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Medical Flashcards

1
Q

Proper management of a dental implant patient about to undergo chemotherapy includes all of the following considerations, EXCEPT:
a. routine use of antibiotics
b. a prechemotherapy dental evaluation by a dentist with expertise in oncology
c. recognition by the dentist of any evidence of implant failures
d. consideration for removal of ailing root forms, blade and subperiosteal implants
that has entered the antrum, which create a risk of fistulization
e. if surgical removal of implants is planned, the oncologist must know the number
of postoperative days to be allowed for oral healing before chemotherapy can
safely begin

A

a. routine use of antibiotics

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2
Q

All of the following statements correctly describe infection in the immunosuppressed
chemotherapy patient, EXCEPT:
a. infection is the most common complication in immunosuppressed chemotherapy patients
b. leucopenia is any situation in which the total number of circulating granulocytes or polymorphonuclear leukocytes is less than normal
c. normal granulocyte level is 3500-4000 cells per cu mm in a healthy individual
d. neutrophilic polymorphonuclear leukocytes are the most numerous of all cell types
found in the acute phase of the inflammatory reaction
e. many chemotherapeutic agents interfere with the action and number of neutrophils
and thereby inhibit phagocytosis

A

c. normal granulocyte level is 3500-4000 cells per cu mm in a healthy individual

On average, a healthy adult has between 4,000 and 11,000 white cells per cubic millimeter or microliter of blood. A high WBC count often means that an infection is present in the body, while a low number can mean that a specific disease or drug has impaired the bone marrow’s ability to produce new cells.

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3
Q 
Which of the following drugs may not cause a dry mouth/throat as a side effect of
drug therapy?
a. diuretics
b. antihistamines
c. atropine
d. anticholinergic
e. salicylic acid
A

e. salicylic acid

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4
Q

All of the following pharmacologic agents interfere with platelet function, EXCEPT:

a. aspirin
b. penicillin
c. cephalosporin
d. alcohol
e. lithium

A

e. lithium

Lithium is used in the treatment of depression.

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5
Q

Which of the following is not a sign of syncope?

a. beads of perspiration on the upper lip
b. weak, thready pulse
c. cold, clammy skin
d. tachycardia
e. pallor

A

d. tachycardia

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6
Q

Complications from local anesthesia include the following, EXCEPT:

a. bacterial contamination
b. hematoma
c. edema
d. after-pain
e. fever

A

e. fever

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7
Q

Which of the following is NOT a feature of Sjogren’s syndrome?

a. increased incidence of lymphoma
b. xerophthalmia
c. increased incidence of connective tissue disease
d. increased incidence of pleomorphic adenoma
e. marked predilection for females

A

d. increased incidence of pleomorphic adenoma

Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland

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8
Q

The cell type involved in Ig-E mediated drug allergies is:

a. mast cell
b. giant cell
c. osteocyte
d. spindle cell
e. basophil

A

a. mast cell
In IgE-mediated reactions, (e.g., urticaria, angioedema, anaphylaxis). drug allergens bind to IgE antibodies, which are attached to mast cells and basophils, resulting in IgE cross-linking, cell activation and release of preformed and newly formed mediators.

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9
Q

A common adverse effect related to the chronic use of aluminum antacids is:

a. nausea and vomiting
b. constipation
c. diarrhea
d. gastrointestinal bleeding
e. none of the above

A

b. constipation

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10
Q

The anti-inflammatory effect of aspirin is due to:

a. an anticoagulant effect
b. an antigen-antibody reaction
c. inhibition of the synthesis of prostaglandins
d. increased membrane permeability of inflamed tissue
e. an increase in cellular immunity

A

c. inhibition of the synthesis of prostaglandins

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11
Q

Which of the following monitors the anticoagulant action of heparin?

a. complete blood count
b. activated partial thromboplastin time
c. prothrombin time
d. bleeding time
e. antiplatelet clotting time

A

b. activated partial thromboplastin time

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12
Q

Hyperthyroidism is accompanied by which of the following?

