Dental Anesthesia 4DD SEM1 – MCQs – Flashcards
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1. Surface activity and low toxic potential? - Cocaine - Benzocaine - Bupivacaine - procaine - Lidocaine
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✓ Benzocaine
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2. Which of the following drugs can cause methemoglonemia? - Cocaine - Lidocaine - Bupivacaine - Procaine - Prilocaine
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✓ Prilocaine
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3. Vasoconstrictor in Local anesthetic solution is? - Reduce toxic effects of LA solution - Decreases depth & duration of LA - Increase bleeding - Increase toxic effects of LA - Has no effect on efficacy LA solution
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✓ Reduce toxic effects of LA solution
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4. When injecting Local solutionin maxilla on buccal side. The technique is ? - Sup periosteal - Supra periosteal - Sup mucosal - Intra osseous - Intra septal
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✓ Supra periosteal
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5. Disto buccal root of upper first molar is supplied by:? - Middle superior alveolar nerve - Posterior superior alveolar nerve - Infra orbital nerve - Mental nerve - Buccal nerve
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✓ Posterior superior alveolar nerve
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6. Technique of anesthesia in which local anesthetic solution is injected into the vein is ? - Nerve block - Infiltration anesthesia - Intra venous regional anesthesia - Epidural anesthesia - No such technique exists.
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✓ Intra venous regional anesthesia
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7. You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland? - to be palpable intraorally - to be palpable extraorally. - To be palpable both intra- and extraorally - only to be detectable by radiographical examination.
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✓ To be palpable both intra- and extraorally
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8. During an inferior alveolar nerve block the needle ideally passes? - Posterior and medial to medial pterygoid. - anterior and lateral to medial pterygoid - through medial pterygoid - Inferior to medial pterygoid.
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✓ anterior and lateral to medial pterygoid
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9. You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the? - Hard palate. - Hard palate and upper lip. - Hard palate, upper lip and upper central incisor. - hard palate, upper lip, upper central incisor and lower first molar
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✓ hard palate, upper lip, upper central incisor and lower first molar
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10. You notice a lesion on the labial alveolar mucosa of the lower right lateral incisor tooth of one of your patients and decide to take a biopsy to send for oral pathology report Which nerve would require local anesthesia in order to carry out a pain-free biopsy? - The incisive nerve - The incisive nerve - The buccal nerve - The lingual nerve
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✓ The incisive nerve
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11. The regional lymphatic drainage of the left side of the tip of the tongue is to the? - left submental lymph node. - left and right submental lymph nodes - left submandibular lymph node. - left and right submandibular lymph nodes.
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✓ left and right submental lymph nodes
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12. A successful inferior alveolar nerve block will produce anesthesia of the? - lower lip. - lower lip and mandibular teeth. - lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth - lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the posterior mandibular teeth.
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✓ lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth
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13. The mucosa of the hard palate is? - keratinised and has submucosa and minor salivary glands posterolaterally - non-keratinised and has submucosa and minor salivary glands posteromedially - keratinised and lacks submucosa and minor salivary glands. - non-keratinised and lacks submucosa and minor salivary glands.
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✓ keratinised and has submucosa and minor salivary glands posterolaterally
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14. A successful infraorbital nerve block will produce anaesthesia of the? - maxillary anterior teeth. - maxillary anterior teeth and their labial gingivae. - maxillary anterior teeth, their labial gingivae and the upper lip - maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate
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✓ maxillary anterior teeth, their labial gingivae and the upper lip
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15. In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be? - light pink in colour on both sides of the mucogingigival junction. - light pink below the mucogingival junction and red above it. - ed below the mucogingival junction and light pink above it - red on both sides of the mucogingival junction
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✓ ed below the mucogingival junction and light pink above it
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16. Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is? - no local irritation - even absorption - no systemic toxicity - higher melting point of combined drug than either lidocaine (Xylocaine) or prilocaine (Citanest) alone - no local irritation, even absorption and no systemic toxicity
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✓ no local irritation, even absorption and no systemic toxicity
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17. Local anesthetic used in greater than 50% of rhinolaryngologic cases:? - prilocaine (Citanest) - cocaine - mepivacaine (Carbocaine) - bupivacaine (Marcaine) - tetracaine (pontocaine)
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✓ cocaine
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18. Mechanism(s) of local anesthetic action in epidural anesthesia:? - direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura - diffusion of local anesthetic into paravertebral regions through the intervertebral foramina - direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina - neither
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✓ direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
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19. Rationale for adding epinephrine to a local anesthetic solution:? - reduced local anesthetic systemic absorption - increased anesthetic concentration near nerve fibers - reduced duration of conduction blockade - all of the above - reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers
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✓ reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers
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20. Zone of differential motor blockade may average up to four segments below the sensory level? - epidural - Spinal - epidural and Spinal
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✓ epidural
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21. Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia? - True - False
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✓ False
