 Hello everyone, hope you are all doing well and safe. As the exam dates of Kerala University Health Sciences, final BDS are nearing and students have a general confusion regarding how to answer or what to write for a given question. We have decided to discuss the recent OMFS question paper topic-wise. The purpose of these discussions is to give an idea as to how to frame an answer. Hope this helps. Today's topic for discussion is Principles of Coral and Maxillofacial Surgery. All these are the short essay questions asked from this particular topic over last few years and they carry 8 marks each. Let's move on to the discussion. The first question is teachers. This is more like a general question. And the students might be confused as to what to write. So in these type of questions where they haven't specified anything, try to cover everything that comes under suture. These are the headings under which you may answer sutures and you can limit your answers to points and you cannot elaborate on each point. So start your answer with definition if there is one and do not write your own definition. Write the definitions given in textbooks. So define what a suture is. Then you write why you suture a wound or what are the indications or purpose of sutures. Then in points you mention what are the requisites of suture materials or what are the ideal properties of suture materials. Like it should have good tensile strength, it should be tissue biocompatible, etc. So you mention each of them in points. Then you classify sutures. You can classify sutures into natural, synthetic, absorbable, non-absorbable, monofilament and multifilament. You also write two or three examples under each classification. Then you mention about size of suture materials. You know that suture materials are available in various sizes depending upon its tensile strength. So the standard for identifying the varying tensile strength of a suture material is by the number of zeros. So you mention a note about the size of suture material. And finally you can add a note on the biological response of tissues to suture materials. Here you write about the cellular response that occur when a suture material is implanted in a living tissue. So all these completes your answer. Other aspects like principles and types of suturing and suture notes though they are important, it's not necessary to write them. This autoplaying which is a direct question, it can be answered also directly to the point. You can find detailed description of autoplaying in oral surgery of microvarious experts. Here you are expected to write the principle of autoplay which is moist heat under high pressure. Different textbooks have mentioned different types of autoplays. You may mention them as well here. Parts of an autoplay can be described with a diagram which is very important. Do not forget to draw a diagram of autoplay. Mention the different articles summarized in autoplay. And write about the steps in autoplaying in flow chart. So here you can illustrate the process of autoplaying with the help of a flow chart. And do not write in paragraphs. Always mention the process of autoplaying in flow chart. Do not miss to mention the relevant temperature or pressure of time scope autoplaying. These factors change according to the type of sterilizer and types of mechanical sterilized. So the sixth point is a very important point. Next you mention about the efficiency test. That means there are several mechanical, chemical and biological parameters which are used to evaluate the sterilizing conditions and also the procedure materials. So mention about those. And finally you complete our answer with the advantages and limitations of autoplaying. Absorbable suture materials again is a very direct and specific question. So here first you explain regarding the biologic response of body to suture materials and the mechanism of this option of absorbable suture materials. Then you write about the natural and synthetic absorbable suture materials available. You need not mention the entire classification of suture materials. You can limit your answer to absorbable sutures only. Once you classify it into natural and synthetic, then you list out all the examples under each heading. And also mention key points about each example. So that will suffice for absorbable suture materials. To answer indications of biopsy, first you define biopsy. Then you write what are the general aims of performing a biopsy. Next you list out the various types of biopsy procedures like incisional and excisional biopsy, aspiration biopsy, punch biopsy, exfoliative cytology and fine needle aspiration. And under each of these heading where they are specifically indicated, what are the particular condition or vision in which each of these procedures are performed. This is what completes your answer. You write the definition, the general aims of biopsy, the types and the specific indications of each type. Principles of antibiotic therapy is a direct question from therapeutics in ovary surgery. So here you need to list out the selection criteria of antimicrobials. So you list out each principle and explain each principle in points. You may also add a note on combination therapy and antibiotic profile axis. Here you are not expected to explain or elaborate on combination therapy and profile axis. But just mention why you combine two antibiotics and where all you give antibiotic profile axis. That is sufficient. Now because you have been asked about the principles of antibiotic therapy, you may also mention the adverse effect of injurious use of antibiotics i.e. bacterial resistance. You may also mention about bacterial resistance or unwise use of antibiotic therapy. So that's all about principles of antibiotic therapy. Anti-platelet drugs have been explained in detail in pharmacology textbooks. So kindly refer them for this answer. Before explaining about anti-platelet drugs, you first mention what are the actions of platelets. You all know that platelets form the initial hemostatic plug at the site of vascular injury. So by inhibiting platelet function, thrombosis and atherosclerotic vascular diseases can be largely prevented. Then you mention about indications of anti-platelets, anti-platelet drugs. Mention what are the conditions in which these drugs are administered. Moving on to classification, there are at least five categories of anti-platelet drugs which you need to list out with examples. Also describe in brief the commonly used drugs. You all know that aspirin in its low dosage act as anti-platelet agent. So mention about aspirin and clopidogrel, which is another commonly used anti-platelet agent. So briefly describe at least four to five anti-platelet agents. So that's all about this answer. Management of patients on long-term steroid therapy, for which you can refer to mental emergencies in dental office by Stanley F. Malema. For this question, the examiner expects you to explain the effects of long-term steroid therapy in the first half of your answer and management in the second. Firstly, you illustrate the HPA axis and cortisol collection with a note on the significance of cortisol during stress conditions. Secondly, explain what is adrenal cortical insufficiency. How it happens due to exogenous steroid administration. Also write about rule of two. This is the criteria used to determine the patients with risk of adrenal cortical insufficiency. And accordingly you decide whether to administer the steroids pre-peri or post-operative. So this comprises your first part of the answer. Moving on to the second part, which is the management. In the management part, consider all the adverse effects of long-term steroid therapy. So practice stress reduction for growth hold. Decide if you need to administer steroids or not to the patient pre-peri and post-operative. Monetary vitals. Understand that the patient is highly susceptible to infection. Therefore, practice asexis and also pro-palatic antibiotics. Patient also will be immunocompromised. Therefore, he has the risk of developing systemic complications or diseases. So all these factors need to be taken into consideration. Then you write about the definitive management in case an emergency arises due to adrenal cortical insufficiency. So these are the points under which this question has to be answered. With this, we have completed the discussion on majority of questions from principles of oral and maxillofacial surgery. We shall discuss questions from local anesthesia in the next video. Thank you. Welcome back to question paper discussion of oral and maxillofacial