01 Fifa 2018.pdf

SJ FILE explanations, comments, pictures (edited in MARCH 2018) Explanations: - the total number of Qs is different than in the original file, because I don’t like repeated Qs, so I was removing some while editing - the numbering system is different than in the original file, because I wanted to fit some pictures on a certain page and due to that I had to move around some Qs, so Qs #123 in this file might be #150 in the original file: I was regretting that step while studying with other people, but there’s nothing I can do now - usually the Qs in this file compared to the original are within +/- 20 Qs range, so if you are discussing a Qs with someone else look for it on a certain page, page up & page down = you will find it - this file is a combination between two SJ files available on the group (forgot which ones), if there was a difference in an answer I would look it up and post an explanation - I edited a lot of answers while studying with others, I believe these answers are correct and have minor mistakes - I passed studying from this file - questions with “????” → I didn’t understand the qs and I am not sure of the answer MC = most common Epi = epinephrine NEpi = norepinephrine LN = lymp node

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1.

Papilla of the tongue, no taste: FILIFORM

2.

Tracheostomy:  PHYSIOLOGICAL DEAD SPACE

Physiological dead space = anatomical dead space + alveolar dead space Anatomical dead space doesn’t contribute to gas exchange. Anatomical dead space is decreased by: I. Intubation (nasal cavity is bypassed and diameter of tube is less than airway diameter) II. Tracheostomy (upper airways and nasal cavity bypassed) III. Hyperventilation (decreasing lung volume) IV. Neck flexion V. Bronchoconstrictors 3. 4. 5. 6. 7. 8. 9.

Gustatory of the anterior 2/3 will travel along: CHORDA TYMPANI TRAVELS ALONG LINGUAL NERVE Hamulus from which bone: MEDIAL PTERYGOID PLATE (SPHENOID) Which muscle inserted to coronoid: TEMPORALIS Lung innervation: T2-T4 (S NS), VAGUS (PS NS) Burning sensations of the mouth, which fibers transmit it: C FIBERS Facial paralysis after anesthesia: FACIAL NERVE PARALYSIS (PAROTID GLAND) Which nerve travels with external jugular vein: GREAT AURICULAR

EJV – great auricular n., superficial cervical LN IJV – accessory n., deep cervical LN

10.

Nerve that innervates muscles below the true vocal cord: INFERIOR LARYNGEAL (RECURRENT LARYNGEAL)

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11.

What cause supination between ulna & radial: BICEPS BRACHII

Origin Insertion Artery Nerve Actions Antagonist

12.

Short head: coracoid process (scapula) Long head: supraglenoid tubercle Radial tuberosity and bicipital aponeurosis into deep fascia on medial part of forearm Brachial artery Musculocutaneous nerve (C5–C7) - flexes elbow - flexes and abducts shoulder - supinates radioulnar joint in the forearm Triceps brachii muscle

What structure doesn’t go through parotid: FACIAL ARTERY

Structures passing over parotid: facial n., ECA, auriculotemporal n., retromandibular v., superficial temporal v. Mneumonic: FEARS Great auricular n. (C2-C3) innervates skin over parotid gland – passes posteriorly.

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13.

Choose two visceral arteries branches of abdominal aorta.

Abdominal aorta: - 3 anterior visceral branches - 3 paired lateral visceral branches - 5 paired lateral abdominal wall branches - 3 terminal branches

14.

coeliac, SMA, IMA suprarenal, renal, gonadal inferior phrenic, 4 x lumbar 2 x common iliac, median sacral

Pepsinogen is secreted from: CHIEF CELLS (STOMACH)

Parietal cells = oxyntic cells → HCl (HOPa: HCl, Oxyntic, PArietal) Chief cells = peptic cells = gastric zymogenic cells → pepsinogen (PCPe: Pepsinogen, Chief cells, PEptic cells) 15. 16. 17. 18. 19. 20.

Epinephrine and glucagon cause: GLYCOGENOLYSIS Gonadotropic hormone causes the release of: LH & FSH Proprioception of trigeminal nerve to which nucleus: MESENCEPHALIC Mechanic proprioception in PDL: INFORMATION IS SENT TO MESENCEPHALIC NUCLEUS Cells of PDL come from: DENTAL SAC Each of the following is located in the external surface of enamel except: HUNTER-SCHERGER BAND

21. 22. 23. 24.

Too much clenching, abuse activation of: MASSETER (or temporalis) Vitamin C is important for: COLLAGEN SYNTHESIS (hydroxylation of proline and lysine) Enamel is harder than bone due to: HIGHER INORGANIC CONTENT / BIGGER CRYSTALS ATP needed for all except: PENTOSE PHOSPHATE PATHWAY / HMP SHUNT

Facilitated diffusion is a passive process: no active energy in form of ATP needed. 25.

What causes depolarization: K+ MOVES OUTSIDE, Na+ MOVES INSIDE

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26.

Muscle contraction causes shortening of: H ZONE & I BAND

27. 28.

Not important gland: ADRENAL MEDULLA Zona fasciculata produce: GLUCOCORTICOID (CORTISOL)

Mineralocorticoid: aldosterone Androgens: testosterone, DHT, androstenedione, DHEA 29. 30. 31. 32.

Herpangina: COX A Cervical cancer: HPV 16 & 18 Fungus with capsules: CRYPTOCOCCUS Fungi treated with: POLYENE ANTIFUNGALS

Amphotericin → systemic fungal infections Nystatin → oral fungal infections 33. 34.

What enzyme does bacteria use to produce caries: GLUCOSYLTRANSFERASE Glucosyltransferase: STREPTOCOCCUS MUTANS

Cariogenic bacteria synthesize glucans (dextrans) and fructans (levans) from their metabolism of dietary sucrose (via glucosyltransferase), which contribute to their adherence to tooth surfaces. As a consequence, lactic acid is formed, reducing salivary pH and creating sites of enamel demineralization and cavitation.

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35. 36.

Which virus is non latent: POLIO & RHINO Where does the vertebral artery enter the skull: FORAMEN MAGNUM

Structures passing through foramen magnum: Spinal Meninges Make A Special Vertical Sheath Spinal cord, Meninges, Meningeal lymphatics, Accessory n., Sympathetic plexus, Vertebral a., Spinal branches of vertebral a. 37.

Which define the mouth size: THE DEGREE OF FUSION BETWEEN MAXILLARY AND MANDIBULAR PROCESS

Lip formation depends on the same. 38. 39.

What is normally not present in plasma: THROMBIN Parafollicular cells produce: CALCITONIN

40. 41. 42. 43. 44. 45. 46.

What muscles are voluntary: RECTUM, 1/3 UPPER ESOPHAGUS Have afferent and efferent vessels: LYMPH NODES What muscle retrudes mandible: POSTERIOR TEMPORALIS During maximal clenching which muscle attach to disc of TMJ to stabilize it: SUPERIOR LATERAL PTERYGOID What ligament attach to the disc of TMJ: COLLATERAL LIGAMENTS What accessory ligament prevent mandible from protrusions: STYLOMANDIBULLAR If the cell starts directly to divide, what will cause to cell cycle (other question: very fast replication of the cells has what kind of effect on other stages of the cell cycle): G1 AND G2 PHASE DECREASES SLE: AUTOANTIBODY The longest part of the cell cycle: G1 (10 hours) Amelogenesis imperfecta due to: AMELX GENE (codes for amelogenin) Alzheimer’s: NEURODEGENERATIVE, DEMENTIA, PLAQUES, NEUROFIBRILLARY TANGLES (primary marker!) A girl from Africa had TB, what would not be a case of a positive TB test: M. LEPRAE (“+” for Mycobacterium and BCG vaccine) Alzheimer’s testlet; patient has depression and also takes medication for it. a. Patient’s depression from the causes of his Alzheimer’s – TRUE b. Effect/deficiency of serotonin in Alzheimer’s – TRUE c. While extracting you broke the marginal ridge – INFORM THE PATIENT Burning sensation, patient wears L RPD: MENTAL NERVE Glucose filtration rate: 0 Glucose clearance: 0 mg/dl How much of the occlusal table form over all? 50-60% OF OCCLUSAL SURFACE IS OCCLUSAL TABLE Where does the submandibular duct open? SUBLINGUAL CARUNCLE IN THE FLOOR OF THE MOUTH Infection of the lower anterior teeth: SUBMENTAL LNs Sensation of the face, which nucleus: VPM Pain of the face, which nucleus: VPM

47. 48. 49. 50. 51. 52.

53. 54. 55. 56. 57. 58. 59. 60.

Face: VPM (ventroposterior medial) Body: VPL (ventroposterior lateral) Mesencephalic nucleus: proprioception of the face & jaw-jerk reflex Spinal nuclei: responsible for pain and T of the face/head/neck; subdivided into oralis, interpolaris and caudalis. Oralis: fine tactile sense from orofacial Interporalis: tactile sense + dental pain Caudalis: nociception + thermal sensation

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61.

Paralysis of the face muscles below zygoma: UMN DAMAGE

UMN damage: paralysis on contralateral side of the lower quadrant of the face only LMN damage: paralysis on ipsilateral side for the upper and lower quadrants of the face

62.

As the patient ages, the arteries loose elasticity – what will happen to the pulse pressure:  SYSTOLIC,  OR NO CHANGE DIASTOLIC,  PP, CONTINOUS FLOW IN THE CAPILLARIES WOULD CHANGE INTO A PULSATILE FLOW

Pulse Pressure: difference between systolic and diastolic 63. 64. 65.

Pulmonary arteries and aorta are alike because: TRICUSPID SEMILUNAR VALVE, AMOUNT OF BLOOD FLOWING IS THE SAME Primary mandibular incisor: STRAIGHT INCISAL EDGE, NO MAMELONS, SMALLEST F-L DIMENSION OF ALL PRIMARY TEETH Why haptens can’t elicit the formation of an antibody: TOO SMALL, THEY NEED A CARRIER

Super-antigen activates a large number of Th cells at one time. 66. 67. 68.

Similarity between salivary gland and kidneys: STRIATED DUCT Similarity between salivary gland and pancreas: INTERCALATED DUCTS Striated ducts of the salivary glands: CONTAIN MITOCHONDRIA

Modifies saliva form isotonic to hypotonic. Striations are related to a combination of foldings of basal cell MBs & radially arranged mitochondria for electrolyte & water transport. Simple, low, columnar epithelium.

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69.

Excessive ACTH will cause: CUSHING’S DISEASE; HYPERGLYCEMIA AND WEIGHT GAIN

Cushing’s disease: excess ACTH being produced (tumor) → excess cortisol Cushing’s syndrome: excess cortisol →  ACTH 70.

Sphingolipid’s structure: SPHINGOSYNE, 1 X FA, FUNCTIONAL GROUP

Functional groups: Cerebroside → glucose Sphingomyelin → choline Ganglioside → a lot of sugars Ceramide → hydrogen 71.

Chronic viral hepatitis: HEPATITIS C

Hepatitis C: flavivirus, ss-RNA, enveloped. 72. 73.

Lining the bone marrow: ENDOSTEUM Gets embedded in the endometrium: BLASTOCYST/BLASTULA

74. 75. 76. 77. 78. 79. 80. 81. 82. 83. 84. 85.

Lining of the trachea: PSEUDOSTRATIFIED CILIATED COLUMNAR Bowman’s capsule: PODOCYTES Colloid-filled follicle: THYROID Functional unit of the thyroid: FOLLICLE Upper cervical ganglion: C1-C4 Blood-brain barrier is efficient because: NOT FENESTRATED, WITH TIGHT JUNCTIONS MX 1st molar root that is not innervated by superior posterior nerve: MB Bifurcated anterior tooth: MN CANINE Liver failure: HYPOALBUMINEMIA Absolute refractory period: BLOCKED Na+ INFLUX Latent virus in saliva: EBV, MUMPS Latent virus in salivary glands: CMV

EBV: B-cells, epithelial cells CMV: lymphocytes 86. 87. 88. 89. 90.

Virus that causes chickenpox can also cause: SHINGELS/HERPES ZOSTER Patient with diabetes t. I should watch 3 of the following: CARBOHYDRATES, FAT, TOTAL CALORIES Leukoplakia, what type of epithelium: PARAKERATOSIS / ORTHOKERATOSIS = HYPERKERATOSIS (can develop into SCC) Decreased water permeability in distal tubule: ALDOSTERONE Cell not found in a purulent secrection: PLASMA CELLS

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91. 92.

ATPase binds to: MYOSIN Promote osteogenesis: SOMATOMEDIN

Stimulated by somatotropin (GH). 93.

Not found in dermis: MELANOCYTES, MYELINATED NERVE FIBERS

Dermis: Epidermis: 94. 95. 96. 97.

Meisnner’s corpuscles, collagen, sebaceous glands, hair follicles, sweat glands, vessels Merkel’s corpuscles

Made of mesenchyme: DERMAL PAPILLA PAH (Paraaminohippurate) clearance determine: RENAL PLASMA FLOW Smallest cusp in the primary MN 1st molar: DISTOLINGUAL Steepness of the condyle:  CROWN HEIGHT, TALLER POSTERIOR CUSPS

The steeper the articular eminence, the longer the posterior cusps. 98.

ACTH increase will cause:  CORTISOL, CUSHING’S DISEASE

ACTH stimulates secretion of cortisol – it is a steroid, glucocorticoid hormone. When used as a medication, it is known as hydrocortisone. It is produced by the zona fasciculata of the adrenal cortex. It is released in response to stress and low blood-glucose concentration. It functions to increase blood sugar through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fat, protein, and carbohydrates. It also decreases bone formation. 99.

Not superficial to hyoglossus: LINGUAL ARTERY

100. From otic ganglion to the parotid gland: SECRETOMOTOR POST GANGLIONIC PARASYPATHETIC FIBERS (that travel along the auriculotemporal branch from CN V3 to the parotid gland) 101. Which part of the nephron uses the most ATP: PCT

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102. From splanchnic to celiac trunk: PRESYNAPTIC SYMPATHETIC

103. 104. 105. 106. 107.

Over contouring of the lingual surface of anterior teeth will? DECREASE OVERJET Pain from teeth to: PARIETAL LOBE, NUCLEUS INTERPOLARIS What separates diencephalon: 3rd VERNTRICLE How increasing anterior overbite will affect the height of posterior cusps? MAKE THEM TALLER/HIGHER Patient was exhibiting a mutually protected occlusion on her L side, then the MX canine was removed. The patient would exhibit: GROUP FUNCTION 108. All of the following are the characteristics of a mutually protected occlusion, except: POSTERIOR CONTACT DURING LATERAL MOVEMENT Found online: Each of the following is a condition usually found in a mutually protected occlusion, in the normal upright position, except one. Which one is this exception? A) None of the posterior teeth contact on the non-working side when the mandible moves laterally B) Anterior teeth disclude all posterior teeth in protrusive movement. C) Condyles are in their most supero-anterior position in closure. D) Anterior teeth contact more heavily than the posterior teeth. E) Axial loading of occlusal forces occurs in closure. 109. Hooks under the hamulus: TENSOR VELI PALATINI

110. Attach to pteromandibular raphe: SUPERIOR CONSTRICTOR OF PHARYNX AND BUCCINATOR Spine of sphenoid and lingula: sphenomandibular ligament. 111. Achalasia is most related to: ESOPHAGUS 112. Aflatoxins produced by: ASPERGILLUS 113. Systemic fungal infection: COCCIDIOMYCOSIS, HISTOPLASMOSIS, BLASTOMYCOSIS

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114. Sensory (pain) innervation from the buccal vestibule of the mouth: LONG BUCCAL NERVE (V3) 115. Which triangle is bounded by superior belly of omohyoid, anterior borders of SCM & posterior belly of digastric: CAROTID

116. Abdominal aorta branches: CELIAC, SUPERIOR & INFERIOR MESENTERIC (compare #13) 117. Portal drainage from: SMALL AND LARGE INTESTINE 118. Vertebral artery enters the skull via: FORAMEN MAGNUM

119. Anterior wrist innervated by: MEDIAN NERVE

120. Parkinson’s disease and Alzheimer’s disease, what they have in common: DEMENTIA 121. Calcitonin: INHIBITS BONE RESORPTION 122. Enamel pearl: HERTWIG’S REMNANT

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123. Myasthenia gravis, defect in: MYONEURAL JUNCTION Myasthenia gravis (MG) is a long-term autoimmune neuromuscular disease that leads to varying degrees of skeletal muscle weakness (attacks Ach receptors). The most commonly affected muscles are those of the eyes, face, and swallowing. It can result in double vision, drooping eyelids, trouble talking, and trouble walking. Onset can be sudden. Those affected often have a large thymus gland or develop a thymoma. Often improves with rest & worsens with activity. IT IS NOT A CNS DEGENERATION. 124. Granular cells in ovaries analogous with which in testes: SERTOLI A Sertoli cell is a "nurse" cell of the testicles that is part of a seminiferous tubule and helps in the process of spermatogenesis; that is, the production of sperm. It is activated by follicle-stimulating hormone (FSH) secreted by the adenohypophysis and has FSH receptor on its membranes. It is specifically located in the convoluted seminiferous tubules (since this is the only place in the testes where the spermatozoa are produced). A granulosa cell or follicular cell is a somatic cell of the sex cord that is closely associated with the developing female gamete (called an oocyte or egg) in the ovary of mammals. 125. Stratum granulosum contains: KERATOHYALIN

126. 127. 128. 129. 130. 131. 132.

Inactive chromosome: HETEROCHROMOSOME Sac-like with non-keratinized epithelial lining: CYST Trifurcated premolar: MX 1st PM (2 buccal, 1 palatal) Shorter incisogingivally than mesiodistally: PRIMARY MX CENTRAL Which cusp contribute to oblique and transverse ridges: MESIOLINGUAL How many pulp horns in MD 1st M: 5 Patient has paralysis in facial muscles due to cerebrovascular injury, which artery is involved: MIDDLE CEREBRAL

Epidural hematoma → MMA Subdural hematoma → bridging vein Subarachnoid hemorrhage → anterior communicating artery, ruptured aneurysm 133. Not a function of CD4: ANTIBODY RELEASE 134. Cellular immunity most important to detect: INTRACELLULAR INFECTIONS 135. Il-1 is released by: ACTIVATED MACROPHAGES Activated macrophages release: Il-1, Il-6, Il-8, Il-12, TNF-a. 136. 137. 138. 139.

Pain is transmitted by which nucleus: SPINAL Salivary nucleus location: BRAINSTEM Neurotransmitter in pulp: SUBSTANCE P Pain: SUBSTANCE P

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Epic mama Subd.b Suba.aca

140. 141. 142. 143. 144. 145. 146. 147.

Muscle between superior and middle pharyngeal constrictors: STYLOPHARYNGEUS (also CN IX) Palatal glands: MUCOUS Purely mucous salivary glands: PALATAL GLANDS Demilunes in submandibular glands: SEROUS Chlamydial infection to conjunctiva and pharynx: TRACHOMA Supraclavicular LN metastasis from which cancer: STOMACH Posterior tongue papillae innervated by: CN IX Does not pass through jugular foramen: HYPOGLOSSAL

Jugular foramen: CN IX, X, XI

148. 149. 150. 151. 152. 153. 154. 155. 156. 157. 158. 159. 160.

Cilia move cerebral fluid from subarachnoid space to: VEINS Supinator of the arm: BICEPS BRACHII (#11) Not the effect of sympathetic nervous system: PUPIL CONSTRICTION To reach submandibular gland duct you will have to: CUT THROUGH MUCOUS MEMBRANE ONLY Infection at the corner of the mouth spreads to: SUBMANDIBULAR LYMPH NODES Most superior part of the larynx: EPIGLOTTIS / ARYEPIGLOTTIC FOLD Greater cornu of hyoid and CN IX (glossopharyngeal) arise from: 3rd ARCH External auditory meatus: 1st CLEFT Graft rejection: TYPE IV HYPERSENSITIVITY REACTION All premolars have DMCR longer than MMCR except: MX 1st PM Morphodifferentiation determines: SHAPE OF THE TOOTH DEJ forms at: BELL STAGE What occurs first: ELONGATION OF IEE

Followed by differentiation of odontoblasts, 1st layer of dentin, 1 layer of enamel 161. Not found in compact bone: TRABECULAE (found in spongy bone) 162. Direct source of energy for muscular contraction: ATP 163. Not an effect on Viagra:  BP / VASOCONSTRICTION (it  BP & relaxes muscles) Viagra (Sildenafil) treats erectile dysfunction and pulmonary arterial hypertension. It inhibits cGMP-phosphodiesterase → promotes the degradation of cGMP.

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164. 165. 166. 167.

Protection against occlusal forces: OBLIQUE FIBERS  acid phosphatase: PROSTATIC CANCER ( alkaline phosphatase – Paget’s) Exotoxin with 3 factors: ANTHRAX (lethal factor, edema factor, protective antigen) Ansa cervicalis innervates: INFRAHYOID MUSCLES

The ansa cervicalis is a loop of nerves that are part of the cervical plexus. It lies superficial to the IJV in the carotid triangle. Branches from the ansa cervicalis innervate most of the infrahyoid muscles, including the sternothyroid muscle, sternohyoid muscle, and the omohyoid muscle. Note that the thyrohyoid muscle, which is also an infrahyoid muscle, is innervated by C1 via the hypoglossal nerve. In addition, the ansa cervicalis does not innervate the stylohyoid muscle, which is innervated by the facial nerve.

168. Why antibiotics give relief in peptic ulcer disease: ELIMINATE H. PYLORI,  ACID SECRETION (PROTON PUMP INHIBITORS) 169. Which nerve to cut to treat peptic ulcer: VAGUS The vagus nerves play a central role in regulating gastric acid production. Vagotomy performed in conjunction with either pyloroplasty or antrectomy was once the gold standard for the treatment of peptic ulcer disease. The following decades saw the development of histamine H2-receptor antagonists and proton pump inhibitors, along with the discovery of the role Helicobacter pylori plays in peptic ulcer disease. The success of these modern nonsurgical therapies reduced the incidence of ulcer-related complications requiring surgical interventions. When surgical interventions are required, technological advances have allowed vagotomy to be performed with minimally invasive techniques with fewer procedure-related complications. 170. Autosomal dominant, 50%: 25% IN OFFSPRING 171. pH=1, glutamate will be: +1 172. Fungus that cause athlete feet: TRICHOPHYTON Trichophyton is a genus of fungi, which includes the parasitic varieties that cause tinea, including athlete's foot, ringworm, jock itch, and similar infections of the nail, beard, skin and scalp. Trichophyton fungi are molds characterized by the development of both smoothwalled macro- and microconidia. 173. Lining of the stomach: SIMPLE COLUMNAR EPITHELIUM

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174. Activation of an enzyme include: PHOSPHORYLATION OF SERINE RESIDUE (PROKARYOTES) OR HYDROLYSIS OF A PEPTIDE UNIT (EUKARYOTES) 175. Afferent of Breuer reflex of the lung: STRETCH RECEPTORS, CARRIED BY VAGUS NERVE TO PREVENT OVER-INFLATION The Hering–Breuer inflation reflex is a reflex triggered to prevent over-inflation of the lung. Pulmonary stretch receptors present in the smooth muscle of the airways respond to excessive stretching of the lung during large inspirations. Once activated, they send action potentials through large myelinated fibers of the vagus nerve to the inspiratory area in the medulla and apneustic center of the pons. In response, the inspiratory area is inhibited directly and the apneustic center is inhibited from activating the inspiratory area. This inhibits inspiration, allowing expiration to occur. The Hering–Breuer deflation reflex serves to shorten exhalation proprioceptors activated by lung deflation. Like the inflation reflex, impulses from these receptors when the lung is deflated. It is initiated either by stimulation of stretch receptors or stimulation of travel afferently via the vagus. Unlike the inflation reflex, the afferents terminate on inspiratory centers rather than the pontine apneustic center. These reflexes appear to play a more minor role in humans than in non-human mammals. 176. Sharp pain: A-DELTA

177. Insulin receptor: TYROSINE KINASE Tyrosine kinase receptor adds phosphate group to tyrosine in a cell. Phosphorylated proteins have greater affinity for GLUT-4 →  glucose uptake from blood to tissues. 178. 179. 180. 181. 182. 183. 184. 185. 186. 187. 188.

