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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 56-year-old man complains of pain in the left parotidomasticatory area, progressing face asymmetry that was noticed a month ago. Objectively: left-sided paresis of mimic muscles. To the fore of earflap there is an ill-defined infiltration, the skin above it is tense and cyanotic; left lymph nodes are enlarged. Opening of mouth is limited down to 2,5 cm. The left parotid duct doesn’t excrete saliva. What is the most probable diagnosis?
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A 55-year-old woman complains of ulcers on the mucous membrane of oral cavity, pain during eating and talking. She fell abruptly ill over a month ago. Objectively: unchanged mucous membrane of her gums, soft palate and palatine arches has big bright-red erosions on it. Intact mucous membrane peels easily off when slightly rubbed and this results in erosions and small hemorrhages. What is the leading diagnostic symptom in the differential disease diagnostics?
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A 47-year-old patient complains of permanent pain in the 27 tooth that is getting worse during cutting. Objectively: the patient’s face is symmetric, skin is of normal colouring, mouth opening is not limited, mucous membrane of alveolar process is edematic and hyperemic at a level with the 27 tooth. The 27 tooth has a deep carious cavity communicating with pulp chamber. Percussion of the 27 tooth causes acute pain. What is presumptive diagnosis?
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A 68-year-old patient has a defect in the lower third of his nose as a result of malignant tumour removal. Objectively: dorsum of nose up to the middle third and external nostril outlines are intact. Skin at the base of nose is thinned and erosive. The patient strongly objects to any plastic operation. What method of fixation of nose ectoprosthesis is the most acceptable?
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A 12-year-old girl complained about a crown defect in the frontal part of her upper jaw. Anamnesis data: the tooth was filled more than once but the fillings fell out. Objectively: the 12 tooth is filled. There is IV class defect according to Black’s classification. Devitalization has never been performed, percussion of the 12 tooth is painless. What orthopaedic construction should be applied in this case?
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A teenager applied to an orthodontist complaining about tooth malposition. Objectively: the face is without pecularities. Occlusion of permanent teeth is present. There are no abnormalities of jaw correlation in three planes. The 23 tooth is vestibularly over the occlusive plane; the space in the dental arch is less than 1/3 of crown size. How is it possible to make room for the malpositioned 23 tooth?
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A patient complains about acute intense pain and a slight swelling in the area of a decayed tooth of the lower jaw on the right, ill health, body temperature rise up to 38,3°C, lack of appetite, insomnia. Objectively: there is collateral edema of soft tissues of submandibular area and lower part of right cheek. Regional lymph nodes are enlarged on the right, palpatory painful. Crown of the 46 tooth is half decayed, the 45, 46, 47 teeth are mobile, there is also a cuff infiltrate in the area of these teeth. Vincent’s symptom is positive on the right. Make a diagnosis:
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A 16-year-old patient complained about discomfort in the area of her upper jaw teeth she has been feeling for 2 weeks. Examination of precervical area of the 11 and 12 teeth revealed whitish matt spots with indistinct outlines that absorb dyes intensively. What treatment of the 11 and 12 teeth should be administered?
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A 48-year-old patient complained about having pain in the 45 tooth during cutting for a year. The 45 was treated before. Objectively: mucous membrane in the area of this tooth is hyperemic and slightly cyanotic. The 45 tooth is pink, the filling fell out. What examination method should be applied in order to choose treatment?
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A 40-year-old patient with mandible fracture applied to a doctor 3 weeks after immobilization of breaks because of pain and body temperature rise. Objectively: a slight swelling in the chin area, mucous membrane of alveolar process in the area of the 2 1 | 1 2 teeth is hyperemic, edematic, palpatory painful. Overtooth splint on 5 4 3 2 1 | 1 2 3 4 5 teeth is in satisfactory condition, no occlusion abnormalities were detected. The patient was diagnosed with acute purulent periostitis of mandible. What surgical action is indicated?
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A 43-year-old patient complains of a neoplasm in the right submaxillary area that appeared a month ago after angina. Body temperature is 37, 0 − 37, 2°C. The patient underwent anti-inflammatory therapy but the neoplasm didn’t diminish. Objectively: palpation of the right submaxillary area reveals a slightly painful spherical neoplasm of dense elastic consistency with regular outlines that is not adherent to skin. The duct of submandibular salivary gland excretes transparent saliva. Sublingual torus is unchanged. What is the most probable diagnosis?
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A 37-year-old man complained about pain and a slight swelling emerging during eating in the left submaxillary area. Objectively: a painful elastic infiltration in the left submaxillary area. Mouth opening is not limited. Bimanual palpation in the area of mylohyoid groove revealed a compact movable oblong induration. Mucous membrane is unchanged. Duct of the left submandibular gland doesn’t excrete saliva. What is the most probable diagnosis?
