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KROK 2 Dentistry 2008 Questions | KROKEXAM
Browse 2008 KROK 2 Dentistry exam questions with answers and explanations.
Exam questions
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A 3-year-old child has a cavity in the 84 tooth. Objectively: there is a carious cavity on the masticatory surface of the tooth within mantle dentin. Dentin is softened, probing of cavity walls is painful, percussion is painless. Make a diagnosis:
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A 45-year-old patient complains about pain induced by thermal stimuli, spontaneous pain in the 26 tooth. A week ago this tooth was treated on account of pulpitis. Objectively: the 26 tooth is filled, percussion is painful, thermal stimuli induce long-lasting, slowly intensifying pain. X-ray picture shows that palatine canal is filled by 2/3, no material can be seen in the buccal canals. What is the most probable cause of this complication?
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A 49-year-old patient complains about pain in the oral cavity induced by eating. He suffers from CHD. Objective examination revealed dyspnea, limb edema. Oral cavity isn’t sanitated. On the mucous membrane, on the right, there is an ulcer with irregular edges covered with greyishwhite necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable diagnosis?
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A 29-year-old patient complains that the crown of his 26 tooth broke off. Objectively: tooth decay index is 0,9, root tissues are hard, roentgenography revealed that the canal was filled to the top, no chronic inflammations of periodontium were revealed. What construction should be used for prosthetics of the 26 tooth?
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A 20-year-old homeless and unemployed patient complains about body temperature rise up to 39°C, pain during eating and deglutition, nasal hemorrhages. He has been suffering from this for 10 days. Objectively: herpetic rash on the lips, irregular-shaped erosions covered with fibrinous deposit on the mucous membrane of oral cavity; filmy deposits on the tonsils. Liver is enlarged and sclerotic. Blood count: erythrocytes - 4,5 × 1012/l; hemoglobin - 120 g/l; ESR - 25 mm/h; leukocytes - 10 × 109/l; eosinophils - 0; rod nuclear cells - 2; segmentonuclear leukocytes - 31, lymphocytes - 41; monocytes - 10; atypical mononuclears - 14%, plasmatic cells - 2. What is the most probable diagnosis?
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A 22-year-old patient complained about colour change of the 11 tooth crown. The tooth was treated on account of chronic deep caries a year ago. Immediately after treatment the patient felt slight pain. She didn’t consult a dentist. X-ray picture shows broadening of periodontal fissure in the area of root apex of the 11 tooth. Percussion is painless. What is the most probable diagnosis?
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A 43-year-old patient applied to a doctor complaining about painful deglutition, limited mouth opening. 3 days ago he felt pain in the decayed 37 tooth, on the next day there appeared limitations of mouth opening. Objectively: a slight soft swelling in the left submaxillary area. Palpation revealed an enlarged lymph node. Mouth can be opened up to 1,5 cm. There is also an edema of the left palatine arch and lateral pharynx wall. The 37 tooth is decayed, mucous membrane around the tooth is edematic, percussion is slightly painful. What is the most probable diagnosis?
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A 45-year-old patient applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lacelike pattern. On the upper jaw there are two soldered bridge dentures, the 47 tooth has an amalgam filling, the 46 tooth has a steel crown. What is the most probable diagnosis?
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A 38 year old patient was admitted to the orthopaedic department after a therapeutic treatment on account of periodontitis. His anamnesis contains data about frequent recurrences of this disease, acute attacks are accompanied by periodontal abscesses. Objectively: the 42, 41,31, 32 teeth manifest mobility of I-II degree, the 43 and 33 are stable, tooth cervices are dehisced by 1/4, hyperesthesia of hard tooth tissues is not observed. What rational construction of permanent splint should be recommended?
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A 52-year-old patient complains of gum inflammation, tooth mobility. Objectively: dentitions are intact, all teeth have the 1-2 degree of mobility. What type of teeth stabilization should be applied in this case?
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A 42-year-old patient complains of pain in the submaxillary and sublingual areas that is getting worse during eating, body temperature rise up to 37,6°C. He has been suffering from this for 2 months. Objectively: infiltration along the right sublingual torus, hyperemia, soft tissue edema, acute pain during palpation. The duct of the right submandubular salivary gland excretes turbid saliva mixed with pus. What is the most probable diagnosis?
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A 38-year-old patient came to a hospital with complaints about a wound in the area of her left cheek. She was injured 16-18 hours ago, didn’t lose consciousness. Objectively: injury of skin, subcutaneous fat and a muscle for about 3 cm long. The wound is bleeding. What initial surgical dbridement should be performed?
