DECKS Flashcards
In the normal patient, an increase ni stress will lead to a/an ___ in ACTH production and large doses of circulating systemic steroids will ___ this production.
a. increase, repress
b. increase, stimulate
c. decrease, repress
d. decrease, stimulate
a. increase, repress
A person who has been on suppressive doses of steroids will? (Select 2)
a. Take as long as a year to regain full adrenal cortical function
b. Take as long as a month to regain full adrenal cortical function
c. May show signs of hyperpigmentation
d. Does not require consultation with a physician prior to surgery
a. Take as long as a year to regain full adrenal cortical function
c. May show signs of hyperpigmentation
Hypercortisolemia can lead to ____, whereas Hypocortisolemia can lead to ____.
a. Addison disease, Cushing syndrome
b. Cushing syndrome, ectopic ACTH syndrome
c. Cushing syndrome, Addison disease
d. Addison disease, ectopic ACTH syndrome
c. Cushing syndrome, Addison disease
NOTES:
HYPER- Cushing syndrome
HYPO- Addison disease
A 52-year-old woman requests removal of a painful mandibular second molar. She tells you that she has not rested for 2 days and nights because of the pain. Her medical history is unremarkable, except that she takes 20 mg of prednisone daily for erythema multiforme. How do you treat this patient?
a. Have patient discontinue the prednisone for 2 days prior to the extraction
b. Give steroid supplementation and remove the tooth with local anesthesia and sedation
c. Instruct the patient to take 3 grams of amoxicillin 1 hour prior to extraction
d. No special treatment is necessary prior to extraction
b. Give steroid supplementation and remove the tooth with local anesthesia and sedation
Sensory innervation to the palate is supplied by ___. Motor innervation to tensor veli palatini is supplied by ____. A greater palatine block can anesthesize the palate as anterior as the maxillary ___.
a. CN V2, CN V3, canine
b. CN V3, CN V2, canine
c. CN V2, CN V3, first premolar
d. CN V3, CN V2, first premolar
c. CN V2, CN V3, first premolar
Please match the following cranial nerves with their appropriate preganglionic parasympathetic fibers. Remember, postganglionic fibers from these nerves are carried via the opthalmic nerve (V1), maxillary nerve (V2), and mandibular nerve (V3).
- CN III Oculomotor
- CN VII Facial
- CN IX Glossopharyngeal
A. Parotid Gland
B. Pupil Constriction, Accomodation
C. Lacrimal, Submandibular, Sublingual Gland
1-B
2-C
3-A
The retrodiscal tissue of the TMJ is highly vascularized and innervated.
Only the extreme periphery of the articular disc is highly innervated.
a. Both statements are true
b. Both statements are false
c. The first statement si true, the second si false
d. The first statement is false, the second is true
a. Both statements are true
The average size of the maxillary sinus is 14.75 mL, with a range of 9.5-20 mL.
On average, the width is ___ ; the height is ___ ; and the depth is ___
a. 1.0 cm, 2.75 cm, 2cm
b. 2.5 cm, 3.75 cm, 3cm
c. 4.0 cm, 4.75 cm, 4cm
d. 5.0 cm, 5.75 cm, 3.5 cm
b. 2.5 cm, 3.75 cm, 3cm
The ____ arises from the anterior surface of the external carotid artery and then passes near the greater cornu of the hyoid bone.
a. submental artery
b. inferior alveolar artery
c. lingual artery
d ascending pharyngeal artery
c. lingual artery
The buccinator and superior pharyngeal constrictor muscles of the pharynx are attached to each other at the:
a. Pterygomandibular raphe
b. Mastoid process
c. Epicranial aponeurosis
d. Genial tubercles on the internal surface of the mandible
a. Pterygomandibular raphe
Which of the following are involved in the path for parasympathetic innervation of the parotid gland? Select 2.
a. Trigeminal nerve
b. Glossopharyneal nerve
c. Vagus nerve
d. Otic ganglion
e. Pterygopalatine ganglion
b. Glossopharyneal nerve
d. Otic ganglion
A dentist is performing a routine restoration on the left mandibular first molar. He is giving an inferior alveolar nerve block injection, where he deposits anesthetic solution right next to the lingula and mandibular foramen. Which ligament is most likely to get damaged?
a. Sphenomandibular ligament
b. Temporomandibular ligament
c. Stylomandibular ligament
d. None of the above
a. Sphenomandibular ligament
The following injuries would cause a patient to deviate toward the side of injury when protruding, EXCEPT:
a. Damage to the lateral pterygoid muscle
b. Ankylosis of the condyle
c. Condylar hyperplasia
d. Unilateral condylar fracture
c. Condylar hyperplasia❌
Which lymph nodes directly receive lymph from the tip of the tongue?
a. Submental lymph nodes
b. Submandibular lymph nodes
c. Parotid lymph nodes
d. None ofthe above
a. Submental lymph nodes
Which artery descends on the posterior surface of the maxilla and supplies the maxillary sinus and the maxillary molar and premolar teeth?
a. Sphenopalatine artery
b. Greater palatine artery
c. Posterior superior alveolar artery
d. Infraorbital artery
c. Posterior superior alveolar artery
The submandibular gland is a ____ gland whose secretomotor innervation comes from the ___
nerve. The sublingual caruncle marks the opening of its duct into the oral cavity.
a. purely mucous, CN VII
b. mixed, CN IX
c. purely mucous, CN IX
d. mixed, CN VII
d. mixed, CN VII
NOTES:
Parotid gland
- Stensen’s duct= SEROUS
Submandibular gland
- Wharton’s duct= SEROMUCOUS (MIXED)
Sublingual gland
(1) Bartholin’s duct (Major)- MUCOUS
(2) Rivini’s duct (Minor)- MUCOUS
The TMJ is a ___ joint whose articular disc is composed of ___ tissue. The TMJ is bound anteriorly by the articular eminence and posteriorly by the tympanic part of the temporal bone.
a. ginglymoarthrodial joint, fibrous connective
b. ginglymus joint, fibrocartilaginous
c. ginglymus joint, fibrous connective
d. ginglymoarthrodial joint, fibrocartilaginous connective
d. ginglymoarthrodial joint, fibrocartilaginous connective
When a maxillary third molar is displaced into the infratemporal fossa, it is usually displaced through the periosteum and located ___ to the lateral pterygoid plate and ___ to the lateral pterygoid muscle with displacement.
a. medial, inferior
b. medial, superior
d. lateral, inferior
e. lateral, superior
d. lateral, inferior
The carotid sheath contains all of the following EXCEPT one. Which one is the EXCEPTION?
a. Carotid artery
b. Sympathetic trunk
c. Jugular vein
d. Vagus nerve
b. Sympathetic trunk ❌
Which nerve may, in some cases, also serve as an afferent nerve for the mandibular first molar, which needs to be considered when there is failure of the inferior alveolar local anesthetic block?
a. Posterior superior alveolar nerve
b. Glossopharyngeal nerve
c. Facial nerve
d. Mylohyoid nerve
d. Mylohyoid nerve
The mandible is formed by ___ ossification and has synovial TMJ with fibrocartilage articular surfaces. The ___ artery provides branches for the most direct blood supply of the TMJ.
a. intramembranous, internal carotid
b. intramembranous, external carotid
c. endochondral, internal carotid
d. endochondral, external carotid
b. intramembranous, external carotid
All of the folowing muscle/nerve combinations are correct EXCEPT one. Which one is the EXCEPTION?
a. Trapezius musle / accessory nerve
b. Stylopharyngeus muscle / glossopharyngeal nerve
c. Sterocleidomastoid muscle / vagus nerve
d. Cricothyroid muscle / superior laryngeal nerve
c. Sterocleidomastoid muscle / vagus nerve❌
Sterocleidomastoid muscle / ACCESSORY nerve
After a stroke on the left side of the brain that affects the left upper motor neurons, the tongue deviates to the:
a. Left on protrusion
b. Right on protrusion
c. Neither of the above, the tongue would not be affected
b. Right on protrusion — and the right half of the tongue will atrophy
The sublingual gland is located in the oral cavity between the mucosa of the oral cavity and the:
a. Masseter muscle
b. Mylohyoid muscle
c. Buccinator muscle
d. Temporalis muscle
b. Mylohyoid muscle
The trigeminal ganglion is located:
a. Superior to the deep lobe of the submandibular salivary gland
b. Posterior surface of the maxillary tuberosity of the maxilla
c. Anterior to the infraorbital foramen of the maxilla
d. At the apex of the petrous part of the temporal bone in the middle cranial fossa
d. At the apex of the petrous part of the temporal bone in the middle cranial fossa
The tongue receives its blood supply from all of the following EXCEPT one. Which one is the EXCEPTION?
a. Tonsillar branch of the facial artery
b. Lingual artery
c. Vertebral artery
d. Ascending pharyngeal artery
c. Vertebral artery
Which of the following nerves exits the skull through the foramen rotundum?
a. Ophthalmic nerve (CN V1)
b. Maxillary nerve (CN V2)
c. Facial nerve
d. Mandibular nerve (CN V3)
b. Maxillary nerve (CN V2)
NOTES:
V1: SOF
V2: F. RO2NDUM
V3: F. OVAL3
All of the following muscle/nerve pairings are correct EXCEPT one. Which one is the EXCEPTION?
a. Lateral rectus muscle / abducens nerve
b. Superior oblique muscle / trochlear nerve
c. Medial rectus muscle / abducens nerve
d. Inferior rectus muscle / oculomotor nerve
c. Medial rectus muscle / abducens nerve
Medial rectus muscle / OCULOMOTOR nerve
NOTES:
LR6 SO4, The rest is 3.
