimplantation

from time of avulsion is 48 hours.

38 B. Long canine roots and impacted 3rd molars

make the bone in the respected areas weak.

Whereas the forces of impactare concentrated at

subcondylar neck region. Therefore rate of

fracture is high in

Subcondylar 33.4% and

Canine/Body 33.6%.

39 C. Though all signs are indicative of injury but

sublingual haematoma is pathognomonic of

fracture of mandible.

40 C. Coronoid process is such a deep structure with

surrounding temporalis attachment on its anterior

and medial surface that direct traumatic

force wouldAnswers

1 B. Such a patient usually has bleeding, CSF rhinorrhoea

and drooling saliva. Lateral position

allows easy outward flow of these thus pre-,

venting aspiration in unconscious patient and

blocking of respiratory tract in other patients.

Prone position though equally effective poses

problem in respiration and abdominal pressure.

In A, D chances of aspiration, and respiratory

blockage are high.

2 A. No movement of neck, spinal area should be

made, rather such patient should be carried with

a neck collar. In all other conditions patient

should be carried in lateral position.

3 D. In all these conditions tongue falls back due to

loss of its attachment via genioglossus muscle in

(B) due to loss of control of the tongue, causing

respiratory embarrassment.

4 B. With all other manoeuvres bleeding would

continue and even increase.

5 D. It is used to mark the level of unconsciousness

by means of ascertaining A,B,C.

6 D. Pupils have a direct relation with physiological

status of the brain.

In concussion: Pupils are dilated and equal in

size, react to light.

In subdural haematoma: Pupils first constrict

and then dilate and become nonreacting to light.

As patient progresses pupils attain normal size

and normal reaction.

7 C. Though all the methods can be used but easy,

quick tentative result can be achieved by (C).

8 C. Most important complication with this method,

if pack left for longer duration of time.

9 B. The IX, X, XI nerve leaves jugular foramen in

middle cranial fossa. IX, X nerve supply

pharynx, palate. Any trauma, haematoma in this

area can cause compression of these nerves.

10 C. The choice of crystalloid is based on the solution

having high osmotic value. This maintains fluid

in the vascular compartment. (Since after such

trauma hypovolumic shock may be precipitated).

Normal saline, 5% dextrose, 10%, dextrose all

are isotonic and fluid moves away in cells again

making vascular compartment hypovolumic

resulting in hypovolumic shock.

11 D.

12 A. If more than 24 hours-delayed primary closure

or secondary healing should be considered. By

this time oedema and infection would have set

in and primary suturing would fail.