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A 26-year-old patient complains about a sense of tooth heaviness and pain caused by hot food stimuli, halitosis. Objectively: crown of the 46 tooth is grey, there is a deep carious cavity communicating with tooth cavity, superficial probing is painless, deep one is painful, percussion is painful, mucous membrane has no pathological changes. Make a provisional diagnosis:
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A 67-year-old patient complains about frequently recurring erosion in the area of vermilion border of his lower lip. The erosion is oval, 0,8х1,3 cm large, covered with thin crusts. After their removal some petechial hemorrhages on glossy surface can be seen. There are also some atrophied areas of the vermilion border. Infiltration is absent. Submandibular lymph nodes are not enlarged. What is your presumptive diagnosis?
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A 51-year-old woman complained about food sticking in a tooth on the right of her lower jaw. Objectively: there is a deep carious cavity on the distalmasticatory surface of the 45 tooth consisting of compact pigmented dentin and not communicating with tooth cavity. The patient was diagnosed with chronic deep caries. What diagnostic method allowed to eliminate chronic periodontitis?
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A 58-year-old patient complains about clicking in the mandibulotemporal joint during eating. Periodically as a result of wide mouth opening the mandible takes up such a position that makes mouth closing impossible. The mandible can be easily placed into its initial position by pressing with fingers upon its coronoid processes. What is your presumptive diagnosis?
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An 11-year-old girl complains about gingival hemorrhage during tooth brushing and eating. She has been suffering from this for a year. Gum of both upper and lower jaws is edematic and congestively hyperemic. Hygienic state of oral cavity is unsatisfactory. Bite is edgeto-edge. Roentgenological examination of periodontium revealed no pathological changes. What is the provisional diagnosis?
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A 13-year-old child complained about painfulness of his lower lip. He has been suffering for two months. Objectively: mucous membrane of lower lip is hyperemic, excretory ducts of minor salivary glands are dilated, "dew"symptom is present. What is the most probable diagnosis?
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A 54-year-old woman complains about wear of the 35 and 36 teeth and pain caused by thermal and chemical stimuli. Objectively: crowns of the 35 and 36 teeth are worn by 1/3 of their height (horizontal type), the 24, 25 26 teeth have fullcast crowns. What crowns should be made for the 35 and 36 teeth?
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A virtually healthy 9-year-old child complains about crown fracture and pain in the right superior frontal tooth. Objectively: crown part of the 11 tooth is broken by 1/3, pulp is pointwise dehisced, it is red, acutely painful and bleeds during probing. Percussion is slightly painful. The child got a trauma several hours ago. Choose an optimal treatment method:
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Objective examination of a patient revealed hard tissue defect of the 24 tooth. Tooth decay index is 0,8. The defect is partly restored by a filling that doesn’t meet the requirements. The tooth has pink colouring. X-ray picture shows no pathological processes. What construction is indicated in this case?
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A 49-year-old patient applied to a dentist complaining about a growing mole, its peeling and itching. According to the patient, the part of skin started changing its colour and size 1 year ago, after an injury got during shaving. Objectively: in the infraorbital area on the left there is an intensely pigmented brown spot, up to 2 cm large, with small nodules on its surface; it is oval, bulging, with signs of peeling, palpatory painless. Regional lymph nodes are enlarged, adhering to skin, painless. Make a provisional diagnosis:
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A patient applied to a dentist complaining about inability to close her mouth, laboured speech. Objectively: oral cavity is half-open with saliva outpouring from it, central line is deviated to the right. There is a cavity in front of antilobium; below the malar arch there is a protrusion of mandible head into the infratemporal fossa. What is the most probable diagnosis?
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A 36-year-old man complains about acute headache, body temperature rise up to 39, 1°C, indisposition. Objectively: a slight face asymmetry because of soft tissue edema of the left infraorbital area. Crown of the 26 tooth is partly decayed. Percussion is acutely painful. Mucous membrane on the vestibular side in the area of the 25, 26 teeth is edematic, hyperemic. Breathing through the left part of nose is laboured, there are purulent discharges. X-ray picture showed a homogeneous shadow of the left part of maxillary sinus. What is the most probable diagnosis?
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A 38-year-old patient got a blow that resulted in upper jaw fracture. Objectively: flattening and impression of face, mobility and dangling of broken jaw with cartilage of nose and eyeballs, nasal hemorrhage, tissue edema, "glasses"symptom; palpation reveals crepitation, subcutaneous emphysema, liquorrhea, loss of sensitivity in the area of half the upper jaw, nose wing and frontal teeth. What is the most probable diagnosis?
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An 8-year-old child has a carious cavity on the masticatory surface of the 16 tooth within circumpulpar dentin. Probing of cavity floor is painful, dentin is softened, slightly pigmented. Cold stimulus causes short-term pain. Choose a dental treatment paste:
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A 24-year-old patient applied to a dental clinic for root removal of her upper wisdom tooth. Tuberal anesthesia caused a postinjection haematoma. What was injured during anesthetization?