Rickettsia and viruses: OBLIGATE INTRACELLULAR (difference: rickettsia has both DNA & RNA) Articulating surfaces in a newborn are covered by: HYALINE CARTILAGE Infection in the posterior wall of maxillary sinus will spread to: ETHMOIDAL SINUS Cytochrome p450: BIOTRANSFORMATION OF DRUG EFFECTS, INNER MEMBRANE OF MITOCHONDRIA, DETOXIFICATION, IN PERICENTRAL VEIN ZONE IN THE LIVER Na+ / K+ is an example of: ION CHANNEL – PRIMARY ACTIVE TRANSPORT Fungal agar: SABOURAUD AGAR (also for bacteria → Nocardia) Anti-A and anti-B both agglutinate: AB type Not in liquid necrosis and inflammation: CELL AUTOLYSIS Bonds between DNA units: PHOSPHODIESTER Bonds between GAGs: GLYCOSIDIC Maxillary molar infection will spread to: INFRATEMPORAL FOSSA, MAXILLARY SINUS & BUCCAL SPACE

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189. Howship lacunae: OSTEOCLASTS (BONY REMODELING) Osteoclasts occupy small depressions on the bone’s surface, called Howship lacunae; the lacunae are thought to be caused by erosion of the bone by the osteoclasts’ enzymes. Osteoclasts are formed by the fusion of many cells derived from circulating monocytes in the blood. These in turn are derived from the bone marrow. 190. Oxidative decarboxylation: PYRUVATE, ISOCITRATE, A-KETOGLUTARATE DEHYDROGENASE

Once glycolysis takes place in the cells cytoplasm it produces pyruvate, which continues on and into the matrix of the mitochondria. The Krebs cycle is the next step of cellular respiration, but before the Krebs cycle takes place we need another step called Oxidative Decarboxylation which has to convert pyruvate into acetyl-CoA. The following steps occur: 1. A carboxyl group is removed as CO2. This is the decarboxylation part. 2. Then the remaining 2-carbon part is oxidized by NAD+. The NAD+ gains two hydrogen’s and the remaining two-carbon compound becomes an acetic acid. 3. Then a coenzyme A (CoA) attaches to the acetic acid part forming acetyl-CoA. This is the molecule that is needed to continue in the Krebs Cycle. 191. Weil-Felix test: ROCKY MOUNTAIN SPOTTED FEVER RMSF is a bacterial disease (RICKETTSIA) spread through an infected tick. Most people who get sick with RMSF will have a fever, headache, and rash. RMSF can be deadly if not treated early with the right antibiotic. Lyme disease = borreliosis (BORRELIA). 192. MD dimension of MX canine pulp canal: WIDEST NEAR THE CERVICAL 1/3 193. Mechanoreceptors in PDL varying in: THRESHOLD

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194. Produces secretin: S CELLS (DUODENUM) Secretin is a hormone that regulates water homeostasis throughout the body and influences the environment of the duodenum by regulating secretions in the stomach, pancreas, liver. It is a peptide encoded by the SCT gene. 195. All cause atrophy in the muscles except: EXCESSIVE HORMONAL STIMULATION Atrophy is caused by disuse, pressure,  blood supply. 196. Gamma fibers: INTRAFUSAL FIBERS, INNERVATE MUSCLE SPINDLE, MAINTAIN MUSCLE TONE Gamma motor neuron is a type of LMN that takes part in the process of muscle contraction, and represents about 30% of fibers going to the muscle. Like alpha motor neurons, their cell bodies are located in the anterior grey column of the spinal cord. They receive input from the reticular formation of the pons in the brainstem. Although muscles can be in a relaxed state, muscles have a general resting level of tension. This is termed muscle tone and is maintained by the motor neurons innervating the muscle. Its purpose is to maintain posture and assist in quicker movements, since if muscles were completely loose, then more neuronal firing would need to take place. 197. Warfarin tested by: PT (PROTHROMBIN TIME, EXTRINSIC PATHWAY) Mnemonic: EX PresidenT went to WARFARIN Warfarin is a prescription medication that interferes with normal blood clotting (coagulation). It is an anticoagulant. The clotting test used to measure the effect of warfarin is the prothrombin time. The PT is a laboratory test that measures the time it takes for a clot to form. It is measured in seconds. It is particularly sensitive to the clotting factors affected by warfarin. The PT is also used to compute the measure most commonly used to adjust the warfarin dose, known as the INR (or International Normalized Ratio). 198. H2 receptors, increase gastric secretion: HISTAMINE Histamine is a ubiquitous messenger molecule released from mast cells, enterochromaffin-like cells, and neurons. Its various actions are mediated by histamine receptors H1, H2, H3 and H4. The histamine receptor H2 belongs to the rhodopsin-like family of G proteincoupled receptors. It is an integral membrane protein and stimulates gastric acid secretion. It also regulates gastrointestinal motility and intestinal secretion and is thought to be involved in regulating cell growth and differentiation. 199. Interferon’s anti-viral effect: INHIBITS REPLICATION Interferons (IFNs) are a group of signaling proteins made and released by host cells in response to the presence of several pathogens, such as viruses, bacteria, parasites, and also tumor cells. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses. IFNs belong to the large class of proteins known as cytokines, molecules used for communication between cells to trigger the protective defenses of the immune system that help eradicate pathogens. Interferons are named for their ability to "interfere" with viral replication by protecting cells from virus infections. 200. Fumarate links urea cycle to: KREBS CYCLE 201. Nitrogen sources in urea cycle: ASPARTATE & AMMONIA Pick aspartate & carbamoyl phosphate (it has ammonia built in it: NH4 + CO2 → carbamoyl phosphate) if the questions says “direct sources of ammonia in the urea cycle”. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211.

MX central erupt occlusally and: FACIALLY Premolar with cusps closest in size: MX 2ND PM Y pattern for MN 2nd PM formed by: LINGUAL & CENTRAL GROOVES Gingival disease: IgG Immunoglobulin in saliva/tears/body fluids: sIgA (different question combinations) Positive PPD indicate all except: LEPROMATOUS LEPROSY PPD: TYPE IV HYPERSENSITIVITY Not in plaque: STREP. PYOGENES Important in clots formation: Ca2+ Most genetic information is transported via: CONJUGATION

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212. What regulates glycolysis: PFK 213. Transduction include all of the following except: CELL TO CELL CONTACT Transduction is DNAase resistant, transformation is susceptible to DNAase. 214. 215. 216. 217. 218. 219.

Last step of gluconeogenesis in the liver: GLUCOSE-6-PHOSPHATASE Dextran: GLUCOSE UNITS ON HYDROLYSIS YIELD FRUCTANS (LEVANS) BY GLUCOSYLTRANSFERASE (???) Substrate of dextran formation: SUCROSE Inhibits prostaglandins: ASPIRIN Penicillin resistance: B-LACTAMASE Differences between dystrophic calcification and metastatic calcification: DYSTROPHIC OCCURS IN NECROTIZING TISSUES

Dystrophic calcification is the calcification occurring in degenerated or necrotic tissue. This occurs as a reaction to tissue damage, including as a consequence of medical device implantation. Dystrophic calcification can occur even if the amount of calcium in the blood is not elevated. Metastatic calcification is deposition of calcium salts in otherwise normal tissue, because of elevated serum levels of calcium, as seen in hyperparathyroidism. These differences in pathology also mean that metastatic calcification is often found in many tissues, whereas dystrophic calcification is localized. Metastatic calcification can occur widely throughout the body but principally affects the interstitial tissues of the vasculature, kidneys, lungs, and gastric mucosa. For the latter three, acid secretions or rapid changes in pH levels contribute to the formation of salts. 220. Respiratory acidosis is caused by: HYPOVENTILATION,  T,  BPG Asthma, COPD, emphysema, cardiac arrest, acute pulmonary edema are some of the causes. In acidosis: Extra H+ goes into the cell and potassium leaves the cell which causes transient hyperkalemia. In alkalosis: H+ leaves the cell and potassium enters the cell leading to transient hypokalemia. 221. Hyperventilation causes: RESPIRATORY ALKALOSIS (CO2 & PH) 222. Suicide inhibitor: SUBLACTAM Suicide inhibition (suicide inactivation or mechanism-based inhibition) is an irreversible form of enzyme inhibition that occurs when an enzyme binds a substrate analogue and forms an irreversible complex with it through a covalent bond. The inhibitor binds to the active site where it is modified by the enzyme to produce a reactive group that reacts irreversibly to form a stable inhibitor-enzyme complex. Examples: aspirin, clavulanic acid, fluorouracil, penicillin, sublactam, allopurinol, AZT, exemestane Thymydylate synthatase is an important enzyme, which inhibition is used in cancer treatment. Augmentin = amoxicillin + clavulanic acid 223. Example of suicide inhibitor: ANTI-CANCER DRUG, FLUOROURACIL 224. Not a step in PCR There are 3 major steps involved in the PCR technique: Denaturation, Annealing, and Extension (in sequence). 225. Actin filaments in cilia are similar to: MICROTUBULES 226. Nissl bodies: RER A Nissl body (Nissl substance) is a large granular body found in neurons. These granules are of rough endoplasmic reticulum (RER) with rosettes of free ribosomes and are the site of protein synthesis. Polio attacks Nissl bodies. 227. 228. 229. 230. 231.

Urticaria (rash, hives) in penicillin allergy, which type of hypersensitivity: TYPE I Clindamycin: BINDS TO 50S RIBOSOMAL SUBUNIT Aminoglycoside: BINDS TO 30S RIBOSOMAL SUBUNIT Long onset – long effect: estrogen, oxytocin, ADH, PTH, GH (???) Slow onset – long effect: ESTROGEN (???; long acting effect = estrogen, GH not in option)

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232. Buccinator: PENETRATED IN INFERIOR MANDIBULAR NERVE BLOCK 233. The relation between lingual nerve and inferior mandibular nerve: ANTERIOR & MEDIAL, ANTERIOR, POSTERIOR & LATERAL, POSTERIOR 234. Aciduric bacteria: LACTOBACILLUS 235. Streptococcus lacks: LIPOPOLYSACCHARIDE 236. Frequent virulence factor: CAPSULE 237. Gram negative bacteria have: LIPOPOLYSACCHARIDE 238. Glucagon phosphorylase: RATE-LIMITING ENZYME IN GLYCONEOGENESIS 239. Form collagen, elastin and reticular fibers: FIBROBLAST 240. Bone and cartilage share all of the following, except: HIGHLY VASCULARIZED 241. Primary teeth have: LIGHTER COLOR 242. Lingual HOC of MX canine: CERVICAL 1/3 243. Cervical lines: ADJACENT CERVICAL LINES ARE THE SAME Cervical lines on adjacent proximal surfaces of adjacent teeth have approximately the same depth of curvature. 244. Contact area: STABILIZE DENTAL ARCH, FORM EMBREASURES, PREVENT FOOD IMPACTION Don’t distribute occlusal forces or protect mucosal tissues. 245. What tooth does MX lateral incisor contact in an edge to edge position: NO TOOTH When protrusive movement first occurs, they contact MN lateral & canine. 246. 247. 248. 249. 250.

Mesial contact point on MX canine: JUNCTION OF INCISAL & MIDDLE THIRD Caries on MX lateral: LINGUAL PIT Left MX 2nd premolar replaces which tooth: PRIMARY 2ND MOLAR Cingulum of the MX central incisor offsets to: DISTAL Occlusal view of MX 1st molar: M-D WIDTH IS WIDER ON LINGUAL THAN FACIAL

This is why the facial embrasure is larger than the lingual one, which is unique to the 1 st MX molars. 251. 252. 253. 254. 255. 256. 257. 258. 259.

Tooth frequently found with 2 canals: MX 1st PM, MN LATERAL INCISOR (28%) Root with 2 canals: MB OF MX 1ST MOLAR, M OF MN 1ST MOLAR, MN LATERAL INCISOR (28%) MX 2nd molar: 3 ROOTS, 3 OR 4 CANALS; STENSON’S DUCT OPENS NEAR IT MX 1st molar: 3 ROOTS, 3 OR 4 CANALS (2 MB, 1 P, 1 DB) Straight mesial surface (looking from labial): MN CANINE How many fossae does MX canine have: 2 LINGUAL FOSSAE Which of the following is bordered by incisal edge and marginal ridges: OCCLUSAL TABLE Which tooth exhibits most deformities: MX LATERAL INCISOR Each of the following is a histologic feature of malignant growth, except: APLASIA & METAPLASIA

Aplasia - defective development or congenital absence of an organ or tissue. 260. 261. 262. 263. 264.

Benign tumor: WELL DIFFERENTIATED CELLS Precancerous: NON-MALIGNANT Leukoplakia: HYPERPLASIA & KERATINIZED EPITHELIUM Squamous cells in the lungs: METAPLASIA Patient has lung infraction and dies within 24h. What will you find in the pathology slide: RED INFRACT/HEMORRHAGIC INFRACT, PULMONARY EMBOLISM

In light microscopy (LM): necrosis of alveolar walls - loss of nuclei, alveolar hemorrhage, +/- evidence of underlying cause. Red infract: lung, brain, liver, intestine; white infract: kidney, retina, brain, heart, spleen 265. Postural position: RESTING POSITION Centric relation: muscles, condyle in the back position. Central occlusion: teeth.

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266. 267. 268. 269. 270. 271. 272.

Protrusion: BOTH LATERAL PTERYGOIDS Stabilize the disc of TMJ: SUPERIOR HEAD OF LATERAL PTERYGOID Left movement: RIGHT LATERAL PTERYGOID CONTRACTION Translation: SUPERIOR COMPARTMENT Articular surfaces of the condyle: SUPERIOR & ANTERIOR Leukocytes leaves vessels at: POSTCAPILLARY VENULES Secrete HCl: OXYNTIC / PARIETAL CELLS

That causes an activation of pepsinogen by converting it to pepsin. Parietal cells (oxyntic), are the epithelial cells that secrete HCl and intrinsic factor. These cells are located in the gastric glands found in the lining of the fundus and in the body of the stomach. They contain an extensive secretory network (called canaliculi) from which the HCl is secreted by active transport into the stomach. The enzyme hydrogen potassium ATPase (H+/K+ ATPase) is unique to the parietal cells and transports the H+ against a concentration gradient of about 3 million to 1, which is the steepest ion gradient form ed in the human body. Parietal cells are primarily regulated via histamine, acetylcholine and gastrin signaling from both central and local modulators. 273. Which of the following is incorrect: ALCOHOLISM CAUSES GUMMATOUS NECROSIS (it is rescricted to necrosis involving spirochaetal infections that cause syphilis) Apoptosis and necrosis: two types of cell death in alcoholic liver disease. Heavy alcohol consumption over long periods of time c an result in severe liver damage, including death of liver cells (hepatocytes). Two mechanisms, apoptosis and necrosis, can contribute to hepatocyte death. 274. 275. 276. 277. 278. 279. 280. 281.

Not essential in Lys hydroxylation: VIT. K Extracellular phase of collagen synthesis: CROSS-LINKING Tooth that inclines MD the most: MX MOLAR Irreversible change: KARYOLYSIS Protein tertiary structure: CYSTEIN Megaloblastic anemia: FOLIC ACID DEFICIENCY Group A Streptococcus can cause: SCARLET FEVER Bone after 1 month of injury: LAMELLAR BONE

Bone injuries: Wham’s “Last Christmas” Rocks! (imagine you’ve been dancing so much that you broke your leg) - woven 1-3 weeks - lamellar 1-3 months - compact 2-3 years - remodeling 4-5 years 282. Between atria: FOSSA OVALIS 283. Pain of upper lip, which nerve: INFRAORBITAL 284. Inactive vaccine: SALK Oral, weakened (OPV) SABIN Injection, inactivated (killed, IPV) SALK

Sabina gives blow-jobs (so you know the other one is intravenous, not oral) K → killed (so you know the other one is alive, not killed)

285. Phagocytes in TMJ: SYNOVIAL MEMBRANE Morphologically, the synovial membrane consists of two layers: an inner cell layer (intima) and a support layer (vascular subintima), which mixes with the fibrous capsule. The intima consists of cells embedded in an amorphous, fiber-free matrix with an approximate thickness of one to four cells. It contains macrophage-like type A cells with phagocytic ability, and fibroblast-like type B cells that synthesize proteins, glycoproteins, and proteoglycans. The subintima consists of loose CT with blood vessels, fibroblasts, macrophages, mastocytes, adipose cells, and some elastic fibers that prevent membrane folding. 286. Mottled teeth: FLUOROSIS

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287. 288. 289. 290. 291. 292.

Calcification begins at: INCISAL EDGE (if DEJ is not an option) Inferior borders of TMJ are formed by: CONDYLES Temporomandibular ligament attaches to: CONDYLE Most anterior & superior position of TMJ: CR Fractured neck of the condyle: MOUTH OPENING IS RESTRICTED, 30 mm (normal: 40-55 mm) Deformed teeth: SYPHILLIS

Hutchinson's teeth (Hutchinson's incisors) are a sign of congenital syphilis. Babies have teeth that are smaller and more widely spaced than normal and which have notches on their biting surfaces. 293. Primary teeth that resemble permanent dentition: 1. Primary MX 1st M – permanent MX 1st PM 2. Primary MX 2nd M – permanent MX 1st M 3. Primary MN 1st M – resembles nothing 4. Primary MN 2nd M – permanent MN 1st M 294. Worsen periodontal disease: AGGRESSIVE PERIODONTITIS Amelogenesis imperfecta is characterized by defective or missing tooth enamel. Secondary effects of this disorder may be early tooth loss, heightened susceptibility to disease of the tissues surrounding the teeth (periodontal) such as gums, cement, ligaments, and the bone in which the tooth root rests (alveolar). 295. Not found in PDL? OSTEOCYTE Contents of PDL: fibroblasts (MC), cementoblasts, cementoclasts, osteoblasts, osteoclasts, macrophages, mast cells, eosinophils, undifferentiated mesenchymal cells. Ground substance: proteoglycans, GAGs, glycoproteins, water. 296. Pulp decreases in size due to: THERMAL SHOCK, NORMAL PHYSIOLOGIC & MASTICATORY FUNCTIONS, EXCESSIVE ATTRITION & ABRASION, AGE, INJURY 297. Why MX molars have a bulbous shape? PRESENCE THE CUSP OF CARABELLI, CONSTRUCTION AT CERVICAL THIRD IN PRIMARY TEETH, TO AID IN LATERAL MOVEMENT OF MN MOLARS 298. MX canine: DICTATES THE MORPHOLOGY OF THE BONE Permanent maxillary canines have roots that, although under bone, dictate overlying cortical bone morphology. The bulge created by the maxillary canine's roots is known as the canine eminence. This bulge is easily palpable. Initiation of calcification: 4 – 5 Months Completion of enamel: 6 – 7 Years Eruption: 11 – 12 Years Root completion: 13 – 15 Years 299. Crepitus of the TMJ: OSTEOARTHRITIS Crepitus (grinding sound) is usually an indication of advanced TMJ damage (degenerative changes). Crepitus is usually due to a tear in the disc or the posterior attachment which produces bone to bone contact of the mandibular condyle with the joint socket in the base of the skull (glenoid fossa). 300. Why capillaries have the slowest flow: GREATER CROSS SECTION AREA The reason of the slower flow of the capillaries is that their united area is considerably greater than that of the arteries supplying them, so that the same quantity of blood flowing through them in a given time has a wider channel to flow in and therefore moves mo re slowly. Substances pass through the capillary wall by diffusion, filtration, and osmosis. Oxygen and carbon dioxide move across the capillary wall by diffusion. Fluid movement across a capillary wall is determined by a combination of hydrostatic and osmotic pressure. The net result of the capillary microcirculation created by hydrostatic and osmotic pressure is that substances leave the blood at one end of the capillary and return at the other end.

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301. 302. 303. 304. 305. 306. 307.

Pitch of sound: FREQUENCY What does not cause edema: SHOCK (this is not a correct answer) NADPH is not necessary for: GLYCOLYSIS After dental prophylaxis: BACTERIEMIA Lateral bone of the face: ZYGOMATIC Sensory to lower lip: MENTAL NERVE Diuretic medication for hypertension: INHIBIT ADH

ADH (vasopressin) causes reduced urine volume & concentrated urine. 308. 309. 310. 311.

TG are imported to liver by: CHYLOMICRONS - ALBUMIN Vital capacity: INSPIRED RESERVE + TIDAL + EXPIRED RESERVE VOLUMES Important for bone integrity, taken as a medication: VIT. D Masseter muscle reflex when it is: STRETCHED

The jaw jerk reflex (masseter reflex) is a stretch reflex used to test the status of CN V and to help distinguish an upper cervical cord compression from lesions that are above the foramen magnum. The mandible is tapped at a downward angle just below the lips at the chin while the mouth is held slightly open. In response, the masseter muscles will jerk the mandible upwards. Normally this reflex is absent or very slight. However, in individuals with UMN lesions the jaw jerk reflex can be quite pronounced. The jaw jerk reflex can be classified as a dynamic stretch reflex. The response to the stimulus is monosynaptic, with sensory neurons of the trigeminal mesencephalic nucleus sending axons to the trigeminal motor nucleus, which in turn innervates the masseter. This reflex is used to judge the integrity of the upper motor neurons projecting to the trigeminal motor nucleus. Both the sensory and mo tor aspects of this reflex are through CN V. 312. Regulatory enzyme in cholesterol synthesis: HMG CoA REDUCTASE 313. Patient is pale & not responding: SYNCOPE Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain. It’s also called fainting or "passing out”. It most often occurs when blood pressure is too low (hypotension) and the heart doesn't pump enough oxygen to the brain. It can be benign or a symptom of an underlying medical condition. 314. All of the following are a part of normal flora except: BORDETELLA PERTUSSIS Normal inhabitant of gingival crevice & tonsillar crypts: Actinomyces naeslundi Normal flora: Neisseria, Bordetella, Corynebacterium, Streptococcus 315. RBC in hypotonic solution, what happens: SWELL & BURST (HEMOLYSIS) 316. Replacement of dog aorta with rigid tube:  SYSTOLIC PRESSURE,  DIASTOLIC PRESSURE, WIDE PULSE PRESSURE, CONTINUOUS FLOW IN THE CAPILLARIES WOULD CHANGE INTO PULSATILE FLOW 317. Atmospheric pressure is given, how much O2 tension should be: 20% OF GIVEN ATMOSPHERIC PRESSURE OF OXYGEN = PARTIAL PRESSURE OF OXYGEN 318. Phenylketonuria, which enzyme is defected: PHENYLALANINE HYDROXYLASE Clinical findings: developmental retardation, seizures, behavioral problems. Tyrosine supplements. 319. 320. 321. 322. 323. 324. 325. 326. 327. 328.

Myoglobin: GREATER AFFINITY FOR BINDING OXYGEN (4x) What is needed for prostaglandins synthesis: POLYUNSATURATED FAT Not innervated by hypoglossal nerve: PALATOGLOSSUS (CN X) Sensory fibers from anterior 2/3 of the tongue: CHORDA TYMPANI (VII) VIA LINGUAL NERVE (V3) What doesn’t cause elevation of BP: BARORECEPTOR CAUSES VAGAL STIMULATION & REDUCES BP Hydrolysis of which of the following will not yield glucose: MANNOSE Heat sensitive object, best sterilization: 2% ETHYLENE OXIDE Object, that contacts mucous membranes: SEMI-CRITICAL Semi-critical object: SHOULD BE STERILIZED Semi-critical items infection control: AUTOCLAVING IF NOT HEAT SENSITIVE

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329. Bacillary dysentery: SHIGELLA SPP. 330. Metastatic calcifications: HYPERPARATHYRODISM Metastatic calcification is the deposition of calcium salts in otherwise normal tissue, because of  serum levels of calcium, which can occur because of deranged metabolism as well as increased absorption or decreased excretion of calcium and related minerals, as seen in hyperparathyroidism. This occurs either from the parathyroid glands in appropriately making too much PTH (primary hyperparathyroidism) or other events triggering increased production by the parathyroid glands (secondary hyperparathyroidism). Most people with primary disease have no symptoms at the time of diagnosis. In those with symptoms the most common is kidney stones with other potential symptoms including weakness, depression, bone pains, confusion, and increased urination. Both typ es increase the risk of weak bones. Primary hyperparathyroidism in 80% of cases is due to a single benign tumor known as a parathyroid adenoma with most of the rest of the cases due to a multiple benign tumors. Rarely it may be due to parathyroid cancer. Secondary hyperparathyroidism typically occurs due to vitamin D deficiency, chronic kidney disease, or other causes of low blood calcium. Diagnosis of primary disease is by finding a high blood calcium and high PTH levels. 331. Which of the following scenarios would cause the greatest decrease in resistance in a single artery (2 mm long, radius: 1,2 mm): INCREASING THE RADIUS OF THE ARTERY BY A FACTOR OF 2 332. Abnormal relation between the crown and the root: DILACERATION 333. Where can you find Raschkow plexus: ADJACENT TO THE CELL FREE ZONE 334. Organisms that cause athlete’s foot: TRICHOPHYTON 335. Disease caused by prions: TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHY (TSE): CREUTZFELD-JACOB DISEASE IN HUMANS / MAD COW DISEASE IN COWS Prions do not elicit inflammatory or antibody responses. 336. What is always found within a protein structure: ALANINE Hydrophobic AA, like ALA, VAL, LEU, ISO, GLY. 337. 338. 339. 340. 341. 342.

