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Mock EMI Questions With Complete Solutions Which glands are profoundly affected by sjorgen's syndrome? minor glands parotid submandibular sublingual 2 types of acinar cells serous mucous Which acinar cell stains darker? serous Production of saliva is regulated by a process called what? stimulus-secretion coupling Protein secretion is regulated by what second messenger? cAMP Fluid secretion is regulated by changes in what? intracellular calcium What are cAMP levels regulated by? noradrenaline binding to beta adrenergic receptors
Increases in calcium are regulated by what? acetylcholine binding to muscarinic receptors Beta adrenergic receptor is a member of what family of coupled receptors? G protein What protein is not made within the salivary gland cells but comes from the bloodstream? IgA What receptor found on basolateral surfaces of mucosal and glandular epithelial cells is responsible for transport of IgA into secretions? Polymeric immunoglobin receptor Receptor that is a member of the G protein family and responsible for fluid secretion from acinar cells M3 muscarinic receptor What does IP3 do? Binds to IP3 receptors on endoplasmic reticulum, releasing calcium into the cytoplasm via calcium channels, increasing intracellular calcium. What do salivary glycoproteins do?
Normal resting salivary flow rate 0.3 ml/min Between 0.1 - 0.6 ml/min is normal Normal stimulated salivary flow rate 1.8 ml/min Between 0.6- 6.0 ml/min is normal IgA antibody that plays a role in the immune function of mucous membranes Nasal bones Bones that form the bridge of the nose Two small, symmetrical oblong bones, each having two surfaces and four borders What happens to the dental papilla in the early bell stage? Small blood vessels start to invade in preparation for hard tissue genesis Where does the dental follicle form in the early bell stage? Between tooth germ and developing bony crypt
What causes crown patterning? Cells rapidly multiplying in the internal enamel epithelium except at the enamel knot What structure forms the dentine of the tooth? dental papilla What structure form the enamel of the tooth? internal enamel epithelium What structure is involved in the protection of the tooth shape and nutrition of the enamel stellate reticulum Ectoderm lips and gum Endoderm tongue and floor of mouth Three primary germ layers ectoderm, mesoderm, endoderm What does the ectoderm eventually form? (4) Epidermis Nervous system Tooth enamel Neural crest cells
epithelial cells are differentiating into ______________ & ________________. supported by basal lamina around the periphery differentiating into IEE & OEE Morphodifferentiation: the enamel organ assumes the shape of an incisiform, caniniform, or molariform tooth. OEE during Bell Stage: *Low cuboidal, forms the outer periphery of enamel organ *At end of bell stage, cells become fluted and the invaginated areas become occupied by blood vessels from the dental papilla. *separated from the dental follicle by a basal membrane Cells between the IEE and SR differentiate into what during the Bell stage? a layer of flattened cells called the Stellate/Stratum Intermedium (SI) with GAP junctions IEE during Bell Stage: *short columnar cells, TOWARDS DENTAL PAPILLA *BASAL LAMINA between the IEE and dental papilla becomes
the DEJ *High concentration of glycogen *Cells differentiate into AMELOBLASTS (to secrete enamel) Joining of the IEE and the OEE is called what? HERTWIG'S EPITHELIAL ROOT SHEATH and it initiates root formation Two important events during Bell Stage, what are they? 1- Dental lamina disintegrates. 2- Crown pattern and number of cusps of the tooth is established by folding of the IEE. This is known as MORPHODIFFERENTIATION. During the Bell Stage, what are the events following the disintegration of the dental lamina? *Tooth continues development *Before the tooth can function, it must reestablish a connection with the oral epithelium by formation of the JUNCTIONAL EPITHELIUM. *POSTERIORMOST EXTENT OF THE DENTAL LAMINA DOES NOT DISINTEGRATE, but elongates in a posterior
Which parts of the brain does this occur? What is the end result? Choline acetyltransferase. In the cerebral cortex and hippocampus. End result is not enough acetylcholine produced and cholinergic neurone death. The plaques in the brain are formed from the protein ___. They can clump together to form small toxic aggregates called ___. Beta amyloid (or A-Beta) Oligomers The tangles are made of a protein called ___. They exist normally in nerve cells but in A.D. they get tangled into strands. Tau Brain's immune cells are called ___.
They get overproduced in the inflammatory response and produce substances that actually promotes death of nerve cells. Microglia. Risk factors for developing Alzheimer's
- Mild cognitive impairment (MCI)
- Metabolic Syndrome: DM/HTN/Dyslipidemia/CVA
- Down's Syndrome
- Injury at Head or traumatic brain injury (TBI)
- Postmenopausal state What are the types of primary drugs used to treat A.D.?