surgery. For every question discussed here, I have framed an outline as to what to include and how to answer. Almost every answer has been structured as per the textbooks of oral and maxillofacial surgery by Neelima Malik and SM Balaji. Any references other than from these books has also been quoted in the presentation. Before going into the discussion, let's have a look at how to present an answer. Yes, it's your knowledge presenting skill that is assessed and not your writing skill. Generally, your questions, especially the long essays, are very specific. So you answer them specifically too. Answer what is asked and only what is asked. Do not be around the bush. List your answers in bullets as you see in this slide as well as the following slides. Look at how answers to each question in this presentation are outlined. Follow the same. Avoid paragraphs because nobody has the time or patience to read stories. Answer again in points. Underline the main headings and subheadings so that it catches the attention of the evaluator. Because nobody will search for an answer, you need to highlight it for them. Make use of flow charts and label diagrams to describe the particular technique, surgical procedure and anatomy. This helps you to express a complete answer accurately. It will help you fetch more marks and most importantly, it saves time. Tabulate your answers for questions like indications, contraindications, advantages and disadvantages. And finally know that it's your answer that counts and not the pages. Therefore, short, neat and precise answers will favor you than your excess and overfilled pages. Last but not the least, write Legible, which I think requires no further explanation about. In this video, first we shall discuss the questions from the topic General Anastasia and Sedation. As you can see here, the most frequently asked questions from this topic are on pre-anesthetic evaluation and pre-anesthetic medication. The other questions are from general anesthetic agents and complications. Moving on to the first question, which is a short essay question. Describe the importance of pre-anesthetic evaluation before administering general anesthesia. So here you first write what is the purpose of a pre-op pre-anesthetic evaluation, which includes obtaining information about the patient's medical history, mental condition, need for a medical consultation, consent for anesthesia. So all these comes under what is the purpose of pre-op evaluation. Then you write about what is the history that you obtain from the patient. You take a brief history of the patient, which includes the current problems, the chief complaint, the present treatment the patient is undergoing, drug history, allergy history, habits and history of any prior anesthesia. So all these comes under the history part. Then you evaluate each organ system. So you write what is the importance of evaluating CVS. So here you can rule out any cardiac conditions like angina, hypertension, any congenital heart disease. So all that should be included while writing about CVS. Then under respiratory system, you can ask the patient about history of recent cough, cold, asthma, URTI. All this comes under respiratory system. Moving on to CNS. Ask the patient about history of headache, any frequent headache, epilepsy, dizziness. So it is important to evaluate the CNS also. Under endocrine system, you can mention about diabetic melitis or any thyroid dysfunction. So these are the importance of evaluating each organ system. Finally, you write about airway assessment. Write about malamperties, airway assessment with help of a diagram. There are four classifications which you need to mention with diagram. So this is how you answer the question on the importance of pre-anesthetic evaluation before administering GA. The next question is classification of GA agents. They have been asked to enumerate complications during and after GA and also to add a note on respiratory obstruction. Classification of general anesthetic agents can be referred from any of the pharmacology textbooks. Commentary complications of general anesthesia during the perioperative and postoperative period. For this, you can refer to either Nelima Malik or SM Balaji textbooks. Both of these books have tabulated the complications. So just enumerate them. Don't explain each point except for respiratory obstruction which you have to elaborate. Write this topic under the science and management. You need to write what are the signs of upper airway obstruction or respiratory obstruction and also the management part. So this completes your answer. Name the drugs used in pre-anesthetic medication. For this, you can refer to the textbook of oral surgery by SM Balaji where the six case of pre-medication has been described. So you list out all the six case of pre-medication with one or two examples. This forms the first part of your answer. In the second part, you have been asked to describe the role of acropin and sedatives which are used as pre-medication. So here you are expected to explain anticholinergic properties of acropin. What are the anticholinergic properties of acropin? It has vagulitic effects and anti-syllabourg actions. So explain these two actions of acropin. Regarding sedatives, you mentioned some of the commonly used sedatives in pre-medication. For example, benzodiazepines, diazepam, flumazenol. All these are the commonly used sedatives in pre-medication. And you explain one or two lines about each example. So this completes your answer. Numerate indications for GA in dentistry. You know that almost every maxillofacial surgical procedures are performed under general anesthesia. So disturb all the major surgical procedures. Some thermoliner surgeries are also carried out under GA, which has clear indications. GA is also administered in patients with anxiety-challenging behaviour, intellectual disability in children and also in patients who are allergic to local anesthesia. So include all these points under indications. Moving on to the second part of the question. We have already seen the importance of pre-anesthetic evaluation. So here you write about the information that you're trying to obtain through a proper history. Then you perform a physical examination. You examine all the organ systems, like the CVS, CNS, respiratory system and endocrine system. You also perform an airway assessment. So add a note on the malampti airway assessment. Then you mention about ASA. ASA is the American Society of Anesthesiologists' Physical Status Scale. So this is a grading system and description of the physical status of a patient requiring anesthesia and surgery. So it has six classifications, which you are supposed to mention in this part of your answer. Then you perform certain investigations as a part of pre-anesthetic evaluation. You perform basic investigations as well as some special investigations. So you write down what all investigations are basic and what all are additional of special investigations. So this makes up your answer. What are the complications during GA and how is it managed? Here you are supposed to write regarding infra-operative complications and not post-operative complications. For this, refer to the textbook of oral surgery by Nelima Malik. Enumerate all the intra-operative complications and explain at least five to six complications in detail. You can explain each complication under the cause and management. Every complication will have a specific cause and definitive management. So this is a direct question and it can be answered also directly. This question is for short answer. Conscious sedation. You define conscious sedation. What are the indications and complications of conscious sedation? And enumerate the agents used for conscious sedation. So this is sufficient for a short answer. If it is asked for a short essay, you also include the technique of administering conscious sedation. The next topic of discussion is Exodontia and minor OB surgical procedures. The first is the question. They have asked the post-operative instructions, all of antibiotics and management of trisocate. So you first list out all the post-operative instructions under the following heading. Like there are few general comments you give to the patient. Then what are the instructions you give to manage bleeding, discoloration, pain, swelling. For any sharp bone projections on oral hygiene and diet. So these are the main headings. You need to explain or list out the instructions under this heading. That is what is expected of you. In the second part of the question, they have asked the role