AA inside the protein: HYDROPHOBIC AA Which is not found in collagen: TROPOELASTIN Sensory innervation for TMJ: AURICULOTEMPORAL NERVE What muscle adducts (pulls together) the scapula: RHOMBOID MINOR, RHOMBOID MAJOR, TRAPEZIUS After an infraction the result will be: ORGANIZATION What structure is affected in case of a cancer of the root of the lung: PULMONARY AORTA, BRONCHI, PULMONARY VEIN

Superior to inferior: Right lung eparietal bronchus, pulmonary artery, hyparietal bronchus, vein Left lung pulmonary artery, bronchus, vein 343. Innervation of biceps brachii: MUSCULOCUTANEUS (C5 & C6) 344. Secretin is released from: S CELLS OF THE DUODENUM S cells: release secretin, found in the jejunum and duodenum. They are stimulated by a drop of the secretion of bicarbonate (HCO3−) into the lumen, via the pancreas. This is primarily accomplished by an increase in cyclic AMP that activates CFTR to releas e chloride anions into the lumen. 345. ADH & aldosterone: ADH WORKS ON THE COLLECTING DUCT, ALDOSTERONE ON THE DISTAL CONVOLUTED TUBULE & COLLECTING DUCT 346. Aldosterone action:  Na+ AND WATER ABSORPTION

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Aldosterone – primary effect is on the kidney tubules, where it stimulates Na+ retention and K+ excretion; collecting tubule: reabsorbs water (controlled by ADH = vasopressin). 347. ADH action:  WATER ABSORPTION 348. Which Is not found in the greater wing of the sphenoid bone: CAROTID CANAL

349. Structures in the sphenoid bone: SUPERIOR ORBITAL FISSURE & OPTIC CANAL 350. Structures passing by foramen rotundum: V2 351. Which muscle is not affected by a patient that had stroke on the motor lesion on the left side of below eye muscles: UPPER THIRD MUSCLES OF FACIAL EXPRESSION & GENIOGLOSSUS All cranial nerve motor nuclei have unilateral corticonuclear connections except: 1. CN VII: upper third mm. of facial expression have bilateral innervation 2. CN XII: genioglossus muscles have bilateral muscle innervaton. 352. Microangiopathy from diabetes mellitus is due to: HYPERGLYCEMIA Also: glycosuria, hyperlipidemia & ketonuria. One cause of microangiopathy is long-term diabetes mellitus. In this case, high blood glucose levels cause the endothelial cells lining the blood vessels to take in more glucose than normal (these cells do not depend on insulin). They then form more glycoproteins on their surface than normal, and also cause the basement membrane in the vessel wall to grow abnormally thicker and weaker. They bleed, leak protein, and slow the flow of blood through the body. As a result, some organs and tissues do not get enough blood (carrying oxygen & nutrients) and are damaged, for example, the retina (diabetic retinopathy) or kidney (diabetic nephropathy). Nerves and neurons, if not sufficiently supplied with blood, are also damaged, which leads to loss of function (diabetic neuropathy, esp ecially peripheral neuropathy). Massive microangiopathy may cause microangiopathic hemolytic anemia (MAHA). 353. Which branch of carotid artery is not in the carotid triangle: SUPERFICIAL TEMPORAL 354. MOA of rifampin: INHIBITS RNA SYNTHESIS (& PROTEIN SYNTHESIS) BY INHIBITING THE DNA-DEPENDENT RNA POLYMERASE Rifampicin inhibits bacterial protein synthesis by inhibiting bacterial DNA-dependent RNA polymerase. It binds away from the active site. The inhibitor prevents RNA synthesis by physically blocking elongation, and thus preventing synthesis of host bacterial proteins. By this "steric-occlusion" mechanism, rifampicin blocks synthesis of the second or third phosphodiester bond between the nucleotides in the RNA backbone, preventing elongation of the 5' end of the RNA transcript past more than 2 or 3 nucleotides. 355. MOA of fluorouracil: SUICIDE INHIBITOR OF THYMIDYLATE SYNTHETASE Fluorouracil (Adrucil) is a medication used to treat cancer by injection into a vein it is used for colon cancer, esophageal cancer, stomach cancer, pancreatic cancer, breast cancer, and cervical cancer. As a cream it is used for actinic keratosis and basal cell carcinoma. Common side effects include inflammation of the mouth, loss of appetite, low blood cell counts, hair loss, and inflammation of the skin. When used as a cream irritation at the site of application may occur. Use of either form in pregnancy may harm the baby. Fluorouracil is in the antimetabolite and pyrimidine analog families of medications. How it works is not entirely clear but believed to involve blocking the action of thymidylate synthase and thus stopping the production of DNA.

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356. MOA of sulfonamides: COMPETE WITH PABA TO INHIBIT FOLIC ACID SYNTHESIS

357. MOA of aminoglycosides: BIND TO 30S RIBOSOMAL SUBUNITS & INHIBIT TRANSLATION 358. MOA of digoxin: BLOCKS VOLTAGE GATED CHANNELS, CARDIAC GLYCOSIDE MOA: mechanism of action It regulates the heart contraction by  the heart rate and  the heart contractility. Digoxin inhibits the Na-K-ATPase membrane pump. 359. What nerve innervates the parotid gland: CN IX Preganglionic: lesser petrosal nerve (IX) Synapse: otic ganglion Postganglionic: travel with auriculotemporal nerve (V3) 360. Where will you find acinar ducts: PANCREAS 361. Demilunes are seen in: SUBLINGUAL GLAND Majority in the sublingual, but also present in the submandibular. 362. 363. 364. 365. 366. 367. 368.

Origin of PDL: DENTAL FOLLICLE Glucagon signals through: cAMP Glucose is sequestered by: HEXOKINASE & GLUCOKINASE What do glucagon & epinephrine have in common: GLYCOGENOLYSIS & GLUCONEOGENESIS Epithelium of the respiratory tract: PSEUDOSTRATIFIED CILIATED COLUMNAR Where can you see squamous metaplasia: BRONCHI (columnar to squamous) After metabolic/respiratory acidosis, which abnormality occurs: HYPERKALEMIA

Associate acidosis & hyperkalemia – when there is an excess of H+ in the blood, K+ leaves the cell in exchange for H+. 369. What would not cause metabolic acidosis: HYPERVENTILATION Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. It is a form of hyperventilation, which is any breathing pattern that reduces carbon dioxide in the blood due to increased rate or depth of respiration. 370. What is the virulence factor of Neisseria meningitidis: CAPSULE Neisseria meningitidis, often referred to as meningococcus, is a Gram-negative bacterium that can cause meningitis. Lipopolysaccharide is a component of the outer membrane of N. meningitidis. This acts as an endotoxin and is responsible for septic shock and hemorrhage due to the destruction of red blood cells. Other virulence factors include a polysaccharide capsule which prevents host phagocytosis and aids in evasion of the host immune response; fimbriae mediate attachment of the bacterium to the epithelial cells of the nasopharynx. 371. Antibiotic resistance in bacteria: CAN BE TRANSFERRED BETWEEN BACTERIA BY CONJUGATION

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372. Kidney end of a proximal tubule osmotic pressure: ISOOSMOTIC PRESSURE 373. How does the osmotic pressure change in the distal part of the proximal convoluted tubule: NO CHANGE 374. Where can you find the highest osmolarity in the renal system: THE ASCENDING LOOP OF HENLE

375. Anterior cerebral artery supplies which lobes: FRONTAL AND PARIETAL

376. 377. 378. 379. 380.

Scarlet fever is caused by: GROUP A STREPTOCOCCUS The cause of rash in Scarlet fever: ERYTHROGENIC TOXIN (EXOTOXIN) What can you find in spores: DIPICOLINIC ACID (responsible for heat resistance) Which fungal infection leads to superficial skin infection: TRICHOPYTON Systemic fungi: HISTOPLASMOSIS

Histoplasmosis (“Cave disease”, "Darling's disease”, "Ohio valley disease”, "reticuloendotheliosis”) is a disease caused by the fungus Histoplasma capsulatum. The disease affects primarily the lungs. Occasionally, other organs are affected; this is called disseminated histoplasmosis, and it can be fatal if left untreated. Histoplasmosis is common among AIDS patients because of their suppressed immunity. In immunocompetent individuals, past infection results in partial protection against ill effects if reinfected. Histoplasma capsulatum is found in soil, often associated with decaying bat guano or bird droppings. Disruption of soil from excavation or construction can release infectious elements that are inhaled and settle into the lung. 381. In the dental plaque (other than bacterial acidic enzyme): DEXTRAN 382. Major component of PDL: COLLAGEN 383. Where does Sharpey’s fiber insert: ACELLULAR EXTRINSIC FIBER CEMENTUM

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384. Alveolar crest: 1-2 mm BELOW CEJ 385. Location of CEJ: 1-2 mm OVER THE ALVEOLAR BONE 386. Patient with cirrhosis: MALLORY BODIES IN CYTOPLASM OF HEPATOCYTES Mallory bodies are classically found in the livers of people suffering from alcoholic liver disease and were once thought to be specific for that. They are MC in alcoholic hepatitis (65%) and alcoholic cirrhosis (51%). They are a recognized feature of Wilson's disease (25%), primary biliary cirrhosis (24%), non- alcoholic cirrhosis (24%), hepatocellular carcinoma (23%) and morbid obesity (8%), among other conditions. 387. 388. 389. 390. 391.

What does Streptococcus mutans produce: DEXTRAN What is the substrate for dextran: SUCROSE (E: glucosyltransferase) Embryonic origin of the body of the hyoid bone: 2nd ARCH Acid-fast stain/bacillus: MYCOBACTERIUM TUBERCULOSIS What does N. meningitidis and H. influenza have in common: THE CAPSULE

Meningitis 1. Neonates 2. Infants and children 3. Young adults 4. Older adults 392. 393. 394. 395. 396.

E. coli H. influenzae N. meningitis S. pneumoniae

Which factor plays an important role in detecting the initiation factor for RNA transcription? SIGMA Gas gangrene has what kind of enzymatic activity: GANGRENOUS NECROSIS MOA of tetanus toxin: INHIBITION OF NT RELEASE What protozoa are spread in cat feces: TOXOPLASMOSA GONDII Which of the following is carried by a vector: RICKETSSIA

Rickettsia is a nonmotile, gram-negative, nonspore-forming, highly pleomorphic bacteria that can be present as cocci, rods, or thread-like. Being obligate intracellular parasites, the Rickettsia survival depends on entry, growth, and replication within the cytoplasm of eukaryotic host cells (typically endothelial cells). Rickettsia cannot live in artificial nutrient environments and is grown either in tissue or embryo cultures; typically, chicken embryos are used. 397. Antigenicity that changes from season to season: ANTIGENIC CAPSULE SPIKES CONTAINING NURAMINIDASE AND HEMAGGLUTININ (H. influenzae) 398. Influenza antigenicity due to: GLYCOPROTEINS / ANTIGENIC DRIFT 399. Iron in serum plasma is carried by: TRANSFERRIN 400. All are organelles except: FAT DROPLETS 401. What is the final electron receptor in ETC: OXYGEN 402. What measures partial pressure of oxygen: CAROTID BODY The carotid body is a small cluster of chemoreceptors and supporting cells located near the bifurcation of the carotid artery. It detects changes in the composition of arterial blood flowing through it, mainly the partial pressure of oxygen, but also of carbon dioxide. Furthermore, it is also sensitive to changes in pH and temperature. 403. Hyperventillation alters the acid balance of arteries by:  CO2 &  pH 404. Which layer of epidermis does not have tonofilaments: BASALE 1. Stratum Basale: the deepest layer, has keratinocytes, the keratinocytes are attached to the basement membrane by hemidemosomes. 2. Stratum Spinosum: high molecular weight keratin with a lot of tonofilaments 3. Stratum Granulosum: disulfide bonds begin to cross-link with tonofilaments. 4. Stratum Lucidum: the cytoplasm consists almost entirely of tonofilaments. 5. Stratum Corneum: the most superficial layer, the cells are called squames, filled with cross linked of tonofilaments.

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405. What will you find in stratum granulosum: KERATOHYALIN GRANULES 406. Which organ has activated PCK: BRAIN Phosphoenolpyruvate carboxykinase While PCK1 is mainly expressed in the liver and kidney, PCK2 is ubiquitously expressed in various cell types, including leukocytes and neurons, as well as in non-gluconeogenic tissues like pancreas, brain, heart. Moreover, while PCK1 expression is regulated by hormones or nutrients involved in gluconeogenesis, PCK2 is constitutively expressed. These differences indicate that PCK2 may also perform non-gluconeogenic functions. 407. What are the steps of DNA amplification: DENATURATION, ANNEALING, ELONGATION All the PCR components are mixed together and are taken through series of 3 major cyclic reactions conducted in an automated, selfcontained thermocycler machine. 1. Denaturation: Heating the reaction mixture to 94°C for 15-30 seconds → DNA is denatured to single strands due to breakage in weak hydrogen bonds. 2. Annealing: Temperature is rapidly lowered to 54-60°C for 20-40 seconds → the primers bind (anneal) to their complementary sequence in the template DNA. 3. Elongation (extension): Occurs at 72-80°C (most commonly 72°C) → the polymerase adds bases to the 3′ each primer, extending the DNA sequence in the 5′ to 3′ direction. Under optimal conditions, DNA polymerase will add about 1,000 bp/minute. With one cycle, a single segment of double-stranded DNA template is amplified into two separate pieces of double-stranded DNA. These two pieces are then available for amplification in the next cycle. As the cycles are repeated, more and more copies are generated and the number of copies of the template is increased exponentially. 408. 409. 410. 411. 412.

Innervation of the carotid body/sinus: CN IX (GLOSSOPHARYNGEAL) Lowers blood pressure: PS NS Patient is on nitrous, what is the best way to measure efficiency: RESERVE MINUTE VOLUME (TV * RR) Which or the following will not happen in a diabetic patient: SPLENOMEGALY The mandible grows by endochondral ossification, while the cartilage is formed interstitially: BOTH STATEMETS ARE FALSE

Condyles of the mandible grow by endochondral ossification, whereas the rest of the mandible grow by intramembranous ossification. 413. Patient with DM type 1 (insulin: 2 x a day), hypertensive, but taking medication for it, during dental visit he passes out & is pale. What is not the reason: HYPERGLYCEMIA 414. What is needed for coagulation: Ca2+ 415. Where does N-glycosylation occur: RER; BETWEEN SUGARS & AA 416. Hormone dependent physiologic/pathologic involution: APOPTOSIS 417. Predominant cell in an acute inflammation: NEUTROPHIL 418. 1st cells to appear in an acute inflammation: NEUTROPHILS 419. While draining an abscess from a lower molar, what kind of cell will predominate: NEUTROPHIL 420. Bacteria most likely to be found in a foul-smell, purulent abscess (abscess on the lower mandible): ACTINOMYCES 421. Circumduction of the arm: DELTOID MUSCLE (axillary nerve) 422. Which one does not contribute to the posterior wall of axilla: SERRATUS ANTERIOR Posterior wall is formed by: latissimus dorsi, teres major, subscapularis. 423. Where does the esophagus begin: LOWER BORDER OF CIRCOID CARTILAGE (C6-T10)

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424. What surrounds a myelin sheath: ENDONEURIUM 425. What vitamin is needed for the hydroxylation of proline: VITAMIN C 426. What is not in periosteum: OSTEOCYTES

427. What is posterior to the abdominal aorta: VERTEBRAE

428. Thoracic duct lies: POSTERIOR TO THE ESOPHAGUS IN POSTERIOR MEDIASTINUM 429. Where does thoracic duct empty: INTO THE LEFT VENOUS ANGLE BETWEEN THE LEFT INTERNAL JUGULAR VEIN AND THE LEFT SUBCLAVIAN VEIN

430. Small vessels affected in diabetic patient: MICROANGIOPATHY

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Retinopathy is any damage to the retina of the eyes, which may cause vision impairment. Retinopathy often refers to retinal vascular disease, or damage to the retina caused by abnormal blood flow. Age-related macular degeneration is technically included under the umbrella term retinopathy but is often discussed as a separate entity. Retinopathy, or retinal vascular disease, can be broadly categorized into proliferative and non- proliferative types. Frequently, retinopathy is an ocular manifestation of systemic disease as seen in diabetes or hypertension. Diabetes is the most common cause of retinopathy in the USA. Diabetic retinopathy is the leading cause of blindness in working-aged people. It accounts for about 5% of blindness worldwide and is designated a priority eye disease by the WHO. 431. 432. 433. 434. 435. 436. 437.

Typhoid fever cause: SALMONELLA TYPHI Embryonic origin of hepatocytes: ENDODERM Lining of visceral cavities: MESODERM (SIMPLE SQUAMOUS) Origin of ligamentum teres: UMBILICAL VEIN How do haptens work: THEY NEED A CARRIER PROTEIN Burkitt’s lymphoma is caused by: EBV EBV is related to: BURKITT’S LYMPHOMA

Burkitt’s lymphoma is a cancer of the lymphatic system, particularly B lymphocytes (B cells cause bone marrow replacement), found in the germinal center. The endemic African variant MC occurs in children living in malaria endemic regions of the world, it involves jaw and facial bones. In America, the abdomen is MC affected. 438. Diabetic patient, using insulin. What cells are destroyed: BETA CELLS 439. Patient with Grave’s disease, in lab findings you will see:  TSH &  T3, T4 Graves’ disease is an autoimmune disease that leads to a generalized over activity of the entire thyroid gland (hyperthyroidism, thyrotoxicosis, diffuse toxic goiter). It is the MC cause of hyperthyroidism in the USA. It is 7-8 x MC in women than men (20-40 years old). TSH is produced when the hypothalamus releases a substance called thyrotropin-releasing hormone (TRH). TRH then triggers the pituitary gland to release TSH. TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism. Characterized by exophthalmos, tachycardia, heat intolerance, and fine tremor, warm, moist skin, and fine hair. Range from anxiety & restlessness to insomnia & weight loss, eyeballs may begin to protrude (exophthalmos) causing irritation & tearing. 440. 441. 442. 443.

Above case, larynx enlargement is due to: HYPERPLASIA After surgery patient suffers from hypocalcemia, how will you explain it: PARATHYROID ACCIDENTAL RECESSION OR DAMAGE MOA of hyperthyroidism and TSH receptor: ANTIBODIES AGAINST TSH RECEPTORS (INTRACELLULAR RECEPTORS) Above case, the receptor is similar to: FAB

TSH receptor: upon binding circulating thyrotropin, a G-protein signal cascade activates adenylyl cyclase and intracellular levels of cAMP rise. cAMP activates all functional aspects of the thyroid cell, including iodine pumping; thyroglobulin synthesis, iodination, endocytosis and proteolysis; thyroid peroxidase activity; and hormone release. “The TSH receptor binding and thyroid stimulating properties of (Fab)2 and Fab fragments of Graves' IgG have been investigated. (Fab)2 fragments were prepared by pepsin digestion of IgG and Fab fragments by reduction of (Fab)2 or papain digestion of IgG. (Fab)2 and Fab were effective in inhibiting TSH binding to its receptor with all five patients' sera studied and both preparations stimulated cyclic AMP release from isolated thyroid cells. However Fab fragments were less active thyroid stimulators than their parent (Fab)2 in all five cases. These studies indicate that antibody divalency is not essential for thyroid stimulation by TSH receptor antibodies.” – I checked multiple articles and they were mentioning only FAB as a binding site. 444. 445. 446. 447. 448.

T-cell receptor binding: FAB Pituitary deficiency causes: HYPOGONADISM, ADDISON’S DISEASE, MYXEDEMA Defect of external meatus: 1ST PHARYNGEAL CLEFT What kind of disease will cause lack of vitamin B12: PERNICIOUS ANEMIA When infundibulum is dissected, which hormone is stopped: VASOPRESSIN (ADH) & OXYTOCIN

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449. Cutting infundibulum without cutting hypophyseal portal system, all of the following will  except: PROLACTIN Answers from the group & web: 1. Prolactin is the only hormone that is suppressed by the hypothalamus via the stalk (infundibulum) whereas the rest are functioning normally under the influence of the stimulators released from the hypothalamus via same stalk. So, it is logical to say, that once that stalk is cut, the inhibition on prolactin is lifted so its secretion will increase whereas the rest of the hormones will decrease. 2.

Prolactin Inhibiting Factor (dopamine) is released from hypothalamus to act on anterior pituitary. When hypophyseal portal system is cut, this inhibitory signal is banned → prolactin release will increase. By dissecting the infundibulum, the portal system is going to remain intact, so there will be no effect in anterior pituitary hormones action.

Wikipedia: damage to the pituitary stalk blocks the release of antidiuretic hormone, resulting in polydypsia (abusive water intake) and polyuria (excessive urination).

450. Motion found in the small intestine: SEGMENTATION Unlike peristalsis, which predominates in the esophagus, segmentation contractions occur in the large intestine and small intestine, while predominating in the latter. While peristalsis involves one-way motion in the caudal direction, segmentation contractions move chyme in both directions, which allows greater mixing with the secretions of the intestines. Segmentation involves contractions of the circular muscles in the digestive tract, while peristalsis involves rhythmic contractions of the longitudinal muscles in the gastrointestinal tract. Unlike peristalsis, segmentation actually can slow progression of chyme through the system. 451. 452. 453. 454. 455. 456. 457.

What is not absorbed in the duodenum: WATER What is not absorbed in jejunum: WATER, IRON, BILE SALTS, B12 Which is the MC deficiency: IRON (MC nutritional deficiency in the world) Lateral shift of the spine: SCOLIOSIS What is dimorphism in fungi: MYCELIUM (MOLD) OR YEAST H filaments found in: ACTINOMICOSIS What is the function of pilli: ADHERENCE / ATTACHMENT TO HOST CELLS or CONJUGATION 458. Decreased size of nuclei & condensed chromatin: PYKNOSIS 459. Nucleus shrinks & becomes basophilic: PYKNOSIS

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460. 461. 462. 463. 464.

Pyknosis: IRREVERSIBLE DAMAGE OF CHROMATIN Cystic fibrosis, what will you find in the sodium chloride test: INCREASED Na+ & ClWhat is the neurotransmitter for umami: GLUTAMATE Substrate for thrombin: FIBRINOGEN Substrate of thromboplastin: PROTHROMBIN

Thromboplastin (TPL) is a plasma protein aiding blood coagulation through catalyzing the conversion of prothrombin to thrombin. It is a complex enzyme that is found in brain, lung, and other tissues and especially in blood platelets and that functions in the conversion of prothrombin to thrombin in the clotting of blood—called also thrombokinase. 465. 466. 467. 468. 469. 470. 471. 472. 473. 474. 475. 476. 477. 478. 479.

What cells are involved with type IV hypersensitivity: T CELLS & MACROPHAGES Measles and rubeola, what virus: PARAMYXOVIRUS Varicella and chickenpox, what virus: VARICELLA-ZOSTER VIRUS Articular disc is made out of: FIBROCARTILAGE Articular surfaces of a baby are made out of: HYALINE CARTILAGE Tissue covering articular surfaces of TMJ: FIBROCARTILAGE HOC on mesial of MAX canine: CERVICAL 1/3 Number of pulp horns in a newly erupted MN molar: 5 How many canals in MX 1st molar: 2MB, 1P, 1DB Where is the accessory canal in MX 1st molar: MB ROOT Mesial is straight in: MANDIBULAR CANINE Broken cusp, what kind of movement: MEDIOTRUSIVE, NON-WORKING Largest sinus infection (largest paranasal sinus) in the skull: MAXILLARY Preganglionic nerve for otic ganglion: LESSER PETROSAL NERVE What substance is used to measure GFR: INULIN

Inulin and it’s analog sinistrin are used to help measure kidney function by determining the glomerular filtration rate (GFR), which is the volume of fluid filtered from the renal glomerular capillaries into the Bowman's capsule per unit time. Inulin is of particular use as it is not secreted or reabsorbed in any appreciable amount at the nephron, allowing GFR to be calculated. However, due to clinical limitations, inulin and sinistrin, although characterized by better handling features, are rarely used for this purpose and creatinine values are the standard for determining an approximate GFR. 480. Which cells secrete IF: PARIETAL CELLS 481. Which one is not an autoimmune disease: ERYTHROBLASTOSIS FETALIS Hemolytic disease of the newborn (hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis fetalis) is an alloimmune condition that develops in a fetus, when the IgG molecules (one of the five main types of antibodies) produced by the mother pass through the placenta. Among these antibodies are some which attack antigens on the RBC in the fetal circulation, breaking down and destroying the cells (hemolysis). Alloimmunity (sometimes called isoimmunity) is an immune response to nonself antigens from members of the same species, which are called alloantigens or isoantigens. Two major types of alloantigens are blood gro up antigens and histocompatibility antigens. In alloimmunity, the body creates antibodies against the alloantigens, attacking transfused blood, allotransplanted tissue, and even the fetus in some cases. Alloimmune (isoimmune) response results in graft rejection, which is manifested as deterioration or complete loss of graft function. 482. 483. 484. 485. 486. 487. 488.

