Term
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Definition
Flat discolored spot,less than 1 cm in size |
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Term
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Definition
| flat discolored spot, larger then 1cm in size |
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Term
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Definition
| soild raised lesion,less then 1cm in diameter |
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Term
|
Definition
| superficial raised lesion, larger then 1cm in diameter |
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Term
|
Definition
soildmass,elevated,marble like lesion larger then 1cm in diameter
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Term
|
Definition
| elevated ,solid ,masess,localized area of skin edma |
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Term
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Definition
| small blistered filled with clear fluid,less then 1cm in diameter |
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Term
|
Definition
| larger fluid filled lesion, larger then 1cm in diameter |
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Term
|
Definition
| small raised pus filled lesion |
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Term
|
Definition
| loss of top layer of skin or mucosa |
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Term
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Definition
| crater like lesion where top two layers of skin or mocusa that are lost |
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Term
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Definition
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Term
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Definition
| individual lesion seperated and distinced one from another |
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Term
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Definition
| dorsa,ventral,right lateral,left lateral,ant-third,mid-third,post-third |
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Term
The metabolic by-product responsible for allergic reactions to the ester classification of anesthetics is:
1. pseudocholinesterase
2. para-aminobenzoic acid
3. propylalanine |
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Definition
| para-aminobenzoic acid (PABA) |
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Term
The primary excretory organ for a local anesthetic agent and its metabolic products is the:
1. liver
2. kidney
3. lungs
intestinal tract |
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Definition
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Term
Why would significant renal impairment be a relative contraindication to the use of ester and amide type anesthetics:
1. it could lead to an allergic reaction
2. it will increase the vasodilating effect of the local anesthetic agent
3. it could cause slightly elevated blood levels and an increased potential for toxicity
4. renal impairment is not a relative contraindication to the use of either esters or amides |
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Definition
| it could cause slighly elevated blood levels and an increased potential for toxicity |
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Term
Which 2 body systems are very susceptible to the action of local anesthetic agents:
1. the digestive system and the respiratory system
2. the digestive system and the central nervous system
3. the central nervous system and the digestive system
4. the cardiovascular system and the central nervous system |
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Definition
| The cardiovascular system and the central nervous system are both very susceptible to the action of local anesthetic agents. |
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Term
What is the brand (proprietary) name for the vasoconstrictor, epinephrine:
1. adrenalin
2. octapressin
3. noradrenalin
4. lidocaine |
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Definition
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Term
In the usual therapeutic doses given in a dental setting, epinephrine is a potent central nervous system stimulant.
1. true
2. false |
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Definition
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Term
What is the brand (proprietary) name for the vasoconstrictor, levonordfrin
neo-cobefrin
2. neo synephrine
3. etidocaine
4. dyclonine |
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Definition
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Term
Generally speaking, levonordefrin has a similar action as epinephrine, but to a lesser degree.
1. true
2. false |
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Definition
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Term
Amides are biotransformed primarily in the:
1. lungs
2. kidney
3. liver
4. urinary tract
5. intestinal tract |
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Definition
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Term
Esters are biotransformed primarily in the:
1. liver
2. plasma
3. intestinal tract
4. kidney |
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Definition
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Term
A1:50,000 concentration of vasoconstrictor has 4 times the amount of vasoconstrictor than a 1:200,000 concentration.
1. true
2. false |
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Definition
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Term
Your patient's medical history indicates that he has significant cardiovascular disease. Which would be the best choice of anesthetic for him
1. Marcaine
2. ravocaine
3. citanest plain
4. xylocaine
a. all of the above
b. none
c. 1 ,2, & 3
d. 2, 3 & 4
e. 1, 3, & 4 |
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Definition
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Term
Your patient has just recived an injection of Marcaine and informs you that there was a burning sensation during the injection. This is due to:
1. the presence of the vasoconstrictor
2. the presence of infection at the site of injection
3. the anesthetic solution is excessively warm
4. the solution was administered too quickly |
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Definition
| the presence of the vasoconstrictor |
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Term
In the previous question, the reason the presence of a vasoconstrictor caused a burning sensation is because:
1. the vasoconstrictor increased the pH of the solution is the cartridge
2. the vasoconstrictor lowered the pH of the solution in the cartridge
3. the vasoconstrictor rendered the solution in the cartridge neutral
4. the vasoconstrictor lowered the pH of the tissues surrounding the injection site |
|
Definition
| the vasoconstrictor lowered the pH of the solution in the cartridge |
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Term
Factors to be considered when slecting a local anesthetic agent for your patients include:
1. the length of time that you anticipate you will require pain control for your patient
2. the potential for your patient to have discomfort during the post-treatment time frame
3. the possibility that your patient may accidentally self-mutilate themselves while numb
4. determining whether hemostasis will be needed during your denta/dental hygiene procedures
5. the medical status of the patient
a. all of above
b. none
c. 1, 2,3 &4
d. 2, 3, 4, & 5
3. 2, 4 and 5 |
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Definition
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Term
Determine the concentration of the local anesthetic agent in a 2% solution lidocaine:
1. 5 mg/ml
2. 15 mg/ml
3. 20 mg/ml
4. 30 mg/ml
5. 40 mg/ml |
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Definition
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Term
Determine the concentration of the vasoconstrictor in a 1:100,000 solution of lidocaine:
