NEET-PG 2020 - Dental PYQs Practice Questions

Q: An HIV positive patient with a CD4 count of 300/cumm presents with mucosal lesions in the mouth as shown in the figure. On microscopy, budding yeasts and pseudohyphae are seen. A most probable diagnosis is?

Candidiasis. ***Candidiasis*** - The image shows **white, creamy patches** on the tongue, which are characteristic of **oral candidiasis** (thrush). These lesions are often easily **scrapable**. - The presence of **budding yeasts and pseudohyphae** on microscopy confirms a fungal infection, and in an **HIV-positive patient with a CD4 count of 300/cumm**, Candida infection is very common due to immunosuppression. *Hairy leukoplakia* - Hairy leukoplakia presents as **white, corrugated, non-scrapable lesions**, typically on the lateral borders of the tongue. - It is caused by the **Epstein-Barr virus (EBV)** and does not show budding yeasts or pseudohyphae on microscopy. *Lichen planus* - Oral lichen planus presents with **white, lacy patterns (Wickham's striae)** on the buccal mucosa or tongue, which are usually not scrapable. - It is a **chronic inflammatory condition** and not an infectious process characterized by yeasts and pseudohyphae. *Diphtheria* - Diphtheria causes the formation of a **thick, gray pseudomembrane** in the throat and tonsils, which is firmly adherent and can cause bleeding if removed. - It is a **bacterial infection** caused by *Corynebacterium diphtheriae*, and microscopic examination would reveal characteristic gram-positive rods, not yeasts. [Practice more Dental PYQs on OnCourse]

Q: A 30-year-old male presents with a one-week history of severe toothache, swelling in the floor of the mouth, and difficulty swallowing. What is the most likely diagnosis?

Ludwig's angina. ***Ludwig's angina*** - The combination of a recent **severe toothache** (suggesting odontogenic infection), **swelling in the floor of the mouth**, and **difficulty swallowing (dysphagia)** are classic signs of Ludwig's angina, a rapidly spreading cellulitis of the submandibular, sublingual, and submental spaces. - This condition is particularly dangerous due to its potential to cause **airway obstruction** if the swelling progresses posteriorly. *Acute parotitis* - Acute parotitis typically presents with swelling and pain primarily in the **parotid gland region**, often located anterior to the ear and extending to the angle of the jaw. - While it can cause pain and difficulty swallowing, swelling is not typically described as being predominantly in the **floor of the mouth**. *Angioneurotic edema* - Angioneurotic edema (or angioedema) is characterized by **rapid, localized swelling of subcutaneous or submucosal tissues**, often affecting the face, lips, tongue, and pharynx. - It usually lacks a preceding infectious etiology like a toothache and is typically attributed to allergic reactions or hereditary/acquired deficiencies in C1-esterase inhibitor. *Parapharyngeal abscess* - A parapharyngeal abscess is a deep neck infection located in the **parapharyngeal space** lateral to the pharynx, often presenting with fever, severe sore throat, and trismus (difficulty opening the mouth). - While it can cause dysphagia and neck swelling, the primary swelling location described in the **floor of the mouth** points away from a parapharyngeal abscess as the most likely diagnosis. [Practice more Dental PYQs on OnCourse]

Question 1

An HIV positive patient with a CD4 count of 300/cumm presents with mucosal lesions in the mouth as shown in the figure. On microscopy, budding yeasts and pseudohyphae are seen. A most probable diagnosis is?

Accepted Answer

Candidiasis

Answer

Hairy leukoplakia

Answer

Lichen planus

Answer

Diphtheria

Question 2

A 30-year-old male presents with a one-week history of severe toothache, swelling in the floor of the mouth, and difficulty swallowing. What is the most likely diagnosis?

Accepted Answer

Ludwig's angina

Answer

Acute parotitis

Answer

Angioneurotic edema

Answer

Parapharyngeal abscess

NEET-PG 2020 — Dental