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A 5-year-old child was diagnosed with congenital complete nonclosure of soft and hard palate. What type of anaesthesia is indicated for uranostaphyloplasty?
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A 23-year-old woman came to a dental clinic for restoration of the 11th tooth’s crown. Objectively: root of the 11th tooth is at a level with gingival edge, its walls are thick enough. A dentist made and adjusted a stump inlay upon which a metal-plastic crown will be fixed. What plastic will be used for veneering?
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A 35-year-old patient needs a metal inlay for the 37 tooth. Objectively: masticatory surface of the 37 tooth has a carious cavity. What is the pecularity of preparation?
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It is planned to make a metal-ceramic crown supported by stump inlay of the 23 tooth. Objectively: the crown of the 23 tooth is decayed down to the gingival edge. Root canal is filled to the top. The dentist made a wax stump model with a pin, cast it in metal, fitted it to the tooth, fixed it by means of visphat-cement and got a working plaster impression. At what stage did he make an error?
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A 23-year-old military servant needs orthopaedic treatment in a specialized hospital. He was diagnosed with false joint of mandible in its frontal part. The teeth are intact, stable, in threes on each side. Orthopaedic treatment by means of a bridge denture will be possible only if the jaw defect is no more than:
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A 17-year-old girl applied to a dental clinic and complained about hard tissue defects on her frontal and lateral teeth. Subjectively these defects don’t cause any inconvenience. Crown defects appeared long ago. The patient was born and and has been living in an area where fluorine concentration in the drinking water makes up 1,2 mg/l. Objectively: on the vestibular surfaces of incisors on both upper and lower jaws in the equator area there are hard tissue defects within deep layers of enamel. The defects are parallel to the cutting edge. The same defects were revealed in the area of tubera of the first molars, floor and walls of the defects are smooth. Enamel of the defect floor is light-brown. What is the most probable diagnosis?
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A 19-year-old patient came to traumatology centre and complained about face asymmetry, right-sided paresthesia of his upper lip, nasal hemorrhage. Objectively: evident face asymmetry due to an edema and haematoma of the right inferior eyelid and infraorbital area. Opening of mouth is slightly limited, occlusion is normal. Palpation reveals a symptom of "step"in the area of the right zygomaticomaxillary suture, deformity in the area of external edge of the right orbit and zygomaticoalveolar crest, gaseous crepitation in the right infraorbital area; percussion reveals a "bursted nut"symptom. What is the most probable diagnosis?
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A patient is 48-year-old, according to the results of clinicoroentgenological examination it is indicated to remove the 26 tooth because of acute condition of chronic granulomatous periodontitis. What conduction anesthesia is indicated for this operation?
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A girl is 1,2-year-old. Vestibular surface of her 52, 51, 61, 62 teeth has large carious cavities within the enamel. Probing is slightly painful, percussion of the 52, 51, 61, 62 teeth is painless. What treatment is to be administered?
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A 2-year-old girl has body temperature 38,5°C, a swelling below her jaw on the right. On the 5th day of illness there apeared rhinitis, cough, a small movable globule under her lower jaw on the right. Objectively: general condition of the child is moderately severe. The face is asymmetric due to the swelling in the right submaxillary area. The skin is hyperemic, glossy, there is a diffuse infiltrate in the right submaxillary area spreading to the upper neck parts on the right, it is dense and painful; the skin doesn’t make folds. Teeth are healthy. What is the most probable diagnosis?
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A 36-year-old woman complains of lip dryness and peeling lasting for a month. Application of indifferent ointments was ineffective. Objectively: vermilion border of her lower lip is bright-red, moderately infiltrated, covered with adherent whitishgrey squamae, their removal causes pain and hemorrhage. On the focus periphery there is epithelium opacity in form of white striae, in the centre of it there is a sinking down area. What is the most probable diagnosis?
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A patient complained about painful deglutition, difficult mouth opening. Several days ago the 47 tooth was removed because of acute condition of chronic periodontitis. The patient’s condition kept worsening. Body temperature is 37,9°C. Results of external examination: the face is symmetric, face skin is slightly pale. Right submandibular lymph nodes are enlarged, palpatory painful. Examination of oral cavity is impossible because of evident contracture of lower jaw (the mouth opens up to 0,5 cm between central incisors). What anesthesia will provide mouth opening?
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A 7-year-old child complains of spontaneous pain in the upper right molar teeth. Examination of medial contact and masticatory surfaces of the 55 tooth revealed a carious cavity composed of softened light dentin and localized within circumpulpar dentin. Floor probing is acutely painful, tooth percussion is slightly painful. Mucous membrane of the alveolar process in projection of 55 tooth roots is intact, there are no roentgenological changes in this area. What is the most probable diagnosis?
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A 12-year-old boy complains about pain and swelling in the parotidomasticatory area on the left, body temperature rise up to 37,5°C. He has been suffering from this for 5 years. Objectively: palpation reveals a dense painful nonmobile formation 3,5х5 large in the parotidomasticatory area on the left. Skin colour is unchanged. Orifice of the left salivary gland duct excretes transparent secretion. What is the most probable diagnosis?