of antibiotics in routine extraction. So for this, you first mention what are the commonly administered antibiotics in oral surgery. Then the indications for antibiotic administration. And then add a note on antibiotic profile access. What are the conditions in which you give profile access? And what is the antibiotic dosage for that? For discussion on management of trisocate, you define what trisocate is and they have asked only management part. So you don't need to explain on the etiology and the clinical features. Under management, you need to write that the patient is first reviewed. Then mention how irrigation is performed. Add a note on intraagular paste used. What are the analgesics given? And how is the regular follow-up or review performed? So this completes your essay on this particular question. The next question has three parts. In the first part, you describe the normal process of haemostasis. You explain about primary haemostasis and their role of platelet. The second way haemostasis can be explained under intrinsic and extrinsic coagulation pathway. You need to then enumerate the various tests carried out in a coagulation screening. Those tests are the bleeding time, trotin time, prothrombin time, partial thromboplastic time and INR. You can write a line each about each test, what is its significance and what are the normal values. In the third part of the question, you need to discuss the various local measures used to arrest a case of post-extraction bleeding. So list out all the haemostatic measures, the local haemostatic measures which are the mechanical, thermal and chemical. You can elaborate the answer by quoting two or three examples and explaining in detail about each of them. List the indications for date extraction. Here you can list 8 to 10 indications. This is a direct question. In the second part of the question, you are asked to describe the principles involving closed method of extraction. Here do not get confused with the principles of elevators. You are asked to describe the principles of closed method of extraction which are access, controlled force and unimpeded path of removal. You can also add the mechanical principles of closed extraction like expansion of the bleeding socket, using a river and fulcrum and insertion of the wedge or wedges. These mechanical principles are given in the book, the extraction of the bleed by Jeffrey L. This is regarding the principles of closed method of extraction. Do not confuse it with the principles of elevators. Here is the question on principles of elevators. So you explain in detail the lever, wedge and wheel and axle principles with diagrams. You also mention examples for each principle and also add a note on the mechanical advantage. The next question is to classify impacted maxillary canines. So this is also a direct question where you can write all the five classifications of impacted maxillary canines and explain them with diagrams. Short answer list out at least 8 to 10 indications for removal of impacted mandibular third molar. For winter's war lines, explain what white amber and red lines are using a diagram and explain what each of them signify. For ideal requirements of a flap, do not confuse it with the principles of incision. Write specifically to that of flap. The next topic is temporal mandibular misalters. As you can see, the long assay that has been asked consecutively for the last 3 years is on joint ankylosis. I can discuss all of them together. A long assay on joint ankylosis can be explained under the following leggings. Definition, etiology, classification, clinical features, radiographs and management. When you write definition, write according to particular order or textbook. Do not make your own definitions. You can just enumerate the etiology. Do not write in paragraphs or don't explain any point. When it comes to classification, you can just mention one classification. Preferably the Sonny's classification. This is the grading of TMJ ankylosis based upon CT findings. But if classification is asked for 8 marks, if only classification is asked, then you can write 3 to 4 classifications. You can explain them as well. Coming on to clinical features. Read the question twice to see if they have asked bilateral or unilateral ankylosis, and write accordingly. You will start all the clinical features of bilateral or unilateral ankylosis. Then you mention what are the different radiographs taken to assess TMJ. For example, OPG, LACW view, EMJ view. You will start all the different radiographs techniques used and also write a different feature for each technique. What are the different features of ankylosis that you can see in each of these radiographs? Coming on to management. You should know that joint ankylosis can be only treated surgically. There is no medical management for joint ankylosis. You cannot cure the condition by giving any medicines. The surgery is the only option. So you first mention what are the aims or objectives of managing a TMJ, which is ankylosed. So why do you need to manage or treat ankylosis? Then you list out all the points of Kaban's protocol. Kaban's protocol is very important, so don't miss to write it. Moving on to the surgical steps. These are the surgical steps followed. You first give an incision, then perform condilectomy, followed by gap arthroplasty and interpositional arthroplasty. Explain all these steps using diagrams. There are beautiful diagrams given in textbooks. Go through them, learn those diagrams, learn how to label each of them, and then that is how you present this answer. And finally, you can finish your answer by writing a list of interpositional materials. There are few interpositional materials that you can use for the interpositional arthroplasty. So list out those materials in the tabulated. So this completes the answer. Before answering this particular essay, check the question once for what all have been asked. For example, every question will not ask all these findings. The first question they have asked are etiology, clinical features and management. So mention only these three aspects. The second question they have asked you to classify DMJ and carousels, and then clinical and videographical features. So do not write etiology and just don't write etiology in it. The rest of them are asked and management is common in all the three lists. So this is how you answer an essay on TMJ and carousels. Another recently asked question from Temporomandograph Joint Disorders is TMJ dislocation and subluxation of TMJ. So dislocation is a complete dislocation of joint and subluxation is incomplete dislocation. So when you write about etiology of dislocation, you first write what are the predisposing factors. For example, you can mention laxative ligaments, ligament injury, degenerative joint diseases, all these as predisposing factors. Then you write the exact etiology of TMJ dislocation. So the causes for TMJ dislocation can be classified into intrinsic and extrinsic factors. So you list out all the points under intrinsic factors and extrinsic factors. So this will be enough for your first answer on etiology of TMJ dislocation. Coming to subluxation of TMJ, you first write the definition of subluxation. You should know how it is different from TMJ dislocation. The predisposing factors and causes are again the same as that of joint dislocation. So you can write, mention what are the etiological factors for subluxation and then write two or three points on the management of subluxation. This list has questions from both optonetic surgery and oral facial infections. They are all for short answers, so we shall discuss all of them together. Recent questions on optonetic surgical procedures are all for short answers. These questions can be asked for long essays and short essays as well. So these are the points under which you explain each technique. History, indications, the technique, osteotomy cuts and any different types if there are any. So we shall see them in general. For a long essay elaborate on the history. You describe how the procedure has evolved over time for a long essay. And for a short answer, you mention only the person who advocated the technique first. Elaborate the indications for long essay and keep them in points for short answers. The surgical types can be elaborated for both short essay and long essay but just mention them in points for short answers. When it comes to technique, limit short answer to one to two labeled diagrams. You need not elaborate on every surgical procedure or the step. Just confine the answer to few labeled diagrams. No