2. A patient suddenly becomes pale and sweaty after an injection of
4ml of lidocaine 2% with epinephrine l:l00,000. The radial pulse is
slow and steady. The respiration is slow. The blood pressure is
80/60. What is the most probable diagnosis?
A. A toxic reaction to lidocaine.
B. A toxic reaction to epinephrine.
C. An allergic reaction to the local anesthetic.
D. Incipient syncope.
E. An impending adrenal insufficiency.
3. A patient returns with persistent bleeding 5 hours after a tooth has been
removed. Your first step is to
A. inject the area with local anaesthetic.
B. give 10 mg of Vitamin K intra-muscularly.
C. have patient bite on gauze saturated with epinephrine.
D. examine to locate source of bleeding.
E. refer the patient for bleeding and coagulation tests.
It is difficult to obtain satisfactory anesthesia in the presence of infection
near the injection site because
A. the swelling causes increased pressure on the nerves.
B. increased blood supply carries the anesthetic solution away too fast.
C. acidity of the infected tissue inhibits action of the anesthetic agent.
D. alkalinity of the infected tissue inhibits action of the anesthetic agent.
6. The most common complication of a venipuncture is
6. Short-acting barbiturates are metabolized mainly in the
C. small intestine.
6. The psychomotor recovery time from nitrous oxide sedation is
B. 1 to 2 minutes.
C. 10 minutes.
D. 30 minutes.
2. Which of the following does NOT influence the rate of induction during
A. Pulmonary ventilation.
B. Blood supply to the lungs.
C. Hemoglobin content of the blood.
D. Concentration of the anesthetic in the inspired mixture.
E. Solubility of the anesthetic in blood.
8. In a standard dental cartridge (carpule)
containing 1.8ml 2% lidocaine with epinephrine 1/100,000, the amount of
A. 18.0 mg.
B. 0.018 mg.
C. 1.8 mg.
D. 0.18 mg.
E. 180.0 mg.
1 ml contains 0.01mg/ml vasoconstrictor in 1:100,000
Cartridge content= 0.01 x % X 1.8
3.Which of the following would you prescribe for an anxious dental patient with a
(Reserpine is an antipsychotic and antihypertensive drug that has been used for the
control of high blood pressure and for the relief of psychotic symptoms,)
(an anticholinergic, antimuscarinic drug used in motion sickness, nausea and vomiting
C. Silica gel.
(absorbs moisture very well, silica gel packets usually bear warnings for the user not to
eat the contents.)
(It is commonly used to treat anxiety, panic attacks. Pre- or postoperative sedation,
anxiolysis and/or amnesia (e.g., before endoscopic or surgical procedures)
E. Calcium carbonate.
(It is commonly used medicinally as a calcium supplement or as an antacid)
4. Unconsciousness in syncope results from
A. electrolyte imbalance.
B. neurogenic shock.
C. cerebral hyperemia.
D. cerebral hypoxia
Local anaethesia in dentistry p 144
10. In a standard inferior alveolar nerve block, which muscle is penetrated by the
C. Superior constrictor.
E. Medial (internal) pterygoid.
1.A 57 year old man received 10mg of diazepam intravenously. He becomes
unresponsive to verbal stimuli, and his respirations are depressed to 10 per
minute. Appropriate treatment is to
A. administer ephedrine.
B. observe the patient.
C. force the patient to drink coffee.
D. support respiration with oxygen.
Medical observation and supportive care are the mainstay of treatment of
benzodiazepine overdose. 10 mg is not considered an overdose and, thus,
supportive measure most probably should be most important.
Do not give this patients O2 because the HIGH CO2 is no longer stimulating their
respiratory chemoreceptors in the brain. The LOW O2 on the other hand is the only
one left to stimulate the peripheral chemoreceptors, and cause the patient to still
breath. By giving them O2 you will increase it from a LOW O2 concentration to a
HIGH O2 concentration in the blood. This will stop/reduce respiratory
drive/chemoreceptor stimulation. The respiration rate will drop even more and, then, it
Supportive measures observation of vital signs, especially Glasgow Coma Scale and
6. What is the maximum number of cartridges (1.8ml) of a 2 % local anesthetic
solution that can be administered without exceeding a total dose of 300mg?
1 ml contains 10mg LA
Ccartridge content= 10 x % X 1.8
7. After an inferior alveolar nerve block injection, a patient would develop
seventh nerve paralysis if the injection was made into the
A. internal maxillary artery.
B. retroparotid space.
C. internal pterygoid muscle.
D. retromandibular vein.
E. pterygoid plexus of veins.