Gen medicine

Dputyrens sign (alcoholic liver disease) brudzinskis sign and kernigs sign stroke
Diagnostic test for infectious mononucleosis : paul bunnel and mono spot tests
Percentage of leucocytes for an extraction
Glucose levels during fasting and random. Normal fasting < 6 mmol/l random < 8 mmol/l. In diabetics
fasting >7mmol/l random >11.1 mmol/l
Asthma, angina treatment
Angina : glyceryl trinitrate, ca channel blockers, asprin, percutaneous transluminal angioplasty (ptca),
coronary artery bypass grafts (cabg)
Asthma : beta agonist such as salbutamol (safest and most effective bronchodialator for routine control,
antimuscuranics such as ipratropium (for those who have asthma with bronchitis),corticosteroids (if there
are daily symptoms of asthma).systemic steroids,o2 and hospitalization for severe recalcitrant patients.
What type of test should you ask for a patient with: diabetes(fasting plasma glucose, random and oral glucose
tolerance test)
Anaemia (blood tests and blood film, schilling test fro vit b12 def)
Pt on warfarin Inr (normal 1,for dento alveolar extractions <3.5) pt time (normal 1.3 and for dento al
veolar surgery < 2.5)
What kind of ag should be detected to check if the infected dentist with hepatitis b can still work.(If hbe ag is
+ve or hbe ag is -ve but have greater than 1000 Hbv viral particles per ml of blood should discontinue
practice involving exposure prone procedures)
Questions about inform consent (age)
Medical emergency (angina, asthma, MI)
Questions about rheumatic fever ( major carditis,polyarthritis ,chorea, E.marginatum,subcutaneous
nodules,ECG changes) Rx Penicillin till 20 yrs 500mg
Cushing's disease : excessive glucocorticoid production by adrenal hyperplasia secondary to excess acth
production by pituitary hyperplasia ( preop hydrocortisone 25-50mg iv)
Tuberculosis (secretion with blood) post part and dorsum of tongue ulcer (X BDZ,paracetamol,azoles)
Picture gigantism and acromegaly
Tetany : contracture of the muscles due to low serum ca levels ( trousseau and chvostek sign)
Leukaemia in adults : acute non lymphoblastic(myeloblastic) leukaemia and chronic lymphocytic
leukemia...aml cll
Graves disease (primary hyper thyroidism with a diffuse goitre-toxic goitre) (type 5)
Trigeminal neuropathy medication used
Cranial arteritis (Esr is raised)
Vaccinations (when should we take them) 2,3,4 mths DPT 12-18 mths MMR ,4-5yrs booster,10-14yrs BCG
Which analysis(tests) to prescribe in certain conditions in patients
Rheumatoid arthritis ulnar deviation,HLA DR4,IgM ab rheumatic factor
Osteoarthritis swelling of joints-herbenden's nodes,Bouchards nodes
Crushing pain in the chest radiating to arm & relieved by sub-lingual gtn - angina
Tightness in the chest, wheezing, shortness of breath asthma
Crushing pain in the chest accompanied by vomiting- MI
Patient with breathlessness and sleeps with 4 pillows, associated medical condition-copd/heart failure:left
heart failure (pul edema and breathlessness LHF, systemic manifestations RHF)
After what percentage of blood loss should transfusion be given?20%
Tuberculosis - weight loss, fever, cough
Treatment for basilar artery aneurysm

