NEET MDS Synopsis
White Blood Cells (leukocytes)
PhysiologyWhite Blood Cells (leukocytes)
White blood cells
are much less numerous than red (the ratio between the two is around 1:700),
have nuclei,
participate in protecting the body from infection,
consist of lymphocytes and monocytes with relatively clear cytoplasm, and three types of granulocytes, whose cytoplasm is filled with granules.
Lymphocytes: There are several kinds of lymphocytes, each with different functions to perform , 25% of wbc The most common types of lymphocytes are
B lymphocytes ("B cells"). These are responsible for making antibodies.
T lymphocytes ("T cells"). There are several subsets of these:
inflammatory T cells that recruit macrophages and neutrophils to the site of infection or other tissue damage
cytotoxic T lymphocytes (CTLs) that kill virus-infected and, perhaps, tumor cells
helper T cells that enhance the production of antibodies by B cells
Although bone marrow is the ultimate source of lymphocytes, the lymphocytes that will become T cells migrate from the bone marrow to the thymus where they mature. Both B cells and T cells also take up residence in lymph nodes, the spleen and other tissues where they
encounter antigens;
continue to divide by mitosis;
mature into fully functional cells.
Monocytes : also originate in marrow, spend up to 20 days in the circulation, then travel to the tissues where they become macrophages. Macrophages are the most important phagocyte outside the circulation. Monocytes are about 9% of normal wbc count
Macrophages are large, phagocytic cells that engulf
foreign material (antigens) that enter the body
dead and dying cells of the body.
Neutrophils
The most abundant of the WBCs. about 65% of normal white count These cells spend 8 to 10 days in the circulation making their way to sites of infection etc Neutrophils squeeze through the capillary walls and into infected tissue where they kill the invaders (e.g., bacteria) and then engulf the remnants by phagocytosis. They have two types of granules: the most numerous are specific granules which contain bactericidal agents such as lysozyme; the azurophilic granules are lysosomes containing peroxidase and other enzymes
Eosinophils : The number of eosinophils in the blood is normally quite low (0–450/µl). However, their numbers increase sharply in certain diseases, especially infections by parasitic worms. Eosinophils are cytotoxic, releasing the contents of their granules on the invader.
Basophils : rare except during infections where these cells mediate inflammation by secreting histamine and heparan sulfate (related to the anticoagulant heparin). Histamine makes blood vessels permeable and heparin inhibits blood clotting. Basophils are functionally related to mast cells. . The mediators released by basophils also play an important part in some allergic responses such as hay fever and an anaphylactic response to insect stings.
Thrombocytes (platelets):
Thrombocytes are cellular derivatives from megakaryocytes which contain factors responsible for the intrinsic clotting mechanism. They represent fragmented cells which contain residual organelles including rough endoplasmic reticulum and Golgi apparati. They are only 2-microns in diameter, are seen in peripheral blood either singly or, often, in clusters, and have a lifespan of 10 days.
WETTABILITY
Dental Materials
WETTABILITY
To minimise the irregularities on the investment & the casting a wetting agent can be used .
FUNCTIONS OF A WETTING AGENT
1 . Reduce contact angle between liquid & wax surface .
2 .Remove any oily film left on wax pattern .
Retention
OrthodonticsRetention
Definition: Retention refers to the phase following active
orthodontic treatment where appliances are used to maintain the corrected
positions of the teeth. The goal of retention is to prevent relapse and ensure
that the teeth remain in their new, desired positions.
Types of Retainers
Fixed Retainers:
Description: These are bonded to the lingual
surfaces of the teeth, typically the anterior teeth, to maintain their
positions.
Advantages: They provide continuous retention
without requiring patient compliance.
Disadvantages: They can make oral hygiene more
challenging and may require periodic replacement.
Removable Retainers:
Description: These are appliances that can be taken
out by the patient. Common types include:
Hawley Retainer: A custom-made acrylic plate
with a wire framework that holds the teeth in position.
Essix Retainer: A clear, plastic retainer that
fits over the teeth, providing a more aesthetic option.
Advantages: Easier to clean and can be removed for
eating and oral hygiene.
Disadvantages: Their effectiveness relies on
patient compliance; if not worn as prescribed, relapse may occur.
Duration of Retention
The duration of retention varies based on individual cases, but it is
generally recommended to wear retainers full-time for a period (often
several months to a year) and then transition to nighttime wear for an
extended period (often several years).
Long-term retention may be necessary for some patients, especially those
with a history of dental movement or specific malocclusions.
Water Acid Bases & Buffers
Biochemistry
Keq, Kw and pH
As H2O is the medium of biological systems one must consider the role of this molecule in the dissociation of ions from biological molecules. Water is essentially a neutral molecule but will ionize to a small degree. This can be described by a simple equilibrium equation:
H2O <-------> H+ + OH-
This equilibrium can be calculated as for any reaction:
Keq = [H+][OH-]/[H2O]
Since the concentration of H2O is very high (55.5M) relative to that of the [H+] and [OH-], consideration of it is generally removed from the equation by multiplying both sides by 55.5 yielding a new term, Kw:
Kw = [H+][OH-]
This term is referred to as the ion product. In pure water, to which no acids or bases have been added:
Kw = 1 x 10-14 M2
As Kw is constant, if one considers the case of pure water to which no acids or bases have been added:
[H+] = [OH-] = 1 x 10-7 M
This term can be reduced to reflect the hydrogen ion concentration of any solution. This is termed the pH, where:
pH = -log[H+]
Aplasticanaemia and pancytopenia
General Pathology
Aplasticanaemia and pancytopenia.