Which of the following teeth could be removed without pain after administration of an inferior alveolar and lingual nerve block?
a. All anterior teeth on the side of the injection
b. Canine and first premolar on the side of the injection
c. All teeth in that quadrant on the side of the injection
d. Both premolars and first molar on the side of the injection
b. Canine and first premolar on the side of the injection
The maxillary first molar is innervated by which of the following nerves? Select 2.
a. Anterior superior alveolar
b. Middle superior alveolar
c. Posterior superior alveolar
d. Greater palatine
e. Ascending pharyngeal
b. Middle superior alveolar
c. Posterior superior alveolar
Shock is characterized by all of the following EXCEPT one. Which one is the EXCEPTION?
a. Increased vascular resistance
b. Bradycardia
c. Myocardial ischemia
d. Mental status changes
e. Adrenergic response
f. Anxiety, vomiting and diarrhea
g. Oliguria
h. Cool mottled skin
b. Bradycardia❌
Tachycardia
NOTES:
Tachycardia- fast heart beat/ heart rate
Bradycardia- slow heart beat/ heart rate
A full E cylinder of oxygen contains approximately:
a. 150 L at a pressure of 2000 psi
b. 300L at a pressure of 2000 psi
c. 600 L at a pressure of 2000 psi
d. 750 L at a pressure of 2000 psi
c. 600 L at a pressure of 2000 psi
According to Guedel’s stages of anesthesia, the proper use of nitrous oxide achieves which level of anesthesia?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
a. Stage I
NOTES:
Stage I (amnesia and analgesia): administration of anesthesia
Stage II (delirium and excitement): beggining of loss of consciousness
Stage III (surgical anesthesia): total loss of consciousness
Stage IV (premortem): Signals danger. Cardiac arrest is imminent.
All of the following drugs help to reduce salivary flow during dental treatment EXCEPT one. Which one is the EXCEPTION?
a. Scopolamine
b. Atropine
c. Local anesthesia
d. Cevimeline HCL
e. Benztropine
d. Cevimeline HCL
Epinephrine and levonordefrin are added to local anestheties because of their:
a. Ability to increase the potency of the local anesthetic
b. Ability to decrease the pain (burning) caused by the injection of the local anesthetic
c. Vasoconstrictive properties
d. Ability ot decrease hte possibility of an alergic reaction ot hte local anesthetic
c. Vasoconstrictive properties
After receiving an injection of a local anesthetic containing 2% lidocaine with 1:100,000 epinephrine, the patient loses consciousness. Which of the following is the most probable cause?
a. Acute toxicity
b. Allergic response
c. Syncope
d. Hyperventilation syndrome
c. Syncope
Which tooth has a root that is NOT consistently innervated by the PSA nerve?
a. The maxillary first molar
b. The maxillary second molar
c. The maxillary third molar
d. All of the above
a. The maxillary first molar
MSA =MB root of M1
All of the following are reasons that vasoconstrictors are included in local anesthetics EXCEPT one. Which one is the EXCEPTION?
a. They prolong the duration of action of the local anesthetic
b. They reduce the chance of an allergic reaction to the local anesthetic
c. They reduce the toxicity because less local anesthetic is necessary
d. They reduce the rate of vascular absorption by causing vasoconstriction
e. They help to make the anesthesia more profound by increasing the concentrations of the local anesthetic at the nerve membrane
b. They reduce the chance of an allergic reaction to the local anesthetic❌
Vasoconstrictors increases the chance of allergic reaction.
Laryngospasm happens when the muscles of the vocal cords seize up, restricting the flow of air into the lungs. It is a well known, infrequent but serious postsurgical complication. In the operating room, it is treated by administering:
a. Nitrous oxide
b. Oxygen
c. Epinephrine
d. Enflurane
b. Oxygen
In regard to nerve fibers, smaller nerve fibers are anesthetized ___ compared fibers are to larger nerve fibers. Comparing nerves of the same size, ___ fibers are blocked first. And finally, nerve fibers with a high firing rate are blocked ___ than slow firing fibers.
a. sooner, myelinated, sooner
b. sooner, myelinated, later
c. later, myelinated, sooner
d. sooner, unmyelinated, later
a. sooner, myelinated, sooner
SMALL → LARGE
MYELINATED → UNMYELINATED
HIGH FIRING → SLOW FIRING
How will a larger than normal functional residual capacity affect nitrous oxide sedation?
a. Nitrous oxide sedation will happen much quicker
b. Nitrous oxide sedation will take longer
c. Functional residual capacity does not affect nitrous oxide sedation
b. Nitrous oxide sedation will take longer
Which of the following correctly describe barbiturates? Select 2.
a. Not lipid soluble
b. Moderately lipid soluble
c. Very lipid soluble
d. Delayed onset of action
e. Rapid onset of action
c. Very lipid soluble
e. Rapid onset of action
Which of the following local anesthetics are available in North America? Select 4.
a. Prilocaine
b. Bupivacaine
c. Procaine
d. Lidocaine
e. Tetracaine
f. Articaine
a. Prilocaine
b. Bupivacaine
c. Procaine❌
d. Lidocaine
e. Tetracaine ❌
f. Articaine
All of the following are appropriate treatments for an impending vasovagal syncopal episode? EXCEPT:
a. Sit patient in upright position
b. Place patient in supine position
c. Monitor vitals
d. Oxygen administration
e. Loosen tight clothing
f. Place a cold compress on patients forehead
a. Sit patient in upright position ❌
For local anesthetics, for every 1% solution there is:
a. 0.10 mg/mL of anesthetic
b. 1mg/mL of anesthetic
c. 10 mg/mL of anesthetic
d. 100 mg/mL of anesthetic
c. 10 mg/mL of anesthetic
All of the following are needed in combination to produce neurolept-anesthesia EXCEPT one. Which one is the EXCEPTION?
a. Narcotic analgesic
b. Benzodiazepine
c. Neuroleptic agent
d. Nitrous oxide
b. Benzodiazepine
The most common cause of loss of consciousness in the dental office is:
a. Anaphylaxis
b. Syncope
c. Heart attack
d. Seizure
b. Syncope
Trauma to muscles or blood vessels in the ____ is the most common etiological factor in trismus associated with dental injections of local anesthetics.
a. Pterygoid fossa
b. Temporal fossa
c. Submandibular fossa
d. Infratemporal fossa
d. Infratemporal fossa
There are no contraindications for the use of nitrous oxide sedation in asthmatic patients.
Because anxiety is a stimulus for an asthmatic attack, nitrous oxide sedation is actually beneficial for these patients.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
A normal platelet count is:
a. 15,000 - 45,000/mm
b. 75,000 - 100,000/mm
c. 150,000- 450,000/mm
d. 450,000 - 600,000/mm
c. 150,000- 450,000/mm
Which of the following pairings are correct regarding the amount of epinephrine in 1.7cc of solution? Select 2.
a. 2% lidocaine 1:200,000 / .0085 mg epinephrine
b. %2 lidocaine 1:200,000 / .017 mg epinephrine
c. %2 lidocaine 1:50,000 / .034 mg epinephrine
d. 2% lidocaine 1:50,000 / .017 mg epinephrine
a. 2% lidocaine 1:200,000 / .0085 mg epinephrine
c. %2 lidocaine 1:50,000 / .034 mg epinephrine
The primary site of biotransformation of amide drugs is in the ___, whereas the biotransformation of ester anesthetics is in the ___.
a. kidney, blood plasma
b. liver, liver
c. blood plasma, liver
d. liver, blood plasma
d. liver, blood plasma
NOTES:
AMIDE- liver
ESTER- blood plasma
The initial clinical signs and symptoms of CNS toxicity for local anesthetics are usually excitatory in nature. However, it is also possible that the excitatory phase of the reaction may be extremely brief or may not occur at all. This is true especially with which local anesthetics? Select 2.
a. Lidocaine
b. Tetracaine
c. Etidocaine
d. Procaine
e. Bupivacaine
a. Lidocaine
d. Procaine
NOTES:
Lidocaine and procaine frequently produce an initial mild sedation or drowsiness (more common with lidocaine).