a. osteoporosis
b. a decrease of calcium and phosphorus in the urine
c. a decrease of faecal calcium
d. a stimulation of bone mineralization
e. an increase in the circulating estrogen

A

a. osteoporosis

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13
Q

In a resting, healthy man, the heart pumps how many liters of blood per minute:

a. 0.8
b. 2 to 3
c. 5 to 6
d. 8 to 10
e. 15 to 18

A

c. 5 to 6

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14
Q

Which of the following statements is true concerning use of medications in
women who are pregnant or breast feeding?
a. Nitrous oxide may be used at all times during pregnancy and while breast feeding
b. Aspiring may be used at all times during pregnancy and while breast feeding
c. Lidocaine (with vasoconstrictor if needed) may be used at all times during pregnancy and while breast feeding
d. Tetracycline may be used at all times during pregnancy and while breast feeding
e. Benzodiazepines and barbiturate should be avoided in the first trimester of pregnancy, but

A

c. Lidocaine (with vasoconstrictor if needed) may be used at all times during pregnancy and while breast feeding

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15
Q

Epinephrine syndrome may include:

a. Tachycardia
b. Increased respiration
c. Increased blood pressure
d. Post operative depression
e. All of the above

A

e. All of the above

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16
Q

Renal insufficiency is associated with significant alteration in the metabolism of drugs. For most NSAIDs the dental practitioner should:

a. reduce the amount administered, keeping the interval constant
b. keep the amount constant, but increaser the interval
c. no change in dosage or interval is necessary for NSAIDs
d. NSAIDs are contraindicated in the end stage of renal disease (ESRD)

A

b. keep the amount constant, but increaser the interval

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17
Q 
The most important agent in the treatment of a toxic (overdose) reaction to a local
anesthetic is:
a. epinephrine
b. benadryl
c. ephedrine
d. oxygen
A

d. oxygen

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18
Q

The most widely held theory for the mechanism of action of local anesthetics is by:
a. blocking acetylcholine from its role as a neurotransmitter at nerve synapses
b. displacing calcium from some membrane site that controls permeability to sodium
c. binding the nerve membrane and changing the electical potential at the membrane surface
d. diffusing the hydrophobic regions of excitable membranes, expanding some critical region(s) in the membrane, thus preventing increased sodium
permeability
e. attaching themselves to specific receptors in the nerve membrane at or near the sodium channel and decreasing or eliminating sodium ion permeability

A

e. attaching themselves to specific receptors in the nerve membrane at or near the sodium channel and decreasing or eliminating sodium ion permeability

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19
Q

The local anesthetic material least likely to cause an allergic response is:

a. ester-type local anesthetics such as procaine and propoxycaine
b. amide-type local anesthetics such as bupivacaine, prilocaine, and mepivacaine
c. methylparaben preservative
d. topical anesthetics such as benzocaine and tetracaine
e. sodium metabisulfate vasoconstrictor preservative

A

a. ester-type local anesthetics such as procaine and propoxycaine

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20
Q

Which of the following is NOT a fat soluble vitamin?

a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin C

A

d. Vitamin C

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21
Q

Pain that is not controlled by the usual over the counter prescription doses of ibuprofen can often be managed by:

a. 600-800 mg. of ibuprofen every 4 to 6 hours
b. 650 mg. of aspirin
c. 200-400 mg. of ibuprofen every 4 hours
d. 600 to 1000 mg. of acetaminophen

A

a. 600-800 mg. of ibuprofen every 4 to 6 hours

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22
Q

A patient who has been undergoing dental treatment for two hours is now experiencing nausea, lethargy, and tachycardia. The patient’s skin feels cold and wet. The patient is most likely experiencing:

a. an anxiety attack
b. a reaction to local anesthesia
c. hypoglycemia
d. myocardial infarction

A

c. hypoglycemia

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23
Q

Which if the following medications are used in treating both congestive hear failure and disorders of the heart beat?

a. Angiotenson converting enzyme inhibitors
b. Digitalis compounds
c. Beta-blockers
d. Diuretics

A

c. Beta-blockers

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24
Q

Which of the following patients would you consider to be a questionable candidate(s) for implant therapy?