Patient with lower denture complaining of burning sensation of buccal gingiva & side of lower lip, which nerve: MENTAL NERVE What protrudes the hyoid bone: GENIOHYOID Most abundant papillae: FILIFORM Mandibular sling muscles: MEDIAL PTERYGOID & MASSETER Which muscle retrudes the mandible: POSTERIOR FIBERS OF TEMPORALIS What is the template & product of reverse transcriptase: TEMPLATE → RNA, PRODUCT → DNA Increased condylar guidance: TALLER POSTERIOR CUSPS

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489. Where are found crypts of Lieberkühn: LAMINA PROPRIA OF THE SMALL INTESTINE In histology, an intestinal gland (also crypt of Lieberkühn and intestinal crypt) is a gland found in the intestinal epithelium lining of the small intestine and large intestine (colon). The glands and intestinal villi are covered by epithelium, which contains multiple types of cells: enterocytes (absorbing water and electrolytes), goblet cells (secreting mucus), enteroendocrine cells (secreting hormones), cup cells, tuft cells and, at the base of the gland, Paneth cells (secreting anti-microbial peptides) and stem cells. These cells are not all present in the colon. 490. What is least likely to be reproduced in an articulator: LATEROTRUSIVE MOVEMENT Depends on the articulator! Most stable and most easily reproduced position is centric relation (used to make dentures using just a mean articulator). Centric relation and protrusive can be reproduced using a semi-adjustable articulator. Centric relation + protrusive + lateral movement can be reproduced using ONLY a FULLY adjustable articulator. 491. What is the least likely to be reproducible on semi-adjustable articulator: LATEROTRUSIVE MOVEMENT 492. Parasympathetic stimulation to salivary glands will cause: THIN SALIVA Sympathetic saliva production → more mucous Parasympathetic saliva production → more serous

493. Severe asthmatic patient will develop: EMPHYSEMA Emphysema damages the inner walls of the lungs' air sacs (alveoli), causing them to eventually rupture. This creates one larger air space instead of many small ones and reduces the surface area available for gas exchange. 494. Taller posterior cusps: INCREASED OVERBITE & STEEPER CONDYLAR GUIDANCE 495. TMJ disc is made from which embryonic cartilage: MECKEL’S CARTILAGE 496. Pregnant woman (6th week), what is present in the fetus that the mother doesn’t have: DUCTUS ARTERIOSUS In the developing fetus, the ductus arteriosus (ductus Botalli) is a blood vessel connecting the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs. Upon closure at birth, it becomes the ligamentum arteriosum. There are two other fetal shunts, the ductus venosus and the foramen ovale. 497. Which organ is a sympathetic receptor: ADRENAL MEDULLA 498. Bone sutures in the head of a newborn: HYALINE CARTILAGE 499. Inferior parathyroid origin: 3rd POUCH

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500. Root frequently found with two canals: MN 1st MOLAR (MESIAL ROOT) 501. Distal concavity: ON MX CANINE & MX 1st MOLAR (more pronounced) Distal concavity: MAX canine Mesial concavity: MN canine 502. 503. 504. 505. 506.

Dead, old lady with signs of liver cirrhosis and change on the epithelium of the uterus: LEIOMYOMAS (FIBROIDS) Crescent shaped central developmental groove: 2nd MN PREMOLAR (“U” shaped) Very prominent triangular ridge: MN 1st PREMOLAR Largest crown compared to MX central: MN CANINE Where is crista terminalis: RIGHT ATRIUM

507. 508. 509. 510. 511. 512.

Ligament that is attached to the lingula: SPHENOMANDIBULAR Ligament that is attached to the inferior border of mylohyoid line in the mandible: STYLOMANDIBULAR What occurs during disc displacement of TMJ: COLLATERAL LIGAMENTS BECOME ELONGATED Centric occlusion: TOOTH GUIDED POSITION 8M urea breaks which types of bonds: IT IS A DISULFIDE BOND WHICH BREAKS HYDROPHOBIC BONDS Which one is autosomal dominant: GARDNER’S SYNDROME

Gardner syndrome, a variant of familial adenomatous polyposis (FAP), is an autosomal dominant disease characterized by GI polyps, multiple osteomas, and skin and soft tissue tumors. Cutaneous findings of Gardner syndrome include epidermoid cysts, desmoid tumors, and other benign tumors. Polyps have a 100% risk of undergoing malignant transformation; consequently, early identification of Gardner syndrome is critical. 513. 514. 515. 516. 517. 518.

519. 520. 521. 522. 523. 524. 525.

Parasympathetic to which part of the colon: TRANSVERSE Innervation of the lungs: T2-T4 & VAGUS NERVE Terminal branch of ECA: MAXILLARY & SUPERFICIAL TEMPORAL Blood in one of the nasal cavity (of a dead body) due to: EPITAXIS (NOSEBLEED) Right condyle fracture, the mandible deviates to: THE RIGHT SIDE High school student, 17 years old, feels pressure on his chest, have had episodes like that before, wheezing sound. What condition: ASTHMA (medication: B2 agonist) Oral examination, yellowish liquid on buccal glands: ECTOPIC SEBACEOUS GLANDS (FORDYCE SPOTS) White plaques that can be removed with light abrasion, cause: FUNGAL INFECTION Evidence of mamelons on teeth #8 & #9 indicate: ANTERIOR OPENBTE Patient is sensitive to hot stimulus on #3, what fibers: C FIBERS Extraction of MX 1st PM, anaesthesia: MIDDLE SUPERIOR ALVEOLAR + GREATER PALATINE NERVES When swallowing, the teeth should be in: INTERCUSPAL POSITION How to measure basal metabolic rate: TEMPERATURE

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526. Where can we perform spinal tap (lumbar puncture): L3-L4

527. Which hormone is not a glycoprotein: GH (SOMATOTROPIN) Glycoprotein: FSH, LH, TSH 528. Patient with myasthenia gravis is most likely to have what kind of neoplasia: THYMOMA A thymoma is a tumor originating from the epithelial cells of the thymus that may be benign or malignant. Thymomas are frequently associated with the neuromuscular disorder myasthenia gravis; thymoma is found in 20% of patients with myasthenia gravis. Onc e diagnosed, thymomas may be removed surgically. In the rare case of a malignant tumor, chemotherapy may be used. A third of all people with a thymoma have symptoms caused by compression of the surrounding organs by an expansive mass. These problems may take the form of superior vena cava syndrome, dysphagia (difficulty swallowing), cough, or chest pain. One-third to one-half of all persons with thymoma have no symptoms at all, and the mass is identified on a chest X-ray or CT/CAT scan performed for an unrelated problem. 529. Thymoma: THYMUS GLAND TUMOR ASSOCIATED WITH MYASTHENIA GRAVIS 530. What makes cerebellum and pons: METENCEPHALON Rhombencephalon: - myelencephalon: medulla oblongata - metencephalon: pons + cerebellum 531. Anticodon is found on: tRNA 532. Basal metabolic rate is for: AMOUNT OF ENERGY USED, BODY SURFACE AREA, AMOUNT OF CARBOHYDRATES METABOLISED, AMOUT OF WATER EXCRETED (OR REABSORBED?) Basal metabolic rate is a direct measure of temperature and indirectly by oxygen consumption. The most appropriate answer is the amount of energy used. 533. 534. 535. 536. 537.

At what age do premolars begin to calcifiy: 1,5-2 YEARS Primary teeth when compared to permanent teeth are: MORE BULBOUS & CONSTRICTED Which primary tooth has a crown similar to a premolar and roots resembling a molar: PRIMARY MX 1st MOLAR Which tooth doesn’t resemble any other tooth: PRIMARY MN 1st MOLAR How do you differentiate a MN central incisor from lateral incisor: THE CROWN OF MN LATERAL TILTS DISTALLY IN RELATION TO LONG AXIS OF THE TOOTH

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538. All muscles elevate larynx except: INFRAHYOID MUSCLES Depress the larynx (infrahyoid):

Elevate the larynx (suprahyoids underlined):

Sternothyroid muscles

Stylopharyngeus

Omohyoid muscles

Digastric

Sternohyoid

Stylohyoid

Thyrohyoid (elevates larynx)!

Mylohyoid Geniohyoid

539. 540. 541. 542. 543.

Which muscle does not elevate larynx: STERNOTHYROID Cells found in visceral layer of Bowman’s capsule/kidney: PODOCYTES Where does atherosclerosis occur: TUNICA INTIMA (LARGER AA.) Testlet about a pregnant woman (6 weeks). What happens to her hormones: LH, FSH, hCG How long do you wait to treat her: 6 WEEKS

The lady needs to be in her 2nd trimester. 544. Why do you need to tell her to take an extra care of her oral health: PREGNANCY-RELATED GINGIVITIS 545. Women secrete endometrium in which phase: LUTEAL PHASE

546. Rattle snake bite on a baby’s lateral forearm, what nerve injured: RADIAL NERVE 547. Proto/oncogene (?): CHROMOSOME 9 (c_abl) Chronic Abelson murine leukemia → viral oncogene homologue 1, located on chromosome 9 Oncogene ass. with neuroblastoma → scr Human breast cancer → HER/2 Ras, myc, etc. 548. Adenosine deaminase deficiency causes: SCID Adenosine deaminase (ADA) deficiency is an inherited disorder that damages the immune system and causes severe combined immunodeficiency (SCID). People with SCID lack virtually all immune protection from bacteria, viruses, and fungi. They are prone to repeated and persistent infections that can be very serious or life-threatening. These infections are often caused by "opportunistic" organisms that ordinarily do not cause illness in people with a normal immune system.

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549. An 8-month-old male infant is admitted to the hospital because of a bacterial respiratory infection. The infant responds to appropriate antibiotic therapy, but is readmitted several weeks later because of severe otitis media. Over the next several months, the infant is admitted to the hospital multiple times for recurrent bacterial infections. Blood work reveals extremely low serum antibody levels. The infant has no previous history of viral or fungal infection. The most likely diagnosis is: X-linked agammaglobulinemia of Bruton X-linked agammaglobulinemia (XLA) is a condition that affects the immune system and occurs almost exclusively in males. People with XLA have very few B cells, which are specialized white blood cells that produce antibodies (immunoglobulins). Individuals with XLA are more susceptible to infections because their body makes very few antibodies. Children with XLA are usually healthy for the first 1 or 2 months of life because they are protected by antibodies acquired before birth from their mother. After this time, the maternal antibodies are cleared from the body, and the affected child begins to develop recurrent infections. In children with XLA, in fections generally take longer and then they come back again. The most common bacterial infections that occur in people with XLA are lung infections (pneumonia and bronchitis), ear infections (otitis), pink eye (conjunctivitis), and sinus infections (sinusitis). Infections that cause chronic diarrhea are also common. Recurrent infections can lead to organ damage. People with XLA can develop severe, lifethreatening bacterial infections; however, affected individuals are not particularly vulnerable to infections caused by viruses. With treatment to replace antibodies, infections can usually be prevented, improving the quality of life for people with XLA. 550. A woman is suffering from ulcerative gingivitis, labs show: 1200 ct of leukocytes, 98% of which are lymphocytes. Red blood cells & thrombocytes counts are normal. What can be the diagnosis: AGRALUNOLYTOSIS, MULTIPLE MYELOMA, ACUTE MYELOGENOUS LEUKEMIA, CHRONIC LYPHOBLASTIC LEUKEMIA. Agranulocytosis (agranulosis / granulopenia) is an acute condition involving a severe and dangerous leukopenia (lowered white blood cell count), MC of neutrophils causing a neutropenia in the circulating blood. It is a severe lack of one major class of infection-fighting white blood cells. People with this condition are at very high risk of serious infections due to their suppressed immune system. In agranulocytosis, the concentration of granulocytes (a major class of white blood cells that includes neutrophils, basophils, and eosinophils) drops below 500 cells/mm³ of blood. 551. Adenosine nucleoside crosses mitochondria by: TRANSLOCATION ADP/ATP translocases, also known as adenine nucleotide translocases (ANT) and ADP/ATP carrier proteins (AAC), are transporter proteins that enable the exchange of cytosolic adenosine diphosphate (ADP) and mitochondrial adenosine triphosphate (ATP) across the inner mitochondrial membrane. Free ADP is transported from the cytoplasm to the mitochondrial matrix, while ATP produced from oxidative phosphorylation is transported from the mitochondrial matrix to the cytoplasm, thus providing the cells with its main energy currency. Under normal conditions, ATP and ADP cannot cross the inner mitochondrial membrane due to their high negative charges, but ADP/ATP translocase, an antiporter, couples the transport of the two molecules. The depression in ADP/ATP translocase alternatively faces the matrix and the cytoplasmic sides of the membrane. ADP in the intermembrane space, coming from the cytoplasm, binds the translocase and induces its eversion, resulting in the release of ADP into the matrix. Binding of ATP from the matrix induces eversion and results in the release of ATP into the intermembrane space, subsequently diffusing to the cytoplasm, and concomitantly brings the translocase back to its original conformation. ATP and ADP are the only natural nucleotides recognized by the translocase. 552. Disease of destruction of bronchi and bronchiole with  mucus: ASTHMA, BRONCHOPNEUMONIA, EMPHYSEMA Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles and mucous production. Pneumonia is a category of lung infections. It occurs when viruses, bacteria, or fungi cause inflammation and infection in the alveoli (tiny air sacs) in the lung. Bronchopneumonia, or lobular pneumonia, is a type of pneumonia that also causes inflammation in the bronchi. These are the air passages that feed air into the lungs. Also excessive mucous production occurs. If there will be no hints about asthma (shortness of breath, wheezing, genetic & enviromental factors, drugs taken) we should go with bronchopneumonia.

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553. Muscles of the sound: LATERAL AND TRANSVERSE CRICOARTYNOIDS 554. Centroacinar cells: PANCREAS

555. Tetrodoxin: INHIBITS SODIUM GATED CHANNELS Tetrodotoxin (TTX) is a potent neurotoxin. It is produced by Pseudomonas and Vibrio. 556. Anterior cerebral artery supply: MEDIAL SURFACE OF FRONTAL & PARIETAL LOBES 557. Middle cerebral artery supplies: PORTION OF THE FRONTAL LOBE, LATERAL SURFACE OF THE TEMPORAL & PARIETAL LOBES (including the primary motor & sensory areas of the face, throat, hand and arm and, in the dominant hemisphere, the areas of speech) 558. Covers articular surfaces: FIBROCARTILAGE (disc is made out of dense fibrous CT and on the outside there is fibrocartilage) 559. Meckel’s cartilage: FORMS AT 4th WEEK IN UTERO 560. Cystic fibrosis is diagnosed by: SWEAT TEST → Cl- + Na+ 561. Patient has dysphonia, dysphagia, weight loss. He is a long-time heavy smoker: CARCINOMA OF THE LARYNX 562. Synthesis of histones for DNA, which phase: THE BEGINNING OF THE S PHASE 563. Found on mutation and cause improper metabolism: ONCOGENE Oncogenes are key drivers of tumor growth. Although several cancer-driving mechanisms have been identified, the role of oncogenes in shaping metabolic patterns in cancer cells is only beginning to be appreciated. Recent studies show that oncogenes directly regulate critical metabolic enzymes and metabolic signaling pathways. 564. Diagnostic features of a breast cancer: PEAU DE ORANGE, FIXITY TO UNDERLYING TISSUES, BRCA1 & BRCA2 565. Thoracic duct position: POSTERIOR TO ESOPHAGUS 566. When you make a cut at recess of larynx, which nerve is least affected: RECURRENT LARYNGEAL

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567. Intracellular fungus: HISTOPLASMA CAPSULATUM 568. On your articulator, altering horizontal condylar guidance will affect all of the following except: LATEROTRUSIVE MOVEMENT

If you take a look at the picture above you will find, that condylar path is making an angle with the horizontal plane and that angle is called 'horizontal condylar path angle', which determines the steepness of the articular eminence, which will affect the anterior guidance and cusp heights as well. To my knowledge the horizontal condylar guidance is related to an anteroposterior plane. Its alteration does not affect laterotrusive or mediotrusive movements. 569. Blood flow relation in arteries and veins: BLOOD FLOW IS THE SAME AS IN ARTERIES (the amount of blood, not velocity)

Type of blood vessels

Total cross-section area

Blood velocity in cm/s

Aorta

3–5 cm2

40 cm/s

Capillaries

4500–6000 cm2

0.03 cm/s[15]

Vena cavae inferior and superior

14 cm2

15 cm/s

570. Blood flow in capillaries: THE SAME AS IN ARTERIES (read: the same amount of blood goes through the capillaries and arteries in a unit of time; the velocity is slower, but the amount of blood transported is the same). 571. Heart congestion leads to: PULMONARY EDEMA Pulmonary edema is an acute left ventricle failure when the left ventricle can’t push the blood to the aorta, so the blood remains in the lungs and cause pulmonary hypertension. Cor pulmonale: due to failure in right ventricle, which is due to pulmonary hypertension. 572. What does skeletal muscle, smooth muscle, cardiac muscle all have in common: TROPOMYOSIN, LITTLE REGENERATIVE CAPACITY, SARCOPLASMIC RETICULUM, NUCLEUS 573. Inferior thyroid develops from: 3rd ARCH 574. Hyoid bone develops mainly from: 2nd & 3rd ARCH

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575. Regeneration of pyruvate by: LACTATE DEHYDROGENASE In the second half of Cori Cycle, lactate is converted to pyruvate by LDH in the liver. 576. Obstruction of ext. auditory meatus due to defect in: 1st PHARYNGEAL CLEFT A pharyngeal groove (branchial groove or pharyngeal cleft) is made up of ectoderm unlike its counterpart the pharyngeal pouch on the endodermal side. The 1st pharyngeal groove produces the external auditory meatus (ear canal). The rest (2 nd, 3rd and 4th) are overlapped by the growing 2nd pharyngeal arch and form the floor of the depression termed the cervical sinus, which opens ventrally, and is finally obliterated. 577. 578. 579. 580.

Cranial base of a newborn is made of: HYALINE CARTILAGE BY ENDOCHONDRAL OSSIFICATION Epithelial lining from ventral to dorsal surface: SURGERY How to measure nitrous oxide inhalation: RESPIRATORY MINUTE VOLUME (RMV) Metabolic acidosis is associated with: HYPERKALEMIA

581. What is an allosteric inhibitor in glycolysis: ATP, CITRATE, H+ 582. Which enzyme is specific for the liver: GLUCOKINASE 583. Difference about Shigella & Salmonella: SALMONELLA HAS FLAGELLA Salmonella: Shigella:

→ Typhoid fever → Bacillary dysentery

flagella, capsule, H2S production non motile, no capsule, doesn’t produce H2S

584. At the isoelectric point, the pH of a tetrapeptide is: ZERO CHARGE Isoelectric point is the pH at which the substance has no charge, so the question & answer make sense and are correct. 585. Brain abscess: LIQUEFACTIVE NECROSIS (enzymatic digestion, suppuration, loss of tissue attachment) 586. All cause brain abscess except: TINEA PEDIS Tinea pedis (fungi) is thought to be the world's MC dermatophytosis. Reportedly, 70% of the population will be infected with tinea pedis at some time. Tinea pedis is the term used for a dermatophyte infection of the soles of the feet and the interdigital spaces. Tinea pedis is MC caused by Trichophyton rubrum, a dermatophyte initially endemic only to a small region of Southeast Asia and in parts of Africa and Australia. Using enzymes called keratinases, dermatophyte fungi invade the superficial keratin of the skin, and the infection remains limited to this layer. Dermatophyte cell walls also contain mannans, which can inhibit the body's immune response.

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587. Ligament active during yawning: OBLIQUE FIBERS OF THE TMJ LIGAMENT (if not an option pick spheno/stylomandibular) 588. All can cause painless hematuria except: NEPHROLITHIASIS Painless hematuria as a common early clinical sign in acute diffuse glomerulonephritis, carcinoma of the bladder, focal glomerulonephritis, and renal cell carcinoma. 589. All in respiratory except: PERTUSSIS (???) Pertussis (whooping cough, a 100-day cough) is a highly contagious bacterial disease. Initially, symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough. This is then followed by weeks of severe coughing fits. Following a fit of coughing, a high-pitched whoop sound or gasp may occur as the person breathes in. The coughing may last for 10 or more weeks, hence the phrase "100-day cough". A person may cough so hard that they vomit, break ribs, or become very tired from the effort. Children less than one year old may have little or no cough and instead have periods where they do not breathe. 590. Filaments, sulfur granules: ACTINOMYCES ISRAELII (lumpy jaw) 591. Bacteria in an abscess: STAPHYLOCOCCUS AUREUS 592. Proline in saliva: BINDS TO CALCIUM & HELPS MAITAINING [Ca2+] IN SALIVA Proline-rich proteins are major components of parotid and submandibular saliva. They can be divided into acidic, basic and glycosylated proteins. The primary structure of the acidic proline-rich proteins is unique and shows that the proteins do not belong to any known family of proteins. The proline-rich proteins are apparently synthesized the acinar cells of the salivary glands and their phenotypic expression is under complex genetic control. The acidic proline-rich proteins will bind calcium with a strength which indicates that they may be important in maintaining the concentration of ionic calcium in saliva. 593. Ksp solubility constant of ions (they were asking how do ions precipitate): PRODUCT CONCENTRATION OF IONS

594. Rheumatoid arthritis affects first: SYNOVIAL MEMBRANE

595. Submandibular gland: SECRETES MORE VOLUME OF SALIVA (the next is parotid) 596. More saliva is secreted: BETWEEN MEALS 597. Cause of a massive hematemesis in alcoholics: ESOPHAGEAL VARICES Cirrhosis → portal hypertension → esophageal varices → bleeding (hematemesis: vomiting of blood)

41

598. The biggest amount of saliva is produced by: SUBMANDIBULAR GLAND

I was taught at school that sublingual is a mixed gland, just like submandibular. Sublingual was mostly mucous and submandibular mostly serous. 599. What lines visceral side of the kidney: PODOCYTES

600. Changes in aorta with age: BECOMES STIFF, LESS ELASTIC; SYSTOLE + NO CHANGE/ DIASTOLE → WIDE PULSE PRESSURE 601. Dissection after emerge from stylomastoid foramen, what happens: IPSILATERAL PARALYSIS OF MM. OF FACIAL EXPRESSION = LOWER MOTOR NEURON OF VII

602. Edinger nucleus: CN III The Edinger–Westphal nucleus (accessory oculomotor nucleus) is the parasympathetic, pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle. 603. Nucleus for sphincter of the pupil: EDINGER-WESTPHAL NUCLEUS 604. C5a: CHEMOTACTIC 605. C3a: VASODILATATION, HYPOTENSION & EDEMA, ANAPHYLAXIS

42

606. Virus attached to MHC I responds to: VIRAL PEPTIDE As viruses induce cellular expression of viral proteins, some of these products are tagged for degradation, with the resulting peptide fragments binding to MHC I molecules. It is in this way, the MCH I dependent pathway of antigen presentation, that the virus infected cells signal T cells that abnormal proteins. 607. 608. 609. 610. 611.

How does the space between teeth change with age: IT GETS LARGER Allosteric activator: AMP, Pi, FRUCTOSE-2,6-BISPHOSPHATE In allergy, IgE binds to: MAST CELLS Soft tissue and bone in a fracture: METAPLASIA Pterygomandibular raphe, origin & insertion: SUPERIORLY TO THE HAMULUS OF MEDIAL PTERYGOID PLATE (SPHENOID BONE) & INFERIORLY TO THE POSTERIOR END OF THE MYLOHYOID LINE OF THE MANDIBLE

612. TB reaction: DELAYED HYPERSENSITIVITY (TYPE IV) 613. Alpha-1-antitripsine: LIVER (CIRRHOSIS) & LUNGS (EMPHYSEMA) Disorders of this protein include alpha-1 antitrypsin deficiency, an autosomal codominant hereditary disorder in which a deficiency of alpha-1 antitrypsin leads to a chronic uninhibited tissue breakdown. This causes the degradation especially of lung tissue and eventually leads to characteristic manifestations of pulmonary emphysema. Evidence has shown that cigarette smoke can result in oxidation of methionine of α1-antitrypsin, a residue essential for binding elastase; this is thought to be one of the primary mechanisms by which cigarette smoking (or second-hand smoke) can lead to emphysema. Because A1AT is expressed in the liver, certain mutations in the gene encoding the protein can cause misfolding and impaired secretion, which can lead to liver cirrhosis. 614. White rami: CENTRAL IN THE BRAIN, PERIPHERAL IN THE SPINAL CORD; MYELINATED AXONS 615. Myocardial infraction after 24h: COAGULATIVE NECROSIS 616. Infract healing: BY ORGANIZATION • 0-24 hours - early coagulative necrosis, edema, hemorrhage, neutrophils appear, hyper contraction of myofibrils • 1-3 days - extensive coagulative necrosis • 3-14 days - macrophages, then granulation tissue at margins • 2 weeks-several months - contracted scar complete 617. 618. 619. 620. 621. 622. 623. 624. 625. 626.