The ph of normal tissue is ___; the pH of an inflamed area is ___
a. 9.0; 3 to 4
b. 7.4; 5 to 6
c. 3.6; 8 to 9
d. 8.0; 2 to 3
b. 7.4; 5 to 6
The maximum nitrous oxide to oxygen ratio that can be safely administered to a patient is:
a. 50%, 50%
b. 40%, 60%
c. 60%, 40%
d. 80%, 20%
c. 60%, 40%
The primary action of local anesthetics in producing a conduction block is to decrease the permeability of the ion channels to:
a. Calcium ions
b. Chloride ions
c. Potassium ions
d. Sodium ions
d. Sodium ions
Which of the following is the phase of anesthesia that begins with the administration of anesthetic and continues until the desired level of patient unresponsiveness is reached?
a. Induction
b. Maintenance
c. Recovery
a. Induction
Volatile liquids require a vaporizer for inhalational administration. Which one additionally requires a heating component to allow delivery at room temperature?
a. Enflurane
b. Halothane
c. Sevoflurane
d. Desflurane
e. Isoflurane
d. Desflurane
The optimum site for IV sedation for an outpatient is the:
a. Median basilic vein
b. Median cephalic vein
c. Median antebrachial vein
d. Axillary vein
b. Median cephalic vein
Ketamine, a phencyclidine (PVP) derivative, is 10 times more lipid soluble than thiopental, enabling it to cross the blood-brain barrier quickly.
It produces dissociative anesthesia, which can be seen on EEG as dissociation between the thalamus and limbic system.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
Malignant hyperthermia (MH) is a hypermetabolic state involving skeletal muscle that is precipitated by certain anesthetic agents in genetically susceptible individuals. The incidence of MH is < 0.5% of all patients who are exposed to anesthetic agents. The major clinical characteristics of MH are all of the following EXCEPT one. Which one is the EXCEPTION?
a. Acidosis
b. Rigidity
c. Fever
d. Myoglobinuria
e. Hypermetabolism
f. Hypocapnea
f. Hypocapnea❌
NOTES:
The earliest findings are an increased production of carbon dioxide (HYPERCAPNEA) and signs of increased sympathetic nervous system activity.
The following signs: nausea, pallor, cold perspiration, widely dilated pupils, eyes rolled up, and brief convulsions are indicative of a patient having a ____ reaction
a. Somatogenic
b. Psychogenic
c. Either of the above
d. None of the above
b. Psychogenic
Postoperative hypotension is usually due to the effect of:
a. Transfusion reactions
b. A fat embolism
c. The anesthetic or analgesics on the myocardium
d. Liver failure
c. The anesthetic or analgesics on the myocardium
Anesthesia performed with general anesthetics occurs in four stages which may or may not be observable because they can occur very rapidly. Which stage is the one in which blood pressure rises and becomes irregular, and breathing rate increases?
a. Analgesia
b. Excitement
c. Surgical anesthesia
d. Medullary paralysis
b. Excitement
NOTES:
Stage I (amnesia and analgesia): administration of anesthesia
Stage II (delirium and excitement): beggining of loss of consciousness
Stage III (surgical anesthesia): total loss of consciousness
Stage IV (premortem): Signals danger. Cardiac arrest is imminent.
All of the following are contraindications for the use of nitrous oxide in a patient EXCEPT one. Which one is the EXCEPTION?
a. Gastrointestinal obstructions
b. Middle ear disturbances
c. Possibly pneumothorox
d. Asthmatic patient
d. Asthmatic patient
The propylene glycol in IV valium can cause:
a. Cellulitis
b. Aunilateral facial paralysis
c. Phlebitis
d. Syncope
c. Phlebitis
NOTES:
Phlebitis is irritation or inflammation of a vein that is sometimes seen after IV administration of
valium. This is usually attributed to the presence of propylene glycol in the mixture.
When a biopsy is being performed, the incisions should be:
a. Oriented perpendicular to lines of muscle tension
b. Oriented parallel to lines of muscle tension
c. As deep as possible into muscle fibers beneath the lesion
d. At a 45-degree angle ot the long axis of any muscle fibers beneath the lesion
b. Oriented parallel to lines of muscle tension
How long should one wait before obtaining a biopsy of an oral ulcer?
a. 4 days
b. 7 days
c.14 days
d. 30 days
c.14 days
An incisional biopsy is indicated for which of the following lesions?
a. 3 x 3 mm well-encapsulated fibroma
b. Necrotizing sialometaplasia of the hard palate
c. 2x 2mm papilloma of left commissure of lips
d. 3 x 2 mm melanotic macule
b. Necrotizing sialometaplasia of the hard palate
All of the following symptoms EXCEPT one suggest that your patient is dehydrated. Which one is the EXCEPTION?
a. Pale or gray skin color
b. Dry mouth
c. Decreased skin turgor
d. Modified state of consciousness
e. High blood pressure
f. Rapid pulse
g. Reduced urine output
e. High blood pressure❌
LOW blood pressure
A fasting level above ___ or nonfasting glucose > ___ is indicative of diabetes
a. 50 mg/dL, 125 mg/dL
b. 75 mg/dL, 150 mg/dL
c. 100 mg/dL, 175 mg/dL
d. 140 mg/dL, 200 mg/dL
d. 140 mg/dL, 200 mg/dL
The most common sign of left-sided heart failure is ___, whereas ___ is the most common sign of right-sided heart failure.
a. low blood pressure, high blood pressure
b. pulmonary edema, peripheral edema
c. kidney failure, liver failure
d. peripheral edema, pulmonary edema
b. pulmonary edema, peripheral edema
NOTES
LEFT- puLmonary edema
RIGHT- peRipheral edema
Apnea
a. Below normal CO, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
e. Transient cessation or absence of breathing
Hypercapnia
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
f. Excess CO2, in arterial blood
Hyocapnia
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
a. Below normal CO2, in arterial blood
Dyspnea
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
h. The unpleasant sensation of difficulty in breathing
Hyperpnea
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
b. Increase in depth of respiration
Respiratory arrest
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
d. Permanent cessation of breathing (unless corrected)
Hyperventilation
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration
d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing
f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
c. An increase in both rate and depth of respiration
Hypoventilation
a. Below normal CO2, in arterial blood
b. Increase in depth of respiration
c. An increase in both rate and depth of respiration d. Permanent cessation of breathing (unless corrected)
e. Transient cessation or absence of breathing f. Excess CO2, in arterial blood
g. A reduced rate and depth of respiration
h. The unpleasant sensation of difficulty in breathing
g. A reduced rate and depth of respiration
___ occurs when air leaks into the pleural space causing the lung to recoil from the chest wall.
a. Bronchiectasis
b. Atelectasis
c. Pneumothorax
d. Pneumonia
c. Pneumothorax
The “blue bloater” suffers from:
a. Viral pneumonia
b. Chronic bronchitis
c. Emphysema
d. Asthma
b. Chronic bronchitis
NOTES:
Chronic Bronchitis- Blue bloater
EmPhysema- Pink puffer
Which of the following acid-base abnormalities will develop in a patient with recurrent vomiting of gastric contents?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
d. Metabolic alkalosis
NOTES:
Respiratory acidosis- COPD, asthma, severe pneumonia or pulmonary edema, CNS depression (drugs, CNS event), acute airway obstruction, pneumothorax.
Respiratory alkalosis- anxiety, hypoxia, CNS disease, drug use (salicylates), pregnancy, sepsis
Metabolic acidosis- diabetic or starvation ketoacidosis, lactic acidosis, uremia, severe dehydration.
