1.

A friend of yours who works for Metropolitan Police Analytical Laboratories

calls and asks for your advice on a case he is working on. They are trying to
analyze an unknown substance which may be human saliva. He asks what
would the expected pH range would be?

A. 4.2-6.8
B. 7.6-9.5
C. 5.2-9.2
D. 5.8-7.4
E. 4.8-8.9

2. A patient who has been suffering from a highly resistant dental infection has
been on a number of different antibiotics for the past two weeks. Whilst
consulting with the patient you find out that they are suffering from bloody
diarrhea. Which of the following drugs on their regimen may be the likely
culprit?

A. Clindamycin
B. Metronidazole
C. Amoxicillin
D. Gatifloxacin
E. Thiabendazole

3. An NHS dental prescription in the UK is coded......and is the
colour......?Select one:

A. FP10(D), Yellow
B. FP10(D), Pink
C. FP10(DS), Yellow
D. FP10(DN), Grey
E. FP10(DT), Yellow

4. Dentist CANNOT prescribe which of the following medications on the NHS?

A. Aciclovir cream
B. Amoxicillin capsules
C. Menthol eucalyptus inhalation
D. Diclofenac sodium tablets
E. Metronidazole capsules

5. Digestion starts in the mouth with the enzyme amylaze. Amylaze breaks
down complex sugars into which of the following?
A. Disaccharide lactose
B. Monosaccharide dextose
C. Disaccharide fructose
D. Monosaccharide maltose
E. Disaccharide maltose


6. In respects to Immunoglobulin M which of the following is correct?

A. It is a glycoprotein
B. It is produced by T cells
C. It is the only immunoglobulin to actively cross the placenta.
D. Plays a major role in the defence against parasites
E. Comprises 75% of the total serum immunoglobulins

7. A patient with a leg prostheses has just had a dental procedure which would
usually mean the patient would be put on antibiotic prophylaxis. Which of the
following statements is true regarding this scenario?

A. Patients with prostheses need a higher dose as there may be residual
scarring after their initial surgery
B. The patient should be prescribed Metronidazole 200mg tds
C. The patient should be prescribed Amoxicillin 250mg tds
D. The patient should be prescribed Amoxicillin 500mg tds
E. Patients who have a prostheses should no be given antibiotic prophylaxis

8. Which of the following drugs does not typically cause dental ulceration?

A. NSAIDS
B. Atenolol
C. Captopril
D. Methotrexate
E. Essential oils





9. Which of the following compounds is not known to stain teeth?

A. Co-amoxiclav suspension
B. Tetracyclines
C. Co-amoxiclav tablets
D. Chlorhexidine
E. Liquid form Iron salts


10. Sterilisation may be achieved by the following chemical agents:

A. Quaternary ammonium compounds
B. Dipicolinic acid
C. Glutaraldehyde
D. Ethylene oxide
E. PTGB

11. In respects to Streptococcus pneumoniae which of the following
statements is true?

A. is not found as part of the normal upper respiratory tract flora in humans
B. is frequently isolated from clinical specimens in cases of acute sinusitis and
acute otitis media
C. is usually susceptible to metronidazole
D. is the commonest cause of community acquired pneumonia in adults
E. is "bile soluble"

12. In respects to Streptococcus pyogenes, which of the following is correct?

A. is the commonest cause of acute pharyngitis
B. can be cultured from heart valves in acute rheumatic fever
C. is always susceptible to penicillin
D. is a frequent cause of cellulitis
E. is alpha-haemolytic when grown on blood agar






13. The submandibular ducts are located either side of which structure?

A. Parotid duct
B. Fungiform papillae
C. Maxilla
D. Palatine Tonsil
E. Frenulum

14. The tongue, at its base, is attached to which of the following structures?

A. Uvula
B. Hyoid bone
C. Palatoglossal arch
D. Palatopharyngeal arch
E. Vallate papillae

15. Which of the following signs indicates that a root canal is NOT needed?

A. A lightening of the tooth
B. Severe toothache pain upon chewing or application of pressure
C. Swelling and tenderness in the nearby gums
D. Prolonged sensitivity/pain to heat or cold temperatures (after the hot or
cold has been removed)
E. Persistent or recurring pimple on the gums

16. Which of the following is NOT a "disulfiram-like reaction" (alcohol-
metronidazole interaction)?

A. Palpitations
B. Sweating
C. Severe diarrhea
D. Throbbing headache
E. Chest pain







17. Which of the following statements may refer to hypoglossal nerves?

A. They are classified as mandibular nerves
B. They are involved with temperature sensation
C. They supply voluntary muscle tissue
D. They are involved with carrying information about taste
E. They are involved with pain sensation

18. Which of the following terms refers to the bony hard palate and muscular
soft palate?

A. Inferiorly
B. Superiorly
C. Laterally
D. Anteriorly
E. Posteriorly

19. Whilst consulting with a patient you read their dental record. A previous
dental nurse had written the abbreviation "O/E" on their records. What does
this stand for?