All in the sphenoid bone except: CAROTID CANAL (temporal bone) Smallest cusp in MN 1st molar: DISTAL Vesicles on the skin at nerve distribution, either small, recurrent chicken pox: HERPES ZOSTER Ergosterol synthesis is blocked by: NYSTATIN Nystatin: MOST COMMON ANTIFUNGAL Cirrhosis commonly is caused by: ALCOHOLISM Which enzyme is associated with phosphorylation of ADP at a substrate level: PYRUVATE KINASE Toxoid vaccine, inactivated: EXOTOXIN Small cell carcinoma: BRONCHIAR HPV infection, not prevented by a vaccine: CONDYLOMATA ACUMINATUM (GENITAL WART)

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627. Myasthenia gravis: ACH Parkinson disease →  dopamine Alzheimer’s disease →  serotonin Myasthenia gravis → Ach receptors are affected (it involves nicotinic receptors) Eton-Lambert → Ach release is affected 628. The effect of Ach on neuromuscular junction, it opens what: VOLTAGE GATED ION CHANNELS, CHEMICAL GATED CATION CHANNELS 629. ACE inhibitors cause: XEROSTOMIA 630. What dilates pupils: EPINEPHRINE 631. Ganglion with nerves that dilate the pupil: SUPERIOR CERVICAL GANGLION (picture on page 41) 632. Mucormycosis infects: BLOOD VESSELS Mucormycosis is any fungal infection caused by fungi in the order Mucorales (species: Mucor, Rhizopus). The disease is often characterized by hyphae growing in and around blood vessels and can be potentially life-threatening in diabetic or severely immunocompromised individuals. 633. Fungus found around blood vessels: MUCORMYCOSIS 634. Tuberculate chlamydospore: HISTOPLASMA Histoplasmosis is thermally dimorphic. The mold form produces tuberculate chlamydospores (asexual spores, like arthrospores). 635. Not in a cell membrane: TRIGLYCERIDES (cholesterol & phospholipids are present) 636. If the anticodon on tRNA is 5’ ACG 3’, then which of the following is it’s corresponding codon on mRNA: 5’ CGU 3’ 637. mRNA by which blot: NORTH Southern blot: specific DNA sequences Western blot: specific proteins in complex samples Eastern: posttranslational modifications of proteins Mneumonic: SNoW DRoP Southern Northern DNA RNA

o o

Western Protein

638. Central groove of MX molar: FROM MESIAL FOSSA TO CENTRAL FOSSA 639. A lot of SER and tubular cisternae in: STEROID PRODUCING CELLS

44

640. Tyrosine kinase, receptor: INSULIN RECEPTOR The insulin receptor is a transmembrane receptor that is activated by insulin, IGF-I, IGF-II and belongs to the large class of tyrosine kinase receptors. Metabolically, the insulin receptor plays a key role in the regulation of glucose homeostasis, a functional process that under degenerate conditions may result in a range of clinical manifestations including diabetes and cancer. 641. Mechanism of action of glucagon: PHOSPHORYLATION OF PROTEIN KINASE

642. Problem in root planning common with all posterior teeth: FACIAL CERVICAL BULGE 643. Rickettssia infection not transmitted by ticks: Q FEVER Q fever is a disease caused by infection with a bacterium Coxiella burnetti. This organism is uncommon, but may be found in cattle, sheep, goats, and other domestic mammals, including cats and dogs. The infection results from inhalation of a spore-like small-cell variant, and from contact with the milk, urine, feces, vaginal mucus, or semen of infected animals. Rarely, the disease is tick-borne. 644. Inanimate infection source: FOMITES 645. Not a normal pathogen of the oral cavity: BORDATELLA PERTUSSIS 646. Antigenic drift due to: GLYCOPROTEIN SPIKES ON THE ENVELOPE, HEMAGLUTTININ & NEURAMINIDASE Drift: minor changes, random mutations → influenza, RSV Shift: major changes, reassortment of the genome 647. Liver embryology: ENDODERM 648. Reticular epithelial cells are seen in: THYMUS 649. Diaphragm innervation: PHRENIC NERVE The diaphragm is primarily innervated by the phrenic nerve (C3, C4, C5). While the central portion of the diaphragm sends sensory afferents via the phrenic nerve, the peripheral portions of the diaphragm send sensory afferents via the intercostal (T5–T11) and subcostal nerves (T12). 
 650. Deep lingual artery ends on: THE TIP OF THE TONGUE

651. 652. 653. 654.

Mechanism of action of albuterol: BETA 2 AGONIST (BRONCHODILATATOR) Most vertical: MX 1st PREMOLAR Not involved in thoracic cage: CLAVICLE Location of the nucleus that opens the pupil in the dark: EDINGER WESTPHAL NUCLEUS please do more research on that one!

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655. 3rd order pain neurons in: THALAMUS

656. Transects pyramids: LOSS OF FINE MOTOR 657. Affected in Parkinson disease: SUBSTANTIA NIGRA The substantia nigra is a basal ganglia structure located in the midbrain that plays an important role in reward and movement. 658. 659. 660. 661. 662. 663.

Dynamic of blood in the pulp is similar to: THE CRANIUM What we don’t need to correct in myasthenia gravis: INFREQUENT BLINKING Injection of TB in previously infected will elicit: HYPERSENSITIVITY REACTION Most abundant cells present in granulomas: MACROPHAGES Ulcer on the palate: ORTHOKERATINIZED (First Aid) 1st step in correcting thiamine dimmers: PHOTO REACTIVATION BY PHOTOLYASE ENZYME

Thymine dimer is an example of frameshift mutation. It can be corrected by photoreactivation. 2nd step is nucleotide excision. 664. AA in the interior of proteoglycans: SERINE, THREONINE 665. AA in the interior of proteins: VALINE AND LEUCINE Valine and leucine can be found in globular proteins. Generally speaking, interior AA are hydrophobic. Hydrophobic AA: phenylalanine, proline, tryptophan, tyrosine, valine, leucine, isoleucine Hydrophilic AA: - positive: arginine, histidine, lysine - negative: aspartate, glutamate - neutral: serine, threonine, cysteine, methionine, asparagine, glutamine 666. Decrease in plasma osmotic pressure will cause diluted urine: FALSE Edema: 1.  in hydrostatic pressure 2.  in colloid osmotic pressure (oncotic pressure) Decrease in colloid osmotic pressure leads to increase in edema, which leads to decrease in urine output, so the urine will b e more concentrated.

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667. Asthma: TYPE 1 HYPERSENSITIVITY

668. Liver’s function, all except: PRODUCTION/STORAGE/SECRETING OF DIGESTIVE ENZYMES (different questions with different answer choices, I combined all three here) 669. Normal flora of nasopharynx: S. EPIDERMIS 670. Right lateral excrusion, mesiofacial cusp of the MX R 1 st molar passes through which of the following grooves of MN R 1st molar: DISTO BUCCAL GROOVE 671. RSV infection can be prevented by vaccination: FALSE 672. Penicillin hypersensitivity: TYPE 1 673. Infection from #19 goes into which nodes: SUBMANDIBULAR 674. Teeth position during swallowing: MAXIMAL INTERCUSPITATION 675. A patient with a peg tooth in MX arch, which tooth is it: LATERAL INCISOR 676. A patient is missing a tooth in MN among posterior teeth, which tooth is most likely to be missing: 3rd MOLAR 677. Cells seen in acute inflammation: NEUTROPHILS 678. Mandible formation: INTERMEMBRANOUS (BODY), ENDOCHONDRAL (CONDYLE) → BICE 679. Postganglionic sympathetic neurotransmitter for sweat glands: ACH 680. Which organ is a sympathetic receptor: ADRENAL MEDULLA 681. Location of the thoracic duct: POSTERIOR TO ESOPHAGUS, MEDIAL TO KIDNEYS, LATERAL & POSTERIOR TO TRACHEA 682. Dimorphism: YEAST & HYPHAE (MOLD) 683. Which cerebral lobe is located in the middle cranial fossa: TEMPORAL LOBE 684. Drop in O2 pressure is detected by: CAROTID BODY 685. Stimulation of carotid sinus leads to: DROP IN BLOOD PRESSURE 686. Which one is not an organelle: LIPID DROPLETS 687. Innervation of the upper lip: BUCCAL BRANCH OF FACIAL N., INFRAORBITAL N.

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688. Voluntary movements in muscles, which tract: CORTICOSPINAL The pyramidal tracts = the corticospinal + corticobulbar tracts These are aggregations of efferent nerve fibers from the UMN that travel from the cerebral cortex and terminate either in the brainstem (corticobulbar) or spinal cord (corticospinal) and are involved in the control of motor functions of the body. The corticobulbar tract conducts impulses from the brain to the cranial nerves. These nerves control the muscles of the face and neck and are involved in facial expression, mastication, swallowing, and other functions. The corticospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The corticospinal tract is involved in voluntary movement. The majority of fib res of the corticospinal tract cross over in the medulla, resulting in muscles being controlled by the opposite side of the brain. The corticospinal tract also contains Betz cells (the largest pyramidal cells), which are not found in any other region of the body. The pyramidal tracts are named because they pass through the pyramids of the medulla. The corticospinal fibers when descending from the internal capsule to the brain stem, converge to a point from multiple directions giving the impression of inverted pyramid. The myelination of the pyramidal fibres is incomplete at birth and gradually progresses in caudo- cranial direction and thereby progressively gaining functionality. Most of the myelination is complete by two years of age and thereafter it progresses very slowly in cranio-caudal direction up to twelve years of age. 689. Submandibular gland innervation: LINGUAL NERVE Preganglionic: chorda tympani (of VII) via lingual nerve Synapse: submandibular ganglion Postganglionic: leaves ganglion and passes to gland 690. Which interaction keeps the cell membrane intact: HYDROPHOBIC BONDS 691. Why a diabetic patient (type 1) was able to reduce the amount of injected insulin after he decided to work out more: INCREASED INSULIN SENSITIVITY 692. Which one is not in the posterior wall of axilla: SERRATUS ANTERIOR 693. Troponin changes the position of: TROPOMYOSIN 694. Connective tissue that covers only one muscle fiber: ENDOMYSIUM 695. Most abundant papilla of the tongue: FILIFORM 696. Which one is not derived from ectoderm: ALVEOLAR BONE 697. Body of the hyoid is derived from which embryonic cartilage: SECOND CARTILAGE 698. What is the nerve in pericardium: PHRENIC NERVE

699. What are Fordyce granules: ECTOPIC SEBACEOUS GLANDS IN THE MUCOSA OF THE CHEEK 700. The cause of diabetes mellitus: AUTOIMMUNE / DECREASED SENSITIVITY TO INSULIN RECEPTORS

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701. Dull pain in the pulp: C FIBERS 702. Anterior pituitary deficiency will cause: HYPOGONADISM, ADDISON’S DISEASE, MYXEDEMA 703. Deeply stained granules in the oral mucosa are: KERATOHYALIN GRANULES Keratohyalin is a protein structure found in granules in the stratum granulosum of the epidermis, which may be involved in keratinization, and in Hassall's corpuscles in the thymus. In H&E stained sections, they are large deeply stained granules found in the cytoplasm of epithelial cells in keratinized oral mucosa. 704. 705. 706. 707.

In fluorosis, where can excessive fluoride be seen: BONES, TEETH, CARTILAGE, NAILS Junctional epithelium is made out of: REDUCED ENAMEL EPITHELIUM Apical 1/3 in the root, few, more than one, communication between PDL & pulp: ACCESSORY CANALS Ligamentum teres is a remnant of: UMBILICAL VEIN

708. Hematoma after injection in the area of MX 1st molar is due to: INSERTION OF THE NEEDLE INTO PTERYGOID PLEXUS 709. Immunity from the mother to the fetus: NATURAL PASSIVE Natural - active - passive Artificial - active - passive

being sick breastfeeding vaccination with attenuated virus or toxoid antitoxin

710. Process of scar formation: THIRD INTENTION & SECOND INTENTION Types of wound healing: 1. First intention: healing occurs directly, without formation of the granulation tissue; minimal scar formation. 2. Second intention: healing occurs with granulation tissue; scar formation is excessive. 3. Third intention: a deeper and wider scar usually result. 711. 712. 713. 714. 715.

Disorganized atypical cells, not invasive: DISPLASIA Erythroblastosis fetalis is what type of hypersensitivity: TYPE 2 Patient with elevated level of PSA & serum acid phosphatase is in risk for: PROSTATIC ADENOCARCINOMA Liquefaction necrosis: IN THE BRAIN AND SPINAL CORD Initiation codon is translated into which amino acid: METHIONINE

49

716. Guiding cusps: NON-FUNCTIONAL CUSPS

717. Roseacea: BIG, RED NOSE Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often the nose, cheeks, forehead, and chin are most involved. A red enlarged nose may occur in severe disease, a condition known as rhinophyma. The cause of rosacea is unknown. Risk factors include a family history of the condition. Factors that may potentially worsen the condition include heat, exercise, sunlight, cold, spicy food, alcohol, menopause, psychological stress, or steroid cream on the face. Diagnosis is based on symptoms. While not curable, treatment usually improves symptoms. Treatment is typically with metronidazole, doxycycline, or tetracycline. When the eyes are affected azithromycin eye drops may help. Dermabrasion or laser surgery may also be used. The use of sunscreen is typically recommended. Rosacea affects somewhere between 1-10% of people. Those affected are most often 30-50 years old and female. Caucasians are more frequently affected. 718. Pitting edema: INDICATES ACUTE DISEASE Pitting edema: observable swelling of body tissues due to fluid accumulation that may be demonstrated by applying pressure to the swollen area (such as by depressing the skin with a finger). Low protein levels in the blood caused by malnutrition, kidney and liver disease can also cause edema. The proteins help to hold water inside the blood vessels so fluid does not leak out into the tissues. If a blood protein, called albumin, gets too low, fluid leaks out the blood vessels and edema occurs, especially in the feet, ankles and lower legs. 719. Pitting edema:  PROTEIN 720. Non-microbial part of the dental plaque is mostly made out of: DEXTRAN This is an ASDA question, E series Streptococcus mutans produce a polysaccharide - dextran - from sucrose. It’s produced outside the cell by an enzyme called dextran sucrase (glycosyl transferase). This enzyme splits the disaccharide into glucose and fructose, and then takes the glucose molecules and links them together to form a dextran polysaccharide. Dextran is made out of glucose molecules linked together by a-1,6 and some a-1,3 branches. It is a sticky polymer that forms a thick glycocalyx around the cell. This is the main reason why bacteria with the dextran sucrase enzyme are cariogenic. Just like dextran is a polymer of glucose, levan (also called fructan) is a polymer of fructose. Levan is formed by the enzyme levan sucrase. It is a reserve food source for bacteria and they damage the teeth by increasing bacterial adhesion and promoting plaque formation. 721. 722. 723. 724. 725. 726. 727. 728.

The difference between facilitated transport and active transport: USE OF ATP What is the ration of the blood circulating in capillaries and aorta: THE SAME What is the second messenger for glycogen: cAMP Proximal view of MN 1st molar: RHOMBOID Which enzyme converts glucose to glucose-6-phosphate: HEXOKINASE What is the pace setting enzyme for glycolysis: PHOSPHOFRUKTOKINASE Asthma medication: B2-ADRENERGIC AGONISTS Urinary tract cancer: SMOKING CIGARETTES (carcinogens from cigarettes get excreted through the urine)

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729. A patient with hypertension is not willing to take his premedication, he is insisting on having the dental procedure done, what should you do: CANCEL THE APPOINTMENT, PRIORITIZING THE OVERALL HEALTH OF THE PATIENT TO HIS DENTAL HEALTH 730. You recommended a pregnant patient to have her teeth cleaning done, why: SHE IS AT RISK FOR PREGNANCY GINGIVITIS / BLEEDING GUMS 731. She is 6 weeks pregnant, how long will you wait to do a procedure: 6 MORE WEEKS (TILL THE 12th WEEK) 732. Junction of proximal ridge and cusp ridge makes: OCCLUSAL TABLE 733. Cervical cross-section of MN lateral incisor: OVAL, FLATTENED M-D 734. Cervical cross-section of MX central incisor: TRIANGULAR 735. Middle cross-section of the root of MX central incisor: TRIANGULAR 736. Proximal outline shape of central incisors: TRIANGULAR 737. Height of contour of MX central incisor: CERVICAL THIRD 738. A 16-year-old patient with 2nd primary molar, what is the reason: AGENESIS 739. Mamelons in a 17-year-old patient due to: MALOCCLUSION 740. Tooth that most likely has two canals in the medial root: MN 1st MOLAR 741. Occlusal surface with grooves in the shape of “Y” is seen in: MN 2nd PREMOLAR 742. “Y” shape is formed by: 2 LINGUAL & 1 FACIAL CUSPS OF MN 2nd PREMOLAR 743. TMJ clicking is a result of damage to which ligament: COLLATERAL 744. Root in primary MN 1st molar that is longer & wider, with flattened apex: MESIAL ROOT 745. Only tooth with lingual surface as the widest: MX 1st MOLAR 746. Excessive sympathetic stimulation inhibits: PERISTALSIS 747. Laterotrusive movement, MN canine contacts: MX CANINE 748. Bucco-lingual space in the interproximal area: COL Col: a craterlike area of the interproximal oral mucosa joining the lingual and buccal interdental papillae.

749. If the mandibule was moved to the right, the contact that occurs on the left is called: NON-WORKING INTERFERENCE 750. Adenosine movement via: ADP/ATP TRANSLOCASE 751. All body cavities are covered with: MESOTHELIUM (SIMPLE SQUAMOUS) Mesothelium: lines the pleural, peritoneal & pericardial cavities. It is composed of monolayer of epithelial-like cells on a thin basal membrane and subserosal connective tissue and blood vessels. Simple squamous epithelium. 752. During laterotrusive movement, the MN canine moves distally or medially to the MX canine: DISTALLY 753. Outlet facet on mesiolingual cusp by which movement: LATEROTRUSIVE 754. Tetracycline stain is due to defect in mutation: MISSENSE

755. Q fever is spread by: AEROSOLS, COXIELLA BURNETTI 756. Surfaces of the curve of Spee: CONCAVE → MANDIBULAR, CONVEX → MAXILLARY

51

757. 758. 759. 760.

Where does submandibular gland duct eject saliva: SUBLINGUAL CARUNCLE Hapten: NON-ANTIGENIC PROTEIN, REQUIRE PROTEIN CARRIER What is not found in the DNA: URACIL Tay-Sachs disease: DEFICIENCY OF HEXOSAMINIDASE A → ACCUMULATION OF GANGLIOSIDE

A ganglioside is a molecule composed of a glycosphingolipid with one or more sialic acids linked on the sugar chain. Tay-Sachs disease (TSD) is a fatal genetic disorder, MC occurring in children, that results in progressive destruction of the nervous system. Tay-Sachs is caused by the absence of a vital enzyme called hexosaminidase-A (Hex-A). Without it, a lipid called GM2 ganglioside accumulates abnormally in cells, especially in the nerve cells of the brain. This ongoing accumulation causes progressive damage to the cells.

761. Ganglioside GM2 accumulation: TAY-SACHS DISEASE 762. What are the working cusps in a posterior cross-bite: UPPER → BUCCAL, LOWER → LINGUAL 763. Dentist lacerated the palate posterior to 2nd molar, it extends to the lower, middle. The dentist sutured the incision, but the blood pulsates and oozes. What nerve is lacerated: GREATER PALATINE NERVE 764. During denaturation of protein all bonds are destroyed except: COVALENT BONDS (PEPTIDE BONDS) 765. Hyaluronate, function: SHOCK ABSORPTION Hyaluronic acid is highly concentrated inside the eyeball. The fluid inside the eye called the vitreous humor is composed almost completely of hyaluronic acid. The HA gives the fluid inside the eye a viscous gel like property. This gel acts as a shock absorber for the eye and also serves to transport nutrients into the eye. HA has been directly injected into the eye during procedures to help maintain the shape of the eye during surgery. It has been said that after the 5 th decade of life, our eyes stop producing the much-needed hyaluronic acid. 766. What is found in the inner membrane of hepatitis virus: MATRIX PROTEIN 767. Bronchial tree sequence: TRACHEA → MAIN (PRIMARY, R & L) BRONCHI → LOBAR (2nd) BRONCHI → SEGMENTAL (3rd) BRONCHI → INTERLOBULAR BRONCHI → LOBULAR BRONCHIOLES → TERMINAL BRONCHIOLE (they lose cartilage) → RESPIRATORY BRONCHIOLE → ALVEOLI 768. Erupts after the last succedaneous tooth: 2nd & 3rd MOLARS 769. Fumarase, what kind of reaction: HYDRATION

770. DNA amplification: PCR 771. PCR: DNA FINGERPRINTING

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• •

DNA fingerprinting is a technique that simultaneously detects lots of minisatellites in the genome to produce a pattern unique to an individual - this is a DNA fingerprint. The probability of having two people with the same DNA fingerprint that are not identical twins is very small.

772. What will cause DNA mutation: X-RAYS, UV LIGHT, CHEMICALS 773. If right MX canine is missing, what will its counter effects be on the left MX canine and left MX molars: NON-WORKING INTERFERENCE (???) 774. What is responsible for taller cusps: STEEPER EMINENCE

775. 776. 777. 778. 779.

Sternothyroid & sternohyoid: ANSA CERVICALIS (C1-C3) Medication for candidiasis: CLOTRIMAZOLE & NYSTATIN What causes repolarization:  IN EXTRACELLULAR POTASSIUM Overcountouring of the labial-incisal surface of MN central incisor causes: DECREASED OVERJET Occlusal table of molars: MX → RHOMBOID, MN 1st → PENTAGON, MN 2nd → RECTANGULAR

53

780. What is the reason for refractory period: SODIUM CHANNEL INACTIVATION & DELAYED CLOSING OF POTASSIUM CHANNEL Refractory period is the amount of time it takes for an excitable membrane to be ready for a second stimulus once it returns to its resting state following an excitation. Absolute refractory period corresponds to depolarization and repolarization, whereas relative refractory period corresponds to hyperpolarization. 781. 782. 783. 784. 785. 786. 787. 788. 789. 790. 791. 792. 793. 794. 795. 796. 797.

Thenar is innervated by: MEDIAN NERVE White spots present in child’s mouth: MEASLES Least common WBC: BASOPHILS Fastest nerve velocity: I A Endothelial cells are affected, what happens: THROMBUS FORMATION Gemination: SEEMS LIKE TWO TEETH HAVE DEVELOPED FROM ONE Facial muscles are derived from: 2nd BRACHIAL ARCH Most carbon dioxide is excreted as: BICARBONATE (HCO 3-) What is not seen in a 10-week-old pregnancy: TMJ Mesiodens: BETWEEN MX CENTRALS Melanin pigmentation: BASAL LAYER Prominence of the throat is due to: THYROID CARTILAGE What is caused by lice: TYPHUS Hunger: HYPOTHALAMUS (Hungry Hippo) Cementoblasts are formed by: ECTOMESENCHYME Smallest cusp in the oral cavity: CUSP OF CARABELLI Number of variable components on complete heavy chains: 2

Each IgG molecule consists of two heavy chains and two light chains. The two heavy chains are linked to each other by disulfide bonds and each heavy chain is linked to a light chain by a disulfide bond. In any given immunoglobulin molecule, the two heavy chains and the two light chains are identical, giving an antibody molecule two identical antigen-binding sites, and thus the ability to bind simultaneously to two identical structures. Fab – variable region: defines the specific target for the antibody Fc – constant region: the same for each species

798. What is formed from neural crest cells: MELANOCYTES, SCHWANN CELLS, CHROMAFFINE CELLS OF ADRENAL MEDULLA In order to activate chromaffin cells, the splanchnic nerve of the sympathetic nervous system releases acetylcholine, which then binds to nicotinic acetylcholine receptors on the adrenal medulla. This causes the release of catecholamines. The chromaffin cells release catecholamines: ~80% of adrenaline and ~20% of noradrenaline into systemic circulation for systemic effects on multiple organs (similarly to secretory neurones of the hypothalamus) and can also send paracrine signals. 799. What is Bowman’s capsule: DOUBLE LAYER; PARIETAL – SIMPLE SQUAMOUS, VISCERAL – PODOCYTES 800. Superior orbital fissure: GREATER AND LESSER WING OF THE SPHENOID BONE 801. Which part of nephron takes up the most ATP: PROXIMAL CONVOLUTED TUBULE

54

802. Carboxyhemoglobin is due to: CARBON MONOXIDE BINDING TO HEMOGLOBIN 803. What passes between palatoglossus and palatopharyngeus: PALATINE TONSILS, TONSILLAR BRANCH & ASCENDING PHARYNGEAL BRANCH OF FACIAL ARTERY, STYLOPHARYNGEUS, GLOSSOPHARYNGEAL NERVE

804. Radio-ulnar joint: SYNDESMOSIS A syndesmosis is a slightly movable fibrous joint in which bones are joined together by connective tissue. Examples include the distal tibiofibular joint as well as the radioulnar joint. Injuries to the ankle syndesmosis are commonly known as a "high ankle sprain". 805. Stretch receptor, what type of synapse: MONOSYNAPTIC Clasp knife → disynaptic Flexion withdrawal → polysynaptic The stretch reflex (myotatic reflex) is a muscle contraction in response to stretching within the muscle. It is a monosynaptic reflex which provides automatic regulation of skeletal muscle length. When a muscle lengthens, the muscle spindle is stretched and its nerve activity increases. This increases alpha motor neuron activity, causing the muscle fibers to contract and thus resist the stretching. A secondary set of neurons also causes the opposing muscle to relax. The reflex functions to maintain the muscle at a constant length. 806. Where does sigmoid sinus drain: INTERNAL JUGULAR VEIN

\\

807. What runs along external carotid artery: SUPERFICIAL LNs, EXTERNAL JUGULAR VEIN, VAGUS NERVE

55

EJV runs with great auricular n., superficial cervical LN IJV runs with CN X (vagus), ICA, ECA, CN XI (accessory), superior deep cervical LN ECA runs with CN X (vagus), ICA, retromandibular vein, great auricular n. Glossopharyngeal and hypoglossal pass between IJV and ICA Refer to picture #147 That’s what I found online: https://www.earthslab.com/category/anatomy/head-and-neck/ EXTERNAL CAROTID ARTERY Is crossed by digastric & styohyoid lingual, common facial, superior thyroid veins CN XII Lateral to hyoid bone, pharynx, superior laryngeal n., parotid Medial to ICA Anterior to superior laryngeal n. Also close styloglossus, stylopharyngeus CN IX pharyngeal branch of CN X INTERNAL JUGULAR VEIN Is crossed by posterior digastric & inferior omohyoid occipital artery & posterior auricular a. CN XI & inferior root of ansa cervicalis EXTERNAL JUGULAR VEIN Crosses SCM Carotid sheath: - CCA (divides into ECA & ICA inside the sheath) - IJV - CN X 808. 809. 810. 811. 812. 813. 814. 815. 816. 817. 818.

