LET'S SLOVE WITH SHREE CASE BASED QUESTIONS RAPID REVISION

hi vanessa hope you're doing good and great uh so let's solve few questions uh most of them uh which i'm going to discuss now were posted as a doubt to me and few of them are case-based questions so question number one during root canal instrumentation the apex constructor is violated and enlarged to a size of 50. so keyword here you have to make a notice 50 size 50 so basically they thought of preparing up to 50 but they have violated the principle so means here they have given information that mpa that is master apical file maf is 50 but they have violated it means now the preparation is more than 50. so just imagine the preparation is more than 50 size 5 that is nothing but more than 0.50 millimeters in diameter so you need to select an option which is more than 0.5 millimeters so what the question is which of the following is appropriate treatment for this scanner obturate with the gutta pacha and surgically remove the uh extruded excess gut apache no that is not required okay so they're simply telling that go for a surgical endodontic surgical endodontics is not advised always go for a non-surgical endodontics that is nothing but called as a root canal therapy or even if mishap happens it's better to go for a re-root canal rather than going for a surgical procedure so option a you can eliminate it coming to option b uh fit a number 50 cone with a seller and careful condensation now the preparation is above 50. you cannot use 50 file because if you use 50 file definitely there will be extrusion of the cone as well as the sealer into the periapical area which is not to be done next option c 50 co fit a 50 cone with a sailor but don't condense uh as to keep the gatapatcha being pushed in the apical foramen they're telling like i'm just uh told you the consequence of option b that they have externality even if you condense it even if you don't condense it when you're using 50 cone okay you need to seal with a 50 50 seller 50 cone should be used whenever you're preparing because typical tuck back is very very important that uh three to five millimeters of apical tuck back like whenever you try to pull the master cone there will be someone there is something like inside holding it that back is very very important whenever you don't maintain the touch back there is no apical seal and there is high chance that the root canal therapy is going to fail so option c is also not appropriate but if you see option d he's telling reinstrument one millimeter short of apex to a size 60 or a larger so they're telling to go for a larger indirectly they're telling to go for a larger size for example if you calculate this considering as a uh two percentage of ios okay so what is going to be the calculation they're telling one millimeter shot of apical foramen okay so this is going to be perfect option when compared to other and the answer for this question is t okay so we'll go with the second question the second question is on kovid 19 question regular more of a common sense question a woman whose sister has tested covet positive came to the clinic with a negative antigen report okay so rapid antigen test is regularly done in the most of the clinics okay because rt pcr will take time like even if you consider my clinic okay so it will advise the patient either to uh either to get the rtpc report okay uh which was recent like maybe like two or three days before or either we'll ask the patient to undergo rapid antigen test and if you talk about the sensitivity and specificity rapid antigen test is not hundred percent is right in all the scenarios okay so keeping that in mind but with other add-on features other add-on findings from the patient the symptoms and signs we can think whether the patient has to go for rtbc or is it mandatory to go for rtpc or not so keeping this in mind comes your training with a negative antigen rapid antigen report or upon which you have done rapid antigen test which was sound to be negative uh and she was a symptomatic as of now what to be done next check the option test again with rapid antigen uh after seven days no meaningless that is okay meaningless to do the rapid antigen frequently test again with the rtpcr after seven days yes you can think of you can think of testing with rtp here after seven days test immediately with rtbc no it is already done and the patient is asymptomatic so there is no pointless of being testing the patient again again test again with rtpcr only if the symptoms are developed okay so so compared to option b option d stands better okay so d is a better option for this compared to that of the b because the patient now is having symptoms previously the patient is a symptomatic fine now he's having symptoms so as you already done the rapid antigen test now just go for rtpc okay right so the answer is d for this particular question jumping into the question number three uh of course we have discussed this question in a different format before uh i mean a few days back on the group so just just we'll try to read the key points in the question because this question has to be finished as fast as possible a 25 year old male who has worked as a truck driver so most of the truck driver based questions definitely they will have a sexual contact unprotected sexual contact will be there presented with presented to the clinic with a genital ulcer which is painless uh do make a note it's a painless ulcer 10 days back and has an unprotected sexual appointed with a commercial sex worker three weeks back on examination the ulcer was found to be injured partially healed and punched out okay we got the clue here the punched out ulcer is syphilis also okay blindly you can go for option c because ulcer in the tuberculosis tuberculosis is not mostly sexually transmitted but uh ulcer the type of ulcer we see in tuberculosis is is undermined okay undermined you see undermine undermined ulcer you've seen tuberculosis okay whereas you see sloping type of ulcer you see in the case of healing ulcer okay right so i mean like if you talk about ulcers okay all these are ulcers ulcer ulcer associated lesions and you see inguinal lymph nodes are enlarged