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KROK 2 Dentistry 2009 Questions | KROKEXAM
Browse 2009 KROK 2 Dentistry exam questions with answers and explanations.
Exam questions
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A 3-month-old child has an inborn tissue defect in the oral cavity. Objectively: the lip is intact, the oral cavity exhibits a cleft defect of soft palate and median part of hard palate. The child was diagnosed with complete schistasis of soft palate and partial schistasis of hard palate. Specify the dispensary group according to A.A.Kolesov:
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A dentist treats a 22-year-old patient on account of acute deep caries of the 26 tooth. As lining material the dentist chose calcium salicylate cement "Life". What material should be chosen for insulation of the lining?
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A 62-year-old patient complains of a painless formation on his tongue that appeared several months ago. Objectively: the patient has a lot of carious and completely decayed teeth, lateral surface of tongue exhibits a painless whitish formation 10x5 mm large with irregular surface in form of verrucae. Histological examination revealed thickening of corneal epithelial layer of intermittent keratinization type. What is the most likely diagnosis?
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A 35-year-old man has a medium deep carious cavity in the 37 tooth (Black's class II). For its filling a dentist chose technique of layer-by-layer restoration. What composite should be coating the floor and walls of the carious cavity in order to form superadaptive initial layer?
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A 9-year-old boy presents with face asymmetry due to the chin deviation to the left. When the third Il'ina-Marcosian diagnostic test is performed face asymmetry disappears. What is the most likely clinical form of this occlusal anomaly?
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A completely edentulous 70-year-old patient has ordered complete removable dentures. Artificial teeth are placed upon the spherical surface. Close teeth contact by movements of the lower jaw will be guaranteed by the following average radius of the spherical surface:
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A 40-year-old patient consulted a prosthodontist about upper jaw teeth mobility that turned up after therapeutic treatment. Objectively: the 13, 12, 11, 21, 22 teeth are pulpless, exhibit II-degree mobility, unchanged colour. What prosthetic construction should be applied?
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A 5-year-old child was bitten by a dog 2 days ago. The child is diagnosed with a bite wound of cheek. The parent's didn't appeal for medical aid in proper time. The wound exhibits proinflammatory process. What kind of surgical d-bridement should be performed?
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A 16-year-old teenager complains about halitosis, general weakness, body temperature rise up to 37,6°C. These symptoms turned up 2 days ago, the boy has a history of recent angina. Objectively: oral cavity hygiene is unsatisfactory, teeth are covered with soft white deposit. Gums are hyperaemic, gingival papillae are covered with greyish coating. What is the most likely diagnosis?
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A patient being at a dentist presented suddenly with tachycardia, sweating, trembling, nausea, hunger. The patient is conscious. He suffers from diabetes melli-tus. What aid should be rendered by the dentist?
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Tooth replacement with complete removable dentures involves adjustment of occlusal relations by different movements of the lower jaw. Transversal movements of the lower jaw are initiated by the following muscle:
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A 50-year-old patient complains about pain in the region of the left temporomandibular joint (TMJ) during mouth opening. Dental formula is 14, 13, 12,11, 21, 22, 23, 24, 33, 32, 31, 41, 42, 43, 44. While opening the mouth the lower jaw moves in a zigzag manner towards the affected joint. What pathological condition are these symptoms typical for?
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A 35-year-old patient is at a dentist. He is anxious, complains of being afraid of the dentist, is unwilling to let the dentist examine him. Drugs of which group should be given the patient before stomatological manipulations?
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A 76-year-old patient has a roundish ulcer in the area of the right nasolabial sulcus. The ulcer has dense, rough floor covered with yellowish-grey crusts, and resembles of a cone. The ulcer edges are dense, crater-like; the ulcer grows both sidewards and deepwards. What is your provisional diagnosis?
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A 40-year-old patient complains about a long-existing fissure in the central part of red border of his lower lip. He has been smoking from the age of 16. Objectively: there is a deep 1,0 cm long fissure along the median line of red border of the lower lip, the fissure edges are bulgi-ngl. Characteristic quality of the fissure is its spontaneous healing, but after epi-thelization the fissure recurs. The patient was diagnosed with chronic fissure of the lower lip. Conservative treatment proved to be ineffective. Choose the most appropriate treatment method in this situation:
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It is planned to lance an abscess of hard palate (it is localized close to the 23, 24, 25 teeth) and to extract the causative 24 tooth that had caused abscess development. What type of anaesthesia is indicated for this operation?
