Board review
About this set
Created by:
JHuguelet on May 9, 2012
Subjects:
Classes:
Collin DH Class'13, Local Anesthesia
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100 terms
Terms | Definitions |
|---|---|
 D | Pain on injection may be due to: A. Dull needles B. Barbs C. To rapid deposition D. All of the above E. None of the above |
| B | Ester local anesthetic agents are metabolized in the blood by the enzyme: A. amidase B. pseudocholinesterase C. cholinesterase D. pyroxidine |
| B | Which part of the structure of a local anesthetic determine whether it is classified as an ester or an amide? A. lipophilic chain B. intermediate chain C. hydrophilic chain |
| D | What influences deflection of the needle? A. gauge B. length C. bevel D. all of the above |
| B | A small bubble may be found in a dental cartridge. The bubble is a small amount of: A. sodium chloride B. nitrogen gas C. sodium bisulfate D. sodium chloride |
| B | Post injection facial nerve paralysis: A. blocks the corneal reflex B. resolves without residual effect C. must be medially managed D. usually causes significant sensory loss |
| C | Trismus after a local anesthetic injection: A. is the most common local complication B. is not associated with the anesthetic solution C. can result from trauma to the muscle or blood vessel D. is a short term easily managed complication |
| D | Faulty technique and _____ are the most common reasons for failure to achieve adequate anesthesia. A. expired anesthesia B. using a vasoconstrictor C. depositing too much solution D. patient's anatomical variations |
| D | Which injection has the highest rate of positive aspiration? A. PSA B. lingual C. GP D. IA E. MSA |
| A | Your patient, Marcus, is a 200 lb adult with a hx of well-controlled HTN, arthritis in his shoulders, and is borderline for Type II diabetes (trying to control with diet and exercise). He reports he had a mils heart attack about a year ago, "but my doctor said there wasn't much damage and that I'm doing great". How many cartridges of 2% lidocaine w/ 1:100k epi could be safely administered? A. 2 B. 4 C. 6 D. 8 E. 11 |
| D | The period during which a nerve cannot conduct an impulse just after completing an impulse is: A. the sodium pump B. the resting membrane potential C. the pre-threshold condition D. the refractory period |
| A | Which of the following gauge numbers indicates the needle with the smallest lumen? A. 30 ga B. 27 ga C. 25 ga D. 23 ga |
| B | The administration of a LA into an area of inflammation has a decreased anesthetic effect. This can be explained by the fact that: A. inflamed tissue has a high pH B. the LA remains in the salt form (ionized) C. vascularity is decreased in the area of the inflammation D. the LA is converted to the free base (unionized) |
| D | Problems associated with the use of topical anesthetics include all of the following, EXCEPT? A. dosage control B. concentration used C. predominance of ester derivatives D. muscle trismus |
| B | Sodium bisulfate is added to a cartridge of anesthetic to increase the stability of the: A. distilled water B. vasoconstrictor C. hydrochloride salt D. plasma cholinesterase |
| C | Which of the following is NOT a routine function of a vasoconstrictor? A. it decreases the volume of required anesthetic B. it prolongs the duration of the anesthetic solution C. it increases the heart rate to prevent hypotension D. it decreases the potential for systemic toxicity |
| C | Vasoconstrictors are metabolized in the: A. liver B. plasma C. bloodstream |
| A | The maxillary division of the trigeminal nerve is: A. sensory only B. motor only C. sensory and motor simultaneously D. mostly sensory and minimally motor |
| D | Post injection infection A. is a common problem B. occurs when injecting LA solution into an area of infection C. may lead to trismus if not properly treated D. can result when normal oral flora contaminates the needle |
| D | Post injection hematoma A. is always visible extraorally B. can be prevented by using a long needle C. should be treated immediately with heat D. should be treated immediately with cold and pressure E. causes embarrassment to the person who administered the LA |