flowchart also required but for long answers and for essay questions you can describe in detail each surgical technique and each step using a flowchart and diagrams also for each step. The osteotomy cuts also can be represented diagrammatically. Do not waste your time writing it. You can draw a mandible or a maxilla and show the osteotomy cuts with copper label. So this is how you answer any question on a panathic surgical technique in general. For hyperbaric oxygen therapy, you first describe what HBO is. Mention the pressure, duration and diures. Then you list out the indications and contraindications of oxygen therapy. Mention the mechanism of action. You describe what HBO does to the tissues and how it helps in tissue healing. You also add a note on Mark's protocol of 1983. About osteo-radio necrosis, you first define what osteo-radio necrosis is. Describe the pathogenesis of condition. You explain what the three Hs are for osteo-radio necrosis. List out all the clinical and radiographic features. You can mention HBO therapy again in the treatment aspect. For Gaddy's osteomyitis, describe what the etiology is. List out the clinical and radiographic features and also the treatment. All these are direct questions from textbooks. You can refer to textbooks of Oval Surgery by Neelima Malik or SM Biology for these questions. For topics on ortho-anathic surgical procedures, you can refer to lecture videos in this channel. The links of which is provided in the description box. That's all for the discussion today. We shall continue with discussion in the next video. Thank you. Continue our question paper discussion of Oval and Maxillofacial Surgery. A long essay question from local anesthesia can always be expected. And the most frequently asked questions are based on the classification, contents, inferior alveolar nerve block and complications of local anesthesia. Posterior superior alveolar nerve block is another technique commonly asked for in the exams. Before starting the discussion, I want to inform you that the only textbook referred to discuss local anesthesia is local anesthesia by Stanley F. Malami. Let's now move on to discussion. The first question is to describe nerve conduction, mechanism of action of local anesthetics, the theories of local anesthesia and classification of local anesthetics based on their action. So here you can explain the electrophysiology of nerve conduction with four figures which has been given in the textbook that forms the first part of your answer. The second part of the question, which is the mechanism of action of local anesthetics, again you can enumerate the eight steps that explains the mechanism of action. Then you need to list out the theories of local anesthesia. Here you need not explain each theory. You can just list out the names of each theories of local anesthesia. And lastly you need to classify local anesthetics and the question is specified. This is based on their action. So here do not write the classification based on the chemical nature of local anesthetic molecule like esterine amide. Do not write that classification. But you need to classify local anesthetics according to their biological action. So you classify them. There are four classifications. There are four classes. Then you write what each class is and then give example. This is how you write your first law. The second question again, you have been asked to classify local anesthetics. So here because they haven't specified any classification, you can list down the classification according to action or due to chemical nature of local anesthetics. The second part of the question, discuss the bio-transformation, excretion and agroesiphexaphylocin. You know lignokine is an amide. Therefore, you can list down the pharmacopinetics and adverse effects of amides which is given in the pharmacology of local anesthetics chapter in Malaman. Then you are asked to add a note on contents of local anesthetic solution used in dentistry. For this, you can refer to the chapter on cartridge where the components of local anesthetic solution has been listed out in a tabulated form. So you mention all the contents of local anesthetic solution. What is their action? This is how you write this answer. In the adverse effects part, you are expected to write the CNS effects of lignokine or amides which again is given in tabulated form. Enumerate the ideal requirements of a local anesthetic agent. Discuss the classic technique of IA&B now block. Discuss the local complications associated with this particular now block. So this is the question. The ideal properties of local anesthetic agent can be referred from Malaman. It is given in the first chapter in the first page. So list out all the 10 ideal properties. Next, you discuss the classic technique of IA&B. So any local anesthetic technique asked can be or should be explained under the following headings. Area of insertion, target area, landmarks, the position of the patient and the operator and then the procedure. You can draw certain diagrams to emphasis on the landmarks or to describe the procedure. Diagrams are very important. Coming on to the complications. Here you have been asked to write the complications associated with inferior alveolar now block. Not the local or systemic complications associated with local anesthesia in general. So be specific. There are three different complications associated with IA&B which has been described in the textbook. So list out all of them. Write one or two lines about each of the complications. We have already discussed the contents of local anesthetic solution. Discuss the factors that guide in the selection of an appropriate local anesthetic agent. For this, you refer to the chapter on specific clinical agents of local anesthesia and you need to elaborate your answer on the duration and maximum dose of local anesthetic solution. So how does the duration of action and the maximum dose varies according to different agents? This is what you are supposed to or expected to answer in the second part of the question. In the third part, you need to add a note on the role of antioxidant in LA solutions. You need to understand that the antioxidant in local anesthetic solution is sodium metabasulfide. And the antioxidant is used to prevent the oxidation of the vasoconstrictor used in the local anesthetic solution and not the local anesthetic agent. So you can just elaborate on sodium metabasulfide and its action. Coming to the next question, enumerate the complications of local anesthetics. Here they haven't specified whether it is local or systemic complications. So it is down all the complications both local and systemic. Then discuss the causes, prevention and management of Christmas in detail. So after you enumerate all the complications, you expand your answer only for Christmas. As they have asked in the question which is very direct, the cause, prevention and management. So explain it and your answer is complete. Describe in detail the posterior-superior alveolar nerve block and mention its complications. So you can explain the answer under the following headings. The nerves and the area anesthetized, indications and complications of the technique, advantages and disadvantages and the technique itself. Under the headings which we have already discussed for inferior alveolar nerve block. Then you list out. You just need to mention the complications. Do not expand every complication. You list out the complications and then explain in detail hematoma following a PSA nerve block. So when you mention the complications associated with PSA, do not list out all the complications of local anesthesia as I have mentioned earlier also. Just mention the complications associated with PSA in specific. And then you can elaborate on hematoma management, which is given in the chapter on local complications of anesthesia. This is how you answer this particular question. Discuss the various techniques of inferior alveolar nerve block. So you mention all the different techniques of IA&P, then you come out and explain them under indications, landmarks and the technique in brief. So for the appropriate diagrams, you can show the difference between each technique also using diagrams. What are the differences in the landmarks? What is the difference in techniques? All these can be explained with diagrams. What are the systemic complications of local anesthesia? How do you manage a case of anaphylaxis? So for this question can be referred from the chapter on systemic complications of local anesthesia in the textbook of Melamed. You first classify all the