1. 0.05 mg/ml
2. 0.02 mg/ml
3. 0.01 mg/ml
4. 0.005 mg/ml |
|
Definition
|
|
Term
| Using the same formula, a 1:200,000 concentration is equal to 0.005 mg/ml (1/200,000 multiplied by 1000 equals 1/200 which is equivalent to 0.005). |
|
Definition
| 1:50,000 concentration =0.02 mg/ml and a 1:20,000 concentration is equal to 0.05 mg/ml |
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Term
If 2 cartridges of 2% lidocaine with 1:100,000 epinephrine are administered to your patinet, what quantity of lidocaine was given:
1. 50 mg
2. 66 mg
3. 72 mg
4. 80 mg
5. 91 mg |
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Definition
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Term
2 cartridges of 2% lidocaine with 1:100,000 epinephrine are administered to your patient, what quantity of epinephrine was given:
1. 0.020 mg
2. 0.030 mg
3. 0.036 mg
4. 0.042 mg
5. 0.050 mg |
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Definition
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Term
If 2 cartridges of 3% mepivicaine plain are administered to your patient, what quantity of mepivicaine was given:
1. 54 mg
2. 60 mg
3. 94 mg
4. 108 mg |
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Definition
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Term
If 4 cartridges of 0.5% bupivicaine with 1:200,000 epinephrine (Marcaine) are administered to your patient, what quantity of bupivicaine was given:
1. 20 mg
2. 36 mg
3. 72 mg
4. 90 mg |
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Definition
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Term
If 4 cartridges of 0.5% bupivicaine with 1:200,000 epinephrine (Marcaine) are administered to your patient, what quantity of epinephrine was give:
1. 0.0036 mg
2. 0.036 mg
3. 0.36 mg
4. 3.6 mg
5. 36 mg |
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Definition
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Term
Calculate the MRD in milligrams for a 120 lb. healthy adult for 3% mepivicaine (Carbocaine):
1. 0.24 mg
2. 2.4 mg
3. 24 mg
4. 240 mg |
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Definition
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Term
Using this same example of 3% mepivacaine (Carbocaine), calculate the MRD is cartridges for a 120 lb. healthy adult:
1. 3.4 cartridges
2. 4.4 cartridges
3. 5.4 cartridges
4. 6.2 cartridges |
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Definition
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Term
Calculate the MRD for a 110 lb. healthy adult in cartridges for .5% bupivacaine (Marcaine) with 1:200,000 epinephrine:
1. .6 cartridges
2. 6.6 cartridges
3. 7.3 cartridges
4. 9 cartridges |
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Definition
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Term
What is the absolute MRD of 2% lidocaine with 1:100,000 epinephrine for a medically compromised cardiac patient:
1. 1 cartridge
2. 2 cartridges
3. 5.5 cartridges |
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Definition
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Term
A 73 year old female, weighing 125 pounds, presents for dental hygiene therapy on the maxillary right quadrant. Her medical history revelas that she had bypass surgery 2 years ago and is being monitored by her physiciian for high blood pressure which is presently controlled by medication.
You decide to administer the following injections: PSA, MSA, ASA, GP and NP and to use 2% lidocaine with 1:100,000 epinephrine (Xylocaine). Can this anesthetic be safely used for this patient:
1. yes, as long as it is used judiciously
2. yes, there are no problems at all with using any type of anesthetic agent with this patient
3. no, this anesthetic is an absolute contraindication
4. no, this patient should not receive any anesthetic agents at this time |
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Definition
| yes, as long as it is used judiciously |
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Term
For the same case as in the previous question, you plan on using 3 cartridges of the local anesthetic (2% lidocaine with 1:100,000 epinephrine) on this patient. Does this amount exceed the MRD for this particular patient:
1. no, 3 cartridges is acceptable
2. yes, this amount exceeds the MRD |
|
Definition
| yes, this amount exceeds the MRD |
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|
Term
A major difference between overdose and allergic reactions is that allergic reactions are not dose related.
1. true
2. fals |
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Definition
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Term
What are the most likely cause(s) of an overdose from a local anesthetic:
1. patient positioned in a supine position during hte injection
2. solution was administered too rapidly
3. solution was inadvertently injected intravascularly
4. solution contained a vasoconstrictor
a. all of above
b. 1 & 2
c. 2 & 3
d. 3 & 4 |
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Definition
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Term
You have begun providing therapy to your patient, and you notice that he is sweating profusely and appears pale. Additionally, his face feels cool to your touch and he isn't responding to your questions about how he is feeling. What is the probable complication:
1. an allergic reaction
2. an overdose reaction
3. syncope
4. infection from the anesthetic |
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Definition
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Term
How would you manage the patient described in the previous question who has fainted:
1. seat the patient in an upright position & administer oxygen
2. recline the patient in a supine position and administer oxygen
3. administer CPR immediately
4. Call 911 immediately |
|
Definition
| recline the patient in a supine position and administer oxygen |
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Term
Upon reviewing your patient's medical history, you note that he has indecated he has atypical pseudocholinesterase. Would this affect your decision to use a local anesthetic agen on him:
1. no, htere would be no contrainidcations to using a local anesthetic
2. yes, he would not be able to tolerate a vasoconstrictor
3. yes, he would not be able to tolerate the amide classification of local anesthetics
4. yes, he would not be able to tolerate the ester classification of local anesthetics |
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Definition
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Term
Of the following injections, which have the highest rates of positive aspiration, which could lead to intravascular injection:
1. PSA
2. MSA
3. IAN
4. Lingual
5. mental/incisive
6. NP
7. GP
a. 1, 2, 3, & 5
b. 1, 3, 5, & 7
c. 2, 3, 4, 5 & 6
d. 1, 3 & 5
e. 6 & 7 |
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Definition
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Term
10 minutes after administering 2% lidocaine with 1:100,000 epinephrine to a healthy female adult, she starts to become very talkative & agitated. You immediately take her vitals & note that her blood pressure & pulse have increased substantially. What is occuring to her:
1. a mild overdose reaction
2. a severe overdose reaction
3. syncope
4. an Allergic reaction |
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Definition
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Term
How would you treat the patient in the previous question who is experiencing a mild overdose reaction to a local anesthetic agent:
1. immediate basic life support
2. IM injection of epinephrine
3. administer oxygen
4. no treatment is necessary - the patient will recover in a few minutes |
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Definition
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Term
Your HIV positive patient presents with severe gingivitis on #18, 19, 20 & 21. These teeth bleed profusely upon gentle probing. You decide to administer an IAN using lidocaine 2% with epinephrine 1:50,000 for hemostasis.