2nd part of swallowing is controlled by: BRAINSTEM What is an involuntary reaction: ESOPHAGO-GASTRO TMJ is a load bearing joint: TRUE Purine synthesis: FOLIC ACID, BEGINS WITH R5P Purine metabolism intermediate product: IMP Purines, end product of catabolism: XANTHINE OXIDASE Action of sympathetic NS: FLIGHT OF FIGHT All MN teeth are at the same level except: LAST MOLAR The dentist touched mucosa, which fibers were activated: A-BETA (table, #176) What is the characteristics of aortic arch: THICK TUNICA MEDIA WITH ELASTIC FIBERS What is similar between the aortic arch and systemic blood supply: FLOW RATE IS THE SAME

Flow rate: the volume of fluid which passes per unit time Flow velocity: how fast 819. Sucrose: GLUCOSE + FRUCTOSE

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820. Chlamydia causes infection of: GENITALS AND EYES 821. Insufficient ADH secretion causes: DIABETES INSIPIDUS Diabetes insipidus: results from insufficient production of the antidiuretic hormone (ADH), a hormone that helps the kidneys and body conserve the correct amount of water. Normally, the antidiuretic hormone controls the kidneys' output of urine. It is secreted by the hypothalamus, stored in the pituitary gland, and then released into the bloodstream. ADH is secreted to decrease the amount of urine output so that dehydration does not occur. Diabetes insipidus, however, causes excessive production of very diluted urine and excessive thirst. The disease is categorized into groups: - central diabetes insipidus - an insufficient production or secretion of ADH; can be a result of damage to the hypothalamus or pituitary gland caused by head injuries, genetic disorders, and other diseases, - nephrogenic diabetes insipidus - a lack of kidney response to normal levels of ADH: can be caused by drugs or chronic disorders, such as kidney failure, sickle cell disease, or polycystic kidney disease. 822. Splanchnic nerve: PS FIBERS TO TRANSVERSE COLON (DISTAL TO SPLENIC FLEXURE), DESCENDING COLON, SIGMOID COLON, RECTUM (S2-S4); S FIBERS TO FOREGUT & MIDGUT

823. Aldosterone is partially responsible for: REABSORPTION OF WATER IN THE COLLECTING DUCT 824. Partial pressure of O2 in Himalayas if atmospheric pressure is 250: 50% (20% from 250) 825. Young permanent tooth with pulp horns: CENTRAL INCISOR

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826. 827. 828. 829.

Does hepatitis C have a carrier: YES Pseudostratified lining came out during extraction of MX molar, where is the lining from: MX ANTRUM/SINUS Most common vaccine in the US: DPT Why is a non-alive vaccine better than alive vaccine for polio: TO INHIBIT REACTIVATION IN LIVE

An inactivated vaccine works when the immune system responds to a piece of a bacteria or virus or to a toxin produced by the germ. Live “attenuated” vaccines mean they have been changed such that they do not cause disease. They grow inside the vaccinated person until the immune system recognizes the bacteria or virus and has the appropriate response, similar to a natural infection. 830. 831. 832. 833.

What stops the immune reaction in the tissues: SUPRESSOR T CELLS Dentin composition: 70% INORGANIC, 20% ORGANIC, 10% WATER Purely serous glands: PAROTID GLAND & VON EBNER GLANDS Hepatitis C patient, you do FNAC (Fine Needle Aspiration Cytology) of the liver and find excess of: COLLAGEN, HEPATOCYTES, NEUTROPHILS

According to the group: Some people are picking COLLAGEN as the correct answer, because of the cirrhosis “fibrosis” (that answer was marked in a 2013 file). Other people are picking HEPATOCYTES, if there will be DAMAGED HEPATOCYTES option available (that speaks to me). 834. A young guy comes to the dental office and complains: “my girlfriend says, that my mouth stinks”. He is obese, diabetic (t. II), alcoholic. The reason for his bad breath is most likely: KETOACIDOSIS 835. What maintains the tissue & water balance: GLYCOSAMINOGLYCANS 836. Eosinophilia due to: PARASITIC INFECTION 837. Patient underwent canine RCT and there is an infection in the same tooth after 5 years. What can be the cause: PRESENCE OF AN ACCESSORY ROOT CANAL 838. Gomphosis: TOOTH & SOCKET 839. Basal cell carcinoma: UPPER FACE, NOSE; INVOLVES SUN-EXPOSED AREAS

840. 841. 842. 843. 844.

Cells that do not differentiate: SKELETAL, CARDIAC, NEURONAL CELLS Drug that activates alpha 1 adrenergic receptors: CAUSES VASOCONSTRICTION Bacteria found in feces: E. COLI, BACTEROIDES, KLEBSIELLA Effects on taking anti-fungal drugs for too long: LIVER DAMAGE = HEPATOTOXICITY Legionnaire’s (Legionellosis) is due to: AC COOLING SYSTEMS

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Legionnaire’s (Legionellosis) is caused by Legionella Pneumophila, a bacterium usually found in streams, rivers and lakes. There are two basic forms of the infection: - Legionnaire’s Disease: a serious form of the Legionellosis infection. Symptoms include chills, fever, a cough, tiredness and fatigue, headache and muscle ache and decreased appetite. Distinguishing Legionnaire’s Disease can be difficult, as chest scans and X-rays taken from patients can often present as pneumonia. Additional tests will be required for a patient to be firmly diagnosed with Legionnaire’s Disease. - Pontiac Fever: a milder form of Legionellosis does not include pneumonia-like symptoms. Symptoms include muscle ache and fever. Patients suffering from Pontiac Fever typically recover within 2-5 days with no need for medical treatment. The onset of Pontiac fever typically occurs within 2 hours and up to 2 days following exposure and Legionnaire’s Disease within 2-10 days of exposure. 845. At what age do MN roots formation ends: PRIMARY → 1-1,5 YEARS AFTER ERUPTION, PERMANENT → 2-3 YEARS AFTER ERUPTION 846. Keloid is formed by: COLLAGEN Keloid, also known as keloid disorder and keloidal scar, is the formation of a type of scar which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type I. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to the color of the person's skin or red to dark brown in color. 847. Cells can’t stop dividing: NEOPLASTIC / ANAPLASTIC 848. Too much uric acid in the body causes: GOUT 849. Refractory period is indicated by: Na+ CHANNELS CLOSURE & K+ CHANNELS OPENING; MORE POTASSIUM INSIDE

850. 851. 852. 853. 854. 855.

S-shape of dentinal tubules is due to: CROWDING OF ODONTOBLASTS Lactase is produced by which organ: BRUSH BORDER OF THE SMALL INTESTINE Laboratory tests for a patient on warfarin: PROTHROMBIN TIME & INTERNATIONAL NORMALIZED RATIO Herpes virus outer layer is made out of: GLYCOPROTEINS How can a low carbohydrate diet cause  in weight: LOW INSULIN OR LOW MALONYLO-CoA Most important complication in a newborn whose mother had gonorrhea: NEONATAL CONJUNCTIVITIS; SEVERE OPHTHALMIA & BLIDNESS 856. Combination of the curve of Wilson & the curve of Spee: SPHERE OF MONSON

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857. The root of the lung is supplied by: BRONCHIAL A., V. & N. L lung → 2 bronchial arteries R lung → 1 bronchial artery 858. Location of the nucleus that opens the pupil: EDINGER-WESTPHAL Pupillary light reflex

afferent (sensory): CN II (optic) efferent (motor): CN III (oculomotor) It does not involve cerebral cortex! Corneal reflex (blink reflex) afferent (sensory): CN V1 - protection from foreign bodies efferent (motor): CN VII - nucleus is in the pons of brain stem Optical reflex - protection from bright lights, mediated by visual cortex in the occipital lobe 859. Why don’t we prescribe penicillin with erythromycin: THEY BOTH ANTAGONIZE THEIR EFFECTS Penicillin inhibits the last step of cell wall synthesis and erythromycin will inhibit cell division (no more cell synthesis), so penicillin loses its effect. Penicillin acts on cells that still multiply, and erythromycin prevents that. 860. TMJ nourishment from: SYNOVIAL FLUID 861. Fluid in TMJ form: SYNOVIAL MEMBRANE 862. Chemotherapy affects the most: BONE MARROW, INTESTINAL MUCOSA, SKIN, LIVER, CARTILAGE High Mild - lymphocytes - spermatids - spermatogonia - osteoblasts - erythroblasts - intestinal crypt cells (small intestine)

Low - muscle cells - nerve cells

863. After extraction of MX 1st & 2nd molar patent came back with a hematoma at the site of middle insertion, why: POSTERIOR SUPERIOR NERVE HEMATOMA 864. Which cell is not present in the periosteum: OSTEOCYTE 865. MN 1st molar, where is the 4th canal: DISTAL ROOT

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866. Normal flora of the oropharynx: STREPTOCOCCUS MUTANS & STREPTOCOCCUS PYOGENES (both are present, but S. pyogenes colonize only 1-5% of healthy individuals) Skin Nose Oropharynx Plaque Vagina

S. epidermidis S. epidermidis, S. aureus Viridans S. mutans Lactobacillus, S. saprophyticus, colonized by E. coli

867. All infrahyoid muscles depress the larynx, except: THYROHYOID MUSCLE 868. 8 M urea denaturates proteins by CARBAMYLATION which breaks HYDROPHOBIC BONDS in the tertiary structure. Dental Decks:

869. Embryonic origin of the external acoustic meatus: 1st PHARYNGEAL CLEFT 870. Atherosclerosis: INTIMA OF THE ARTERIES 871. Pittng seen in: HEART FAILURE, VARICOSE VEINS, INSECT BITES, THROMBOPHLEBITIS Non-pitting: lipedema, myxedema, lymphedema 872. A lady had an accident a few days before, she came to your office complaining about her loose teeth (both MX central incisors), she has a black pigmentation around her left eye. - which fibers were not responsible for the teeth to become loose: INTERRADICULAR - what can be the reason for a radiolucent structure between the teeth: INCISIVE FORAMEN - what formed around her eye: ECCHYMOSIS (escape of blood into the tissues from ruptured blood vessels) - when could her accident happened: 2-5 DAYS AGO In the beginning - red color Within 5 days bluish purple/black 5-10 days green/yellow 10-14 days yellow brown/light brown 873. Most common benign tumor in women: UTERINE LEIOMYOMAS 874. Hyperestrogenism is a major risk factor for developing: ENDOMETRIAL CARCINOMA 875. Complication of fibroid: PROFUSE, PAINFUL MENSES, INFERTILITY

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876. PNET and Ewing’s sarcoma account of: PRIMARY MALIGNANT TUMOR PNET: Primitive Neuroectodermal Tumor Ewing's sarcoma/PNET are small round cell tumors showing a varying degree of neuroectodermal differentiation. They are one of the most common tumors of childhood and occur in bone and within soft tissues. Both of them are malignant tumor of the bone, but PNET is well differentiated and Ewing’s sarcoma is not. There is no difference clinically. 877. Pathologic fracture: MULTIPLE MYELOMA Multiple myeloma is a cancer of plasma cells. Often, no symptoms are noticed initially. When advanced, bone pain, bleeding, frequent infections, and anemia may occur. Complications may include amyloidosis. The cause is unknown. Risk factors include drinking alcohol, obesity, radiation exposure, family history, and certain chemicals. The underlying mechanism involves abnormal plasma cells producing abnormal antibodies which can cause kidney problems and overly thick blood. The plasma cells can also form a mass in the bone marrow or soft tissue. When only one mass is present, it is known as a plasmacytoma while more than one is known as multiple myeloma. Multiple myeloma is diagnosed based on blood or urine tests finding abnormal antibodies, bone marrow biopsy finding cancerous plasma cells, and medical imaging finding bone lesions. Another common finding is high blood calcium levels. Multiple myeloma is considered treatable, but generally incurable. Remissions may be brought about with steroids, chemotherapy, thalidomide or lenalidomide, and stem cell transplant. Bisphosphonates and radiation therapy are sometimes used to reduce pain from bone lesions. In the United States, it develops in 6.5 per 100,000 people per year and 0.7% of people are affected at some point in their lives. It usually occurs around the age of 61 and is more common in men. Without treatment, typical survival is seven months. With current treatments, survival is usually 4–5 years. This gives a five-year survival rate around 49%. 878. A woman was killed on the beach, she has lacerated neck and a knife puncture 12 cm deep to the left of T4 vertebra. - what organ is most likely to be injured: LUNG/AORTA - laboratory investigation proved she had multiple nodular cirrhosis, what is the cause: ALCOHOLISM - she had an infraorbital fracture involving the left canthus of the eye, bone: ZYGOMATIC 879. Autoimmune: DIABETES TYPE I 880. What nerve for muscles responsible for circumduction: AXILLARY NERVE (deltoid muscle)

881. Glycolysis, enzymes and products: PHOSPHOFRUCTOKINASE, PYRUVATE 882. Deviation of the tongue to the left: TONGUE DEVIATES TO THE AFFECTED SIDE 883. Preganglionic parasympathetic fibers to or from otic ganglion: LESSER PETROSAL NERVE

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884. Cause protrusion of the cricoid cartilage: PREVERTEBRAL LAYER OF DEEP CERVICAL FASCIA First Aid: the prevertebral layer of deep cervical fascia is why the thyroid moves with laryngeal movements. Sensory innervation of the upper lip in the middle: MAXILLARY → INFRAORBITAL → SUPERIOR LABIAL Bacteria that cause a foul odor: ACTINOMYCOSIS Filamentous formation on the angle of the mandible: ACTINOMYCETES Crown with mesial concavity: MX 1st PREMOLAR (also MX canine) Mesial furcation in the upper posterior teeth: MESIAL & DISTAL IN MX 1st PREMOLAR; BUCCAL, MESIAL & DISTAL IN MX MOLARS 890. Maxillary furcations: MESIAL, DISTAL, BUCCAL 891. What is probably a radiolucent irregular line in the outer canthus: SUTURE 892. Dead child, what is the counter bone (the bone on the opposite site of the impact → left eye and it’s surroundings; bone around the orbit): PARIETAL BONE 885. 886. 887. 888. 889.

893. Why does the crown of a MN canine looks longer: CROWN LOOKS SLENDER DUE TO SMALL MESIODISTAL DIMENSION WHEN COMPARED TO MX CANINE 894. Increase in 2,3-bisphosphoglycerate causes:  THE AFFINITY OF Hb TO O2 • • • 895. 896. 897. 898. 899.

Left shift: higher O2 affinity Right shift: lower O2 affinity Fetal Hb has higher O2 affinity than adult Hb Receptors in medulla immediately sense: H+ Anemia, what is affected: QUANTITY OF Hb (depends on the type of anemia) Atrophic gastritis: PERNICIOUS ANEMIA What causes acute gastric bleeding: PEPTIC ULCER, ESOPHAGEAL VARICES What is not a sequelae of shock: LIVER CIRRHOSIS

Cirrhosis & portal hypertension → hematemesis & bleeding from esophageal varices → hemorrhage → hypovolemic shock (so liver cirrhosis is the reason for, not a sequelae of, shock). 900. 901. 902. 903. 904. 905. 906.

Painless hematuria in all, except: NEPHROLITHIASIS (KIDNEY STONE DISEASE) Herring-Breuer inflation reflex (stretch reflex): OVERINFLATION OF THE LUNGS / EXPANSION OF THE ALVEOLI In SCC, what is affected; it is anterior to root of the bronchus: PHRENIC NERVE Lymph from the right MN posterior teeth goes to the lymph nodes located in: RIGHT SUBMANDIBULAR TRIANGLE How does the MN 3rd molar differ from MN 1st molar: ROOTS ARE MORE CONVERGENT, SHORTER & THE CROWN IS SMALLER Salivary glands do not have: HILUS Medial to hyoglossus: LINGUAL ARTERY & VEIN

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907. 908. 909. 910. 911. 912.

Taste sensation to circumvallate papillae: GLOSSOPHARYNGEAL NERVE Contact areas over a period of time: GET BROADER Height of contour in MX molars, facially: CERVICAL 1/3 Primary MN molar, cervical ridge: PROMINENT ON MN 1st PRIMARY MOLAR Primary teeth, cervical ridges are prominent on: FACIAL AND LINGUAL SURFACES MN lateral incisor vs. MN central incisor

MN lateral incisor: - is wider M-D - D-L twist of the incisal edge seen from the M (& occlusal) - root is tipped to the D - D crown tilt 913. Pulp chamber is triangular, becomes ovoid in mid-root: MAXILLARY CENTRAL INCISOR 914. Ksp solubility constant of ions – how does ions precipitate: PRODUCT CONCENTRATION OF IONS Precipitation occurs when cations and anions are combined in aqueous solution to form insoluble ionic solid.

915. Primary 1st molar, facial surface has no developmental groove: TRUE 916. Afferent fibers involved with the gag reflex: CN IX Gag reflex (pharyngeal reflex) • sensory limb: CN IX (glossopharyngeal nerve) • motor limb: CN X (vagus nerve) 917. Pupillary reflex, which nerve and which muscle is involved when entering a dark room: CN II & CN III, DILATOR PAPILLAE 1. 2. 3. 4. 918. 919. 920. 921. 922.

Left direct pupillary reflex is the left pupil's response to light entering the left eye. Left consensual pupillary reflex is the left pupil's indirect response to light entering the right eye, the contralateral eye. Right direct pupillary reflex is the right pupil's response to light entering the right eye. Right consensual pupillary reflex is the right pupil's indirect response to light entering the left eye, the contralateral eye.

Number of pulp horns and canals in MN 1st molar: 5 HORNS, 3 CANALS (sometimes 4 canals) Asthma is characterized by: EPISODIC AIRWAY OBSTRUCTION, BRONCHI CONSTRICTION Fusion only by the cementum: CONCRESCENCE Acellular cementum formed at: CERVICAL 1/3 Cellular cementum formed at: APICAL PORTION

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923. 924. 925. 926.

Secondary cementum has all except: BLOOD Hereditary defect causes improper formation of: ENAMEL Necessary for formation of the bone & the periosteum: VITAMIN C & D Collagen: TROPOELASTIN IS NOT PRESENT

Collagen and elastin are similar in that they contain proline residues and are composed of approximately 1/3 glycine. However, elastin differs from collagen because it contains very few hydroxyproline molecules, and completely lacks hydroxylysine. Remember that hydroxyproline or hydroxylysine commonly precede glycine in collagen fibers. Glycine and proline = components of collagen and elastin.

927. A doctor develops urticaria (hives) after donning latex gloves – which reaction is it: TYPE 1 Atopic allergies are common type I HS reactions that have a strong genetic predisposition for excessive IgE production. Clinical manifestations include asthma, edema, and erythema (“wheal and flare”), and urticaria (hives). Common allergens include pollens, animal danders, foods (shellfish and peanuts), drugs (penicillin), bee venom, and latex. Contact allergy is due to inadequate washing during manufacture, which results in the retention of water-soluble proteins that cause allergic reactions in susceptible people. 928. Latex allergy, angioedema, cells seen: MAST CELLS / BASOPHILS Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage. Acute episodes often involve the lip, eyes, and face; however, angioedema may affect other parts of body, including respiratory and GI mucosa. Laryngeal swelling can be life-threatening. Mast cells are the primary effector cells in urticaria and in many cases of angioedema. These cells are widely distributed in the skin, mucosa, and other areas of the body, and have high-affinity IgE receptors. Mast cell degranulation leads to the rapid release of various inflammatory mediators, such as histamine, leukotrienes and prostaglandins, which, in turn, cause vasodilation and leakage of plasma in and below the skin. There is also a more delayed (4–8 hour) secretion of inflammatory cytokines (e.g., TNF, Il-4 and Il-5) that potentially leads to further inflammatory responses and longer-lasting lesions. 929. 930. 931. 932. 933.

Hepatocyte function: SYNTHESIS OF ALBUMIN Inanimate objects passing infection: FOMITES (clothes, utensils, furniture, toys) Tooth swelling, lined with epithelium: CYST Least resistance to pH changes: LIVER Epithelium of the cervix: NONKERATINIZED STRATIFIED SQUAMOUS

Ectocervix - nonkeratinized SS, endocervix - mucous-secreting, columnar Squamocolumnar junction: ectocervix/endocervix junction, migrates during woman’s reproductive life, site of most epithelial diseases of the cervix.

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934. Vestibular swelling epithelium: NONKERATINIZED STRATIFIED SQUAMOUS 935. After endodontic treatment, biopsy was done showing resorbed bone and a lot of neutrophils. Pain occurs again, what is the reason: ABSCESS 936. A woman with leiomyoma. Tongue with a swelling, lumen lined with epithelium: CYST 937. Cells of the basement membrane of seminiferous tubules: SPERMATOGONIA

938. Sites difficult to perform scaling: BUCCAL, DISTAL, MESIAL (FURCATIONS!) 939. Related to cell surface receptors with CDR complex: T CELLS Complementarity-determining regions (CDRs) are part of the variable chains in immunoglobulins and T cell receptors, generated by B-cells and T-cells respectively, where these molecules bind to their specific antigen. A set of CDRs constitutes a paratope. As the most variable parts of the molecules, CDRs are crucial to the diversity of antigen specificities generated by lymphocytes. Above: sketch of an antibody with the variable domains (blue) and CDRs (light blue, part of the variable domains): 940. MHC-1 binds: CD8 Th CELLS (smaller – 1 – MHC with bigger – 8 – CD) 941. MHC-2 binds: CD4 Th CELLS (bigger – 2 – MHC with smaller – 4 – CD) 942. Why do CD8 lymphocytes respond to antigen associated with MHC-1 The function of the class I MHC is to display intracellular proteins to cytotoxic T cells (CTLs); however, class I MHC can als o present peptides generated from exogenous proteins, in a process known as cross-presentation. A normal cell will display peptides from normal cellular protein turnover on its class I MHC, and CTLs will not be activated in response to them due to central and peripheral tolerance mechanisms; when a cell expresses foreign proteins, such as after viral infection, a fraction of the class I MHC will display these peptides on the cell surface; consequently, CTLs specific for the MHC:peptide complex will recognize and kill presenting cells. 943. For immunization, what do you inject in a toxigenic infection: TOXOID (antitoxin would be used in treatment) 944. What is incorporated in the cell membrane of nerve cells: SPHINGOMYELIN, WHICH ALSO CONTAINS LECITHIN Sphingomyelin (SPH) is a type of sphingolipid found in animal cell membranes, especially in the membranous myelin sheath that surrounds some axons. It usually consists of phosphocholine and ceramide, or a phosphoethanolamine head group; therefore, sphingomyelins can also be classified as sphingophospholipids. In humans, SPH represents ~85% of all sphingolipids, and typically make up 10–20 mol % of plasma membrane lipids.

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945. Action of norepinephrine on heart rate:  HR 946. Action of norepinephrine on the force of contraction:  the force Norepinephrine also causes vasoconstriction →  blood pressure 947. Action of beta blokers on the heart and respiration: BRONCHOCONSTRICTION, NEGATIVE INOTROPY, NEGATIVE CHRONOTROPY Since its going to act on B receptors, it is going to reverse the effect of what they usually do (B1 which increases heart rate will cause it to decrease, B2 which causes dilation of bronchioles, smooth muscles, increase glucose hepatic uptake - all will be decreased)

Definition

Classification

Examples

Origin

Inotropic

Chronotropic

Dromotropic

Affects the force of contraction

Affects the heart rate

Affects conduction velocity

“+”: strengthens “-“: weakens

“+”: accelerates “-“: slows down

“+”: speeds up “-“: slows down

“+”: dopamine, adrenaline “-“: labetalol and propanolol

“+”: adrenaline “-“: digoxin

“+”: phenytoin “-“: verapamil

in- = fibre / sinew

chrono = time tropos = a turn

dromos = running, a course, a race

948. Immediately distal to terminal bronchiole: RESPIRATORY BRONCHIOLE / CUBOIDAL CELLS 949. What is present in the epithelium of microvilli: MICROFILAMENTS, SIMPLE COLUMNAR CELLS WITH GOBLET CELLS 950. Where does lamina propria attach directly to the periosteum: ATTACHED GINGIVA (also hard palate) Junction between epithelium and lamina propria is more visible than between lamina propria and submucosa.

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951. Hemidesmosomes are present in: THE BASAL LAMINA / STRATUM BASALE

952. Intracellular connection between two cells that allows them to communicate: GAP JUNCTION (nexus, macula communicans) 953. Which cell-cell junction is the most resistant passage of communication between cells: ZONULA OCCLUDENS (thight junction) 954. Which nerve won’t be directly affected if there was an infection in cavernous sinus: OPTIC NERVE Affected first would be CN VI (abducens; it’s in the middle of cavernous sinus, whereas the rest are on the periphery).