systemic complications, then note down the relevant features of generalized anaphylaxis. You mention all the signs and symptoms associated with this condition. And then briefly explain the management part. Briefly explain what is P, A, B and C and then in detail the definitive management. All these answers, all these points can be referred from the same chapter, the systemic complications of local anesthesia. These are the short essay questions from local anesthesia. We have covered a majority of these questions under long essay. There is a question on infrarbital nerve block which needs to be answered like that for IA&P or PSA. There is another question where management of facial nerve palsy has been asked. The answer for which can be referred from chapter on local anesthesia complications. The local complications of local anesthesia. The next two questions are on vasoconstrictors in local anesthetic solution. So you describe all the five popular reasons for using VC in local anesthetic solution and mention what are the conditions in which VC is contraindicated. You can then list down all the vasoconstrictors used in local anesthetic solution. All these are direct questions. They are all direct picks from the good textbook. So I don't think there is a need for detail or elaborate explanation. The next question is to discuss the mechanism of action of local anesthesia which is a repeat. And what are the factors affecting the action of local anesthesia. For this you are expected to explain about dissociation of local anesthetic molecule and a note on effect of pH change. What happens when the pH of blood increase or decrease. So this can be again referred from the chapter on neurophysiology which is the first chapter in the textbook. Explain the answer using appropriate diagrams. So we have recently asked short note questions. We have discussed most of them under long essay and short essay. Next topic for discussion is maxillopacea chroma. This is a very important topic from which sometimes multiple questions come for the same reason. As you can see, question on mandibular fractures is highly common. There are also questions on ZMC, zygomatic or maxillary complex fractures and orbital fractures. There are two questions here on classification of mandibular fractures and description of the clinical features, diagnosis and management of angle fractures. So the difference here is that in the first question what has been asked is displaced or unfavorable angle fracture. And the second question is on favorable mandibular fracture, angle fracture. There are number of classifications given in textbooks, you can mention just one of them here. Then you explain what is unfavorable or what is favorable fracture depending on the question. You need to diagrammatically represent the favorability of fracture horizontally and vertically. Then you list out all the clinical features of angle fracture. Coming on to the diagnosis, we need to elicit a proper history. To diagnose what kind of fracture is, what is the type, what is the direction and what is the impact of force that has acted upon the patient. You also need to mention what are the supporting radiographs required. Moving on to management, you need to first list out what are the fixation techniques used for treating a displaced angle fracture. You know that a displaced or unfavorable angle fracture can only be managed using open reduction and internal fixation techniques. This can be done with or without intermaxillary fixation. So you list out all the techniques and explain only the relevant techniques. You can explain two to three techniques. For management of favorable fracture, you can mention that favorable fractures can be managed using closed reduction methods. List out all the closed reduction methods and explain each of them and give diagrams where all necessary. Diagrams are very important. I need not keep squishing upon that. Diagrams are very important and that will help you fetch more marks. A detailed lecture on manual fracture management has been uploaded earlier in this channel. Please use them for reference. The next question is on condylar fractures. Describe the clinical features, diagnosis and management of unilateral condylar fractures. Note the word unilateral condylar fractures. So the clinical features will change accordingly for unilateral and bilateral. You write down all the clinical features and the diagnosis. How do you diagnose this condition? What are the different investigations needed? So this forms the first part of your answer. In the second part, you need to explain the management of unilateral condylar fractures. So the examiner hasn't specified as to whether you need to explain on conservative or surgical options. So you have to describe everything in brief. So first you mention what are the conservative methods or what is the closed reduction method of condylar fractures. What are the different measures taken and what are the various immobilization methods? All they should be mentioned under the heading conservative or closed reduction. Coming to surgical or open reduction. There are certain indications given by Zaidan Kent as to which case of condylar fracture needs to be treated surgical. So you need to mention at least five to six indications specified for surgical reduction or surgical treatment of condylar fractures. And then you list out all the fixation methods of condylar fractures. What are the different fixation techniques used and explain one or two a month. That will complete your answer on condylar fracture management. So you first describe the clinical features, diagnosis and management of Lefort 1 fracture. So you first describe the fracture line of Lefort 1 with diagram. You need to explain how the fracture line runs in case of a Lefort 1 fracture. Then you list down all the clinical features of Lefort 1 fracture. There are at least six to eight clinical features you need to mention. Coming to the diagnosis part mention what are the different imaging techniques used to detect a Lefort 1 fracture. And how can a CTB useful, a completed homography can be useful in case of Lefort 1 fracture. In the management part you need to write how you reduce the fracture and how you fix the fracture. So what are the different reduction techniques? You need to describe by finger pressure or holes, dissection forceps or a Hayton Williams instrument. So all these are the reduction techniques which you need to elaborate for a long answer. And the different fixation techniques are direct fixation and suspension wiring. Here also you first enumerate what are the different techniques of fixation and then elaborate on few relevant ones. Here you can see questions on management of the Lefort 1 fracture. Also be asked like management of zygomatic fractures or ZMC, zygomatic or maxillary complex fractures. Unless it is specified as zygomatic arch fracture as in the third question, you always explain on ZMC fractures. So there are at least 10 to 15 clinical features which you need to mention. That is the clinical features of ZMC fractures. Then come into a diagnosis, mention what are the different imaging techniques used, what are the different radiographs that supports and diagnosis of zygoma fractures. And while explaining management, write the answer under the following headings like approaches which can be intraoral or extraoral, close reaction methods using either Gilles approach or Keynes approach and fixation. It can be done using 1 point fixation, 2 point, 3 point or 4 point fixation. So this is a detailed explanation of ZMC fractures. In one of the questions, you have been asked to discuss Gilles temporal approach in detail. So elaborate on Gilles temporal approach and the rest all can be just mentioned in brief. Coming on to zygomatic arch fracture, the management of which is little different from that of ZMC fracture. So here you first briefly explain the anatomy of zygomatic arch. Mention its articulations, what are its associated bones. Add a note on the fracture pattern which is usually a depressed V kind of pattern and what are the clinical features associated with this particular fracture pattern. Write what are the causes of zygomatic arch fracture and the usually employed technique for management of zygomatic arch fracture is closed reduction. So write a note upon it. So this is how you answer questions on zygomatic or maxillary complex fracture or zygomatic arch fracture. Next question is on orbital blowout fractures. So this can be asked in a short essay or for a short note answer. So first you write what are the