After administering the nerve block, your patient tells you he has a throbbing headache, he becomes dizzy & also perspires profusely. He also states that his heart is pounding.
What appears to have happened
1. overdose of lidocaine
2. allergic reaction to the lidocaine
3. overdose of epinephrine
4. allergic reaction to the epinephrine
5. syncope |
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Definition
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Term
What would be the course of treatment for the preceding patient experiencing an epinephrine overdose:
1. recline the patient so his head & heart are parllel to the floor with his feet slightly inclined
2. no treatment is necessary; this episode is transitory & will be over quickly
3. administer CPR
4. position the patient in a sitting position to minimize any cardiovascular effects |
|
Definition
| position the patient in a sitting position to minimize any cardiovascular effects |
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Term
Immediately after applying lidocaine for a topical anesthetic & administering 3% mepivacaine to your patient, he loses consciousness & begins to convulse. What is the most likely cause of this:
1. epinephrine overdose
2. local anesthetic overdose
3. reaction to using 2 different types of anesthetic
4. allergic reaction to the topical anesthetic
5. allergic reaction to the local anesthetic |
|
Definition
| local anesthetic overdose |
|
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Term
In this instance where the patient is experiencing a severe overdose reaction to a local anesthetic & is experiencing convulsions, what is the recommended management of the situation:
1. 911, basic life support, administer IV anti-convulsant if seizure lasts longer than 4-5 minutes with no signs of terminating
2. position patient in sitting position, monitor vitals for 5 minutes, summon 911 if vitals remain at high levels over 5 minutes
3. position patient in supine position, monitor vitals for 5 minutes, summon 911 if vitals remain at high levels over 5 minutes
4. administer oxygen, administer epinephrine via aerosol inhaler |
|
Definition
| 911, basic life support, administer IV anti-convulsant if seizure lasts longer than 4-5 minutes with no signs of terminating |
|
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Term
Using the same patient experiencing an overdose reaction to a local anesthetic agent, what could be done to prevent this from occurring:
1. deposit the solution slowly
2. deposit the solution in a quick manner
3. use a vasoconstrictor to slow the absorption of hte local anesthetic agent
a. all of above
b. 2 & 3
c. 1 & 3
d. 2 |
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Definition
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Term
Signs of anaphylaxis include:
1. intense itching
2. severe abdominal cramps
3. nausea & vomiting
4. substernal tightness or pain in the chest
5. hypotension
6. convulsions
a. all of above
b. 1, 2, 3 & 4
c. 2, 3, 4, 5 & 6
d. 1, 2, 3, 4, & 5 |
|
Definition
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Term
Your patient, a 35-year old healthy female, indicates on her medical history that she is allergic to penicillin & is 4 months pregnant. Her chief complaint is that she is noticing blood on her toothbrush when she brushes her teeth & that her "gums hurt."
Upon clinical exam, you observe that she has a pyogenic granuloma between her maxillary central incisors & there is moderate to advanced gingival inflammation throughout her mouth, accompanied by large deposits of supra- and sub-gingival calculus.
Your treatment plan includes full-mouth root debridement, to be performed in quadrants in 4 subsequent appointments. Your plan is to use lidocaine 2% with epinephrine 1:100,000.
Is the use of this anethetic contraindicated:
1. yes, epinephrine should not be used on pregnant women
2. yes, lidocaine should not be used on pregnant women
3. no, there are not any contrindications to the use of local anesthetic agents on pregnant women
4. no, however the clinician should be conservative in using any drugs on pregnant women |
|
Definition
| no, however the clinician should be conservative in using any drugs on pregnant women |
|
|
Term
Indications of the use of nitrous oxide include all of the following except:
1. mild apprehension
2. an allergy to local anesthetics
3. presence of an upper respiratory tract infection
4. cerebral palsy
5. hypersensitive gag reflex
6. asthma |
|
Definition
| presence of an upper respiratory tract infection |
|
|
Term
Nitrous oxide acts on the body by:
1. exciting the CNS
2. depressing the CNS
3. exciting the cardiovascular system
4. depressing the cardiovascular system
5. increasing lung capacity |
|
Definition
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Term
Indications that your pt has reached a desirable level of nitrous oxide sedation include all of the following except:
1. BP is increased
2. drosy, relaxed appearance
3. physical relaxation
4. lessened pain reaction
5. tingling or numbness
6. floating sensation |
|
Definition
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|
Term
Indications that your pt has reached an undesirable level of nitrous oxide sedation include the following:
1. flushing of skin
2. slow speech
3. uncontrollable laughing
4. mild perspiration |
|
Definition
| 3. uncontrollable laughing |
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|
Term
The colors of the nitrous oxide & O2 cylinders are
1. red for o2 & green for nitrous
2. blue for O2 & green for nitrous
3. green for O2 & blue for nitrous
4. yellow for O2 & red for nitrous |
|
Definition
| 3. green for O2 & blue for nitrous |
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|
Term
The f(x) of the O2 flush button is to:
1. provide an alarm that will go off when the O2 runs out
2. indicates the rate of flow of the gas
3. reduces the level of nitrous oxide exhaled into the air by the pt
4. fill the reservoir bag w/100% O2 |
|
Definition
| 4. fill the reservoir bag w/100% O2 |
|
|
Term
Nitrous oxide exits the body through the:
1. lungs
2. kidney's
3. liver
4. urinary system