Couple of questions on leukemia n its age of occurrence (acute lymphoblastic 2-4yrs most common in
children , AML most common acute leukemia in adults, CLL most common in adults,CML >40yrs)
Classified as acute or chronic or acc to cells of origin (lymphoblast or non lymphoblast)
Acute lymphoblastic leukemia-peak incidence 2-4yrs but can affect any age grp.most common childhood
leukemia.tx :cytotoxic drugs,bm transplantation if chemo fails
Adult acute lymphoblastic leukemia - worse pognonsis than chilhood rest all the same as above
Acute non lymphoblastic (myeloblastic) leukemia - most common acute leukemia of adults.esp causes
gingival enlargement
Chronic lymphocytic leukemia - most common type of leukemia. men particularly affected.
asymptomatic patients may not need Rx.symptomatic- with radio and chemo therapy. prognosis better
than acute.
Chronic myeloid leukmia - proliferation of myeloid cells in bone marrow,peripheral blood and
tissues.have philepedia chromosome. >40 yrs age grp affected.lymphadenopathy is rare.
Study different git conditions...especially git infections.....
Questions on sle, scleroderma, rheumatoid arthritis like what does swelling of distal interphalyngeal joints
indicate?( anti topoisomerase ,anticentrromere ab in scleroderma, SLE anti nuclear and anti
DNA)Sjogrens syndrome
Questions on lichen planus and desquamative gingivitis`:also caused by phemphigoid
Oral features of gardeners syndrome : multiple osteomas particularly of jaws and facial bones.,epidermoid
cyts and fibromas of the skin,lipomas,adenocarcinomas,Colon polyps,dental anomalies
Association of carious teeth in 16 year old with intake of high sugar content and foods with low calorific
value; options- schizophrenia, depression, anxiety, etc.
Questions on hypo and hyperthyroidism
Questions on multiple myeloma :disseminated plasma cell neoplasm (uncommon grp of b lympho
disorders).detected by electrophoresis by over production of Specific Ig.(IgG 50%,Iga 25%).predominantly
causes bone lesions. Malignant plasma cells produce defective igs which release osteoclast activating
factors that cause bone resorption and pain. disease of middle aged and elderly. detected by high esr,
leucopenia, thromocytopenia in routine blood tests and bence jones proteinuria causes bone destruction
,hypercalcemia, suppression of haemopoiesis, normochromic anemia. osteolytic lesions in skull radiographs
(round discrete punched out osteolytic lesions called pepper pot skull). amyloid may be deposited in oral soft
tissues causing macroglossia. Rx: chemotherapy with corticosteroids and bisphosphonates.
Lots of questions on candidiasis; related questions on angular chelitis, pseudomembranous candidiasis
treatment in immunocompromised patients
Questions on asthma
Questions on tuberculosis and the side effects the drugs used to treat it cause
Ethambutol can cause ocular damage,streptomycin ototoxic, ISN is peripheral neuropathy and hepatotoxic,
rifampicin nephro and hepato toxic, red saliva and urine, pyrazinamide is hepatotoxic, streptomycin is oto and
nephrotoxic, circumoral paraesthsia

Various questions on conscious sedation and GA, their applications in various clinical settings; inhalational
and iv sedation
Questions on infectious mononucleosis: EBV
Picture of comparatively large hands of a woman
Woman with hiatus hernia with tooth surface loss. Best treat. Option: (surgery wasnt an option)
Medicine
Dietary advice
Occlusal splint
Reason for tingling of hands and feet during treatment of long standing procedures
Question on sleep apnoea?
What vaccine is used to prevent tb? BCG 14 yrs

In which condition would elective surgery be contraindicated for 6 months?

o Myocardial infarction
o Angina
o Cardiac failure
o Infective endocarditis
What is the age of onset for type 1 diabetes? (20yrs)
What is used for the management of type 1 diabetes?
o Insulin
o Oral hypo glycaemic drugs.
o Diet alone
o Drugs and diet
What substances are increased in a diabetic coma?Ketones
Clinical presentation of
o Asthma (exp wheeze)
o Chronic bronchitis thick mucus
o Tumour in the upper lobe of the lungs (stridor)
o Codeine use (constipation)
o Pethidine use
o Carbamazepine use (dry airway)

The options were: inspiratory wheeze, expiratory wheeze, Stridor, daily mucus production, dry airway, dry cough,
constipation.

Which communicable disease should be informed to the consultant?