two mechanisms associated with orbital blowout fractures using diagrams. Beautiful diagrams have been given in the textbooks. You explain this part of the question using diagrams. Then you list out all the clinical signs associated with orbital blowout fractures. Give special mention about the altered load level, the anti-mangloids land and of thalamus. Why it happens and then the propium. All these needs to be mentioned under the clinical features of blowout fractures. Coming to the management, you list down what are the different approaches to the orbit and the orbital flow. Enumerate all the approaches and then explain regarding orbital flow reconstruction which is the most important aspect of a blowout fracture. Blowout fracture will always result in the fracture of the orbital flow and the orbital contents will herniate into the maxillary sinus. So here you need to carry out orbital flow reconstruction. So explain about the reconstruction and list down all the materials. What are the reconstruction materials used for orbital flow? These are some of the short note questions asked. We have covered a majority of them under long essay and short essay. There are certain terminologies related to fractures that you need to be familiar with. They are wherein sign called a man's sign, battle sign or a guard man's fracture. So wherein sign is a classical feature of LeFoq 1 fracture. So while answering this question, describe what a LeFoq 1 fracture line is. Describe what the sign is, where it is seen, why it is seen. And if needed, you can briefly describe the management also of LeFoq 1 fracture. Coming on to guard man's sign again. Similar to wherein sign, describe its significance and what are the associated signs. So guard man's sign is found in mandibular fractures. We can also mention what are the other signs and what are the associated signs of mandibular fractures. Next question on CSF rhino area. We will answer this question. These are the headings under which this question needs to be explained. But if it is asked for a short note, you can just brief them. You need not explain everything in detail. You can just list the contents in each heading that is sufficient. But for a short answer, for a short essay, you can elaborate on each of these points. So you first mentioned what is CSF fluid. The question is CSF rhino area. So you say what CSF fluid is and then what is CNS rhino area. You list down the contents of CSF fluid. What are the causes of rhino area? Where does CSF rhino area happen? What are the website tests for confirming CSF rhino area? What are the chemical markers? What are the imaging studies done and how is this managed? So this forms the complete structure of CSF rhino area. You answer according to the marks of the question. Then regarding malunion, nonunion and delayed union. These are certain complications of mandibular or any fracture. Just not mandibular fracture of any fracture. These are the certain complications associated. So in this question paper they have asked regarding malunion. But you can also be asked for nonunion and delayed union. So you first define these conditions. Say what are the causes for this particular condition? How is it managed? And what are the future complications? This is how you answer all these short known questions. Moving on to the questions from cysts and tumors of Orofacial region. The three most important cysts to be considered are deradicular cysts, dendigeros cysts and autogenic keratosis. And the most frequently asked tumor for exam cysts, amyloblastoma. Procedures like enucleation, mass-supplication, maxlectomy and mandibular procedures for tumor resection are repeatedly asked questions and hence should not be overlooked. The first long assay question is what is cyst? Describe the features and management of radicula cysts. So you define cysts according to grammar. Then you list down all the clinical and radiological features of radicula cysts. When it comes to management part, enumerate the treatment options for radicula cysts. For example, extraction, endodontics, enucleation with primary closure and Waldron's procedure. Waldron's procedure is nothing but mass-supplication followed by enucleation. As I have mentioned it in the previous video also, you present the surgical steps in flow charts and using diagrams. So this is how you write a long assay on management of radicula cysts. So this applies for other cysts also. Even if you are asked to write on dentugeros cysts or OPC, this is how you write or frame the answer. The frequently asked question is amyloblastoma. Here you have been asked to classify adipotent tumors. Mention the features and management of amyloblastoma in the mandibular. Note that the question is management of amyloblastoma in the mandible and not maxilla. So whenever you are preparing an answer for long assay on amyloblastoma, always try to include the following headings. All these headings in your answer. Do not mention them unless asked for. You can find the classification of adipotentogenic tumors in any of your oral pathology or surgery textbooks. Define amyloblastoma according to Robinson. You add a note on the pathogenesis of amyloblastoma and enumerate the histological variants of this condition. You can then write down the clinical features and radiological features of amyloblastoma and if they haven't specified anything in the question as to which amyloblastoma that you need to explain about, you can always write down the radiological features of conventional amyloblastoma. That is the soberable appearance and honeycomb appearance. All that comes in conventional amyloblastoma. And you can list down the features of unicistic amyloblastoma only if they have mentioned it specifically in the question. Coming to the management part. First list down all the treatment options for amyloblastoma which includes enucleation, curatage and block segmental resection, amyloblastomy followed by reconstruction. You can explain all these procedures in brief using diabetics. For a question of amyloblastoma in maxilla everything up till the management remains the same. In the management aspect you need to expect the only difference. The detailed description of surgical procedures of jaw tumors has been already uploaded in this channel. So you may have a look at them for reference. Here is a question on keratocystic or ontogenic tumor which is nothing but ontogenic keratocyst. So you will list down all the clinical features of OKC in which you need to give special mention on the syndromes related to this particular cyst. OKC is associated with several syndromes which you need to mention. In the management aspect first you disturb all the treatment modalities as it was explained in the question for rhinoculosis then you briefly explain the procedures of massacralization and enucleation. Carnoid solution needs a special mention whenever you are answering a question on OKC. So you apply Carnoid solution after the procedure of enucleation. So whenever you answer OKC these are the points to be kept in mind. Moving on to radiological features of dentigerocyst here you are expected to explain all the three variants of dentigerocyst with good diagrams. All these questions are given in your textbooks under the same headings. So it shouldn't be very difficult for you to write an answer for all these. If a question on massacralization or enucleation is asked or for that matter if any surgical procedure is asked write down the indications, advantages, disadvantages types or modifications of that particular technique and also explain the stepwise procedure with the help of flow charts and diagrams. This is how you need to explain or elaborate upon any surgical procedure if asked. Ashley's flap is the only question that has been asked from Maxlery Sinus in the recent years. Whenever a question on flap is asked you first mention what type of flap it is. For example if it is a palatal flap or buckle flap what are the indications and advantages how is the technique performed and add a note on modification if any. Press into an answer with good label diagrams. From Maxlery Sinus this is not the only flap that is important. You have to read and practice writing all kinds of flap but this is the only recently asked question from this particular topic. Similarly with pre-plastic surgery only vestibular plastic has been seen in the recent question papers but other procedures like correction procedures, which correction procedures, aguloplasty all these are very important topics. So when you have to write an answer on vestibular plastic first you define