5. digestive system |
|
Definition
|
|
Term
A person's tidal volume is:
1. the amount of air expired in a single breath
2. the amount of air a person needs for 1 respiration cycle
3. the total amount of air utilized in 1 minute
4. the amount of O2 a person needs while receiving nitrous oxide sedation |
|
Definition
| 2. the amount of air a person needs for 1 respiration cycle |
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Term
You are initially preparing your pt to receive nitrous sedation. You have determined that her tidal volume is most likely 6 liters, so you set the O2 flowmeter at this amount. After placing the nose mask comfortably on hernose & assuring that it fits properly, how can you tell that 6 liters of O2 is the correct tidal volume for her:
1. she states that she is breathing comfortabley
2. she states that air is blowing up her nose
3. she states that it is just a bit difficult to breathe
4. her hands & feet begin to tingle |
|
Definition
| 1. she states that she is breathing comfortabley |
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Term
After you have determined you pt's tidal volume (in this example, 6 liters of O2), at which rate would you introduce the nitrous:
1. 0.5 liters/min
2. 1.0 liters/min
3. 1.5 liters/min
4. 2.0 liters/min
5. 2.5 liters/min |
|
Definition
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Term
You have determined that your pt tidal volume is 6 liters. Therefore, you are administering 3 liters of nitrous oxide 7 3 liters of O2 (together 6 liters). What is the dose of nitrous oxide administered to your pt:
1. 33%
2. 50%
3. 65%
4. 75%
5. 80% |
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Definition
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Term
You have determined that your pt tidal volume is 7 liters. Therefore, you are administering 4 liters of nitrous oxide & 3 liters of O2 (together total 7). What is the dose of nitrous oxide administered to your pt:
1. 30%
2. 40%
3. 57%
4. 76% |
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Definition
|
|
Term
What is considered to be the usual range for optimal nitrous oxide-oxygen analgesia:
1. 25%
2. 35%
3. 45%
4. 60%
5. 70% |
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Definition
|
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Term
You have completed wk on your pt 7 administered nitrous oxide-O2 analgesia to him for 30 min. What is your next step:
1. turn off the nitrous, increase the O2 to the tidal volume amount, allow him to breathe 100% O2 for 10 min
2. turn off the nitrous, increase the O2 to the tidal volume amount, allow him to breathe O2 for 5 min
3. turn off the nitrous & the O2, remove the mask, and allow him to relax for 10 min before dismissing him
4. turn off the O2, increase the nitrous to the tidal volume amount, allow him to breathe 100% nitrous for 5 min |
|
Definition
| 1. turn off the nitrous, increase the O2 to the tidal volume amount, allow him to breathe 100% O2 for 10 min |
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Term
While getting ready to dismiss your pt after a long appointment where you had him on nitrous oxide-O2 analgesia for 45 min, he complains of a headache & nause. What most likely is the cause of this:
1. he recievd the nitrous-O2 analgesia for too long aperiod of time
2. he did not recive 100% O2 for a sufficient amount of time after the nitrous was turned off
3. he recieved too much 100% O2 after the nitrous was turned off
4. it has nothing to do with administration of nitrous oxide-O2 |
|
Definition
| 2. he did not recive 100% O2 for a sufficient amount of time after the nitrous was turned off |
|
|
Term
In AZ, it is legal for the dental assistant to administer nitrous-O2 analgesia to a pt:
1. true
2. false |
|
Definition
|
|
Term
In AZ, it is legal for the dental hygienist to administer nitrous oxide-O2 analgesia to a pt when the dentist is not present on the premises:
1. true
2. false |
|
Definition
|
|
Term
In AZ, what requirements must a dental hygienist meet in order to administer nitrous oxide in a dental office:
1. the only requirement is that the individual is a graduate of an accredited dental hygiene program
2. they must pass an anesthesia course, but do not need to hold a certificate for local anesthesia/nitrous oxide administration
3. they must by an AZ licensed dental hygienist, they must pass an anesthesia course, & they must hold the AZ certificate for local anesthesia/nitrous oxide administration |
|
Definition
| 3. they must by an AZ licensed dental hygienist, they must pass an anesthesia course, & they must hold the AZ certificate for local anesthesia/nitrous oxide administration |
|
|
Term
Name the 2 major classifications of local anesthetic agents:
1. lidocaine & epinephrine
2. injectable & infiltratable
3. amides & esters |
|
Definition
|
|
Term
Which of the following is true of the ester classification of local anesthetic agents:
1. the primary by-product of the metabolism of esters is methemoglobinemia
2. esters are metablolized in the plasma by the enzyme pseudocholinesterase
3. some metabolism of esters can occur in the lungs
4. examples of esters include Lidocaine 2% & Etidocaine 1.5% |
|
Definition
| esters are metablolized in the plasma by the enzyme pseudocholinesterase |
|
|
Term
Generally speaking, the effect that most local anesthetic agents have on the vascular bed is:
1. vasodilating
2. vasoconstricting
3. they have no effect |
|
Definition
|
|
Term
Generally speaking, which classification of local anesthetic agents is the MOST vasodilating:
1. amides
2. esters
3. neither-they are both equally vasodilating |
|
Definition
|
|
Term
What are the important clinical effects of vasodilation of local anesthetics
1. it will increase the rate of absorption of the local anesthetic agent into the blood
2. it will decrease the duration of pain control of the local anesthetic agent
3. it will increase the level of local anesthetic in the blood
4. it will increase the potential for overdose
5. all of the above |
|
Definition
|
|
Term
Local anesthetic agents readily cross the placenta & can then enter the circulatory system of the fetus.
