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KROK 2 Dentistry 2014 Questions | KROKEXAM
Browse 2014 KROK 2 Dentistry exam questions with answers and explanations.
Exam questions
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A 15-year-old teenager consulted an orthodontist about misalignment of teeth. Objectively: the face is unremarkable. The patient has permanent dentition. There are no abnormalities of jaw relationship in three dimensions. The 23 tooth has a vestibular position and is located above the occlusal plane, the space in the dental arch is less than 1/3 of crown. The space for the misaligned 23 tooth can be gained due to:
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An 11-year-old boy complains of a carious cavity in a mandibular tooth on the right. Objectively: the 46 tooth exhibits a carious cavity within the mantle dentin. The dentin is dense, pigmented; there is pain response to the cold stimulus, probing and percussion cause no pain response. Make a provisional diagnosis:
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A 45-year-old male patient complains of inertness, headache, fever up to 39°C, burning neuralgic pain in the mandible on the right. Objectively: the skin of chin on the right is hyperemic, there is vesicular rash with a vesicle diameter of 1 to 6 mm. Similar vesicles can be found on the hyperemic oral mucosa on the right. They burst easily making erosions which are covered with fibrinous pellicles. Regional lymphadenitis is present. What is the most likely diagnosis?
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A 50-year-old patient complains of dryness and burning sensation in the mouth, pain during eating, taste perversion. The symptoms occurred a week ago after taking the course of antibiotics for acute bronchitis. Objectively: oral mucosa is covered with patches of white caseous deposit. The deposit can be easily removed when scraped, revealing hyperemic areas of mucous membrane. Which is the most likely diagnosis?
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A 56-year-old female patient complains of burning neuralgic pain in the left half of the mandible, which appeared two days ago. There is also rash in form of tense vesicles on the reddened skin and mucosa of the lower lip on the left, accompanied by malaise, headache, body temperature elevation up to 38°C, left-sided lymphadenitis. What is the most likely diagnosis?
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A 21-year-old dental patient has been found to have a circular ulcer on the tongue dorsum. The ulcer is up to 1 cm in diameter, has demarcated raised edges and a deep inflammatory infiltrate at the base. The ulcer floor is flat, clean, of crimson color. The regional lymph nodes are of cartilaginous density, mobile, painless. The ulcer appeared a week ago and doesn't cause any discomfort. What kind of ulcer should be suspected in the first place?
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An 11-year-old boy complains of a short-term pain from the cold in a left mandibular tooth. Objectively: the medial surface of the 36 tooth exhibits a carious cavity within parapulpar dentin. The cavity is filled with light, softened dentin and does not communicate with the cavity of the tooth. Probing the of the 36 tooth floor causes pain response, the tooth is not sensitive to percussion, the response to the cold stimulus does not stay long after its removal. What is the most likely diagnosis?
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A 36-year-old patient with the face and neck burns resulting from gasoline ignition has been delivered to the emergency room. Palpebral fissures are closed due to the eyelid edema. The face skin is erythematous, there are large tense blisters on the skin of the chin, cheeks, nose, forehead, superior surface of neck. Specify the degree of burns:
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A 9-year-old child has a symmetrical maxillary diastema with crown divergence. The relationship of the lateral teeth is neutral. In the anterior segment the depth of incisal overbite is 1/3 of the crown height. What appliance can be used for simultaneous treatment of diastema and crown divergence?
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A 52-year-old female patient complains of a persistent burning sensation at the tip and lateral surface of the tongue. The burning occurs in the morning and gets worse in the evening, the sensation disappears when eating. The patient reports having had these symptoms for about a year and associates the disease with wearing removable dentures. The patient has a history of anacid gastritis, a surgery for uterine fibroids, second degree hypertension, poor sleep, anxiety. Objectively: the tongue is slightly swollen, the tongue dorsum is covered with a thin white plaque, filiform papillae are atrophied. The rest of the mucosa exhibits no visible pathological changes. Pharyngeal reflex is suppressed. What is the most likely diagnosis?
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A 28-year-old female patient consulted a dentist about pain caused by thermal and chemical stimuli in the mandibular and maxillary teeth. Objectively: in the cervical zone of mandibular and maxillary incisors and canines there are irregularly shaped defects of hard dental tissues within the amelodentinal junction in form of tissue softening. In this clinical case a dentist will find it difficult to differentiate between the following diseases:
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A 52-year-old male patient working as a driver consulted a dentist about pain, difficult mouth opening. The patient had been diagnosed with ulcerative leukoplakia. After a 10-day course of therapy sluggish granulation began. On the periphery of the ulcer the keratini-zation processes became more active. Which of the following tests must be conducted in the first place?
