NEET MDS Synopsis
Warfarin
Pharmacology
Warfarin (Coumadin):
The most common oral anticoagulant.
It is only active in vivo.
Warfarin is almost completely bound to plasma proteins. -96% to 98% bound.
Warfarin is metabolized by the liver and excreted in the urine.
Coumarin anticoagulants pass the placental barrier and are secreted into the maternal milk.
Newborn infants are more sensitive to oral anticoagulants than are adults because of lower vitamin K levels and lower rates of metabolism.
Bleeding is the most common side effect and occurs most often from the mucous membranes of the gastrointestinal tract and the genitourinary tract.
Oral anticoagulants are contraindicated in:
• Conditions where active bleeding must be avoided, Vitamin K deficiency and severe
hepatic or renal disease, and where intensive salicylate therapy is required.
INNERVATION OF THE DENTIN-PULP COMPLEX
Dental Anatomy
INNERVATION OF THE DENTIN-PULP COMPLEX
Dentine Pulp
Dentin
Nerve Fibre Bundle
Nerve fibres
The nerve bundles entering the tooth pulp consist principally of sensory afferent fibers from the trigeminal nerve and sympathetic branches from the superior cervical ganglion. There are non-myelinated (C fibers) and myelinated (less than non, A-delta, A-beta) fibers. Some nerve endings terminate on or in association with the odontoblasts and others in the predentinal tubules of the crown. Few fibers are found among odontoblasts of the root.
In the cell-free zone one can find the plexus of Raschkow.
MAXILLARY CUSPIDS
Dental Anatomy
MAXILLARY CUSPIDS (CANINE)
The maxillary cuspid is usually the longest tooth in either jaw. canines are considered the corner stones of the dental arch They are the only teeth in the dentition with a single cusp.
Facial Surface:- The facial surface of the crown differs considerably from that of the maxillary central or lateral incisors. In that the incisal edges of the central and lateral incisor are nearly straight, the cuspid has a definite point, or cusp. There are two cutting edges, the mesioincisal and the distoincisal. The distoincisal cutting edge is the longer of the two. The developmental grooves prominent on the facial surface extending two-thirds of the distance from the tip of the cusp to the cervical line. The distal cusp ridge is longer than the mesial cusp ridge
Lingual Surface: Distinct mesial and distal marginal ridges, a well-devloped cingulum, and the cusp ridges form the boundries of the lingual surface. The prominent lingual ridge extends from the cusp tip to the cingulum, dividing the lingual surface into mesial and distal fossae.
Proximal: The mesial and distal aspects present a triangular outline. They resemble the incisors, but are more robust--especially in the cingulum region
Incisal: The asymmetry of this tooth is readily apparent from this aspect. It usually thicker labiolingually than it is mesiodistally. The tip of the cusp is displaced labially and mesial to the central long axis of this tooth.
Root Surface:-The root is single and is the longest root in the arch. It is usually twice the length of the crown.
OCCLUSION AND DENTAL DEVELOPMENT-Stages-Mixed Dentition Period
Dental Anatomy
Permanent dentition period
-Maxillary / mandibular occlusal relationships are established when the last of the deciduous teeth are lost. The adult relationship of the first permanent molars is established at this time.
-Occlusal and proximal wear reduces crown height to the permanent dentition and the mesiodistal dimensions of the teeth
occlusal and proximal wear also changes the anatomy of teeth. As cusps are worn off, the occlusion can become virtually flat plane. -In the absence of rapid wear, overbite and overjet tend to remain stable.
-Mesio-distal jaw relationships tend to be stable,
With aging, the teeth change in color from off white to yellow. smoking and diet can accelerate staining or darkening of the teeth.
Gingival recession results in the incidence of more root caries . With gingival recession, some patients have sensitivity due to exposed dentin at the cemento-enamel junction.
Curve of Spee.
-The cusp tips and incisal edges align so that there is a smooth, linear curve when viewed from the lateral aspect. The mandibular curve of Spee is concave whereas the maxillary curve is convex.
-It was described by Von Spee as a 4" cylinder that engages the occlusal surfaces.
-It is called a compensating curve of the dental arch.
There is another: the Curve of Wilson. Clinically, it relates to the anterior overbite: the deeper the curve, the deeper the overbite.
Postnatal Developmental
PedodonticsPostnatal Period: Developmental Milestones
The postnatal period, particularly the first year of life, is crucial for a
child's growth and development. This period is characterized by rapid physical,
motor, cognitive, and social development. Below is a summary of key
developmental milestones from birth to 52 weeks.
Neonatal Period (1-4 Weeks)
Physical Positioning:
In the prone position, the child lies flexed and can turn its head
from side to side. The head may sag when held in a ventral suspension.
Motor Responses:
Grasp reflex is active, indicating neurological function.
Visual Preferences:
Shows a preference for human faces, which is important for social
development.
Physical Characteristics:
Face is round with a small mandible.
Abdomen is prominent, and extremities are relatively short.
Criteria for Assessing Premature Newborns:
Born between the 28th to 37th week of gestation.
Birth weight of 2500 grams (5-8 lb) or less.
Birth length of 47 cm (18 ½ inches) or less.
Head length below 11.5 cm (4 ½ inches).
Head circumference below 33 cm (13 inches).
4 Weeks
Motor Development:
Holds chin up and can lift the head momentarily to the plane of the
body when in ventral suspension.
Social Interaction:
Begins to smile, indicating early social engagement.
Visual Tracking:
Watches people and follows moving objects.