1. true
2. false |
|
Definition
|
|
Term
If the use of a certain local anesthetic agent is absolutely contraindicated for a patient, this means:
1. under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction
2. the agent may be administered to the patient after considering the risks and benefits from its use and if an alternative agent is not available
3. there is no risk whatsoever from the use of this local anesthetic agent |
|
Definition
| under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction |
|
|
Term
The allergic reactions that occur from the use of esters are due to:
1. the type of ester that is used
2. the type of topical anesthetic that was used prior to injection
3. the degree of vasodilation of the ester that was used
4. the metabolic by-product of esters |
|
Definition
| the metabolic by-product of esters |
|
|
Term
Explain what the term "half-life" means in relation to a local anesthetic agent:
1. the time it takes for the local anesthetic to reach half its potential effect on the patient
2. the time it takes for the local anesthetic in the cartridge to lose half its potency
3. the time required for a 50% reduction of the local anesthetic agent in the patient's blood level
4. the time required for the patient to lose 50% of the sensation in the targeted area |
|
Definition
| the time required for a 50% reduction of the local anesthetic agent in the patient's blood level |
|
|
Term
What type of effect do local anesthetics have on the central nervous system:
1. they excite the CNS
2. they depress the CNS
3. they have no effect on the CNS |
|
Definition
|
|
Term
Vasocontrictors are added to local anesthetics for which of the following reasons:
1. to counteract the vasodilating effects of the local anesthetic agent
2. to increase the blood flow to the site of the injection
3. to prolong vasodilation
4. to increase the rate at which the local anesthetic is absorbed into the cardiovascular system |
|
Definition
| to counteract the vasodilating effects of the local anesthetic agent |
|
|
Term
The role of vasoconstrictors is to:
1. constrict blood vessels, thereby decreasing the blood flow to the site of injection
2. increase hemostasis
3. reduce allergic reactions
4. increase metabolism of the local anesthetic agent |
|
Definition
| constrict blood vessels, thereby decreasing the blood flow to the site of injection |
|
|
Term
Vasoconstrictors will allow higher volumes of the local anesthetic to remain in & around the nerve for shorter periods of time which will decrease the duration of action of the local anesthetic agent.
1. true
2. false |
|
Definition
|
|
Term
While esters are more vasodilating tha amides, there is one ester which is an exception & produces vasocontriction. This drug is:
1. procaine
2. cocaine
3. lidocaine
4. mepivacaine |
|
Definition
|
|
Term
Local anesthetics are absorbed readily when applied topically to intact skin
1. true
2. false |
|
Definition
|
|
Term
Factors that influence the blood level of a local anesthetic agent after it has been injected include:
1. the health status of the individual
2. the rate that the drug is absorbed into the cariovascular system
3. the amount of food the individual has eaten in the past 12 hours
4. 1 & 2
5. 1, 2, & 3
6 none of the above |
|
Definition
|
|
Term
The metabolic by-product responsible for allergic reactions to the ester classification of anesthetics is:
1. pseudocholinesterase
2. para-aminobenzoic acid
3. propylalanine |
|
Definition
|
|
Term
The primary excretory organ for a local anesthetic agent & its metabolic products is the:
1. liver
2. kidney
3. lungs
4. intestinal tract |
|
Definition
|
|
Term
Why would significant renal impairment be a relative contraindication to the use of ester & amide type anesthetics:
1. it could lead to an allergic reaction
2. it will increase the vaodilating effect of the local anesthetic agent
3. it could cause slightly elevated blood levels & an increased potential for toxicity
4. renal impairment is not a relative contraindication to the use of either esters or amides |
|
Definition
| it could cause slightly elevated blood levels & an increased potential for toxicity |
|
|
Term
Which 2 body systems are very susceptible to the action of local anesthetic agents:
1. the digestive & respiratory
2. digestive & CNS
3. CNS & digestive
4. cardiovascular & CNS |
|
Definition
|
|
Term
What is the brand (proprietary) name for the vasoconstrictor, epinephrine:
1. adrenalin
2. octapressin
3. noradrenaline
4. lidocaine |
|
Definition
|
|
Term
In the usual therapeutic doses given in a dental setting, epinephrine is a potent CNS stimulant
1. true
2. false |
|
Definition
|
|
Term
What is the brand (proprietary) name for the vasoconstrictor, levonordefrin:
1. Neo-Cobefrin
2. Neo-Synephrine
3. Etidocaine
4. Dyclonine |
|
Definition
|
|
Term
Generally speaking, levonordefrin has a similar action as epinephrine, but to a lesser degree
1. true
2. false |
|
Definition
|
|
Term
Amides are biotransformed primarily in the:
1. lungs
2. kidney
3. liver
4. urinary tract
5. intestinal tract |
|
Definition
|
|
Term
Esters are biotransformed primarily in the:
1. liver
2. plasma
3. intestinal tract
4. kidney |
|
Definition
|
|
Term
A 1:50,000 concentration of vasoconstrictor has 4 times the amount of vasoconstrictor than a 1:200,000 concentration.
1. true
2. false |
|
Definition
|
|
Term
A new patient's medical history indicates that the use of a vasoconstrictor is absolutely contraindicated. On the day of her appointment, she is to receive scaling & root planing on her mandibular right quadrant, accompanied by an IAN, lingual & long buccal injection.