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22. Primary side effect/toxicities associated with local anesthetic use:? - allergic reactions - systemic toxicity - allergic reactions and systemic toxicity - neither
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✓ allergic reactions and systemic toxicity
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23. Factors enhancing bupivacaine (Marcaine) toxicity? - Pregnancy - presence of calcium channel blockers - arterial hypoxemia - acidosis and hypercarbia - Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
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✓ Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
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24. Agents added to local anesthetics that prolonged local anesthetic duration of action? - Epinephrine - phenylephrine (Neo-Synephrine) - dextran - Epinephrine, phenylephrine (Neo-Synephrine) and dextran
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✓ Epinephrine, phenylephrine (Neo-Synephrine) and dextran
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25. Typically a zone of differential sympathetic nervous system blockade? - epidural - spinal - epidural and spinal
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✓ spinal
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26. Preferred local anesthetics for local infiltration:? - lidocaine (Xylocaine) - ropivacaine (Naropin) - bupivacaine (Marcaine) - lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
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✓ lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
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27. Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia -- may because by nonhomogeneous local anesthetic distribution? - anterior spinal artery syndrome - cauda equina syndrome - transient radicular irritation
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✓ cauda equina syndrome
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28. Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain? - cauda equina syndrome - transient radicular irritation - anterior spinal artery syndrome
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✓ transient radicular irritation
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29. Factors that influence lidocaine (Xylocaine) metabolism:? - pregnancy-induced hypertension - hepatic disease - reduced liver blood flow - volatile anesthetics - pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
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✓ pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
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30. Most common cause of toxic plasma local anesthetic concentrations? - incorrect dosage during peripheral or block - accidental direct intravascular injection during block - increase vasoconstrictors solution in the anesthetic - without solution of vasoconstrictors for anesthetic
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✓ accidental direct intravascular injection during block
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31. Common eutectic mixture of local anesthetics (EMLA)? - tetracaine (pontocaine) and epinephrine - lidocaine (Xylocaine) and tetracaine (pontocaine) - prilocaine (Citanest) and bupivacaine (Marcaine) - tetracaine (pontocaine) and bupivacaine (Marcaine) - lidocaine (Xylocaine) and prilocaine (Citanest)
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✓ lidocaine (Xylocaine) and prilocaine (Citanest)
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32. Most frequent local anesthetic clinical use:? - treatment of grand mal seizure - analgesia - management of cardiac arrhythmias - regional anesthetia - management of increased intracranial pressure
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✓ regional anesthetia
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33. Lidocaine (Xylocaine) effect on ventilation response to hypoxia? - enhanced response - depressed response - no effect - enhanced response and no effect
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✓ depressed response
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34. Clinical use(s) of EMLA applications:? - arterial cannulation - venipuncture - myringotomy - lumbar puncture
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✓ lumbar puncture
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35. Allergic reactions to local anesthetics:? - common > 10% of adverse reactions due to allergic mechanisms - high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds - cross-sensitivity between esters and amide-type local anesthetics are common - intradermal testing for possible allergy to local anesthetics should use preservative-free drug - high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug
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✓ high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug
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36. Factors which increase local anesthetic CNS toxicities:? - Hypokalemia - rate of injection - patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used - high PaCO2 (reduced local anesthetic seizure threshold) - rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)
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✓ rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)
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37. Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.? - lidocaine (Xylocaine) - tetracaine (pontocaine) - mepivacaine (Carbocaine) - bupivacaine (Marcaine) - dyclonine (Dyclone)
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✓ dyclonine (Dyclone)
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38. Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.? - Hypoxemia - Hyperkalemia - Acidosis - Hypoxemia, Hyperkalemia and Acidosis
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✓ Hypoxemia, Hyperkalemia and Acidosis
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39. Local anesthetic which produces localized vasoconstriction and anesthesia? - tetracaine (pontocaine) - lidocaine (Xylocaine) - cocaine - prilocaine (Citanest) - chloroprocaine (Nesacaine)
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✓ cocaine
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40. Agents not recommended for Bier block: - chloroprocaine (Nesacaine - mepivacaine (Carbocaine) - bupivacaine (Marcaine) - chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
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✓ chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
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41. Manifestation of systemic toxicity - CNS toxicity - cardiovascular toxicity - neurological symptoms - CNS toxicity, cardiovascular toxicity and neurological symptoms
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✓ CNS toxicity, cardiovascular toxicity and neurological symptoms
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42. Most commonly used local anesthetic for rhinolaryngologic cases - ropivacaine (Naropin) - bupivacaine (Marcaine) - mepivacaine (Carbocaine) - cocaine - tetracaine (pontocaine)
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✓ cocaine
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43. Commonly use local anesthetics for topical/surface application: - chloroprocaine (Nesacaine) - lidocaine (Xylocaine) - tetracaine (pontocaine) - cocaine - lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
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✓ lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
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44. Clinical presentations suggestive of local anesthetic allergies: - Rash - laryngeal edema - bronchospasm - urticarial and possibly hypotension - All are correct