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A 36-year-old patient consulted a dentist about permanent acute pain in the upper jaw teeth, body temperature rise. The dentist found out that the 26 tooth had been repeatedly treated, the rest of teeth were intact. After roentgenological examination the patient was diagnosed with acute highmoritis. What is the most effective way of treatment?
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A 44-year-old patient complains about the astringent sensation in the upper jaw incisors, which appeared 1,5 years ago. Objectively: the most convex part of the vestibular surfaces of the 12, 11, 21, 22 crowns has roundish defects with smooth, shiny, dense surface, that reach dentine in depth. The depth of defects is gradually decreasing from the centre to the periphery. What is the most likely diagnosis?
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Examination of a 6-year-old boy revealed enlarged lymph nodes in both submandibular and cervical regions. Objectively: the 75, 84 and 85 teeth are decayed, there are presentations of commissural cheilitis. According to the boy's mother, he has been quickly getting tired, sweating from the least physical exercise, complaining about weakness throughout the last 2-3 months. He also gave up training in a sports class. What plan of additional examination should be adopted?
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A 32-year-old patient complains about pain and swelling in the region of his mandible and left cheek. He has been suffering from this for 2 days. Objectively: his general condition is satisfactory. Body temperature is 37,5°C. There is an edema of soft tissues in the left buccal region. Submandibular lymph nodes are bilaterally enlarged, painful on palpation. Crown of the 37 tooth is partially decayed, the tooth is immobile, percussion is slightly painful. Mucogingival fold in the region of the 37 tooth is edematic, hyperaemic, flattened, its palpation causes acute pain. What is the most likely diagnosis?
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A 12-year-old girl complains about swelling, reddening and itching of lips. She has a history of bronchial asthma. Such condition has been observed in the child for 3 years in winter period. Objectively: red border of lips and adjacent skin exhibit a well-defined erythema and edema, small cracks. There are signs of lip li-chenification. There are also marks of scratches on the skin of lips, cheeks and forehead in form of abrasions and crusts. Mucous membrane exhibits no pathological changes. What is the most likely diagnosis?
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Parents of a 5-year-old child noted irregular colour of the child's back of tongue and consulted a pedodontist about this. Objectively: the oral cavity is sanitized, DF index = 4, dorsal and lateral surfaces of tongue have area of desquamating epithelium bordering upon areas of hypertrophy and increased corni-fication of filiform papillae. The child has a history of being allergic to some foodstuffs. What is the clinical diagnosis?
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A 4-year-old girl was bitten by a dog in her upper lip. Which of the following solutions should be primarily used for the wound d-bridement?
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A 12-year-old boy complains about permanent intense throbbing toothache that is getting worse when biting down on food. Objectively: the patient's face is asymmetric because of a collateral edema of soft tissues, submandibular lymph nodes are enlarged and painful on palpation. The 26 tooth has a deep cavity not communicating with the tooth cavity. Thermal test is positive, probing is painless, percussion causes acute pain, the tooth is mobile. X-ray picture of the 26 tooth shows no changes in the periodontium. What is the most likely diagnosis?
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A 6-year-old girl was brought to the dentist for completing the treatment of the 75 tooth for chronic granulating periodontitis. The patient has no complaints. Objectively: occlusive dressing on the 75 tooth remains intact, percussion is painless, mucous membrane in the region of the 75 tooth exhibits no pathological changes, is painless on palpation. What material is the most appropriate for the root canal filling in this case?
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A 4-year-old child presents with headache, nausea, pain when swallowing. Body temperature is 39°C. Examination of the oral cavity revealed extremely hyperaemic mucous membrane and tonsils. On the first day of disease the child's tongue was furred with greyish coating, on the second day the tongue was found to be self-purified. On the third day the tongue was smooth, of crimson colour, with hyperaemic fungiform papillae. What is presumptive diagnosis?
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A 15-year-old child presents with puffiness in the region of the mandible branch; enlarged, dense and painless lymph nodes adhering to the surrounding tissues. X-ray picture of mandible branch shows a well-defined bone resorption area containing small sequestra. After Mantoux test a 12 mm papule was noted. What is the most likely diagnosis?