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4 hours after application of arsenic paste to the 36 tooth pulp, a 27-year-old patient complained of pain in the treated tooth. Objectively: on the distal surface of the 36 tooth the temporary filling is present. Percussion causes no pain response. Gingival papilla in the region of the 36, 37 teeth is hyperemic and edematous, its apex is necrotized. What is the optimal tactics of this patient management?
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A 43-year-old female patient has been diagnosed with generalized periodontitis. What examination is most informative for determining the severity grade of the disease?
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A 7,5-year-old boy fell down on his face and damaged his front maxillary teeth. Objectively: the crowns of the 11 and 12 teeth are destroyed by 1/4. The tooth cavity is closed. Probing causes pain along the break-off line, percussion of the 11 and 12 teeth causes no pain response. Mucosa around the 11 and 12 teeth is slightly hyperemic. Radiograph of the 11 and 12 teeth shows the intactness of the dental tissues and alveolar process. What tactics of a dentist would be optimal in the first hours after the injury?
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A 9-year-old child complains of pain in the left mandibular molar that occurs during eating. The masticatory surface of the 75 tooth exhibits a carious cavitiy filled with softened dentin and localized within parapulpar dentin. The cavity communicates with the tooth cavity. Probing at the site of communication causes acute pain and moderate bleeding. Percussion of the tooth causes no pain response. Radiography revaled no periodontal alterations in the 75 tooth. Select the method of treatment:
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Preventive examination a 6-year-old child revealed that the child had deciduous dentition, direct incisor contact in the frontal segment, no gaps between teeth; contact of homonymous canines and molars; abrasion of masticatory tubercles of the molars. The child's condition corresponds with the following period:
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A 12-year-old girl visited a dentist for a regular check-up. Objectively: the teeth are intact, the bite is open, the mucosa in the papillary and marginal regions is hyperemic and cyanotic, the gingival papillae are roundish, enlarged and cover one third of the crown height of the anterior maxillary teeth. Make a provisional diagnosis:
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A 29-year-old male patient complains of gingival hemorrhages during tooth brushing, and bad breath. Objectively: gingival papillae and marginal gingiva are hyperemic with a cyanotic tint, bleed on probing. Periodontal pockets are 3-3,5 mm deep, with serous exudate expressed from them. The sub- and supragingival calculus is present. Orthopantomograph shows osteoporosis of the alveolar process, resorption of interalveolar septa to 1/3. What is the most likely diagnosis?
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A 40-year-old patient complains of fever up to 38°C, and a roundish infiltration on the upper lip. Objectively: the upper lip on the left exhibits a round infiltrate, the overlying skin is deep crimson. The infiltrate adheres to the surrounding tissues and has a necrotic core in the center. The upper lip is hyperemic, edematous. What di- agnosis can be made?
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A 20-year-old female patient consulted a dentist about a short-term pain in the 22 tooth caused by cold stimuli or contact with food. The pain had been observed for several months. After the examination, the patient was diagnosed with acute deep caries of the 22 tooth. What material should be used as a base for the cavity filling?
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A 48-year-old female patient underwent parotidectomy for a benign tumor of the parotid gland. Postoperatively, the patient was observed to have mouth downturning, midline deviation towards the unaffected side, speech disturbance. Which branch of the facial nerve was damaged during the surgical intervention?
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On examination a 42-year-old patient was diagnosed with acute suppurative periostitis of the mandible beginning from the 35 tooth. What is the most rational method of anesthesia for the 35 tooth extraction and dissection of the subperiosteal abscess?
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Examination of a 31-year-old patient revealed perforation of the pulp chamber floor of the 36 tooth with a minor radiolucency of the interradicular septum. Which of the following methods of surgical treatment should be applied in order to save the 36 tooth and use it as an abutment tooth for a bridge denture?
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A 42-year-old patient complains of pain in the right side of her head, restricted movements of the lower jaw, clicking sound, periodic spasms of chewing muscles. Objectively: the face is symmetric, mouth opening is restricted. On palpation of the right temporo-mandibular joint (TMJ) there are crepitation and clicking that accompany the mandible movements. Examination of the oral cavity revealed also a Kennedy's class II defect on the right. What is the most likely diagnosis?
