TEST NAVIGATION

Board: MDS-2016
Class: AIPG-2016 Grand Tests (To be created New)
Subjects: All (To be created New)
Chapters: (To be created New)
1. Human Anatomy
2. Physiology
3. Biochemistry
4. General Pathology
5. Microbiology
6. Pharmacology
7. General Medicine
8. General Surgery
9. Dental Materials
10. Oral Histology & Dental Anatomy
11. Oral Pathology
12. Radiology
13. Orthodontics
14. Pedodontics
15. Community Dentistry
16. Prosthodontics
17. Periodontics
18. Cons & Endo
19. Oral Surgery

Total MCQS: 200

Total Marks: 800 (04 Marks per Question)
Negative Marking: 1/4th per wrong Question

HUMAN ANATOMY

1. Greatest barrier for diffusion of LA is

A. Epineurium
B. Perineurium
C. Endoneurium
D. Neural membrane

Ans: B. Perineurium

2. In case of inferior alveolar nerve block, needle is placed in which of the following space
A. Pterygopalatine fossa
B. Pterygomandibular space
C. Submandibular space
D. Masticator space

Ans: B. Pterygomandibular space

3. A patient experiences post-operative nausea and vomiting is due to all except

A. Opioid
B. Ingested blood
C. Nitrous oxide
 D. Acetaminophen

Ans: A. Acetaminophen

4. Which of the following is the most potent topical local anaesthetic

A. Tetracaine
B. Benzocaine
C. Mepivacaine
D. Prilocaine

Ans: A. Tetracaine

5. In case of posterior superior alveolar nerve, which of the following tooth region will be completely anaesthetized
A. Maxillary first second and third molar
B. Maxillary second and third molar
C. Maxillary molar and premolar
D. Maxillary arch

Ans: B. Maxillary second and third molar

6. For performing periapical surgery with maxillary central incisor, which of the following local anesthesia will be given
A. PSA and greater palatine
B. ASA and nasopalatine
C. Anterior superior alveolar nerve block and greater palatine block
D. PSA and nasopalatine block

Ans: B. ASA and nasopalatine

7. Which of the following will be the ideal endotracheal tube for TMJ ankylosis cases
A. North facing RAE tube
B. South facing RAE tube
C. Cuffed endotracheal tube
D. Non cuffed endotracheal tube

Ans: A. North facing RAE tube

8. In case of patient requiring bilateral sagittal split osteotomy along with disimpaction of mandibular third molar, which of
the following is true regarding the timing of extraction of third molar
A. At the time of surgery
B. 1 month after surgery
C. 6 month before surgery
D. 8-12 weeks after surgery

Ans: C. 6 month before surgery

9. Which of the following nerve fibres carry the radiating pain caused due to teeth which is referred to some other location
A. Myelinated nerve fibres
B. C fibres
C. A delta fibre
D. Non myelinated fibres

Ans: A. Myelinated nerve fibres

10. Which of the following is the best mode of intubation in case of maxillofacial trauma cases
A. Cricothyroidoctomy
B. Tracheostomy
C. Nasal intubation
D. Oral intubation

Ans: C. Nasal intubation

11. Von Reherman flap is used for treatment of which of the following
A. Cleft lip
B. Cleft palate
C. Oroantral fistula
D. Bifid uvula

Ans: C. Oroantral fistula

12. General anesthesia is used for all of the following procedures except
A. Treatment of controlled epileptic patient
B. Cerebral palsy
C. Mental retardation
D. Very uncooperative patients

Ans: A. Treatment of controlled epileptic patient

13. Trigeminal nerve stimulation during gap arthroplasty leads to which of the following
A. Tachycardia
B. Bradycardia
C. Paroxysmal arterial tachycardia
D. Ventricular arrhythmia

Ans: B. Bradycardia

14. Which of these is not true about throat packing

A. Done when patient is awake
B. Should be done after induction of GA
C. Prevents soiling of trachea
D. Prevents contamination of pharynx

Ans: A. Done when patient is awake

15. Which of the following is not true regarding tracheostomy

A. Dead space is increased
B. Chances of infection
C. Mucocilliary stream is arrested
D. Prevent normal swallowing

Ans: A. Dead space is increased

16. All of the following are true for ultrasonographic analysis of malignant lymph nodes except
A. Hyporesonanace is seen
B. Hyperecho seen
C. Cortical thickening can be seen
D. Hylum is absent
 Ans: B. Hyperecho seen

PHYSIOLOGY

17. Heme is converted to bilirubin mainly in

A. Kidney
B. Liver
C. Spleen
D. Bone marrow

Ans:- C Spleen
Ref:- Lipincott’s biochemistry 3/e p 280
Explanation:-

Breakdown of heme to bilirubin occurs in macrophages of the reticuloendothelial system mainly in the spleen also in the
liver and bone marrow.

18. Salivation by dog seen when food is given along with ringing of bell is

A. Conditioned reflex
B. Reinforcement
C. Habituation
D. Innate reflex
Ans:-D Innate reflex
Ref:- Ganong 22/e p-267,268
Explanation:-

- Salivation by dog on seeing food- Inmate reflex

- Salivation by dog on ringing the bell-conditional reflex only without food

19. Small intestinal peristalsis is controlled by

A. Myentric plexus
B. Meissners plexus
C. Vagus nerve
D. Para sympathetic system
Ans:- A Myentric plexus
Ref:- Ganong 22/e p 479
Explanation:-

Myenteric plexus is situated b/w and innervates outer longitudinal and middle circular muscular layers and the primarily
concerned with motor control. Submucosal plexus situated between middle circular layer and mucosa is primarily concerned with
control of intestinal secretion as it innervates glandular epithelium, intestinal endocrine cells and submucosal blood vessels.

20. Maximum absorption of water takes place in

A. Proximal convoluted tubule

B. Distal convoluted tubule
C. Collecting duct
D. Loop of henle
Ans:- A Proximal convoluted tubule
Ref:- Guyton 10/e p 300
Explanation:-

The proximal convoluted tubule reabsorbs about 50-60% of water and solute that is filtered at glomerulus water
absorption occurs entirely by osmotic diffusion.

21. Vasopressin acts by

 A. Water transport across collecting duct
B. Water absorption at medullary ducts
C. Water secretion at loop of Henle
D. Water transport at PCT
Ans:- A Water transport across collecting duct
Ref:- Ganong 22/e p 716-244
Explanation:-

Vasopressin acts by increasing permeability of collecting ducts to water. The key to the action of vasopressin on collecting
duct is aquaporin-2. The overall effect is retention of water in excess of solute which in decrease effective osmotic
pressure.

22. A person is having normal lung compliance and increased airway resistance. The most economical way of breathing for
him

A. Rapid and deep

B. Rapid and shallow
C. Slow and deep
D. Slow and shallow
Ans:- C Slow and deep
Ref:- Harrison 16/e p 1549
Explanation:-

As the lung deflates, the intrapleural rises from negative to zero-this creates a situation when the bronchioles are no more
stretched- bronchodilation ceases- bronchial narrowing-increased air flow resistance-drop of rate of airflow.

Slow and deep breathing is better than rapid and shallow breathing

- Because of the dead space, rapid shallow breathing produces much less alveolar ventilation than slow deep breathing
at the same respirator minute volume.
- Slow and deep breathing encounter less airway resistance.

BIOCHEMISTRY

23. Arsenic inhibits all except

A. PDH
B. Lipoic acid
C. α-KG dehydrogenase
D. Enolase
Ans:-D Enolase
Explanation:-

Arsenite (trivalent form of arsenic) forms a stable complex with thiol (-SH) group of lipoic acid, making it unavailable to
serve as a coenzyme. So arsenic poisoning is primarily d/t inhibition of enzymes that require lipoic acid (lipoate) as a
coenzyme including E2 of PDH complex, α-Ketoglutarate dehydrogenase and branched chain α-ketoacid dehydrogenase.

24. Thiamine deficiency causes decreased energy production because

A. It is required for the process of transamination
B. It is co-factor in oxidative reduction
C. It is co-enzyme for transketolase in pentose phosphate pathway
D. It is co-enzyme for pyruvate dehydrogenase
Ans:- D It is co-enzyme for pyruvate dehydrogenase
Explanation:-

Thiamine has central role in energy yielding metabolism especially carbohydrates. So thiamin requirement increases in
excess intake of carbohydrates and its deficiency leads to decreased energy production. Hampered or decreased function
 of pyruvate dehydrogenase enzyme and α-ketoglutarate dehydrogenase enzyme in which thiamin acts as coenzyme is the
main cause of this decreased energy production. Decreased PDH function also l/t pyruvic and lactic acidosis.

25. Normal parent with 2 siblings having osteogenesis imperfecta. Pattern of inheritance is

A. Mutation
B. Anticipation
C. Genomic imprinting
D. Germline mosacism
Ans:- D Germline mosacism
Ref:- Harrison 16/e p 375
Explanation:-

- Differential expression of same gene depending on parent of origin is referred to as genomic imprinting.
- Germline mosacism results from a mutation only affecting cells destined a form gonads-Postzygotically during early
embryonic development. So the individual is phenotypically normal but can transmit the disease to offsprings
through mutant gametes. And because the progenitor cells gametes carry mutation, there is a high possibility that
more than 1 child of such parent would be affected.

26. Vitamin which is excreted in urine is

A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin K
Ans:- B Vitamin D
Ref:- Harrison 16/e p 406-07,2469
Explanation:-

- Vitamin C is a water soluble vitamin, which is mainly excreted in urine. Its intake above 100 mg/day results in
saturation of its metabolic capacity and excretion into urine. So large does (1 gm TDS/81p) are used to acidify urine in
preventing and treating UTI as some drugs acidic urine.
- Vitamin A,D,E,K are fat soluble and so excreted mainly in bile and very minimally in urine.

27. Most lipogenic carbohydrate

A. Fructose
B. Glucose
C. Ribose
D. Sucrose

Ans: A. Fructose
Ref: Vasudevan, 6/E, p. 227.
Explanation:
 Fructose rapidly enters the tissues,leading to enhanced fatty acid synthesis, raised serum triglycerides and increased LDL
cholesterol level in blood; all these are atherogenic and harmful.Fructose metabolism in liver bypasses the PFK control
point; hence fructose increases the flux of glycolyticpathway, leading to lipogenesis. Moreover, glycerol phosphate
required for TAG synthesis is provided by themetabolism of fructose, leading to the increase in TAG pool in the body.

28. Denaturation of DNA

A. Fragmentation of DNA molecules
B. Reversible separation of DNA
C. Irreversible separation of DNA
D. Coagulation of DNA

Ans: B.Reversible separation of DNA

Ref: Lippincott's Illustrated Reviews:Biochemistry, 29/E, p. 397
Explanation:
 When DNA is heated, the temperature at which one half of the helical structure is lost is defined as the melting
temperature (Tm). The loss of helical structure in DNA, called denaturation, can be monitored by measuring its
absorbance at 260 nm. (Note: ssDNA has a higher relative absorbance at this wavelength than does dsDNA) Under
appropriate conditions, complementary DNA strands can reform the double helix by the process called renaturation (or
reannealing).

29. Cereals are deficient in

A. Vitamin C
B. Vitamin B – Complex
C. Iron
D. Calcium

Ans: A.Vitamin C
Ref: Lippincott's Illustrated Reviews:Biochemistry,29/E, p. 15

30. FSH, LH, TSH acts through

A. Cyclic AMP
B. Cyclic GMP
C. Both
D. None

Ans:A.Cyclic AMP
Ref:DM Vasudevan, 6/E, p. 520
Explanation:
 GENERAL PATHOLOGY

31. Which of the following complement component can be activated in both common as well as alternative pathways?
A. C1
B. C2
C. C3
D. C4

Ans:- C C3
Ref:- Robbins 8th/63-64
Explanation:-

The complement proteins can be activated by 3 pathways; classical, lectin and alternate pathways. Terminal pathway is
common to the first three pathways and is present at the level of post activation stage of C3. It eventually leads to the
membrane attack complex that lyses cells.

As can be seen in the text, C3 is the first common complement protein to be activated in both classical and alternate
pathway.

32. Free radicals are generated by all except

 A. Superoxide dismutase
B. NADPH Oxidase
C. Myeloperoxidase
D. NO synthase

Ans:- A Superoxide dismutase

Ref:- Robbins 8th/21
Explanation:-

Superoxide dismutase (SOD) is an anti oxidant enzyme

Some clarification regarding option ‘d’ Nitric oxide (NO), an important chemical mediator generated by endothelial cells,
macrophages, neurons and other cell types can act as a free radical and can also be converted to highly reactive
peroxynitrite anion (ONOO-) as well as No2 and No3-.

33. Nephrocalcinosis in a systemic granulomatous disease is due to

A. Over production of 1,25 dihydroxy vitamin D
B. Dystrophic calcification
C. Mutation in calcium sensing receptors
D. Increased reabsorption of calcium

Ans:- A Over production of 1, 25 dihydroxy vitamin D

Ref:- Robbins 8th/433-6
Explanation:-

Nephrocalcinosis is defined as calcification of the renal interstitium and tubules. It is associated with hypercalcemia. In
chronic granulomatous inflammation, the important cells involved are macrophages and lymphocytes.

Direct quote Heptinstall’s Sarcoidosis and other granulomatous disease can be cause of hypercalcemia and hypercalciuria
owing to excess vitamin D from extra renal conversion of 1,25 (OH) 2D3. Nephrocalcinosis was found to be associated
with 22% patients with chronic sarcoidosis.

In other granulomatous conditions (like sarcoidosis), there is presence of metastatic calcification due to activation of
vitamin D precursor by macrophages …. Robbins

Interstitial Lung Disease 5th… Hypercalciuria is seen in almost a third of patients with sarcoidosis. Serum calcium levels in
sarcoidosis rise with serum vitamin D levels. The dysregulation of calcium metabolism appears to be modulated through
abnormal synthesis of vitamin D by activated pulmonary macrophages and granulomatous tissue that leads to excessive
hydroxylation of 25- monohydroxylated vitamin D precursors. This could be an adaptive response to the antigen in
sarcoidosis.

34. Main feature of chemotaxis is

A. Increased random movement of neutrophils
B. Increase adhesiveness to intima
C. Increased phagocytosis
D. Unidirectional locomotion of the neutrophils

Ans:- D Unidirectional locomotion of the neutrophils

Ref:- Robbins 8th/50
Explanation:-

Chemotaxis is defined as locomotion oriented along a chemical gradient.

