anesthesia midterm

  1. which of the following is NOT a cardiovascular diseases symptom?
    a. urticaria 
    b. dyspnea
    c. undue fatigue
    d. swollen ankles
    urticaria
  2. For healthy patients, the local anesthetic drug is the controlling agent for all drugs except 2% lidocaine w/ 1:50,000 epinephrine.
    T/F?
    True
  3. All of the following are correct when considering Maximum Recommended Dosages (MRDs), except
    a. mepivacaine = 400 mg (3 mg/lb, 6.6 mg/kg)
    b. articaine = no MRD, (3.2 mg/lb, 7 mg/kg)
    c. lidocaine = 200 mg (2 mg/lb, 4.4 mg/kg)
    d. bupivacaine = 90 mg, (0.9 mg/lb, 2.0 mg/kg)
    lidocaine = 200 mg (2 mg/lb, 4.4 mg/kg)
  4. which of the following would a highly anxious patient be LEAST likely to experience during dental procedures?
    a. High pain reaction threshold
    b. low pain reaction threshold
    c. hyperventilation
    d. syncope
    high pain reaction threshold
  5. how do local anesthetics stop working?
    a. By enzymatic breakdown of the local anesthetic within the neuron itself
    b. By metabolism of the local anesthetic itself in the liver
    c. By reactivation of the chloride channels in the neuronal cell nucleus
    d. By diffusion of the local anesthetic molecules out of the neuron
    By diffusion of the local anesthetic molecules out of the neuron
  6. Amide-linked local anesthetic drugs are metabolized (biotransformed) primarily
    a. these drugs cannot be hydrolyzed therefore cannot undergo biotransformation
    b. in the plasma via microsomal enzymes
    c. in the plasma via pseudocholinesterase
    d. in the kidneys
    e. in the liver via microsomal enzymes
    in the liver via microsomal enzymes
  7. The mesiolingual (mesiopalatal) cusp of the maxillary second molar provides a
    landmark for the height of needle insertion in which of the following techniques?
    a. Inferior alveolar nerve block
    b. Posterior superior alveolar nerve block
    c. Gow-Gates mandibular nerve block
    d. Greater palatine nerve block
    Gow-Gates mandibular nerve block
  8. Upon administration of a left inferior alveolar injection with 1.8 ml of anesthetic
    solution, profound anesthesia is not achieved. Which of the following changes in
    technique is most appropriate to achieve profound anesthesia for this patient?
    a. select a penetration site 5-10 mm inferior to the original injection site
    b. select a penetration 5-10 millimeters lateral to the original injection site
    c. select a penetration site 5-10 millimeters superior to the original injection
    site
    d. no changes to technique are necessary; readminister the injection in the
    same location
    select a penetration site 5-10 mm superior to the original injection site
  9. Epinephrine is metabolized (biotransformed) in the liver. T/F?
    True
  10. Why don't patients always demonstrate the expected duration of anesthesia?
    1. variability of individual response
    2. inaccurate deposition of local anesthetic
    3. tissue status (vascularity, pH)
    4. anatomic variation
    5. type of injection (infiltration/supraperiosteal versus nerve block)

    a. 1 and 2
    b. 1, 2, 3
    c. 1, 2, 3, 4 and 5
    d. 1, 2, 3 and 4
    1, 2, 3, 4 and 5
  11. When using a 30 gauge, short needle to administer the mandibular block, what is the
    main problem likely to occur?
    a. inability to penetrate the medial pterygoid muscle
    b. inability to express solution
    c. inability to get a positive aspiration
    d. inability to reach the proper site of deposition
    inability to reach the proper site of deposition
  12. Which characteristic of a local anesthetic drug determines how well it works without
    a vasoconstrictor?
    a. vasoactivity
    b. pKa
    c. potency
    d. lipophilic ability
    vasoactivity
  13. The TARGET area for the posterior superior alveolar nerve block is
    a. height of the mucobuccal fold above the maxillary first molar
    b. height of the mucobuccal fold above the maxillary second molar
    c. posterior, superior and medial to the posterior border of the maxilla
    d. none of the answers are correct
    posterior, superior and medial to the posterior border of the maxilla
  14. Which one of the following statements is true?
    a. Cardiac stimulation from levonordefrin is lesser compared to epinephrine.
    b. Cardiac stimulation from levonordefrin is equal compated to epinephrine.
    c. Cardiac stimulation from levonordefrin is greater compared to epinephrine.