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An 11-year-old child complains about missing crown of the 12 tooth as a result of a trauma. The tooth root is well treated. What prosthetic construction is indicated for elimination of this defect?
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A 34-year-old patient has indication for extraction of the 38 tooth because of chronic fibrous periodontitis. Oral surgeon performed torus anaesthesia. This anaesthesia blocked transmission of pain information from the following nerves:
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A patient got a trauma that resulted in limited mouth opening, nasal hemorrhage, numbness of inferior eyelid as well as skin in the infraorbital area. Objectively: there is face deformation caused by depression of soft tissues in the malar region on the left; there is also a step-off deformity in the median part of the infraorbital rim and in the region of zygomatico-alveolar crest. What method of examination will be the most effective for the diagnostics?
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A 22-year-old patient is afraid of pain from conduction anaesthesia. A dentist decided that this anaesthesia should be preceded by applicational anaesthesia of mucous membrane on the spot of injection. What drug should be used for this purpose?
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A 12-year-old girl complains about intense pain in the region of the 46 tooth socket that was extracted 3 days ago. The pain is irradiating along the branches of trigeminus. Objectively: lymph nodes are enlarged and painful on palpation, tissues around the tooth socket are edematic and hyperaemic. The socket walls are covered with grey-and-green deposition with putrid smell. What is the most likely diagnosis?
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A 42-year-old patient consulted a dentist about intense lancinating paroxysmal pain accompanied by a sensation of current passage in the region of her upper lip on the right. Pain attacks occur spontaneously and last 35 minutes. The patient usually has 2-3 attacks a day. The patient is unable to establish the cause of this disease. Examination of her oral cavity revealed no pathological changes. What is the most likely diagnosis?
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A 23-year-old patient was delivered to a traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient's condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation?
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A man was found in a street in unconscious state and delivered to the sanitary inspection room. At small intervals the man presents with recurrent attacks of tonic and clonic convulsions of the upper and lower limbs. Objectively: the patient is unconscious, his pupils are mydriatic, don't react to light. The tongue has teeth indentations. Involuntary urination was noted. Examination revealed no symptoms of focal cerebral lesion. AP is 140/90 mm Hg. The patients head can be freely brought to the chest. Specify the most probable pathology:
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A patient was found unconscious in her flat heated with firewood. The stove pipe damper was closed, it smelt of smoke in the room. Objectively: the patient is unconscious, her skin and mucous membranes are of cherry red colour. Pupils exhibit no reaction to light, corneal and tendinous reflexes are absent, muscle tone is decreased. Ps is 96 bpm, of poor volume. Heart sounds are muffled, there are solitary extrasystoles, AP is 90/60 mm Hg. In the lower lungs solitary small bubbling rales are present, respiratory rate is 28/min. What is the most likely diagnosis?
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During transportation of a 60-year-old patient an emergency doctor noted aggravation of his general condition, pulselessness, mydriatic pupils, absence of respiratory movements. It will take 5 minutes to get to the admission ward. What actions should the doctor take in the first place?
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An 18-year-old woman has been suffering from diabetes mellitus for 5 years. She receives 36 units of insulin per day. During pneumonia her condition got abruptly worse: the patient presented with increased thirst, abdominal pain, nausea, vomiting and sleepiness. In the evening the patient refused to eat and didn't get her regular insulin dose; in the morning she lost consciousness. Objectively: the patient is unconscious, the skin is dry, turgor is decreased. The tongue is also dry. Respiration is deep and noisy, there is sharp smell of acetone from the mouth. Body temperature is 36,6°C, Ps is 100 bpm, small; AP is 90/50 mm Hg. Urine exhibits extremely positive reaction to acetone. Blood glucose is 33 millimole/l. What is your
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A 28-year-old man attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place?
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A 68-year-old patient has been taking diclofenac because of pain in the knee joints for about a year. In the evening after substantial meal the patient presented with liquid black stool, drastic weakness, single vomiting after which the patient lost consciousness. Emergency team delivered him to the hospital. Objectively: the patient is conscious, with slightly deferred reaction, pale. Heart rate is 20 breaths/min, Ps is 102 bpm, AP is 110/70 mm Hg. Abdomen is soft, painful in the epigastrium. What is the most likely di- agnosis?
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