35. Eosinophilic Abscess in lymph node is characteristically seen in –DPG 2011

A. Kimura’s disease
B. Hodgkin’s lymphoma
C. Tuberculosis
D. Sarcoidosis
 Ans:- A Kimura’s disease
Ref:- Loachim’s lymph node pathology/190
Explanation:-

Kimura Disease is a chronic inflammatory disorder prevalent in Asians. It involves subcutaneous tissues and lymph nodes
predominantly in the head and neck region and is characterized by angiolymphoid proliferation and eosinophilia

36. Light microscopic characteristic feature of apoptosis is

A. Intact cell membrane
B. Eosinophilic cytoplasm
C. Nuclear moulding
D. Condensation of the nucleus

Ans:- D Condensation of the nucleus

Ref:- Robbins 8th/14-15, 26-27
Explanation:-

The morphologic features characteristic of apoptosis includes

 Cell shrinkage: The cell is smaller in size having dense cytoplasm and the organelles are tightly packed
 Chromatin condensation: This is the most characteristic feature of apoptosis.
 Formation of cytoplasmic blebs and apoptotic bodies

37. True about cell ageing

A. Free radicals injury
B. Mitochondria are increased
C. Lipofuscin accumulation in the cell
D. Size of cell increased

Ans:- C Lipofuscin accumulation

Ref:- Robbins 8th/36,39-41

38. Mallory hyaline is seen in

A. Alcoholic liver disease
B. Hepatocellular carcinoma
C. Wilson’s disease
D. I.C.C (Indian childhood cirrhosis)
E. Biliary cirrhosis

Ans:- A Alcoholic liver disease; B hepatocellular carcinoma; C wilson’s disease; D ICC (Indian childhood cirrhosis); E
Biliary cirrhosis
Ref:- Robbin’s 7th/905
Explanation:-

Mallory Bodies: Scattered hepatocytes accumulate tangled skins of cytokeratin intermediate filaments and other proteins,
visible as eosinophilic cytoplasmic inclusions in degenerating hepatocytes, see details in chapter on liver

39. Russell bodies are seen in

A. Lymphocytes
B. Neutrophils
C. Macrophages
D. Plasma cells

Ans:- D Plasma cells

Ref:-Robbins 8th/35, 7th/37

40. Liquefactive necrosis is seen in

 A. Heart
B. Brain
C. Lung
D. Spleen

Ans:- B Brain
Ref:-Robbins 8th/15, 7th/22

41. Psammoma bodies show which type of calcification

A. Metastatic
B. Dystrophic
C. Secondary
D. Any of the above

Ans:- B Dystrophic
Ref:-Robbins 8th/38,7th41

MICROBIOLOGY

42. Basanti, 29 year aged female from Bihar present with active TB. She delivers baby. All of the following are indicated except
A. Administer INH to the baby
B. Withhold breastfeeding
C. Give ATT to mother for 2 years
D. Ask mother to ensure proper disposal of sputum

Ans:- B Withhold breastfeeding

Ref:- Nelson 17/e p 971
Explanation:-

If the mother is suspected of having active disease or detection of an acid fast bacilli in sputum shows evidence of current
tuberculosis disease, besides giving ATT to mother certain additional steps are necessary to protect the infant. The most
important

a. INH therapy
INH therapy for new borns is so effective that separation of mother and infant is no longer considered mandatory
- Separation should done (until mother become non-infectious) only if:
 Mother is so ill so as to require hospitalization
 She is expected to become non-adherent with her treatment.
 There is strong suspicion that she has drug resistant tuberculosis.
- INH treatment of infant should be continued until the mother has been shown to be sputum culture negative for
at least 3 months.
b. Appropriate treatment of mother and other family members
- Though there is controversy in the question as according to some books breast feeding is contraindicated and
isolation of infant from the mother having active TB should done.
- But as all other three options are totally correct and as Indian child must have breastfeeding. I have to go with
Nelson only.

43. The main cytokine, involved in erythema nodosum leprosum (ENL) reaction, is
A. Interleukin-2
B. Interferon-gamma
C. Tumor necrosis factor-alpha
D. Macrophage colony stimulating factor

Ans:- C Tumor necrosis factor-alpha

Ref:- Harrison 17/e p 1023
Explanation:-
 TNF plays a central role in pathobiology of ENL.

Type I lepra reaction Type II lepra reaction

Downgrading or reversal Erythema nodosum
reaction leproticum
Type IV hypersensitivity Type III hypersensitivity
TNF play a central role IFNγ and IL-2 are main
cytokines involved
Edema is characteristic Vasculitis and panniculitis
microscopic feature are seen
Treatment: DOC- DOC- Thalidomide
Glucocorticoid Clofazimine
Other drugs: Chloroquine
Clofazimine Glucocorticoids
Chloroquine NSAID’s and Antibiotics
Analgesics

Thalidomide-Ineffective

44. Infectivity of chickenpox lasts for

A. Till the last scab falls off
B. 6 days after onset of rash
C. 3 days after onset of rash
D. Till the fever subsides

Ans:- B 6 days after onset of rash

Ref:- Park 21/e p 134
Explanation:-

Period of communicability of varicella range from 1 to 2 days before the appearance of rash, and 4 to 5 days there after

The patient ceases to be infectious once the lesions have crusted.

So, option a is wrong

Important features of chicken pox

Causative agent- varicella zoster virus (HHV type 3)

Incubation period- 14-16 days
Secondary attack rate-90%

Rash
Chicken pox Small pox
Superficial Deep seated
Pleomorphic Only one stage of rash
at 1 time
Centripetal Centrifugal
Unilocular Multilocular
Dew drop like Umbilicated
appearance
Inflammation (+) nt No area of inflammation
around vesicle
Mostly flexor surface Mostly extensor surface

45. H5N1 is
A. Bird flu virus
B. Vaccine and HIV
C. Causative agent of Japanese encephalitis
D. An eradicated virus
 Ans:- A Bird flu virus
Ref:- park 19/e p 133
Explanation:-

H5N1 is a type of new influenza virus which is a causative agent of bird flu.

Majority of avian influenza do not infect humans. However, avian H5N1 is a strain with pandemic potential since it
ultimately adapt into a strain that is contagious among humans.

46. Which of following is not transmitted by lice?

A. Q. fever
B. Trench fever
C. Relapsing fever
D. Epidemic typhus
Ans : A: Q fever :
Ref: Ananthanarayana, 9th/ed, pg: 411 , Chapter: Rickettsiaceae
Explanation:
 Etiological agent of Q fever: Coxiella burnetii
 Vector: Ixodid ticks
 Morphology of Coxiella burnetii:
 Pleomorphic, coccobacilli, with a Gram negative cell wall & ill defined developmental cycle.
 Manifestations of Q fever in humans :
 Severe Influenza like illness
 Chronic Endocarditis
 Complications :
 Hepatitis
 Chronic infection
 Endocarditis
 Cirrhosis.

Human disease : acute systemic illness characterized by Interstitial Pneumonia.

Additional information :
 Etiology of Trench Fever:
 Bartonella Quintana/ Rochalimaea Quintana
 Synonyms for Trench Fever: 5 day fever
 Relapsing fever:
 Types :
 Epidemic relapsing fever/ louse borne relapsing fever:
 Etiological agent: Borrelia recurrentis
 Vector : Pediculus Humanus Corporis
 Endemic relapsing fever/ Tick borne relapsing fever:
 Etiology: Borrelia duttonii , B. parkeri
 Vector : Ticks

 Epidemic Typhus:
 Synonyms: Louse borne Typhus
 Etiology : Rickettsia prowazekii
 Vector : Pediculus Humanus Corporis

 SPECIAL NOTE : DISEASES IN MICROBIOLOGY WITH NUMBERS:

 3 day Fever with Rash: German Measles / Rubella
 5 day Fever : Trench Fever
 5th disease: Erythema Infectiosum/ Parvovirus B19.
 6 disease:
th Exanthem Subitum/ Roseola Infantum/ Human Herpes Virus-6( HHV-6)
 8th day disease: Tetanus Neonatorum
47. Chronic carrier state is seen in all EXCEPT
A. Measles
B. Diphtheria
C. Typhoid
D. Gonorrhea
Ans : A : Measles
Ref: Ananthanarayana,9th/ed, pg: 511-512, Chapter: Paramyxoviruses: Section: Measles/ Rubeola
Explanation :
 Measles is Endemic throughout the world & produces Epidemics every 2-3 years .
 Maximum incidence in children of 1-5 years of age , uncommon in 1st 6 months due to the presence of Maternal
antibody.
 Route of transmission: direct contact with respiratory secretions , aerosols created by coughing & sneezing .
 Koplik’s Spots in Measles:
 Buccal Mucosa opposite to lower molars.
 Colour: bluish- white ulcerations
 Composition : giant cells, cytoplasmic & intranuclear inclusions , virion components which indicates local viral
replication .
 Rare sites : Conjunctiva, Intestinal mucosa.
 Sites of rash appearance: forehead first & then spreads downwards.
 Complications:
 Croup
 Bronchitis
 Secondary bacterial infections: Pneumonia, otitis media .
 Most serious, late complication: SSPE: Sub acute Sclerosing Pan Encephalitis .

48. True about Polio

A. Paralytic polio is most common
B. Spastic paralysis
C. Decreased muscular activity leads to increased paralysis
D. Polio drop given only n < 3 year

Ans: C. Decreased muscular activity leads to increased paralysis

Ref: Ananthanarayan, 9/E, p. 487
Explanation:
 FamilyPicorna viridae includes ss RNA viruses, 27-30 nm in size
 4 genera of Picorna viruses include
1. Enterovirus: infects enteric tract
2. Rhinovirus: infects nasal mucosa
3. Hepatovirus
4. Parechovirus
 Entero virus includes, Poliovirus 1-3, Coxsackie group A, Coxsackie group B, ECHO virus, Numbered Entero virus (
EV) 68-71
 Polio virus affects Anterior Horn Cells of Grey matter of Spinal cord
 Type of paralysis: flaccid muscle paralysis
 Intact sensory system , pure motor paralysis
 Coxsackie group A
 Herpangina or vesicular pharyngitis
 Aseptic meningitis
 HFMD – Hand foot and mouth disease
 Coxsackie group B
 Myocarditis and Pericarditis
 Juvenile diabetes
 Post viral fatigue syndrome
 PHARMACOLOGY

49. Alkaline dieresis is done for treatment of poisoning due to

A. Morphine
B. Amphetamine
C. Phenobarbitone
D. Atropine

Ans:- C Phenobarbitone
Ref:- KK Sharma 2nd/46
Explanation:-
Phenobarbitone is a barbiturate which is a derivative of barbituric acid (weakly acidic drug) and its excretion can be
enhanced by making the urine alkaline

50. Comparison of efficacy of a new drug B with an existing drug A is done in which phase of clinical trials?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV

Ans:- C Phase III

Ref:- Ethical guidelines for biomedical research on human participants by ICMR, 2008/39
“The purpose of phase III trials is to obtain adequate data about the efficacy and safety of drugs in a larger number of
patients of either sex in multiple centres usually in comparison with the standard drug.

51. A new born baby was born with phocomelia. It results due to which drug taken by mother during pregnancy?
A. Tetracycline
B. Thalidomide
C. Warfarin
D. Alcohol

Ans:- B Thalidomide
Ref:- KD Tripathi, 6th/85, Katzung 11th/973
Explanation:-
Thalidomide is highly teratogenic drug that can result in phocomelia as congential anomaly

52. Pharmacovigilance means

A. Monitoring of drug safety
B. Monitoring of unethical trade of drugs
C. Monitoring pharma students
D. Monitoring drug efficacy

Ans:- A Monitoring of drug safety

Ref:- Internet
Explanation:-
Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of
adverse effect or any other possible drug related problems

53. A patient presented in emergency with tachycardia, hyperthermia, bronchial dilatation and constipation. The person is
likely to be suffering from overdose of
A. Atropine
B. Organophosphorus compound
C. Mushroom
D. Paracetamol

Ans:- A Atropine

Ref:- Modi’s Medical Jurisprudence and Toxicology 23rd, 2005/92, 403, 429-430, Goodman and Gilman12th/234-235
 Explanation:-

These are the characteristic features of anit-cholinergic overdose

54. A patient came to the casualty with acute bronchial asthma after treatment for glaucoma. The probable drug may be
A. Timolol
B. Betaxolol
C. Latanoprost
D. Anticholinesterase

Ans:- A Timolol

Ref:- KDT 6th/139

Explanation:-

Timolol is a non-selective beta blocker and can precipitate acute attacks of asthma in a susceptible individual via blockade
of β2 receptors. Betaxolol is a cardioselective beta blocker and is less likely to cause this adverse effect

GENERAL MEDICINE

55. Which of the following statements about iron deficiency anemia is true

A. Decreased TIBC
B. Increased Ferritin levels
C. Bone marrow iron is decreased after serum iron is decreased
D. Bone marrow iron is decreased earlier than serum iron
Ans:- D. Bone marrow iron is decreased earlier than serum iron
Ref:- Harrison 18th p 846
Explanation:-

Serum levels of iron decrease after bone marrow iron is decreased

As long as iron stores are present (serum ferritin, bone marrow iron), and can be mobilized, the serum iron. Total iron
binding capacity and red cell protoporphyrin levels remain within normal limits.

56. Autoimmune haemolytic anemia is seen in

A. ALL
B. AML
C. CLL
D. CML
Ans:- C. CLL
Ref:- Harrison 14th/666
Explanation:-

Leukemias specially of the CLL type are associated with autoimmune hemolytic anemia

Autoimmune hemolytic anemia of the warm antibody type are caused by leukemias specially of the chronic
lymphocytic type and NonHodgkin lymphoma.

57. Millard Gubler syndrome includes the following EXCEPT

A. 5th nerve palsy
B. 6th nerve palsy
C. 7th nerve palsy
D. Contralateral hemiparesis
Ans: A. 5th nerve palsy
Ref: Harrison, 17/E, p.
Explanation:
 5th nerve palsy is not a feature of Millard Gubler syndrome.
 Millard Gubler syndrome result from ventral pontine injury and is associated with lateral nerve weakness(6th CN
involvement), ipsilateral facial palsy(7th nerve palsy), and contralateral hemi paresis.

58. All of the following statements are true about Benedict's syndrome, EXCEPT?
A. Contralateral tremor
B. 3rd Nerve palsy
C. Involvement of the penetrating branch of basilar artery
D. Lesion at the level of pons

Ans: D. Lesion at the level of pons

Ref: Harrison, 17/E, p.
Explanation:
 Benedict's syndrome, also known as Dorsal Midbrain Syndrome, results from a lesion in the midbrain tegmentum/red
nucleus. It is not a pontine syndrome.
 In Benedict's syndrome, injury to the red nucleus of midbrain results in ipsilateral occulomotor palsy, contralateral
tremor, chorea and athetosis.

59. Most common organism associated with Reactive Arthritis is

A. Staphylococcus
B. Ureeplasma urealyticum
C. Shigella
D. Yersinia

Ans: B. Ureeplasma urealyticum

60. Chronic burrowing ulcer is caused by

A. Micro aerophilic streptococci
B. Peptostreptococcus
C. Streptococcus viridians
D. Streptococcus pyogenes

Ans: A. Micro aerophilic streptococci

Ref: Bailey & Love, 24/E, p. 124
Explanation:
Synergistic spreading gangrene (necrotizing fasciitis) is not caused by clostridia. A mixed pattern of organisms is responsible:
coliforms, staphyolococci, Bacteroides spp., anaerobic streptococci and pepto-streptococci have all been implicated. Abdominal
wall infections are known as Meleney’s synergistic hospital gangrene and scrotal infection as Fournier’s gangrene’
Meleney’s synergistic hospital gangrene is another name for chronic burrowing ulcer.

