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Dental Medicine — MCQ ও উত্তর

ডেন্টাল ভর্তি · । এই অধ্যায়ে মোট 53টি প্রশ্ন আছে। নিচে প্রথম 10টি প্রশ্ন ও সঠিক উত্তর দেওয়া হলো।

এই অধ্যায়ে সব প্রশ্নে অনুশীলন করুন

  1. A patient presents with excessive thirst, frequent urination, and unexplained weight loss. Which laboratory finding is most likely?

    1. Hypoglycemia
    2. Hyponatremia
    3. Hyperglycemia
    4. Hypercalcemia

    সঠিক উত্তর: Hyperglycemia

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option C The patient's symptoms of excessive thirst (polydipsia), frequent urination (polyuria), and unexplained weight loss are classic signs of diabetes mellitus. This condition is characterized by impaired insulin secretion or action, leading to elevated blood glucose levels (hyperglycemia). High glucose levels increase osmotic diuresis, causing dehydration and triggering thirst, while the inability of glucose to enter cells results in weight loss due to cellular starvation. Therefore, the most likely laboratory finding is hyperglycemia.Reference: Harrison's Principles of Internal Medicine, Jameson et al., 20th Edition.

  2. Which of the following is a classic feature of Parkinson's disease?

    1. Pill-rolling tremor at rest
    2. Intention tremor
    3. Choreaform movements
    4. Hemiballismus

    সঠিক উত্তর: Pill-rolling tremor at rest

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option A The classic feature of Parkinson's disease is the pill-rolling tremor at rest, which refers to a fine, rhythmic movement of the thumb and fingers resembling the motion of rolling a small object. This tremor is most prominent when the patient is at rest and typically decreases with voluntary movement. It results from the degeneration of dopaminergic neurons in the substantia nigra, leading to altered basal ganglia circuitry. Unlike intention tremor or choreaform movements, the resting tremor is distinctive for Parkinson’s disease. Reference: Harrison's Principles of Internal Medicine, J. Larry Jameson et al., 20th Edition.

  3. Which of the following is a hallmark clinical sign of rheumatoid arthritis?

    1. Morning stiffness lasting less than 30 minutes
    2. Morning stiffness lasting more than 1 hour
    3. Joint pain relieved by activity
    4. Heberden's nodes

    সঠিক উত্তর: Morning stiffness lasting more than 1 hour

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The hallmark clinical sign of rheumatoid arthritis is morning stiffness lasting more than 1 hour. This prolonged stiffness reflects the chronic inflammatory process characteristic of RA, resulting in synovial inflammation and joint swelling. Unlike osteoarthritis, where stiffness typically resolves within 30 minutes, RA's persistent stiffness improves gradually with activity. This duration of morning stiffness is a key diagnostic feature and helps differentiate RA from other joint disorders. Reference: Harrison's Principles of Internal Medicine, Jameson et al., 20th Edition.

  4. What is the most important initial step in taking a patient's history?

    1. Documenting the past medical history
    2. Eliciting the chief complaint in the patient's own words
    3. Reviewing systems
    4. Recording the family history

    সঠিক উত্তর: Eliciting the chief complaint in the patient's own words

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The most important initial step in taking a patient's history is eliciting the chief complaint in the patient’s own words. This step focuses the clinical encounter on the primary reason for the visit, guiding further questioning and examination. It ensures that the clinician understands the patient’s perspective and concerns directly, which is essential for accurate diagnosis and patient-centered care. Without this, subsequent history components may lack context and relevance, potentially missing key clinical information. Eliciting the chief complaint sets the foundation for an efficient and effective clinical evaluation.Reference: Bates' Guide to Physical Examination and History Taking, Lynn Bickley, 13th Edition.

  5. Which mnemonic is commonly used to systematically explore a symptom during the history of present illness?

    1. SOAP
    2. APGAR
    3. ABCDE
    4. OLDCARTS

    সঠিক উত্তর: OLDCARTS

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option D The mnemonic OLDCARTS is specifically designed to systematically explore a symptom during the history of present illness. It stands for Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing, and Severity. This structured approach helps clinicians obtain detailed and relevant information about the symptom, allowing for a thorough and focused assessment. Unlike general frameworks, OLDCARTS targets symptom analysis, which is crucial for accurate diagnosis and management. Reference: Bates' Guide to Physical Examination and History Taking, Lynn Bickley, 13th Edition.