a. A relatively active person with diabetes
b. A person with cerebral palsy and minimal control of motor functions
c. An otherwise healthy person with limited salivary flow
d. A middle-aged woman with blood pressure at the low end of normal

A

b. A person with cerebral palsy and minimal control of motor functions

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25
Q

Which of the following is NOT an advantage of acetaminophen over aspirin:

a. No alteration of bleeding time
b. Greater anti-inflammatory action
c. No occult blood loss
d. No appreciable effect on uric acid excretion
e. Less gastric irritation

A

b. Greater anti-inflammatory action

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26
Q 
A patient is to undergo radiation treatment and one of his recently placed implants is failing. You removed the falling implant and make the patient wait how long to start radiation treatment:
A) 7 days
B) 10 days
C) 21 days
D) 45 days
A

D) 45 days?

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27
Q

Patient has Padgets disease, the best option to restore this edentulous patient with the typical cotton wool radiographic appearance is by: Pg61
A) Subperiosteal
B) Conventional removable appliance
C) 5 Root forms.

A

B) Conventional removable appliance

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28
Q

First cell to appear in the inflammation response is:

A

Neutrophils

29
Q

A woman has been on coumadine. A good test to determine if she is a good
candidate for implants Is:
A) Partial thrombin time PTT (Intrinsic Pathway)
Aspirin inhibits platelet function because it interferes with hepatic production of prothrombin by blocking the use of K vitamins
B) PT (Extrinsic Pathway) associated with Liver damage
Long term antibiotics

A

B) PT (Extrinsic Pathway) associated with Liver damage
Long term antibiotics.
International normalized Ratio (INR) Accepted PT are 2.0 to 2.5. Coumadin is a Vit K antagonist, it interferes with synthesis of Prothrombin.

30
Q 
5 minutes into procedure patient starts gasping for air. Patient has no pulse and no respiration: CPR is started and now you should:
F) Administer Solu-Cortef
G) Administer sublingual nitroglycerin
H) Administer sublingual Epinephrine
I) Administer IM -Epinepherine
A

I) Administer IM -Epinepherine

31
Q

A patient with cardiac disease can best be revealed by elevated levels of which;
A) Elevated levels of LDH, SGOT, Potassium
B) Elevated levels of LDH, SGOT, Sodium.

A

A) Elevated levels of LDH, SGOT, Potassium

32
Q 
Which antibiotic chelates calcium and arrests bone growth. Pg 458
A) Amoxicillin
B) Penicillin
C) Ceflaxin
D) Tetracycline
A

D) Tetracycline

33
Q

If the patient has a bleeding disorder what tests would you order?

A

PTT Test- It is used to determine the ability of the blood to coagulate within the vessels. Therefore it tests the intrinsic and common pathways of coagulation.

PT Test- It is used to determine the ability of the blood to coagulate outside the vessels therefore tests the extrinsic and common pathways of coagulation. Both systems are necessary for normal coagulation.

34
Q

Which of these values in a chem. Exam would most likely be abnormal if the patient has cardiac disease?

A

Lactic dehydrogenase (LDH) is an intracellular enzyme presented in all tissues. Normal is o-625 U/L.

35
Q

Which of the following penicillin is also specifically indicated for gram negative organisms?

A

Amoxicillin- Ampicillin was developed in an attempt to extend penicillins spectrum of activity. Unlike Penicillin G & V Ampicillin is active against several gram negative organisms including H. Influenza and Escherichia coli, implicated respectively in sinus and urinary tract infections. Amoxicillin provides an identical antimicrobial spectrum and demonstrates an oral bioavailability greater than that
of either Ampicillin or Penicillin V.

36
Q

When Vancomycin IV is used for pre-operative prophylaxis, it should be administered in doses of not less than two grams:
A. Rapidly to avoid stomach irritation.
B. On an empty stomach.
C. Slowly over a time period of one hour.
D. Only when mixed with dental water

A

C. Slowly over a time period of one hour.

37
Q

What are the characteristics of bactericidal antibiotics?
A. Ability to kill or destroy bacteria.
B. Ability to stimulate body defenses against bacteria.
C. Ability to arrest bacterial growth.
D. Ability to prevent spore maturation

A

A. Ability to kill or destroy bacteria

38
Q

What are the characteristics of bacteriostatic antibiotics?

