All the questions have been directly picked from Carranza 11th edition
a. Juvenile periodontitis1. A patient comes to the department with a punched out crater like lesion on the interdental papillae. On radiographic examination, there is an evidence of crestal bone loss. Most probable diagnosis is
b. Acute necrotizing ulcerative gingivitis
c. Acute necrotizing ulcerative periodontitis
d. Aggressive periodontitis
Ans: C
Hint✅🔑
· When bone loss occurs, the condition is called necrotizing ulcerative periodontitis (NUP)
2. The surface of the gingival craters is covered by a gray, pseudomembranous slough, demarcated from the remainder of the gingival mucosa by
a. Mucogingival junction
b. Linea alba
c. linear erythema
d. outer projection of the gingival sulcus
ans: C
3. True about ANUG is
a. Pocket formation
b. Viable junction epithelium
c. Rare in edentulous mouth
d. extremely sensitive to touch
ans: D
4. The pseudomembrane in ANUG is composed of all except
a. necrotic epithelial cells
b. polymorphonuclear leukocytes (PMNs, neutrophils)
c. lymphocytes
d. microorganism
ans: C
5. Predominant organism associated with ANUG
a. A. actinomycetemcomitans
b. Fusospirochetes
c. Vibrios
d. Gram negative rods
Ans: B
6. Lesions seen in ANUG differs from the lesions of agranulocytosis in that
a. necrosis of the gingiva is present in ANUG only
b. Agranulocytosis lacks the severe inflammatory reaction seen in ANUG
c. necrosis of the gingiva is present in agranulocytosis only
d. ANUG lacks the severe inflammatory reaction seen in Agranulocytosis
Ans: B
Hint✅🔑
· The oral condition in agranulocytosis is primarily necrotizing but lacks the severe inflammatory reaction seen in NUG.
7. Vitamin deficiency associated with NUG is
a. Vit-B1
b. Vit-B2
c. Vitamin A
d. Vit-B12
Ans: B
Hint✅🔑
Nutritional deficiencies (e.g., vitamin C, vitamin B2) accentuate the severity of NUG.
8. NUG is
a. Transmissible but not communicable
b. Communicable but not transmissible
c. Transmissible and communicable
d. Neither transmissible nor communicable
Ans: A
Hint✅🔑
· The term transmissible denotes a capacity for the maintenance of an infectious agent in successive passages through a susceptible animal host
· The term communicable or contagious signifies a capacity for the maintenance of infection by natural modes of spread such as direct contact through drinking water, food, and eating utensils; via the airborne route; or by means of arthropod vectors.
· Disease associated with the fusospirochetal bacterial complex is transmissible but not communicable or contagious.
9. In ANUG, there is
a. No pocket, no bone loss
b. Bone loss without pocket formation
c. Pocket formation without bone loss
d. Both pocket and bone loss
Ans: A
Hint✅🔑
· When there is bone loss, it is called NUP not NUG.
10. Untrue about primary herpetic gingivostomatitis is
a. occurs most often in infants and children younger than 6 years of age
b. Occurs with equal frequency in male and female
c. the primary infection is very painful in most of the cases
d. caused by the herpes simplex virus type 1 (HSV-1)
ans: C
Hint✅🔑
· In most persons, however, the primary infection is asymptomatic.
11. Which of the following is not the type of secondary manifestation of herpes?
a. herpes genitalis
b. ocular herpes
c. herpetic encephalitis
d. herpetic endocarditis
ans: D
12. primary herpetic gingivostomatitis is not characterized by
a. ballooning degeneration
b. Tzanck cells
c. Acanthosis
d. Multinucleated cells
Ans: C
Hint✅🔑
· The virus targets the epithelial cells, which show “ballooning degeneration” that consists of acantholysis, nuclear clearing, and nuclear enlargement. These cells are called Tzanck cells.
· Infected cells fuse, forming multinucleated cells, and intercellular edema leads to formation of an intraepithelial vesicles.