    Cardiac stimulation from levonordefrin is lesser compared to epinephrine.
  15. Analgesia is the loss of pain, touch, temperature, and pressure. Anesthesia is the absence of pain sensation only.
    a. Both statements are true.
    b. Both statements are false.
    c. The first statement is false; the second statement is true.
    d. The first statement is true; the second statement is false.
    Both statements are false.
  16. Sensory information is supplied for the soft palate by which of the following nerves?
    a. lesser palatine
    b. posterior superior alveolar
    c. greater palatine
    d. nasopalatine
    lesser palatine
  17. Which of the following is not an amide derivative?
    a. All answers are correct
    b. Xylocaine
    c. Prilocaine
    d. Benzocaine
    e. Carbocaine
    Benzocaine
  18. At the onset of vasodepressor syncope, the situation may be reversed very quickly if
    the patient is
    a. seated upright
    b. immediately placed in the supine position
    c. treated with drugs from the emergency kit
    d. asked to dial 911
    immediately placed in the supine position
  19. An oral surgeon requires hemostasis on the palatal tissues in the maxillary left
    quadrant prior to elevating a surgical flap. Which one of the following drugs would
    furnish the most vigorous hemostasis?
    a. 2% lidocaine, 1:50,000 epinephrine
    b. 4% Citanest, 1:200,000 epinephrine
    c. 4% Septocaine, 1:100,000 epinephrine
    d. 2% Carbocaine, 1:20,000 levonordefrin
    2% lidocaine, 1:50,000 epinephrine
  20. The dilution of a vasoconstrictor is best expressed as a ratio such as 1:100,000,
    which represents grams of solute (vasoconstrictor) to total grams of solution. T/F?
    False
  21. Which vasoconstrictor has the greater beta effect?
    a. levonordefrin
    b. epinephrine
    epinephrine
  22. The most common reason cited for missing the inferior alveolar nerve block is
    depositing solution too low. T/F?
    True
  23. The first step in the administration of local anesthetic solutions is which of the
    following?
    a. Thoroughly assess the patient.
    b. Check the flow rate.
    c. Obtain informed consent.
    d. Assemble the armamentarium.
    Thoroughly assess the patient.
  24. In a patient taking Coumadin, which of the following three local anesthetic
    techniques would be the preferred method to prevent a bleeding complication?
    a. Akinosi Nerve Block
    b. Inferior Alveolar Nerve Block
    c. Gow-Gates Nerve Block
    Gow-Gates Nerve Block
  25. Which of the following nerves serves the pulpal tissues of the mandibular molars?
    a. mental nerve
    b. incisive nerve
    c. long buccal nerve
    d. inferior alveolar nerve
    e. lingual nerve
    Inferior alveolar nerve
  26. Your pt weighs 90 lbs. How many milligrams of Articaine 1:100,000
    epinephrine can you provide?
    a. 400
    b. 500
    c. 288
    d. 200
    e. 320
    • 1.8 mg X 4.0mg = 72mg drug/cartridge
    • pt weight is 90lbs x 3.2mg/lb = 288 mg can be given to this pt
  27. In the posterior superior alveolar nerve block in an average-sized adult, the depth of needle penetration from the usual landmark is which of the following?