8 Weeks
Head Control:
Sustains head in line with the body during ventral suspension.
Social Engagement:
Smiles in response to social contact.
Auditory Response:
Listens to voices and begins to coo.
12 Weeks
Head and Chest Control:
Lifts head and chest, showing early head control with bobbing
motions.
Defensive Movements:
Makes defensive movements, indicating developing motor skills.
Auditory Engagement:
Listens to music, showing interest in auditory stimuli.
16 Weeks
Posture and Movement:
Lifts head and chest with head in a vertical axis; symmetric posture
predominates.
Sitting:
Enjoys sitting with full truncal support.
Social Interaction:
Laughs out loud and shows excitement at the sight of food.
28 Weeks
Mobility:
Rolls over and begins to crawl; sits briefly without support.
Grasping Skills:
Reaches for and grasps large objects; transfers objects from hand to
hand.
Vocalization:
Forms polysyllabic vowel sounds; prefers mother and babbles.
Social Engagement:
Enjoys looking in the mirror.
40 Weeks
Independent Sitting:
Sits up alone without support.
Standing and Cruising:
Pulls to a standing position and "cruises" or walks while holding
onto furniture.
Fine Motor Skills:
Grasps objects with thumb and forefinger; pokes at things with
forefinger.
Vocalization:
Produces repetitive consonant sounds (e.g., "mama," "dada") and
responds to the sound of their name.
Social Play:
Plays peek-a-boo and waves goodbye.
52 Weeks
Walking:
Walks with one hand held and rises independently, taking several
steps.
Object Interaction:
Releases objects to another person on request or gesture.
Vocabulary Development:
Increases vocabulary by a few words beyond "mama" and "dada."
Self-Care Skills:
Makes postural adjustments during dressing, indicating growing
independence.
A dermatofibroma
General Pathology
A dermatofibroma is a benign tumor of the dermis, MC located on the lower extremity, where it has a nodular, pigmented appearance.
- composed of benign histiocytes.
ANTIGEN-ANTIBODY REACTIONS
General Microbiology
ANTIGEN-ANTIBODY REACTIONS
Affinity of the antigen-antibody reaction refers to the intensity of the attraction between antigen and antibody molecule.
Antigen-antibody reactions
Reaction test Modified test
Precipitation -> Immunoelectrophoresis, Immunoprecipitation
Agglutination -> Latex agglutination, Indirect, Haemagglutination , Coagglutination ,Coombs test
Neutralization -> Measurement of LD, Plaque assays
Complement fixation -> Conglutination
Immunofluorescence -> Indirect immunofiuorescence, Immunoofluoremetric Assay
Enzyme immunoassay -> Enzyme linked, Immunosorbent assay
Radioimmunoassay -> Immunoradiometric assay
Avidity is the strength of the bond after the formation of antigen-antibody complex.
Sensitivity refers to the ability of the test to detect even very minute quantities of antigen or antibody. A test shall be called as highly sensitive if false negative results are absent or minimal.
Specificity refers to the ability of the test to detect reactions between homologous antigens and antibodies only, and with no other. In a highly specific test, false positive reactions will be minimal or absent.
Classification of Periodontal Pockets
PeriodontologyClassification of Periodontal Pockets
Periodontal pockets are an important aspect of periodontal disease,
reflecting the health of the supporting structures of the teeth. Understanding
the classification of these pockets is essential for diagnosis, treatment
planning, and management of periodontal conditions.
Classification of Pockets
Gingival Pocket:
Also Known As: Pseudo-pocket.
Formation:
Formed by gingival enlargement without destruction of the
underlying periodontal tissues.
The sulcus is deepened due to the increased bulk of the gingiva.
Characteristics:
There is no destruction of the supporting periodontal tissues.
Typically associated with conditions such as gingival
hyperplasia or inflammation.
Periodontal Pocket:
Definition: A pocket that results in the
destruction of the supporting periodontal tissues, leading to the
loosening and potential exfoliation of teeth.
Classification Based on Location:
Suprabony Pocket:
The base of the pocket is coronal to the alveolar bone.
The pattern of bone destruction is horizontal.
The transseptal fibers are arranged horizontally in the
space between the base of the pocket and the alveolar bone.
Infrabony Pocket:
The base of the pocket is apical to the alveolar bone,
meaning the pocket wall lies between the bone and the tooth.
The pattern of bone destruction is vertical.
The transseptal fibers are oblique rather than horizontal.
Classification of Periodontal Pockets
Suprabony Pocket (Supracrestal or Supraalveolar):
Location: Base of the pocket is coronal to the
alveolar bone.
Bone Destruction: Horizontal pattern of bone loss.
Transseptal Fibers: Arranged horizontally.
Infrabony Pocket (Intrabony, Subcrestal, or
Intraalveolar):
Location: Base of the pocket is apical to the
alveolar bone.
Bone Destruction: Vertical pattern of bone loss.
Transseptal Fibers: Arranged obliquely.
Classification of Pockets According to Involved Tooth Surfaces
Simple Pocket:
Definition: Involves only one tooth surface.
Example: A pocket that is present only on the
buccal surface of a tooth.
Compound Pocket:
Definition: A pocket present on two or more
surfaces of a tooth.
Example: A pocket that involves both the buccal and
lingual surfaces.
Spiral Pocket:
Definition: Originates on one tooth surface and
twists around the tooth to involve one or more additional surfaces.
Example: A pocket that starts on the mesial surface
and wraps around to the distal surface.