955. Protein bodies in Parkinson disease are called: LEWY BODIES 956. Late symptom of Parkinson disease: RIGIDITY (also dementia) Parkinson disease: TRAP → tremor (at rest), rigidity, akinesia, postural instability 957. When the dentin become sclerotic: AFTER INJURY / WITH AGE 958. Type I collagen is a main constituent of all of the above except: ENAMEL 959. Collagen structure: TRIPLE HELIX Each helix is left-handed, makes 30% of the whole-body protein content, quaternary structure stabilized by hydrogen bonds, has 3.3 residues per turn, Gly-Pro-X or Gly-X-Hyp. Gly: 1/3 (every third AA is glycine) Pro/Hyp: 1/6 960. In bruxism which cusps are flattened: WORKING CUSPS 961. In bruxism, which surfaces show attrition: OCCLUSAL (due to attrition contacts become “area to area”)

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962. Myasthenia gravis testlet, dysphagia – problem with which muscles: PALATOGLOSSUS, STYLOPHARYNGEUS, ORBICULARIS ORIS, PALATOPHARYNGEUS, TENSOR VELI PALATINI, LATERAL PTERYGOID MUSCLE

963. SABE is a sequel (an after effect of a disease) of: RHEUMATIC FEVER SABE = Subacute Bacterial Endocarditis Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops 2-4 weeks after a streptococcal throat infection. Signs and symptoms: fever, multiple painful joints, occasionally a non-itchy rash (erythema marginatum). The heart is involved in about 50% of cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves. Rheumatic fever may occur following an infection of the throat by the bacterium Streptococcus pyogenes. If the infection is untreated rheumatic fever can occur in up to 3% of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Other risk factors include malnutrition and poverty. Diagnosis of RF is based on the presence of signs and symptoms in combination with a recent streptococcal infection. Treating people who have strep throat with antibiotics, such as penicillin, decreases the risk of developing rheumatic fever. In order to avoid antibiotic misuse this often involves testing people with sore throats for the infection, which may not be available in the developing world. Other preventive measures include improved sanitation. In those with rheumatic fever and rheumatic heart disease, prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or valve repair is required. Otherwise complications are treated as per normal. Rheumatic fever occurs in about 325,000 children each year and about 33.4 million people currently have rheumatic heart disease. Those who develop RF are most often between the ages of 5 and 14, with 20% of first-time attacks occurring in adults. The disease is most common in the developing world and among indigenous peoples in the developed world. In 2015 it resulted in 319,400 deaths down from 374,000 deaths in 1990. Most deaths occur in the developing world where as many as 12.5% of people affected may die each year.

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964. Maxillary sinuses drain into: MIDDLE MEATUS

965. Adenoids removed due to upper airway obstruction, present where: NASOPHARYNX OPENING AT CHOANCHA

966. Patient with night bruxism, which muscle is painful: MASSETER (or temporalis) 967. More abundant SER with Golgi apparatus is found: IN CELLS PRODUCING STEROIDS 968. Testlet with a patient with Parkinsons disease: while performing RCT on MX 2 nd molar the patient moved and the dentist penetrated the cheek with a handpiece, pulsating blood flow was seen, which structure was involved: BUCCAL ARTERY 969. Nerve exiting from stylomastoid foramen was damaged, which muscles were affected: ORBICULARIS ORIS (facial expression muscles due to CN VII injury) 970. A broad facet is present on the outer side of MX lingual surface on the left side; caused due to: LEFT LATEROTRUSIVE MOVEMENT (WORKING SIDE)

971. Cusp height in a cast restoration is least affected by: INTERCONDYLAR DISTANCE 972. The  the condylar guidance: THE  CUSP HEIGHT 973. Mechanism of filling the lungs with air: INTRATHORACIC PRESSURE , SO THE AIR FLOWS INTO THE LUNGS

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974. 975. 976. 977.

Shock and cor pulmonale: GI BLEEDING (???) Ligament active during protrusion: STYLOMANDIBULAR Ligament active while yawning: OBLIQUE FIBERS OF TM LIGAMENT Which ligaments prevent protrusion, excessive opening, yawing

Collateral ligaments (medial and lateral): - "discal ligaments" - arise from the periphery of the disc, attached to the medial and lateral poles of the condyle respectively - stabilize the disc on the top of the condyle - allow the disc to move with the condyle - restrict movement of the disc away from the condyle during function - responsible for hinging movement of the TMJ - composed of collagenous CT, thus they do not stretch – strain produces pain - innervated, supplied with blood Capsular ligament: - surrounds the entire joint, retains the synovial fluid - resist medial, lateral or inferior forces - well innervated → proprioceptive feedback of the joint (its’ position and movement) TM ligament (lateral): - the main stabilizing ligament of the TMJ - from lateral surface of the zygomatic arch and a tubercle on its lower border, directed obliquely downward and backward to insert into the posterior border and lateral surface of the neck of the mandible - restricts downward and posterior movement and guides the forward motion of the condyle during opening - outer oblique portion → excessive drooping of the condyle, limits mouth opening - inner horizontal portion → limits posterior movement Sphenomandibular ligament: - accessory ligament - attached to the lingula of the mandible - does not have any significant limiting effects Stylomandibular ligament: - accessory ligaments - attached at the angle of the mandible - limits excessive protrusive movements of the mandible 978. Which component of adrenal gland had steroid producing fat cells in it: ZONA RETICULARIS Z. glomerulosa Z. fasciculata Z. reticularis

mineralo glucocortico androgens

aldosterone cortisol largest, lipid droplets, mitochondria, SER DHEA, androstenedione lipofuscin pigment

GFR: G = salt, F = sugar, R = sex 979. 980. 981. 982. 983. 984.

Erosion on MX teeth (lingual surfaces) due to: BULIMIA Square-shaped premolar: MN 2nd PREMOLAR Premolar with the same lingual and buccal cusp height: MX 2nd PREMOLAR MX 2nd premolar has more rounded outline when compared to MX 1st premolar: TRUE Mesial view of MN canine: STRAIGHT Incisal view of MX canine: DIAMOND Buccal aspect of the crown: pentagonal

985. Contact point on the mesial of MX lateral incisor: JUNCTION (between incisal 1/3 & middle 1/3) 986. Congenital missing tooth: MN 3rd molar > MX 3rd molar > MX lateral incisor > MN 2nd premolar

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987. Tooth difficult to restore: MESIAL MX 1st PREMOLAR & DISTAL MX 1st MOLAR; PALATALLY MX LATERAL INCISOR 988. MX premolar, cusp offset to distal in table form: BUCCAL CUSP (MX 1st premolar) 989. MN incisors comprasion Central: more symmetrical, minimal distal & mesial bulge of the crown, proximal contacts on the same level mesially & distally, smaller than lateral incisor Lateral: less symmetrical crown, obvious bulge of the crown, crown tilted distally, mesial proximal contact is more incisal, larger than central incisor 990. 991. 992. 993. 994.

Cusp height and fossa depth are not influenced by: INTERCONDYLAR DISTANCE Primary teeth lack: MAMELONS & ROOT TRUNKS Primary 1st molar has no groove on the buccal surface and has a groove on the lingual surface: TRUE Primary molar below the plane of occlusion, the permanent tooth hasn’t erupted: ABSCENSE OF THE PERMANENT TOOTH BUD Mesiolingual cusp of MX tooth & distobuccal cusp of MN tooth: MEDIOTRUSIVE MOVEMENT

ML cusp of MX molar & DB cusp of MN molar are in the cusp-fossa relationship. During mediotrusive movement, ML cusp of MX molar → DB groove & DB cusp of MN molar → ML cusp 995. Cross-bite, class III, MN lateral incisor contacts: MX LATERAL INCISOR CONTACTS MN LATERAL & CANINE ON RETRUSION IN A CLASS III ANTERIOR CROSS-BITE (???) 996. Largest cusp of MX molars: ML FOR PERMANENT MX MOLARS; MB in primary (MB > ML > DB > DL) 997. Cusp of Carabelli: ML 998. Oblique ridge connects: ML TO DB CUSPS 999. Class V cavity from mesial to distal on MX 2nd molar, facial surface, where are the proximal contacts & height of contour: MIDDLE THIRD & CERVICAL THIRD What we need to take under consideration while rebuilding lost tissues in a class V cavity: - proximal contacts on MX 2nd molar: MIDDLE THIRDS (both mesially & distally) - height of contour on MX 2nd molar, facially: CERVICAL THIRD 1000. Accessory muscles of mastication that depress the mandible: SUPRAHYOID GROUP 1001. Condylar disc is stabilized by: SUPERIOR HEAD OF LATERAL PTERYGOID 1002. Are not functions of lateral pterygoid: ELEVATION & RETRUSION 1003. Anesthesia for MX 1st molar: POSTERIOR SUPERIOR ALVEOLAR NERVE, MIDDLE SUPERIOR ALVEOLAR NERVE, GREATER PALATINE NERVE 1004. Innervation of MX 2nd molar, palatal: GREATER PALATINE NERVE 1005. Pancreas & liver are affected by: HEMOCHROMATOSIS (occurs in the bone marrow, spleen & liver) This build-up of iron can cause unpleasant symptoms. If it isn't treated, this can damage parts of the body such as the liver, joints, pancreas and heart. Haemochromatosis most often affects people of white north European background and is particularly common in countries where lots of people have a Celtic background, such as Ireland, Scotland and Wales. 1006. The cause of thrombosis: INFRACTION 1007. Transformation of the tumor, meaning: DIFFERENT TUMOR AT THE SAME SITE 1008. Acetyl-CoA is not synthesized by: ADENOSINE 1009. Muscle not innervated by CN IX: STYLOPHARYNGEUS 1010. Ketogenic AA: LYSINE & LEUCINE 1011. Lung cancer: LINING EPITHELIUM OF TRACHEA-BRONCHIAL TREE 1012. Most common place to find lung cancer: SCC → BRONCHIAL, CIGARETTE SMOKING → PARABRONCHIAL 1013. Air left in the lungs after expiration: RESIDUAL VOLUME 1014. Chronic smoking with increased mucus: COPD (Chronic Obstructive Pulmonary Disease) 1015. Not the cause of cancer: ANTHRACOSIS Anthracosis: accumulation of carbon in the lungs due to repeated exposure to air pollution or inhalation of smoke or coal dust particles. 1016. Nucleic acid analogue in therapy of: HEPATITIS 1017. Inferior joint space in TMJ: ROTATION; CONDYLAR HEAD & DISC

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1018. Death due to infraction after 24h: COAGULATION NECROSIS (not sure about the logic of that answer, check #264) Evolution of MI 1st day: coagulative necrosis within the first 24h leads to release of contents of necrotic cells into the bloodstream, beginning of neutrophil emigration. 2-4 days: neutrophil emigration, the muscle shows an extensive coagulative necrosis 5-10 days: macrophages & neutrophils 7 weeks: infract healed by organization 1019. Splanchnic nerves: PRESYNAPTIC 1020. Preganglionic sympathetic nerve cell origin: INTERMEDIOLATERAL GREY COLUMN OF THORACIC & LUMBAR VERTEBRAE

1021. Cigarette smoking do not cause: ACUTE RESPIRATORY DISTRESS SYNDROME Acute respiratory distress syndrome (ARDS) is a rapidly progressive disease occurring in critically ill patients. The main complication in ARDS is that fluid leaks into the lungs making breathing difficult or impossible. 1022. Articular disc develops from: 1st PHARYNGEAL ARCH → MECKEL’S CARTILAGE 1023. TMJ develops from: 2nd PHARYNGEAL ARCH → REICHERT’S CARTILAGE 1024. Thymus, origin: 3rd PHARYNGEAL POUCH 1025. Respiratory center characteristics: SQUAMOUS EPITHELIUM; LOCATED IN THE BRAINSTEM, PONS & MEDULLA; 4 GROUPS: INSPIRATORY, EXPIRATORY, PNEUMOTAXIC, APNEUSTIC

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1026. Parathyroid blood supply: INFERIOR THYROID ARTERY

1027. Lesion derived from epithelial cells: BONE, DENTIN, CEMENTUM, PDL, ENAMEL 1028. Receptor of salt: IONIC RECEPTOR 1029. Pyrimidine dimer is broken down by which enzyme: EXONUCLEASE 1030. Cancer do not involve: DYSPLASIA 1031. Bonds in an alpha helix conformation in a protein chain: HYDROGEN BOND 1032. Biotin: PYRUVATE CARBOXYLASE; FA SYNTHESIS Only four enzymes in humans require biotin: - pyruvate carboxylase - propionyl-CoA carboxylase - acetyl-CoA carboxylase - methylcrotonyl-CoA carboxylase 1033. Infective endocarditis due to: RHEUMATIC FEVER 1034. All permanent teeth replace primary teeth, except: MOLARS 1035. Mediotrusive movement, what is the condyle position: DOWNWARD & MEDIAL & ANTERIOR 1036. Niacin deficiency: PELLAGRA Pellagra, literally meaning “rough skin” 4 x “D” • Dermatitis • Diarrhea • Dementia • Death 1037. Submental lymph nodes collect the lymph from which teeth: MANDIBULAR INCISORS 1038. Bacteria of the oral cavity: FERMENTATION 1039. Why polymyxin B is given only in fungal infections, not bacterial: BINDS TO ERGOSTEROL IN THE FUNGAL WALL 1040. Parasympathetic activity of the heart:  HEART RATE 1041. Increased blood pressure, baroreceptor’s action will inhibit: SYMPATHETIC (AND INCREASE PARASYMPATHETIC) Stretch receptors are found in carotid sinus (baroreceptors!). Stimulation leads to decreased heart rate, decreased arterial blood pressure and decreased venous return, activation of parasympathetic nervous system and inhibition of sympathetic to drop BP. Increased pressure in the carotid sinus increases the discharge of efferent fibers that travel in the CN IX.

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1042. Medulla is sensitive to: HYDROGEN IONS When PCO2 goes up, also increases H+ because CO2 + H2O forms carbonic acid, which then disassociates to H +. 1043. GTP action: ACTIVATE AND INACTIVATE ADENYL CYCLASE OR CLEAVED BY PROTEASOME

1044. Fungus that resemble TB: HISTOPLASMOSIS 1045. Filaments of a fungus: MYCELIUM Mycelium is the vegetative part of a fungus or fungus-like bacterial colony, consisting of a mass of branching, thread-like hyphae. 1046. Lymph from anterior part of the skin drains to which superficial lymph nodes: SUBMANDIBULAR The superficial lymph nodes of the head and neck receive lymph from the scalp, face and neck. They are arranged in a ring shape; extending from underneath the chin, to the posterior aspect of the head. They ultimately drain into the deep lymph nodes. • Occipital: There are usually between 1-3 occipital lymph nodes. They are located in the back of the head at the lateral border of the trapezius muscle and collect lymph from the occipital area of the scalp. • Mastoid: There are usually 2 mastoid lymph nodes, which are also called the post-auricular lymph nodes. They are located posterior to the ear and lie on the insertion of the sternocleidomastoid muscle into the mastoid process. They collect lymph from the posterior neck, upper ear and the back of the external auditory meatus (the ear canal). • Pre-auricular: There are usually between 1-3 pre-auricular lymph nodes. They are located anterior to the auricle of the ear, and collect lymph from the superficial areas of the face and temporal region. • Parotid: The parotid lymph nodes are a small group of nodes located superficially to the parotid gland. They collect lymph from the nose, the nasal cavity, the external acoustic meatus, the tympanic cavity and the lateral borders of the orbit. There are also parotid lymph nodes deep to the parotid gland that drain the nasal cavities and the nasopharynx. • Submental: These lymph nodes are located superficially to the mylohoid muscle. They collect lymph from the central lower lip, the floor of the mouth and the apex of the tongue. • Submandibular: There are usually between 3-6 submandibular nodes. They are located below the mandible in the submandibular triangle and collect lymph from the cheeks, the lateral aspects of the nose, upper lip, lateral parts of the lower lip, gums and the anterior tongue. They also receive lymph from the submental and facial lymph nodes. • Facial: This group comprises the maxillary/infraorbital, buccinator and supramandibular lymph nodes. They collect lymph from the mucous membranes of the nose and cheek, eyelids and conjunctiva. • Superficial Cervical: The superficial cervical lymph nodes can be divided into the superficial anterior cervical nodes and the posterior lateral superficial cervical lymph nodes. The anterior nodes lie close to the anterior jugular vein and collect lymph from the superficial surfaces of the anterior neck. The posterior lateral nodes lie close to the external jugular vein and collect lymph from superficial surfaces of the neck.

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1047. Secondary hypertension, renal cause: RENAL ARTERY STENOSIS 1048. Athrematous plaque in renal artery is caused by: ATHEROSCLEROSIS & CAUSE SECONDARY HYPERTENSION If renal artery is occluded, you will get secondary HTN – kidney thinks blood volume is low, so it tries to compensate and you end up with HTN.
 An atheroma is a reversible accumulation of degenerative material in the inner layer of an artery wall. The material consists of mostly macrophage cells, or debris, containing lipids, calcium and a variable amount of fibrous CT. The accumulated material forms a swelling in the artery wall, which may intrude into the channel of the artery, narrowing it and restricting BF. Atheroma occurs in atherosclerosis. In the context of heart or artery matters, atheromata are commonly referred to as atheromatous plaques. It is a pathological condition found in most humans. 1049. Opsonized bacteria: EASY TO PHAGOCYTE 1050. Toxoid vaccine for: TETANUS Toxoids are antigenic and non-toxic, most often prepared by treating toxins with formaldehyde. They consist of weakened bacterial toxins that are no longer toxic but do induce antibodies production. 1051. Vaccinia not cure molluscum contaginosum? SMALL POX Vaccinia is a vaccine which is effective against small pox, but not effective against molluscum. Small pox vaccine: live attenuated Molluscum contaginosum: no vaccine 1052. Gamma carboxyl glutamate in blood clotting binds to: CALCIUM 1053. After surgery the patient is not able to speak, which nerve was affected: RECURRENT & TRANSVERSE LARYNGEAL The recurrent laryngeal nerves control all intrinsic muscles of the larynx except for the cricothyroid muscle. These muscles act to open, close, and adjust the tension of the vocal cords, and include the posterior cricoarytenoid muscles, the only muscle to open the vocal cords. 1054. After the surgery the patient develops tetany: HYPOPARATHYRODISM 1055. MO and DO preparations instead of one MOD preparation are done in: MX 1st MOLAR & MN 1st PM MN 1st premolar: very prominent transverse ridge in the middle with mesial & distal fossae on the sides (“snake eyes”) MX 1st molar: prominent oblique ridge 1056. Groove from mesial pit to central pit in MX molar: CENTRAL GROOVE 1057. Linguogingival groove is found in: MX LATERAL INCISOR 1058. Mandibular premolar: 3 PITS; 2nd PREMOLAR IS THE ONLY PREMOLAR WITH 5 DEVELOPMENTAL LOBES 1059. MN premolar, cusps from biggest to smallest: B > ML > DL 1060. Primary MX canine, outline of the facial surface: ARROW-SHAPED, PENTAGONAL 1061. Primary MX canine, outline of the incisal surface: DIAMOND 1062. Which primary tooth looks like a diamond: CANINE 1063. Which tooth has its long axis oriented most vertically: MX 1st PREMOLAR 1064. A tooth with three canals: MN MOLARS 1065. MN canine, 3 different configurations: 1 ROOT CANAL, 1 ROOT & 2 CANALS, 2 ROOTS & 2 CANALS 1066. Broken filling (ML cusp) of MX tooth, due to: MEDIOTRUSIVE MOVEMENT 1067. Tooth with one pulp horn: CANINE & MN 1st PREMOLAR 1068. Arbovirus: INSECT VECTOR 1069. Not transmitted by vectors: RICKETTSIA → Q FEVER 1070. Endogenous spread: E. COLI, STREPTOCOCCUS, ACTINOMYCES 1071. HIV associated diseases: NECROTIZING ULCERATIVE GINGIVITIS, PERIODONTAL DISEASE, CANDIDIASIS, HAIRY LEUKOPLAKIA, KAPOSI SARCOMA 1072. HIV lymphoma: KAPOSI SARCOMA, PRIMARY LYMPHOMA OF THE BRAIN, NON-HODGKIN’S LYMPHOMA 1073. Denture stomatitis: CANDIDIASIS 1074. Cardiac problem, BP medication for: TACHYCARDIA (B-BLOCKERS) 1075. Sharpest incisal angle: MN CENTRAL INCISOR (MESIAL ANGLE)

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1076. Most concave side of MX canine: DISTAL 1077. Fungi in the mouth: CANDIDA 1078. Dimorphism in: HISTOPLASMOSIS, BLASTOMYCOSIS, COCCIDIOIDES, CANDIDA 1079. Action on macrophages on T-cells: MACROPHAGES EXPRESS MHC-2 & ATTRACT Th CELLS, WHICH IN TURN ACTIVATE MACROPHAGES FOR PHAGOCYTOSIS TO RELEASE CYTOKINES 1080. Lower compartment of TMJ: INFERIOR AREA OF THE DISC & SUPERIOR AREA OF THE CONDYLE 1081. Sphenomandibular ligament (internal lateral ligament) origin from: SPINE OF THE SPHENOID BONE

1082. Difference between cellular & acellular cementum: LACUNAE 1083. Secondary cementum: CELLULAR Acellular Formed first Cervical 1/3 or 1/2 of the root Does not contain cells Formed before the tooth reaches the occlusal plane More calcified Sharpey’s fibers are the main component, which insert at approximately right angles onto the root surface Rate of the development is faster Incremental lines are wide apart

Cellular Formed second Mainly in the apical 1/3 Cementocytes in lacunae Formed after the tooth reaches the occlusal plane Less calcified Sharpey’s fibers occupy smaller portion, other fibers are present, arranged parallel to the root surface Rate is slower Lines are closer

1084. Carotid sinus function: CONTROLLING BP 1085. Hyperkalemia in: RESPIRATORY ACIDOSIS, METABOLIC ACIDOSIS (DIARRHEA), DIABETIC KETOACIDOSIS 1086. Which branch of ECA isn’t covered by carotid sheath: SUPERFICIAL TEMPORAL ARTERY 1087. Varicose veins arise from: SUPERFICIAL VEINS 1088. Thumb nerve supply: RADIAL & MEDIAN NERVE 1089. Palm, thumb area innervation: MEDIAN NERVE 1090. Pain nucleus: PARS INTERPOLARIS 1091. Crista galli: FLAX CEREBRI

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1092. Bacteria inhibiting an inhibitor: ANTIBIOTIC RESISTANT (CONTAINS BETA-LACTAMASE) Beta-lactamases are a family of enzymes involved in bacterial resistance to beta-lactam antibiotics. They act by breaking the betalactam ring that allows penicillin-like antibiotics to work. 1093. Yellowish residue in the corner of the mouth: ANGULAR CHEILITIS / CHEILITIS EXFOLIATIVA

1094. Mucogingival junction: ALVEOLAR MUCOSA + ATTACHED GINGIVA 1095. Col location: INTERDENTAL PAPILLAE 1096. Partial bone healing (woven bone) by how many weeks: 1-3 WEEKS 1097. Silicosis can be misdiagnosed with: TB Silicosis (previously miner's phthisis, grinder's asthma, potter's rot and other occupation-related names) is a form of occupational lung disease caused by inhalation of crystalline silica dust and is marked by inflammation and scarring in the form of nodular lesions in the upper lobes of the lungs. It is a type of pneumoconiosis. Silicosis (particularly the acute form) is characterized by shortness of breath, cough, fever, and cyanosis (bluish skin). It may often be misdiagnosed as pulmonary edema (fluid in the lungs), pneumonia, or tuberculosis. May lead to mesothelioma: is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs. 1098. Melanocytes: STRATUM BASALE 1099. Too much acetylocholine will cause:  HEART RATE 1100. Most likely to have three cusps: MX 3rd MOLAR, MN 2nd PREMOLAR 1101. Shape of the root of MX canine: CONICAL 1102. Allows bacteria to stick together: GLUCOSYLTRANSFERASE 1103. Ascorbic acid acts on which enzyme: LYSYL OXIDASE OR HYDROXYPROLINE DEHYDROGENASE 1104. Daughter cells multiplication occurs mostly in: M PHASE 1105. Mandible deviation to the left due to injury of lateral pterygoids, which movement occurs: RIGHT TRANSLATION → MANDIBLE MOVES TO THE AFFECTED SIDE Left side damage, left lateral pterygoid is not working. Movement of right lateral condyle causes mandible to move to left and hence translation on right. 1106. Depression is due to: DROP IN SEROTONIN 1107. Does not cause fatty liver: APOXIA (altitude sickness) / SEPTICEMIA 1108. Difference between MN central incisor and lateral incisor: DISTOLINGUAL TWIST (LI) 1109. The main mineral in bones is: HYDROXYAPATITE 1110. Polyenes are selective for fungal treatment, because: THEY BIND ERGOSTEROL IN THE FUNGAL MEMBRANE Polyene antimycotics, sometimes referred to as polyene antibiotics, are a class of antimicrobial polyene compounds that target fungi. These polyene antimycotics are typically obtained from some species of Streptomyces bacteria. The polyenes bind to ergosterol in the fungal cell membrane and thus weakens it, causing leakage of K+ and Na+ ions, which may contribute to fungal cell death. Amphotericin B, nystatin, and natamycin are examples of polyene antimycotics. They are a subgroup of macrolides. 1111. Basophilia in: MYELOPROLIFERATIVE DISEASE, CML 1112. Basophilic organelle: RER The structures usually stained are those that contain negative charges, such as the phosphate backbone of DNA in the cell nucleus and ribosomes.

