Хірургічна стоматологія



Download 273 Kb.
Page1/6
Date31.01.2017
Size273 Kb.
  1   2   3   4   5   6
Хірургічна стоматологія

1

A 42-year-old patient complains about general weakness. Body temperature is 41oC, he

presents with sickness, emesis, dyspnea. There is evident well-defined skin redness in form of

flame tips on her face. Submandibular lymph nodes are enlarged. What is the most likely diagnosis?



A Erysipelas

B Streptococcal impetigo

C Phlebitis of facial vein

D Lupus

E Anthrax

2

A 35-year-old male consulted a dentist about the 26 tooth extraction. After the patient had been

given tuberal anaesthesia, he presented with progressing tissue edema and limited mouth

opening. This condition was caused by:



A Vessel trauma

B Muscle trauma during anaesthetization

C Nerve trunk trauma

D Hypersensitivity to the anaesthetic

E Anaphylactic shock

3

A 54-year-old patient complains of a tumour-like formation in the region of the lower lip which

appeared 1-1,5 months ago. Objectively: on the vermilion border of the lower lip on the right

there is a roundish tumour up to 1 cm in diameter with raised rolled edges. The tumour is

painless, the regional lymph nodes are not enlarged. What is a provisional diagnosis?

A Keratoacanthoma

B Carcinoma of the lower lip

C Papilloma of the lower lip

D Fibroma of the lower lip

E Verrucous precancer

4

A 34-year-old patient had got in a car accident. The patient stayed conscious. He complains of

headache, dizziness, general weakness, nausea. 12 hours after the injury the patient got

"raccoon eyes" (periorbital haematomas) within the limits of the circular muscle of eye. What

fracture does the victim have?

A Fracture of skull base

B Le Fort II fracture of maxilla

C Fracture of nasal bones

D Bilateral fracture of zygomatic bones

E Fracture of frontal bones

5

After a car accident a patient consulted a dentist about pain at the base of the nose. Palpation

reveals tenderness of the nose wall, mobility of the nasal bones. Nasal passages are filled with

blood clots. What is the provisional diagnosis?



A Fracture of nasal bones

B Le Fort I fracture of maxilla

C Le Fort II fracture of maxilla

D Le Fort III fracture of maxilla

E Fracture of cheekbone

6

A victim got a perforating wound of the left cheek contaminated with radioactive materials on the

battlefield. The wound was dressed with aseptic bandage from the individual first-aid pack and

processed with anaesthetic and antibacterial medicaments. The dressing should be changed at

the following station of medical evacuation:

A At each station of evacuation

B At the battalion aid station

C At the regimental aid station

D At the station of the separate medical battalion

E Only when the dressing is unsatisfactory

7

A 49-year-old patient complains of constant mandibular pain irradiating to the ear, soft tissue

edema, body temperature rise up to 39oC. Objectively: there is an edema in the submandibular region, the skin has not changed in colour. Alveolar mucosa around the 45, 46 teeth is hyperemic and edematic on the oral and vestibular side. Crowns of the 45, 46 teeth are completely destroyed, the teeth are mobile. Vincent's symptom is present. What is the most likely diagnosis?

A Acute mandibular osteomyelitis

B Abscess of submandibular region

C Exacerbation of chronic mandibular osteomyelitis

D Acute serous periostitis of mandible

E Acute purulent periostitis of mandible

8

A 43-year-old man complains about painful swallowing, limited mouth opening. Destroyed 37

tooth caused pain 3 days ago. Painful swallowing appeared the next day. Limited mouth

opening was present a day later. Objectively: there is a small soft swelling in the left

submaxillary area. An enlarged lymph node is palpated. The mouth can be opened by 1,5 cm.

Edema of left palatine arch and pharynx lateral wall is present. The 37 tooth is destroyed.

Mucous membrane around the tooth is edematic. Percussion is slightly painful. What is the

most likely diagnosis?



A Odontogenic peripharyngeal phlegmon

B Odontogenic pterygomandibular phlegmon

C Odontogenic submaxillary phlegmon

D Peritonsillar abscess

E Acute submaxillary lymphadenitis

9

A 43-year-old patient complains of a tumour in the right submandibular region which appeared

two months ago after having flu. Objectively: palpation of the right submandibular region reveals

a painful spherical neoplasm of dense elastic consistency with regular outlines which is not

attached to the skin. Submandibular salivary gland secretes transparent saliva. Sublingual plica

is unchanged. Which disease are these clinical presentations typical for?