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✓ All are correct
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45. Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport: - lidocaine (Xylocaine) - bupivacaine (Marcaine) - dibucaine (Nupercainal, generic) - prilocaine (Citanest) - procaine (Novocain)
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✓ prilocaine (Citanest)
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46. This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase - ropivacaine (Naropin) - bupivacaine (Marcaine) - dibucaine (Nupercainal, generic) - procaine (Novocain) - chloroprocaine (Nesacaine)
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✓ dibucaine (Nupercainal, generic)
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47. Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution - Hypertension - Arrhythmias - Hypertension and Arrhythmias - Neither
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✓ Hypertension and Arrhythmias
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48. ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine) - true - false
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✓ true
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49. Factor(s) which determine extent of systemic local anesthetic absorption: - initial dose - injection site vascularity - intrinsic drug properties - whether or not epinephrine was used to provide local vasoconstriction - All are not correct
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✓ All are not correct
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50. Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics - ECG -PR interval prolongation - increased conduction velocity - reduced phase 4 depolarization - reduced automaticity - All are not correct
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✓ All are not correct
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51. Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia: - more lipophilic anesthetics benefit most by epinephrine in addition to local anesthetic solutions - more lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions®
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✓ more lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions®
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52. Neurotoxicity following local anesthesia: lower extremity paresis-- predisposing conditions may include advanced age and peripheral vascular disease - transient radicular irritation - cauda equina syndrome - anterior spinal artery syndrome - cauda equina syndrome and anterior spinal artery syndrome
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✓ anterior spinal artery syndrome
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53. Local anesthetic not recommended for peripheral nerve blockade: - lidocaine (Xylocaine) - bupivacaine (Marcaine) - ropivacaine (Naropin) - tetracaine (pontocaine)
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✓ tetracaine (pontocaine)
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54. Frequently used amide-type local anesthetic for Bier block - chloroprocaine (Nesacaine) - prilocaine (Citanest) - bupivacaine (Marcaine) - ropivacaine (Naropin)
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✓ prilocaine (Citanest)
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55. The first ever peripheral nerve block is performed by - William Salk - Nils Lofgren - William Halsted - Alfred Einhorn
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✓ William Halsted
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56. The axons of peripheral nerve is supported by - Support by Connective tissue - Supported by cell - Support by muscle - Support by blood
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✓ Support by Connective tissue
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57. Unmeyelinated fiber is surround by - A single wrapping - Plural wrapping - Wrapping by nerve - Wrapping by artery
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✓ A single wrapping
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58. The function organization of axon and schwann cell is called - Nerve fiber - Nerve cell - Neuron cell - Call myelin sheath
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✓ Nerve fiber
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59. The groups of the axon, the fasciculi, are enclosed in an additional connective tissue sheath called - The perineurium - Endoneurium - Fasciculi - Epineurium
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✓ The perineurium
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60. Individual nerve fibers(axons) are surround and separated from each other by - Edoneurium - Perineurium - Epineurium - Fasciculi
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✓ Edoneurium
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61. Which layer is considered as anatomical barrier to the diffusion of local anesthetic substances - Endoneurium - Epineurium - Fasciculi - Perineurium
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✓ Endoneurium
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62. Afferent or sensory nerves conduct impulses to the - CNS. - Periphery of the body - Motor nerves of muscles - Pain stimulus
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✓ CNS.
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63. Efferent or motor neurons conduct messages from: - The periphery of the body to the CNS. - The pain stimulus to the periphery. - The CNS to the periphery. - The cell body to the CNS.
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✓ The CNS to the periphery.
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64. The most widely help theory on nerve transmission attributes conduction of the nerve impulse to changes in the - Axoplasm. - Axolemma. - Cell body. - CNS
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✓ Axolemma.
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65. For a local anesthetic to be clinically useful is - It should be compatible with the tissues - It's action should be temporary - It's action should be completely reversible - All to the above.
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✓ It should be compatible with the tissues
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66. Which one is the Amide anesthetics type - Lidocaine - Cocaine - Movocaine - Procaine
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✓ Lidocaine
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67. Which one is the ester type of local anesthetic - Mepivacaine( or carbocaine) - Prilocaine ( or citanest) - Procaine - Bupivacaine(or Marcaine)
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✓ Procaine
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68. Which one are the three major types of local anesthesia can be performed in the maxillary for pain control? - Infiltration, field block, and nerve block - Nerve block, field block, and topical - Field block, infiltration , and intraseptal - Field block, infraorbital , intraosseus
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✓ Infiltration, field block, and nerve block
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69. How many major types of Local Anesthesia can be performed in the maxillary for pain control? - Three major types - Two major types - One major type - Four major types
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✓ Three major types
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70. The injection that able to perform in maxilla with thin cortical nature of bone, to tissue immediately surgical site is called. - Nerve block - Field block - Infiltration - Inferior alveolar nerve block
