question

which statement best describes pain as a protective response? a. pain is a physiological, conscious reaction b. pain is a psychological reaction based on blood flow to injured site c. pain is a rapid, reflexive, subconscious reaction d. pain is a slow, deliberate reaction to avoid further tissue injury

answer

c. pain is a rapid, reflexive subconscious reaction

question

which of these groups of variables does not affect the experience of pain? a. sex, genetics, mental health b. personality, age, hormones c. attitudes, learned responses d. body weight, height

answer

d. body weight, height

question

which one of the following statements regarding nociception is true? a. nociception is polymodal b. nociceptive receptors can distinguish between chemical and thermal stimuli c. nocicpetion is a physiological and psychological process d. nociceptive pain is identical to somatic and visceral structures

answer

a. nociception is polymodal

question

which one of the following is an example of neuropathic pain? a. fractured bone b. psychological disorder c. postsurgery pain d.trigeminal neuralgia

answer

d. trigeminal neuralgia

question

which one of the following will help patients cope with anxiety and fear? a. avoid discussions about anxiety and fear b. only the dentist should ask about anxiety and fear to avoid patient embarrassment c. assure the patient that difficulties during past dental visits could not have been avoided d. prepare, rehearse, empower, and praise patients to reduce anxiety and fear

answer

d. prepare, rehearse, empower, and praise patients to reduce anxiety and fear

question

in the process of debriefing, which one of the following is not useful when managing fearful patients? a. patient and clinician discussion period at the end of each appointment b. patient give input on the duration and plan for the next appointment c. future appointments are modified based on the insights from the patient/clinician discussion d. clinicians select strategies for the patient for his or her next appointment

answer

d. clinicians select strategies for the patient for his or her next appointment

question

which of the following statements most accurately describes the major differences between sensory and motor neurons? 1. sensory neurons are afferent and conduct impulses toward the CNS 2. Motor neurons are efferent and conduct impulses to effector tissues and organs 3. sensory neuronal cell bodies do not participate in impulse conduction and they are located away from the axon 4. motor neuronal cell bodies participate in impulse conduction and are located along the length of the neuron at their terminal arborizations a. 3 only b. 1 and 2 c. 1, 3 and 4 d. all of the above

answer

d. all of the above

question

which of the following sequences best describes the events in a successful impulse generation? a. stimulation, slow depolarization, firing threshold, rapid depolarization, recovery b. stimulation, firing threshold, rapid depolarization, slow repolarization, resting state c. resting state, stimulation, slow depolarization, rapid depolarization, firing threshold d. resting state, stimulation, slow depolarization, rapid depolarization, slow depolarization

answer

a. stimulation, slow depolarization, firing threshold, rapid depolarization, recovery

question

how are schwann cells and nodes of ranvier related? a. schwann cells are nodes of ranvier b. at the nodes of ranvier, schwann cells are one layer thin c. gaps between schwann cells are called nodes of ranvier d. they are not related

answer

c. gaps between schwann cells are called nodes of ranvier

question

which fiber types are responsible for providing sensory information from dental and periodontal tissues? a. C and B fibers b. B and A delta fibers c. Gamma and C fibers d. A delta and C fibers

answer

d. A delta and C fibers

question

which of the fibers listed are myelinated? a. A delta and C fibers b. B fibers and C fibers c. A fibers D. none of the above

answer

c. A fibers

question

what are three divisions of the dental plexus? a. inertdental, interradicular and periodontal b. inner dental, interradicular and dental c. interdental, interradicular and dental d. inner dental, interradicular and periodontal

answer

c. interdental, interradicular and dental

question

elimination half-life refers to which one of the following? a. time it takes for a drug to be half metabolized b. time it takes for half of the drug to be out of the system c. time it takes for half of the drug to be out of the circulation d. time it takes for a drug to be out of half of the circulation

answer

c. time it takes for half of the drug to be out of the circulation

question

ester local anesthetics are metabolized in one of the following pathoways? a. liver b. blood c. kidneys d. brain

answer

b. blood

question

CNS toxicity occurs due to: a. expected response of neurons in the CNS to the drug dose b. frank neural tissue damage due to the excessive dose c. compromised vascular supply in the CNS due to vasoconstrictor doses d. none of the above