A Chronic lymphadenitis

B Chronic sialoadenitis

C Sialolithiasis

D Adenoma of the salivary gland

E Lipoma

10

A 27-year-old male patient underwent extraction of the medial root of the 36 tooth, but the distal

tooth root was broken in its middle third. What tools should be applied for root extraction?

A Left angled elevator

B Right angled elevator

C Straight elevator

D Broad-beaked forceps

E Close-beaked forceps

11

A 64-year-old patient presents with bleeding from the left nostril, mobility of the upper left teeth.

For the last 2 years the patient has had dull pain in the left side of maxilla. On the left side of

neck there is a dense tumour-like formation. The patient is exhausted. What is the most likely

diagnosis?

A Left-sided maxillary carcinoma

B Left-sided sinusitis

C Left-sided maxillary cyst

D Chronic osteomyelitis of the left upper jaw

E Osteoclastoma of the left upper jaw

12

A 42-year-old patient complains about acute pain in the region of the left temporomandibular

joint (TMJ) that irradiates to the ear; headache, general indisposition, impossible mastication

and limited mouth opening. Objectively: the patient’s face is asymmetric due to the edema in

the region of the left temporomandibular joint. The skin in this region is hyperemic. The pain is

made worse by the smallest movements of mandible. Palpation of the joint causes acute pain.

Mouth opening is limited down to 15-20 mm. What is the most likely diagnosis?

A Acute arthritis of the left TMJ

B Acute purulent parotitis

C Mandible subluxation

D Deforming arthrosis of the left TMJ

E Myogenous osteoarthrosis

13

A 42-year-old patient complains of pain in the submaxillary and sublingual areas that is getting

worse during eating, body temperature rise up to 37,6oC. He has been suffering from this

for 2 months. Objectively: infiltration along the right sublingual torus, hyperemia, soft tissue

edema, acute pain during palpation. The duct of the right submandubular salivary gland

excretes turbid saliva mixed with pus. What is the most likely diagnosis?



A Exacerbation of salivolithiasis

B Acute purulent lymphadenitis of submaxillary area

C Adenophlegmon of submaxillary area

D Abscess of maxillolingual groove

E Retention cyst of sublingual salivary gland

14

A 42-year-old patient complains about pain in the submandibular and sublingual region that is

getting worse during eating; body temperature rise up to 37,6oC. The patient has been

suffering from this for 2 months. Objectively: along the right sublingual plica there is infiltration,

hyperaemia, edema of soft tisues, acute pain on palpation. The duct of the right submandibular

salivary gland discharges turbid saliva with pus admixtures. What is the most likely diagnosis?



A Exacerbation of urolithiasis

B Acute purulent lymphadenitis of submandibular region

C Adenophlegmon of submandibular region

D Abscess of alveololingual groove

E Retention cyst of sublingual salivary gland

15

A patient consulted a dental surgeon about fever up to 37,60C, soft tissue swelling, pain in the

47 tooth on the lower jaw on the left, the pain is getting worse when the tooth is touched by the

antagonist. Objectively: mucogingival fold of the alveolar process is hyperemic and flat on the

vestibular side of the decayed 47 tooth. What is the most likely diagnosis?

A Acute purulent odontogenic periostitis

B Acute serous periodontitis

C Exacerbation of chronic periodontitis

D Acute odontogenic osteomyelitis

E Periodontal abscess

16

A 48-year-old female patient had been delivered to a hospital with a cheek wound and severe

headache, nausea, dizziness. It is known from the history that the patient had got a trauma as a

result of a fall. After examination she was diagnosed with a contused lacerated wound of cheek,

closed craniocerebral injury, brain concussion. This trauma can be qualified as:

A Concominant trauma

B Isolated trauma

C Combined trauma

D Polytrauma

E Single

17

A 38-year-old female patient came to a hospital and complained about a wound on her left

cheek. She got this trauma 16-18 hours ago, didn't loose consciousness. Objectively: a 3 cm

long injury of skin, subcutaneous fat and muscle. The wound is bleeding. What kind of initial

surgical d-bridement should be performed?

A Early surgical d-bridement

B Delayed surgical d-bridement

C Secondary surgical d-bridement

D Initial surgical d-bridement along with plasty

E -

18

A patient complains about mobility of the 26, 27, 28 teeth, periodic pain, sensation of heaviness

in the corresponding half of the upper jaw, haemorrhagic discharges from the left side of nose.