61. All of the following can cause osteoporosis except:

A. Hyperparathyroidism
B. Steroid use.
C. Fluorosis
D. Thyrotoxicosis
Ans: c: flourosis
Ref:harrison 17/e – pg -966

62. Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease?
A. Aminotransaminase
B. Alkaline phosphatase.
C. Bilirubin
D. Albumin

ANS:D: albumin

Ref: robins pathology 8/e – pg 633-634

Exp:Only minimal changes in serum albumin are seen in acute liver conditions. Hypoalbumenianis common in chronic liver
diseases such as cirrhosis.

63. A 25-year-old female presents with 2-year history of repetitive, irresistible thoughts of contamination with dirt associated
with repetitive hand washing. She reports these thoughts to be her own and distressing; but is not able to overcome them
along with medications. She is most likely to benefit from which of the following therapies:
A. Exposure and response prevention
B. Systemic desensitization
C. Assertiveness training
D. Sensate focusing

Ans:A: EXPOSURE AND RESPONSE PREVENTION.

REF: net sources

Exp:The patient is a case of obsessive compulsive neurosis and is not responding to the drug treatment.The treatment of choice is
behavioural therapy. Exposure and response prevention is the first line technique of behavioural therapy in Obsessive compulsive
neurosis patients.

64. Persistent vomiting most likely cause

A. Hyperkalemia
B. Acidic urine excretion
C. Hypochloremia
D. Hyperventilation

Ans: B: acidic urine excretion

Ref: Harrison 17 / e- pg 20
Exp:
persistent vomiting causes hypocholeremia , hypokalemia, hypoventilation metabolic alkalosis with paradoxical acidic urine
excretion. Thus both B and C are alternatives. Hypocholeremia is found in both initial as well as compensatory phase but
paradoxiacal aciduria exists only when there is severe hypokalemia. Since the question specifically asks about the likely event B is
the choice of answer.
 GENERAL SURGERY

65. Which among the following is not a feature of peripheral arterial occlusion
A. Shock
B. Pallor
C. Pain
D. Pulselessness

Ans:- A Shock
Ref:- Bailey & Love 25/e p 909
Explanation:-

 Symptoms and signs of peripheral arterial occlusion are classically remembered by 5 ps

 Pain-Pallor-Pulselessness-Paralysis &
 Paraesthesia (actually it is anesthesia, complete loss of sensation)
 Some add a sixth P- Poikilothermia or perishing cold
 MC presenting symptom of acute arterial occlusion-Pain (Schwartz Pretest)

66. All may be seen in deep burns except

A. Hyperthermia
B. Increase vascular permeability
C. Fluid loss by evaporation
D. Vasodilatation

Ans:- A Hyperthermia
Ref:- Harrison 17/e p 135
Explanation:-

 Burns may lead to hypothermia (not hyperthermia)

Schwartz writes- Radiant heat loss is increased from the burn wound secondary to increased blood flow and
integumentary loss
 Heat loss also occurs because of evaporation of water from the burn wounds. This evaporation from wounds cause a
significant fluid loss
 About option b & d sabiston writes
“Significant burns are associated with massive release of inflammatory mediators, both in the wound in the other
tissues. These mediators produce vasoconstriction and vasodilation, increased capillary permeability, and edema
locally and in distant organs.

67. Immediate management of a patient with multiple fracture and fluid loss includes the infusion
A. Blood
B. Dextran
C. Normal saline
D. Ringer lactate

Ans:- D Ringer lactate

Ref:- Washington Manual of Surgery 4/e p 79
Explanation:-

 Resuscitation following fluid loss from multiple fractures, begins with administration of 2-3 liters of Isotonic
crystalloids immediately to restore BP and peripheral circulation.
 Lactated ringer’s solution is generally preferred over 0.9% NaCL (Normal Saline) as it is balanced salt
solution and is designed to mimic extracellular fluid.
(0.9% NaCL is preferred in presence of hyperkalemia, hypercalcemia, hyponatremia, hypochloremia and
metabolic alkalosis.
 Resuscitation with colloidal solution is found to be no more effective than crystalloids and is more expensive.
68. Commonest organ injured in blast injury is
A. Lung
B. Liver
C. Spleen
D. Pancreas

Ans:- A Lung
Ref:- Love & Bailey 25/e p 422
Explanation:-

The structures injured by the primary blast wave, in order of prevalence are the middle ear, the lungs and the bowel

- The hollow organs containing gas or air are most readily damaged by blast waves. The homogenous tissues like liver and
muscle are least likely injured.
- In underwater blast, injuries occur mostly in gastrointestinal tract and less commonly in lungs.
- The lung injury can introduce air into the circulatory system. Death may occur from systemic air embolism
- Tympanic membrane rupture is a sensitive marker for primary blast injury.

69. True regarding non accidental traumatic fractures all except

A. Costochondral joint fracture
B. Sterna fracture
C. Parietal fracture
D. Metaphyseal corner fracture

Ans:- C Parietal fracture

Ref:- Medico-legal Radiology by Hare 2007/149

70. Advantages of full thickness skin graft over split thickness graft are all except
A. Better color matching
B. Less contraction
C. Less chances of injury after healing
D. Large surface area can be covered

Ans:- D Large surface area can be covered

Ref:- CMDT, 2002/94

71. To replenish the inventory the blood banks routinely issue blood packets which are close to the expiry date. Which of the
following will be closest to expiry date according to the anticoagulant used and the method of storage of the packet
A. CPDA, 27 days
B. SAGM 25 days with irradiation
C. SGAM 35 days
D. ACD 14 days

Ans:- B SAGM 25 days with irradiation

Ref:- Ajay Yadav, 5th/17,

72. Which of the following is the best indication for transfer of maternal blood components to an infant
A. Plasma to prevent ITP
B. RBCs to prevent TA-GVH
C. Plasma to prevent NAIT (Neonatal Alloimmune Idiopathic thrombocytopenia)
D. Platelets to prevent NAIT

Ans:- D Platelets to prevent NAIT

Ref:- Danforth’s Obstetrics and Gynecology, 10th/326

73. A 36 year female complains of abdominal pain and constipation since 5 years, she has on & off rectal bleed when she tries
to defecate forcefully. The most probable diagnosis is
A. Ulcerative colitis
 B. Crohn’s disease
C. Tuberculous intestine
D. Irritable bowel syndrome

Ans:- D Irritable bowel syndrome

74. A 15 year old boy is suffering from Hodgkin’s disease which shows involvement of lymph nodes. Which of the following
treatment will have high success rate
A. Lymph node resection
B. Chemotherapy
C. Immunotherapy
D. Surgery + immunotherapy

Ans:- B Chemotherapy
Ref:- Hematology by Handin, et al, 2003/847

75. Throat pack true is

A. Not caused with cuffed enotracheal tubes
B. Removed prior to extubation
C. Well tolerated by awake patient
D. Should be used even after surgery

Ans:- B Removed prior to extubation

Ref:- Airway Management by Dalal, Dolenska, Taylor, 2004

76. All of the following tests can be useful in identifying syncope except
A. Pet scan
B. Table tilt test
C. Hollanders test
D. Electrophysiology

Ans:- C Hollanders test

Ref:- General surgery board review/21

DENTAL MATERIALS

77. Impression material of choice in patients with Submucous fibrosis is

A. Zinc oxide eugenol
B. Addition silicon
C. Condensation silicon
D. Plaster of Paris

Ans: B. Addition silicon

Ref:
Explanation:
 In oral Submucous fibrosis zinc oxide eugenol may cause discomfort due to increased burning sensation
 Silicone impression material have been the material of choice for these patients. But additional silicones are preferred over
condensation silicones due to dimensional accuracy

78. Which of the following is not correct about dental stone?

A. High strength low expansion dental stone contains some additives to reduce expansion
B. Dental stone is manufactured by heating gypsum at temperature 110 - 120°C in an open kettle
C. Dental stone is much harder and stronger than β – hemihydrate
 D. Microscopically it is seen as cleavage fragments and crystal in the form of rods and prisms

Ans: B. Dental stone is manufactured by heating gypsum at temperature 110 - 120°C in an open kettle
Ref: Craig's, 13/E, p. 301
Explanation:
 Plasters are produced when the gypsum mineral is heated in an open kettle at a temperature of about 110° to 120° C.
The hemihydrate produced is called β- calcium sulfate hemihydrate. Such a powder is known to have a somewhat
irregular shape and is porous in nature. These plasters are used in formulating model and lab plasters. Crystals of
model plaster are shown in Figure 12-20. If gypsum is dehydrated under pressure and in the presence of water vapor
at about 125° C, the product is called hydrocal. The powder particles of this product are more uniform in shape and
denser than the particles of plaster. Crystals of a dental stone are shown in Figure 12-21. The calcium sulfate
hemihydrate produced in this manner is designated as α-calcium sulfate hemihydrate.

79. Which of the following is not true about casting calcium sulfate bonded investment material
A. It is used for gold alloy
B. 65 – 75% of gypsum changes to form α – hemihydrates
C. The investment material is heated at 500 - 700°C temperature
D. Heating above 700°C of investment causes formation of sulfur dioxide from copper sulfate

Ans: B. 65 – 75% of gypsum changes to form α – hemihydrates

Ref: Phillips, 12/E, p. 201
Explanation:
 In general, the investments suitable for casting gold alloys contain 65% to 75% quartz or cristobalite, or a blend of the
two, in varying proportions; 25% to 35% of α-calcium sulfate hemihydrate; and about 2% to 3% chemical modifiers.

80. Which of the following is true about hybrid ionomer

A. Release less fluoride than compomer
B. Fluoride release at the same level as conventional GIC
C. More ionic activity compared to conventional GIC
D. More sensitive to water contamination than conventional GIC

Ans: B. Fluoride release at the same level as conventional GIC

Ref: Craig's, 13/E, p. 153
Explanation:
 Resin-modified glass ionomers, also known as hybrid ionomers, are used for restorations in low stress-bearing areas
and are recommended for patients with high caries risk. Hybrid ionomers release more fluoride than compomers and
composites but almost the same as glass ionomers.

81. Which of the following is used as a thickening agent in dentifrices

A. Calcium carbonate, calcium phosphate and calcium sulphate
B. Sodium bicarbonate and aluminum oxide
C. Sodium lauryl sulphate and sodium lauryl succinate
D. Carboxymethyl cellulose and alginate amylase

Ans: D. Carboxymethyl cellulose and alginate amylase

Ref: Scholarly Brief Dentifrices—Advances in Research and Application: 2013 Edition, p. 19
Explanation:
82. Which of the following is not a noble metal
A. Silver
B. Gold
C. Ruthenium
D. Osmium

Ans: A. Silver
Ref: Phillips, 12/E, p. 367
Explanation:
 Noble metal—Gold and platinum group metals (Platinum, Palladium, Rhodium, Ruthenium, Iridium, and Osmium),
which are highly resistant to oxidation and dissolution in inorganic acids. Gold and platinum do not oxidize at any
temperature, rhodium has excellent oxidation resistance at all temperatures, osmium and ruthenium form volatile
oxides, and palladium and iridium form oxides in the temperature ranges of 400 °C to 800 °C and 600 °C to 1000 °C,
respectively.

83. Distortion of wax pattern can be minimized by

A. Softening the wax at high temperature
B. Keeping the die in cold water before making pattern
C. Use of a high temperature for heating wax
D. Carving with warm instruments

Ans: D. Carving with warm instruments

Ref: Craig 12th ed pg.349
Explanation:
Residual stress in waxes are incorporated least if
 Wax is heated uniformly at 50 degrees for 15mins before use
 Use warm instruments for carving
 Use warm die
 Adding wax to the die in small amounts

84. The lowest blood mercury level at which the earliest nonspecific symptoms start appearing at
A. 25 ng/ml
B. 35 ng/ml
C. 40 ng/ml
D. 45 ng/ml

Ans: B. 35 ng/ml
Ref: Phillip’s 12th ed 124
Explanation:
  In spite of attempts to demonstrate direct relationship between the presence of dental amalgams and elevated blood
levels of mercury, none has been found till date. It has been seen that the average mercury level in the blood of
subjects with amalgams is around 0.7 ng/ml, whereas the level in subjects without amalgam is 0.3 ng/ml. in
comparison, the ingestion of one saltwater seafood meal per week raised the average blood mercury level from 2.3 to
5.1 ng/ml, which can contribute seven times more mercury to blood levels than the presence of multiple dental
amalgam restorations.
 It has been estimated that a patient with 9 amalgam occlusal surfaces will inhale daily only about 1% of the amount
 The lowest level of total blood mercury at which the earliest nonspecific symptoms occur is 35 ng/ml or 3 pg/L (after long term
exposures)
 The lowest dose of mercury that illicit a toxic reaction is 3 to 7 pg/kg body weight.
 Paraesthesia (tingling of extremities) occurs at about 500 pg/kg of body weight, followed by ataxia at 1000 pg/kg of
body weight, joint pain at 2000 pg/kg of body weight, and hearing loss and death at 4000 pg/kg of body weight.
Therefore, these values are much greater in magnitude than the exposure to mercury from amalgam or from a normal
diet.
 The body cannot retain metallic mercury, but passes it through the urine. By using radioactive mercury in amalgams,
it is possible to monitor the mercury levels in urine caused only by dental amalgams. One study showed that urine
mercury levels peak at 2.54 pg/L 4 days after placing amalgams and, after 7 days return to zero. On removal of
amalgam, urine mercury levels reach a maximum value of 4 pg/L and return to zero after a week.
 OSHA has set a Threshold Limit Value (TLV) of 0.05 mg/m3 as the maximum amount of mercury to be inhaled in the
workplace

85. Munsell system is used to

A. Defines and measures color qualitatively
B. Defines and measures physical properties of gold alloys
C. Evaluate brittleness of different alloys
D. Defines and measures color quantitatively

Ans: D. Define and measures color quantitatively

Ref: Craig’s, 12/E, pp. 30-31

Explanation:

Measurement of color
Various color systems are used to measure color among them CIE L*a* b system, RGB system, CMYK system, and Munsell
system
Munsell system
It consists of three independent dimensions represented cylindrically in three different directions.
Three dimensions of color are
VALUE: - which increases from black at bottom to white at top center
Chroma: - Which increases from the center outward for a particular color
Hue
The color is written as HV/C which is called as Munsell notation
It is very useful for color matching purposes for hair, skin, and mucosa

86. Which of the following test is classified as micro hardness test?

A. Brinell
B. Knoop
C. Rockwell
D. None

Ans: B. Knoop
Ref: Phillips, 12/E, p. 65

87. Addition of 2% potassium sulfate and 0.5% borax in Agar

A. Reduce setting and working time of plaster
B. Increases strength of gel
C. Retard the setting reaction of gel
D. Modified the chemical reaction

Ans: B. Increases strength of gel

Ref: Phillips, 12/E, p. 170
Explanation:
 A small percentage of borax is added to strengthen the gel. Since borax is a potent retarder for the setting of gypsum,
an accelerator such as potassium sulfate is added to counteract the effect of borax.