What is the average respiratory rate for adults? 12/min
What is the average respiratory rate for children? 25/min
In a patient with colonic polyps diagnosed by colonoscopy, which other feature is present? osteomas
(Gardeners syndrome)
Ulnar deviation is seen in which condition? rheumatoid arthritis
A patient who is under-weight, has a diet high in sugar with very few calories has anorexia nervosa
Tightness in the chest, wheezing, shortness of breath asthma
Swelling of inter-pharngeal joints RA
Condition which is relieved by sleeping on 3-4 pillow LHF
Weight loss, fever, cough tuberculosis
Weight gain & intolerance to cold hypothyroidism
Picture of a lady with very large hands acromegaly
Ques on cranial nerve examination like when they are damaged what happens eg Occulomotor and abducens.
Pls read from scully
Investigations used for different types of anemias
Investigations for coeliac disease, chrons, ibs etc. ( sigmoidoscopy,colonoscopy,mucosal biopsy,raised C
proteins,ESR,blood tests for vit def,intestinal scans,barium scan, Coeliac disease blood test, ELISA for gliadin
IgA ab,Jejunal biopsy,absorption tests)
Asthma what happens to the airway?Bronchospasm
Pls read emphysema, upper respiratory tract infections, copd they had asked indirect ques on them.
Which of the following would u not notify? So need to read notifiable diseases
A patient had angina in past six months would u continue treatment, refer, not treat etc. Pls read angina and mi
Type 1 diabetes features like patients age? Usually underweight <20 yrs
Type 2 diabetes: Pt would be overweight age? Also, if u r treating a diabetic patient ask him to take his dose
normally before appointment.
What would u give in hyperglycemic collapse/dizziness situation?(20 units Im stat)
Ulnar deviation:rheumatoid arthritis options sle,pemphigus,pemphigoid etc.
Sjogrens syndrome triad type 1 and 2
Causes and features for Addisons and Cushing disease. They had given options like rickets, graves disease
etc.

Microcytic anaemia, ferritin levels normal what exam to check probable cause? Name of exam requested
to check thalassemia???(Falling ferritin raised iron binding capacity and transferring saturation indicate
microcytic anaemia due to iron def, if TIBC increases it is thalassmeia, if that decreases liver disease.
Schilling test vit B12 def, Sickle test for sickle cell anaemia, thalessmia aniso poikilocytosis target
cells,basophilic strippling)
Asthma, emphysema, cystic fibrosis(sweat test Na > 60mmol/l)
Hands signs related with diseases, koilonichia, ulnar deviation, etc
Dental characteristics in patient with bulimia
Test to determine infectious mono-neucleosis(Paul bunnel test)
What is the normal fasting blood sugar level? 3.5 5.5 mmol/l
Patient with niddm diabetes undergoing dental procedure. Eat normally & take regular dose of metformin
Hand sign in mitral valve problems (Splinter haemorrhages)
Hand sign in rheumatoid arthritis. Ulnar deviation
Hand sign in inflammation of hand joints. Heberdens nodes
Most difficulty in brushing teeth? In rheumatoid arthritis
Antibiotic prophylaxis required in mitral valve defect
Patient with rheumatoid arthritis and biliary cirrhosis has secondary ss
Hand sign in mitral valve problems. Splinter hemorrhages
Hand sign in rheumatoid arthritis. Ulnar deviation
Hand sign in inflammation of hand joints. Heberdens nodes
Most difficulty in brushing teeth? In rheumatoid arthritis
Antibiotic prophylaxis required in mitral valve defect
Patient with rheumatoid arthritis and biliary cirrhosis has secondary ss
Patient has bilateral involvement of joints and pain in the morning & weight-bearing joints are involved.
Rheumatoid arthritis
Patient with splenomegaly & intra-oral lesions. Infectious mononucleosis
65-year old lady with forgetfulness & difficulty in doing daily tasks? Alzheimers disease
Picture of tongue with several small white lesions. Celiac disease
Which test will you perform in an afro-caribbean if the tests for anemia are normal? Sickle cell test
Cleft lip & palate increases with maternal intake of antibiotics
Anemia in rheumatoid arthritis? Anemia of chronic disease and iron def anemia
In which condition is intra-articular bleeding minimal? Von williebrand disease
Factor VIII is reduced in hemophilia
Period of vaccination (scully)
What is the minimum platelet count required in a patient undergoing extraction? 50 x 109
Patient with fatigue & excessive bleeding? Leukaemia
Most commom bleeding disorder?Von willibrands.warfarin and asprin
Haemophilia a: factor viii deficiency
Bechets disease :recurrent oral ulcers,uveitis and genital ulcers
Sarcoidosis-granulomatous disease
Tuberculosis
Kaposiss sarcoma: hhv-8
Burkitts lymphoma: ebv
Temporal arteritis
Trigeminal neuralgia
Atypical facial pain
Where can you assess masseter?
Most common cause of chronic renal disease? diabetes Pyelonephritis, hepatitis, etc
Pagets disease: alkaline phosphatase increased
Alveolar osteitis
Osteomyelitis
Whats increased in elderly? Systole, diastole, stroke volume, etc
Iron deficiency anaemia