answer

a. expected response of neurons in the CNS to the drug dose

question

CVS toxicity occurs due to: a. compromised vascular supply b. frank tissue damage c. decreased myocardial contractility, vasodilation and hypotension d. decreased myocardial contractility, vasoconstriction and hypertension

answer

c. decreased myocardial contractility, vasodilation and hypotension

question

which portion of the anesthetic molecule is responsible for binding to the receptor site inside the nerve membrane, thereby preventing depolarization? a. calcium ion b. anesthetic free base c. anesthetic anion d. anesthetic cation

answer

d. anesthetic cation

question

which part of the local anesthetic molecule determines the classification of the drug as an ester or amide? a. lipophilic protion b. hydrophilic portion c. intermediate chain d. caine linkage

answer

c. intermediate chain

question

which of the following is not a systemic reaction to an overdose of a local anesthetic agent? a. CNS stimulation b. depression of myocardium c. vasodilation of peripheral blood vessels d. respiratory arrest

answer

a. CNS stimulation

question

the definition of the maximum recommended dose of a drug best fits which one of the following definitions? a. a safe dose to administer in all situations b. a dose that a 150 pound person can have c. a dose that cannot be exceeded under any circumstance d. a safe guideline when administering local anesthetic drugs

answer

d. a safe guideline when administering local anesthetic drugs

question

which one of the following best describes articaine's metabolism? a. metabolized approximately 25% in liver b. metabolized primarily via plasma cholinesterase c. much of articaine is excreted unchanged d. metabolized in similar fashion to prilocaine

answer

b. metabolized primarily via plasma cholinesterase

question

you are treating a pt with significant cardiovascular compromise who suffers from significant liver damage. which one of the following drugs would be most appropriate for this pt when you anesthetize the maxillary right quadrant? a. 2% lido 1:100k epi b. 3% mepivacaine plain c. 4% articaine 1:20k epi d. 0.5% bupivacaine 1:200k epi

answer

c. 4% articaine 1:20k epi

question

which characteristic of local anesthetic drug determines how well it works without vasoconstrictor? a. potency b. vasoactivity c. pKa d. lipophilic ability

answer

b. vasoactivity

question

if a pt is taking a tricyclic antidepressant and a beta blocker which one of the following drugs would be most appropriate to administer? a. lidocaine b. mepivacaine c. prilocaine d. bupivacaine

answer

c. prilocaine

question

arrange the injectable local anesthetic drugs in descending order of overall CNS and CVS toxicity a. bupivacaine, mepivacaine, lidocaine, prilocaine, articaine b. bupivacaine, mepivacaine, lidocaine, articaine, prilocaine c. bupivacaine, mepivacaine, articaine, lidocaine, prilocaine d. bupivacaine, lidocaine, mepivacaine, articaine, prilocaine

answer

b. bupivacaine, mepivacaine, lidocaine, articaine, prilocaine

question

which one of the following vasoconstrictors is most useful in providing hemostasis? a. phenyephrine b. epinephrine c. levonordefrin d. felypressin

answer

b. epinephrine

question

a pt has significant cardiovascular disease and requires a restorative procedure on tooth #5. retraction cord and hemostasis are needed in order to keep the restorative site dry. Which one of the following drugs would be most indicated in this situation? a. 4% articaine 1:200k epi b. 2% mepivacaine 1:20k levonordefrin c. 2% lido 1:50k epi d. 4% prilocaine plain

answer

a. articaine 1:200k epi

question

which one of the following statements is true? a. levonordefrin is more potent compared to epi b. cardiac stimulation from levonordefrin is greater compared to epi c. cardiac stimulation from levonordefrin is less compared to epi d. levonordefrin is equal in potency compared to epi

answer

c. cardiac stimulation from levonordefrin is less compared to epi

question

t/f epinephrine's metabolism is relatively rapid after local anesthesia administration

answer

true

question

metabolic enzymes for epinephrine include which of the following a. COMT and MAO b. hepatic isoenzymes c. renal isoenzymes d. COMT only

answer

a. COMT and MAO

question

a diabetic pt requires periodontal therapy on the upper and lower right quadrants. She is well controlled and otherwise healthy. Which one of the following represents the safest and most effective LA regime? a. 4 carts of 2% lido 1:100k epi b. 2 carts of 2% lido 1:100k epi and 2 carts 3% mepivacaine plain c. 2 carts 2% lido 1:100k epi and 2 carts 4% articaine 1:200k epi