| E | The cause of paresthesia is indicated all of the following EXCEPT: A. trauma to nerve B. contaminated LA solution C. LA are not neurotoxic D. hemorrhage at the nerve sheath E. all of the above could cause paresthesia |
| A | Overdose reactions are the most common of all true drug reactions. A. true B. false |
| A | Which of the following is NOT an indication of MODERATE overdose levels? A. slurred speech B. dizziness C. unilateral numbness of the tongue D. drowsiness |
| C | The most frequent cause of needle breakage is: A. using a needle with too small gauge B. inserting the needle too deep C. sudden unexpected patient movement D. depositing anesthetic solution too rapidly |
| B | Psychogenic responses: A. are organic in nature B. have no organic origin C. can be life threatening D. are anesthetic dose related E. are predictable |
| B | You plan to SRP the entire right side. You apply topical lidocaine ointment to 6 sites and then administer 4 cartridges of 3% mepivicaine. Immediately after the last injection, the patient loses consciousness and begins to convulse. The most likely cause is: A. epinephrine overdose B. LA overdose C. reaction to mixing two different agents D. allergic reaction to the topical agent E. allergic reaction to the LA |
| B | You have administered 2 cartridges of 2% xylocaine with epi 1:50k to the patient. Within a few minutes the patient complains of a throbbing headache and a rapid heart rate. He sweats profusely and becomes dizzy. The patient is experiencing: A. an overdose to lidocaine B. an overdose to epinephrine C. an allergic response to epinephrine D. an allergic response to lidocaine E. syncope |
| D | If the patient has controlled hypertension, you can: A. give the patient LA but in reduced amounts B. use vasoconstrictor but in reduced amounts C. avoid use of LA and vasoconstrictor D. A and B |
| B | If a patient is taking a NON-SPECIFIC beta blocker, you should: A. avoid LA B. avoid vasoconstricors C. reduce vasoconstrictors D. see no change in agents based alone on this history |
| D | Trismus may be often caused by A. multiple injections in the same site B. contaminated solution C. injection of excessive volume D. All of the above |
| A | If the patient is taking SPECIFIC beta blockers, you should: A. consider cardiac problem individually based on patient's past and present history B. Reduce vasoconstrictor in all cases C. Avoid using LA due to cardiac problems |
| B | A hematoma can result from an incorrectly administered PSA block because the needle was overinserted and penetrated the: A. parotid salivary gland B. pterygoid plexus of veins C. floor of the nose D. facial or cranial nerve VII |
| D | Amide LAs A. are more likely than esters to cause allergic reactions B. are known to produce serious overdose reactions C. may be safely applied to wide areas of mucous membrane D. are less likely than esters to cause overdose reactions |
| C | Which of the following areas most often exhibit persistent anesthesia? A. lower lip B. tip of the nose C. tongue D. upper eye lid |
| A | The difference between a block injection and infiltration is that when administering a block injection, the anesthetic is delivered in the area of the nerve branch. A. True B. False |
| C | Tachyplhylaxis means: A. increased heart rate B. decreased deart rate C. increased tolerance to a drug D. decreased tolerance to a drug E. none of the above |
| C | The pH of an inflamed area is: A. 7.5 - 10 B. 7.4 C. 5 - 6 D. 5.5 E. 3.3 |
| E | The pH of a LA with epi is: A. 7.5 - 10 B. 7.4 C. 5 - 6 D. 5.5 E. 3.3 |
| C | What is the dose of anesthetic for the mental injection? A. 0.2-0.3 mL B. 0.4-0.6 mL C. 0.6 mL D. 0.9-1.2 mL E. 1.5-1.8 mL |
| D | Name the nerve which provides sensory innervation to the lingual gingiva of the mandibular molars. A. inferior alveolar B. lingual C. mental D. incisive |