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A 55-year-old patient has a painless, tuberous, cyanotic pedunculated formation 2х1х1,5 cm large that appeared on the spot of the removed 46th tooth. Opening of mouth is not limited. Intra-oral X-ray picture of alveolar process in the area of the removed 46th tooth shows a focus of bone tissue destruction. What is the most probable diagnosis?
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A 40-year-old woman complains about slight painfulness of gums, high temperature sensitivity of teeth. Objectively: the gums are pale and compact, in the area of lower frontal teeth there is retraction with cervix dehiscence. X-ray picture shows steady decrease of interdental septa height down to 1/3 of root length. What disease are these symptoms typical for?
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A soldier injured by a shell splinter was diagnosed with gunshot fracture of mandible accompanied by an over 3 cm long bone defect in the chin area. What method of fixation of mandible fragments is indicated?
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A 43-year-old patient complained about mobility of his 24, 26, 27 teeth, pus excretion from alveolus of the extracted 25 tooth. 1,5 month ago dissection along the mucogingival fold was performed and the 25 tooth was extracted. Objectively: there is a slight swelling of soft tissues in the right infraorbital area, lymph nodes of the right submaxillary area are enlarged, slightly painful, nasal breathing is normal. Mucous membrane of alveolar process in the area of the 24, 26, 27 teeth is edematic and cyanotic. There is also a fistula with bulging granulations along the mucogingival fold. Alveolus of the extracted 25 tooth excretes purulent granulations. What disease does this clinical presentation correspond with?
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A 57-year-old patient came to an orthopaedic stomatology center with complaints about dull pain in the area of his right temporomandibular joint that is getting worse during eating. The disease developed gradually, it began with constrained mandibular motion in the morning that sometimes grew more intensive, sometimes less. Objectively: the face is symmetric, the mouth can be opened up to 3 cm. Opening of mouth is accompanied by articular noise and clicking (step-like dislocation of mandible). Skin above the joint is intact. Muscle tone is palpatory unchanged. What is the most probable diagnosis?
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During opening a phlegmon of mouth floor a doctor revealed greyish necrotic masses in purulent foci, gas vesicles and fat droplets, sharp unpleasant smell of exudate. The tissues are of dark-brown colour, muscles resemble of boiled meat. What medications should be administered in order to prevent further spreading of this process?
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A 43-year-old patient complained about mobility of lower jaw teeth. Objectively: the dentition is intact. Tooth mobility is of I-II-degree. It is planned to immobilize teeth by means of a removable splint common for the whole dentition. What stabilization will be provided by means of this splint?
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A patient complains about long-lasting pain attacks in the lower jaw teeth, on the left. The pain irradiates to the ear, occiput and is getting worse during eating cold and hot food. Objectively: there is a deep carious cavity on the approximal-medial surface of the 36 tooth. Floor probing is overall painful and induces a pain attack. What is the most probable diagnosis?
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A 35-year-old woman complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 5 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 10 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched. What is the most probable diagnosis?
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A 38-year-old driver complains of acute pain in his mouth and sore throat, difficult ingestion, indisposition, temperature rise up to 38,6°C. These symptoms appeared after exposure to cold. He has been ill for a day, in the evening he has to go to work. Objectively: gums in the area of inferior frontal teeth as well as pharynx mucous membrane are hyperemic, edematic; gingival edge is necrotic, tonsills are enlarged. Results of bacterioscopy: fusospirochetal symbiosis. In blood: erythrocytes - 4,5 × 1012/l; leukocytes - 7, 2 × 109/l; ESR - 18 mm/h. What actions should a stomatologist take?
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A 25-year-old man complains about itching and reddening of his skin in the buccal area, general weakness, flaccidity. He associates the begin of disease with a skin injury he had got during shaving. Objectively: body temperature is 39, 0°C. In the buccal area a part of skin is hyperemic, slightly bulging, well-defined. Hyperemic surface has some vesicles with serous fluid. What is the most probable diagnosis?
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A 13-year-old child has been suffering from pain in the left inferior molar induced by cold stimuli for several months. Objectively: on the masticatory surface of the 37 tooth there is a carious cavity with overhanging enamel edges filled with circumpulpar dentin. The cavity is filled with light softened dentin. Probing of the cavity floor is somewhat painful. Cold stimuli cause short-term pain. Make a provisional diagnosis:
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A 65-year-old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: leftsided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place?
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A 46-year-old patient complains about pain and bleeding from the carious cavity of her 27 tooth during eating. Previously she had spontaneous pain. Examination of the 27 tooth revealed a deep carious cavity on the masticatory surface consisting of red tissue, probing induced pain and hemorrhage. What treatment method should be chosen?
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