13. Which of the following is not seen in case of pericoronitis?
a. foul taste
b. Trismus
c. Lymphoma
d. Swelling of the cheek
Ans: C
Hint✅🔑
· The patient is extremely uncomfortable because of a foul taste and an inability to close the jaws, in addition to the pain.
· Swelling of the cheek in the region of the angle of the jaw and lymphadenitis are common findings.
· Trismus may also be a presenting complaint.
· The patient may also have systemic complications such as fever, leukocytosis, and malaise.
14. Most common complication of pericoronitis is
a. pericoronal abscess
b. Peritonsillar abscess formation
c. Cellulitis
d. Ludwig's angina
Ans: A
Hint✅🔑
· Peritonsillar abscess formation, cellulitis, and Ludwig's angina are infrequent but potential sequelae of acute pericoronitis.
15. Acute necrotizing ulcerative gingivitis is also called as
a. Vincent’s angina
b. Vincent’s infection
c. Vincent’s ulceration
d. Vincent’s gingivitis
Ans: B
16. Which of the following is not recommended in the initial visit of the ANUG?
a. Periodontal probing
b. Removal of pseudomembrane and nonattached surface debris
c. Removal of superficial calculus
d. cleaning with warm water
ans: A
Hint✅🔑
· After the area is cleansed with warm water, the superficial calculus is removed.
· Ultrasonic scalers are very useful for this purpose because they do not elicit pain, and the water jet and cavitation aid in lavage of the area.
· Subgingival scaling and curettage are contraindicated at this time because these procedures may extend the infection into the deeper tissues and may also cause bacteremia.
17. Procedures such as extractions or periodontal surgery for ANUG patients,
a. Can be carried out once the patient is symptom free
b. Can be carried out once the patient is symptom free for at least 1 week
c. Can be carried out once the patient is symptom free for at least 2 weeks
d. Can be carried out once the patient is symptom free for at least 4 weeks
Ans: D
Hint✅🔑
· Unless an emergency exists, procedures, such as extractions or periodontal surgery, are postponed until the patient has been symptom free for 4 weeks, to minimize the likelihood of exacerbating the acute symptoms.
18. The second visit is made
a. 1-2 days after the first visit
b. 4-5 days after the first visit
c. A week after the first visit
d. 2 weeks after the first visit
Ans: A
Hint✅🔑
· Third Visit is made approximately 5 days after the second visit
19. Subgingival scaling in the treatment of ANUG is done,
a. At the first visit
b. At the second visit
c. At the third visit
d. Should never be done
Ans: B
20. At the 3rd visit of treatment,
a. comprehensive plan for the management of the patient's periodontal conditions is formulated.
b. hydrogen peroxide rinses are continued, but chlorhexidine rinses are discontinued.
c. root planing may lead to exacerbation of the disease
d. all of the above
ans: A
Hint✅🔑
Third Visit
· Approximately 5 days after the second visit
· Comprehensive plan for the management of the patient's periodontal conditions is formulated. The patient should be essentially symptom free but some erythema may still be present in the involved areas, and the gingiva may be slightly painful on tactile stimulation
· The patient is further counseled on plaque control, nutrition, smoking cessation, and other conditions or habits associated with a potential recurrence.
· The hydrogen peroxide rinses are discontinued, but chlorhexidine rinses can be maintained for 2 or 3 weeks.
· Scaling and root planing are repeated if necessary.
21. Shelflike gingival margin seen as a consequences of ANUG,
a. Formed, if there has been loss of facial and lingual bone in an unequal proportion
b. Formed, if there has been loss of facial and lingual bone in an equal proportion
c. favors retention of plaque
d. Has no esthetic significance.
Ans: C
Hint✅🔑
Shelflike gingival margin seen as a consequences of ANUG,
· Formed if there has been loss of interdental bone, if the teeth are irregularly aligned, or if the entire papilla is lost,
· favors retention of plaque and recurrence of gingival inflammation as well as being an esthetic problem.
