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Tumour-suppressor genes commonly act as components of control mechanisms that regulate entry of the cell from the G1 phase of the cell cycle into the S phase or passage through the S phase to G2 and mitosis acne facials order betnovate 20 gm with mastercard. Examples of oncogenes and tumour-suppressor genes involved in haemopoietic malignancies are shown in Table 11 skin care jogja buy 20 gm betnovate otc. The most significant tumour-suppressor gene in human cancer is p53 which is mutated or inactivated in over 50% of cases of malignant disease acne and hormones buy betnovate online pills, including many haemopoietic tumours acne quick treatment generic 20 gm betnovate visa. Clonal progression Malignant cells appear to arise as a multistep process with acquisition of mutations in different intracel- Table 11. Karyotype is the term used to describe the chromosomes derived from a mitotic cell which have been set out in numerical order. A somatic cell with more or less than 46 chromosomes is termed aneuploid; more than 46 is hyperdiploid, less than 46 hypodiploid; 46 but with chromosome rearrangements, pseudodiploid. These meet at the centromere and the ends of the chromosomes are called telomeres. On staining each arm divides into regions numbered outwards from the centromere and each region divides into bands. When a whole chromosome is lost or gained, a - or + is put in front of the chromosome number. If there is extra material replacing part of a chromosome the prefix add (for additional material) is used. Chromosome translocations are denoted by t, the chromosomes involved placed in brackets with the lower numbered chromosome first. The prefix inv describes an inversion where part of the chromosome has been inverted to run in the opposite direction. An isochromosome, denoted by i, describes a chromosome with identical chromosome arms at each end; for example, i(17q) would consist of two copies of 17q joined at the centromere. Germ cells and stem cells, which need to self-renew and maintain a high proliferative potential, contain the enzyme telomerase which can add extensions to the telomeric repeats and compensate for loss at replication and so enable the cells to continue proliferation. Telomerase is also often expressed in malignant cells but this is probably a consequence of the malignant transformation rather than an initiating factor. In many cases the disease develops new characteristics during its clinical course and this may be accompanied by new genetic changes. Selection of subclones may occur during treatment or reflect disease acceleration. In one example the cells express a protein that actively pumps a number of different drugs to the outside of the cells (multidrug resistance). Chromosome nomenclature the normal somatic cell has 46 chromosomes and is called diploid; ova or sperm have 23 chromosomes Chapter 11 Haematological malignancy: aetiology and genetics / 157 Figure 11. Probe sets developed from the chromosomes of gibbons are combinatorially labelled and hybridized to human chromosomes. Translocations these are a characteristic feature of haematological malignancies and there are two main mechanisms Bands Regions Figure 11. Genetic abnormalities associated with haematological malignancies the genetic abnormalities underlying the different types of leukaemia and lymphoma are described with the diseases which are themselves increasingly 158 / Chapter 11 Haematological malignancy: aetiology and genetics. Epigenetic alterations Gene expression in cancer may be dysregulated not only by structural changes to the genes themselves but also by alterations in the mechanism by which genes are transcribed. These changes are called epigenetic and are stably inherited with each cell division so they are passed on as the malignant cell divides. Chapter 11 Haematological malignancy: aetiology and genetics / 159 Fusion gene gene transcription Dysregulation gene transcription Enhancer Fusion protein Aberrant expression of normal protein Figure 11. This binding allows recruitment of coactivators which lead to transcription from these genes. Part of the heavy-chain gene (the V region) is reciprocally translocated to chromosome 8. C, constant region; IgH, immunoglobulin heavy-chain gene; J, joining region; V, variable region.