or say what is vestibular plastic what are the techniques of vestibular plastic in both maxilla and mandible because here it is asked for short note you can just enumerate the technique names. In maxilla and mandible separate then diagrammatically present 2-3 techniques with diagram. Here you need not elaborate on the technique because it is asked only for 4 marks you can just present it with diagrams. vestibular plastic is also known as rich extension procedure which not be confused with other rich augmentation procedures or rich correction procedure. vestibular plastic can also be asked as rich extension procedure. The 3 very important topics from the chapter facial neuro pathology are trigeminal neuralgia facial nerve palsy and nerve injuries. Here we are discussing only trigeminal neuralgia because that is the most repeatedly and frequently asked recent question. So you first define trigeminal neuralgia list down the other names of this condition. There are a few other names for trigeminal neuralgia which you mention. Trigeminal neuralgia and what are the theories associated with the etiology. In the clinical features trigeminal points need a special mentioning. When it comes to diagnosis what are the imaging techniques used to diagnosis condition and what is Swede's criteria. Swede's criteria and trigeminal points are very important while writing an answer on trigeminal neuralgia. Do not miss to mention them in your answer. When it comes to management part this condition can be managed in two different ways. There is medical management as well as surgical management. So first you enumerate what are the options in medical treatment and what are the options in surgical treatment and explain which you think is very relevant. If they have asked specifically one kind of treatment either medical or surgical just explain whatever is asked. The only question asked for oral malignancy is TNM staging and classification. If you are answering a short note the TNM classification of oral cancer will be sufficient. You mention what TN and what H component is and what is the classification of each component. If you are answering a short essay along with TNM classification you also add a note on TNM staging that is how the disease is classified into four stages based on the TNM classification. Two important questions from the topic implantology is Osho integration and dental implants. So for this you need to know the definition of Osho integration and dental implant preferably the GPT-9 classification. You define Osho integration and enumerate the types of dental implants. There are different classifications given for dental implants where you can classify based on the design of dental implants. The surgical procedure for implant placement is also given elaborately in textbooks. You first mention all the main headings of the procedure and explain it very briefly with diagrams. That will be sufficient for short essay. And if dental implant is asked for short note you can just define dental implants and mention the components of dental implant. You draw a dental implant and label it properly show what all parts are there in dental implant. You can also just enumerate the surgical steps in points. And if it is asked for short essay explain it briefly. Dear students, here I would like to tell you all that this video is not a substitute your textbook and class notes reading. This is not your syllabus either. This presentation is only to guide you through how to answer a particular question if asked. There are several other topics which having been asked recently but are still important for your exams. The content of this video can help you to answer questions from those topics as well. Hope you all benefit from this discussion. That's all for part 3. We shall continue in the next video. Thank you. Paper discussion of Overland Maxillofacial Surgery. Hope you are all finding the discussion videos helpful while preparing for your exams. First topic is Salivary gland disorders. Here are few recently asked questions. Apart from these other questions like pleomorphic adenoma, botanist tumor, xylography are also important. The first question is adenoid cystic carcinoma. For any salivary gland tumor question you need to include all these headings in your answer. First you mention all these synonyms of the given condition and the classification. You need to mention under what classification does that particular tumor belong to. If it is benign or malignant if it is a material in origin or not all that needs to be included. Then you list down all the clinical and histological features of that particular tumor. Do not elaborate on features. Mention them in points. Then you list out all the investigations required to diagnose this particular condition. For example, computer tomography, MRI, xylography. All these are few investigations that you carry out to diagnose a salivary gland disorder. So you list out all the investigations required. Then mention what is the differential diagnosis of this particular condition. And then the treatment. Almost every salivary gland tumor is treated surgically. Adenoid cystic carcinoma is a radio resistant lesion. So radiotherapy cannot be a primary treatment option. The first option is definitely surgical. Then add a note on its prognosis. Whether the given tumor has a good prognosis or not. And also the associated complications. So these are the headings under which you need to answer any question especially short days on salivary gland tumor. So short notes. You can confine your answer to clinical features, the synonyms, clinical features, investigations and treatment. The most frequently asked short note questions from salivary gland disorders are ranula, mucosil, the management of ranula, free synchrone and cell adenitis. All these questions have been very frequently asked. So for ranula and mucosil mention their other names and write what classification do they belong to. You know that ranula is a mucosil is an excavation system. So that needs to be mentioned. List out all the possible etiology for this particular condition. Write down what are the causes of this particular system. What are the clinical features followed by investigations, differential diagnosis and the surgical treatment. So the headings under which you write these answers is the same as that for salivary gland tumors. You need to represent this site and the surgical procedure. For example, what is the incision given? What are the landmarks for the surgical procedure? All this needs to be represented schematically. In case of cell adenitis you need to mention that it is an infection. Infection can be viral or bacterial. Then you need to mention what are the organisms that remain the same. For phrase syndrome again, mention the synonyms, the etiology, the pathophysiology of phrase syndrome. You need to mention how the autonomic fibers of auriculotemporal nerve is affected. Then you elaborate a little bit on the pathophysiology. What is the diagnosis? You perform iodine test. You need to mention these are the questions that are asked for short notes. You can keep your answers also short but remember to include all the relevant points in your answer. Moving on to orophacial and neck infections. The repeatedly encountered questions are on terbomandibular space infection, lipid angina and osteomyelitis. Equally important other topics are all the primary and secondary spaces of cavernous sinus thrombosis, medial standard which is a complication of lipid angina, cellulitis and abscess. You need to be also thorough with the anatomy of facial spaces, their boundaries and their communication with neighboring spaces. You can see a question in the short notes. Eagleton's criteria is six diagnostic criteria for cavernous sinus thrombosis. Terbomandibular space infection. Any question on space infection can be answered under the following headings. Anatomy and boundaries of that particular space needs to be explained with good diagrams. Both general and specific features need to be listed. General features for example fever, chills, malaise, lethargy all that are general features of any space infection. And you also mentioned to that particular space. Lab and radiological investigations include blood culture and sensitivity, hemogram and imaging techniques like CT and MRI. Management for any space infection is the same. General management is the same. For example, you administer antibiotics, analgesics, fluids and electrolytes. Coming to surgical management the only difference is local anesthesia technique and also where you place