| A | Myelinated nerves have constricted sections of the myelin sheath occurring at regular intervals forming gaps. These gaps are known as: A. nodes of Ranvier B. axoplasms C. biomolecular layers of lipids D. Schwann cells |
| B | The thin cable-like structure of a neuron that is responsible for transmitting impulses is the: A. cell body B. axon C. dendrite D. nucleus |
| C | A minimum of _____ of nerve must be covered by anesthetic solution to ensure thorough blockade of impulse conduction. A. 1 - 2 mm B. 3 - 4 mm C. 8 - 10 mm D. 18 - 20 mm |
| A | At resting state, the interior of the nerve is primarily comprised of _____ ions. A. K B. Na C. Cl D. O |
| C | _____ is responsible for the depolarization of the nerve membrane from its resting level to its firing threshold. A. an influx of Cl ions to the interior of the nerve cell B. a movement of CL ions to the exterior of the nerve cell C. an influx of Na ions to the interior of the nerve cell D. a movement of Na ions to the exterior of the nerve cell |
| D | Benzocaine topical anesthetic is least effective on which of the following? A. tracheal mucosa B. damaged tissue C. gingiva D. intact skin |
| B | Which of the following is true of initial clinical signs and symptoms of CNS toxicity of LA? A. tonic-clonic seizure is a symptom characteristic of initial CNS toxicity B. they are depressive to the CNS C. the symptoms include depressed blood pressure, heart rate, and respiration D. they are excitatory in nature |
| D | When hemostatic control is needed for dental procedures on cardiovascularly compromised patients, ASA II and ASA III, whose medical conditions have been diagnosed and controlled, the preferred solution concentration is: A. plain B. 1:50k C. 1:100k D. 1:200k |
| D | Which of the following statements is false regarding LA dosage? A. one should always administer the smallest clinically effective dose B. the maximum calculated drug dose should always be decreased in medically compromised, debilitated, or elderly persons C. when using more than one LA, the total dose of both LAs should not exceed the lower of the two maximum doses of the individual agent D. All statements are true |
| D | If a patient has had a myocardial infarction, how long should dental treatment be delayed? A. 1 year B. 2 years C. 3 months D. 6 months |
| D | If a patient has a history of methemoglobinemia, which anesthetics should be avoided? A. prilocaine B. lidocaine C. benzocaine D. A and C only E. all of the above |
| C | The recommended rate of deposition of the anesthetic solution should be: A. 1/2 cartridge per minute B. 1/4 cartridge per minute C. 1 cartridge per minute D. 1 1/2 cartridge per minute |
| D | Where does the maxillary division of the trigeminal nerve exit the skull? A. foramen ovale B. superior orbital fissure C. jugular foramen D. foramen rotundum |
| A | Where does the mandibular division of the trigeminal nerve exit the skull? A. foramen ovale B. foramen rotundum C. Superior orbital fissure D. mandibular canal |
| D | The landmark that is necessary for the anesthesia of the lingual gingiva of the maxillary anterior teeth is: A. greater palatine foramen B. nasopalatine foramen C. foramen ovale D. incisive foramen |
| D | The first anatomical landmark that is necessary to identify for the IA block is: A. mandibular condyle B. occlusal plane of the mandibular posterior teeth C. ramus of the mandible D. coronoid notch |
| D | When administering the IA block, which of the following tissues will be anesthetized? A. all areas except the linguals of the 1st, 2nd, and 3rd molars B. all areas except the facials of the anterior teeth C. all areas except the facials of the 1st, 2nd, and 3rd molars D. all areas except the buccals of the 1st, 2nd, and 3rd molars |
| B | What is the treatment for a patient with trismus? A. cold therapy, saline rinses, and aspirin B. heat therapy, saline rinses, and aspirin C. heat therapy followed by cold therapy D. heat therapy, saline rinses, and codeine |
| A | What is the primary cause of a slight burning sensation during injection of LA? A. the pH of the solution B. rapid injection of LA C. contamination of the LA D. warm solution |