answer

b. 2 carts of 2% lido 1:100k epi and 2 carts 3% mepivacaine plain

question

all of the following are correct when considering MRDs except: a. articaine-500mg b. bupivicaine-90 mg c. lidocaine-200 mg d. mepivicaine-300 mg

answer

c. lidocaine-200 mg

question

relevant information and mathematical operations required to calculate drug doses for local anesthetics and vasoconstrictors include all but which one of the following: a. dilution percentages b. standard cartridge volumes c. defined MRD for each drug d. height and weight

answer

d. height and weight

question

which one of the following is not related to the MRD of 2% lido 1:100k epi a. 8 cartridges b. 11 cartridges c. 2 mg/lb for a 150 lb pt d. 300 mg/lb for a 150 lb pt

answer

b. 11 cartridges

question

what is the MRD for vasoconstrictors when administering 2% lido 1:100k epi to a healthy pt a. 0.02 mg b. 0.1 mg c. 0.2 mg d. 1.0 mg

answer

c. 0.2 mg

question

a pt has received 4 carts of 2% lido 1:100k epi and is not profoundly anesthetized. How many carts of 4% articaine 1:200k epi may be administered if pt weighs 160 lbs a. 1 b. 2 c. 3 d. 4

answer

b. 2

question

how many carts of 4% articaine 1:200k epi may be given for a pt with significant cardiovascular compromise a. 1 b. 2 c. 3 d. 4

answer

d. 4

question

which one of the following accurately describes available formulations a. 2% lido 1:100k epi, 3% lido 1:200k epi b. 2% lido 1:100k epi, 4% lido 1:200k epi c. 2% lido 1:100k epi, 2% lido 1:50k epi d. 2% lido 1:200k epi, 2% lido 1:20 levonordefrin

answer

c. 2% lido 1:100k epi, 2% lido 1:50k epi

question

the maximum dose per weight of 4% articaine 1:100k epi for children is: a. 2 mg/lb b. 3 mg/lb c. 2.2 mg/lb d. 3.2 mg/lb

answer

d. 3.2 mg/lb

question

0.5% bupivacaine, 1:20k epi contains how many mg of anesthetic drug per cartridge? a. 9 b. 18 c. 36 d. 54

answer

a. 9

question

eutectic mixtures have which of the following characteristics? a. the work more rapidly than most other topicals b. the penetrate more deeply on skin than mucosa c. their melting points exceed that of their ingredients acting alone d. their formulations facilitate deeper more efficient penetrations of tissues compared to their ingredients acting alone

answer

d. their formulations facilitate deeper more efficient penetrations of tissues compared to their ingredients acting alone

question

which of the following lists is most accurate when describing topical anesthetic uses? a.prior to exposing radiographs, prior to injections, prior to placing retraction cord b. prior to dental hygiene therapy and in subgingival tissues c. in procedures confined to mocosa and prior to taking impressions d. all of the above

answer

d. all of the above

question

which one of the following statements is incorrect regarding MRDs of topical anesthetics a. they are sometimes difficult to track b. MRDs are not always provided c. Spray forms have easy to track dosing d. dentipatch has easy to track dosing

answer

c. spray forms have easy to track dosing

question

generous quantities of topical and injected anesthesia have been administered, when the pt begins to shake and appears agitated and anxious. Is there reason for concern. a. Yes, because they may be early signs of CNS depression b. No, because this is a very nervous pt and she hates dental appts c. No, because the dose of injectable anesthetic were within safe guidelines d. Yes, because the pt is a dental phobic

answer

a. Yes, because they may be early signs of CNS depression

question

topical anesthetic mixtures may be of benefit in all but which one of the following ways? a. combinations may increase therapeutic ranges b. combinations may increase penetration depths c. mixtures may allow drugs to be used as topicals that are not suitable when used alone d. mixtures decrease the potential for adverse reaction

answer

d. mixtures decrease the potential for adverse reaction

question

all of the following statements are true regarding compounded drugs, except: a. compounded drugs are formulated for individuals for whom they are prescribed b. compounded drugs may be used on other pts as long as the use is the same as the original use c. compounded drugs may contain much larger quantities of drug compared to multiuse commercial preparations d. compound topicals are dispensed by prescription