You anticipate that it will take you approximately 1 hour to complete this dental hygiene therapy. Which of the following anesthetic agents would be the correct one to use:
1. Duranest
2. Marcaine
3. Citanest Plain
4. Citanest forte |
|
Definition
|
|
Term
Your patient's medical history indicates that he has significant cardiovascular disease. Which would be the best choice of anesthetic for him:
1. Marcaine
2. Ravocaine
3. Citanest Plain
4. Xylocaine
a. all of the above
b. none of the above
c. 1, 2, & 3
d. 2, 3 & 4
e. 1, 3, & 4 |
|
Definition
|
|
Term
A patient has received the IAN, lingual & long buccal injections for dental hygiene therapy in the mandibular right quadrant. The procedure has taken longer than expected & the patient is experiencing pain in the area. The injections are repeated, however, this time patient still expresses that the area reamins sensitive.
What is the name given to this clinical situation:
1. reverse order
2. tachyphylasis
3. drug depression
4. impulse conduction |
|
Definition
|
|
Term
Your patient has just received an injection of Marcaine & informs you that there was burning sensation during the injection. This is due to:
1. the presence of the vasoconstrictor
2. the presence of injfection at the site of injection
3. the anesthetic solution is excessively warm
4. the solution was administered too quickly
5. the presence of the vasoconstrictor is probably the cause of the burning sensation. |
|
Definition
| the presence of the vasoconstrictor is probably the cause of the burning sensation. |
|
|
Term
In the previous question, the reason the presence of a vasoconstrictor caused a burning sensations is because:
1. the vasoconstrictor increased the pH of the solution in the cartridge
2. the vasocontrictor lowered the pH of the solution in the cartridge
3. the vasocontrictor rendered the solution in the cartridge neutral
4. the vasocontrictor lowered the pH of the tissues surrounding the injection site |
|
Definition
| the vasocontrictor lowered the pH of the solution in the cartridge |
|
|
Term
Factors to be considered when selecting a local anesthetic agent for your patients include:
1. the length of time that you anticipate you will require pain control for your patient
2. the potential for your patient to have discomfort during the post-treatment time frame
3. the possibility that your patient may accidentally self-mutilate themselves while numb
4. determine whether hemostasis will be needed during your dental/dental hygiene procedures
5. the medical status of the patient
a. all of the above
b. none of the above
c. 1, 2, 3, & 4
d. 2, 3, 4, & 5
e. 2, 4 & 5 |
|
Definition
|
|
Term
Determine the concentration of the local anesthetic agent in a 2% solution of lidocaine:
1. 5 mg/ml
2. 15 mg/ml
3. 20 mg/ml
4. 30 mg/ml
5. 40 mg/ml |
|
Definition
|
|
Term
Determine the concentration of the vasoconstrictor in a 1:100,000 solution of lidocaine:
1. 0.05 mg/ml
2. 0.02 mg/ml
3. 0.01 mg/ml
4. 0.005 mg/ml |
|
Definition
|
|
Term
If 2 cartridges of 2% lidocaine with 1:100,000 epinephrine are administered to your patient, what quantity of lidocaine was given:
1. 50 mg
2. 66 mg
3. 72 mg
4. 80 mg
5. 91 mg |
|
Definition
|
|
Term
2 cartridges of 2% lidocaine with 1:100,000 epinephrine are administered to your patient, what quantity of epinephrine was given:
1. 0.020 mg
2. 0.0303 mg
3. 0.036 mg
4. 0.042 mg
5. 0.050 mg |
|
Definition
|
|
Term
If 2 cartridges of 3% mepivicaine plain are administered to your patient, what quantity of mepiivaine was given:
1. 54 mg
2. 60 mg
3. 94 mg
4. 108 mg |
|
Definition
|
|
Term
If 4 cartridges of 0.5% bupivicaine with 1:200,000 epinephrine (Marcaine) are administered to your patient, what quantity of bupivicaine was given:
1. 20 mg
2. 36 mg
3. 72 mg
4. 90 mg |
|
Definition
|
|
Term
If 4 cartridges of 0.5% bupivicaine with 1:200,000 epinephrine (Marcaine) are administered to your patient, what quantity of epinephrine was given:
1. 0.0036 mg
2. 0.036 mg
3. 0.36 mg
4. 3.6 mg
5. 36 mg |
|
Definition
|
|
Term
Calculate the MRD (Maximum Recommended Dose) in milligrams for a 120 lb. healthy adult for 3% mepivicaine (Carbocaine):
1. 0.24 mg
2. 2.4 mg
3. 24 mg
4. 240 mg |
|
Definition
|
|
Term
Using this same example of 3% mepivacaine (Carbocaine), calculate the MRD in cartridges for a 120 lb. healthy adult:
1. 3.4 cartridges
2. 4.4 cartridges
3. 5.4 cartridges
4. 6.2 cartridges |
|
Definition
|
|
Term
Calculate the MRD for a 110 lb. healthy adult in cartridges for .5% bupivacaine (Marcaine) with 1:200,000 epinephrine:
1. .6 cartridges
2. 6.6 cartridges
3. 7.3 cartridges
4. 9 cartridges |
|
Definition
|
|
Term
What is the absolute MRD of 2% lidocaine with 1:100,000 epinephrine for a medically compromised cardiac patient:
1. 1 cartridge
2. 2 cartridges
3. 5.5 cartridges |
|
Definition
|
|
Term
A 73 year old female, weighing 125 poinds, presents for dental hygiene therapy on the maixllary right quadrant. Her mdical history reveals that she had bypass surgery 2 years ago & is being monitored by her physician for high blood pressure which is presently controlled by medication.