Not considered premalignant skin care industry purchase betnovate discount, unless related to "reverse smoking" (lighted end in mouth) skin care expiration date purchase 20gm betnovate amex. Questions of apexogenesis and apexification (they gives you a short case and you have to decide) Apexogenesis -> Vital tooth / Apexification -> non-vital 49 acne 8 year old child order 20gm betnovate with amex. Reciprocal anchorage - used for closure of midline diastema skin care for swimmers betnovate 20 gm mastercard, use of Crossbite elastics. Disadvantage of partial thickness flap - thin flap so tear easily, can get lost easily, Difficult to elevate. More common reason of amalgam failure - if ask for failure water contamination, if ask for fracture then cavity preparation. The contamination of the amalgam by moisture during trituration and condensation is unquestionably the principal cause of failures. True about Niti over stainless steel (options something like harder, more adaptable in curvatures (keep shape), flexibility. That question of 3 years old with 5 mm intrusion (they did not give to much details) leave it 79. Herpetic gingiva stomatitis (short description) - Acute herpetic gingivostomatitis diagnosed early (within 3 days of onset) is treated immediately with antiviral therapy (acyclovir, 15 mg/kg ve times daily for 7 days). Patients should be made aware of the contagious nature of this disease when vesicles are present. Where to grind, balanced occlusion concept - Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the maxillary (upper) and mandibular (lower) teeth when they approach each other, as occurs during chewing or at rest. More common cells in cellulitis ͠leukocytosis (white cells above the normal range in the blood) 86. Most common tooth lost due to periodontitis - Max 2nd molar, maxi first most affected by periodontitis and max 2nd most common lost. Pathology with early teeth lost - Papillion-Lefevre syndrome, Chediak-Higashi syndrome, hypophosphatasia, neutropenia, leukemia and in some cases Langerhans cell histiocytosis 88. K sparing drugs - Eplerenone (Inspra), Spironolactone (Aldactone), Triamterene (Dyrenium) 97. Diagnostic radiolucency of the mandible secondary to invagination of the lingual surface of the jaw. Atropine has direct inhibitory effect on vagal mediated sympathetic stimulus resulting into reflex tachycardia, even though Epinephrine do also have effect but it causes Cardiac Arrthymia. A question said something like more cost effective fluoride treatment - community water fluoridation. Allograft concept - this graft material is obtained from cadaver bone that is processed to ensure sterility and to decrease substances in the bone that can trigger host immune response. However, this process destroys the osteoinductive capability of the bone, whereas the osteoconductive property of the graft remains. Although allograft avoids the need for a second surgical site, a greater amount of the grafted material is resorbed compared with autografts. Allogra materials include undecalci ed, freeze- dried bone allogra (osteoconductive material) and decalci ed, freezedried bone allogra (osteo- genic material owing to the presence of bone morphogenetic proteins that are exposed during the demineralization process). Anug (2 quesntions, onhe for treatment and one they gave me a short description) 115. Treatment of acute necrotizing ulcerative gingivitis includes evaluation of the medical history, application of topical anesthetic followed by gently swabbing the necrotic lesions to remove the pseudo-membrane, and removal of local factors such as calculus (o en with ultrasonic instruments unless contraindicated by the medical history). Systemic antibiotics should be prescribed only if there is evidence of lymphadenopathy or fever. The patient should be instructed to avoid alcohol and tobacco, rinse with chlorhexidine, get adequate rest, remove bacterial plaque gently, and take an analgesic as needed for pain. Patient should be seen again approximately 5 days later for reevaluation; further counseling regarding diet, rest, and tobacco use; reinforcement of oral hygiene instruction (including chlorhexidine rinses); and periodontal evaluation. Belladone alkaloids (contraindications) - Belladonna alkaloids and phenobarbital combination is used to treat cramping and spasms in the stomach and intestines. Morphine side effects - respiratory depression, constipation, dysphoria, toxic: miosis, coma, resp depr. Bur used to polish porcelain - diamond Tons of questions of pulpal pathology, flaps indications and contraindications, side effects of medsGuys thanks for your everything.
Headache 4- cold 8 Diabetic undergoing surgery Take clear fluids with same insulin intake Take clear fluids with 1/2 amt of insulin? There is no tooth mobility skin care khobar purchase betnovate 20gm mastercard, but the practitioner notes a small skin care for rosacea discount betnovate 20 gm without prescription, draining sinus tract adjacent to the tooth acne 6 dpo generic 20gm betnovate visa. Formocresol pulpotomy 13-pt positive ept acne surgery purchase on line betnovate,sensitive to cold and linger pain,pain to specific tooth? Which lab test for the viral infecon: HgSab,/ HgcAb/, Transaminase,/ no test 5. What is true for his malocclusion Related only to the anterior region (on the left side he had a missing canine maxillary and the posterior bite looked collapsed) Correction of ant cross bite will improve esthetic and function the premolar will function for the missing canine(smthg like this) 8. Most important to consider when deciding for the anbioc prophylaxis: me elapsed since the surgery 4- no test 5- osteoradionecrosis 6- retained primary tooth - lingual eruption of permanent 8- prophylaxis should be given 6-The most common etiologic factor for non-skeletal anterior crossbites is a lack of space for the permanent incisors. Case 2: 8 yr old girl with many missing teeth due to caries and poor oral hygiene. All are negave sequel of extracon of the supernumary tooth except Necrosis of 7 Non erupon of 7 Necrosis of 8 Necrosis of 6 3. Correcon of the anterior cross bite will result in all except Increase maxillary arch perimeter Improve erupon of tooth 11 Stop root development of the central incisor One more option 4. Case 4: 42 yr old man, many teeth missing, wants denture Oral finding: mandibular Canine to canine teeth r present, posteriors all edentulous Maxillary: upper 2nd molar and 2nd premolar