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✓ Infiltration
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71. Which one is NOT include in the type of infiltration technique? - Supraperiosteal injections - Intraseptal injections - Periodontal ligament injections - Infraorbital injection
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✓ Infraorbital injection
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72. Local Anesthetic deposited near a larger terminal branch of a nerve is called - Nerve Block - Infiltration - Field block - Periapical injection
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✓ Field block
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73. Local anesthetic deposited near the main nerve trunk and is usually distant form the operative site is called - Field block - Infiltration - Nerve block - Periapical injection
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✓ Nerve block
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74. Which one are called local anesthesia nerve block? - PSA , MSA, ASA - Periodontal ligament injection - Intraseptal injections - Supraperiosteal injection
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✓ PSA , MSA, ASA
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75. Which one is the best answer for nerve block of local anesthesia in the maxillary nerve block? - PSA, MSA,ASA, Infraorbital , Greater palatine , and Naso palatine nerve - Supraperiosteal injection, infraseptal injection and periodontal ligament injection - PSA,MSA,ASA, Mental Nerve, Inferior Alveolar Nerve Block and lingual nerve block - PSA,MSA,ASA, Greater Palatine and Lingual Nerve block
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✓ PSA, MSA,ASA, Infraorbital , Greater palatine , and Naso palatine nerve
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76. The area used to anesthetized the pulp tissue corresponding alveolar bone and buccal gingival tissue to maxillary 1st, 2nd, 3rd is called - PAS, nerve block - MSA nerve block - ASA nerve block - Greater palatine nerve block
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✓ PAS, nerve block
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77. The technique insertion of mucobuccal fold between apex of 2nd and 3rd molars at 45 degree is called - PSA, nerve block - MSA, nerve block - ASA, nerve block - Infraorbital nerve block
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✓ PSA, nerve block
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78. The area used to anesthetized the maxillary premolars, corresponding alveolus, and buccal gingival tissue is called - MSA nerve block - PSA nerve block - ASA nerve block - Naso palatine nerve block
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✓ MSA nerve block
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79. The technique of insertion at mucobuccal fold in the area of 1st and 2nd premolars is called - PSA nerve block - MSA nerve block - ASA nerve block - Infraorbital nerve block
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✓ MSA nerve block
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80. The technique used to anesthetized the maxillary canine, lateral incisor, and central incisors and buccal gingival is called - PSA nerve block - MSA nerve block - ASA nerve block - Greater palatine nerve block
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✓ ASA nerve block
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81. The technique of insertion at mucobuccal fold in the area of lateral incisor and canine on maxillary is called - ASA nerve block technique - PSA nerve block technique - MSA nerve block technique - Greater palatine nerve block technique
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✓ ASA nerve block technique
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82. The technique used to anesthetizes the maxillary 1st and 2nd premolars, canine, lateral incisor, central incisor, corresponding alveolar bone, and buccal gingiva is called - Infraorbital nerve block - PSA nerve block - MAS nerve block - ASA nerve block
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✓ Infraorbital nerve block
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83. The nerve that combines MSA and ASA block is called - Infraorbital nerve block - Greater palatine nerve block - Naso palatine nerve block - Posterior superior alveolar nerve block
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✓ Infraorbital nerve block
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84. When given nerve block , will also cause anesthetized to the lower eyelid, lateral aspect of nasal skin tissue, and skin of infraorbital region is called - Infraorbital nerve block - Posterior superior alveolar nerve block - Middle superior alveolar nerve block - Anterior superior alveolar nerve block
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✓ Infraorbital nerve block
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85. The technique palpate from extra orally and place thum or index finger on region with retract the upper lip and buccal mucosa and the area of injection is at the mucobuccal fold of the 1st premolar and canine area is called - Infraorbital nerve block - Field block - PSA nerve block - Middle superior alveolar nerve block
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✓ Infraorbital nerve block
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86. The technique can be used to anesthetize the palatal soft tissue of the teeth posterior to maxillary canine and corresponding alveolus and hard palate is called - Greater palatine nerve block - Naso palatine nerve block - PSA nerve block - Infraorbital nerve block
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✓ Greater palatine nerve block
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87. The area of insertion needle of local anesthesia is about 1cm medial from 1st and 2nd maxillary molar on the hard palate foramen is called - Greater Palatine nerve block - PSA nerve block - MSA nerve block - ASA nerve block
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✓ Greater Palatine nerve block
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88. The technique can be used to anesthetize the soft and hard tissue of the maxillary anterior palate from canine to canine is called - Greater palatine nerve block - Naso palatine nerve block - Infraorbital nerve block - Posterior superior alveolar nerve block
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✓ Naso palatine nerve block
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89. The area of insertion needle is at the incisive papilla into incisive foramen and inject 0.3cc to 0.5cc of local anesthetic is called - Naso-palatine nerve block - Greater palatine nerve block - Infraorbital nerve block - Posterior superior alveolar nerve block
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✓ Naso-palatine nerve block
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90. Which techniques do not work in the adult mandible due to dense cortical bone the below technique is - Infiltration injection technique - Field block - Nerve block - Mental nerve block
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✓ Infiltration injection technique
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91. The area of insertion needle is at the mucous membrane of the medial border of the mandibular ramus at the intersection of a horizontal line and vertical line is called - Long buccal nerve block - IAN block, lingual nerve block - Lingual nerve block only - Akinosi or close mouth nerve block
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✓ IAN block, lingual nerve block