answer

b. compounded drugs may be used on other pts as long as the use is the same as the original use

question

t/f the predominantly base form of lidocaine topical anesthetic is safer than the predominantly hydrochloride salt

answer

true

question

dyclonine hydrochloride is an excellent and very durable topical anesthetic and belongs to which one of the following classes: a. amide b. ketone c. ester d. none of the above

answer

b. ketone

question

which one of the following statements is correct? a. the standard aspirating syringe is designed to provide negative pressure on aspiration, unlike the self aspirating syringe b. the standard aspirating syringe is designed to provide positive pressure on aspiration, unlike the self aspirating syringe c. neither the standard nor the self aspirating syringes provide negative pressure on aspiration d. the standard aspirating syringe is designed to provide negative pressure on aspiration similar to the self aspirating syringe

answer

d. the standard aspirating syringe is designed to provide negative pressure on aspiration similar to the self aspirating syringe

question

which one of the following is correct when addressing OSHA requirements for medical device safety in dentistry? a. two hands are allowed as long as one hand only secures the needle cap b. contaminated needles may be bent as long as the bend is accomplished with cotton pliers or a hemostat c. two hands are never allowed to recap needles even when one hand is holding a hemostat or locking pliers to secure the protective cap d. uncontaminated needles may be bent

answer

d. uncontaminated needles may be bent

question

in comparing the 25 gauge needle to the 30 gauge needle, the 25 gauge needle: 1. has better aspiration 2. breaks more easily 3. is less comfortable than 30 gauge 4. has a smaller diameter 5. can be used in highly vascular areas a. 2, 4, 5 b. 2, 4 c. 1, 3, 5 d. 1, 5

answer

d. 1,5

question

long needles are approximately _____ long a. 12 to 22 mm b. 32 to 36 mm c. 40 to 42 mm

answer

b. 32 to 36 mm

question

when a stopper is extruded, what has likely caused the problem? a. the cartridge was overfilled during manufacturing b. freezing occurred during shipping or handling c. overheating has caused pressure in the cartridge d. oxidation of sodium bisulfate has created gas in the cartridge

answer

b. freezing occurred during shipping or handling

question

during an infiltration you give the pt three stopper-widths of LA. How much solution have you injected into the pt a. 0.2 ml b. 0.9 ml c. 1.8 ml d. 0.6 ml

answer

d. 0.6 ml

question

what substance is used as the preservative for epinephrine in LA cartridges? a. sodium bisulfite b. sodium hypochlorite c. methylparaben d. nitrogen

answer

a. sodium bisulfite

question

the delivery of LA requires both medical and technical skill. Which one of the following is NOT one of the six elements of the ASA medical components of care associated with regional aesthesia? a. pre-anesthetic evaluation of pt b. comprehensive tooth charting c. remain present during the course of the anesthesia d. providing indicated postanesthesia care

answer

b. comprehensive tooth charting

question

the ASA (american society of anesthesiologist) physical status classification system categorizes patients based on their overall health. Classification P3 describes which one of the following a. normal healthy pt b. severe systemic disease c. moribund pt d. severe systemic disease (constant threat to life)

answer

b. severe systemic disease

question

which of the following is NOT considered a main tool for pt assessment when planning for LA? a. medical/dental questionnaire b. clinical examination c. drug MRDs d. medical consultation

answer

c. drug MRDs

question

which one of the following drugs is an absolute cx for pts with poorly controlled or uncontrolled hyperthyroidism? a. lidocaine b. bupivacaine c. epinephrine d. felypressin

answer

c. epinephrine

question

your pt has identified or you suspect that your pt has used methamphetamines approximately 20 hours ago. Which of the following would be the most appropriate action when considering the use of LA? a. continue with procedures, as it has been more than 12 hours since use b. restrict the dose of vasoconstrictors to 20 percent of standard dose c. consider postponing care for a full 24 hours d. use only bupivacaine as the LA

answer

c. consider postponing care for full 24 hours

question

for which one of the following medical conditions is it unnecessary to obtain a medical consultation from the pts physician prior to dental treatment? a. significant liver disease b. myocardial infarction within three weeks c. kidney dialysis pts d. organ transplant pts

answer

b. myocardial infarction within three weeks

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