Known Questions

Question 1

What are the signs of loss of CN7 function?

Answer 1

Total facial weakness, forehead sparing weakness

Can be caused by:

LMN – bells palsy, skull fracture, parotid tumour

UMN – stroke, tumour

Question 2

What are the signs of loss of CN11 function?

Answer 2

Weakness turning head away from affected side, weakness shrugging shoulders

Can be caused by:

Polio or stroke

Question 3

What structures are innervated by CN7?

Answer 3

Superior salivary nucleus

Stapedius muscle

Tympanic plexus

Frontalis muscle

Orbicularis oculi

Orbicularis oris

Buccinator

Taste to anterior 2/3rds of the tongue

Question 4

What are the possible causes of VII weakness?

Answer 4

Can be idiopathic - bell’s palsy, melkersson-rosenthal syndrome

Infection - Ear infection, TB, Ramsay hunt syndrome, glandular fever, AIDS

Trauma - Facial laceration, parotid surgery

Neoplastic - primary or secondary cancers, neuroma of VII, acoustic neuroma

Metabolic - diabetes mellitus, sarcoidosis, guillain-barre syndrome

Question 5

What are the warning signs of a stroke?

Answer 5

FAST:

Face drooping

Arm weakness

Speech

Time

Question 6

How can stroke be prevented?

Answer 6

Smoking cessation

Hypertension control

Diabetic control

Atrial fibrillation

Hypercholesterolaemia

Question 7

How damaging is stroke?

Answer 7

Leading cause of long term disability in western countries

3rd most common cause of death

Question 8

How should acute stroke be managed?

Answer 8

Cease dental treatment

Call 000

Give oxygen

Maintain airway

Monitor patient’s vital signs until assistance arrives

Question 9

What is trigeminal neuralgia?

Answer 9

A disorder characterized by recurrent unilateral brief electric-shock like pains abrupt in onset and termination. limited to distribution of one or more divisions of the trigeminal nerve and triggered by innocuous stimuli

Question 10

What are the diagnostic criteria for trigeminal neuralgia?

Answer 10

Recurrent paroxysms of unilateral facial pain in the distribution of one or more divisions of the trigeminal nerve with no radiation beyond.

Pain has all of the following characteristics:

Lasting from a fraction of a second to 2 minutes

Severe intensity

Electric shock-like, shooting, stabbing or sharp in quality

Question 11

What are the characteristics of trigeminal neuralgia pain?

Answer 11

Pain may radiate to another division

Duration can change over time with paroxysms becoming more prolonged

Some attacks appear spontaneously. Doctor should attempt replicating the triggering phenomenon.

Mild autonomic symptoms such as lacrimation and/or redness of the ipsilateral eye.

Following pain there is usually a refractory period where pain cannot be triggered

Question 12

How is trigeminal neuralgia treated?

Answer 12

Surgery:

Peripheral ablative procedures - neurectomy, cryotherapy, alcohol injection

Trigeminal ganglion - radiofrequency, thermocoagulation, glycerol rhizotomy, balloon decompression

Posterior fossa level - microvascular decompression, gamma knife

Medications:

Carbamezapine

Phenytoin

Gabapentin

Pregabalin

Baclofen

Question 13

Where is pain usually felt in a cluster headache?

Answer 13

In and around one eye

Question 14

Where is pain felt in a tension headache?

Answer 14

Pain like a band squeezing the head

Question 15

Where is pain felt in a migraine?

Answer 15

Pain on one side, nausea, and visual changes

Question 16

Where is pain felt for a headache caused by neck pain?

Answer 16

Back of head and top of head

Question 17

What is the concentration of adrenaline in an epipen?

Answer 17

IM adrenaline in epipen is 0.5mg at 1:1000 concentration

Question 18

What is the difference between oral surgery and oral maxillofacial surgery?

Answer 18

Oral surgery:

Only requires a dental degree with postgrad procedures

Mainly intra-oral procedures

Tooth exo, cysts, implants

Maxillofacial surgery:

Require both dental and medical degree

Larger area of face and neck and even the cranial portion

Cancers, orthognathic surgery, TMJ

Question 19

What are DRSABCD?

Answer 19

Danger

Response

Send for help

Airway open

Breathing normal

CPR start:
30:2 compression to breathe ratio
120 compressions per minute
4cm for infants and 5cm for adults

Defibrillator attachment

Question 20

What are the 4Hs and 4Ts of advanced cardiac life support?

Answer 20

Hypovolemia
Hypo/hyperkalaemia
Hypoxia
Hypo/hyperthermia

Thrombosis
Toxins
Tamponade (cardiac)
tension pneumothorax

Question 21

What are the phases of hepatitis?

Answer 21

Incubation period

Preicteric period

Icteric period

Convalescence

Question 22

meds

Answer 22

• Peptic ulcer = should give pain meds and antacids but be careful with antibiotics
• Cimetidine and ranitidine possible bone marrow suppression
• PPI’s may change taste perception
• For UC = consider giving pain medication and prophylaxis if they’re immune compromised but can cause C. Difficile over growth
• Pseudomembranous colitis = penicillin and clindamycin can cause overgrowth of C. Difficile

Question 23

How should HCW respond to HBsAg+ve patient, HBs-ve, and unknown patient following needlestick injury?

Answer 23

HBsAg+ve = HBIG (0.06mL/kg) as soon as possible + initiate hep B vaccine if unvaccinated.
If HCW is vaccinated administer HBIG or 2 doses of HBIG with second 1 month after the first dose.

Question 24

Which drugs can be given for people with peptic ulcers?

Answer 24

Should give pain meds and antacids but be careful with antibiotics

Question 25

What is a possible adverse outcome of cimetidine and ranitidine use?

Answer 25

Possible bone marrow suppression

Question 26

How can PPIs affect patients?

Answer 26

Can change taste perception

Question 27

What medications should be prescribed to patients with ulcerative collitis?

Answer 27

Pain meds and prophylaxis are fine if they’re immunocompromised but this can cause C.difficile overgrowth

Question 28

What medications shouldn’t be given to patients with pseudomembranous colitis?

Answer 28

Penicillin and clindamycin because they can cause C. Difficile overgrowth