88. The Hysteresis defined as

A. Conversion of gel to sol
B. Time lag between conversion of primary gel temperature to secondary gel temperature
C. Absorption of water from the surface of the impression material
D. Exudation of water from agar during physical changes

Ans: B. Time lag between conversion of primary gel temperature to secondary gel temperature
Ref: McCabe’s dental material pg.134
Explanation:
There is a temperature hysteresis effect on the gel to sol and sol to gel transition in that the latter process occur at lower
temperature and gel to sol occurs at higher temperature.
Also know
Syneresis: - gel may loss water from its surface or by exudation of fluid on to surface by a process called as Syneresis
Imbibition: - gel absorb water by a process called imbibition
 DENTAL ANATOMY & DENTAL HISTOLOGY

89. Fovea palatini represent

A. Depressions along courses of greater palatine nerve
B. Orifice of minor palatine salivary glands
C. Crypts in palatine tonsils
D. Tensor palatine insertion

Ans: B. Orifice of minor palatine salivary glands

Explanation:
 Fovea palatine are a pair of pits in the soft palate locate to the either side of the midline, near but just posterior to
the vibrating line.
 They are openings of ducts of minor palatine mucous glands.

90. The cells that are present in stratum spinosum and stratum basale are
A. Basket cells
B. Melanocytes
C. Keratinocytes
D. Markel cells

Ans: B. Melanocytes

Ref: Orban’s, 12/E, p. 295

91. The thickness of prism less enamel in deciduous teeth is

A. 25 µm
B. 50 µm
C. 75 µm
D. 100 µm

Ans: A. 25 µm

Ref: Orban’s, 12/E, p. 51

Explanation:

 A relatively structure less layer of enamel, approximately 30 microns thick called prismless enamel, has been
described in 70% of permanent teeth and all deciduous teeth.
 This is least often seen on the cusp tips and mostly toward the cervical areas of the enamel surface.
 In this surface layer no prism outlines are visible, and all of the apatite crystals are parallel to one another and
perpendicular to the striae of retzius. It is also somewhat heavily mineralized than the bulk of enamel beneath it.

92. In which part of oral cavity, mucous membrane is the thinnest

A. Soft palate
B. Labial mucosa
C. Floor of mouth
D. Buccal mucosa

Ans: C. Floor of mouth

Ref: Orban’s, 12/E, p. 236

 Explanation:

 The mucous membrane on the floor of the oral cavity is thin and loosely attached to the underlying structures to
allow for the free mobility of the tongue.
 The epithelium is non keratinized, and papillae of the lamina propria are short.

93. Which is the predominant factor in the formation of the alveolar system
A. Eruption of teeth
B. Normal process of growth
C. Lengthening of the condyle
D. Overall growth of the bodies of the maxilla and the mandible
Ans: A. Eruption of teeth

94. Relative to primary mandibular incisors, permanent mandibular incisors lies

A. Lingually
B. Facially
C. Distally
D. Mesially

Ans: A. Lingually

Ref: Orban’s, 12/E, p. 294

Explanation:

 Mandibular permanent teeth lies inferiorly and lingually in relation to deciduous tooth.
 Permanent mandibular incisors usually does not move to the apical position and thus erupts lingually to the still
functioning deciduous tooth.
 In general, the pressure generated by the growing and erupting permanent tooth dictates the pattern of deciduous
teeth resorption.
 At first this pressure is directed against the root surface of the deciduous teeth itself. Because of the developmental
position of the permanent incisor and canine tooth germs and their subsequent physiological movement in an
occlusal and vestibular direction, resorption of the roots of the deciduous incisors and canines begin on their
lingual surface.
 Later these developing tooth germ occupy a position directly apical to the deciduous tooth, which permits them to
erupt in the position formerly occupied by the deciduous teeth.

95. At what age, a child is expected to have 12 primary teeth and 12 permanent teeth
A. 4 ½ years
B. 6 ½ years
C. 8 ½ years
D. 12 years

Ans: C. 8 1/2 years

96. Which of the following deciduous teeth shows the least resemblance to any of the other deciduous or permanent teeth
A. Mandibular primary canine
B. Mandibular primary 1st molar
C. Mandibular primary 2nd molar
D. Maxillary primary 1st molar
 Ans: B. Mandibular primary 1st molar

Ref: Wheeler’s, 9/E, p. 62

Explanation:

 Mandibular primary first molar does not resemble any other teeth, deciduous or permanent. Because it varies so
much from all others, it appears strange and primitive.

97. The mesial outline of the labial aspect of mandibular canine from contact area to apex is
A. Convex
B. Concave
C. Irregular
D. Straight

Ans: D. Straight

Explanation:

Permanent Mandibular Canine

 Mesial outline is straight with the mesial outline of the root, while distal is convex.
 Both converge slightly toward the cervix.
 Mesial height of contour is just below MI angle while DI angle is between incisal & middle thirds.
 The crowns of the mandibular canines appear longer than maxillary canines due to the narrowness of the crown
mesiodistally and the height of the contact areas above the cervix.

98. In an ideal arrangement of permanent teeth, the largest incisal embrasure lies between
A. Maxillary central incisors
B. Maxillary central and lateral incisor
C. Maxillary lateral incisor and canine
D. Mandibular cervical and lateral incisor

Ans: C. Maxillary lateral incisor and canine

Explanation:

 The distal contact area on the lateral incisor is approximately at the middle third. The mesial contact area on the
canine is at the junction of incisal and middle thirds. The form of these teeth creates an embrasure that is more wide
and open.

99. In the intercuspal position, the lingual cusp of maxillary 2 nd premolar contacts the
A. Distal fossa of mandibular 2nd premolar
B. Mesial marginal ridge of mandibular 1st molar
C. Distal marginal ridge of mandibular 2nd molar
D. Distal marginal ridge of mandibular 2nd premolar

Ans: D. Distal marginal ridge of mandibular 2nd premolar

Explanation:

 The underlying picture illustrates the different contact points on maxillary and mandibular teeth.
 The lingual cusp of maxillary 2nd premolar contacts with distal marginal ridge.
100. Enamel lamellae may be defined as
A. Imperfections filled with organic material
B. Enamel imperfections extending from the enamel surface to the dentinoenamel junction and dentin
C. Imperfection confined to enamel
D. Imperfection confined to dentin
Ans: B. Enamel imperfections extending from the enamel surface to the dentinoenamel junction and dentin

Ref: Orban’s, 12/E, pp. 51, 54

Explanation:

 Enamel lamellae are thin leaf like structures that extends from enamel surface towards the DEJ.
 The lamellae represent improperly mineralized enamel which is a failure of removal of organic matrix and water
during development.
 Lamellae arise developmentally due to incomplete maturation of groups of rods and contain enamel proteins

ORAL PATHOLOGY & ORAL MEDICINE

101. Persistence of Tuberculam impar leads to
A. Median rhomboid glossitis
B. Benign migratory glossitis
C. Cleft tongue
D. Lingual tonsil

Ans: A. Median rhomboid glossitis

Ref: Shafer’s, 7/E, p. 30

Explanation
 Median Rhomboid glossitis is congenital anomaly of tongue which is presumably due to failure to tuberculam
impar to retract before fusion of lateral halves of tongue .
 Current concept suggest that it results from a chronic C. albicans infection

102. Viral Load detection

A. RT – PCR
B. Western blot
C. Biopsy
D. ELISA

Ans: A. RT – PCR
Ref: Reverse Transcription And Polymerase Chain Reaction: Principles And Applications In Dentistry. J Appl Oral Sci
2004; 12(1): 1-11

Explanation
Enzymes used in Recombinant DNA technology
 Enzymes
Type II restriction endonuclease
DNA ligases
DNA polymerases I (E.coli)
Reverse transciptase
Polynucleotide Kinase
Tuminal transferase
Alkaline phosphatase
Functions
Cleaves DNA at specific base sequences
Joins two DNA molecules or fragements
Fill gaps in duplexes by stepwise
addition of nucleotide to 3 ends
Make DNA copy of RNA molecule
Add a phosphate to 5-OH end of
polynucleotide to label it
Adds homopolymer tails to 3-OH ends
of a linear duplex
Remove terminal phosphate from either
5 or 3 end

103. True about Acanthosis Nigricans

A. Insulin resistance + obesity + Hyperpigmentation
B. Insulin resistance + Leanbody + Hyperpigmentation
C. Hyper MSH + Obesity + Hyperpigmentation
D. Insulinoma + Obesity + Hypopigmentation

Ans: A. Insulin resistance + obesity + Hyperpigmentation

Ref: Shafer’s, 7/E, p. 823

Explanation
 Acanthosis Nigricans is an unusual dermatosis.
 It is divided into two broad categories, benign and malignant.
 Benign forms exhibit skin lesions & an associated insulin resistance.
 Malignant forms isassociated with significant complications because the underlyingmalignancy, which is often
an aggressive tumor (e.g. adenocarcinomasof various internal organs, particularly the stomach or
malignantlymphomas).
 Pseudoacanthosis nigricans, a clinical form similar to benign acanthosis nigricans may occur in some obese
people.
 The skin lesions vary from a symmetric, mild hyperpigmentation andmild papillary hypertrophy of only small
patchy areas to heavilypigmented, aggressively verrucous lesions involving much ofthe skin, especially the
axillae, palms and soles, and face and neck.

104. Raw beefy tongue is seen in

A. Niacin
B. Riboflavin
C. Cyano cobalamine
D. Scarlet fever

Ans: A. Niacin
Ref: Shafer’s, 6/E, p. 645

Explanation:
 Niacin deficiency causes
 Raw beefy tongue
 Bald tongue of sand with
 Mucosa becomes very red and painful
 Vitamin B2 deficiency: Magenta colored tongue
 Vitamin Folic acid deficiency: Fiery red tongue
 Vitamin B12 deficiency: Beefy red tongue
Hunters or Moeller's glossitis (Similar to bald tongue of sand with of Niacin deficiency)
105. Taurodontism is associated with
A. Klinfelter’s syndrome
B. Marfan’s syndrome
C. Regional odonto dysplasia
D. Cleidocranial dysplasia

Ans: A. Klinfelter’s syndrome

Ref: Shafer’s, 7/E, p. 45

Explanation
 Syndromes associated with Taurodontism
1. Down’s syndrome
2. Hypophosphatasia
3. Klinefelter’s syndrome
4. Oral-facial-digital syndrome
5. Occulo-dento-digital dysplasia
6. Tricho-dento-osseous type I, II, III
7. Cranio ectodermal dysplasia
8. Ectodermal dysplasia
9. Amelogenesis imperfecta - Taurodontism type IV
10. Hypoplastic Amelogenesis imperfecta

106. In HIV infection, the blood cells infected the most are
A. CD4
B. B – lymphocyte
C. RBC
D. Neutrophils

Ans: A.CD4
Ref: Shafer’s, 7/E, p. 357

Explanation
 After gaining entry into the host, either through exposureto blood, body fluids, or sexual activity, HIV binds to
CD4 T lymphocytes mediated by GP120 protein in the virus envelope.
 After binding, the virus becomes internalized intothe host cell where it becomes uncoated.
 Within the host nucleus,viral RNA replicates rapidly &later propagates to various parts of the body.

107. Most common primary malignant bone tumour

A. Multiple myeloma
B. Osteosarcoma
C. Ewing sarcoma
D. Osteochondroma

Ans: B. Osteosarcoma
Ref: Shafer’s, 7/E, p. 174

Explanation
 Most common primary malignant bone tumour: Osteosarcoma
 Second common primary malignant bone tumour: Chondrosarcoma
 Most common malignant bone tumor in children : Ewing’s sarcoma
 Third most common cancer in adolescence : Osteosarcoma
108. What is the other name of Nasoalveolar cyst
A. Klestadt’s cyst
B. Nasopalatine duct cyst
C. Median palatal cyst
D. Epstein’s pearl

Ans: A. Klestadt’s cyst

Ref: Shafer’s, 7/E, p. 66-67

109. Staghorn pattern is a feature of

A. Hemangioma
B. Hemangiopericytoma
C. Neurofibromatosis
D. Traumatic Neuroma

Ans: B. Hemangio pericytoma

Ref: Shafer’s, 6/E, p. 166-167

Explanation
 Hemangiopericytoma consists of numerous slit-like, branching vascular channels lined by plump endothelial
cells&surrounding tightly packed proliferatingoval & spindle cells.
 The branching vascular channels of varying sizes resemble antlers &is often called as stag horn pattern.

110. Rhabdomyosarcoma originates from

A. Nerve tissue
B. Vascular endothelium
C. Smooth muscle
D. Striated muscle

Ans: D. Striated muscle

Ref: Shafer’s, 7/E, p. 196

Explanation
 Rhabdomyosarcoma is the malignant tumor of striated muscle, relatively uncommon tumor in the oral cavity.
 Tumours of skeletal muscle
 Benign: Rhabdomyoma
 Malignant: Rhabdomyosarcoma
 Tumours of smooth muscles
 Benign: Leiomyoma
 Malignant: Leiomyosarcoma

111. Which is a T – cell Neoplasm

A. Mycosis fungoides
B. Burkitt’s lymphoma
C. Hairy cell leukemia
D. Mental

Ans: A. Mycosis fungoides

Ref: Neville, 3/E, p. 598-599
 Explanation
 Mycosis fungoidesis an epidermotropic (propensity to invade the epidermis of the skinlymphomaderived from
mature T-cells, especially T-helper cells (CD4+)
 It presents initially in the skin, withstepwise progression from patches to plaques andtumors.

Stage Clinical features Histopathologic features

Erythematous/ Well-demarcated, scaly, Psoriasiform epithelial changes & scattered slightly, atypical
eczematous stage erythematous patches lymphocytes in the connective tissue papillae.
Plaque stage Slightly elevated red lesions  Surface epithelium shows infiltration by atypical
lymphocytes called mycosis cells/ Sezary cells.
 Small intraepithelial abscesses formed by these atypical
lymphocytes is called as Pautrier’s abscess.
 Lesional cells exhibit cerebriform nucleus – marked
infoldings of the nuclear membrane.

Tumor stage Plaque becomes distinct Diffuse infiltration of the dermis & epidermis by the
papules & nodules atypical lymphocytes which characterizes the lesion as
malignant.

 Intraoral sites that are gingiva, hard & soft palate, tongue, buccal mucosa, tonsils, lips, sinuses, nasopharynx.
 Oral lesions present as indurated plaques or nodules that are typically ulcerated.
 Oral lesions develop late in the course of the disease & develop after cutaneous lesions.
 Sezary syndrome – an aggressive expression of mycosis fungoides that represents a dermatotrophic T-cell
leukemia.

112. Melanin pigmentation of sun exposed skin of face and neck which is strongly associated with pregnancy and use of oral
contraception is called as
A. Melanoma
B. Cafe au lait spots
C. Freckle
D. Melasma

Ans: D. Melasma
Ref: Neville, 3/E, p. 329

Explanation
 Melasma of pregnancy is called Chloasma which is also called the Mask of pregnancy occurs more in dark
skinned people and is related to hormonal changes in pregnancy or contraceptives containing both estrogen and
progesterone.