A. Occasional Erosion
B. Oral Emergency
C. Oral Endoscopy
D. Obstetrics and Endocrinology
E. On Examination


20. Which one of the following nerves is the most likely to be responsible for
the perception of this pain?

A. Facial
B. Incisive
C. Long buccal
D. Marginal mandibular
E. Mental




ANSWERS WITH FEEDBACK

1. D - This is highly dependent on the rate of flow of saliva. Produced in
salivary glands, human saliva is 98% water, but it contains many
important substances, including electrolytes, mucus, antibacterial
compounds and various enzymes.

2. A - Clindamycin is classified in the macrolide group of antibiotics. It is
indicated for the treatment of various bacterial infections. The
recommended dose of the drug is 150-300 mg every 6 hours. Bloody
diarrhea, pseudomembranous colitis, anaphylaxis and Steven Johnson
Syndrome are reported side effects of the drug.

3. A - FP10D - Yellow - Forms issued by dentists in primary care. Only items
listed in the dental formulary can be prescribed on this prescription.

4. E - This is a little bit of a trick question! Although all these items are on
the tariff including metronidazole, only metronidazole TABLETS are
allowed on the NHS. Remember the Formulary is both drug specific and
formulation specific. If it does match exactly, you cannot prescribe it.

5. E - Maltose, or malt sugar, is a disaccharide formed from two units of
glucose joined with an α(1→4)bond. The isomer isomaltose has two
glucose molecules linked through an α(1→6) bond. Maltose is the
second member of an important biochemical series of glucose chains.
Maltose is the disaccharide produced when amylase breaks down starch.
It is found in germinating seeds such as Barley as they break down their
starch stores to use for food.

The addition of another glucose unit yields maltotriose; further additions
will produce dextrins (also called maltodextrins) and eventually starch
(glucose polymer).

6. A - Immunoglobulin M, or IgM for short, is a basic antibody that is
produced by B cells. It is the primary antibody against A and B antigens
on red blood cells. IgM is by far the physically largest antibody in the
human circulatory system. It is the first antibody to appear in response
to initial exposure to antigen.

 7. E - This is correct as advice for the Working Party for the British Society
for Antimicrobial Chemotherapy states patients with a prosthetic
implant do not require antibiotic prophylaxis for dental treatment as the
side effects have been show to out weigh any benefits. Reference BNF,
Antimicrobials - Dental.

8. B - This is not a common side effect of beta blockers.

9. A - Co-amoxiclav suspension (augmentin) causes discoloration however,
the tablets do not.

10. D - Ethylene oxide inhibits growth of microorganisms (disinfectant
properties) and when present in high concentrations, can completely
destroy them. Strong alkylating properties make ethylene oxide a
universal poison for protoplasm: it causes clotting of proteins,
deactivation of enzymes and other biologically important components of
a living organism.

Ethylene oxide acts more strongly against bacteria, especially gram-
positive bacteria, than against yeast and fungi. The disinfectant effect of
ethylene oxide is similar to that of sterilization by heat, but because of
limited penetration, it affects only the surface. The Sterility Assurance
Level, after a certain specified exposure to ethylene oxide is 10−6,
meaning that the chance of finding a single bacterium is below 1 per
million.

11. E - This test is useful in distinguishing S. pneumoniae from viridans
group streptococci which are also alpha-haemolytic.

Streptococcus pneumoniae, or pneumococcus, is gram-positive, alpha-
hemolytic, bile-soluble aerotolerant anaerobe and a member of the
genus Streptococcus. A significant human pathogenic bacterium, S.
pneumoniae was recognized as a major cause of pneumonia in the late
19th century and is the subject of many humoral immunity studies.

12. D - A streptococcus is one of the most common pathogens responsible
for cellulitis.

 13. E- The frenulum is a small fold or ridge of tissue which supports or
checks the motion of the part to which it is attached, in particular a fold
of skin beneath the tongue, or between the lip and the gum.

14. B - This is a U-shaped bone in the neck which supports the tongue.

15. A- Usually a discoloration (darkening) of the tooth indicates this is
needed.

16. C - You should know this well due to metronidazole!

17. C - The hypoglossal nerve is the twelfth cranial nerve, and innervates all
extrinsic and intrinsic muscles of the tongue, except for the
palatoglossus.

18. B

19. E - O/E is a generic medical abbreviation which stands for "on
examination", where the information observed by health professionals is
noted.

20. C