You decide to administer the following injections: PSA, MSA, ASA, GP & NP & to use 2% lidocaine with 1:100,000 epinephrine (Xylocaine). Can this anesthetic be safely used for this patient:
1. yes, as long as it is used judiciously
2. yes, there are no problems at all with using any type of anesthetic agent with this patient
3. no, this anesthetic is an absolute contraindication
4. no, this patient should not receive any anesthetic agents at this time |
|
Definition
| yes, as long as it is used judiciously |
|
|
Term
For the same case as in the previous question, you plan on using 3 cartridges of the local anesthetic (2% lidocaine with 1:100,000 epinephrine) on this patient. Does this amount exceed the MRD for this particular patient:
1. no, 3 cartridges is acceptable
2. yes, this amount exceeds the MRD |
|
Definition
| yes, this amount exceeds the MRD |
|
|
Term
| Nasopalatine nerve block how much for hygiene procedure? |
|
Definition
|
|
Term
| nasopalatine nerve block what lenght and gauge needle? |
|
Definition
|
|
Term
| nasopalatine nerve block -what penetration and angle ? |
|
Definition
|
|
Term
| nasopalatine nerve block-what penatration site and landmarks? |
|
Definition
| palatal mucosa just lateral to the incisive papilla,cen incisors, and incisive papilla |
|
|
Term
| nasopalatine nerve block-hard tissue anestized? |
|
Definition
| ant protion of the hard palate from the messial of the right first premolar to the mesial of the the first left premolar |
|
|
Term
| nasopalatine nerve block-soft tissue anestized? |
|
Definition
| ant bilatel from right mesial of first premolar to left mesial of first premolar |
|
|
Term
| nasopalatine nerve block-other name? |
|
Definition
|
|
Term
| nasopalatine nerve block-what nerves anesthetized? |
|
Definition
| nasopalatine nerves bilaterally |
|
|
Term
| buccal nerve block-other name? |
|
Definition
|
|
Term
| buccal nerve block-nerves anesthetized? |
|
Definition
|
|
Term
| buccal nerve block-soft tissues anestheized ? |
|
Definition
| soft tissues and periosteum buccal to the mand molar teeth |
|
|
Term
| buccal nerve block- hard tissues anestheized ? |
|
Definition
|
|
Term
| buccal nerve block- lenght and gauge of needle ? |
|
Definition
|
|
Term
| buccal nerve block-penatration and landmarks ? |
|
Definition
| mucous membrane distal and buccal to the most distal molar tooth in the man arch,man molars, mucobuccal fold |
|
|
Term
| buccal nerve block- pen depth and angle ? |
|
Definition
| 1-2 mm,parallel with the occlusal plane on the side of injection but bucccal to it |
|
|
Term
| buccal nerve block-dosage for dental hygiene procedure? |
|
Definition
|
|
Term
| inferior alveolar nerve block-other name? |
|
Definition
|
|
Term
| inferior alveolar nerve block- nerves anestheized ? |
|
Definition
| inferior alveolar,incisive, mental ,lingual |
|
|
Term
| inferior alveolar nerve block-soft tissue anestheized? |
|
Definition
| buccal mucoperiosteum mucous membrane ant to the man first molar,ant too thirds of the tongue and floor of the mouth,lingal soft tissue and periosteum |
|
|
Term
| inferior alveolar nerve block-hard tissue anestheized? |
|
Definition
| man teeth to midline ,body of the man(inferior portion of ramus) |
|
|
Term
| inferior alveolar nerve block- length and gauge? |
|
Definition
|
|
Term
| inferior alveolar nerve block- pen site and landmarks? |
|
Definition
| mucouse membrane on medial side of man ramus,IA nerve,coronoid notch,ptergomandibular raphe |
|
|
Term
| inferior alveolar nerve block- pen depth and angle? |
|
Definition
|
|
Term
| inferior alveolar nerve block- dosage for dental hygiene procedure? |
|
Definition
|
|
Term
| mental nerve block -nerves anesthetized? |
|
Definition
| mental-a terminal branch of the inferior alveolar |
|
|
Term
| mental nerve block-soft tissue anesthetized? |
|
Definition
| buc muocous membrane ant to mental foramen to the midline and skin of the lower lip and chin |
|
|
Term
| mental nerve block-hard tissue anesthetized? |
|
Definition
|
|
Term
| mental nerve block-length and gauge? |
|
Definition
|
|
Term
| mental nerve block- pen site and landmarks ? |
|
Definition
| mucobuccal fold at or just ant to mental foramen ,man premolars |
|
|
Term
| mental nerve block- pen depth and angle? |
|
Definition
| 5-6 mm parallel to the tooth |
|
|
Term
| psa(posterior superior nerve block)-nerves anesthetized? |
|
Definition
| posterior superior alveolar and branches |
|
|
Term
| psa(posterior superior nerve block)-soft tissue anesthetized? |
|
Definition
| pulps of 1st,2nd,3rd molars |
|
|
Term
| psa(posterior superior nerve block)-hard tissue anesthetized? |
|
Definition
| buccal periodontium and bone in max molar region |
|
|
Term
| psa(posterior superior nerve block)-soft hard variances tissue anesthetized? |
|
Definition
| 25% 0f pt mb root of max 1st molar not intervated,deposition lat to PSA may cause degrees of man anesthesia |
|
|
Term
| psa(posterior superior nerve block)- legth and gauge ? |
|
Definition
|
|
Term
| psa(posterior superior nerve block)-pen site and landmark? |
|
Definition
| height of mucobuccal fold above the max second molar,mocobuccal fold ,max tuderosity,zygomatic process of the max |
|
|
Term
| psa(posterior superior nerve block)-pen depth and angle? |