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A 40-year-old patient complains of malaise, weakness, headache, fever up to 38,5°C. Objectively: there is a symmetric red lesion in form of butterfly-wing rash on the face around the nose and cheeks. The lesion is clearly demarcated, tender on palpation, does not disappear when pressed upon. The skin is raised and glossy. Submandibular and parotid superficial lymph nodes are enlarged, tender to palpation. What is the most likely diagnosis?
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A 43-year-old male patient awaits fabrication of full swaged crowns for the 26 and 27 teeth. What material should be used for the dental dies?
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Examination of a 9-year-old child revealed chalky spots in the cervical zone of the 12, 11, 21, 22 teeth. The spots appeared two weeks ago. Lustreless surface of the spots is stainable with methylene blue. The affected teeth are not sensitive to the cold stimulus. Specify the physician's tactics in respect of the affected teeth:
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An 18-year-old male has a furuncle in the region of the mandible angle. The surrounding tissues are rigid. Cyanosis and induration in form of a cord extend to the corner of the eye. General condition is deteriorated, body temperature is of 38,5°C. What complication has developed in this case?
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Regimental aid station admitted a wounded soldier with a diagnosis of a gunshot fracture of the mandibular body. What kind of immobilization is required at this stage?
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A 17-year-old male patient complains about having a fistula on the anterior surface of his neck. The fistula has been present since birth. Periodically there appears a small amount of mucoid discharge. The patient has been diagnosed with a middle cervical fistula. What tactics of treatment should be preferred for this patient?
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A 70-year-old patient complains of inability to take food, a cosmetic and phonetic defect due to the complete loss of mandibular teeth. Objectively: the lateral segment of the alveolar process of the mandible is significantly atrophied, while the frontal segment is relatively preserved. Buccal folds are attached at the crest of the alveolar process. These clinical presentations correspond with the following class of edentulous jaws according to Keller classification:
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A 24-year-old male who had been injured in a fight was delivered to the maxillofacial department. The patient was diagnosed with a fracture of the left zygomatic bone with a displacement; a fracture of the anterior wall of the maxillary sinus. What kind of surgery is indicated for this patient?
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A 50-year-old male patient has a gunshot wound to the mandible and a bone defect in the mental area. What method of immobilization is indicated for this patient?
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3 days ago a 35-year-old patient underwent the extraction of the 47 tooth, which was followed by health deterioration. Objectively: the patient is pale, body temperature is of 38,1°C, the mandible on the left is thickened, the surrounding soft tissues are swollen, mouth opening is difficult. Mucogingival junction at the 48, 47, 46 teeth is edematous, mucous membrane is hyperemic. There are purulent discharges from the 47 tooth socket, the 48, 46, 45 teeth are sensitive to percussion. There is also paresthesia in the lower lip region. What is the most likely diagnosis?
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A female patient presented to a clinic for prosthetics. Objectively: the lower third of the face is shortened; nasolabial folds are deepened; the front teeth of both jaws are missing; the crowns of the 17, 15, 26, 27, 36, 37, 45, 47 teeth are worn by 2/3 of their height; the chewing surfaces of these teeth are smooth and pigmented; alveolar bone is not hypertrophied, interalveolar height is decreased. Specify the form of pathological dental abrasion in this patient:
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Following the extraction of the 12, 11, 21, 22, 23 teeth, a 50-year-old pati- ent will receive an immediate-insertion denture. What denture should be used in this situation?
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A 10-year-old child was undergoing complex dental care. During the procedures, a deep carious cavity communicating with the tooth cavity was revealed in the 36 tooth. The tooth was not sensitive either to probing, percussion, or temperature stimuli. The patient was diagnosed with chronic periodontitis. During the treatment, the accidental perforation of the tooth cavity floor occurred. What measures should be taken in this case?
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Dental examination of a 19-year-old girl revealed white spots in the cervical zone of the 11, 21 teeth. According to the patient, the spots appeared about two months ago and had slowly enlarged since that time. Which of the following diseases is characterized by such history?
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A 52-year-old patient complains of pain and a swelling in the right parotid region. These manifestations have been present for about 2 years. Over the last month the swelling has grown bigger, pain has intensified. Objectively: the face is asymmetric due to a dense infiltrate in the right parotid region. The poorly circumscribed, tender to palpation lump infiltrates the surrounding tissues. On the right side of neck in front and behind the sternocleidomastoid muscle there are enlarged, dense, mobile lymph nodes. The right naso-buccal groove is flattened, the corner of mouth is downturned. The mouth opens freely. The are pronounced symptoms of the right facial nerve paresis. What disease can be suspected?
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