Quiz 1

Question 1

How does local anesthesia work?
a. it initiates depolarization
b. it blocks depolarization
c. it allows sodium transport across the nerve membrane

Answer 1

b. it blocks depolarization

Question 2

Which of the following makes local anesthetic most effective?
a. rapid injection
b. injecting a larger amount of anesthetic
c. lipid solubility

Answer 2

c. lipid solubility

Question 3

Local anesthetics typically produce vasoconstriction.
a. true
b. false

Answer 3

Correct answer: b. false

Question 4

Amide-type local anesthetics are metabolized in?
a. liver
b. lungs
c. kidneys
d. blood plasma

Answer 4

a. liver

Question 5

Where is the anesthetic Mepivacaine metabolized?

a. liver
b. lungs
c. kidneys
d. blood plasma

Answer 5

a. liver

Question 6

Which of the following is true of the ester classification of local anesthetic agents?

a. the primary bi-product of the metabolism of esters is methemoglobinemia
b. esters are metabolized by the enzyme pseudocholinesterase
c. some metabolism of esters can occur in the lungsd. examples of esters include Lidocaine 2% and Prilocaine 4%

Answer 6

b. esters are metabolized by the enzyme pseudocholinesterase

Question 7

What are the important clinical effects of vasodilation of local anesthetics?
a. it will increase the rate of absorption of the local anesthetic agent into the blood
b. it will decrease the duration of pain control of the local anesthetic agent
c. it will increase the level of local anesthetic in the blood
d. it will increase the potential for overdose
e. all of the above

Answer 7

e. all of the above

Question 8

Local anesthetics can cross the placenta and enter the circulatory system of the fetus.

a. true
b. false

Answer 8

a. true

Question 9

If the use of a certain local anesthetic agent is absolutely contraindicated for a patient, this means:
a. under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction.
b. the agent may be administered to the patient after considering the risk and benefits from its use and if an alternative agent is not available.
c. there is no risk whatsoever from the use of this local anesthetic agent

Answer 9

a. under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction.

Question 10

What type of effects do local anesthetic agents have on the central nervous system (CNS)?

a. they excite the CNS
b. they depress the CNS
c. they have no effect on the CNS
d. both a and b

Answer 10

“desired” answer is
d. both a and b

HOWEVER, symptoms of CNS depression are bi-phasic with temporary signs of CNS excitation (due to depression of normal inhibitory pathways of the CNS). This early loss of inhibition may be absent in some cases

Question 11

While esters are more vasodilating than amides, there is one ester which is an exception and produces vasoconstriction. This drug is:

a. procaine
b. cocaine
c. lidocaine
d. mepivacaine

Answer 11

b. cocaine

Question 12

Factors that influence the blood level of a local anesthetic agent after it has been injected include:

a. the health status of the individual
b. the rate that the drug is absorbed into the cardiovascular system
c. the amount of food the individual has eaten in the past 12 hours
d. answers a and b
e. answers a, b and c

Answer 12

d. answers a and b

Question 13

The metabolic bi-product responsible for allergic reactions to the ester classification of anesthetics is:

a. pseudochalinesterase

b. para-aminobenzoic acid (PABA)

c. propylalanine

d. propranolol

Answer 13

b. para-aminobenzoic acid (PABA)

Question 14

The primary excretory organ for local anesthetics is:

a. liver

b. lungs

c. kidneys

d. intestines

Answer 14

c. kidneys

Question 15

Why would significant renal impairment be a relative contraindication to the use of anesthetics?

a. it could lead to an allergic reaction

b. it will increase the vasodilating effects of the local anesthetic agent

c. it could cause slightly elevated blood levels and an increased potential for toxicity

d. renal impairment is not a relative contraindication to the use of anesthetics

Answer 15

c. it could cause slightly elevated blood levels and an increased potential for toxicity

Question 16

Factors to consider when selecting a local anesthetic agent for your patients include:

a. the length of time that you anticipate you will require pain control for your patient

b. the potential for your patient to have discomfort during the post-treatment time frame

c. the possibility that your patient may self-mutilate themselves while numb

d. determine whether hemostasis will be needed during your procedures

e. all of the above

Answer 16

e. all of the above

Question 17

A patient has received the IA injection for scaling and root planning in the mandibular right quadrant. The procedure has taken longer than expected and the patient is experiencing pain in the area. The injection is repeated, however, this time the patient still expresses that the area remains sensitive. What is the name given to this clinical situation?

a. reverse order
b. tachyphylaxis
c. drug depression
d. impulse conduction

Answer 17

b. tachyphylaxis

Question 18

A high pKa value means:

a. the agent is highly water soluble

b. the agent is highly fat soluble

c. aids in the diffusion of anesthetic into the nerve membrane

d. the pH in the area is high also

Answer 18

a. the agent is highly water soluble

Question 19

Explain the term “half-life” and what it means in relationship to a local anesthetic agent:

a. the time is takes for the local anesthetic to reach half its potential effect on the patient

b. the time it takes for the local anesthetic in the cartridge to lose half its potency

c. the time required for a 50% reduction of the local anesthetic agent in the patient’s blood level

d. the time required for the patient to lose 50% of the sensation in the targeted area

Answer 19

c. the time required for a 50% reduction of the local anesthetic agent in the patient’s blood level

Question 20

Which two body systems are very susceptible to the action of the local anesthetic agents?

a. digestive system and respiratory system

b. digestive system and central nervous system

c. central nervous system and digestive system

d. cardiovascular system and central nervous system

Answer 20

d. cardiovascular system and central nervous system

Question 21

Explain the term “half-life” and what it means in relationship to a local anesthetic agent:

a. the time it takes for the local anesthetic to reach half its potential effect on the patient.
b. the time it takes for the local anesthetic in the cartridge to lose half its potency.
c. the time required for a 50% reduction of the local anesthetic agent in the patient’s blood level
d. the time required for the patient to lose 50% of the sensation in the targeted area

Answer 21

c. the time required for a 50% reduction of the local anesthetic agent in the patient’s blood level

Question 22

For a local anesthetic agent to work it must be both _________and ______soluble.

a. water, protein
b. protein, lipid
c. water, lipid
d. alcohol, water

Answer 22

c. water, lipid

Question 23

How does inflammation in the area of an injection reduce the effect of local anesthetic?

a. The acid environment of the inflamed region makes the pH low which makes the pKa high. Therefore the area is more water soluble.

b. Decreased tissue vascularity increases the blood supply to the area of infection

c. Inflammation in the area of the injection does NOT decrease the effect of local anesthetic

d. None of the above answers are correct

Answer 23

a. The acid environment of the inflamed region makes the pH low which makes the pKa high. Therefore the area is more water soluble.

Question 24

Which of the following is NOT found in a dental anesthetic cartridge?

a. sodium chloride
b. local anesthetic agent
c. vasodilator
d. antioxidant

Answer 24

c. vasodilator