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86 Cards in this Set
- Front
- Back
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What is the largest of the paranasal sinuses?
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maxillary sinus
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The maxillary sinus is ______ in shape
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pyramidal
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What bone forms the base of the maxillary sinus?
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laternal nasal bone
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T/F Asymmetry exists between the sinuses in the same individual
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True
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What causes the maxillary sinus to increase in size?
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aging
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The avg height of the max sinus is ____ cm, depth is ____ cm, width is ____ cm, and capacity is _____ cc.
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3.5 cm
3.2 cm 2.5 cm 15 cc |
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The maxillary sinus is divided into several compartments by bony septa, which are also known as _____?
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Underwood's septa
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T/F The max sinus is lined with what kind of epithelium?
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pseudo-stratified columnar ciliary epithelium
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T/F The purposes of the max sinus are:
1. Speech and voice resonance 2. Reduces weight of skull 3. Cools inspired air 4. Filters inspired air 5. Immunologic barrier |
1. True
2. True 3. False, warms 4. True 5. True |
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What causes acute sinusitis?
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suppurative (pus-forming) or non-suppurative inflammation of the mucosal lining of the sinus causing drainage sites to be pinched off and a collection of fluid causing pressure and pain
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What are causes of acute sinusitis?
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can be 2ndary to hay fever, allergic rhinitis, acute rhinitis or URT infection.
Can also be a bacterial infection from dental sepsis, swimming, trauma or foreign body dislodgment |
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What is a diagnostic tool for acute sinusitis?
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x-ray exam
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What are treatment options for acute sinusitis?
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rest, fluids, antibiotics after culture is done, analgesics, antihistamines
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What typically causes acute sinusitis?
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pneumococci and streptococci
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This nerve splits into the posterior scrotal/labial n. and the dorsal n. to the penis/clitoris
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Perineal nerve S2-4
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How can you investigate for chronic sinusitis?
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proof puncture or x-ray
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What are treatments for chronic sinusitis?
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antibiotics, systemic decongestants or sinus wash-out
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Orbital abscesses, intracranial abscesses, osteomyelitis and cavernous sinus thrombosis are all possible complications of what?
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sinusitis
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Aspergillosis is a _____ infection of the maxilla, caused by "________" in people with low immunity. How is it treated?
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mycotic
aspergillosis aeroginosa surgical removal of associate lesion in the max sinus |
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What is the standard of care for checking if there is trauma to the max sinus?
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CT scan
can also do water's view xray or orthopantomogram |
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When examining the nasal passage, what is being looked for?
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nasal patency
pus discharge nasal polyps erythema |
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What is the surgical creation of a hole in the lateral nasal wall between the nasal passages and the maxillary sinus cavity? Where is the opening made?
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antrostomy
at level of inferior or middle meatus |
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T/F Any pathological lesion that is removed from the sinus cavity does not need to be sent for biopsy.
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False, always sent for biopsy
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Invasion of the max sinus and establishment of a direct communication with the oral cavity is called what?
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oro-antral communication
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What epithelium are fistulas lined with?
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stratified squamous
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What is a biological tract that connects an anatomical cavity with the external surfaces or another anatomical cavity?
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fistula
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What is one of the main signs of an oro-antral fistula being created?
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bubbling of blood from socket or nostril
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What teeth are most commonly lost into the sinus cavity proper? What typically causes this?
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3rd molar and 2nd PM
poor surgical technique |
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What is the Caldwell-luc approach and what is it used for?
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creation of lateral access into the sinus to retrieve a tooth that's been displaced into the sinus that can't be retrieved by traditional means
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If a displaced tooth is retrieved by an invasive procedure and oro-antral communication is created, what are the post-op instructions/meds given?
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no forceful nose blowing, good OH
given antibiotic (pen), analgesic, nasal decongestant, steam inhalation |
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T/F Odontogenic cysts can be diagnosed based on radiograph alone.
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False, need histology too
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Where in the mouth do dentigerous cysts most commonly occur? What sex?
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mandibular 3rds
males |
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What is needed for removal of dentigerous cysts?
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histopathology to definitively diagnose
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T/F Dentigerous cysts have a well-defined unilocular radiolucency.
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True, has a sclerotic border
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Odonotogenic keratocysts are often associated with what syndrome when there are multiple cysts? Do they recur?
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Nevoid basal cell carcinoma syndrome
yes, high rate of recurrence |
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What are characteristics of basal cell nevus syndrome?
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multiple OKCs
basal cell carcinomas bifid ribs hypertelorism frontal bossing |
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What is Carnoy's solution?
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very caustic material placed in cavity after lesion removed, which helps kill anything around edges.
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Where are ameloblastomas typically located? What age is most common?
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3rd molar area of mandible
3rd or 4th decade of life |
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How are ameloblastomasa resected?
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resected with 1.0-1.5 cm linear margins and one intact anatomic barrier
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What do unicystic ameloblastomas typically look like radiographically?
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dentigerous cysts
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What are the 3 types of unicystic ameloblastomas?
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luminal
intramural mural |
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How do peripheral ameloblastomas appear radiographically?
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"cupped out"
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What are the most commonly occurring odontogenic tumos?