    a. 10 mm
    b. 16 mm
    c. 20 mm
    d. 25 mm
    e. until bone is contacted
    16 mm
  28. ALL of the following are signs of anaphylaxis EXCEPT
    a. urticaria
    b. difficulty breathing
    c. hypertension
    d. rapid pulse
    hypertension
  29. Local anesthetics work by prevention of neuron
    a. polarization
    b. depolarization
    c. repolarization
    d. none of the answers are correct
    e. All answers are correct
    depolarization
  30. The mylohyoid nerve is a branch of which nerve?
    a. incisive nerve
    b. lingual nerve
    c. infraorbital nerve
    d. inferior alveolar nerve
    inferior alveolar nerve
  31. Why do local anesthetics not work well in infected tissues?
    a. Leukocytes present in inflamed tissue physically block sodium channels in
    the neuronal cell membrane
    b. Pus in infected tissue chemically breaks down the local anesthetic
    molecules
    c. The highly basic environment of inflamed tissue reduces the number of
    ionized molecules necessary for the anesthetic to be actively transported across
    the neuronal cell membrane
    d. The lower pH of infected tissue reduces the number of available nonionized
    local anesthetic molecules to diffuse across the nerve cell membrane
    The lower pH of infected tissue reduces the number of available nonionized local anesthetic molecules to diffuse across the nerve cell membrane
  32. A drug with local anesthetic properties that has inherent vasoconstrictive abilities is
    a. mepivacaine
    b. lidocaine
    c. cocaine
    cocaine
  33. The Gow-Gates injection anesthetizes which of the following nerves?
    a. inferior alveolar, incisive, lingual, auriculotemporal and mylohyoid
    b. inferior alveolar, lingual, auriculotemporal and mylohyoid
    c. inferior alveolar, lingual and mylohyoid
    d. inferior alveolar and lingual
    The correct answer is: inferior alveolar, incisive, lingual, auriculotemporal and mylohyoid
  34. The predominantly base form of lidocaine topical anesthetic is safer than the
    predominantly hydrochloride salt. T/F?
    True
  35. Sodium bisulfite or sodium metabisulfite is added to a dental cartridge to
    a. act as an antioxidant for the local anesthetic
    b. act as an antioxidant for a vasopressor
    c. serve as a diluent
    d. make the solution isotonic
    act as an antioxidant for a vasopressor
  36. Methemoglobinemia is a life-threatening condition that may be precipitated by which
    of the following drugs?
    a. mepivacaine
    b. articaine and prilocaine
    c. bupivacaine
    d. lidocaine
    articaine and prilocaine
  37. When using Levonordefrin, for a healthy patient the dose would be _______ while the
    cardiac compromised dose would be ________.
    a. 1.0 mg, 0.5 mg
    b. 0.2 mg, 0.02mg
    c. 1.0mg, 0.2mg
    d. 2mg, 0.2mg
    e. 1.0 mg, 1.0 mg
    1.0 mg, 0.2 mg
  38. Lidocaine, articaine and mepivacaine are the same as the following (listed in the
    same order):
    a. Zorcaine, Isocaine, Polocaine
    b. Xylocaine, Septocaine and Carbocaine
    c. Xylocaine, Polocaine, Citanest
    Xylocaine, Septocaine and Carbocaine
  39. The mandibular foramen in children lies mesial and more superior to the occlusal
    plane than in adults. The mandibular foramen in children lies at the height of the
    occlusal plane.
    a. Both statements are true.
    b. Both statements are false.
    c. The first statement is false. The second statement is true.
    d. The first statement is true. The second statement is false.
    The first statement is false. the second statement is true.
  40. How do local anesthetics block the nerve impulse from reaching the brain?
    a. By causing massive neurotransmitter release without uptake
    b. By blocking sodium channels, thereby preventing nerve cell depolarization
    and impulse propagation
    c. By overwhelming influx of fluoride ions, thereby changing the resting
    membrane potential
    d. By permanently depolarizing the nerve cell membrane
    By blocking sodium channels, thereby preventing nerve cell depolarization and impulse propagation
  41. The difference between local anesthetic solutions and topical solutions regarding
    active ingredient concentration is
    a. locals have higher concentrations
    b. locals have lower concentrations
    c. locals have the same concentration as topicals
    locals have lower concentrations
  42. Which of the following facilitates the diffusion of topical anesthetics through the
    mucous membrane?
    a. thickness of the tissue
    b. higher concentration of the topical solution
    c. pH of the solution
    d. length of time on the tissue
    higher concentration of the topical solution
  43. Which of the following nerves is NOT anesthetized during the inferior alveolar nerve
    block?
    a. incisive nerve
    b. mental nerve
    c. long buccal nerve
    d. lingual nerve
    long buccal nerve
  44. What is the MRD for vasoconstrictors when administering 4% articaine, 1:100,000
    epinephrine to a normal, healthy patient?
    a. 0.02 mg
    b. 0.1 mg
    c. 0.2 mg
    d. 1.0 mg
    0.2 mg
  45. Which of the following locations is the most successful when using the
    supraperiosteal injections of local anesthetic?