A

Stops replication by interfering with protein synthesis at ribosome.

39
Q 
Which of the following conditions can be produced when prescribing sedatives for patients on antihypertensive drugs?
A. Increased hypertension
B. Hypotension
C. Endocarditis
D. Nausea
E. Dysphagia
A

B. Hypotension

40
Q

With a negative history of allergy, which of the following antibiotics should be initiated immediately for enteric therapy with post-op purulence?
A. Penicillin G
B. Penicillin V
C. Amoxicillin and Penicillin V
D. Clindamycin
E. Clindamycin, erythromycin and tetracycline
F. Amoxicillin

A

F. Amoxicillin

41
Q

Which of the following is oral bactericidal?
A. Amoxicillin, Pen G, Pen V
B. Amoxicillin, erythromycin
C. Amoxicillin, penicillin and amoxicillin
D. Clindamycin and erythomycin

A

C. Amoxicillin, penicillin and amoxicillin

42
Q 
All of the following medications are contained in an emergency kit to treat anaphylaxis except?
A. Narcan
B. Epinephrine
C. Aminophylline
D. Hydrocortisone
E. Phenergan
A

A. Narcan
Naloxone is a drug used to counter the effects of opioid overdose, for example heroin or morphine overdose.

Epinephrine (Adrenalin) remains a useful medicine for several emergency indications

Aminophylline is less potent and shorter-acting than theophylline. Its most common use is in the treatment of airway obstruction from asthma or COPD.

Hydrocortisone Cortisol, known more formally as hydrocortisone (INN, USAN, BAN), is a steroid hormone, more specifically a glucocorticoid, produced by the zona fasciculata of the adrenal cortex.[1] It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis

Promethazine (Phenergan) is a neuroleptic medication and first-generation antihistamine of the phenothiazine family

43
Q 
All of the following medications are contained in an emergency kit for cardiac arrest except one?
A. Epinephrine
B. Aminophylline
C. Hydrocortisone
D. Meperidine
E. isoproterenol
A

C. Hydrocortisone

Epinephrine (Adrenalin) remains a useful medicine for several emergency indications

Aminophylline is less potent and shorter-acting than theophylline. Its most common use is in the treatment of airway obstruction from asthma or COPD.

Hydrocortisone Cortisol, known more formally as hydrocortisone (INN, USAN, BAN), is a steroid hormone, more specifically a glucocorticoid, produced by the zona fasciculata of the adrenal cortex. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis

Meperidine - Pethidine is often employed in the treatment of postanesthetic shivering. The pharmacologic mechanism of this anti-shivering effect is not fully understood, but it may involve the stimulation of κ-opioid receptors.

Isoprenaline (INN) or isoproterenol (USAN, trade names Medihaler-Iso and Isuprel) is a medication used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma. It is a non-selective beta-adrenergic agonist and structurally similar to adrenaline

44
Q 
Which of the following categories of antibiotics require the strictest compliance due to their mechanism of action?
A. All bactericidal
B. All IM or IV bactericidal
C. All mixed static and cidal
D. All IM or IV static and cidal
E. Static
A

E. Static
A bacteriostatic agent or bacteriostat, abbreviated Bstatic, is a biological or chemical agent that stops bacteria from reproducing, while not necessarily harming them otherwise. Depending on their application, bacteriostatic antibiotics, disinfectants, antiseptics and preservatives can be distinguished. Upon removal of the bacteriostat, the bacteria usually start to grow again. This is in contrast to bactericides, which kill bacteria

45
Q

Which of the following statements is correct when considering the use Of prophylactic antibiotics?
A. An antibiotic should be coordinated with the antibiotic used in the osseous graft material therefore tetracycline is indicated because of its useful ph.
B. A cephlosporin for penicillin allergic patients, to be coordinated with antibiotic used in osseous graft.
C. Amoxicillin should be used because of its excellent bioavailability and activity against strep and enterococci.
D. Sine doxycline, ampicillin and amoxicillin are all types of betalactams, they are ultimately as effective as penicillin.