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92. Which one are the following technique used only on the mandibular nerve Block , please choice the best answer - IAN, Akinosi, Gow-Gates, Mental nerve Block - IAN, Akinosi, PSA, MSA, ASA, Greater palatine nerve block - IAN, Long buccal nerve Block, infraorbital nerve block - IAN, Lingual nerve Block , Gow-Gate nerve Block
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✓ IAN, Akinosi, Gow-Gates, Mental nerve Block
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93. Inferior alveolar nerve block (IAN) mouth must be open for this technique, best to utilize mouth drop, the depth of injection is about - 25 mm to 27mm - 27mm to 29mm - 29mm to 30 mm - 30 mm to 33 mm
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✓ 25 mm to 27mm
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94. The technique that the mouth must be open widely during injection and the area of injection from contralateral premolar region is called - IAN block - Akinosi Nerve Block - Gow-Gate nerve Block - Mental Nerve Block
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✓ IAN block
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95. The technique that use the non-dominant hand to retract the buccal soft tissue at the area of coronoid notch of mandible , and index finger on posterior border of extra oral mandible is called - IAN nerve block - Gow-Gate Nerve block - Akinosi Nerve Block - Mental Nerve Block
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✓ IAN nerve block
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96. The technique of about 1.0 cc of local Anesthetic and continues to inject about 0.5 cc on removal from injection site to anesthetize the lingual branch, inject remaining anesthetic in to corrode notch region of mandible in the mucous membrance distal and buccal to most distal molar to perform a long buccal nerve block is called - IAN, Long buccal, Lingual nerve block - IAN, Long buccal nerve Block - IAN,Long Buccal nerve block only - IAN, Mental nerve Block and Lingual nerve Block
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✓ IAN, Long buccal, Lingual nerve block
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97. The technique Provides same area of anesthesia as the Inferior alveolar nerve block and useful for injected patients with trismus, fractured mandible are needs to be used - Akinosi nerve Block(R) - IAN Block - Long Buccal nerve Block - Lingual nerve Block
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✓ Akinosi nerve Block(R)
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98. Which technique is useful for infected patients with trismus, fractured mandibles, and mentally handicapped individuals - IAN Block - Akinosi Nerve Block(R) - Mental nerve Block - Lomng Buccal Nerve Block
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✓ Akinosi Nerve Block(R)
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99. The technique Provides sensory input for the lower lip skin, mucous membrane, pulpal and alveolar tissue for the premolar, canine and incisors on the side blocked is called - Mental Nerve Block - IAN Block - Gow-Gate Nerve Block - Akinosi Nerve block
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✓ Mental Nerve Block
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100. The area of injection mucobuccal fold between the mandible premolars is called - Mental Nerve Block - IAN Block - Long buccal Nerve block
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✓ Mental Nerve Block
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101. Gow- Gate nerve block The trigeminal nerve is predominantly sensory, and motor nerve, who supplied for the three large trunks, originate from the ganglion. Which of the following nerves is supply related only sensory? - the maxillary nerves - the mandibular nerve - the lingual nerve - the infra-orbital nerve
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✓ the maxillary nerves
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102. The trigeminal nerve is the sensory fibres form the semilunar ganglion (the Gasserian ganglion). Where does these ganglion or Gasserian lie in the bottom of the following? - the middle cranial fossa - the posterior cranial fossa - the anterior cranial fossa - the roof of the cranial fossa
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✓ the middle cranial fossa
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103. The maxillary nerve exclusively sensory, passes through the foramen rotundum to reach the pterygopalatine fossa, where it off a number of branches.How many branches will theses nerves passes through the sphenopalatine ganglion? - two branches - three branches - four branches - five branches - There two branches of maxillary nerve, which enter the sphenopalatine ganglion.
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✓ two branches
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104. Which of the following nerves are entering the sphenopalatine ganglion? - The greater, the nasopalatine nerve and posterior nasal nerve twigs. - The greater palatine nerve, and the posterior superior alveolar nerve - The greater palatine nerve, and the middle superior alveolar nerve - The greater palatine nerve, and the anterior superior alveolar nerve
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✓ The greater, the nasopalatine nerve and posterior nasal nerve twigs.
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105. The infraorbital nerve are supply for the front teeth both side left and right of the maxillary , especially for anterior superior alveolar nerve twigs and leave the trunk just before it exit of the infraorbital foramen and outside the foramen twigs to the skin between the nostril and eye.Which area is used for injection local anesthesia for these teeth? - at the apex between the canine and first premolar - at the apex between the second premolar and first molar - at the apex between the second and third molar - at the apex between the first and second molar
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✓ at the apex between the canine and first premolar
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106. Nerve impulse travel in myelinated nerves by a process called what? - Domino effect - Salutatory conduction - Relative refractory - Nodes of Ranvier
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✓ Salutatory conduction
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107. Which portion of the nerve do local anesthetics work on? - Neuron - Dendrites - Nerve membrane - Myelinated sheath - Schawann cellS
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✓ Nerve membrane
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108. What is one important way that local anesthetic drugs differ from all other drugs used in dentistry? - High potential of overdose - Route of administration - Rate of uptake into bloodstream - Action ceased when absorbed into bloodstream - Blood levels must be sufficient to exert effect
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✓ Action ceased when absorbed into bloodstream
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109. When procaine undergoes metabolic breakdown, the major metabolic product (metabolite) is what? - Pseudocholinesterase - chloroprocaine - Succinylcholine - Para-aminobenzoic acid
answer
✓ Para-aminobenzoic acid
question
110. Biotransformation of amides take place where? - liver - kidney - blood plasma - spleen - bloodstream
answer
✓ liver
question
111. The concentration of epinephrine that is optimal for hemostasis is what? - 1:5000 - 1:50,000 - 1:150,000 - 1:100,000 - 1:200,000
answer
✓ 1:50,000
question
112. All of the following are reasons to include a vasoconstrictor, ECEPT one.Which one is the EXCEPTION? - lower blood flow to injection site - increase anesthetic blood levels - increase duration of local anesthetic - lower anesthetic toxicity - improve field of vision for treatment