22. Not an option for the treatment of ANUG,
a. Metronidazole
b. silver nitrate
c. vitamin supplements
d. hydrogen peroxide
ans: B
Hint✅🔑
· Escharotic drugs, such as phenol, silver nitrate, chromic acid, or potassium bichromate, should not be used.
· They are necrotizing agents that alleviate pain by destroying the nerve endings of the ulcerated gingiva.
· They also destroy young cells needed for repair and delay healing
23. Which of the following is not the cause of the recurrence or refractory NUG in the mandibular anterior area?
a. Inadequate removal of calculus and other local factors
b. Inadequate local therapy
c. persistent pericoronal inflammation of third molars
d. All are the causes of recurrence or refractory NUG in the mandibular anterior area.
Ans: D
Hint✅🔑
· Recurrent acute involvement in the mandibular anterior area can be associated with persistent pericoronal inflammation arising from partial eruption and pericoronal inflammation of third molars. The anterior involvement is less likely to recur after the third molar situation is corrected.
24. Persistent symptom-free pericoronal flaps
a. Should be removed as a preventive measure against subsequent acute involvement.
b. Requires close monitoring
c. Indicates extraction of the involved tooth as preventive measure
d. Should be irrigated and cleansed every month.
Ans: A
Hint✅🔑
· If the gingival flap is swollen and fluctuant, an incision may be necessary to establish drainage and relieve pressure.
25. Untrue about the pericoronal flap,
a. It is necessary to remove the tissue distal to the tooth, as well as the flap on the occlusal surface.
b. It is not necessary to remove the tissue distal to the tooth, as it may cause unnecessary trauma to the patient.
c. Done once the acute phase subsides
d. Done only when the tooth is planned to retain.
Ans: B
Hint✅🔑
If the decision is made to retain the tooth, the pericoronal flap is surgically reduced. It is necessary to remove the tissue distal to the tooth, as well as the flap on the occlusal surface. Incising only the occlusal portion of the flap leaves a deep distal pocket, which invites recurrence of acute pericoronal involvement.
26. A 6 years old immunocompetent child patient presents with pain, difficulty in eating and diffuse erythema of the entire gingiva accompanied by fever since 4 days. Which of the following treatment modality is not an appropriate treatment modality?
a. acyclovir therapy
b. NSAID (e.g., ibuprofen)
c. topical anesthetics before eating
d. removal of plaque and food debris
ans: A
Hint✅🔑
· If primary herpetic gingivostomatitis is diagnosed within 3 days of onset, acyclovir suspension should be prescribed: 15 mg/kg 5 times daily for 7 days.
· If diagnosis occurs after 3 days in an immunocompetent patient, acyclovir therapy may have limited value.
· Such patients may receive palliative care, including removal of plaque and food debris. An NSAID (e.g., ibuprofen) can be given systemically to reduce fever and pain. Patients may use either nutritional supplements or topical anesthetics (e.g., viscous lidocaine) before eating . Periodontal therapy should be postponed until the acute symptoms subside to avoid the possibility of exacerbation.
27. Which of the following is not the characteristic feature of desquamative gingivitis?
a. desquamative gingivitis was not a specific disease entity
b. Patients may be asymptomatic
c. mild burning sensation to an intense pain
d. primary herpetic gingivostomatitis is one of the cause
ans: D
Hint✅🔑
· many mucocutaneous autoimmune conditions, such as bullous pemphigoid, pemphigus vulgaris, linear immunoglobulin A (IgA) disease, dermatitis herpetiformis, lupus erythematosus, and chronic ulcerative stomatitis, can clinically manifest as desquamative gingivitis.
28. The reshaping process of the gingiva in the absence of the periodontal pocket is
a. curettages
b. gingivoplasty
c. gingivectomy
d. flap operation
ans: B
29. Gingival deformities due to the fixed orthodontic treatment can be corrected by
a. curettages
b. gingivoplasrty
c. gingivectomy
d. all of the above
ans: B
30. Gingivoplasty is more likely to be useful in
a. ANUG
b. Juvenile periodontitis
c. Desquamative gingivitis
d. All of the aboveAns: A
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