Mark, is a 37-year-old male patient, complains of painful ulcers which started as vesicles on the lower lip, which had been present for less than 2 weeks. He had pain and burning sensation on his lips since 3 -4 days. He has an axial temperature of 38.5oC. He tells you that he is annoyed as blisters recur every summer and burst to form ulcers. Medical reports states that he is HIV positive and is under medication for the past 5 years. Clinical picture is provided.

Q1. What could be the appropriate approach to reach the diagnosis/ how could you reach the diagnosis?

Q2. What is the most likely diagnosis?

Q3. What will be your management?

Q4. After 1 week, patient reports back to you complaining that his symptoms have not been improved. Which of the following is the best way to confirm the diagnosis?

Q5. What is incorrect regarding recurrent oral mucocutaneous herpes?

Mrs Janson a 75-year-old lady presented to you complaining of badly decayed, unrestorable tooth #48 and wants to you to remove it today. Medical history form reveals that She is Asthmatic and is on Prolia for osteoporosis and on Prednisolone for rheumatoid arthritis.

Q1. What further information or investigation you need to be able to evaluate the risks
associated with removing this tooth.

Q2. Which statement is true regarding adrenal crisis?

Q3. You suspect that the tooth will be removed in more than one hour, what will you do first?

Q4. Which statement is true regarding MRONJ?

Q5. You managed to obtain her medical record from her medical practitioner and found out that she has been on Prolia for 4 years and her last Prolia injection was 3 days ago. Based on the information gathered so far, how do you evaluate Mrs Janson’s risks of developing MRONJ following extraction of tooth #48?

Mr. George, a 22-year-old university student attended you practice complaining of sore ear, pain during chewing. He also reported that pain is worse on morning and reduces throughout the day. The medical history is clear, but he smokes 10 cigarettes a day and drinks alcohol occasionally.

Q1. Based on the information provided, what is your initial diagnosis?

Q2. Risk factors for such disorders include the following except?

Q3. What will be the 1st thing you will do for this patient?

Q4. Which is the drug of choice for this pain, provided it is indicated?

Q5. What advice would you give to the patient?

Martin is a 61-year-old patient with oedema around the eye presented to you seeking some advice. He is quite unwell. History shows that the patient had undergone a recent root canal treatment in the tooth in question. Martin has no/ slight elevation of temperature.

Q1. Which tooth could be the cause of infection?

Q2. Which space infection could be involved?

Q3. What is the immediate treatment for this patient?

Q4. Martin did not do any treatment and has returned to you with elevation of temperature of 39 C and he is not able to open his mouth, what is the management?

Q5. Patient now complaints of headache and drooping of eyelid what is the condition?

Sandra is a 19-year-old female patient presents with swollen gums around erupting lower wisdom tooth. Photo shows inflamed operculum covering more than 2/3rd of the occlusal surface of lower tooth # 38

Q1. You have inspected around tooth #38 and had a photo so, what will you do next to approach the diagnosis?

Q2. What is your initial management?

Q3. She is allergic to penicillin, what antibiotic will you advise her?

Q4. You have booked her for an extraction after 2 weeks. What is your advice until extraction?

Q5. You are concerned about mandibular nerve approximation; how will you investigate?