diagnosed serum with vdr also there are many clues here vdrl is a very beautiful clue that you can conclude it as a syphilis one second thing you have a clue of punched out syphilis okay you have a painless ulcer syphilis right so there are many clues who are concluding it as a syphilis so it's a syphilis and we have already discussed recently the vdrl test is perfectly positive in the case of secondary syphilis when compared to any stage of syphilis okay any stage of syphilis uh the sensitivity and specificity of vdrl test is going to be 100 percentage in the case of secondary secondary stage of syphilis okay so jumping into the question number next question uh next question is again a case-based lengthy question you can check it off they have given a radiograph chest radiograph was given and we will try to solve it 50 year old patient present with a low grade favor with evening rays of temperature okay so whenever you see like a evening rays of temperature like rays of temperature you can think of malaria apart from the diagnosis you can think of malaria okay right so then you see a product of for two to three months so when you see cough nowadays you will definitely think of kovid 19 but it's a cough of two to three months clovid 19 cough is an acute cough most of the viral related signs and symptoms are acute but most of the bacterial things can be both acute as well as chronic but here you you can remove that option of viral infection because it's a cough which is going two to three months ahead okay he approached a local clinic for advice since he has started coughing blood blood things are also there from the cough from the past three to four days with a history of loss of hepatitis and weight loss loss of hepatitis weight loss uh of 10 cages are most common in the case of hiv okay age related aspects okay but now the combination is of a different thing for example you see upon chest radiograph there is a nodular infiltration on the apical part of right lobe that clearly sees on the radiograph and the patient is positive to acid fast specialize so you have a beautiful clue acid fast basilic so among the options you have two acid fast basilas one is leprosy and one is tb okay so option b and option d are simply eliminated and then if you jump into the other contents cough weight loss okay and come coming to that of the radiographic features on the chest x-ray so clearly concludes it is a tb not a leprosy the answer is c for this question when you're talking about acid fast basil day sometimes the paper setter may be have more concern towards you and they may give you an add-on things okay for example they may give you 20 days of h2so4 is used in acid baseline then your answer is simple which ever closes tubercles is very specific using 20 days of sulfuric acid whereas when i'm talking about leprosy it is just five percent is five percent is only sometimes i give a clue twenty percent is or five percentages whenever they give twenty percent is you can blindly list equal to the option tb or whenever they give five percent is you can blindly stick on to the option leprosy okay so leprosy they'll have a different uh background history which is nowhere related to the tuberculosis but both are acid fast baseline okay so i hope you are clear with this question the answer is tuberculosis for this particular question so jumping into the next question so this is already discussed when i'm taking the oral surgery classes in a different format but uh i do make a note okay so a 28 year old professional rugby player who is playing second row forward presented with an acute articular hematoma he has been aspirated by the club doctor but how however quick re-accumulated means the recurrence is there on examination the hematoma affects the central part of pinna and was causing approximately 75 percent as occlusion of external auditory meters the patient main consent was potential defect that could cause the hearing loss as well as the cosmetics also okay now uh cosmetics as well as the uh like long-term effect as well as the uh look effect look means the cosmetics like how he appeared to look which of the following complication may occur which may affect his cosmetic appearance uh around the crowd around the people around it okay so if we jump into this this is basically a perfect case of boxers here but now here uh it was given as a rugby player okay so rugby player also may have uh the similar sort of punched over traumas or over the face or over the ears okay because of uh i mean like because of this particular type of sport which is more of an a like a violence violence related sport okay so so this is basically called as cauliflower like here okay so the ear looks like the ear looks like a cauliflower okay and it's also called as boxers here what happens here in this particular question is uh i mean uh it's they have given its as a rugby player okay so that is uh that is like a it would be so better if the question was framed around the boxer around the boxer because it's most often called as in a boxer's ear or cauliflower here okay so but the theology is almost the same it is most often related to the violence associated sport okay the answer is c for this particular question and i'm done for now okay so do like subscribe and we'll be coming out with few more rapid revision as well as few more case-based questions sort of videos and i'll try to solve them from my point of view solving a case-based question particularly a new case-based question the approach of solving will be different for different persons okay so most of them i'll i'll try to solve from my point of view but make sure you need to practice this and this is the peak time that you need to uh you need to like you need to understand the keywords uh i mean there will be one or two keywords in the question which are going to simply conclude you to the right answer and guys to make a note this questions has to be solved as fast as possible in the examination hall because these are going to eat over your time stay positive god bless you love you all and we'll be back with one more video very very soon bye take care signing off doctor sleep from team mds phone bye you