113. Multiple punched out lesions are seen in

A. Paget’s disease
B. Osteosarcoma
C. Ewing sarcoma
D. Multiple myeloma

Ans: D. Multiple myeloma

Ref: Shafer’s, 7/E, p. 189

Explanation
  Radiographic examinations of Multiple myeloma reveals numerous sharply punched-out areas in avariety of
bones, which may include the vertebrae, ribs, skull,jaws and ends of long bones (all these aresites of active
hematopoiesis)

114. Reilly bodies are present in

A. Lymphocyte
B. Monocyte
C. Neutrophil
D. Plasma cell

Ans: A.Lymphocyte
Ref: Shafer’s, 7/E, p. 630-631

Explanation
 In Hurler’s syndrome, metachromic granules or Reilly bodies often can be demonstrated in the cytoplasm of
circulating lymphocytes

ORAL RADIOLOGY
115. A dark gray color radiolucency is seen in dentin at dentinoenamel junction that is often confused with dentinal caries is
A. Hunter Shreger band
B. Dead tracts
C. Mach band
D. Tome’s granular layer

Ans: C. Mach band

Ref: White & Pharoah, 6/E, p. 274
Explanation:
 When there is a sharply defined density difference, such as between enamel and dentin, there may appear to be a
more radiolucent region immediately adjacent to the enamel. This is an optical illusion referred to as the Mach
band. This illusion can contribute to the number of false-positive interpretations; therefore, when there are no
clinical signs of a lesion, it is reasonable to observe these cases and withhold operative treatment. The classic
radiographic appearance of occlusal caries extending into the dentin is a broad-based, radiolucent zone, often
beneath a fissure, with little or no apparent changes in the enamel. The deeper the occlusal lesion, the easier it is
to detect on the radiograph

116. Zygomatic arch fractures are best seen in

A. Submentovertex view
B. Occipitomental view
C. Lateral view of skull
D. Postero – anterior view of skull

Ans: A. Submentovertex view

Ref: White and pharaoh, 6/E, p. 554
Explanation:
Submentovertex (SMV)
 This projection shows the base of the skull, sphenoidal sinuses and facial skeleton from below.

Indications
 Destructive/expansive lesions affecting the palate, pterygoid region or base of skull
 Investigation of the sphenoidal sinus
 Assessment of the thickness (medio-lateral) of the posterior part of the mandible before osteotomy
 Fracture of the zygomatic arches — to show these thin bones the SMV is taken with reduced exposure factors.
 Technique and Positioning
 The patient is positioned facing away from the film. The head is tipped backwards as far as is possible, so the
vertex of the skull touches the film. In this position, the radiographic baseline is vertical and parallel to the film.
 The X-ray tube head is aimed upwards from below the chin, with the central ray at 5° to the horizontal, centred
on an imaginary line joining the lower first molars.
 Note: The head positioning required for this projection means it is contraindicated in patients with suspected
neck injuries, especially suspected fracture of the odontoid peg.

117. The SI unit of radioactivity is

A. Gray
B. Curie
C. Rad
D. Rem

Ans: B. Curie

118. Least radiation exposure occurs in

A. MRI
B. CT scan
C. Arthrography
D. OPG

Ans: A. MRI

119. All of the following procedures are recommended in dark room processing, EXCEPT
A. Use of high intensity and short wavelength light
B. Light is placed 4 feet above the processing tank
C. Light is placed behind the processing tank
D. For processing X –ray, red GBX – 2 filter is used

Ans: A. Use of high intensity and short wavelength light

Ref: White & Pharoah, 6/E, p. 69
Explanation:
 The processing room should have both white illumination and safe lighting. Safe lighting is low-intensity
illumination of relatively long wavelength (red) that does not rapidly affect open film but permits one to see well
enough to work in the area. It is best to place one safelight above the work area on the wall behind the processing
tanks and somewhat to the right of the fixing tank. To minimize the fogging effect of prolonged exposure, the
safelight should have a I5-watt bulb and should be mounted at least 4 feet above the surface where opened films are
handled.
 X-ray films are very sensitive to the blue-green region of the spectrum and less sensitive to yellow and red
wavelengths. Accordingly, the red GBX-2 filter is recommended as a safelight in darkrooms where either intraoral or
extraoral films are handled, because this filter transmits light only at the red end of the spectrum. Film handling
under a safelight should be limited to about 5 minutes because film emulsion shows some sensitivity to light from a
safelight with prolonged exposure. The older ML-2 filters (yellow light) are not appropriate for fast intraoral dental
film or extraoral panoramic or cephalometric film.

120. All of the following factors are considered as safety measures in X ray production, EXCEPT
A. Beam of primary X – ray
B. At an angle from primary sources
C. Use of lead in wall is mandatory
D. Use of low KVp is recommended

Ans: D. Use of low KVp is recommended

Ref: White & Pharoah, 6/E, p. 40
Explanation:
  Increasing the kVp increases the potential difference between the cathode and anode, thus increasing the energy of
each electron when it strikes the target. This results in an increased efficiency of conversion of electron energy into x-
ray photons, and thus an increase in
 The number of photons generated
 Their mean energy
 Their maximal energy
 The increased number of photons produced per unit time by use of higher kVp results from the greater efficiency in
the production of bremsstrahlung photons that occurs when increased numbers of higher-energy electrons interact
with the target. The ability of x-ray photons to penetrate matter depends on their energy. High-energy x-ray photons
have a greater probability of penetrating matter, whereas relatively low-energy photons have a greater probability of
being absorbed. Therefore the higher the kVp and mean energy of the x-ray beam, the greater the penetrability of the
beam through matter.

121. All of the following EXCEPT one are true

A. Density has direct relation with milli ampere and time
B. Increasing milli ampere increases the quantity of radiation
C. Contrast increases with increases in milli ampere
D. Use of low KVp produces image with high contrast and superior quality

Ans: C. Contrast increases with increases in milli ampere

Ref: White & Pharoah, 6/E, p. 40

122. All of the following are true, EXCEPT

A. Use of speed-E film reduces radiation exposure.
B. Use of rectangular collimator decreases density
C. Use of rectangular collimator is indicated to decrease the radiation exposure
D. Use of collimator is recommended to reduce the size of X-ray beam

Ans: B. Use of rectangular collimator decreases density

Ref: White & Pharoah, 6/E, p. 37
Explanation:
 Use of a rectangular PID having an exit opening of 3.5 x 4.4cm (1.38 x 1.34 inches)reduces the area of the patient's skin
surface exposed by 60% over that of round (7 cm).Depending on the FSFD, use of rectangular collimation may result
in a 71 % to 80% decrease in the E, a significant reduction. This reduction in beam size, however, may make aiming
the beam difficult. To avoid the possibility of unsatisfactory radiographs (cone cutting), a film-holding instrument
that centers the beam over the film is recommended. Second, film holders with rectangular collimators may be used
with round PIDs; these holders reduce patient exposure to the same degree as rectangular PIDs.

123. All of the following use non ionizing radiation, EXCEPT

A. Ultrasonography
B. Thermography
C. MRI
D. Radiography

Ans: D. Radiography
Ref: White & Pharoah, 6/E, p. 217
Explanation:
 Radiography uses ionizing radiation. The biologically damaging effects of ionizing radiation are classified into three
main categories
1. Somatic deterministic effects
2. Somatic stochastic effects
3. Genetic stochastic effects
 The somatic effects are further subdivided into
 Acute or immediate effects — appearing shortly after exposure, e.g. as a result of large whole body doses
  Chronic or long-term effects — becoming evident after a long period of time, the so called latent period (20 years
or more) e.g. leukemia.

124. All of the following radioisotopes are used as systemic radionuclide, EXCEPT
A. Phosphorus-32
B. Strontium-89
C. Iridium-192
D. Samarium-153

Ans: C. Iridium-192
Ref: Connie Yarbro, Cancer Nursing: Principles and Practice, 7/E, p. 301
Explanation:
 Radioactive iridium-192 needles or wires implanted into tumours of the breast, tongue and floor of the mouth known
as brachytherapy.

125. Phosphorous-32 emits

A. Beta particles
B. Alpha particles
C. Neutrons
D. X-rays

Ans: A. Beta particles

Ref: Merdith Radiation Physics and Nuclear Medicine, 1/E, p. 28
Explanation:
 If a nucleus has more neutrons than it needs for stability, it can stabilize itself by converting a neutron to a proton and
electron. The proton remains in the nucleus and the electron is emitted from it. The emitted electron is called a beta
particle and the process is called beta emission.
 A phosphorus 32 nucleus has 15 protons & 17 neutrons. The nucleus remaining after an electron has been emitted
now has 16 protons & 16 neutrons. Its atomic number is increased by 1 but its mass number is unchanged. The new
nucleus is sulphur-32. Thus when the unstable phosphorus -32 (15 protons and 17 neutrons) is converted to sulphur
32(16 protons and 16 neutrons), nuclear stability is achieved.

126. Which one of the following has the maximum ionization potential?
A. Electron
B. Proton
C. Helium ion
D. Gamma(γ) photon

Ans: C. Helium ion

Ref: White & Pharoah, 6/E, p. 04
Explanation:
 Alpha particles are helium nuclei consisting of two protons and two neutrons. They result from the radioactive decay
of many elements. Because of their double charge and heavy mass, alpha particles densely ionize matter through
which they pass (maximum ionization potential). Accordingly, they quickly give up their energy and penetrate only a
few microns of body tissue. (An ordinary sheet of paper absorbs them) After stopping, alpha particles acquiring two
electrons and become neutral helium atoms.

ORTHODONTICS

127. Dontrix gauge is used for

A. Measurement of wire strength
B. Measurement of force
 C. Measurement of wire distortion
D. Measurement of wire deformation

Ans: B. Measurement of force

Ref: C.P.Adams, /E, p. 17
Explanation:
Repeat from AIPG-2007 (Q. 19)
 Dontrix gauge is a precision instrument used in measurement of force. In Orthodontics it is used in measuring the exerted
by the elastics or other active element such as torquing spurs. Measures one ounce increments up to 16 ounces

128. The highest point on the concavity present behind the occipital condyle is
A. Basion
B. Bolton’s point
C. Porion
D. Gonion

Ans: B. Bolton’s point

Ref: Change of Incisor Inclination Effects on Points A and B. The Angle Orthodontist: May 2009, Vol. 79, No. 3, pp. 462-467
Explanation:
 Some authors have stated that point A and B are dentoalveolar landmarks that are influenced by growth as well as
dentoalveolar remodeling during orthodontic treatment. Thus, changes in the position of points A and B are due to a
combination of skeletal and dental changes.

 Bo - Bolton point: point in space (roughly at the centre of the foramen magnum) that is located on the lateral cephalometric
radiograph by the highest point in the profile image of the post-condylar notches of the occipital bone.
 Basion: It is median point of the anterior margin of foramen magnum
 Porion:The superior point of the external auditory meatus
 Gonion: Constructed point at the intersection of lines tangent to posterior border of ramus and lower border of mandible

129. During orthodontic tooth movement of maxillary central incisor,centre of rotation is present at apex, then it shows
A. Controlled tipping
B. Uncontrolled tipping
C. Translation
D. Intrusion

Ans: A. Controlled tipping

Ref: Proffit, 4/E, p. 375
Explanation:
Controlled tipping - 0<Mc/Mf<1
 A force of 100 gm applied in a distal direction at the bracket results in a 1000 gm-mm clockwise tipping
moment. If we apply a counterclockwise moment of 600 gm-mm (M:F = 6:1), then, although this counter moment
is not sufficient to totally negate the effect of the clockwise tipping moment, it is, however, sufficient to decrease
the amount of tipping by moving the centre of rotation to the apex of the root. The centre of resistance also
moves in the direction of the force

130. Which of the following cephalometric point can be altered by orthodontic tooth movement?
A. Point A
B. ANS
C. Nasion
D. Gonion

Ans: A. Point-A
Ref: Moyer's Hand book of Orthodontics, 4/E, p. 256
Explanation:

 Point A is a dento-alveolar point and is likely to remodel. it is routinely obscured and/or rapidly moving during the
eruption of the upper central incisors. Similarly during Orthodontic tooth movement point A is altered.
 Whereas Gonion, ANS, Nasion are skeletal landmarks and are not affected by orthodontic movement.

131. Which cephalometric point represents centre of ramus of mandible?

A. Xi point
B. Pm point
C. Ptm point
D. N point

Ans: A. Xi point
Ref: Alex Jacobson's Radiographic Cephalometry: From Basics to 3-D Imaging, 1/E, p. 88
Explanation:
Xi point:
 The geometric centre of the ramus of the mandible.
 Contacts the mandibular canal.
  Ricketts proposed the Archival method of growth prediction, according to which a normal human mandible grows by
superior-anterior (vertical) apposition at the ramus on a curve or a arc which is a segment formed from a circle.
 Then radius of the circle is described by using the distance from the mental protuberance to a point at forking of the stress
lines at the terminus of oblique ridge on the medial side of the ramus.
 Arc was constructed using Pogonion (Po), Xi and the centre of the condyle head (C2),to this arc increments were added.
The mandible became more obtuse.

132. Relative to a heterogenous population, the incidence of malocclusion in a homogenous population generally is
A. Lower
B. Slightly higher
C. Significantly higher
D. About the same

Ans: A. Lower
Ref: Proffit, 4/E, p. 142
Explanation:
 Homogenous population: population with similar type of genetic information
 Heterogeneous population: population with dissimilar type of genetic information
 Primitive populations: individuals in whom tooth size-jaw size discrepancies are infrequent, and groups in which
everyone tends to have the same jaw relationship (not necessarily one that produces ideal dental occlusion).This was more
of homogenous population where in the incidence of malocclusion was less.
 As the out breeding between originally distinct human population group occurred, teeth of one population were
combined in the offspring with the jaw of the other thus leading to malocclusion.
 If inherited disproportion of the functional components of the face and jaws were frequent, one would predict that
modern urban populations would have a high prevalence of malocclusion and a great variety of orthodontic problems.
The United States, reflecting its role as a "genetic melting pot" should have one of the world's highest rates of
malocclusion.

Homogenous population

Similar genetic information

Similar jaw and teeth size from both the parents

No malocclusion

133. The arch space for eruption of permanent 2nd and 3rd molar is occupied by
A. Apposition of alveolar process
 B. Resorption of posterior border of the ramus of the mandible
C. Resorption of anterior border of the ramus of the mandible
D. Apposition on the lower border of the mandible

Ans: C. Resorption of anterior border of the ramus of the mandible

Ref: Proffit, 4/E, p. 47
Explanation:
 In infancy, the ramus is located at about the spot where the primary first molar will erupt. Progressive posterior
remodeling creates space for the second primary molar and then for the sequential eruption of the permanent molar
teeth. This is called “ramus to body conversion”.
 More often , this growth ceases before enough space has been created for eruption of the third permanent molar,
which becomes impacted in the ramus.

