63.Injury at the lower border of a rib will most likely damage which structure?

A. intercostal a. B. intercostal n.
C. intercostal v. D. internal intercostal muscle

ANS>B. The three structures in the intercostal space are, from superior to inferior, the intercostal vein, artery, and nerve. The proper site for insertion of an intercostal drain is superior to a rib, not directly at the level of the superior border but slightly higher to avoid the collateral branches of the nerve, artery, and vein. The nerve is the most inferior structure and thus most likely to be damaged by the drain (producing an anesthetic dermatome). In addition, the nerve is the least protected by the costal groove.

The intercostal artery (choice A) is the middle structure and thus is not the most likely to be damaged.

The intercostal vein (choice C) is the most superior structure and is thus the least likely to be damaged. In addition, the vein is the structure best protected by the costal groove (the further superior the structure, the more protected by the costal groove).

The internal intercostal fibers (choice D) will tend to be separated by the drain. In addition, the internal intercostal muscle is membranous (internal intercostal membrane) posteriorly, from the neck of the rib to its angle; therefore, many drains, when inserted, will not even pass through a layer of internal intercostal muscle.


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62.A trauma patient is bleeding in the casualty. The immediate measure of management would be:

1.Suture the tongue with silk 2.Use towel clip

3.Oro-pharyngeal airway 4.Definite airway

ANS.4

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61.Gingivoplasty is not indicated in all the following except:

1.ANUG 2.Desquamative gingivitis
3.Acute herpetic gingivitis 4.Erosive lichen planus


ANS. 1


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60.The cavo surface angle for inlay cavity preparation :

a. 90 degree b. 150 degree
c.<90 d. 180

Ans. B

The angle at the junction of the walls of the cavity preparation and the external surface of the tooth.

It is of two types

[Ref Sturdevant 4th ed. Pg 300]

Butt joint

Lap / Slip joint

90o cavosurface angle

Advocated in amalgam restorations because amalgam is a brittle material and has low edge strength

Butt joint produces maximal strength for both tooth and amalgam.

It is also advocated in silicate and porcelain restorations

> 90 degree cavosurface angle.

Advocated in cast and composite restorations

30 – 40o marginal metal and 140 – 150o cavosurface angle.

Beveling enables superior adaptation and burnishability of marginal metal

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59.Tuberculosis is immunologically mediated disorder of

a. Autotoxic type b. Immune complex disease
c. Delayed hypersensitivity d. Anaphylactic type

Ans: C. Delayed hypersensitivity: A non-immunized person by a tuberculin skin test, which yields a delayed hypersensitivity type response to purified protein derivatives of M. tuberculosis. Those immunized for TB or with past-cleared infection will respond with delayed hypersensitivity parallel to those currently in a state of infection and thus the test must be used with caution, particularly with regard to persons from countries where TB immunization is common.

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58.Which of the following structures is lined with epithelium derived from mesoderm of the ureteric bud?

A. Bowman's capsule b. Distal convoluted tubule

C. Loop of Henle D. Ureter

ANS. D. The transitional epithelium that lines the ureter, the renal pelvis, and the major and minor calyces is derived from mesoderm of the ureteric bud, as is the cuboidal epithelium of the collecting tubules. The simple squamous epithelium lining Bowman's capsule (choice A) is derived from mesoderm of the metanephric vesicle. The simple cuboidal epithelium lining the distal convoluted tubule (choice B) is derived from mesoderm of the metanephric vesicle. The simple squamous epithelium lining the loop of Henle (choice C) is derived from mesoderm of the metanephric vesicle.

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