  6. During a respiratory examination, which finding is most suggestive of pleural effusion?

    1. Hyperresonance on percussion and increased breath sounds
    2. Dullness on percussion and decreased breath sounds
    3. Bronchial breath sounds and egophony
    4. Wheezing and crackles

    সঠিক উত্তর: Dullness on percussion and decreased breath sounds

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B Dullness on percussion and decreased breath sounds indicate the presence of fluid in the pleural space, which impedes sound transmission through the lung. Fluid accumulation causes the normally resonant lung area to become dull and muffles breath sounds because the fluid blocks both the air and sound waves. This is a classic finding in pleural effusion. Other options like hyperresonance or bronchial breath sounds point to different pathologies such as pneumothorax or consolidation. Therefore, dullness and decreased breath sounds are the most reliable signs to suggest pleural effusion during examination. Reference: Bates' Guide to Physical Examination and History Taking, Lynn Bickley, 13th Edition.

  7. In the assessment of an unconscious patient, what is the first priority?

    1. Checking for a pulse
    2. Ensuring a patent airway
    3. Assessing pupillary response
    4. Obtaining a blood glucose level

    সঠিক উত্তর: Ensuring a patent airway

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The first priority in assessing an unconscious patient is ensuring a patent airway because without airway patency, oxygen cannot reach the lungs, leading to rapid hypoxia and brain injury. Even if circulation and breathing are intact initially, an obstructed airway can quickly cause life-threatening respiratory arrest. Securing the airway allows effective ventilation and oxygenation, which is critical before proceeding to other assessments such as pulse or neurological status. This approach follows the Airway-Breathing-Circulation (ABC) principle in emergency care. Reference: Tintinalli's Emergency Medicine: A Comprehensive Study Guide, Judith E. Tintinalli, 9th Edition.

  8. Which of the following is essential when performing a cardiovascular examination?

    1. Palpating the carotid pulse only
    2. Measuring blood pressure in one arm
    3. Auscultating heart sounds with both the diaphragm and bell of the stethoscope
    4. Inspecting for clubbing

    সঠিক উত্তর: Auscultating heart sounds with both the diaphragm and bell of the stethoscope

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option C Auscultating heart sounds with both the diaphragm and bell of the stethoscope is essential because each part is designed to detect different frequencies. The diaphragm is best for high-pitched sounds such as S1, S2, and murmurs of aortic or mitral regurgitation, while the bell is optimal for low-pitched sounds like S3, S4, and some mitral stenosis murmurs. Using both enhances diagnostic accuracy by allowing thorough assessment of all heart sounds and murmurs, which is critical for identifying valvular and other cardiac abnormalities during a cardiovascular examination. Reference: Bates' Guide to Physical Examination and History Taking, Lynn Bickley, 13th Edition.

  9. A patient suspected of having appendicitis is most likely to exhibit which of the following?

    1. Murphy's sign
    2. McBurney's point tenderness
    3. Rovsing's sign
    4. Cullen's sign

    সঠিক উত্তর: McBurney's point tenderness

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The hallmark clinical sign of acute appendicitis is tenderness at McBurney's point, located one-third the distance from the anterior superior iliac spine to the umbilicus. This area corresponds to the anatomical position of the inflamed appendix. Palpation here typically elicits localized pain due to peritoneal irritation. Identification of McBurney's point tenderness is crucial for surgical decision-making and differentiates appendicitis from other acute abdominal conditions. This sign guides timely appendectomy, preventing complications like perforation.Reference: Sabiston Textbook of Surgery, Townsend et al., 21st Edition.

  10. A patient with syncope is found to have a slow, irregular pulse. What is the most likely cause?

    1. Vasovagal syncope
    2. Complete heart block (Stokes-Adams attack)
    3. Atrial fibrillation
    4. Ventricular tachycardia

    সঠিক উত্তর: Complete heart block (Stokes-Adams attack)

    ব্যাখ্যা: সমাধান সঠিক উত্তর: Option B The patient's syncope with a slow, irregular pulse is most consistent with complete heart block (Stokes-Adams attack). In this condition, the atrial impulses fail to conduct to the ventricles, causing a significant drop in ventricular rate and cardiac output. The resulting transient cerebral hypoperfusion manifests as syncope. The pulse is characteristically slow and irregular due to the escape rhythm. This contrasts with vasovagal syncope, which generally features a normal or slow pulse without conduction abnormalities. Recognition of this bradyarrhythmia is critical as it may require a pacemaker to prevent recurrent syncopal episodes.Reference: Braunwald's Heart Disease, Douglas P. Zipes, 11th Edition.

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