ORE Part 1 Medical Sciences 2 — Questions and Answers
Question 1: What is the normal resting blood pressure range for a healthy adult according to NICE hypertension guidelines?
- Below 120/80 mmHg
- Below 140/90 mmHg (Correct answer)
- Below 130/85 mmHg
- Below 150/90 mmHg
Correct answer: Below 140/90 mmHg
NICE guidelines define hypertension as a clinic blood pressure persistently at or above 140/90 mmHg (with ambulatory or home monitoring confirmation at 135/85 mmHg). Below 140/90 is considered the normal range in clinical practice, though lower targets may apply for certain patient groups.
Question 2: Which cranial nerve is responsible for the motor supply to the muscles of mastication?
- Facial nerve (VII)
- Trigeminal nerve (V) — mandibular division (Correct answer)
- Glossopharyngeal nerve (IX)
- Hypoglossal nerve (XII)
Correct answer: Trigeminal nerve (V) — mandibular division
The mandibular division (V3) of the trigeminal nerve provides motor innervation to the muscles of mastication (masseter, temporalis, medial and lateral pterygoids) as well as mylohyoid, anterior belly of digastric, tensor veli palatini, and tensor tympani.
Question 3: A patient with uncontrolled hyperthyroidism is at risk of which dental emergency?
- Hypoglycaemic episode
- Thyroid crisis (thyroid storm) (Correct answer)
- Adrenal crisis
- Myxoedema coma
Correct answer: Thyroid crisis (thyroid storm)
Thyroid crisis (thyroid storm) is a life-threatening exacerbation of hyperthyroidism that can be precipitated by stress, infection, or surgery. Signs include extreme tachycardia, hyperthermia, agitation, and cardiovascular collapse. Dental treatment should be deferred until the patient's thyroid function is controlled.
Question 4: Which type of white blood cell is most increased in a bacterial infection?
- Lymphocytes
- Neutrophils (Correct answer)
- Eosinophils
- Basophils
Correct answer: Neutrophils
Neutrophils are the primary phagocytic cells of the innate immune system and are the first responders to bacterial infection. A raised neutrophil count (neutrophilia) on a full blood count is a hallmark of acute bacterial infection. Lymphocytosis, in contrast, is more associated with viral infections.
Question 5: A patient collapses in the dental chair and is unresponsive with no pulse. What is the correct compression-to-ventilation ratio for adult CPR?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 30:2
The Resuscitation Council (UK) guidelines recommend a compression-to-ventilation ratio of 30:2 for adult basic life support. Compressions should be performed at a rate of 100–120 per minute, at a depth of 5–6 cm, with minimal interruptions. An AED should be applied as soon as available.
Question 6: Addison's disease is characterised by insufficiency of which endocrine gland?
- Thyroid gland
- Pituitary gland
- Adrenal cortex (Correct answer)
- Parathyroid gland
Correct answer: Adrenal cortex
Addison's disease (primary adrenal insufficiency) results from destruction of the adrenal cortex, leading to deficiency of cortisol and aldosterone. Dental relevance includes risk of adrenal crisis during stress and characteristic oral hyperpigmentation. Steroid supplementation may be needed before invasive dental procedures.
ORE Part 1 Medical Sciences 2
What is the normal resting blood pressure range for a healthy adult according to NICE hypertension guidelines?