Metabolic alkalosis- vomiting, diuretic use, Cushing syndrome, Conn syndrome, and exogenous steroids
All of the following statements are NOT true regarding type 2 diabetes EXCEPT one. Which one is the EXCEPTION?
a. Was formally known as insulin-dependent diabetes
b. Patients have little or no insulin secretion capacity
c. Symptoms appear abruptly and include polyuria, polydipsia, polyphagia, and weight loss
d. Accounts for 90% of all cases of clinical diabetes
d. Accounts for 90% of all cases of clinical diabetes
NOTES:
TYPE I
- Insulin dependent, can’t produce insulin
- SYMPTOMS: polyuria, polydipsia, polyphagia, and weight loss
- Accounts for 10% of all cases of clinical diabetes
TYPE II
- Insulin- Independent, can produce insulin but reduced sensitivity of insulin’s target cells
- SYMPTOMS: polyuria, polydipsia, polyphagia, and weight gain
- Accounts for 90% of all cases of clinical diabetes
The three basic pathophysiological changes that occur in an asthmatic patient include all of the following EXCEPT one. Which one is the EXCEPTION?
a. Airway inflammation
b. Airway obstruction
c. Irreversible airway narrowing
d. Airway Hyperresponsiveness
c. Irreversible airway narrowing❌
Hemophilia A is the most common type of hemophilia present in North America and involves which coagulation factor?
a. VI
b. VIII
c. XI
d. IX
b. VIII
NOTES:
HEMOPHILIA
A = 8
B = 9
C = 11
A history of rheumatic fever, IV drug abuse, or heart murmur should alert the dentist to the possibility of:
a. Diabetes mellitus
b. AIDS
c. Valvular disease
d. End-stage renal disease
c. Valvular disease
A tall, thin patient presents to your office with shortness of breath. On examination, you note the patient is breathing through “pursed” lips, his expiratory phase is prolonged, and lung sounds are distant. Which of the following is the most likely diagnosis?
a. Asthma
b. Bronchiectasis
c. Cystic fibrosis
d. Emphysema
d. Emphysema
Special considerations must be taken when treating a patient on renal dialysis. Which of the following should be considered? Select 3.
a. Treat the day before dialysis
b. Treat the day after dialysis
c. NSAIDs are the best analgesic to use
d. Morphine is acceptable for use as an analgesic
e. Be aware of shunts when taking the patients blood pressure
f. Consider that the patient may be on steroid therapy
b. Treat the day after dialysis
e. Be aware of shunts when taking the patients blood pressure
f. Consider that the patient may be on steroid therapy
Codeine, a widely used analgesic in dentistry:
a. Is a natural constituent of opium
b. May be given only by injection
c. Has a calming effect on gastric mucosa
d. Is stronger than morphine, more addictive, and more constipating
a. Is a natural constituent of opium
____ is the least lipid soluble of the three main benzodiazepines, resulting in a slow onset of action but a long duration of action.
a. Midazolam
b. Lorazepam
c. Diazepam
b. Lorazepam
NOTES:
Midazolam (Versed): is the MOST lipid soluble= rapid onset and a relatively SHORT duration of action.
Lorazepam (Ativan): is the LEAST lipid soluble =SLOW onset of action but LONG duration of action.
Diazepam (Valium): is water-insoluble and requires the organic solvent propylene glycol to dissolve it. The onset time is slightly slower than that of midazolam.
Which of the folowing drugs would be BEST given to a patient with a history of gastric ulcers?
a. Aspirin
b. Ibuprofen
c. Acetaminophen
d. Naproxen
c. Acetaminophen
Which of these barbiturates can be classified as a long-acting compound?
a. Amobarbital
b. Thiopental
c. Phenobarbital
d. Pentobarbital
c. Phenobarbital
NOTES:
Amobarbital- immediate acting
Thiopental- ultra short acting
Phenobarbital- long acting
Pentobarbital- short acting
___ should be used cautiously in the elderly. It should never be given to patients on monoamine oxidase inhibitors for psychiatric disease and is generally contraindicated in patients receiving phenytoin (Dilantin) for seizure disorders.
a. Ibuprofen
b. Acetaminophen
c. Meperidine
d. Codeine
c. Meperidine
Atropine and scopolamine have similar pharmacologic effects. They share the following actions EXCEPT
a. Reduction of salivation
b. Prevention of cardiac slowing during general anesthesia
c. CNS depression
d. Mydriasis
e. Cycloplegia
c. CNS depression❌
A sedative dose of a barbiturate should be expected to produce:
a. Respiratory depression
b. Minor analgesia
c. Decreased BMR
d. All of the above effects
e. None of the above effects
e. None of the above effects
All of the folowing are true statements concerning the principles of suturing technique EXCEPT one. Which one is the EXCEPTION?
a. The needle should be perpendicular when to enters the tissue
b. Sutures should be placed at an equal distance from the wound margin (2-3 mm) and at equal depths
c. Sutures should be placed from mobile tissue ot thick tissue
d. Sutures should be placed from thin tissue to thick tissue
e. Sutures should not be overtightened
f. Tissues should be closed under tension
g. Sutures should be 2-3 mm apart
h. The suture knot should be on the side of the wound
f. Tissues should be closed under tension❌
What areas are impacted maxillary third molars occasionally displaced into? Select 2.
a. Canine/ space
b. Pterygomaxillary space
c. Infratemporal space
d. Pharyngeal space
e. Maxillary sinus
c. Infratemporal space
e. Maxillary sinus
For maxillary extractions, the upper jaw of the patient should be:
a. Below the height of the operator’s shoulder
b. Above the height of the operator’s shoulder
c. At the same height of the operator’s shoulder
d. It makes no difference where the patient’s upper jaw is in relation to the operator’s shoulder
c. At the same height of the operator’s shoulder
All of the following are contraindications to tooth extraction EXCEPT one. Which one is the EXCEPTION?
a. Acute pericoronitis
b. Acute apical abscess
c. End-stage renal disease
d. Acute infectious stomatitis
b. Acute apical abscess
All of the following are ways of eliminating dead space EXCEPT one. Which one is the EXCEPTION?
a. Close the wound in layers to minimize the postoperative void
b. Apply pressure dressings
c. Use drains ot remove any bleeding that accumulates
d. Allow the void to fill with blood so that a blood clot will form
d. Allow the void to fill with blood so that a blood clot will form❌
Which of the following is the primary direction of luxation for extracting maxillary deciduous molars?
a. Buccal
b. Palatal
c. Mesial
d. Distal
b. Palatal
NOTES:
Buccal - Permanent
Palatal - Deciduos
During extraction of a maxillary third molar, you realize the tuberosity has also been extracted. What is the proper treatment in this case?
a. Remove the tuberosity from the tooth and reimplant the tuberosity
b. Smooth hte sharp edges of hte remaining bone and suture the remaining soft tissue
c. No special treatment is necessary
d, None of the above
b. Smooth the sharp edges of the remaining bone and suture the remaining soft tissue
The following can be safely excised in preparing the edentulous mandible for dentures EXCEPT
a. Labial frenum
b. Lingual frenum
c. Mylohyoid ridge
d. Genial tubercles
e. Exostosis
d. Genial tubercles
The ideal time to remove impacted third molars is:
a. When the root is fully formed
b. When the root is approximately two-thirds formed
c. Makes no difference how much of the root is formed
d. When the root is approximately one-third formed
b. When the root is approximately two-thirds formed
All of the following are normal postextraction procedures EXCEPT one. Which one is the EXCEPTION?
a. Digital compression of alveolus after extraction
b. Suture placement when gingival papillae have been excised or there is excessive bleeding
c. Patient is instructed ot bite down on apressure dressing for 30-60 minutes
d. Printed post-operative instructions are given to the patient
e. Patient is told they can return to normal smoking habits immediately following the extractions
e. Patient is told they can return to normal smoking habits immediately following the extractions❌
The most commonly impacted teeth are the mandibular third molars, maxillary third molars, and the:
a. Maxillary canines
b. Maxillary lateral incisors
c. Mandibular first molars
d. Mandibular premolars
a. Maxillary canines
NOTES:
MOST COMMON
(1) mandibular third molars
(2) maxillary third molars
(3) maxillary canines
(4) mandibular premolars
All of the following are cardinal signs of a localized osteitis (dry socket) EXCEPT one. Which one is the EXCEPTION?
a. Throbbing pain (often radiating)
b. Bilateral lymphadenopathy
c. Fetid odor
d. Bad taste
e. Poorly healed extraction site
b. Bilateral lymphadenopathy
Before removing a palatal torus:
a. An intraoral picture should be taken
b. A mandibular torus, if present, should be removed
c. A stent should be fabricated
d. A biopsy should be taken
c. A stent should be fabricated
For impacted mandibular third molars, place the following in their correct order from the least difficult to most difficult to remove.