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odontomas
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What are the differences between compound and complex odontomas?
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compound - many tooth like structures
complex - one large mass not resembling anything |
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What age do ameloblastic fibromas occur?
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1st or 2nd decade
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Odontogenic myxomas occur where in the mouth and at what age?
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evenly throughout jaw
2nd or 3rd decade |
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What does the histology of an odontogenic myxoma resemble?
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dental papilla of developing tooth
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T/F Odontogenic myxomas are slow-growing with a potential for aggressive behavior with high recurrence rate.
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True
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What is aka 2/3 lesion?
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adenomatoid odontogenic tumor
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Where are adenomatoid odontogenic tumors located?
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maxilla, usually canine area, in young females
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What is the most common presenting sign of calcifying epithelial odontogenic tumors? What age do they occur, what are they often associated with?
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1. painless, slow-growing mass
2. 5th decade 3. impacted tooth |
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What syndrome is associated with osteomas?
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Gardner's syndrome
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T/F Osteomas appear radiographically as a well-circumscribed sclerotic radiolucent masses.
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False, radiopaque
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Where can oral malignancies develop?
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epithelium, CT, salivary glands, metastatic diseases
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What is the most common oral malignancy, and what part of oral cavity is it most commonly seen?
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SCC
lip |
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T/F If looking into an oral malignancy, a chest CT may be needed.
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True, if pt has oral malignancy, pt probably has risk factors for other malignancies
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Typically when is radiation therapy done in a pt with an oral maligancy? Before or after surgery?
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After surgery
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When treating an oral malignancy what typically allows for the best results for the pt?
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if the pt is medically optimized, everything is well controlled
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T/F The first chance is the best chance to remove oral maligancies
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True, easiest to see margins initially
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What is an En bloc resection? How big are the margins? What type of section is taken?
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where the tumor is encased in a cuff of normal tissue
1-2 cm frozen sections |
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What is the difference btw marginal and segmental resections of the mandible?
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Marginal - leave inferior border of mandible, so mand still continuous
Segmental - entire segment of mand is taken |
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What's the most common type of radiation beam? What is a neutron beam used for?
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external beam
salivary gland tumors |
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What are the indications for SCC of the oral cavity?
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T3, T4, close or positive margins, extra-capsular spread, or greater than one positive lymph node
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T/F The less undifferentiated the cells, the more effective the external beam radiation.
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False, more undifferentiated
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What is the dosage recommended for external beam radiation?
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1.8-2.0 Gy monday through friday for 6-7 weeks
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After doing 50 Gy of external beam radiation to the head/neck tumor, how much "boost" radiation is sometimes given to primary tumor site?
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20 Gy
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Adjuvants and neo-adjuvants are given before or after surgery for chemotherapy?
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adjuvants - after
neo-adjuvants - before |
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What does chemotherapy cause to the hematopoietic system?
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anemia, thrombocytopenia and neutropenia
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Chemotherapy is most toxic to what type of cells?
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rapidly turning over cells
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Tumors secrete growth factors and enzymes that prevent normal cells from utilizing nutrients....what is this called?
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tumor load
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What's the most common infection associated with cancer?
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pneumonia
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What are worries of paraneoplastic syndromes when it comes to cancer? What hormones are commonly affected?
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can cause electrolyte imbalances, affecting the heart
PTH (PTHrp) ADH (SIADH) |
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What arch do giant cell lesions more commonly occur? How are they treated?
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mandible
some respond to steroid injections. large lesions typically give injections once/week for 6 weeks, giving in multiple locations throughout lesion. lesion often disappears or shrinks making surgery easier |
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If someone has polyostotic type fibrous dysplasia, cafe au lait spots and endocrine abnormalities, what syndrome could they have?
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McCune-Albright
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What disorder has a ground glass appearance?
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fibrous dysplasia
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What is the preferred treatment of fibrous dysplasia? Is radiotherapy recommended?
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no treatment
no, b/c can transform into osteosarcoma or fibrosarcoma |
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Hyperparathyroidism histologically and clinically looks like what?
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central giant cell granuloma
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In primary, 2ndary and tertiary hyperparathyroidism, what is happening to serum calcium levels?
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1 - increased serum Ca
2 - decreased serum Ca 3 - increased serum Ca |
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What often causes secondary hyperparathyroidism?
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renal failure
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Radiographically aneurysmal bone cysts appear as a well circumscribed "________" type lesion
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soap bubble
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Central giant cell granulomas, hyperparathyroidism, giant cell tumors, cherubism and aneurysmal bone cysts are all lesions containing what type of cell?
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giant cells moron
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What type of bone cyst appears radiographically well-defined with a scalloped appearance btw roots?
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traumatic bone cyst
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What disorders appear as "gum bumps"? 4 P's
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pyogenic granuloma
peripheral giant cell granuloma peripheral ossifying fibroma peripheral odontogenic granuloma |
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What is the most common type of masticatory pain and dysfunction?
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myofascial pain
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If a pt has atypical facial pain, what could be some meds to prescribe?
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antidepressants, anticonvulsants and antispasmatics
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If pt has facial paralysis after a mandibular extraction, and it persists, what should the treatment be?
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refer pt and administer steroids
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