134. With a flush terminal plane, permanent first molars will

A. Initially be Class II
B. Initially be Class III
C. Immediately assume a normal relationship
D. Erupt immediately into an end – to – end relationship

Ans: D. Erupt immediately into an end – to – end relationship

Ref: Proffit, 4/E, p. 62
Explanation:
 A normal relationship of the primary molar teeth is the flush terminal plane relationship. The primary dentition
equivalent of Angle's Class II is the distal step.
 A mesial step relationship corresponds to Angle's Class I. An equivalent of Class III is almost never seen in the primary
dentition because of the normal pattern of craniofacial growth in which the mandible lags behind the maxilla.
 When the first permanent molar erupt, their relationship is determined by that of the primary molars. The molar
relationship tends to shift at the time of second primary molars are lost and the adolescent growth spurt occurs. The
amount of differential mandibular growth and molar shift into the leeway space determines the molar relationship.
135. Which is the most often and most stable used plane for superimposition of lateral cephalogram in studying the growth of a
child?
A. Frankfort plane
B. S – N plane
C. Mandibular plane
D. Occlusal plane

Ans: B. S-N plane

Ref: Proffit, 4/E, p. 216
Explanation:
 Steiner highlighted difficulties in accurate location of the porion point and its relative variation, which could be
observed in successive radiographs. This in turn, affected the orientation of the Frankfort plane.
 Although, Frankfort horizontal plane was traditionally the logical choice of anthropologists (as porion and
infraorbital points were easily visible in dry skulls, unlike S and N points), they could not be easily and accurately
located on a cephalogram.
 On the contrary, S(Sella) and N(Nasion) were easily dissemble in a lateral cephalogram and could be located with
relatively higher accuracy. Moreover, S and N points had another advantage, of being located in the mid-sagittal plane of
the head, and move minimally with any deviation of head from true profile position.
 In the average individual, the SN plane is oriented at 6 to 7 degrees upward anteriorly to the Frankfort plane. Sella nasion
plane is the most reliable cranial base plane connecting sella and nasion.
 Sella - this is the point representing the midpoint of the pituitary fossa (sella turcica); it is a constructed point in the
median plane.
 Nasion - the most anterior point of the fronto nasal suture in the median plane (midline).
  SN plane is principal plane for Steiner's analysis

136. In the examination of growth by overlapping cephalogram at registration point and SN plane, the true is
A. Growth is maximum at the point
B. Growth is maximum farthest point
C. Growth is maximum nearest to the point
D. All of the above

Ans: B. Growth is maximum farthest point

Ref: Athanasios's Orthodontic Cephalometry, 1/E, pp. 46, 109-119
Explanation:
 Registration point(R): Bolton's registration point is the midpoint of the bisector of Bo-Na plane through sella. The triangle
formed by Na-S-Bo is called Bolton's triangle
 The two tracings taken periodically, are oriented so that the R points are registered and the Bolton planes (Bo-Na) are
parallel. This superimposition will show the overall changes.
 On super imposing the radiographs one can see that the growth is maximum farthest from the registration point.
137. Cephalometrics is useful in a accessing the following relationships, EXCEPT
A. Tooth to tooth
B. Bone to bone
C. Tooth to bone
D. Soft palate to gingiva
Ans: D. Soft palate to gingiva
Ref: Proffit, 4/E, p. 202
Explanation:

 The structural components of cephalogram are

 The cranium and cranial base
 The skeletal maxilla and naso-maxillary complex
 The skeletal mandible.
 The maxillary teeth and alveolar process
 The mandibular teeth and alveolar process
 The goal of cephalometric analysis is to establish the relationship of these components in both the anteroposterior and
vertical planes of space.

PEDODONTICS

138. Chronic pulpal involvement in a deciduous molar is first manifested as

A. Widening of PDL in apical one third
B. Radiolucency in furcation area
C. Radiolucency at apex of root
D. Internal Resorption

Ans: B. Radiolucency in furcation area

Ref: Shobha Tandon, 2/E, pp. 304-305
Explanation:
 In primary molars, the furcation is more towards cervical area so that the root trunk is smaller. The floor of the pulp chamber
in primary molars is very porous.
 The increased number of accessory canals in the primary molars pulp chamber floor leads directly into inter-radicular
furcation.
 Therefore first manifestation of infection is observed as radiolucency at the furcation areas in primary molars.
  Accessory canals extend from pulpal chamber to the inter-radicular area at the furcation. Therefore the radiographic
changes (radiolucency that is caused due to widening of the periodontal space and resorption of bone) is seen in the inter-
radicular region rather than the periapical region.

139. Most common caries seen in primary 1st molar

A. Occlusal pits and fissures
B. Proximal surface below contact point
C. Proximal surface above contact point
D. Buccal surface below height of contour

Ans: B. Proximal surface below contact point

Ref: Pinkham, 4/E, p. 286
Explanation:
 The second most susceptible site for caries initiation is, on certain areas of the smooth enamel surfaces where contour or
tooth position protects (shelters) plaque against the rubbing action of some foods and often from being loosened by the
toothbrush. These include the areas of the contacting proximal surfaces which are gingival of the contact and thereby highly
susceptible to caries because of shelter afforded to plaque.
 In the interproximal areas
 Primary molars have a flat surface with contact line
 Permanent molars have a contact point
 Primary first molars in both arches are less susceptible to occlusal caries because of the relative lack of deep pits and fissures
on that tooth as compared with primary second molars. The broad contact area between primary first and second molars
contributes to a high proportion of proximal caries occurring at those surfaces.

140. “High viscosity saliva may lead to increased caries in children”. This statement is
A. Really true
B. Partially true
C. Partially true
D. Really false

Ans: A. Really true

Ref: Mc Donald, 8/E, p. 213
Explanation:
 It has been long suggested that the viscosity of saliva is related to the rate of dental decay. Both thick, ropy saliva and thin,
watery saliva have been blamed for rampant dental caries.
 There seems to be statistically significant direct relationship between the viscosity of saliva and the number of decayed,
missing, and filled teeth. This relationship held true for all regardless of age.
 Patients with thick, ropy saliva invariably had poor oral hygiene. The teeth were covered with stain or plaque, and the
rate of dental caries ranged from greater than average to rampant.

141. Tooth brush of a child differs from that of adult in?

A. Soft bristles with smaller head size
B. Soft bristles, big head with small handle
C. Size of head of tooth brush
D. Soft bristles, big head, big handle

Ans: C. Size of head of tooth brush

Ref: Mc Donald, 8/E, p. 239
Explanation:
 The soft brush is preferable for most uses in pediatric dentistry because of the decreased likelihood of gingival tissue
trauma and increased inter-proximal cleaning ability.
  It is best to use a brush with a smaller head and a thicker handle than on the adult-size brush to aid in access to the oral cavity
and facilitate the child’s grip of the handle.
 For pediatric usage, it is preferable to use a toothbrush with a head size that conveniently fits the oral cavity of the child. The
brush handle should be of the length appropriate enough to be held by the child and the angulation of the head should be
enough so that the child can carry

142. While prescribing NSAIDs to a child, most important factor to be considered is

A. Age of child
B. Body weight of child
C. Flavor of salt
D. Chronicity of pain

Ans: B. Body weight of child

Ref: Nikhil Marwah, 2/E, pp. 211-212

143. Percentage of NaOCl in Carisolv

A. 0.5 – 1%
B. 3 – 5%
C. 11
D. 8 – 9

Ans: A. 0.5 – 1%
Ref: Nikhil Marwah, 2/E, p. 388
Explanation:
 Carisolv™ gel (Mediteam, Sävadelen, Sweden), a chemomechanical caries removal system, has been developed for use in
dentistry as an adjunctive therapy to the mechanical excavation of carious dentin. This system consists of a mixture of
sodium hypochlorite ((0.5%) and three amino acids (lysine, leucine and glutamic acid) in a gel preparation. This product
softens the carious dentin, which is then hand-excavated
 This procedure has gained importance due to the selective removal of carious dentine and avoidance of painful and
unnecessary removal of sound dentine.
 The mechanism of action of NMG (N-monochloroglycine) and NMAB (N Monochloroaminobutyric acid) involves
chlorination of the partially degraded collagen in the carious lesion and the conversion of hydroxyl-proline to pyrrole-2-carboxylic
acid.
 The cleavage by oxidation of glycine residues could also be involved. This cause disruption of collagen fibrils which
become more friable and can then be removed.
 Carisolv is isotonic in nature.

144. Ferric sulphate in pulpotomy is applied for

A. 10 – 15 sec
B. 60 – 90 sec
C. 2.5 min
D. 4.5 min

Ans: A. 10 – 15 sec

Explanation:
 Ferric sulphate being a non-aldehyde haemostatic compound forms a metal-protein clot at the surface of pulp-stump and acts
as barrier to irritating compounds.
 It is applied on pulp-stump for 15 seconds.
 Mechanism of action of ferric sulphate
 Agglutination of blood proteins result from the reaction of blood with both ferric and sulphate ions.
 The agglutinated protein forms plugs to occlude the capillary orifices.
 Unlike, traditional haemostatic agents, ferric sulphate affects hemostasis though a chemical reaction with blood.
 It is proposed as a pulpotomy agent on the theory that its mechanism of controlling hemorrhage might minimize the
chances for inflammation and internal resorption believed by Schroeder to be associated with physiologic clot formation.
145. pH of MTA is
A. 8
B. 12.5
C. 10
D. 144

Ans: B. 12.5
Ref: Shobha Tandon, 2/E, p. 426
Explanation:
 MTA has a pH of 10.2 immediately after mixing and increases to 12.5 after 3 hrs of setting which is almost similar to CaOH.
 MTA being hydrophilic requires moisture to set making absolute dryness contraindicated.
 Commercial MTA exists in both Grey and White forms.
 The difference between the grey MTA and the white MTA has been reported to be in the lack of iron in the white version.
 One of the main drawbacks of MTA is the extended setting period and the prolonged maturation phase

146. A HIV positive child comes to your clinic for the extraction of his carious mandibular first molar. Your approach for the
treatment of this child should be
A. ELISA test & consult with physician
B. This child should referred to HIV clinic
C. Check CD4 count & consult with physician
D. Advice TB test & consult with physician

Ans: C. Check CD4 count & consult with physician

Ref: Mc Donald, 8/E, p. 567
Explanation:
 HIV infects cells of the immune system, specifically lymphocytes and macrophages. These WBC’s contain the greatest
number of CD4 cell surface receptors, which permit attachment with viral surface proteins and enhance host-cell invasion.
 Diagnosis is made by screening the serum for antibodies to HIV and is confirmed by Western Blot analysis. Ongoing
management is guided by the CD4+ cell count and viral load as measured by PCR and subsequent opinions from the
concerned specialist physicians.

COMMUNITY DENTISTRY
147. Mean=70 and SD=25%,then 95% Confidence interval is?
a. 60-80
b. 45-95
c. 20-120
d. 50-100

Ans: C. 20-120

Ref: Park, 19/E, p. 751

Explanation:

 Assuming the data is obtained from a normal distribution, 95% confidence interval (CI) = Mean + 2 (Standard deviation)
Upper limit = 70 + 2(25)=120
Lower limit= 70 – 2(25)= 20

148. For a survey, some schools were selected randomly, from which sections selected randomly and from which students
were selected randomly. Which type of sampling method is this?
A. Simple Random
B. Cluster
 C. Stratified
D. Multi stage

Ans: D. Multi stage

Ref: Park, 19/E, p. 752

Explanation:

 Multi-stage sampling is like the cluster method, except that it involves picking a sample from within each chosen cluster,
rather than including all units in the cluster.
 This type of sampling requires at least two stages. In the first stage, large groups or clusters are identified and selected.
 These clusters contain more population units than are needed for the final sample.
 In the second stage, population units are picked from within the selected clusters (using any of the possible probability
sampling methods) for a final sample.
 If more than two stages are used, the process of choosing population units within clusters continues until there is a final
sample.
 In this example, first stage schools are selected randomly and second stage sections were selected randomly and from the
selected sections students were included in the sample.

149. Which of the following is used to depict frequency or percentages in a cancer study?
A. Bar diagram
B. Line diagram
C. Pie diagram
D. Stem and leaf

Ans: A. Bar diagram

Ref: Park, 19/E, p. 748

Explanation:

 Bar charts are merely a way of presenting a set of numbers by the length of a bar - the length of the bar is proportional to
the magnitude to be represented.

150. Occupational cancer involves following organs EXCEPT

A. Lung
B. Breast
C. Bladder
D. Liver

Ans: B.Breast

Ref: Park, 19/E, p. 663

Explanation:

 The most common etiologic factor for breast cancer is genetic.

151. Which of the following Plaque Index divides each tooth surface into 9 areas
A. PHP Index
B. Plaque Index bySilness and Loe
C. Modified Navy Plaque Index
D. Glass criteria for scoring debris
Ans: C. Modified Navy Plaque Index

152. In India, the cause of maximum maternal mortality is?

A. Anemia
B. Hemorrhage
C. Abortion
D. Sepsis

Ans: B. Hemorrhage

Ref: Park, 19/E, pp. 446-447

Explanation:

 Hemorrhage is the single most common cause of all maternal deaths worldwide and also in India.
 According to 2001-2003 SRS survey of causes of maternal mortality in India are
Hemorrhage 38%
Sepsis 11%
Hypertension 5%

153. Specificity of screening test measures

A. True positive
B. False positive
C. False negative
D. True negative

Ans: D. True negative

Ref: Park, 19/E, p. 663

Explanation:

 Specificity is defined as the ability of a test to identity correctly those who do not have the disease, that is, "true negatives".
90 per cent specificity means that 90 per cent of the non-diseased persons will give "true negative" result, 10 per cent of
non-diseased people screened by the test will be wrongly classified as "diseased" when they are not.

154. To classify obesity,BMI should be

A. > 20
B. >30
C. > 40
D. > 50

Ans: B. >30

Ref: Park, 19/E, p. 663

Explanation:

 Body Mass Index (BMI) is a simple index of weight-for height thatis commonly used to classify underweight, overweight
and obesity in adults. It is defined as the weight inkilograms divided by the square of the height in meters (kg/').
 For example, an adult who weighs 70 kg and whose height 1.75 m will have a BMI of 22.9
 BMI = 70 (kg)/1.75 2(m2) = 22.9
 The classification of overweight and obesity, according to BMI is shown below
 Classification BMI Risk of co morbidities

Underweight <18.5 Low risk

Normal range 18.5-24.99 Average
Overweight >25
Pre-obese 25-29.99 Increased
Obese class I 30-34.99 Moderate
Obese class II 35-39.99 Severe
Obese class III > 40 Very severe

 Obesity is classified as a BMI >30.0 and this classification is recommended by WHO, but includes an additional
subdivision at BMI 35.0-39.9 in recognition of the fact that management options for dealing with obesity differ above a
BMI of 35. The WHO classification is based primarily on theassociation between BMI and mortality.
 These BMI values are age-independent and the same is for both sexes. The table shows a simplistic relationship betti.eer.
BMI and the risk of comorbidity, which can be affected by a range of factors, including the nature of the diet. ethnic group
and activity level. The risks associated with increasing BMI are continuous and graded and begin at a BMI above 25.
Although it can generally be assumed that individuals with a BMI of 30 or above have an excess fat mass in their body.
BMI does not distinguish between weight associated with muscleand weight associated with fat. As a result. the
relationship between BMI and body fat content varies according to body build and proportion, and it has been shown
repeatedly that: agiven BMI may not correspond to the same degree of fatness across populations. Polynesians, for
example. tend to havelower fat percentage than Caucasian Australians at an identical BMI. In addition, the percentage of
body fat mass increaseswith age up to 60-65 years in both sexes. and is higher in women than in men of equivalent BMl. In
cross-sectional comparisons, therefore, BMI values should be interpreted with caution if estimates of body fat are
required.