a. Vertical
b. Horizontal
c. Distoangular
d. Mesioangular
d. Mesioangular , b. Horizontal , a. Vertical , c. Distoangular
NOTES
MAXILLARY
Mesioangular - MOST difficult
Distoangular - LEAST difficult
MANDIBULAR
Mesioangular - LEAST difficult
Distoangular - MOST difficult
Which two major forces are used for routine tooth extractions?
a. Rotation
b. Pulling
c. Pushing
d. Luxation
a. Rotation
d. Luxation
The root of which tooth is most often dislodged into the maxillary sinus during an extraction procedure?
a. Palatal root of the maxillary first premolar
b. Palatal root of the maxillary first molar
c. Palatal root of the maxillary second molar
d. Palatal root of the maxillary third molar
b. Palatal root of the maxillary first molar
The Caldwell-Luc procedure eliminates blind procedures and facilitates the recovery of large root tips or entire teeth that have been displaced into the maxillary sinus. When performing this procedure, an opening is made into the facial wall of the antrum above the:
a. Maxillary tuberosity
b. Maxillary lateral incisor
c. Maxillary premolar roots
d. Maxillary third molar
c. Maxillary premolar roots
Which suture grading below is the thinnest?
a. 2/0
b. 3/0
c. 4/0
d. 5/0
d. 5/0
The following events are correctly paired with the stages of wound healing, EXCEPT
a. Fibroblasts lay a bed of collagen /proliferative phase
b. Platelet aggregation / inflammatory phase
c. Contraction of the wound / remodeling phase
d. Thromboplastin makes a clot / inflammatory phase
c. Contraction of the wound / remodeling phase❌
Contraction of the wound / PROLIFERATIVE phase
NOTES:
(1) INFLAMMATORY
- Platelet aggregation
- Thromboplastin makes a clot
(2) PROLIFERATIVE (FIBROPLASTIC PHASE)
- Granulation
- Contraction
(3) REMODELING (MATURATION)
- new collagen formation, scar formation
Please match the following resorbable suture types with the approximate time period of resorption in the mouth.
- Plain Catgut
- Chromic Sutures
- Dexon (synthetic)
A. 30 days
B. 8 days
C. 12-15 days
- Plain Catgut- 8 days
- Chromic Sutures -12-15 days
- Dexon (synthetic)- 30 days
Regardless of the flap design used, certain principles should be followed while incising and reflecting the gingiva. With this in mind, the termination of a vertical incision at the gingival crest must be:
a. Midbuccal of the tooth
b. At the line angle of the tooth
c. Midlingual of the tooth
d. Beyond the depth of the mucobuccal fold
b. At the line angle of the tooth
While attempting to remove a grossly decayed mandibular molar, the crown fractures. What is the recommended next step to facilitate the removal of this tooth?
a. Use a larger forcep and luxate remaining portion of tooth ot the lingual
b. Separate the roots
c. Irrigate the area and proceed to remove the rest of the tooth
d. Place a sedative filling and reschedule patient
b. Separate the roots
While extracting a mandibular third molar, you notice that the distal root tip is missing. Where is it most likely to be found?
a. In the infratemporal fossa
b. In the submandibular space
c. In the mandibular canal
d. In the pterygopalatine fossa
b. In the submandibular space
Arrange the following five phases of healing of an extraction site in their correct order.
- Replacement of the connective tissue by fibrillar bone
- Hemorrhage and clot formation
- Replacement of granulation tissue by connective tissue and epithelialization of the site
- Recontouring of the alveolar bone and bone maturation
- Organization of the clot by granulation tissue
2-5-3-1-4
2. Hemorrhage and clot formation
5. Organization of the clot by granulation tissue
3. Replacement of granulation tissue by connective tissue and epithelialization of the site
1. Replacement of the connective tissue by fibrillar bone
4. Recontouring of the alveolar bone and bone maturation
If a subcondylar fracture occurs, which of the following muscles will displace the condyle both anteriorly and medially?
a. Digastric muscle
b. Temporalis muscle
c. Lateral pterygoid muscle
d. Medial pterygoid muscle
c. Lateral pterygoid muscle
____ are second only to nasal fractures in frequency of involvement.
a. Lefort I
b. Lefort II
c. Lefort III
d. Zygomatic fractures
d. Zygomatic fractures
The most frequent complication associated with mandibular fracture management is:
a. Hematoma
b. Wound dehiscence
c. Facial or trigeminal nerve injury
d. Infection
d. Infection
What determines whether muscles will displace fractured segments from their original position?
a. Attachment of the muscle
b. Type of fracture
c. Direction of muscle fibers
d. Line of fracture
d. Line of fracture
In general, mandibular fractures are less common in children than in adults. When mandibular fractures occur in children, ___ fractures of the mandible, particularly in the condylar region, are relatively common.
a. Simple
b. Greenstick
c. Compound
d. Comminuted
b. Greenstick
Computed tomography (CT) scan is the gold standard for evaluation of which of the following?
a. Mandibular fractures at the angle
b. Fractures of the mandibular condyle
c. Lefort I fractures
d. Zygomatic fractures
e. AOTA
f. NOTA
e. AOTA
Closed reduction is best used in the treatment of:
a. Favorable, non-displaced fractures
b. Displaced and unstable fractures, with associated midface fractures, and when MMF is contraindicated
c. Either of the above
d. None of the above
a. Favorable, non-displaced fractures
The process of fracture healing can occur in:
a. One way: by direct or primary bone healing which occurs without callus formation
b. One way: by indirect or secondary bone healing which occurs with a callus precursor stage
c. Two ways: by direct or primary bone healing, which occurs without callus formation, and indirect or secondary bone healing, which occurs with callus precursor stage
c. Two ways: by direct or primary bone healing, which occurs without callus formation, and indirect or secondary bone healing, which occurs with callus precursor stage
The most common pathognomonic sign of a mandibular fracture is:
a. Nasal bleeding
b. Exophthalmos
c. Malocclusion
d. Numbness in the infraorbital nerve distribution
c. Malocclusion
Which type of LeFort fracture is often referred to as a transmaxillary fracture?
a. LeFort I
b. LeFort II
c. LeFort III
a. LeFort I
LeFort I: (Horizontal / Guerin’s / Transmaxillary)
LeFort II: (Pyramidal)
LeFort III: (Craniofacial separation/disjunction)
Battle sign: racoon eyes/ panda eyes (Post auricular eccymosis)
A patient presents to your office after a skateboarding accident with complaint of an anterior open bite and deviation of his mandible to the right side. Based on what you know and anatomic distribution of mandibular fractures, you suspect the patient has a(an) ___ fracture on the ____ side.
a. condylar, left
b. angle, left
c. angle, right
d. condylar, right
e. symphysis, right
d. condylar, right
Patients with hypocalcemia have an ionized calcium level below 2.0 or serum calcium concentration lower than 9 mg/dL. Some of the most common causes are:
a. Hyperparathyroidism and cancer
b. Diabetes and hypothyroidism
c. Renal failure and hypoalbuminemia
d. Graves disease and hypopituitarism
c. Renal failure and hypoalbuminemia
Whether a bone cyst or other cysts are completely enucleated or treated by marsupialization depends on the:
a. Duration
b. Origin
c. Color
d. Size and location to vital structures
d. Size and location to vital structures
NOTES:
Enucleation- complete removal of the cysts
Marsupializtion- (Decompression/ Partsch’s operation) creating a surgical window in the wall of the cyst and evacuating it contents
A patient presents to your office with a fasting blood glucose of 150mg/dL. Based on what you know, you suspect the patient might have an underlying diabetic condition because the normal range of a fasting blood glucose is:
a. 70-110 mg/dL
b. 90-125 mg/dL
c. 70-90 mg/dL
d. 110-125 mg/dL
a. 70-110 mg/dL
Which phase of hemostasis is most affected by patients taking an anticoagulant such as warfarin?
a. Vascular phase
b. Platelet phase
c. Coagulation phase
c. Coagulation phase
When a child less than 8 years of age has a pulse but is breathless, what is the recommended rate of rescue breathing?
