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