answer
✓ increase anesthetic blood levels
question
113. When it is necessary to administer more than one anesthetic drug, a safe total should be determined by not exceeding what? - the lower of the two maximum doses for the individual agents - the maximum dose of each drug being administered - 25% of the maximum dose of each drug being administered - 35% of the maximum dose of each drug being administered - Dental work being done in many more than on quadrant
answer
✓ the lower of the two maximum doses for the individual agents
question
114. One of the many proprietary names for lidocaine is what? - Xylocaine HCL - 35%Polocaine - Sandonest HCL - Mepivacaine - Candicaine HCL
answer
✓ Xylocaine HCL
question
115. A healthy patient weighing 155 lbs has been given 2 cartridges of 2% lidocaine with epinephrine 1:100,000. How many MORE cartridges of 3% arestocaine can they have? - 4.0 - 4.2 - 4.4 - 4.6
answer
✓ 4.2
question
116. All of the following are ways of caring for a syringe EXCEPT one. Which one is the EXCEPTION? - Place in an ultrasonic bath - dismantle and lubricate every 5 uses - Sharpen or replace harpoon as needed - Rinse syringe of saliva and foreign matter - clean with an ultrasonic instrument
answer
✓ clean with an ultrasonic instrument
question
117. In the dental office, the MOST important consideration when selecting a syringe type is the ability of the following:? - Delivery anesthetic solution to a patient - Aspirate - Accept a 30 gauge needle - Be cost effective
answer
✓ Aspirate
question
118. In local anesthetic dissociation, tissues with a low pH would have effect on base(RN) and cation(RNH+) in the solution? - A lower portion of RN and higher portion of RNH+ - A lower portion of RNH+ and a higher portion of RN - Rapid onset of local anesthetic - Increase duration of local anesthetic - Decrease potency of local anesthetic
answer
✓ A lower portion of RN and higher portion of RNH+
question
119. After properly loading the cartridge into the syringe, a few drops of local anesthetic should be expelled. Why? - The ensure proper placement of the harpoon - To ensure free flow of the solution - The ensure the correct anesthetic has been used - To ensure the needle has not been barded - To ensure the ability to aspirate
answer
✓ To ensure free flow of the solution
question
120. The major factor influencing the ability to aspirate is what? - Gauge of the needle - Size of clinician hand'S - Site of injection - Size of thumb ring - Harpoon being sterile
answer
✓ Gauge of the needle
question
121. All of the following methods will REDUCE the chance of needle breakage, EXCEPT one. Which one is the exception? - establishing a firm hand rest - Using a larger gauge needle - Burying the needle to the hub - Minimizing the need for redirection in tissue - Not bedding the needle excessively
answer
✓ Burying the needle to the hub
question
122. The antioxidant used to preserve epinephrine in a local anesthetic solution is? - Sodium bisulfate - Sodium bicarbonate - Sodium chloride - Sodium pentanol - Sodium hydrochloride
answer
✓ Sodium bisulfate
question
123. A small bubble of approximately 1 to 2 mm diameter will frequently be found in the local anesthetic cartridge. These bubbles are cause by what? - The anesthetic solution being frozen - The cartridge was stored in a chemical disinfectant - Nitrogen gas being pumped in during manufacturing - Oxygen gas being trapped in the cartridge - Shaking the cartridge vigorously
answer
✓ Nitrogen gas being pumped in during manufacturing
question
124. Distilled water is added to the cartridge for what purpose? - To make the solution isotonic with the tissues of the body - To increase the safely and the duration of the anesthetic - To prevent the biodegradation of the vasopressor - To provide the volume of the solution - To prevent the probation of nerve impulses
answer
✓ To provide the volume of the solution
question
125. Topical antiseptic does which of the following? - Numbs 2-3mm of tissue prior to injection - Makes patient more comfortable during initial penetration - Lessens the chance of inflammation or infection - Allows the clinician to practice their site of penetration - Reduces the risk of a local anesthetic overdose
answer
✓ Lessens the chance of inflammation or infection
question
126. What is the MOST important reason hemostats/cotton roll pliers are part of the armamentarium? - They are used to remove the Deptinpatch - They are used to place a cotton roll on the needle - They are used for the retrieval of a broken needle - They are used to place the plastic cap on the needle - they are used to unscrew the needle from the syringe
answer
✓ They are used for the retrieval of a broken needle
question
127. At what time are professionals MOST at risk for a needle stick? - Disassembly of syringe - Recapping - Assembling the syringe - Giving the injection - Unsheathing the needle
answer
✓ Recapping
question
128. All of the following are acceptable ways of recapping a needle EXCEPT? - Carefully direction the cap over needle with fingers - Utilizing "Card" or other holding device - Performing the one handed scoop technique - Implementing cotton roll pliers or a hemostat - Securing cap with fingers on vertical syringe
answer
✓ Carefully direction the cap over needle with fingers
question
129. Stacey, a 18 year old soccer player, arrives for extraction of teeth #4,12, and 20, and she is given 5 cartridges of 4% Articaine with epi 1:100,000.Her mother calls 3 hours following the appointment stating that Stacey appears cyanotic and sluggish. Her nail beds look dark and the blood in the extraction sites is chocolate brown. What is MOST likely the condition presented? - A typical plasma cholinesterase - Methemoglobinemia - Malignant hyperthermia - Local anesthetic overdose - Local anesthetic allergy
answer
✓ Methemoglobinemia
question
130. A patient with epilepsy is scheduled for root planning and scaling with local anesthetic today. What should the dental hygienist know about this condition? - Epilepsy is a relative contraindication to ester type anesthetics - In low doses local anesthetic is an anti-convulsant - The patient should be pre-medicated prio to treatment - Epilepsy is an absolute contraindication to amide type anesthetics - Oxygen should be available to deliver in an emergency.
answer
✓ In low doses local anesthetic is an anti-convulsant
question
131. A patient attends for an extraction of a lower molar tooth. Following the administration of an inferior alveolar nerve block only, the patient complains of pain during the procedure.Which one of the following nerves is the most likely to be responsible for the perception of this pain? - Facial nerve - Incisive nerve - Long buccal nerve - Marginal mandibular - Mental nerve
answer
✓ Long buccal nerve
question
132. Which one of the following local anesthetic agents (at the correct dosage) is the most likely to provide the most prolonged analgesia? - Articaine - Bupivacaine - Lidocaine (lignocaine) - Mepivacaine - Prilocaine
answer
✓ Bupivacaine
question
133. Which of the following local anesthetics is used exclusively for its good surface activity and low toxic potential? - Cocaine - Benzocaine - Bupivacaine - Procaine - Lidocaine
answer
✓ Benzocaine
question
134. Which of the following drugs can cause methemoglobinnemia when used in larger doses for regional anesthesia? - Cocaine - Lidocaine - Bupivacaine - Procaine - Prilocaine
answer
✓ Prilocaine
question
135. Epinephrine added to a solution of lidocaine for local anesthesia will:? - Cause cyanosis locally. - Increase the risk of convulsion. - Increase the duration of local anesthesia - Increase the absorption of lidocaine - Decrease the heart rate when absorbed.