A

C. Amoxicillin should be used because of its excellent bioavailability and activity against strep and enterococci.

46
Q 
All of the following suggest that efficacious use of anti-inflammatory analgesics with implant surgeries except one, which one is the exception?
A. NSAID's are a class of drugs indicated prophylactically before Implant surgery.
B. Anti-inflammatory analgesics repeatedly perform better in the dental pain relief model than single entity narcotics.
C. Combinations of analgesics that can surpass the analgesic ceiling of individual agents alone can control severe pain.
D. Anti-inflammatory and non-narcotic analgesics have a direct relationship in their effectiveness to reduce inflammation and control pain.
A

D. Anti-inflammatory and non-narcotic analgesics have a direct relationship in their effectiveness to reduce inflammation and control pain.

47
Q 
A patient who was given penicillin post 24 hours after oral administration complains of itching and mild rash, in addition to instructing the patient to discontinue the penicillin prescription for which of the following would be beneficial?
A. Aspirin
B. Erythromycin
C. Dilantin
D. Benadryl
A

D. Benadryl

48
Q

Which of the following hypertension medications alter cardiac rate?
A. Angiotensive converting enzymes, which are acc-inhibitors
B. Beta blockers ?
C. Calcium channel blockers
D. Alpha blockers
E. Thiozide

A

B. Beta blockers ?

They are particularly used for the management of cardiac arrhythmias, protecting the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention)

49
Q 
All of the following hypertension medications alter peripheral resistance except one, which is the one?
A. Ace inhibitors
B. Beta blockers
C. Calcium channel blockers
D. Alpha blockers
E. Thiozide
A

B. Beta blockers

50
Q

The use of non-steroidal anti-inflammatory drugs and gluccosteroids are helpful is reducing post- op edema, which of the following statements is
true regarding their primary mechanism of action?
A. NSAIDs block the release of histamine
B. NSAIDs act upon the cellular phospolipids and gluccosteroids act upon
the cyclo-oxygenase pathway.
C. Both drugs act upon the metabolism of arachodonic acid.
D. NSAIDs act upon the cyclo oxygenase pathway and gloccocortioids
block the release of histamine from mast cells.
E. NSAIDs should not be given concurrently with gluccosteroids.

A

C. Both drugs act upon the metabolism of arachodonic acid.

51
Q

According to the American heart association which of the following is the correct dose in administration of erythromycin
ethyl succinate in SBE prophylaxis?
A. 800mg two hours before, 400mg six hours after
B. One gram orally two hours before, half gram six hours later
C. 300mg, one hour before, 150mg six hours later
D. 800mg, one hour before, 4oomg q6h for two days

A

D. 800mg, one hour before, 4oomg q6h for two days

52
Q

What is the rational for not prescribing aspirin for patients who are taking NSAID?
A. Increase the NSAID duration of action
B. Displace some of the NSAID from its protein binding sites
C. Decrease the absorption of NSAID ?
D. Decrease the effectiveness of the NSAID

A

C. Decrease the absorption of NSAID ?

53
Q 
NSAIDs are contraindicated when a dental patient is taking which of the medications?
A. Appresoline
B. Diuretic
C. Inderal
D. Low sodium diet
A

Inderal (propranolol) is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).

54
Q

Scientific studies about routine antimicrobial oral prophylaxis generally agree that a blood level of antibiotic be present at
the time of wounding and there is no advantage to sustaining medications post operatively for which duration of time?