| B | What is the maximum dose of epinephrine for a cardiac risk patient? A. 0.2 mg B. 0.04 mg C. 0.02 mg D. 0.01 mg |
| B | Which of the following anesthetics has the longest duration of action? A. lidocaine B. bupivicaine C. prilocaine D. mepivicaine |
| D | Which of the following anesthetics has the shortest duration of action? A. lidocaine B. bupivicaine C. prilocaine D. mepivicaine |
| E | How many mgs of a LA are in 1 cartridge containing 2% lidocaine HCl and epinephrine 1:100k? A. 1.8 B. 2.0 C. 18 D. 20 E. 36 |
| D | Extensive periodontal debridement must be performed on all surfaces of the maxillary right first molar and both premolars. Which injections must be administered if the patient exhibits sensitive roots and gingival tissue around root surfaces? A. PSA & MSA B. PSA & infiltration over the premolars C. MSA & NP D. PSA, MSA, & GP E. PSA, MSA, & ASA |
| A | All of the following are nerves of the mandibular division of the trigeminal nerve EXCEPT: A. PSA B. IA C. buccal D. lingual E. mental |
| D | The acid MOST commonly combined with a LA drug is: A. amino acid B. Sodium Chloride acid C. acetic acid D. hydrochloric acid |
| D | Which of the following are LEAST indicated to provide pulpal anesthesia for a class II amalgam on a 4 year old? A. 3% mepivicaine plain B. 2% carbocaine w/ 1:20k Neo-Cobefrin C. 4% prilocaine plain D. 0.5% bupivicaine w/ 1:200k epi E. all are optimally suited |
| C | Where is articaine metabolized? A. plasma B. liver C. both plasma and liver D. kidney E. spleen |
| D | You have administered 1 cartridge of lidocaine 2% w/ 1:100k epi to your patient. How much epi have you administered? A. 0.18 mL B. 1.8 mL C. 18 mL D. 0.018 mL |
| B | The incisive nerve is a branch of the infraorbital nerve, exiting onto the hard palate through the incisive foramen. A. True B. False |
| E | How many mg of anesthetic are contained in 5 cartridges of prilocaine 4% w/ 1:200k epi? A. 72 B. 144 C. 216 D. 288 E. 360 |
| A | How much epinephrine was administered in 5 cartridges of prilocaine 4% w/ 1:200k epi? A. 0.045 B. 0.0045 C. 0.45 D. 0.05 E. 0.005 |
| E | Which of the following are currently believed to be potential risks of long-term occupational exposure to N2O in an unprotected environment? A. increased rate of spontaneous abortion B. increased rate of birth defects C. increased rate of liver diseases D. reduced fertility E. all of the above |
| B | Most of the nitrous oxide is metabolized/ eliminated in the: A. GI tract B. lungs C. liver D. kidneys E. all of the above |
| D | At 50% nitrous oxide the patient states that he is not feeling much effect. What should you do? A. check hoses to see if there are any kinks B. keep increasing the level by 10% per minute to see if effect increases C. Check nose piece to see if there is a seal around the nose D. A and C E. All of the above |
| E | For which of the following patients may nitrous oxide be contraindicated? A. recovered alcoholic B. person taking CNS sedatives C. emphysema D. B and C E. All of the above |
| E | Which of the following is a characteristic of nitrous oxide? A. nitrous oxide is stored in the body B. nitrous oxide is a sweet-smelling, colorless gas C. nitrous oxide is easily titrated D. patients may be allergic to nitrous oxide E. B and C |
| E | Which of the following is a disadvantage of the IANB? A. 15 - 20% rate of inadequate anesthesia B. 10 - 15% rate of positive aspiration C. intraoral landmarks are inconsistent D. A and C E. All of the above |
| C | What is the average depth of penetration for the IANB? A. 10 - 15 mm B. 15 - 20 mm C. 20 - 25 mm D. 1/2 to 1/3 |
| B | This nerve provides anesthesia to the pulp of tooth #25 A. buccal B. incisive C. mental D. lingual |
| A | The most common reason for failure of an IANB is: A. solution deposited too inferior to the mandibular foramen B. solution deposited too anterior to the mandibular foramen C. solution deposited too lateral to the mandibular foramen D. solution deposited too superior to the mandibular foramen |