answer
✓ Increase the duration of local anesthesia
question
136. vasoconstrictor in local anesthetic(LA) solution is used to ? - Reduces toxic effects of LA - Decreases depth & duration LA. - Increases bleeding. - Increases toxic effects of LA
answer
✓ Reduces toxic effects of LA
question
137. Reducing agent local anesthetics solution is ? - Methyl paraben - Sodium metabisulphite - Thymol - Adrenaline - Ringer lactate
answer
✓ Sodium metabisulphite
question
138. Needle used for infiltration is ? - 30 gauge - 25 gauge - 27 gauge - 16 gauge - 18 gauge
answer
✓ 30 gauge
question
139. When injecting Local anesthetic solution in maxilla on buccal side. Which of the following technique is used? - sub periosteal - supra periosteal - sub mucosal - intra osseous - intra septal
answer
✓ supra periosteal
question
140. Most common complication of posterior Superior alveolar nerve block is:? - Trismus - Hematoma - Infection - Facial palsy - Blanching of the area
answer
✓ Hematoma
question
141. Disto buccal root of upper 1st molar is supplied by:? - Middle superior alveolar nerve - Posterior superior alveolar nerve - infra orbital nerve - mental nerve - buccal nerve
answer
✓ Posterior superior alveolar nerve
question
142. Which of 2 nerves blocked when injection is given in pterygo mandibular space? - Buccal & lingual nerve - Lingual & inferior alveolar nerve - Buccal & inferior alveolar nerve - Buccal nerve & infra orbital nerve - inferior alveolar & posterior superior alveolar nerve
answer
✓ Lingual & inferior alveolar nerve
question
143. Blanching at the site of injection is caused by:? - Increased tissue tension - local effects of reducing agent in LA solution - Decreased tissue tension - Infection at the site of injection - Warm LA solution
answer
✓ Increased tissue tension
question
144. what are the local anesthetic produce for:? - analgesia, amnesia, loss of consciousness - blocking pain sensation without loss of consciousness - alleviation of anxiety and pain with an altered level of consciousness - a stupor or somnolent state
answer
✓ blocking pain sensation without loss of consciousness
question
145. A good local anesthetic agent shouldn't cause:? - Local irritation and tissue damage - systemic toxicity - Fast onset and long duration of action - Vasodilation
answer
✓ Fast onset and long duration of action
question
146. Most local anesthetic agents is consist of :? - Lipophilic group (frequently an aromatic ring) - Intermediate chain (commonly including an ester or amide) - amino group - All of the above
answer
✓ All of the above
question
147. Which one of the following groups is responsible for the duration of the local anesthetic action? - Intermediate chain - Lipophilic group - Ionizable group - Nonionize group
answer
✓ Intermediate chain
question
148. Indicate the local anesthetic agent, which has a shorter duration of action:? - Lindocaine - Procaine - Bupivacaine - Articaine
answer
✓ Procaine
question
149. Which one of the following groups is responsible for the potency and the toxicity of local anesthetic? - Inonizable group - Intermediate chain - Lipophylic group - Non Ionize group
answer
✓ Lipophylic group
question
150. Indicate the drug, which has greater potency of the local anesthetic action:? - Lidocaine - Bupivacaine - Procaine - Mepivacaine
answer
✓ Bupivacaine
question
151. Ionizable group is responsible for ? - The potency and the toxicity - The duration of action - The ability of diffuse to the site of action - All of the above
answer
✓ The ability of diffuse to the site of action
question
152. which one of the following local anesthetics is an ester of benzoic acid:? - Lidocaine - Procaine - Ropivacaine - Cocaine
answer
✓ Cocaine
question
153. Indicate the local anesthetic, which is an ester of paraaminobezoic acid:? - Mepivacaine - Cocaine - Procaine - Lidocaine
answer
✓ Procaine
question
154. Which of the following local anesthetics in an acetanilide derivative? - Tetracaine - Lidocaine - Cocaine - Procaine
answer
✓ Lidocaine
question
155. Indicate the local anesthetic, which is a toluidine derivative:? - Lindocaine - Bupivacaine - Prilocaine - Procaine
answer
✓ Prilocaine
question
156. Which of the following local anesthetics is a thiophene derivative? - Procaine - Ultracaine - Lidocaine - Mepivacaine
answer
✓ Ultracaine
question
157. Local anesthetics are? - Weak bases - Weak acids - Salts - pH
answer
✓ Weak bases
question
158. For therapeutic application local anesthetics are usually made available as salt for the reason of:? - Less toxicity and higher potency - Higher stability and greater lipid solubility - Less local tissue damage and more potency - More stability and greater water solubility
answer
✓ More stability and greater water solubility
question
159. Which of the following statements is NOT correct for local anesthetics? - In a tissue they exist either as an uncharged base or as a cation - A charge cationic form penetrates biologic membranes more readily than and uncharged form - Local anesthetics are much less effective in inflamed tissues - Low ph in inflamed tissues decreases the disscociation of nonionized molecules
answer
✓ A charge cationic form penetrates biologic membranes more readily than and uncharged form
question
160. Which one of the following statements about the metabolism of local anesthetics is incorrect? - Metabolism of local anesthetics occurs at the site of administration - Metabolism occurs in the plasma or liver but not at the site of administration - Ester group of anesthetics like Procaine, are metabolized systemically by pseudocholinesterae - Amides such as Lignocaine, are metabolized in the liver by microsomal mixed function oxidases