a. Once every 3 seconds
b. Once every 5 seconds
c. Once every 8 seconds
d. Once every 10 seconds
a. Once every 3 seconds
NOTES:
CHILD: Once every 3 seconds - (20 breaths/min)
ADULT: Every 5-6 seconds - (10-12 breaths/min)
A patient presents to your office with a medical history including recent unstable angina. This patient’s ASA classification would be:
a. Class 1
b. Class 2
c. Class 3
d. Class 4
e. Class 5
f. Class 6
d. Class 4
NOTES:
Class 1— Healthy patient, no medical problems
Class 2— Mild systemic disease
Class 3 — Severe systemic disease, but not incapacitating
Class 4 — Severe systemic disease that is a constant threat to life
Class 5 — Moribund, not expected to live 24 hours regardless of operation
What is the most frequent cause of airway obstruction in an unconscious person?
a. Chewing gum
b. Cigarette
c. Tongue
d. Hard candy
c. Tongue
Which of the following is a calculated value developed to normalize the reporting of prothrombin time (PT)?
a. IMR
b. IGR
c. ITR
d. INR
d. INR (International normalized ratio)
Which of the following is the most common error in blood pressure measurement?
a. Applying the blood pressure cuff too tightly
b. Applying the blood pressure cuff too loosely
c. Overinflating the blood pressure cuff
d. Underinflating the blood pressure cuff
e. The use of too large or too small cuffs
e. The use of too large or too small cuffs
Which of the following is the gold standard for bone regenerative grafting materials for several reasons, including the capability to support osteogenesis and having osteoinductive and osteoconductive properties?
a. Xenogenic bone
b. Allogenic bone
c. Autogenous bone
d. Alloplastic bone
c. Autogenous bone
NOTES:
Autograft=Osteogenesis, Osteoinductive and Osteoconductive
Allograft= Osteoinductive and Osteoconductive
Xenograft= Osteoconductive
Alloplastic= Osteoconductive
Allogenic grafts such as freeze-dried bone displays which of the following properties?
a. Osteoconductive
b. Osteogenic
c. Osteoinductive
a. Osteoconductive
NOTES:
Freeze-dried bone- osteoconductive
Demineralized freeze-dried- osteoinductive, osteoconductive
Which of the following refers to a horizontal osteotomy of the anterior mandible?
a. Blepharoplasty
b. Genioplasty
c. Cervicofacial rhytidectomy
d. Rhinoplasty
b. Genioplasty
Tissue removed from an animal donor and surgically transplanted to a human
a. Autograft
b. Allograft
c. Xenograft
d. Isograft
c. Xenograft
Tissue surgically removed from one area of a person’s body, such as the iliac crest, and transplanted ni another site on the same person
a. Autograft
b. Allograft
c. Xenograft
d. Isograft
a. Autograft
Tissue surgically transplanted from an individual of the same species who is genetically related to the recipient
a. Autograft
b. Allograft
c. Xenograft
d. Isograft
d. Isograft
Tissue surgically transplanted from one individual to a geneticlly non-identical individual of the same species
a. Autograft
b. Allograft
c. Xenograft
d. Isograft
b. Allograft
The term alloplastic is synonymous with:
a. Original
b. Natural
c. Synthetic
d. Genuine
c. Synthetic
In reference to the bone-implant interface, which of the following yields the most predictable long-term stability?
a. Fibro-osseous integration
b. Osseointegration
c. Biointegration
b. Osseointegration
Which of the following is found between the bone and implant of an endosseous dental implant?
a. Periodontal ligament
b. Peri-implant ligament
c. Epithelial ligament
d. A bone-implant interface
d. A bone-implant interface
Which area of the mouth has a the highest failure rate in osseointegration of dental implants?
a. Anterior mandible
b. Posterior mandible
c. Anterior maxilla
d. Posterior maxilla
d. Posterior maxilla
Currently, the most popular used implants are:
a. Blade form implants
b. Subperiosteal implants
c. Transosseous implants
d. Root form implants
d. Root form implants
To prevent infective endocarditis in patients at risk for such infections, the American Heart Association (AHA) frequently issues guidelines for prophylactic antibiotic coverage during dental procedures. In accordance with the most recently revised AHA guidelines, The following are acceptable antibiotic options for the prevention of infective endocarditis EXCEPT
a. Cephalexin
b. Amoxicillin
c. Clarithromycin
d. Erythromycin
e. Azithromycin
f. Clindamycin
d. Erythromycin
The roots of the third, second, and first molars are all below the level of the mylohyoid. Infection of these teeth pass through the root, directly into the ___ and then to the lateral pharyngeal space.
a. buccal space
b. canine space
c. infratemporal space
d. submaxillary space
d. submaxillary space
NOTES:
The mylohyoid muscle, stretching across the floor of the mouth, serves as the inferior border of the sublingual space and the superior border of the submaxillary space.
The mandibular left second molar of a 14-year-old boy is unerupted. Radiographs show a small dentigerous cyst surrounding the crown. What is the treatment of choice?
a. Surgically extract the unerupted second molar
b. Uncover the crown and keep it exposed
c. Prescribe an anti-inflammatory medication and schedule a follow-up appointment in 6 months
d. No treatment is necessary at this time
b. Uncover the crown and keep it exposed
All of the following are considered primary fascial spaces EXCEPT one. Which one is the EXCEPTION?
a. Buccal
b. Canine
c. Submaxillary
d. Masticator
e. Vestibular
d. Masticator
NOTES:
PRIMARY FASCIAL SPACES
Buccal, Canine, Sublingual, Submaxillary, Submental and Vestibular
SECONDARY FASCIAL SPACES
Pterygomandibular, Infratemporal, Masseteric, Lateral pharyngeal, Superficial and Deep temporal, Retropharyngeal, Masticator, and Prevertebral.
Body temperature can be measured in several different ways, which one is the least accurate?
a. Orally
b. Axillary
c. Rectally
d. Aurally
b. Axillary
NOTES:
Axillary- least accurate
Rectally- most accurate
Osteomyelitis usualy begins in the medullary space involving the
a. Periosteum
b. Soft tissues
c. Cortical bone
d. Cancellous bone
d. Cancellous bone
Why is a conventional handpiece that expels forced air contraindicated when performing dentalveolar surgery?
a. Too much bone will be removed
b. These handpieces can cause tissue emphysema or an air embolus, which can be fatal
c. These handpieces are not high-powered enough ot remove bone
c. All of the above
b. These handpieces can cause tissue emphysema or an air embolus, which can be fatal
Anyone scheduled for general anesthesia should have a chest x-ray and patients over 40 years old should also have a/an:
a. ECG
b. MRI
c. Panorex
d. Biopsy
a. ECG
NOTES:
Anyone scheduled for general anesthesia should have a chest x-ray, and patients over 40 years old should also have an ECG.
Incision for drainage (I&D) in an area of acute infection should only be performed after:
a. Aculture for antibiotic sensitivity has ben performed
b. Localization of the infection
c. A sinus tract is formed
d. The patients fever has cleared up
b. Localization of the infection
Which of the following techniques is best for a wide-based frenectomy?
a. Diamond excision
b. V-Y advancement
c. Z-plasty
b. V-Y advancement
NOTES:
DIAMOND EXCISION AND Z-PLASTY
-are effective when the mucosal and fibrous tissue band is relatively narrow. These techniques relax the pull of the frenum.
V-Y ADVANCEMENT
- is often preferred when the frenal attachment has a wide base. This technique is good for lengthening tissue and usually results in less scarring.
An orofacial infection can reach the cavernous sinus through two routes:
- an anterior route via the ___ and ____ ,
- and a posterior route via the ___ and the ____.
a. transverse facial vein; pterygoid plexus of veins,
angular; inferior ophthalmic veins
b. inferior alveolar, anterior superior alveolar arteries,
descending palatine; greater palatine arteries
c. supratrochlear; supraorbital veins,
superficial temporal; lingual veins
d. angular; inferior ophthalmic veins,
transverse facial vein; pterygoid plexus of veins
d. angular; inferior ophthalmic veins,
transverse facial vein; pterygoid plexus of veins
A surgical procedure used to recontour the supporting bone structures in preparation of a complete or partial denture is called a/an:
a. Closed reduction
b. Operculectomy
c. Alveoloplasty
d. Gingivoplasty
c. Alveoloplasty
While there are many reasons for autotransplanting teeth, tooth loss as a result of dental caries is the most common indication, especially when:
a. Maxillary central incisors are involved
b. Mandibular first molars are involved
c. Mandibular canines are involved
d. Maxillary third molars are involved
b. Mandibular first molars are involved
All of the following are systemic contraindications to elective surgery EXCEPT one. Which one is the EXCEPTION?
a. Blood dyscrasias (i.e., hemophilia, leukemia)
b. Controlled diabetes mellitus
c. Addison disease or any steroid deficiency
d. Fever of unexplained origin
e. Nephritis
f. Any debilitating disease
g. Cardiac disease
b. Controlled diabetes mellitus❌
___ is the most common type of oral cancer and ___ is the most common site.
a. SCC, buccal mucosa
b. SCC, tongue and floor of the mouth
c. Acinic cell carcinoma, palate
d. Acinic cell carcinoma, attached gingiva
b. SCC, tongue and floor of the mouth
The universal sign of laryngeal obstruction is:
a. Mydriasis
b. Stridor (crowing sounds)
c. Sweating
d. Tachycardia
b. Stridor (crowing sounds)
Pericoronitis is acute inflammation of the tissue overlying and surrounding a partially erupted or erupting tooth. The most commonly involved tooth is a:
a. Maxillary third molar
b. Maxillary second molar
c. Mandibular third molar
d. Mandibular second molar
c. Mandibular third molar
NOTES:
The maxillary third molar is the most frequent contributing factor to pericoronal infections found around mandibular third molars. Always examine the maxillary third molar, it may be supererupted or malaligned.
