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- NEETMDS- courses
NEET MDS Lessons
Periodontology

  • Mobility Tests: Perio test, Fremitus test.
  • Bone Evaluation: Transgingival probing.
  • Halitosis Detection: Gold standard = Organoleptic analysis.
  • Indices:
    • PMA Index: Gingival disease.
    • Ramfjord Index Teeth: 16, 21, 24, 36, 41, 44.
    • Merin’s Classification: Patient recall.
    • Surrogate Endpoint: Reduction in probing depth.

  • Least risk site: Atrial septal defect
  • IV drug user: Tricuspid valve affected
  • Common organism: Staph aureus
  • Late prosthetic valve endocarditis: CoNS
  • Signs:
    • Osler’s nodes – Palms & soles
    • Roth spots – Retinal hemorrhage
  • Best test: Echocardiography
  • Criteria: Duke’s
  • Dental prophylaxis: Amoxicillin

🫁 Respiratory Physiology & Pathology

Concept Key Insight
Mean Arterial Pressure Diastolic + 1/3 pulse pressure
Pulse Pressure Systolic – Diastolic
Hemoptysis source Most commonly bronchial artery
Cavitary TB lesion Highly infective, absent in HIV-associated TB
Miliary TB Mantoux negative
Recurrent hemoptysis Often due to TB reactivation or vascular erosion

Aggressive Periodontitis (formerly Juvenile Periodontitis)

  • Historical Names: Previously referred to as periodontosis, deep cementopathia, diseases of eruption, Gottleib’s diseases, and periodontitis marginalis progressive.
  • Risk Factors:
    • High frequency of Actinobacillus actinomycetemcomitans.
    • Immune defects (functional defects of PMNs and monocytes).
    • Autoimmunity and genetic factors.
    • Environmental factors, including smoking.
  • Clinical Features:
    • Vertical loss of alveolar bone around the first molars and incisors, typically beginning around puberty.
    • Bone loss patterns often described as "target" or "bull" shaped lesions.

Diagnosis Criteria

  • FBS ≥ 126 mg/dL
  • HbA1C > 6.5%
  • eAG based on HbA1C
  • Oral GTT 2-hr post-load: 140–199 mg/dL → Impaired Glucose Tolerance
  • HbA1C 5.7–6.4% → Pre-diabetic range

  • Plaque & Bacteria:
    • Plaque: Mainly extracellular polysaccharides.
    • Pellicle: Thin film post-cleaning.
    • Bacteria in 1g plaque: 2 × 10¹¹.
    • Early plaque: Gram-positive.
    • Saliva: Streptococci dominate.
    • First oral colonizer: S. sanguis.
    • Secondary colonizer: S. mutans.
    • Red Complex: Most associated with periodontal disease.
    • Green Complex: A. actinomycetemcomitans, E. corrodens, Capnocytophaga.
  • Tests & Toxins:
    • BANA test: Detects P. gingivalis, T. denticola, B. forsythia.
    • Leukotoxin (116-kDa): Secreted by A. actinomycetemcomitans.
    • Myeloperoxidase: Prevents A. viscosus attachment.
  • Immunoglobulins:
    • Saliva: IgA.
    • GCF: IgG.
  • GCF Lymphocyte Ratio: T:B = 1:3.
  • TLRs: Absent on bacterial cells.

  • Bence Jones Proteins: Mostly gamma chains
  • Commonest lytic lesion site: Vertebral column
  • Russell bodies: Found in plasma cells
  • Bone scan not useful
  • No ALP elevation
  • High ESR: Often seen
  • Prognostic marker: Beta-2 microglobulin

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