present rest all missing Quest: 1. Phenytoin used in which conditions- status epileptics, grand mal, petit mal, absence seizures? Pain at mental foremen- traumatic neuroma, neurofibromas, ossifying fibroma and last one with neuro something 25. What you tel for good oral hygiene maintenance- it will affect your ortho tx/ give oh instructions and follow up/ electric tooth brush? Mandibular molar 30 moved to the right during occlusion, where is the interference? Mandibular molar endodontically treated with furcation involvement 5mm to apex, how to treatment plan (hemisection and treat as if it where 2 premolars) 41. If you have a patient having intravenous bisphosphonate and you need to do a dental treatment what would you do? In a Perio maintainece every 3 month: could be modified if patients condition changes? Pronouncing the letter F or "ph", the incisal edge of the anterior mandibular teeth: (contact at the vermillion of the lower lip, anterior to the vermillion of the lower lip, posterior to the vermillion of the lower lip) 80. There is a compliant patient that is now denying to do a root canal tx, what is the appropriate approach? Periodontium regeneration: cementum, alveolar bone, sharpeys fibers, or cementum, alveolar bone and gingiva? Direction of regeneration in implants like coronalyy connective tissue or pdl or apically connective tissue or pdl 55. Do definitions and asa classification for all subjects esp pt management these q look like rqs but they were very twisted and close options I got lots of q on gtr and lots on implant. Odontoblast nuclei within dentinal tubules Deccisation Chemical Mechanical Thermal 3. Radiolucent Nares Midpalatal suture Turbinates Mylohyoid ridge Genial tubercles Nasal fossa 7. Enamel deminarelized Tenancious Rough cavitated More resistant to acid Softer Smaller apatits 8. On cephalometric looks single Sella turcica i put Orbitale Pterygomax fissure Mandibular plane 22. Male 64 yrs with white lesion on lip Smoke ciggarettes and smokeless tobacco Brown pogmentation on palate Bad quality of photos Complaint Anterior teeth misalign 1. The reason of that brown pigmantation Smokless tobacco Smoking ciggarettes Medication Smth else 3. Reason of that white lesion on the lip Smokless tobacco Smoking ciggarettes Medication Smth else 4. Some big yellow nodule on the buccal (looked like Fordyce spots) but yellow and q was about one nodule and it was inside the buccal. Biopsy Should include everyrhing except Normal site or smth Submucous tissue Smth else 6.
A negative test should lead to investigations for other causes of haemodynamic instability skin care kiehls order genuine betnovate on-line. In not high-risk patients skin care 2 in 1 betnovate 20 gm with mastercard, the clinical probability of pulmonary embolus should be determined using a scoring system such as the revised Geneva rules (Table 10 acne denim buy betnovate cheap. The only definite indication for thrombolysis in acute massive embolism is persistent arterial hypotension acne 9 weeks pregnant purchase betnovate without prescription. Surgical embolectomy is occasionally undertaken if thrombolysis is contraindicated or ineffective. In contrast, patients who are cardiovascularly stable and who have no coexistent serious medical pathology can be treated at home once the diagnosis is confirmed. Insertion of a vena caval filter is used to prevent further emboli when emboli recur despite adequate anticoagulation or in high-risk individuals where anticoagulation is contraindicated. Cardiomyopathy 477 Pulmonary embolism in pregnancy Pulmonary embolism occurs more frequently in pregnancy and is the leading cause of maternal death in the developed world. Clinical features Patients present with an acute illness characterized by fever and varying degrees of biventricular failure. Cardiac biopsy is not usually performed as the findings rarely influence management. The hypertrophic non-compliant ventricles impair diastolic filling, so that stroke volume is reduced. Most cases are familial, autosomal dominant and caused by mutations in genes encoding sarcomeric proteins. Clinical features Patients may be symptom-free (and detected through family screening) or have breathlessness, angina or syncope. Complications include sudden death, atrial and ventricular arrhythmias, thromboembolism, infective endocarditis and heart failure. The carotid pulse is jerky because of rapid ejection and sudden obstruction to the ventricular outflow during systole. An ejection systolic murmur occurs because of left ventricular outflow obstruction, and the pansystolic murmur of functional mitral regurgitation may also be heard. A pattern of left ventricular hypertrophy with no discernible cause is diagnostic. Vasodilators should be avoided because they may aggravate left ventricular outflow obstruction or cause refractory hypotension. In selected cases, outflow tract gradients are reduced by surgical resection or alcohol ablation of the septum, or by dual-chamber pacing. Clinical features Shortness of breath is usually the first complaint; less often, patients present with embolism (from mural thrombus) or arrhythmia. Subsequently, there is progressive heart failure with the symptoms and signs of biventricular failure. Other tests such as coronary angiography, viral and autoimmune screen and endomyocardial biopsy may be needed to exclude other diseases (Table 10. Management Heart failure and atrial fibrillation are treated in the conventional way (pp. Primary restrictive cardiomyopathy the rigid myocardium restricts diastolic ventricular filling and the clinical features resemble those of constrictive pericarditis (pp. Diagnosis is by cardiac catheterization, which shows characteristic pressure changes. An endomyocardial biopsy may be taken during the catheter procedure, thus providing histological diagnosis. There is no specific treatment and the prognosis is poor, with most patients dying less than a year after diagnosis. The typical presentation is ventricular tachycardia or sudden death in a young man. Other causes include uraemia, autoimmune rheumatic diseases, trauma, infection (bacterial, tuberculosis, fungal) and malignancy (breast, lung, leukaemia and lymphoma). Clinical features There is sharp retrosternal chest pain which is characteristically relieved by leaning forward. Complications of acute pericarditis are pericardial effusion and chronic pericarditis (>6ͱ2 months).
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