- Cholinesterase inhibitors
- NMDA receptor antagonists Name the cholinesterase inhibitors (3)
- Donepezil
- Rivastigmine
- Galantamine NMDA antagonist example is ___. Memantine. Secondary medications to treat alzheimer's
- Antidepressants
- Hypnotics
- Levodopa/carbidopa
- Monoamine oxidase (MAO)-B inhibitors
- Other dopamine agonists (eg, ropinirole, pramipexole)
- Anticholinergic agents (eg, trihexyphenidyl, benztropine): Second-line drugs for tremor only What is Huntington Disease? An inherited progressive neurodegenerative disorder. It is inherited in an autosomal dominant pattern- If a parent has Huntington's, there's a 50/50 chance of giving it to a child. Hallmark of HD
- psychiatric disturbance
- chorea- treat by tetrabenazine = basal ganglia
- Dementia- this is the most debilitating part Treatment of HD -> Antipsychotic - haloperidol -> Antidepressants -> Antichorea - tetrabenazine to control movement
What is an antimicrobial agent? Substance with inhibitory properties against micro-organisms What is an antibiotic? Substance produced by micro-organisms with inhibitory effects against other micro-organisms What is a bacteriostatic antibiotic? Substance that inhibits the growth of a micro-organism What is a bactericidal antibiotic? Substance that kills a micro-organism What are the four main sites of action of an antibiotic? Cell wall synthesis Protein synthesis Nucleic acid synthesis Cell membrane function What is innate antibiotic resistance? Organism does not possess the correct target site or is impermeable to the agent What is acquired antibiotic resistance? Change in genetic makeup; either from plasmid or chromosome What are the four mechanisms of antibiotic resistance?
What are three clinical uses of amoxicillin in dentistry? Acute abscesses Periodontitis/gingivitis Oral-antral fistula What is the main clinical use of cefalexin in dentistry? Penicillin allergy (rash) What is the mechanism of action of a macrolide? Inhibits protein synthesis Bacteriostatic What are the two mechanisms of resistance of a macrolide? Efflux pumps Alteration of drug and/or target What is the spectrum of macrolides? Similar to beta lactams Oral streptococci Oral gram negatives Oral anaerobes Common medical indication for erythromycin Whooping cough Give an example of a Lincosamide Clindamycin
What is the mechanism of action of a Lincosamide? Inhibit protein synthesis Bacteriostatic What is the mechanism of action of tetracyclines? Inhibit protein synthesis Bacteriostatic What are the clinical uses of tetracyclines in dentistry? Adjunct to scaling and root planing in periodontitis Aggressive periodontitis in conjunction with root surface debridement What is the mechanism of action of nitromidazoles? Disruption of microbial nucleic acid synthesis Give an example of a nitroimidazole Metronidazole What are the two clinical uses of metronidazole in dentistry? Acute abscesses Periodontitis & Gingivitis The anticoagulant effect of warfarin is enhanced by which three antibiotics?
loose areolar tissue, some lymphatic vessels, anterior mediastinal lymph glands, small mediastinal branches of the internal mammary artery What are the contents of the middle inferior mediastinum? heart enclosed within the pericardium, the ascending aorta, lower half of the superior vena cava, trachea and the two bronchi, the pulmonary artery, the right and left pulmonary veins & phrenic nerve What is the transverse thoracic plane? An imaginary line going through the sternal angle and a line between the fourth and fifth thoracic vertebrae What are the contents of the posterior portion of the inferior mediastinum? the descending aorta, azygos vein, the hemiazygos vein, vagus nerve, oesophagus & thoracic duct What are the contents of the superior mediastinum? internal jugular vein, subclavian vein, arch of aorta, common carotid arteries, subclavian arteries, trachea and oesophagus At what level does the oesophagus pass through the diaphragm? T 10 What lymphatic vessels are located in the superior mediastinum? the thoracic duct
What important neural structures are found within the superior mediastinum? vagus nerves, phrenic nerves, sympathetic chains What are the sympathetic trunks? two ganglionated nerve trunks that extend the whole length of the vertebral column At what level does the inferior vena cava pierce the diaphragm? T At what vertebral level does the aorta pass through the diaphragm to enter the abdomen T In which part of the mediastinum is the thoracic aorta located? the posterior mediastinum What is the composition of enamel? 96% hydroxyapatite 4% Water/protein/fat Which layer of prism in enamel has a higher organic content? outer Demarcation between prisms within the enamel is called what? rod sheath