Bleeding that consists of pinpoint dots of blood is called ____. Larger flat areas where blood has collected under the tissue, up to a centimeter in diameter are called ____. A very large area is called a/an ____.
a. purpura, petechiae, ecchymosis
b. petechiae, ecchymosis, purpura
c. ecchymosis, purpura, petechiae
d. petechiae, purpura, ecchymosis
d. petechiae, purpura, ecchymosis
Thrombocytopenia (low platelet count) that is less than ____ is an absolute contraindication to elective surgical procedures because of the possibility of significant bleeding.
a. 50,000/mm
b. 75,000/mm
c. 100,000/mm
d. 125,000/mm
a. 50,000/mm
All of the following characteristics raise the suspicion of malignancy EXCEPT one. Which one is the EXCEPTION?
a. Erythroplasia
b. Ulceration
c. Duration
d. Slow growth
e. Bleeding
f. Induration
g. Fixation
d. Slow growth❌
Fast growth
____ can be used for mandibular advancement or setback, whereas ____ can only be used for mandibular setback.
a. Vertical ramus osteotomy, the step osteotomy
b. Sagittal split osteotomy, vertical ramus osteotomy
c. Vertical ramus osteotomy, LeFort I osteotomy
d. Sagittal split osteotomy, LeFort I osteotomy
b. Sagittal split osteotomy, vertical ramus osteotomy
The prototypic neuropathic facial pain is:
a. Postherpetic neuralgia
b. Burning mouth syndrome
c. Trigeminal neuralgia
d. Temporal arteritis
c. Trigeminal neuralgia
What is the best way to palpate the posterior aspect of the mandibular condyle?
a. Intraorally
b. Externally over the posterior surface of the condyle with the mouth open
c. Through the external auditory meatus
d. Any of the above
b. Externally over the posterior surface of the condyle with the mouth open
Which surgical approach is the best to expose the TMJ?
a. Preauricular
b. Submandibular
c. Both are the same
a. Preauricular
The most common direction in which the articular disc in the TMJ can be displaced is:
a. Laterally
b. Medially
c. Posteriorly
d. Anteromedially
d. Anteromedially
What clinical sign is considered pathognomonic for the first stage of internal derangement of the articular disc?
a. Ringing in the ears
b. Reciprocal clicking
c. Muscle inflammation
d. Headaches
b. Reciprocal clicking
NOTES:
STAGE 1: Reciprocal clicking
STAGE 2: Reciprocal clicking with intermittent locking
STAGE 3: Close lock
STAGE 4: Increase in opening and Crepitus
Which type of digital image receptor is most commonly used at this time?
a. CID (charge injection device)
b. CMOS/APS (complementary metal oxide semiconductor/active pixel sensor)
c. CCD (charge-coupled device)
c. CCD (charge-coupled device)
All of the following are advantages of direct digital radiography EXCEPT one. Which one is the EXCEPTION?
a. Superior gray-scale resolution
b. Reduced patient exposure to x-radiation
c. Increased speed of image viewing
d. Lower equipment and film costs
e. Sensor size
f. Increased efficiency
g. Effective patient education tool
h. Enhancement of diagnostic image
e. Sensor size
A method of obtaining a digital image where the sensor captures the image and immediately
transfers it to a computer is termed:
a. Indirect digital imaging
b. Direct digital imaging
c. Storage phosphor imaging
b. Direct digital imaging
A patient is extremely concerned about radiation exposure. Which of the following is best for limiting the amount of exposure he will receive during a full mouth series?
a. Use of digital imaging
b. Use of E-speed films
c. Use of F-speed films
d. Substitute a panoramic image for the full mouth series
a. Use of digital imaging
A patient of record has been in a fight where he was punched just below the right eye. A zygomatic complex fracture is suspected. Which of the following extraoral projections is best for evaluating this type of injury?
a. Waters projection
b. Submentovertex projection
c. Reverse Towne projection
d. Lateral cephalometric projection
e. Posteroanterior projection
b. Submentovertex projection
NOTES:
Waters projection: MAXILLARY SINUS
Submentovertex projection: BASE OF THE SKULL, ZYGOMATIC PROCESS
Reverse Towne projection: CONDYLE, RAMUS OF THE MANDIBLE
A patient complains of swelling associated with a decayed upper left molar. The patient also complains of “stuffiness” especially when she bends over to pick up anything. Which of the following is the best projection for evaluation of the maxillary sinus area?
a. Waters projection
b. Submentovertex projection
c. Reverse Towne projection
d. Lateral cephalometric projection
e. Posteroanterior projection
a. Waters projection
NOTES:
Waters projection: MAXILLARY SINUS
Submentovertex projection: BASE OF THE SKULL, ZYGOMATIC PROCESS
Reverse Towne projection: CONDYLE, RAMUS OF THE MANDIBLE
A patient sustains an injury to the mandible. Which of the following is the best projection for evaluation of the condylar neck and ramus area?
a. Waters projection
b. Submentovertex projection
c. Reverse Towne projection
d. Lateral cephalometric projection
e. Posteroanterior projection
c. Reverse Towne projection
NOTES:
Waters projection: MAXILLARY SINUS
Submentovertex projection: BASE OF THE SKULL, ZYGOMATIC PROCESS
Reverse Towne projection: CONDYLE, RAMUS OF THE MANDIBLE
The purpose and use of the panoramic image include all of the following EXCEPT one. Which one is the EXCEPTION?
a. To evaluate impacted teeth
b. To evaluate growth & development
c. To evaluate & diagnose caries
d. To examine the extent of large lesions
e. To evaluate trauma
c. To evaluate & diagnose caries
A panoramic image is viewed as if you are looking at the patient, with structures on the patient’s
right side positioned on your left.
In panoramic radiography, when screen film is used as the image receptor, the use of calcium tungsten screens are preferred over the use of rare earth screens.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
c. The first statement is true, the second is false
In panoramic radiography, when screen film is used as the image receptor, the use of calcium tungsten screens are preferred over the use of rare earth screens.❌
NOTES:
In panoramic radiography, rare earth screens are preferred
A radiograph that exhibits areas of black and white is termed high contrast and is said to have a short contrast scale; a radiograph that exhibits many shades of gray is termed low contrast and is said to have a long contrast scale.
To limit image magnification, the longest target-receptor distance and shortest object-receptor distance are used.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
NOTES:
LOW CONTRAST= LONG CONTRAST SCALE (SHADES OF GRAY)
HIGH CONTRAST= SHORT CONTRAST SCALE (BLACK AND WHITE)
From the list provided below, order the following from LEAST to MOST radiopaque.
a. Amalgam
b. Bone
c. Dentin
d. Maxillary sinus
e. Enamel
d. Maxillary sinus
b. Bone
c. Dentin
e. Enamel
a. Amalgam
Dental radiographs are the legal property of the:
a. Patient
b. Dentist
c. State
d. None of the above
b. Dentist
A dental hygienist in your practice has an adult recall patient without evidence of caries who states she needs bite-wing x-rays because it has been 6 months since her last dental images. The hygienist should tell the patient that:
a. Yes, she is correct, it is time for new X-ray images
b. Bite-wings should be taken only once per year, not twice
c. Images should be taken based on patient need instead of a set time frame
d. None of the above
c. Images should be taken based on patient need instead of a set time frame
The coronoid process often appears on what periapical image?
a. maxillary incisor
b. maxillary molar
c. mandibular incisor
d. mandibular molar
b. maxillary molar
The pattern of stored energy on an exposed film is termed the latent image; this image remains invisible until it undergoes processing.