Whats the most frequent site of endocarditic? Aortic valve, tricuspid, bicuspid, mitral, etc
Emphysema: destruction of alveoli
Faint
Sign of asthma: wheezing
Lung silicosis clinical features and diagnosis
Fev1/fev what happens is lung silicosis
C/f of heart burn, MI, angina, rib fracture
Heart burn is it worse lying down? Standing will relieve it
Hypoglycaemia, adisonian crisis,epilepsy, mi c/f
Hand signs match with disease eg ra ulnar deviation etc
Diabitis insipidus(hypo-osmolar urine)
Haemoglobinopathy
Infection in a man who travelled to asia.treponema pallidum ..syphilis is no longer commonplace in
the developed world but it is still widespread in asia
Woman with bloody sputum
Man with candidiasis, generalised lymphadenopathy
Bilateral parotid swelling options sarcoidosis, etc
Infection with weight loss in an afro-carribean.tb
Man with pain in the phalangesRA
Treatment for sinusitis( penicillin/erythromycin/doxycycline)
Pain worsened by bending forwarddiagnosis heartburn
Lady with swelling of buccal mucosa and other symptoms?Chrons
Pain in interphalangeal joints.Ra
Deformed finger joint.ra
Disease with progressive cartilage destruction.ra
Ab cover in surgery and hospital
Sign and symptoms in medical emergencies
Different values of fbc were given and type of anaemia was asked
Questions on hypothyroidism and hyperthyroidism
Clinical situations (5 questions) tests: fasting glucose <6mmol/l, fbc, inr for warfarin - <3.5, etc
Asthma acute attack best medication salbutamol
Medical emergencies clinical situations (2 questions with 5 sub questions each) mi, anaphylaxis,
addisonians crisis, angina, hypoglycaemia
Prosthetic valves ab prophylaxis: not, but increased risk of infective endocarditis
Infective endocarditis causative micro organism in the uk streptococcus viridans
Psychiatric disorders claustrophobia, hypochondriasis, obsessive compulsive disorder, mania, schizophrenia
Pain and diagnostic
Crohns disease main gi part affected: ileum
Parkinson
Whats the most frequent cause of dementia? Alzheimers, etc
Whats more likely to cause sickle cell crisis? Exercise, chirurgic trauma, etc
(infection,hypoxia,acidosis,dehydration) sickle cell traiar HbsA
Which one is a hemoglobulinopathy? Sickle cell, thalassemia, etc
Rheumatoid arthritis
Osteoarthroses: heberdens nodes
Most likely to suffer from hypoglycemia during dental treatment: young diabetic patient insulin dependent
during mealtimes