These presentations have been observed for 4 months, within the last month the pain has

become worse, the patient presents now with general weakness. Examination of the oral cavity

reveals the grade II mobility of the 26, 27, 28 teeth. On palpation of the maxillary tuber, the

bone wall was found to be absent. X-ray picture shows a homogeneous shadowing of maxillary

sinus; bone structures have unclear contours. What is the most likely diagnosis?



A Upper jaw cancer

B Upper jaw adamantinoma

C Upper jaw sarcoma

D Chronic odontogenous maxillary sinusitis

E Upper jaw osteoclastoma

19

A patient consulted a dentist about constant dull pain in the 38 tooth. Mouth opening is limited

down to 1 cm. It is necessary to extract the 38 tooth. What kind of anesthesia should be applied

for operation?



A Bercher-Dubov

B Mandibular

C Torus

D Extraoral mandibular technique

E Tuberal

20

During extraction of the 47 tooth its distal root was broken halfway along its length. What tool

should be chosen for extraction of the residual root fragments?

A Left angled elevator

B Broad-beaked forceps

C Close-beaked forceps

D Right angled elevator

E Straight elevator

21

A patient consulted a doctor about recurrent pain in the frontal part of his upper jaw. He has

history of previous treatment for pulpitis. Objectively: the crown of the 12 tooth is restored with a

filling. X-ray picture of the upper jaw shows an area of bone tissue destruction (up to 1 cm in

diameter) at the root apex of the 12 tooth. The root channel of the 12 tooth is filled up to the

top. The patient was diagnosed with cystogranuloma of the 12 tooth. Choose the best method

of treatment:

A Root apex resection

B Extraction of the 12 tooth

C Conservative treatment

D Dissection along the mucogingival junction

E Replantation of the 12 tooth

22

A 67 year old patient complains about frequently recurring erosion in the area of vermilion

border of his lower lip. The erosion is oval, 0,8х1,3 cm large, covered with thin crusts. After

their removal some petechial haemorrhages on glossy surface can be seen. There are also

some atrophied areas of the vermilion border. Infiltration is absent. Submandibular lymph

nodes are not enlarged. What is your presumptive diagnosis?



A Abrasive precancerous Manganotti's cheilitis

B Erosive-ulcerous form of leukoplakia

C Keratoacanthosis

D Bowen's disease

E Glandular cheilitis

23

During an armed conflict soldier K. was injured and delivered to the station of the separate

medical battalion. The patient has a gunshot wound of his right cheek, splintered fracture of the

body of mandible, arterial bleeding from the wound. A brigade of the separate medical battalion

performed surgical debridement and final bleeding arrest. Specify the scope of further medical

and evacuation actions for this patient:



A Transport immobilization of mandible fragments, evacuation of the patient to the military field

surgical hospital



B Therapeutic immobilization of mandible fragments, evacuation to the military field hospital for

minor casualties



C Transport immobilization of mandible fragments, evacuation to the military field hospital for

minor casualties



D Transport immobilization of mandible fragments, no need of further evacuation

E No need of fragment immobilization, evacuation to the military field hospital for minor

casualties



24

A 46-year-old patient complains of spontaneous pain in the 36 tooth. Its crown is decayed. The

patient presented with edema of soft tissues adjacent to the mandible. Body temperature rose

up to $39,0^oC$, the patient has chill. Examination of the oral cavity revealed a pronounced

edema of the left mandibular alveolar process on the vestibular and oral side (acute periostitis);

the 35, 36, 37 teeth are mobile, subgingival pockets contain purulent exudate; their percussion

causes acute pain. Positive Vincent's symptom is present. What is the presumptive diagnosis?

A Acute odontogenic osteomyelitis of mandible from the 36 tooth

B Exacerbation of chronic periodontitis from the 36 tooth

C Acute purulent periostitis of mandible from the 36 tooth

D Exacerbation of generalized periodontitis

E Exacerbation of chronic mandibular osteomyelitis

25

A 58 year old patient complains about clicking in the mandibulotemporal joint during eating.

Periodically as a result of wide mouth opening the mandible takes up such a position that

makes mouth closing impossible. The mandible can be easily placed into its initial position by

pressing with fingers upon its coronoid processes. What is your presumptive diagnosis?