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A 5-year-old child has temperature rise up to 39, 2°C, sore throat, nausea. Objectively: mucous membrane of soft palate and palatine arches is brightly hyperemic, it can be distinctly distinguished among the surrounding tissues. The tongue is dry, edematic, bright-red, its lateral surfaces have no fur on them, fungiform papillae are evidently enlarged. Face skin is hyperemic apart of pale nasolabial trigone, is covered with spotty rash. Submaxillary lymph nodes are palpatory painful. What is the causative agent of this disease?
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A 65-year-old patient complains about pain during eating, reduced tongue mobility, an ulcer in the posterior part of mouth floor on the left, weight loss. Objectively: the patient uses a partial removable denture for the lower jaw. In the area of the left mylohyoid duct there is an ulcer in form of a cleft up to 1,6 cm long with everted edges, covered with grey-yellowish deposit, closely adhering to an infiltrate that can be detected during bimanual palpation. In the left submandibular and superolateral areas of neck several enlarged nonmobile lymph nodes can be palpated. What is the most probable diagnosis?
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A 7 month old child was brought to a dentist because of an ulcer in the oral cavity. The child was born prematurely. She has been fed with breast milk substitutes by means of a bottle with rubber nipple. Objectively: on the border between hard and soft palate there is an oval ulcer 0,8х1,0 cm large covered with yellowishgrey deposit and surrounded with a rolllike infiltration. Make a provisional diagnosis:
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A 16-year-old patient complains of a cosmetic defect in the area of his upper frontal teeth in form of white spots that were revealed long ago and haven’t changed since that. Objectively: there are white spots on the vestibular surfaces of the 11, 12, 21, 22 teeth by the cutting edge and on the vestibular surfaces of the 16, 26, 36, 46 teeth close by the masticatory surface. Probing showed that the spot surface was smooth, painless; reaction to the cold stimulus was painless. The spots couldn’t be stained by 2% solution of methylene blue. What is the most probable diagnosis?
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A 31-year-old man complains about dryness, burning of tongue dorsum that appeared for about a week ago and is getting worse during eating stimulating food. Some time ago the patient had pneumonia. He spent two weeks at a hospital, was taking antibiotics. He doesn’t take any drugs at the moment. Objectively: mucous membrane of oral cavity is hyperemic, dry and glossy. On the tongue dorsum and palate some greyishwhite films are present that can be easily removed. Threads of saliva follow the spatula. What is the most probable provisional diagnosis?
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A 10-year-old boy applied to a dentist and complained about pain in his palate during eating. Objectively: the lower third of his face is shortened, mouth opening is not reduced. During joining of teeth the cutting edge of inferior incisors contacts with mucous membrane of palate. On the site of contact mucous membrane is hyperemic and slightly edematic. Lateral teeth have 1 class joining (according to Angle’s classification). Propose a rational plan of treatment of the patient’s lower jaw:
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A 32-year-old patient applied to a dental surgeon for oral cavity sanitation before prosthetics. During examination of oral cavity the dentist revealed that crown of the 35 tooth was decayed. The root is stable, its percussion is painless. Mucous membrane of alveolar process was unchanged. X-ray picture showed a slight broadening of periodontal fissure. What is your presumptive diagnosis?
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A patient has indication for removal of his medial incisor of the right upper jaw on account of chronic periodontitis. What types of anaesthesia should be applied for tooth removal?
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A 45-year-old man complains about liquid outpouring from his nose, inability to blow his nose, inflated cheeks. Objectively: there is a perforating defect (1х1,5 cm) of alveolar process at a level of the extracted 26th tooth in the lateral part of his upper jaw. Air inhalation through the nose with held nostrils is accompanied by generation of bubbles in the area of perforation. What denture construction should be recommended?
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Preventive examination of an 8-year-old boy revealed matted chalky spots on the vestibular surface of the 11 and 21 teeth localized in the precervical area. The child has no subjective complaints. What is the most probable diagnosis?
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A patient complains about pain in the 51 tooth that is getting worse during cutting. Anamnesis data: the patient underwent treatment on account of pulpitis of the 51 tooth, the tooth was treated with devitalizing paste, the patient didn’t come to see a dentist for the second time. Objectively: carious cavity of the 51 tooth is closed by dentin layer. Percussion is painful. Mucous membrane in the root apex projection of the 51 tooth is hyperemic, edematic, palpatory painful. Make a diagnosis:
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An 8-year-old boy was referred to the oral surgery for extraction of his 64 tooth because of acute condition of chronic periodontitis. Tooth crown is intact. What instrument should be applied?
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A 43-year-old man applied to the dental clinic for tooth prosthetics. Objectively: the crown of the 37th tooth is decayed by 2/3, buccal and lingual walls are thin. Occlusion picture shows strong contact with antagonists. How thick should be the layer of tooth surface that must be ground off during preparation for metallic stamped crown?
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