A

24 hours

55
Q 
Which of the following will cause an increase in eosinophils?
A. Drug toxicity
B. Bacterial infection
C. Viral infection
D. Parasitic infection (also allergy)
E. Diabetes
A

B. Bacterial infection

56
Q 
Which of these values in a blood chemistry exam will most likely be abnormal in a patient with alcoholic-hepatic
disease?
A. Glucose
B. SGOT
C. LDH
D. Total bilirubin
E. Potassium
A

D. Total bilirubin

57
Q 
Which of these values in a chem exam would most likely be abnormal if the patient has cardiac disease?
A. SGOT
B. CPK
C. LDH
D. Total Billirubin
E. Chloride, CO2,BUN
F. Calcium, phosphorus, potassium
A

C. LDH

Lactate dehydrogenase is of medical significance because it is found extensively in body tissues, such as blood cells and heart muscle. Because it is released during tissue damage, it is a marker of common injuries and disease

58
Q

Which of the values in a blood chemistry would most likely be abnormal in a patient with renal disease?
A. Albumin, SGOT, BUN
B. Chloride, CO2
C. Calcium, phosphorus
D. Potassium
E. Chloride, CO2, calcium, phosphorus, potassium

A

C. Calcium, phosphorus

59
Q 
Which of the values in a chem test would be abnormal in a patient who has
undetected diabetes?
A. SGOT
B. BUN
C. LDH
D. Glucose
A

D. Glucose

60
Q 
All of the following are causes of anemia except one?
A. Foliate deficiency
B. Iron deficiency
C. Menstrual blood loss
D. Vitamin B deficiency
E. Vitamin C deficiency
A

E. Vitamin C deficiency

61
Q

All of the following are characteristics related to hypertension except one, which one?
A. The type or class of hypertension medication taken by the patient can Indicate the source of the hypertension.
B. Hypertension can result in peripheral resistance
C. Hypertension can result in cardiac dysfunction
D. Hypertension can result from both peripheral resistance and cardiac dysfunction.
E. Higher levels of blood pressure differentiate secondary hypertension.

A

E. Higher levels of blood pressure differentiate secondary hypertension.

62
Q 
All of the following are considered one of the two phases of wound healing except one, which one is the exception?
A. Blood coagulation
B. Inflammation
C. Maturation
D. Proliferation
A

A. Blood coagulation

63
Q 
Which class of drugs are those that are non-contributory to gingiva hyperplasia?
A. Cycosporins
B. Calcium channel blockers
C. Dilating
D. Beta Blockers
A

D. Beta Blockers

64
Q 
Which of the following active mediators are found in the early phase of inflammation?
A. Lisozymes
B. Collagenase
C. Histamine
D. Histadine
E. Aracodonic acid
A

C. Histamine

65
Q

Which of the following terms or conditions should be applied as a result of medical history information?
A. Steroid therapy is indicated for GI ulcers to prevent swelling of the ulcerated tissue.
B. A three month waiting period is recommended for patients following MI
C. Diabetic patients respond best to stress when blood sugar levels are balanced. Schedule surgery between
meals 2-3 hours after eating.
D. Patients with fordyce spots may have tissue lesions incorporated into the healing incision line.
E. Patients on steroid medication should have antibiotics prescribed since steroids can mimic signs of an
inflammation.

A

C. Diabetic patients respond best to stress when blood sugar levels are balanced. Schedule surgery between
meals 2-3 hours after eating.

66
Q 
All of the following are true of hepatitis A infection except one?
A. High morbidity
B. High mortality
C. May be transmitted by fecal material
D. May be transmitted by blood products.
A

B. High mortality

67
Q 
All of the following are acute features of severe anaphylaxis except one?
A. Bronchi spasm
B. Laryngeal edema
C. Circulatory collapse
D. Renal shut down
E. Skin rash or hives
A

D. Renal shut down

68
Q

All of the following are potential complications that increase the risks of elective surgery on diabetic patients? Except
one
A. Poor or prolonged soft tissue healing
B. Increased susceptibility to secondary infection
C. Increased tendency for associated hypertension?
D. Increased tendency for associated high cholesterol level and coronaryartery disease.
E. Increased tendency for allergic response to NSAIDs and anti-inflammatory.

A

E. Increased tendency for allergic response to NSAIDs and anti-inflammatory.

69
Q

What should you test for cardiac disease?
A. Alkaline Phosphatace
B. Potassium
C. Sodium

A

B. Potassium

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