| C | This injection is also referred to as the closed mouth technique: A. IANB B. Gow-Gates C. Vazarani-Akinosi D. buccal E. B & C |
| C | If bone is not contacted with the IANB injection the needle is lying: A. too far posterior B. too far mesial C. too far anterior D. too far superior |
| A | The site of penetration for the buccal nerve block is: A. distal and buccal to the last molar B. distal and facial to the last molar C. mesial and buccal to the last molar D. mesial and facial to the last molar |
| B | Ideally, topical anesthetic should remain in contact with the tissue for how many minutes? A. 1 B. 2 C. 3 D. 4 |
| C | What is the recommended depth of penetration for the mental nerve block? A. 3-4 mm B. 4-5 mm C. 5-6 mm D. 6-7 mm |
| D | Which of the following situations may require anesthetizing the buccal nerve? A. a crown prep on #30 B. SCRP on the mandibular right C. placement of a rubber dam clamp on #29 D. A & B only E. all of the above |
| B | Following distribution, this area of the body contains the greatest percentage of LA of any tissue or organ in the body. A. kidneys B. skeletal muscle C. brain D. lungs E. heart |
| A | Shortly after administration of 2 cartridges of articaine 4% w/ 1:100k epi, your patient exhibits slurred speech, sweating, and complains of a rapid heart rate. Your patient is most likely exhibiting signs and symptoms of: A. vasoconstrictor overdose B. vasoconstrictor allergy C. LA overdose D. LA allergy |
| C | Upon injection of an anesthetic containing a vasoconstrictor, all of the following situations occur, EXCEPT: A. decreased blood flow to the injection site B. slow absorption of anesthetic into the bloodstream C. decreased duration of anesthetic D. decreased bleeding at the injection site |
| A | The site of penetration for the ASA injection is the height of the mucobuccal fold: A. slightly mesial to the apex of the canine B. between the premolars C. distal buccal of the 2nd molar D. lateral to the incisive papilla |
| B | The site of penetration for the GP is: A. slightly anterior to the lesser palatine foramen B. slightly anterior to the greater palatine foramen C. slightly lateral to the incisive papilla, at the widest aspect D. slightly anterior to the incisive papilla, at the widest aspect |
| E | What is the depth of insertion for the PSA for an average size adult? A. 2-3 mm B. 3-5 mm C. 4-6 mm D. 6-8 mm E. 16 mm |
| D | What is the dose of anesthetic for a PSA? A. <= 0.4 mL B. 0.4 - 0.6 mL C. 0.9 - 1.2 mL D. 0.9 - 1.8 mL |
| B | What is the dose of anesthetic for a GP? A. <= 0.4 mL B. 0.4 - 0.6 mL C. 0.9 - 1.2 mL D. 0.9 - 1.8 mL |
| A | A patient complains of sensitivity to heat, cold, and pressure. Examination of the radiograph reveals a radiolucency around the apex of tooth #15. Which of the following is the best injection(s) to provide complete anesthesia of that tooth? A. PSA B. MSA C. IO D. local infiltration above #15 E. A & B |
| A | Why are topical anesthetics manufactured in higher concentrations than injectable anesthetics? A. more base molecules are needed to allow the drug to diffuse through the mucous membranes B. They cannot produce toxicity when applied topically C. decreased amounts are applied topically than when injected D. they do not contain vasoconstrictors E. C & D |
| C | What is the average rate of onset and duration of Oraqix? A. 20 min; 30 sec B. 15 sec; 30 min C. 30 sec; 20 min D. 30 sec; 30 min |
| C | Elevated blood levels of LA may result from all EXCEPT: A. biotransformation of the drug is unusually slow B. too large a total dose is administered C. absorption from the injection site is unusually slow D. inadvertent intravascular administration occurs |
| C | A patient has a reaction of wheals and respiratory distress 5 minutes after you administer LA. To resolve this situation, this patient may need which of the following treatments? A. 0.3 mg of epi 1:1,000 B. administer an antihistamine C. administer oxygen D. place patient in a semi-reclined position |
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