The function of the developer solution is to chemically reduce the exposed, energized silver halide crystals to black metallic silver.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
NOTES:
DEVELOPER: to chemically reduce the exposed, energized silver halide crystals to black metallic silver.
FIXER: to remove all unexposed and underdeveloped silver halide crystals from the emulsion.
Which ingredient’s main function is to remove all unexposed and underdeveloped silver halide
crystals from the emulsion?
a. Fixing agent
b. Acidifier
c. Hardening agent
d. Preservative
e. None of the above
a. Fixing agent
NOTES:
DEVELOPER: to chemically reduce the exposed, energized silver halide crystals to black metallic silver.
FIXER: to remove all unexposed and underdeveloped silver halide crystals from the emulsion.
Your assistant has processed three panoramic films today. She noticed the films are progressively
getting lighter and lighter. What should be done to correct the problem?
a. Decrease the temperature of the developer
b. Increase the temperature of the fixer
c. Replenish the developer
d. Process the films a second time
e. Decrease the time in the developer
c. Replenish the developer
Your assistant has just processed a film that appears too dark. Identify each of the potential causes of this problem. Select 3.
a. Inadequate time in developer
b. Excessive time in developer
c. Developer solution too cool
d. Developer solution too hot
e. Depleted developer
f. Concentrated developer
b. Excessive time in developer
d. Developer solution too hot
f. Concentrated developer
Dose equivalent is expressed in terms of:
a. Coulombs/kilogram (C/kg)
b. Gray (Gy)
c. Sievert (Sv)
d. Quality factor (QF)
c. Sievert (Sv)
List the following cells from most RADIORESISTANT to most RADIOSENSITIVE.
a. Muscle
b. Small lymphocyte
c. Skin
d. Thyroid gland
a. Muscle
d. Thyroid gland
c. Skin
b. Small lymphocyte
After exposure to radiation, symptoms such as hair loss can occur but not until days after the initial exposure. The time between the initial exposure and onset of symptoms is termed:
a. Latent period
b. Period of cell injury
c. Recovery period
d. Cumulative effects period
a. Latent period
A patient with a large squamous cell carcinoma of the lateral border of the tongue is scheduled for a radical neck dissection. Prophylactic extractions of hopeless teeth must be done to prevent which of the following?
a. Osteoradionecrosis
b. Bisphosphonate osteoradionecrosis
c. Periodontal disease
d. Rampant caries
e. None of the above
a. Osteoradionecrosis
The most common oral problems that occur following radiation and chemotherapy include mucositis, infection, pain and bleeding.
The oral cavity is irradiated during the course of treating radiosensitive oral malignancies, usually
squamous cell carcinoma.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
In the dental x-ray tube, the number of electrons flowing per second is measured by:
a. Kilovoltage peak (kVp)
b. Milliamperage (mA)
c. Time (in seconds)
d. None of the above
b. Milliamperage (mA)
When the PID length is changed from 8” to 16”, the target-receptor distance is doubled. According
to the Inverse Square Law, the resultant x-ray beam is:
a. 1/4 as intense
b. 1/8 as intense
c. Four times more intense
d. Eight times more intense
e. None of the above
a. 1/4 as intense
A 6’5” muscular male with a large mandible requires a complete series of dental images. You plan to increase the kVp because of his size. Identify each of the following that would change as a result to the increased kVp. Select 3.
a. A more penetrating beam
b. A less penetrating beam
c. A reduced subject contrast
d. An increased subject contrast
e. Long scale contrast
f. Short scale contrast
a. A more penetrating beam
c. A reduced subject contrast
e. Long scale contrast
All of the following influence the density of an image EXCEPT one. Which one is the EXCEPTION?
a. kVp
b. mA
c. Exposure time
d. Use of a 2-film packet
d. Use of a 2-film packet
Which of the following supplies electrons necessary to generate x-rays?
a. Positive anode
b. Negative anode
c. Positive cathode
d. Negative cathode
d. Negative cathode
NOTES:
Anode: (+)
Cathode: (-)
Which of the following focuses the electrons into a narrow beam and directs the beam across the
tube toward the tungsten target of the anode?
a. Copper stem
b. Tungsten filament
c. Insulating oil
d. Molybdenum cup
e. Lead collimator
d. Molybdenum cup
Identify each of the following that are properties of x-rays. Select 4.
a. No weight
b. Travel at speed of sound
c. Have no charge
d. Cannot be deflected or scattered
e. Are invisible
f. Are absorbed by matter
g. Do not damage living cells
h. Do not cause fluorescence
a. No weight
c. Have no charge
e. Are invisible
f. Are absorbed by matter
Rectification is the conversion of a direct current (DC) to an alternating current (AC).
The dental x-ray tube acts as self-rectifier in that in changes DC to AC while producing x-rays.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
b. Both statements are false
NOTES:
Rectification is the conversion of AC) to an alternating current (DC).
The dental x-ray tube acts as self-rectifier in that in changes AC to DC while producing x-rays.
Which of the following occurs only at 70 kVp or higher and accounts for a very small part of the x-
rays produced in the dental x-ray machine?
a. Compton scatter
b. Coherent scatter
c. Characteristic radiation
d. General (Bremsstrahlung) radiation
c. Characteristic radiation
All of the following are components of inherent filtration EXCEPT one. Which one is the
EXCEPTION?
a. Insulating oil
b. Unleaded glass window
c. Lead lined PID
d. Tubehead seal
c. Lead lined PID
Identify each of the following that is recommended for operator protection during exposure.
a. Stand 3 feet away from x-ray tubehead
b. Stand at a 45-75 degree angle to the beam
c. Wear a lead apron
d. Stand behind a barrier
e. Hold the PID
f. Hold the film if the patient cannot stabilize it
d. Stand behind a barrier
Prior to x-ray exposure, the proper prescribing of radiographs and the use of proper equipment can minimize the amount of radiation that a patient receives.
Radiographs must be prescribed by the dentist based on the individual needs of the patient.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
Which of the following is used to restrict the size and shape of the x-ray beam and to reduce patient exposure?
a. Aluminum discs
b. Collimation
c. Inherent filtration
d. Total filtration
b. Collimation
If a processed film appears stretched and distorted, which of the following is the likely cause?
a. The film was bent during placement
b. The film was reversed (placed backwards) during exposure
c. The film was exposed twice
d. The patient moved during exposure
a. The film was bent during placement
Of the following factors that influence the geometric characteristics of an image, which one is NOT able to be changed by the operator?
a. Target-receptor distance
b. Object-receptor distance
c. Film composition
d. Focal spot size
e. Object-receptor alignment
d. Focal spot size
A periapical image shows maxillary central incisors which appear very short. Which of the following is the likely cause?
a. Vertical angulation is excessive/too steep
b. Vertical angulation is insufficient/too flat
c. Incorrect horizontal angulation
d. Any of the above
a. Vertical angulation is excessive/too steep
A periapical image shows overlapped contacts. This error is cause by:
a. Vertical angulation is excessive/too steep
b. Vertical angulation is insufficient/too flat
c. Incorrect horizontal angulation
d. Beam not centered over receptor
e. Poor receptor placement
c. Incorrect horizontal angulation
Identify all that are advantages of using the paralleling technique. Select 3.
a. Receptor placement
b. Comfort
c. Accuracy
d. Simplicity
e. Duplication
c. Accuracy
d. Simplicity
e. Duplication
Identify all that are disadvantages of using the bisecting technique. Select 2.
a. Decreased exposure time
b. Can be used without a beam alignment device
c. Distortion
d. Angulation problems
c. Distortion
d. Angulation problems
Identify which of the following is the correct vertical angulation for an exposure of a bite-wing
receptor using a tab.
a. -10 degrees, PID pointed down
b. -10 degrees, PID pointed up
c. +10 degrees, PID pointed down
d. +10 degrees, PID pointed up
c. +10 degrees, PID pointed down
A bite-wing image includes the crowns of maxillary and mandibular teeth, interproximal areas and areas of crestal bone, all on the same image.
Bite-wing images are most useful for identifying interproximal at or just below the contact area on premolars and molars.
a. Both statements are true
b. Both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
The occlusal image may be used for the evaluation of periodontal disease.
The bisecting technique is the preferred periapical exposure method for the documentation of periodontal diseases.
a. Both statements are true
b. both statements are false
c. The first statement is true, the second is false
d. The first statement is false, the second is true
a. Both statements are true