answer
✓ Metabolism of local anesthetics occurs at the site of administration
question
161. Indicate the anesthetic agent of choice in patient with a liver disease:? - Lidocaine - Bupivacaine - Procaine - Eticaine
answer
✓ Procaine
question
162. Which of the following local anesthetics is preferable in patient with pseudocholinesterase difiency? - Procaine - Ropivacaine - Tetracaine - Benzocaine
answer
✓ Ropivacaine
question
163. The primary mechanism of action of local anesthetics is:? - Activation of ligand-gated potassium channels - Blockade of voltage-gated sodium channels - Stimulation of voltage-gated N-type calcium channels - Blockade the GABA-gated chloride channels
answer
✓ Blockade of voltage-gated sodium channels
question
164. Which of the following local anesthetics is more water-soluble? - Tetracaine - Etidocaine - Procaine - Bupivacaine
answer
✓ Procaine
question
165. Indicate the local anesthetic, which is more lipid-soluble:? - Bupivacaine - Lidocaine - Mepivacaine - Procaine
answer
✓ Bupivacaine
question
166. The more lipophilic drugs ? - Are more potent - Have longer duration of action - Bind more extensively to protein - All of the above
answer
✓ All of the above
question
167. Which of the following fibers is the first to be blocked? - Type A alpha fibers - B and C fibers - Type A beta fibers - Type A gamma fibers
answer
✓ B and C fibers
question
168. Indicate the function, which the last to be blocked:? - Paine, temperature - Muscle spindles - Motor function - Touch, pressure
answer
✓ Motor function
question
169. Which of the following fibers participates in high-frequency pain transmission? - Type A delta and C fibers - Type A alpha fibers - Type B fibers - Type A beta fibers
answer
✓ Type A delta and C fibers
question
170. Which of the following local anesthetics is an useful antiarrhythmic agent? - Cocaine - Lidocaine - Bupivacaine - Ropivacaine
answer
✓ Lidocaine
question
171. Which of the following local anesthetcs is a short-acting drug? - Procaine - Tetracaine - Bupivacaine - Ropivacaine
answer
✓ Procaine
question
172. Indicate the local anesthetic, which is a long-acting agent:? - Lidocaine - Bupivacaine - Procaine - Mepivacaine
answer
✓ Bupivacaine
question
173. The anesthetic effect of the agent of short and intermediate duration of action cannot be prolong by adding:? - Epinephrine - Norepinephrine - Dopamine - Phenylephrine
answer
✓ Dopamine
question
174. A vasoconstrictor does not :? - Retard the removal of drug from the injection site - Hence the chance of toxicity - Decrease the blood level - Reduce a local anesthetic uptake by the nerve
answer
✓ Reduce a local anesthetic uptake by the nerve
question
175. Vasoconstrictors are less effective in prolonging anesthetic properties of :? - Procaine - Bupivacaine - Lidocaine - Mepivacaine
answer
✓ Bupivacaine
question
176. Which of the following local anesthetics is only used for surface or topical anesthesia ? - Cocaine - Tetracaine - Procaine - Bupivacaine
answer
✓ Cocaine
question
177. Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia? - Dibucaine - Bupivacaine - Tetracaine - Cocaine
answer
✓ Bupivacaine
question
178. Which of the following local anesthetics is used for infiltrative and regional anesthesia related to amide type? - Procaine - Lidocaine - Cocaine - Tetracaine
answer
✓ Lidocaine
question
179. Which of the following local anesthetics is called a universal anesthetic? - Procaine - Ropivacaine - Lidocaine - Bupivacaine
answer
✓ Lidocaine
question
180. Most serious toxic reaction to local anesthetics is:? - Seizures - Cardiovascular collapse - Respiratory failure - All of the above
answer
✓ All of the above
question
181. Correct statements concerning cocaine include all of the following EXCEPT:? - Cocaine is often used for nose and throat procedures - Limited use because of abuse potential - Myocardial depression and peripheral vasodilation - Causes sympathetically mediated tachycardia and vasoconstriction
answer
✓ Myocardial depression and peripheral vasodilation
question
182. Which of the following local anesthetics is more cardiotoxic? - Procaine - Bupivacaine - Lidocaine - Mepivacaine
answer
✓ Bupivacaine
question
183. Most local anesthetics can cause:? - Depression of abnormal cardiac pacemaker activity, excitability, conduction - Depression of the strength of cardiac contraction - Cardiovascular collapse - All of the above
answer
✓ All of the above
question
184. Which one of the following local anesthetics causes methemoglobinemia? - Prilocaine - Procaine - Lidocaine - Ropivacaine
answer
✓ Prilocaine
question
185. Prilocaine has all of the following properties EXCEPT:? - It has ester linkage - Its metabolic product can inhibit the action of sulfonamides - It readily penetrates the skin and mucosa - It is relatively short-acting
answer
✓ It readily penetrates the skin and mucosa
question
186. Correct statements concerning lidocaine include all of the following EXCEPT:? - It is an universal anesthetic - It has esteratic linkage - It widely used as an antiarrhythmic agent - It is metabolized in liver
answer
✓ It has esteratic linkage
question
187. Which of the following local anesthetics is more likely to cause allergic reaction? - Lidocaine - Bupivacaine - Procaine - Ropivacaine
answer
✓ Procaine
question
188. Correct statements concerning bupivacaine include all of the following EXCEPT? - It has low cardiotoxicity - It has amide linkage - It is a long-acting drug - An intravenous injection can lead to seizures.
answer
✓ It has low cardiotoxicity