Aplastic anaemia is a reduction in all the formed elements of blood due to marrow hypoplasia.
Causes
- Primary or Idiopathic.
- Secondary to :
1 Drugs :
Antimetabolites and antimitotic agents.
Antiepileptics.
Phenylbutazone.
Chloramphenicol.
2 Industrial chemicals.
Benzene.
DDT and other insecticides.
TNT (used in explosives).
3 Ionising radiation
- Familial aplasia
Pancytopenia (or reduction in the formed elements of blood) can be caused by other conditions also like:
-Subleukaemic acute leukaemia.
-Megaloblastic anaemia
-S.L.E.
-hypersplenism.
-Marrow infiltration by lymphomas metastatic deposits, tuberculosis, myeloma etc
Features:
- Anaemia.
- Leucopenia upper respiratory infections.
- Thrombocytopenis :- petechiae and bruising.
Blood picture:
- Normocytic normochromic anaemia with minimal anisopoikilocytosis in aplastic anaemia. Other causes of pancytopenia may show varying degrees of anisopoikilocytosis
- Neutropenia with hypergranulation and high alkaline phosphatase.
- Low platelet counts
Bone marrow:
- Hypoplastic (may have patches of norm cellular or hyper cellular marrow) which may -> dry tap. .
- Increase in fat cells , fibroblasts , reticulum cells, lymphocytes and plasma cells
- Decrease in precursors of all three-Series.
- Underlying cause if any, of pancytopenia may be seen
Impression Materials - Types
Dental Materials
Impression Material
Materials
Type
Reaction
Composition
Manipulation
Initial setting time
Plaster
Rigid
Chemical
Calcuim sulfate hemihydrate, water
Mix P/L in bowl
3-5 min
Compound
Rigid
Physical
Resins, wax, stearic acid, and fillers
Soften by heating
Variable (sets on
cooling)
Zinc oxide-eugonel
Rigid
Chemical
Zinc oxide powder, oils, eugenol, and
resin
Mix pastes on pad
3-5 min
Agar-agar
Flexible
Physical
12-15% agar, borax, potassium sulfate,
and 85% water
Mix P/L in bowl
Variable (sets on
cooling)
alginate
Flexible
Chemical
Sodium alginate, calcium sulfate, retarders,
and 85% water
Mix P/L in bowl
4-5 min
Polysulfide
Flexible
Chemical
Low MW mercaptan polymer, fillers, lead
dioxide, copper hydroxide, or peroxides
Mix pastes on pad
5-7 min
Silicone
Flexible
Chemical
Hydroxyl functional dimethyl siloxane, fillers,
tin octoate, and orthoethyl silicate
Mix pastes on pad
4.5 min
Polyether
Flexible
Chemical
Aromatic sulfonic acid ester and polyether
with ethylene imine groups
Mix pastes on pad
2-4 min
Polyvinyl siloxane
Flexible
Chemical
Vinyl silicone, filler, chloroplatinic acid,
low MW silicone, and filler
Mix putty or use
two-component
mixing gun
4-5 min
FUNGAL INFECTION- Histoplasmosis
General Pathology
FUNGAL INFECTION
Histoplasmosis
A disease caused by Histoplasma capsulatum, causing primary pulmonary lesions and hematogenous dissemination.
Symptoms and Signs
The disease has three main forms. Acute primary histoplasmosis is usually asymptomatic
Progressive disseminated histoplasmosis follows hematogenous spread from the lungs that is not controlled by normal cell-mediated host defense mechanisms. Characteristically, generalized involvement of the reticuloendothelial system, with hepatosplenomegaly, lymphadenopathy, bone marrow involvement, and sometimes oral or GI ulcerations occurs, particularly in chronic cases
Progressive disseminated histoplasmosis is one of the defining opportunistic infections for AIDS.
Chronic cavitary histoplasmosis is characterized by pulmonary lesions that are often apical and resemble cavitary TB. The manifestations are worsening cough and dyspnea, progressing eventually to disabling respiratory dysfunction. Dissemination does not occur
Diagnosis
Culture of H. capsulatum from sputum, lymph nodes, bone marrow, liver biopsy, blood, urine, or oral ulcerations confirms the diagnosis
Types of Forces in Tooth Movement
OrthodonticsTypes of Forces in Tooth Movement
Light Forces:
Forces that are gentle and continuous, typically in the range
of 50-100 grams.
Effect: Light forces are ideal for orthodontic
tooth movement as they promote biological responses without causing
damage to the periodontal ligament or surrounding bone.
Examples: Springs, elastics, and aligners.
Heavy Forces:
Forces that exceed the threshold of light forces, often
greater than 200 grams.
Effect: Heavy forces can lead to rapid tooth
movement but may cause damage to the periodontal tissues, including root
resorption and loss of anchorage.
Examples: Certain types of fixed appliances or
excessive activation of springs.
Continuous Forces:
Forces that are applied consistently over time.
Effect: Continuous forces are essential for
effective tooth movement, as they maintain the pressure-tension balance
in the periodontal ligament.
Examples: Archwires in fixed appliances or
continuous elastic bands.
Intermittent Forces:
Forces that are applied in a pulsed or periodic manner.
Effect: Intermittent forces can be effective in
certain situations but may not provide the same level of predictability
in tooth movement as continuous forces.
Examples: Temporary anchorage devices (TADs) that
are activated periodically.
Directional Forces:
Forces applied in specific directions to achieve desired tooth
movement.
Effect: The direction of the force is critical in
determining the type of movement (e.g., tipping, bodily movement,
rotation) that occurs.
Examples: Using springs or elastics to move teeth
mesially, distally, buccally, or lingually.