    a. facial surface of posterior maxilla
    b. facial surface of posterior mandible
    c. facial surface of anterior mandible
    d. facial surface of anterior maxilla
    facial surface of anterior maxilla
  46. Potency of a local anesthetic drug is related to
    a. pKa
    b. lipid solubility
    c. none of the answers are correct
    d. diffusability
    lipid solubility
  47. As a group, ester-type local anesthetics are more likely than amide-type local
    anesthetics to provoke which of the following adverse drug reactions?
    a. overdose
    b. allergy
    c. vasovagal syncope
    d. hypertension
    allergy
  48. Which of the following structures does not help form boundaries of the
    pterygomandibular triangle?
    a. parotid gland
    b. sphenomandibular ligament
    c. medial pterygoid muscle
    d. Anterior border of the ramus of the mandible
    parotid gland
  49. The injection site for the AMSA Nerve Block is on the hard palate about halfway
    along an imaginary line connecting the midpalatal suture to the free gingival margin.
    The location of the line is at the contact point between the second and third molars.
    a. Both statements are false.
    b. The first statement is true. The second statement is false.
    c. The first statement is false. The second statement is true.
    d. Both statements are true.
    The first statement is true. The second statement is false.
  50. The ASA (American Society of Anesthesiologists) Physical Status Classification System categorizes patients based on their overall health. Classification III describes
    which one of the following?
    a. severe systemic disease
    b. moribund patient
    c. severe systemic disease that is a constant threat to life
    d. normal, healthy patient
    severe systemic disease
  51. What effect will an anesthetic solution with a lower pH have on onset of action?
    a. faster onset of action than a solution with higher pH
    b. pH of the anesthetic solution has no influence on onset of action
    c. slower onset of action than a solution with higher pH
    slower onset of action than a solution with higher pH
  52. What is the most appropriate injection for a 5-year-old child who needs anesthesia
    for a DO on tooth #J?
    a. Supraperiosteal #J
    b. PSA nerve block
    c. Gow-Gates nerve block
    d. Infraorbital
    e. Inferior alveolar nerve block
    Supraperiosteal #J
  53. How does a nerve conduct an impulse?
    a. By sequential blockade of sodium channels in the cell membrane
    b. By movement of electrons along the nerve as in an electrical wire
    c. By sequential neuron cell membrane depolarization from segment to
    segment or node to node
    d. By rapid influx of chloride ions across the neuronal cell membrane
    By sequential neuron cell membrane depolarization from segment to segment or node to node
  54. Adverse reactions to local anesthetics in dentistry are usually related to:
    a. fear and anxiety
    b. toxic overdose
    c. drug interaction
    d. allergic reaction
    fear and anxiety
  55. For which of the following conditions would you decrease vasoconstrictor dosage?
    a. significant cardiovascular disease, clinical hyperthyroidism
    b. significant cardiovascular disease, liver disease
    c. significant cardiovascular disease, sulfa allergy
    d. significant cardiovascular disease, liver disease, clinical hypothyroidism
    significant cardiovascular disease, clinical hyperthyroidism
  56. Sodium bisulfite is added to a cartridge of anesthetic to increase the stability of the
    a. epinephrine
    b. plasma cholinesterase
    c. distilled water
    d. hydrochloride salt
    epinephrine
  57. A four (4) percent anesthetic solution requires half the dose of anesthetic to reduce the risk of toxicity to the nerves. T/F?
    True
  58. How should the barrel of the syringe be held in the traditional inferior alveolar nerve
    block?
    a. over the contralateral premolars, resting on the mandible
    b. over the contralateral premolars, 8-10 mm above the mandibular occlusal
    plane
    c. over the contralateral cuspid, 8 to 10 mm above the mandibular occlusal
    plane
    d. barrel position is not important in this injection
    over the contralateral premolars, 8-10 mm above the mandibular occlusal plane
  59. Which one of the following is not related to the MRD for 2% lidocaine, 1:100,000
    epinephrine?
    a. 3 cartridges is absolute maximum
    b. 500 mg per appointment
    c. All are related to the MRD for 2% lidocaine
    d. 3.2 mg/lb for a 150 lb patient
    3 cartridges is absolute maximum
  60. What foramen does the mandibular division of the trigeminal nerve (cranial nerve V)
    pass through?
    a. infratemporal foramen
    b. foramen rotundum
    c. superior orbital fissure
    d. foramen ovale
    foramen ovale
Author
mroberts
ID
337943
Card Set
anesthesia midterm
Description
anesthesia midterm
Updated