A Habitual dislocation of mandible

B Acute dislocation of mandible

C Subluxation of mandible

D Anterior dislocation

E Posterior dislocation

26

After a fall a 28-year-old patient visited the clinic of maxillofacial surgery and complained of

restricted mouth opening, skin numbness in the left infraorbital region, upper lip, wing of the

nose, pain in the left zygomatic region that gets worse when he opens his mouth. Palpation

revealed step deformity. What is the most likely diagnosis?

A Fracture of the left zygomatic bone with a displacement

B Fracture of the left zygomatic bone without a displacement

C Fracture of the upper jaw of Le Fort II (medium type)

D Fracture of the upper jaw of Le Fort I (top type)

E Fracture of the left zygomatic bone

27

A 49-year-old male patient consulted a dental surgeon about an enlarging "mother's mark", itch

and desquamation. According to patient, changed in color and size skin area appeared a year

ago after a shaving trauma. Objectively: there is an intensely pigmented brown spot up to 2 cm

large with small oval protruding nodules on its surface in the infraorbital region on the left.

Desquamation factors are present. Palpation is painless. Regional lymph nodes are matted

together with skin and painless. What is the most likely diagnosis?

A Melanoma

B Pigmented nevus

C Verrucous nevus

D Epidermoid cancer

E Papillomatosis

28

A 75-year-old patient has been admitted to the dental department for the right-angle mandibular

fracture with a displacement. Objectively: the face is asymmetric due to the post-traumatic

swelling, palpation reveals the mobility of fragments and pain. The patient has a lifelong history

of epilepsy. What is the best method of treatment?

A Osteosynthesis

B Immobilization with Vasilyev splints

C Immobilization with Tigerstedt splints

D Immobilization with Port splint

E Immobilization with Vankevich splint

29

A female patient consulted a stomatologist about inability to close her mouth, speech difficulty.

Objectively: the oral cavity is half-open, there is drooling, central line deviates to the right. There

is a depression in front of the tragus, and above the malar arch the mandibular condyle bulges

inward the infratemporal fossa. What is the most likely diagnosis?

A Unilateral anterior dislocation of mandible on the left

B Unilateral anterior dislocation of mandible on the right

C Unilateral posterior dislocation of mandible on the left

D Unilateral posterior dislocation of mandible on the right

E Bilateral anterior dislocation

30

A week ago an 18-year-old girl complained of pain in the 22 tooth which was treated and filled

several years ago. Over the past two days the pain got worse. Objectively: the 22 tooth is filled,

percussion is painful, mucous membrane is hyperaemic and edematic. Spot-film

roentgenograph of the 22 tooth shows an ill-defined pariapical bone rarefaction 0,4x0,5 cm

large. What is the most likely diagnosis?



A Exacerbation of chronic periodontitis of the 22 tooth

B Suppuration of the radicular cyst

C Acute odontogenic osteomyelitis

D Acute purulent periodontitis of the 22 tooth

E Acute maxillary periostitis

31

A 36 year old man complains about acute headache, body temperature rise up to 39,1oC,

indisposition. Objectively: a slight face asymmetry because of soft tissue edema of the left

infraorbital area. Crown of the 26 tooth is partly decayed. Percussion is acutely painful. Mucous

membrane on the vestibular side in the area of the 25, 26 teeth is edematic, hyperemic.

Breathing through the left part of nose is laboured, there are purulent discharges. X-ray picture

showed a homogeneous shadow of the left part of maxillary sinus. What is the most probable

diagnosis?



A Acute purulent odontogenous maxillary sinusitis

B Acute condition of chronic periodontitis of the 26 tooth

C Acute periostitis of upper jaw

D Suppuration of maxillary cyst

E Acute odontogenous osteomyelitis

32

A 22-year-old patient complains of a painful swelling in the right parotid gland. A week earlier

the patient got a cheek abrasion which healed under the purulent crust. Over the past two days

the patient had observed progressing pain and fever up to 38,6oC. Objectively: there is a

soft tissue edema in the right parotid region, the skin is slightly strained but has not changed in

colour. There is a dense painful infiltration 2,5x3,5 cm large, the skin over it exhibits limited

mobility. The mouth can be fully opened, the mucous membrane around the orifice of the

salivary duct is unchanged, the saliva is transparent. What is the most likely diagnosis?



A Acute lymphadenitis

B Exacerbation of chronic parotitis

C Abscess of the parotid-masseteric region

D Acute non-epidemic parotitis

E Epidemic parotitis



Share with your friends:
  1   2   3   4   5   6


The database is protected by copyright ©dentisty.org 2019
send message

    Main page