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1113. ML developmental groove: MESIAL OF MN 1st PREMOLAR 1114. All of these microglia are present in CNS except: SCHWANN CELLS (in PNS) 1115. Oral contraceptives: LH DECREASES (prevent LH surge) 1116. Biosynthesis of cholesterol: SQUALENE 1117. Truncated (shorten by cutting off the top or the end) cells in the kidney: PROXIMAL CT 1118. Face formation: 1st & 2nd PHARYNGEAL ARCHES 1119. Size of the mouth is defined by: MX & MN PROCESSES UNION 1120. Which cross-section is the biggest in a FL diameter: MX CANINE 1121. Which enzyme is associated with phosphorylation of ADP at the substrate level: PRUVATE KINASE 1122. Which disease is most often characterized by hyphae growing in and around the vessels: MUCORMYCOSIS 1123. Preganglionic sympathetic fibers to the head have their cell bodies of origin in the: INTERMEDIOLATERAL HORNS OF THE THORACIC SPINAL CORD 1124. Bifid tongue: LATERAL SWELLINGS FAIL TO FUSE 1125. Which are not standard AA: SELENOCYSTEINE, HYDROXYLYSINE & PYRROLYSINE There are 20 standard AA that builds proteins. Among those, we have 9 essential & 11 nonessential AA. 1126. Class II occlusion, patient retruded, MX canine oppose which teeth: NO CONTACTS On protrusion it will contact MX canine and 1st premolar. 1127. Enlargement of a lymph node due to: INFECTION 1128. Parotid & submandibular innervation 1129. Somatostatin: D CELLS OF THE PANCREAS & FROM THE HYPOTHALAMUS; INHIBIT GH, INSULIN, GLUCAGON, TSH 1130. Metastatic tumor with Virchow’s nodes indicates a primary cancer of: GASTRIC CANCER Virchow's node, or Troisier's node, refers to carcinomatous involvement of the supraclavicular nodes at the junction of the thoracic duct and the left subclavian vein. Usually, nodal enlargement is caused by metastatic gastric carcinoma, although supraclavicular nodal involvement can also be seen in other gastrointestinal, thoracic, and pelvic cancers. Gastric cancers tend to metastasize to this region by means of migration of tumor emboli through the thoracic duct, where subdiaphragmatic lymphatic drainage enters the venous circulation in the left subclavian vein. 1131. ADH promotes the retention of water by: INCREASING AQUAPORINS IN COLLECTING DUCT 1132. The advantage of dry heat: DOESN’T CAUSE CORROSION OF METAL INSTRUMENTS 1133. The result of exon activity: CHANGES DNA SEQUENCE, REVERSE TRANSCRIPT, MISSENSE, NONSENSE 1134. Eagle’s syndrome: STYLOHYOID SYNDROME Eagle syndrome (stylohyoid syndrome, styloid syndrome, styloid-stylohyoid syndrome or styloid–carotid artery syndrome) is a rare condition commonly characterized but not limited to - sudden, sharp nerve-like pain in the jaw bone and joint, back of the throat, and base of the tongue, triggered by swallowing, moving the jaw, or turning the neck. Since the brain to body's nerve connections pass through the neck; many seemingly random symptoms can be triggered by impingement or entanglement. The condition is caused by an elongated or misshapen styloid process, the slender, pointed piece of bone just below the ear, and/or calcification of the stylohyoid ligament, which interferes with the functioning of neighboring regions in the body, giving rise to pain. Possible symptoms include: • Sharp, shooting pain in the jaw, back of the throat, base of the tongue, [1] ears, neck, and/or face • Difficulty swallowing • Sensation of having a foreign object in throat • Pain from chewing, swallowing, turning the neck, or touching the back of the throat • Ringing or buzzing in the ears Classic eagle syndrome is present on only one side, however, rarely, it may be present on both sides. In vascular Eagle syndrome, the elongated styloid process comes in contact with the internal carotid artery below the skull. In these cases, turning the head can cause compression of the artery or a tear inside the blood vessel, which restricts BF and can potentially lead to a transient ischemic attack (TIA) or stroke. 1135. Function of the masseter: SLING MUSCLE, ELEVATION OF THE MANDIBLE, STRONGEST MUSCLE OF MASTICATION 1136. Cranial nerves with parasympathetic function: III, VII, IX, X 1137. Clogged ears can be caused by a restricted function of: TENSOR VELI PALATINI OR SALPINGOPHARYNGEUS

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1138. Blood and nerve supply to the larynx All muscles of the larynx are supplied by recurrent laryngeal nerve (except: cricothyroid by external branch of superior laryngeal nerve). Blood supply is provided by superior & inferior laryngeal arteries. 1139. Structures in the pterygopalatine fossa: PTERYGOPALATINE GANGLION

1140. Function of aryepiglottic fold: PHONATION (located at the entrance of larynx), CLOSETS THE INLET, PREVENTS FOOD FROM ENTERING THE AIRWAY 1141. Steroid hormones: ESTROGEN & PROGESTERONE (OVARIES), ADRENAL CORTEX HORMONES 1142. Transports FA: ALBUMIN 1143. IL-2: PRODUCED BY T CELLS, ATTRACT MORE T CELLS 1144. Protection against hepatitis B: VACCINE; WHEN CONCENTRATION OF IgG IN SERUM IS HIGH 1145. Viremia: VIRUS STARTS RULING IN THE BLOOD 1146. Dry heat sterilizes by: KILLING THE SPORES 1147. Edema may result from: HYPERTENSION 1148. Primary molars lack: MAMELONS 1149. Muscle protein caused increase blood glucose level the released alanine cause: LIVER TO PRODUCE GLUCOSE, MUSCLE ITSELF TO PRODUCE GLUCOSE, TRANSFER PROTEIN TO THE LIVER THAT WILL FORM THE GLUCOSE 1150. Condensed chromatin: HETEROCHROMATIN 1151. Warfarin lab test: PT & INR 1152. Histamine is produced by: OXYNTIC GLANDS Oxyntic glands mainly produce pepsinogen, histamine, and HCl. Pyloric glands mainly produce mucus and gastrin. 1153. Similarity between MX 1st and 2nd premolar: TRAPEZOIDAL PROXIMAL SHAPE 1154. Pain from teeth on the right side: LEFT PARIETAL LOBE The spinal trigeminal nucleus (nucleus of fascial pail) cross over the contralateral VPM and then to the parietal lobe. In case of normal sensation, it’s the right lobe, because the main sensory nucleus will not cross over, so it’s ipsilateral. 1155. Ear is developed from which arch pouch: 1st PHARYNGEAL CLEFT 1156. Glossopharyngeal muscle: 3rd PHARYNGEAL ARCH 1157. All of the following are innervated by the glossopharyngeal nerve except: PALATOGLOSSUS Palatoglossus is the only muscle of the tongue that is not innervated by the hypoglossal nerve (CN XII). It is innervated by the vagus nerve (CNX). 1158. Dextran: ALPHA-1,6 GLYCOSIDIC BODNS (BRANCHES AT ALFA-1,3)

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1159. Microorganism on the surface of the tongue: STREP. SALIVARIUS 1160. MOA of digitalis compounds (cardiac glycosides): BLOCKS Na+/K+ ATPASE By inhibiting the Na+/K+-ATPase, cardiac glycosides cause intracellular sodium concentration to increase. This then leads to an accumulation of intracellular calcium via the Na+-Ca++ exchange system. In the heart, increased intracellular calcium causes more calcium to be released by the sarcoplasmic reticulum, thereby making more calcium available to bind to troponin-C, which increases contractility (inotropy). Inhibition of the Na +/K+-ATPase in vascular smooth muscle causes depolarization, which causes smooth muscle contraction and vasoconstriction. 1161. Replacement of a human organ with a pig organ: XENOGRAFT 1162. Patient is hyperventilating in the dental chair, what can be a result of that: RESPIRATORY ALKALOSIS 1163. Sound in the ear: AMPLITUDE 1164. Brown color, 1 cm x 1 cm sized nodule, near the nose: MELANOMA 1165. Increase in serum phosphatase and alkaline levels: PROSTATE CARCINOMA 1166. What is the least indicator for risk prognosis of breast cancer: LATE MENARCHE 1167. DNA fingerprinting, restriction sites: PALIDROME ARE THE SITES WHERE THE DNA IS CUT & THE ENZYME USED IS A RESTRICTION ENDONUCLEASE 1168. Brain lobe in the mid-cranium: TEMPORAL LOBE

1169. Decrease in O2 will stimulate: PERIPHERAL CAROTID & AORTIC BODIES 1170. Edema can be caused by: PULMONARY LEFT HEART FAILURE, PERIPHERAL RIGHT HEART FAILURE, INCREASED CAPILLARY HYDROSTATIC PRESSURE, INCREASED INTERSTITIAL ONCOTIC PRESSURE 1171. Precursor of urea: ARGININE 1172. Carbamoyl phosphate, citrulline, aspartate and ammonia are sources of nitrogen derived from: UREA CYCLE 1173. Cholesterol formation de novo: HMG CoA REDUCTASE 1174. Patient didn’t get anaesthetized anted blocked: PTERGOID PLEXUS (?) 1175. Upon taking a panoramic picture of the patient’s mouth, what obscure the TMJ disc: SUPERIMPOSITION OF THE CONDYLE TMJ disc is cartilage so it doesn't appear in panoramic and looks like radiolucent so bony structure of TMJ will cover it. 1176. Growth of the bone in a scar: OSSEOUS METAPLASIA 1177. The main cause of pulmonary congestion: LEFT HEART FAILURE 1178. Secretion phase: LUTEAL PHASE 1179. Parasympathetic fibers to the parotid gland: LESSER PETROSAL BRANCH OF CN IX

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1180. Prostate cancer: PROSTATE SPECIFIC ANTIGEN AND  IN ACID PHOSPHATASE 1181. Iron storage in the body: FERRITIN 1182. The only function of the spinal cord in CNS: SIMPLE REFLEXES, COORDINATION OF THE MOTOR MOVEMENT, RESPIRATION 1183. Organism with a polypeptide capsule: BACILLUS ANTHRACIS 1184. All of these fungi spread from person to person, except: CANDIDA 1185. N-glutamic acid found in: THE CELL WALL 1186. Tay-Sachs disease cause: CNS DEGENERATION, DEVELOPMENTAL RETARDATION, CHERRY SPOT ON THE MACULA, RAPIDLY FATAL CONDITION 1187. Rough cocci get the DNA from soft cocci through: TRANSFORMATION 1188. Endothelial fungi: MUCORMYCOSIS 1189. Mycotic organism: MUCORMYCOSIS 1190. Longest and shortest root of the MX molar: PALATAL (LONGEST) & DB (SHORTEST) 1191. The location of the palatal canal; under what cusp: ML 1192. The mesial view of the incisal edge of MN central incisor: MMR = DDR; DI corner is as sharp as MI; INCISAL EDGE LINGUAL TO LONG AXIS (FROM PROXIMAL) 1193. Failing RCT in lower canine due to: 6% WITH 2 COMPLETE ROOT CANALS, BIFURCATED ROOT, OCASIONALLY 2 ROOTS (LABIAL & LINGUAL) 1194. Lower canine canal shape: ROUGHLY OVAL 1195. PSA to MX 2nd molar, what other nerve with the same injection could get anesthetized too: Under PSA complication: - hematoma - mandibular anesthesia → the mandibular division of the CN V3 is located to the PSA nerves. Deposition of local anesthetia lateral to the desired location may produce varying degrees of mandibular anesthetia. 1196. Root and incisal edge comparison between lower central and lateral: ROOT IS LONGER IN LATERAL, INCISAL EDGE IS TWISTED IN LATERAL (IN CENTRAL IT IS PERPENDICULAR TO B-L BISECTOR), INCISAL EDGE IS LINGUAL TO LONG AXIS IN BOTH 1197. Root completion of MX canine: 14 1198. Hypothyroidism is associated with: HASHIMOTO’S DISEASE 1199. The receptors damaged by autoantibodies in Myasthenia Gravis are: NICOTINIC The autoimmune attack occurs when autoantibodies form against the nicotinic acetylcholine postsynaptic receptors at the neuromuscular junction of skeletal muscles. 1200. The proximal contact area between MX central and MX lateral: AT JUNCTION OF INCISAL & MIDDLE THIRDS 1201. Submandibular gland innervation: CHORDA TYMPANI 1202. Disaccharide intolerance, why the patient can’t digest lactose (what is the defect exactly or why the deficiency of lactase in disaccharide intolerance) Lactose intolerance occurs when the small intestine does not make enough of an enzyme called lactase. Your body needs lactase to break down, or digest, lactose. L. Acidophilus is added to milk products to aid in digestion of them. Bacterial enzymes convert milk sugars to digestible products. 1203. What increases the action potential: A GENERATOR POTENTIAL ACTS TO INCREASE THE ACTION POTENTIAL FREQUENCY IN RESPONSE TO INCREASED STIMULUS ACTIVITY; EXTRACELLULAR Na + 1204. Carcinoma in situ: CANCEROUS CELLS DO NOT INVIDE BASEMENT MEMBRANE Carcinoma in situ (CIS), also known as in situ neoplasm, is a group of abnormal cells. While they are a form of neoplasm there is disagreement over whether CIS should be classified as cancer. This controversy also depends on the exact CIS in question (i.e. cervical, skin, breast). Some authors do not classify them as cancer, however, recognizing that they can potentially become cancer. Others classify certain types as a non-invasive form of cancer. The term "pre-cancer" has also been used.

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1205. Muscle that helps in stabilization in maximum intercuspitation: SUPERIOR HEAD OF LATERAL PTERYGOID (if disc stabilization), MASSETER (if mandible stabilization) 1206. Pitting edema: HYPOALBUMINEMIA 1207. Rheumatoid arthritis, why does it cause infective endocarditis: RHEUMATIC FEVER CAN CAUSE INFECTIVE ENDOCARDITIS; DAMAGE TO THE HEART VALVES RESULTS IN AN INCREASED RISK OF BACTERIAL ATTACHMENT - findings in the synovial fluid - rheumatoid factor - findings in endocarditis - viridians streptococci 1208. LMN defect: FACIAL PARALYSIS, IPSILATERAL 1209. Paralysis of the face muscle below zygoma, right side of the face: UPPER MOTOR NEURON

1210. Last strep of the urea cycle: CYTOSOL The urea cycle consists of 5 reactions: 2 mitochondrial and 3 cytosolic. The cycle converts two amino groups, one from NH 4+ and one from Asp, and a carbon atom from HCO3-. 1211. Form of CO2 in the blood: HCO31212. Plasma doesn’t contain: FORMED ELEMENTS 1213. Basophilia, etiology: COMMON FEATURE OF MYELOPROLIFERATIVE DISORDERS AND PARTICULARLY PROMINENT IN CML 1214. CN VII & CN VIII, what foramen: INTERNAL ACOUSTIC MEATUS 1215. TMJ is formed at: 4 – 12 WEEKS 1216. Most of the face is formed by: 1st & 2nd PHARYNGEAL ARCHES 1217. Sagittal sinus: BIGGEST CRANIAL SINUS (DURAL VENOUS SINUS) 1218. Which description is accurate about the gingiva: HIGH CONNECTIVE TISSUE PAPILLAE 1219. Big toe involved in: GOUT 1220. Production of milk: OXYTOCIN 1221. Cortisone is produced from: ZONA FASCICULATA 1222. Organ with no submucosa: GALL BLADDER (also, no muscularis mucosae there) 1223. Which of the following describe the effect of fluoride: FLUORIDE INHIBITS ENOLASE 1224. Cementum originates from: DENTAL FOLLICLE (CEMENTOBLASTS OF THE PDL) 1225. Action of the oblique fiber of TMJ ligament: PREVENTS EXCESSIVE MOUTH OPENING (#977) - oblique fibers: outer fibers, articular eminence to neck and mandible; help guide condyle during opening - horizontal fibers: deep fibers, articular eminence to lateral pole and posterior disc; limits posterior movement of condyle 1226. Contour lines of Owen (in dentin) can be analogous to: STRIAE OF RETZIUS (FOUND IN ENAMEL) 1227. Not a part of the enamel: ENAMEL SPINDLE 1228. Sympathetic effect on an eye: PUPIL DILATATION

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1229. Hard palate behind the central incisors formed by: PREMAXILLA, BY MEDIAL NASAL PROCESS 1230. An organ below/near the right kidney: COLON, LIVER, DUODENUM 1231. Epidural hematoma: MIDDLE MENINGEAL ARTERY 1232. Gout characteristic: NIGHT PAIN, SKIN ERYTHEMA, KIDNEY STONES 1233. Sudden cardiac arrest: CARDIAC TAMPONADE 1234. MOA of methotrexate: INHIBITS THE SYNTHESIS OF FOLIC ACID, WHICH IS IMPORTANT FOR THE SYNTHESIS OF PURINES AND THYMINE 1235. Aschoff bodies: RHEUMATIC FEVER 1236. Not a part of an oral epithelium: STRATUM LUCIDUM (skin of the palms, soles) 1237. All true about AIDS, except: IT IS AN OPPORTUNISTIC DISEASE 1238. Alzheimer’s characteristic: AMYLOID DEPOSITS 1239. Herpangina: THROAT, SOFT PALATE, TONGUE, ORAL LESIONS Viral disease with oral manifestations; 3 year-olds with fever, vesicles, ulcers on soft palate & larynx. 1240. Best fungal medication: AMPHOTERICIN 1241. A molecule becomes active after binding: HAPTEN, CARRIER PROTEIN 1242. If an internal carotid becomes blocked, the blood can still reach the brain via: THE VERTEBRAL ARTERIES Suboccipital triangle- deep in the triangle passes the vertebral artery and the suboccipital nerve (aka dorsal ramus of C1).

1243. The immune system fights Staph. aureus, what doesn’t contribute: GAMMA INTERFERON 1244. Last product of urea: ORNITHINE & UREA 1245. Which vitamins are important for enamel and bone: VITAMIN C, VITAMIN D For teeth: A, C, D

For bone: C, D

1246. Patient with an injury from T4, what will you be afraid of during dental treatment: BLADDER EMPTYING An injury above T12/L1 often prevents central control of the bladder function. Reflex impulses take over, causing the sphincter muscle holding urine in the bladder and the bladder itself work against each other. If bladder pressure gets too high, it can cause incontinence (leakage), or a dangerous back-up of urine into the kidneys. Treatment is usually to reduce bladder pressure with medicine and empty the bladder with clean intermittent catheterization (CIC). 1247. If the pH becomes lower than the isoelectric point of a protein, then how will the protein respond in an electrophoretic system: IT WILL MIGRATE TO THE NEGATIVE POLE

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1248. A patient has xerostomia, she licks lollipops to moist her mouth, what would the dentist recommend for her instead of this habit: CHEWING GUM 1249. A 50-year-old man comes for an orthodontic treatmet. He has an FPD on #12-#14. Need to remove the anterior abutment. What is the following is not likely to be a complication in the extraction of this tooth: ONE ROOT 1250. ATP is attached to which component of skeletal muscle: MYOSIN HEAD 1251. Nerve that don’t pass through jugular formen: CN XII (CN IX, X, XI pass) 1252. Achalasia is related to: ESOPHAGUS 1253. Submucosa found in: STOMACH, SMALL & LARGE INTESTINE 1254. Caries is most likely to develop on which anterior tooth: LATERAL MAXILARY INCISOR 1255. Blastomycosis: IN SOIL 1256. Rathke’s pouch gives rise to: ADENOHYPOPHYSIS 1257. MN premolar erupts: 10-12 YEARS, BEFORE THE COMPLETION OF THE ROOT FORMATION 1258. LMN is located: VENTRAL HORN OF THE SPINAL CORD 1259. What is the vagus nerve responsible for: CEPHALIC PHASE OF GASTRIC SECRETION 1260. Squamous epithelial metaplasia seen in: BRONCHIAL MUCOSA 1261. Keratohyalin granules seen in: STRATUM GRANULOSUM 1262. Preganglionic autonomic nerve fibers, where are they located: WHITE RAMUS COMMUNICANS 1263. When secondary cementum is built, everything is expected to occur except: BLOOD VESSELS 1264. Allosteric activation of glycolysis: cAMP, Pi, FRUCTOSE-2,6-BISPHOSPHATASE 1265. Tooth #17 has to be extracted, each of the following justifies the extraction, except: IT WOULD CAUSE THE RESORPTION OF THE DISTAL ROOT OF MN RIGHT 2nd MOLAR 1266. What will not elevate the larynx: INFRAHYOID MUSCLES 1267. IAN didn’t work, what is the cause: INJECTED INTO THE PAROTID GLAND 1268. Hyperthyroidism, rheumatoid arthritis – what is the cause: AUTOIMMUNE 1269. NE production: POSTSYNAPTIC SYMPATHETIC FIBERS 1270. Mamelons in a 17-yeard-old are a result of: MALOCCLUSION, ANTERIOR OPEN BITE 1271. Most anterior-superior position: CR 1272. TSH decreased, why: ANTIBODIES AGAINST THE TSH RESEPTORS OF THE THYROID CELLS 1273. Angina pectoris: NITROGLYCERATE 1274. What would you expect in a patient with Graves’ disease: EXOPHTHALMUS 1275. All of these hormones are present in pre-pregnancy state except: BETA hCG 1276. All of these are used to identify a dead body except: MITOCHONDRIAL mRNA 1277. What damage comes from the bite: NECROSIS 1278. TMJ load bearing: TRUE 1279. What is not from the 1st arch: BUCCINATOR MUSCLE 1280. Lewy bodies: PARKINSON DISEASE 1281. Not in dermis: MERKEL, MELANIN 1282. Multiple drug resistance: PLASMIDS KEY WORDS TO REMEMBER • Pulmonary edema – left sided heart failure • Peripheral edema – right sided heart failure • Bronchiectasis – cystic fibrosis • Chronic bronchitis – persistent cough + sputum production • Chronic myeloid leukemia – Philadelphia chromosome • Neurofibromatosis – cafe an lait spots • Squamous cell carcinoma – prickle cells and keratin pearls • Nematodes – marked eosinophilia • Hodgkin's disease – Reed-Sternberg cells • Ewing's sarcoma – small, blue cells • Bence-Jones proteins (urine) – multiple myeloma • Butterfly rash – systemic lupus erythematosus (SLE) • Acute inflammation – neutrophils • Chronic inflammation – macrophages (epithelioid cells and giant cells) • Ferruginous bodies – asbestosis • Pink puffer – emphysema

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Blue bloaters – chronic bronchitis Russell bodies and Mott cells – multiple myeloma Lipschultz body – HSV Civatte bodies – lichen planus Osteogenesis imperfecta – blue sclera + brittle bones Lewy bodies – Parkinson disease Negri bodies – rabies Albert’s bone disease – marble bones Spleen enlargement – myelofibrosis Behcet’s Disease – mouth sores (chronic), skin blisters Hemophilia A – deficiency of factor VIII Osteomalacia – deficiency of vitamin D Ecchymosis – purpura (large) / petechiae (small) Paget’s disease of bones – serum alkaline phosphate Acute gouty arthritis – uric acids deposits Sever hemolytic disease – fetus has Rh+ and mother RhErythema multiform – target, iris, bull’s eye shape Neimann-Pick disease - genetic defect in the enzyme sphingomyelinase Tay-Sachs disease – deficiency of the enzyme hexosaminidase Neurologic dysfunction – vitamin E deficiency Addison’s disease – increased melanin pigmentation Albinism and vitiligo – decreased melanin pigmentation Vitamin B1 deficiency – beri-beri Hashimoto disease – hypothyroidism by a reaction of immune system against the thyroid gland Diabetes insipidus – extreme thirst and excessive urine output Acute pancreatitis – elevation of both enzymes: lipase (more) and amylase Pellagra – vitamin B3 deficiency Osteoporosis – drop in estrogen (women) at time of menopause / drop in testosterone in men Sickle cell anemia – abnormal type of Hb Osteoarthritis – osteophyte formation Exophthalmos – Grave’s disease Cri-du-chat syndrome – cat-like cry: chromosome 5 Edwards’ syndrome – micrognathia, pinched face: trisomy 18. Patau syndrome – cleft lip and palate: trisomy 13 DiGeorge syndrome – deletion in chromosome 22: CATCH 22 Tetanus – risus sardonicus, opisthotonus Tetany – Trousseau’s sign and Chvostek's sign Klinefelter syndrome – XXY Turner’s syndrome – XO Primary hyperparathyroidism – adenoma Pseudoparathyroidism – defective end-organ responsiveness to PTH Nuclear pyknosis – irreversible cellular injury Shock, progressive stage – metabolic acidosis SCID – absence of B and T cells Acromegaly – increased GH in adults Gigantism – increased GH in childhood before epiphysial closure Hypovolemic shock – blood loss Hydronephrosis – chronic urinary tract obstruction Lung abscess – MC cause is aspiration of anaerobic bacteria Emphysema – cigarettes smoking Hepatitis B – DNA virus, enveloped Lung cancer – persistent cough Pheochromocytoma – cardinal sign is persistent or paroxysmal hypertension Primary tubercle – Ghon tubercle Primary syphilis – non-painful chancre Secondary syphilis – maculopapular rash and condylomata lata Tretiary syphilis – gumma Myxedema – extreme hypothyroidism

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HOW TO REMEMBER THESE BAD BOYS MEISSNER LIGHT TOUCH Meissner’s foreceps require a light touch to extract a tooth (that’s not really true, but who cares ;) ) MERKEL PRESSURE/TEXTURE Angela Merkel from Germany wears textured outfits and works under a lot of pressure. RUFFINI CONSTANT TOUCH / PRESSURE Ruff, ruff! Like a big dog. We love to pet them (constant touch), but hate when they sit on our faces (pressure). PACINIAN VIBRATION Pacman, the game for your phone – when you die, the phone vibrates.

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