155. In National Water Supply & Sanitation Programme, a problem village is defined as all EXCEPT
A. Distance of safe water is greater than 1.6 km
B. Water is exposed to the risk of cholera
C. Water source has excess iron & heavy metals
D. Water infested with guinea worm

Ans: D. Water infested with guinea worm

Ref: Park, 19/E, p. 391

Explanation:

 According to the National Water Supply and Sanitation Programme, a problem village is one where no source of safe
water is available within a distance of 1.6 km, or where water is available at a depth of more than 15 meters, or where
water source has excess salinity, iron, fluorides and other toxic elements, or where water is exposed to the risk of cholera.

156. Which index would you use to assess the severity of periodontitis in epidemiological studies of a large population.
A. PMA index
B. Gingival index
C. Periodontal index
D. Sulcus bleeding index

Ans:Periodontal index

157. In which of the following diseases, the overall survival rate is increased by screening procedure
A. Prostate Ca
B. Lung Ca
 C. Colon Ca
D. Ovarian Ca

Ans: C. Colon cancer

PROSTHODONTICS

158. Clicking sound in complete denture is due to

A. Insufficient occlusal clearance
B. Insufficient vertical dimension
C. Increased vertical dimension of rest
D. Reduced vertical dimension of occlusion

Ans: A. Insufficient occlusal clearance

Ref: Winkler's, 2/E, pp. 191, 203, 214, 215
Explanation:
 Insufficient clearance/decreased freeway space is a result of excess VD, which causes the teeth to contact first even at VDR
thus producing a clicking sound.

159. A patient reports after 3 months of wearing complete dentures and complains of gagging while wearing treatment be
A. Medication
B. Removing all mechanical and biological factors responsible for it
C. Psychiatric consultation
D. Any of the above or combination of it

Ans: B. Removing all mechanical and biological factors responsible for it

Ref: Zarb & Bolender, 13/E, pp. 71, 277
Explanation:
 Gag reflex is most often related to the location of posterior palatal seal and occasionally mandibular denture. Gagging
occurs when posterior palatal is disrupted as the tissue distal to the vibrating line moves upward and downward during
function. A thorough history will reveal the problem. It might be due to biomechanical inadequacies of existing denture,
anatomical anomalies or iatrogenic, organic disturbances or psychological factors.
 Management: combinations of distraction methods and occasional medication. If posterior palatal seal in inadequate,
modeling compound can be added to reshape the part. Correcting the occlusion may also help alleviate the problem.
 House has classified gagging into three classes.
Class I : Normal
Class II: Subnormal
Class III: Super normal

160. Midline fractures of the maxillary dentures are mainly due to

A. Teeth set too far buccally
B. No relief in midpalatal line
C. Ridge resorption
D. Porosities in denture

Ans: C. Ridge resorption

Ref: Zarb & Bolender, 13/E, p. 312
Explanation:
 Fracture of denture baseis a common problem
 It can be due to
 Impact – from dropping of denture
 Fabrication errors & inappropriate design – excess thinning of palate, inadequate cross section in midline of lower
denture, accentuated frenal notches
 Excessive loading – complete denture opposing natural teeth
  Alveolar resorption – resorption of maxilla results in the denture being flexed around midline and loads are enhanced
by leverage effect
 Wear of occlusal surface –wear results in mandibular molars facing buccally and maxillary molars facing lingually
and when the patient occludes the upper denture will be flexed around the mid-line leading to fracture
 The most possible cause as for the given options is due to the ridge resorption

161. Function of guiding plane is

A. Permit multiple pathways of insertion
B. Provide single path of insertion and removal
C. Provide single insertion and multiple removal
D. Generate functional pathways

Ans: B. Provide single path of insertion and removal

Ref: McCracken, 12/E, p. 125
Explanation:
Guiding Plane (GP)
 It is two or more parallel vertical surfaces of abutment teeth, so shaped to direct a prosthesis during placement and
removal.
 Functions
1. Provide one path of placement and removal
2. It ensures the intended actions such as retention, reciprocation and stabilization.
3. Eliminates food entrapment
 GP should be ½ th width of distance between the tips of buccal and lingual cusps/ 1/3 rd the B-L width. 2/3rd the length of
enamel crown. In preparation creation of line angles should be avoided
 GP is located on abutment teeth adjacent ot eh edentulous area.

Other means of gaining Support

 All aid in Retention, Stability, Support and esthetics to various extent.
 Implants
 Splint Bar for denture support
 Internal Clip attachment
 Overlay abutment
 Component partial – tooth supported and tissue supported components and individually fabricated and joined by
high impact acrylic resin

162. In facial porcelain margin, the risk of fracture can be reduced by?
A. By increasing axial depth
B. Cavo surface margin at 90º
C. Margin of the tooth reduction at incisal edge
D. Providing contact during centric relationship
Ans: B. Cavo surface margin at 90º
Reference: Contemporary Fixed Prosthodontics- Rosensteil, 4th Edition, Page 324
Related Facts: The unforgiving nature of porcelain, if an inadequate tooth preparation goes uncorrected, can result in fracture
Proper preparation design is critical to ensuring mechanical success. 90 degree cavosurface angle is needed to prevent unfavorable
distribution of stresses and to minimize the risk of fracture. The preparation should provide support for the porcelain along its
entire incisal edge, unless a ceramic system that includes high strength core is chosen.

The advantages of complete ceramic crown include:

1. Superior esthetics, its excellent translucency (similar to that of natural tooth structure)
2. Generally good tissue response
3. Lack of reinforcement by a metal sub structure enables slightly more conservative reduction of the facial surface than is
possible with the metal ceramic crown, although the lingual surface needs additional reduction for strength.
 4. The appearance of the completed restoration can be influenced and modified by selecting different colors of luting gent.

The disadvantages of a complete ceramic crown include

1. Reduced strength of the restoration because of the absence of a reinforcing metal substructure
2. Because of the need for a shoulder type margin cirumferentially, a significant tooth reduction is necessary on the proximal and
lingual aspects.
3. Difficulties may be associated with obtaining a well fitting margin when certain techniques are used.

163. In an edentulous patient the average distance between upper and lower sulcus is
A. 38 cm
B. 40 cm
C. 42 cm
D. 45 cm

Ans: A. 38 cm
Ref: Winkler, 2/E, p. 138
Explanation:
 The vertical height of the maxillary rim is adjusted to approximately 22mm from the reflection of the cast.
 The posterior height is fabricated to equal the approximate length of the first maxillary molar crown.
 A slightly different vertical height is applied to the mandibular rim.
 An anterior height of approximately 16mm is used, while in the posterior region the height is equal to a point
representing one half the height of the retromolar pad.
 The width of the rim in the anterior area is approximately 5mm and in the posterior approximately 8 to 10 mm.

164. To transfer the axis – orbital plane, we require

A. Arbitary face – bow
B. Kinematics face – bow
C. Either Arbitrary or Kinematic face – bow
D. An Ear – bow only

Ans: C. Either Arbitary or Kinematic face – bow

Ref: Winkler, 2/E, p. 184
Explanation:
 Either Arbitrary or Kinematic face – bow can be used to transfer the axis-orbital plane. In most instances arbitrary facebow
is used for the purpose.

165. Anterior vibrating line is located on

A. Soft palatal tissue
B. Hard palatal tissue
C. Either on soft or hard palatal tissue
D. Posterior to fovea palatine

Ans: A. Soft plate tissue

Ref: Winkler, 2/E, pp. 110-111

166. The correctly placed posterior palatal seal creates

A. Vacuum in posterior part of palate
B. Vacuum beneath the maxillary denture
C. Partial vacuum beneath the maxillary denture
D. A close adaptation of maxillary denture at tuberosity

Ans: C. Partial vacuum beneath the maxillary denture

Ref & Explanation:
Posterior palatal seal
 Purpose of PPS
1. Minimize interference of tongue on the posterior end of the denture during swallowing and speaking
2. Creates border seal to prevent dislodgement
3. Counters polymerization shrinkage
 It is divided into two regions
 Pterygomaxillary seal – extends across the hamular notch
 Post palatal seal – extends between two maxillary tuberosities.
 It is Cupid bow in shape.
 Methods used to record PPS are
1. Conventional method
2. Fluid wax technique
3. Arbitrary scraping of master casts
4. Extended palatal seal
 House classification of palate
 Class I – most favorable for denture retention, palate is more horizontal
 Class II – soft palate makes 450angle to the hard palate.
 Class III – more vertical and immediate elevation of soft palate. Cannot tolerate any overextension and is associated
with ‘V’ shaped palatal vault.
 A functional impression with impression wax can be created at the palatal seal area. The impression wax should be
painted on the surface within the outlines to approximately 2mm in thickness.

167. Arrangement of teeth

A. Depends on height of the ridge
B. Depends on shape and contour of the ridge
C. Polishing the tooth surface with pumice
D. Uniform on both the arches

Ans: B. Depends on shape and contour of the ridge

Ref: Zarb & Bolender, 13/E, p. 1215
Explanation:
Teeth arrangement
 Important landmarks
 Maxillary Incisive Papilla – guide to the midline for maxillary central incisor and prominence of the incisors and
cuspid
 Mandibular bicuspid residual ridge – guides the bucco-lingual positioning of the bicuspids
 Retromolar pad – guide the height and width of the mandibular posterior teeth.
 Except for upper anteriors, the rest of the teeth are designed for the best function of the mandibular denture.
 Best sequence to teeth setup is – set upper anterior / lower anterior first followed by lower posterior and lastly the upper
posterior.
 Overjet and overbite are minimized to prevent denture dislodgement
 Avoid setting teeth over the inclines of the retromolar pad

168. The reciprocal arm is

A. Rigid with placement at middle one third of the crown
B. Flexible with placement at middle one third of the crown
C. Rigid with placement at occlusal one third of the crown
D. Flexible with placement at occlusal one third of the crown

Ans: A. Rigid with placement at middle one third of the crown

Ref: McCracken's, 12/E, p. 69
Explanation:
Reciprocal arm
 Resists forces in response to retentive arm.
 It engages tooth at the height of contour.
 Reciprocal arm will not come into contact with tooth until the denture is fully seated.
 True reciprocation can be accomplished only by use of crown surfaces made parallel to the path of placement.
 It may also act as indirect retainer to a minor degree. But its effectives may be limited by its proximity to the fulcrum line.

Principles of clasp design

The Basic principle

 The framework is designed in such a way to prevent movement at right angles to the tooth axis. This is ‘Principle of
encirclement’ (>1800 of tooth is encircled). This ensures stability to the tooth as well as the prosthesis.
 Minimum of 3 areas of contact should be established, they can be done by
 Continuous contact/ encirclement – Circumferential clasp
 Discontinuous contact/ encirclement – Bar clasp

Other principles

 Occlusal rest must prevent movement towards cervical.

 Reciprocation to resist pressure from retentive arm and reciprocal arm must be at the junction of gingival and middle
third.
 Avoid tipping or rotational forces to abutment (Stress breakers by location of retentive terminal or by using flexible clasp
arm)
 Retentive clasps should be bilaterally opposed i.e. buccal retention should be opposed by buccal retention at least for
primary abutment teeth.
 Path of escapement for each retentive terminal must be other than path of removal of prosthesis
 Retention must be as minimal as required

PERIODONTICS

169. Supragingival plaque undergoes which of the following changes with time
A. Plaque mass decreases
B. Plaque microflora becomes more gram positive
C. Plaque microflora becomes more gram negative
D. None

Ans: C. Plaque microflora becomes more gram negative

Ref: Carranza 11th Edition, Pg 246
Explanation:

- Microbial composition of the dental plaque will change with a shift toward a more anaerobic and a more gram-negative
flora, including an influx of fusobacteria, filaments, spiral forms, and spirochetes.

- In this ecologic shift within the biofilm, there is a transition from the early aerobic environment characterized by gram-
positive facultative species to a highly oxygen-deprived environment in which gram negative anaerobic microorganisms
predominate.

- Bacterial growth in older plaque is much slower than in newly formed dental plaque, presumably because nutrients
become limiting for much of the plaque biomass.

170. The difference in the color between subgingival and supragingival calculus is due to ___
A. pH of the saliva
 B. Death of the leukocytes
C. Hemolysis of erythrocytes
D. All

Ans: C. Hemolysis of erythrocytes

Ref: Carranza 11th Edition, Pg 217

Explanation: Subgingival calculus color is typically dark green or dark brown, probably reflecting the presence of blood products
associated with subgingival hemorrhage.

171. Indifferent fibers are

A. Elastic fibers
B. Oxytalan fibers
C. Collagen fibers
D. None of the above

Ans: C. Collagen fibers

Ref: Carranza 10th Edition, Pg 71
Explanation: These are small collagen fibers associated with the large principal fibers running in all directions, forming a plexus

172. Which of the following is a characteristic of supragingival plaque and not of subgingival plaque in humans
A. Motile bacteria are predominant
B. Spirochetes are evident microscopically
C. Gram negative bacteria are predominant
D. Bacterial composition is altered by dietary sugar consumption

Ans: D. Bacterial composition is altered by dietary sugar consumption

Ref: Carranza 10th Edition, Pg 150
Explanation: The supragingival plaque use sugars as an energy source and saliva as a carbon source.

173. The interdental col is more prone to periodontal disease because ____
A. Is covered with non-keratinized epithelium
B. Is difficult to clean
C. None
D. All of the above

Ans: A. Is covered with non-keratinized epithelium

Ref: Carranza 10th Edition, Pg 48, Fig 4-5
Explanation:
- Width of keratinized gingiva includes free gingiva and attached gingiva.

174. Mother donated one kidney to her daughter, what type of graft is it
A. Allograft
B. Xenograft
C. Autograft
D. Isograft

Ans: A. Allograft
Ref: Carranza 11th Edition, Pg 580
Explanation: Allograft is defined as a graft obtained from different individual of the same species

175. The disadvantages of the modified Widman flap is

A. Adaptation of healthy tissue to the tooth surface
 B. Post operative interproximal architecture is normal
C. The procedure is feasible when implantation of bone is contemplated
D. Conservative of bone and optimal coverage of root surface by the soft tissues

Ans: B. Post operative interproximal architecture is normal

Ref: Carranza 11th Edition, Pg 563
Explanation:
- The modified Widman flap facilitates instrumentation for root therapy.
- It does not attempt to reduce the pocket depth, but it does eliminate the pocket lining.
- The original intent of the surgery was to access the root surface for scaling and root planing.
- This technique offers the possibility of establishing an intimate postoperative adaptation of healthy collagenous
connective tissue to tooth surfaces and provides access for adequate instrumentation of the root surfaces and immediate
closure of the area.