incision. If the patient has Christmas or limited mouth opening then you need to administer local anesthesia through an extra oral block or vasovaniac nosy technique for mandibular block in cases of Christmas. Also incision is ready. You can either place an incurable incision so the location of incision also varies according to space. So this is how you answer any space infection question. A detailed description of oral facial infections has already been uploaded in the channel. I recommend you all to listen to them as you read your textbooks and prepare each answer. An answer on Ludwig Sanchina is incomplete without its definition. It is a unique identity of Ludwig Sanchina. Ethiological factors need to be enumerated. You mentioned what are the microorganisms responsible for this particular condition. Write down all the clinical features both general and regional features of Ludwig Sanchina. You also need to mention what is the intraoral and extra oral findings. How do you diagnose the condition? What are the laboratory situations carried out for Ludwig Sanchina? Coming to the management aspect mention the medical management and also the surgical management. You add a note on airway maintenance. There is a chance of airway compromise for Ludwig Sanchina. So you need to mention what are the airway maintenance techniques. Ludwig Sanchina is associated with a different range of complications. There are several potential threats. Serious complications like septicemia, pericarditis, mediastionitis, neurological complications, all of them has to be enumerated. Include all these points in your answer to make it complete. There is a question on dental alveolar abscess. You first define an abscess and then mention a flow chart on the sequelae of dental infection which is given in the textbook of oral pathology by Schafer. Just out all the etiological factors of dental alveolar abscess which is the same as adentrogenic infection. What are the clinical features? Mention them. And also add a note on the course of abscess formation. There are different stages of abscess formation which you need to list out. Coming to the management you can manage an abscess with antibiotics analgesics, antibiotics and surgically by performing endodontic therapy or extraction of the offending tooth. Other few things you need to know here is the difference between an abscess and cellulitis. Also difference between periapical abscess, dental alveolar abscess and periodontal abscess. All these are given in tabulated forms in your textbooks. Another important and frequently asked question is osteomyelitis. Osteomyelitis can be asked for a long assay or for a short assay. The management aspect alone can be asked for short assay. You include the following headings for a long assay the definition, etiological and predisposing factors pathogenesis of osteomyelitis which always needs to be There are several classifications of osteomyelitis given among which you can include one or two in your answer. The clinical features include both intraoral and extraordinary findings. Unless asked you can always write about the radiographic features of chronic osteomyelitis because acute osteomyelitis rarely show any radiographic changes. All these forms the first part of your answer. The second part and the most important aspect is the management. Osteomyelitis can be managed both conservatively and surgically. There are few points under conservative management among which antibiotic therapy and HBO therapy needs special mentioning about. Elaborate the different regimens of antibiotic therapy. You can also add one or two lines about HBO therapy. The rest all can remain in points. Submissive treatment here again you can elaborate on certain important surgical procedures like decortication, sequestromy saucerization and jaw restriction. All these steps can be represented diagrammatically and the rest can remain in points. These are the subheadings of osteomyelitis which you may expand or condense as per the mark allotment. Submissive treatment is a part of masticated space which is a potential second to a space of mandible. One thing I forgot to mention while explaining tergomandibular space infection was involvement. Involvement refers to how a space get infected. For example, submissive space gets infected because of pericoronitis of the lower third molars. So for every space infection you need to mention the involvement of the space. Same like tergomandibular space infection here also you mentioned the anatomy, boundaries and contents of the space with figures. This down the involvement and how spread occurs to neighboring spaces. You also mentioned the features of submissive space infection both the general and specific features. The next and the final topic is the management of medical emergencies. For any question on medical emergency that arises in a dental clinic the answer must include definition, pathophysiology, clinical manifestations and management in flow chart including the drug dosage. You can get questions from emergencies related to CVS, RS, endocrine system, CNS, also hemorrhage and shock which again is vascular. You also need to mention the stage and root of administration especially for epinephrine, apropine, glucagon and diazepam as different situations demand different dosage of torque. Cardiopulmonary resuscitation is a very important topic for exams as well as for a medical practitioner. Begin your answer by defining cardiac arrest and disown the various conditions for cardiac arrest. Define basic life support or solutions of CPR by highlighting the method of rescue breathing and pulse check. Next come to the technique of chest compression. Here you need to emphasize on location of compression, rescuer position, rate and CV ratio. You can present this answer in two ways. In first method you explain CPR for adults in detail and at the end of your answer mention the differences in chest compression and pulse check for a child. The compression technique also varies for a child. So all this you can point out at the end of your answer. Another way is to compare the procedure in adults and in a child in a table form. Whichever style you follow make sure to include all these headings. You have a question on emergency drugs. Discuss the role of adrenaline all the four modules. You know that there are four modules of emergency drugs with few equipment also. So just list them out. Do not explain or elaborate on the function or action of each drug or equipment. If the question was only on emergency drugs then you can give the function of each drug used in each module. Then you explain the pharmacological action of adrenaline and atmorphin are used in different emergency situations. So that comes in therapeutic indications. You mentioned what are the indications of each drug. How is it available and what is the dose given for each emergency situation. So that is how you write this answer. All these questions here are direct questions from textbooks. The first one is indication and procedure for accuracy. The second one is to situate indications and before explaining the surgical procedure. Anatomical landmarks for incision for fociostomy should be diagrammatically represented followed by stepwise surgical procedure in points. The subheadings for bronchospasm and anapylaxis remain the same like already explained before. When a question bronchospasm was asked you can mention that bronchospasm occur in acute asthma as well as anapylaxis. Pathophysiology remains almost the same for both and you can develop your answer under the same headings for both bronchospasm and anapylaxis. I needn't explain again on how to write hyperventilation and syncope. It has been told enough. Hemostatic agents have already been discussed in the second discussion. Hemostatic agents are of three types mechanical, thermal and chemical. Quote a few examples and explain two examples each from each category. Other important questions from medical emergencies are hypoglycemia, hyperglycemia, adrenal crisis, epilepsy status, epilepticus, myocardial infarction and angina. Keep presenting your answers precisely and to the point. It happens that in spite of reading and revising you forget to mention some important facts or features in your answer. Our discussion will help you to overcome this issue. For any topic after you have read your textbooks and notes keep revising the subheadings for every question so that it's easy for you to understand the recent OMFS question paper discussion by Kerala University of Health Sciences. I wish you all the very best for your exams. Thank you.