176. Ultrasonic instrument size required to remove bulk of restoration and dentin islands
A. CPR – 1
B. CPR – 2
C. Both
D. None
Ans: B. CPR – 2
Ref: Carranza 9/E, p 641

177. Highest migrating cells in the sulcus due to plaque accumulation is

A. Macrophages
B. Plasma cells
C. Neutrophils
D. T- lymphocytes

Ans: C. Neutrophils
Ref: Carranza 11th Edition, Pg 197
Explanation: In stage 1 gingivitis adherence of neutrophils to vessel wall occur within 1 week and sometimes as early as 2 days
after plaque has been allowed to accumulate.

178. The reverse bevel incision is made to

A. Allow atraumatic reflection of the gingiva margin
B. Remove the infected tissue in the sulcus
C. Provide access to the alveolar crest
D. All of the above

Ans: B. Remove the infected tissue in the sulcus

Ref: Carranza 11th Edition, Pg 551
Explanation:
- It is the incision from which the flap is reflected to expose the underlying bone and root.
- It accomplishes 3 things:
o Removes pocket lining
o Conserves the relatively uninvolved outer surface of gingiva, which if apically positioned, becomes attached
gingiva.
o Produces a sharp, thin flap margin for adaptation to the bone-tooth junction

179. Indications for mucogingival surgery include the following except

A. A shallow vestibule
B. Insufficient attached gingiva
C. Infrabony pockets
D. A high frenum attachment
Ans: C. Infrabony pockets
Ref: Carranza 11th Edition, Pg 595
Explanation:
Traditional definition of mucogingival surgery:
- Widening of attached gingiva
- Deepening of shallow vestibules
- Resection of the aberrant frena

CONSERVATIVE DENTISTRY & ENDODONTICS

180. Which of the following is true about etching in case of fluorosis affected teeth?
A. Etching with phosphoric acid
B. Etching with citric acid
C. Etching with HCL
D. No need of etching

Ans: A. Etching with phosphoric acid

Ref: Alber’s Tooth Colored Restoratives, 9/E, p. 130

Explanation:

 The fluoride content of teeth affects etching time. Young teeth with mild fluorosis may need upto 120 seconds. Severely
mottled teeth may require longer than 120 seconds
 The first step in bonding to enamel is called etching, to enable micromechanical bonding. Resin flowing into the etched
enamel porosities is termed “resin tag formation
 Buonocore initially used 85% phosphoric acid for etching, however, later studies have shown that etching with 20 to 50%
phosphoric acid creates the deepest channels in permanent enamel. Research suggests 37% phosphoric acid is the ideal
concentration.
 The best total etch time depends on the age of the tooth. The average time to etch adult permanent teeth is 20 seconds;
newly erupted permanent teeth may need only 15 seconds, this provides adequate microporosity for resin adhesion and
sealing and bond strength. On primary teeth, most research shows a 60-second etch is optimal but some studies show 120
seconds provides more consistent bond strengths.This may be because primary enamel is amorphous and does not easily
form the type of deep resin tags seen when etching permanent teeth.
 Clinically, the most important measure of a properly etched tooth is the frosty white appearance of the surface. If the
etched surface is not frosty white, it is unlikely that adequate microporosities are present for successful bonding.
 Clinically, it is best to etch and wash in 20-second intervals until the desired frosty look appears. Some older teeth may
require over 2 minutes of etch time to achieve this endpoint.
 Freshly cut enamel etches faster than unprepared enamel.

181. The most important criteria during root canal irrigation is

A. Quantity of irrigant
B. Thickness of syringe used
C. Concentration of irrigants
D. None of the above

Ans: A. Quantity of irrigant

Ref: Anil Kohli's Textbook of Endodontics, 1/E, p. 167

Explanation:
Factors influencing the efficacy of Root Canal Irrigants
1. Quantity of irrigants
 Cleaning efficacy of the irrigant is directly proportional to the volume of the quantity of irrigant used.
 More the volume of the irrigant used more the removal of the debris, hence cleaner the canal.
  It is important to irrigate frequently and voluminously to introduce fresh solution and enhance its circulation into all
areas of the root canal system.
 According to Schielder, appropriate volume of irrigants should be at least 1-2 ml each time the canal is flushed.
 The clearance of debris is proportional to the quantity of irrigant used.
2. Frequency of irrigation
 Canal should be irrigated copiously, re-capitulated, and are irrigated at least after using two or three instruments.
3. Concentration of the solution
 More the concentrated the irrigant more will be the dissolving efficacy and anti- microbial property. Therefore, their
toxicity is high and their decalcifying action too rapid to control
4. Temperature of the irrigating solution
 The temperature of the NaOCl is relevant because if it is heated from 21⁰C to 37⁰C, itsability to degrade collagen is
increased.
5. Length and time of contact
 More the time the irrigant is left in the canals more is the dissolution of the organic tissues.
 Necrosed tissue readily dissolves whereas vital tissue comparatively takes longer time to dissolve.
6. Others include
 The gauge of irrigating needle, the type of irrigating needle, the depth of the penetration of the needle, the diameter
of the canal, surface tension of the irrigating solution, and age of the irrigating solution

182. What is the major difference between a class V cavity preparation for amalgam and one for composite resin by acid etch
technique
A. Depth of the cavity
B. Mesial and distal walls of the cavity
C. Placement of retentive groove
D. Angulation of enamel cavosurface margin

Ans: D. Angulation of enamel cavosurface margin

Ref: Sturdevant's, 5/E, pp. 556-559

183. A patient reports after 1 hour of restoration of a mandibular molar with a gold inlay with the complaint of shooting pain
when the teeth come in contact. What must be the cause
A. Supraocclusion
B. Excess acid in mix
C. Galvanic current between opposing amalgam restorations
D. Retained cement in sulcus

Ans: C. Galvanic current between opposing amalgam restorations

Ref:Sturdevant's, 5/E, p. 144
Explanation:
Electrochemical corrosion
 Involves two coupled chemical reactions (half cells) at separate sites, connected by two paths. One path (a circuit) is
capable of transporting electrons, while the other path (an electrolyte) is capable of transferring metallic ions.
 Therefore the basic components required for any electrochemical cell are:
 An anode (site of corrosion)
 A cathode
 A circuit
 An electrolyte
 Electrochemical corrosion occurs intraorally when these four components are present. The conditions define which of the
metallic sites acts as an anode. A number of types of electrochemical cells are possible in a single restorative dentistry
situation.
 When an amalgam is in contact with a gold alloy restoration, galvanic, local galvanic, crevice, and stress corrosion are possible.

Galvanic corrosion
  It isassociated with the presence of macroscopically different electrode sites (amalgam andgold alloy).
 If an amalgam is in direct contact with an adjacent metallic restoration such as a gold crown, the amalgam isthe anode in
the circuit.
 Residual amalgam alloy particles act as the strongest cathodes. Sn-Hg or Cu-Sn reaction product phases are thestrongest
anodes in low-copper and high-copper amalgams, respectively

Local galvanic corrosion (structure-selective corrosion)

 It isdue to the electrochemical differences of differentphases in a single material (such as amalgam).

 .Electrochemical cells may arise whenever a portion of the amalgam is covered by plaque or soft tissue. The covered area
has a locally lowered oxygen and/or increased hydrogen ion concentration, making it behave more like an anode and
corrode- concentration cell corrosion

Cracksand crevices produce similar conditions and encourageconcentration cell corrosion. Both corrosion processesare commonly
termed Crevice corrosion.

When the restorationis under stress, the distribution of mechanical energyis not uniform and this produces different
corrosionpotentials. This process is called Stress corrosion.

184. While restoring a tooth with composite resin, the etched surface gets contaminated with saliva accidentally, what would be
done next
A. Wipe the saliva with cotton and continue to restore
B. Wash with water, dry the area and continue restoration
C. Rinse away the saliva with water, dry the preparation with air, then repeat the etching procedure
D. Add excess composite material and cure it

Ans: C. Rinse away the saliva with water, dry the preparation with air, then repeat the etching procedure

Ref: Sturdevant's, 5/E, p. 519

Explanation:
 Any contamination by saliva necessitates repeating the placement of etchant for a minimum of 10 seconds, followed again
by appropriate primer and adhesive placement.

185. An eight year old child reports with avulsion of central incisors due to trauma 20 minutes back. On inspection the teeth are
contaminated with debris. What should be done?
A. Clean root surface with saline and reimplant
B. Scrubbing of root surface and reimplant
C. Clean root surface, do RCT and reimplant
D. Clean and curette root surface and reimplant

Ans: A. Clean root surface with saline and reimplant

Ref: Cohen’s, 10/E, p. 648
Explanation:
 Preparation of the root in case of an avulsed tooth is dependent on the maturity of the tooth (open versus closed apex) and
on the dry time of the tooth before it was placed in a storage medium.
 A dry time of 60 minutes is considered the point where survival of root periodontal ligament cells is unlikely.

186. Caries detection is done by all,EXCEPT

A. Cephalometry
 B. DIFOTI
C. Bite wing
D. IOPA

Ans : A. Cephalometry
Ref: Vimal Sikri,2/E, p. 96
Explanation:
 Diagnosis is defined as the utilization of scientific knowledge for identifying a diseased process and to differentiate it
from other diseased processes.
 Various aids used for diagnosis of caries are as follows,
1. Radiographic methods
i. Conventional radiography: IOPA, Bitewing
ii. Xeroradiography
iii. Digital imaging
iv. Computer image analysis
v. Subtraction radiography
2. Electrical Resistance
3. Fiber optic Transillumination
4. Digital Imaging Fiber optic Transillumination
5. Laser Auto fluorescence
6. Quantitative Laser Fluorescence
7. Infrared Fluorescence
8. Ultraviolet Detection
9. Endoscope/ Videoscope
10. Ultrasonic Detection
11. Optical Coherence Tomography
12. Tetra hertz Imaging
13. Magnetic Resonance Micro-imaging
14. Dye Penetration Method

187. In case of moderate sized class I cavity,choice of restoration providing maximum compressive strength
A. Amalgam
B. Gold foil
C. Composite inlay
D. Ceramic inlay

Ans : A. Amalgam
Ref: Sturdevant’s, 5/E, p. 695
Explanation:
 Amalgam functions as a direct restorative material by easily being inserted into a tooth preparation and, oncehardened,
restoring the tooth to proper form and function.

188. Which of the following is not a method of hand piece sterilization

A. Auto clave
B. Dry heat
C. Gluteraldehyde
D. Ethylene dioxide

Ans : B. Dry heat

Ref: Sturdevant’s, 5/E, p. 695
Explanation:
  Handpieces are semi critical instrumentation requiring sterilization. Sterilization of handpieces must be monitored and
documented.
 The motor end of the attached low-speed handpiece can be covered by pulling a disposable, single use, slender plastic bag
up over it and pushing the handpiece through the sealed end of the bag so the bag covers the motor end and part of the
hose. Otherwise scrub and disinfect the motor-end for each reuse if it cannot be sterilized.
 Steam sterilization of handpieces:Autoclave sterilization of handpieces is one of the mostrapid methods. If proper
cleaning and lubricating is performedas prescribed by the manufacturer, good utility isobtainable with regular
autoclaving. Fiber optics dimwith repeated heat sterilization in a number of months toa year, apparently due to oil residue
and debris baked onthe ends of the optical fibers. Cleaning with detergent solutionand wiping ends of optics with alcohol
or othersuitable organic solvents may prolong use
 Chemical vapor pressure sterilization recommended forsome types of handpieces apparently works well with ceramic-
bearing handpieces. Always obtain the handpiece manufacturer's recommendations.
 Ethylene oxide (ETOX) gas is the gentlest method of sterilization used for handpieces. Internal and external cleaning are
important. Otherwise, preparation of handpieces before sterilization is not as critical because noheat is involved. Oil left in
handpieces can impair sterilization.
 Dry heat sterilization of handpieces is generally not recommended.

ORAL SURGERY

189. Not a theory of TMJ ankylosis

A. Condylar burst
B. Fusion with zygomatic arch due to increased condylar distance
C. Synovial fluid attracting Ca ions
D. Calcification around joint

Ans: C. Synovial fluid attracting Ca ions

190. Following a bilateral fracture of mandible in the canine region, the anterior segment of the mandible is displaced
posteriorly by the action of
A. Anterior belly of digastrics, geniohyoid and genioglossus
B. Thyrohyoid, geniohyoid and genioglossus
C. Mylohyoid, geniohyoid and genioglossus
D. Geniohyoid and temporalis

Ans: D. Geniohyoid and temporalis

191. Normal dental care under LA usually feasible in?

A. Mentally retarded
B. Adults
C. Psychological patient
D. children

Ans: B. Adults

192. Patient with prosthetic valve is under surgery to avoid sub-acute endocarditis which regimen should be given
A. 2 mg amoxicillin 1hour before surgery
B. 2 gm amoxicillin 1hour before surgery
C. 500 gm penicillin 1 hour before surgery
D. 1 gm amoxicillin 2 hour before surgery

Ans: B. 2 gm amoxicillin 1hour before surgery

193. A patient has an infection associated with maxillary right lateral incisor that tooth is deeply carious and non-restorable.
His temperature is 102°F. The patient has not able to chew for the past 24 hours. The right side of the face is swollen. The
 patient cannot open his right eye, on palpation the area is soft, painful to touch and tissue rebound when palpated;
treatment for the patient should be
A. Aspiration
B. Antibiotics of heat only
C. Incision and drainage
D. Antibiotics, heat and fluid

Ans: C. Incision and drainage

194. Oronasal intubation contraindicated in

A. Lefort I fractures
B. Lefort II & III fractures
C. Parietal bone fractures
D. Mandible fractures

Ans: B. Lefort II & III fractures

195. A patient on steroid therapy and has need for extraction of chronically infected teeth requires premedication’s with
A. Atropine to reduce the hazard of vagal stimulation and cardiac arrest
B. Antihypertensive to combat tendency towards shock
C. Antihistaminics to prevent allergic reaction
D. Antibiotics
Ans: D. Antibiotics

196. Orthognathic procedure for anterior open bite correction

A. LeFort-I osteotomy
B. Inverted L osteotomy
C. Bilateral saggital split osteotomy
D. Intraoral subsigmoid osteotomy
Ans: A. LeFort-I osteotomy

197. Greatest barrier for diffusion of LA is

A. Epineurium
B. Perineurium
C. Endoneurium
D. Neural membrane

Ans: B. Perineurium

198. In case of inferior alveolar nerve block, needle is placed in which of the following space
A. Pterygopalatine fossa
B. Pterygomandibular space
C. Submandibular space
D. Masticator space

Ans: B. Pterygomandibular space

199. A patient experiences post-operative nausea and vomiting is due to all except
A. Opioid
B. Ingested blood
C. Nitrous oxide
D. Acetaminophen

Ans: A. Acetaminophen
200. Which of the following is the most potent topical local anaesthetic
A. Tetracaiine
B. Benzocaine
C. Mepivacaine
D. Prilocaine

Ans: A. Tetracaiine

201. General anesthesia is used for all of the following procedures except
A. Treatment of controlled epileptic patient
B. Cerebral palsy
C. Mental retardation
D. Very uncooperative patients

Ans: A. Treatment of controlled epileptic patient