|
Definition
| 16mm upward and inward at a 45 degree |
|
|
Term
| psa(posterior superior nerve block)-dosage for hygiene? |
|
Definition
|
|
Term
| ASA(ant superior alveolar nerve block)-nerves anesthetized? |
|
Definition
| ASA,MSA,infraorbital nerve |
|
|
Term
| ASA(ant superior alveolar nerve block)-soft tissue anesthetized? |
|
Definition
| pulps of the max central incisor through the canine on the injected side,in 72% of the pt max.premolars and mesiobuccal root of 1st molar |
|
|
Term
| ASA(ant superior alveolar nerve block)-hard tissue anesthetized? |
|
Definition
| buccal periodontium and bone in max. incisors to canine |
|
|
Term
| ASA(ant superior alveolar nerve block)-hard/soft tissue variances anesthetized? |
|
Definition
| lower eyelide,lat aspect of the nose ,upperlip |
|
|
Term
| ASA(ant superior alveolar nerve block)-length and gauge of needle? |
|
Definition
|
|
Term
| ASA(ant superior alveolar nerve block)-?pen site and landmarks? |
|
Definition
| height of mucobuccal fold directly over first premolar, mucobuccalfold ,infraorbital foramen/ notch |
|
|
Term
| ASA(ant superior alveolar nerve block)-pen depth and angle? |
|
Definition
| 16mm parallel to the tooth ,5 degree to long axis of tooth |
|
|
Term
| ASA(ant superior alveolar nerve block)-dosage for hygiene procedure? |
|
Definition
|
|
Term
| MSA (middle superior alveolar branch)-nerves anesthetized? |
|
Definition
| ,MSA and terminal branches |
|
|
Term
| MSA (middle superior alveolar branch)-soft tissue anesthetized? |
|
Definition
| pulps of max 1st,2nd premolars,mb root of 1st molar |
|
|
Term
| MSA (middle superior alveolar branch)-hard tissue anesthetized? |
|
Definition
| buccal periodontium and bone in max .premolar region |
|
|
Term
| MSA (middle superior alveolar branch)-soft/hard variances tissue anesthetized? |
|
Definition
|
|
Term
| MSA (middle superior alveolar branch)-pen site and land marks? |
|
Definition
| hieght of mucobuccal fold above the max second premolar , |
|
|
Term
| MSA (middle superior alveolar branch)-pen depth and angle? |
|
Definition
| 5mm parallel to the tooth |
|
|
Term
| MSA (middle superior alveolar branch)-legth and gauge of needle? |
|
Definition
|
|
Term
| MSA (middle superior alveolar branch)-dosage for hygiene procedure? |
|
Definition
|
|
Term
| greater palatine nerve block-other name? |
|
Definition
|
|
Term
| greater palatine nerve block-nerves anesthetized? |
|
Definition
|
|
Term
| greater palatine nerve block-soft tissue anesthetized? |
|
Definition
| overlying soft tissue,ant as far as the first premolar and medially to the midline |
|
|
Term
| greater palatine nerve block-hard tissue anesthetized? |
|
Definition
| post portion of the hard palate |
|
|
Term
| greater palatine nerve block-soft/hard variances tissue anesthetized? |
|
Definition
|
|
Term
| greater palatine nerve block-length and gauge? |
|
Definition
|
|
Term
| greater palatine nerve block-pen site and land marks? |
|
Definition
| soft tissue slightly ant to the greater palatine foramen |
|
|
Term
| greater palatine nerve block-pen depth and angle ? |
|
Definition
| less then 10mm ,right angle to the target area |
|
|
Term
| greater palatine nerve block-dosage hygiene procedure? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| prilocain duration with epi? |
|
Definition
|
|
Term
| prilocain duration without epi? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
Which of the following aesthetics is an ester?
a. Lidocaine
b. Ravocaine
c. Citanest Forte
d. Carbocaine |
|
Definition
|
|
Term
Which of the following is the most potent & efficient vasoconstricting drug used in dental anesthetic solutions?
a. Levophed
b. Cobefrin
c. Neo-cobefrin
d. Epinephrine |
|
Definition
|
|
Term
Pre-operative blood pressures should be taken in a dental office to:
a. provide a baseline BP in the event of a medical emergency
b. establish a diagnose of hypotension
c. Show patients that you are trained in taking BP
d. prevent a malpractice suit |
|
Definition
| a. provide a baseline BP in the event of a medical emergency |
|
|
Term
Which of the following injections will give soft tissue anesthesia to the facial of the mandibular molars & the distal of the second premolar?
a. inferior alveolar
b. long buccal
c. mental
d. lingual |
|
Definition
|
|
Term
After giving a PSA, the first molar remains sensitive, but the second & third molars are anesthtized, the best explanation would be:
a. aesthetic solution deposited too high
b. not enough solution deposited
c. the mesial buccal root is normally not anaesthetized by the PSA
d. the root is normally not anaesthetized by the PSA palatal |
|
Definition
| c. the mesial buccal root is normally not anaesthetized by the PSA |
|
|
Term
The guage with the smallest lumen is?
a. 23
b. 27
c. 25
d. 30 |
|
Definition
|
|
Term
What signs would a patient demonstrate if a local anesthtic containing epinephrine was mistakenly injected directly into a blood vessel?
a. saliva becomes water
b. heart rate slows
c. blood pressure increases
d. muscles of mastication contract |
|
Definition
| c. blood pressure increases |
|
|
Term
Whithin seconds after a posterior superior alveolar injection, a patient's face become extremely distended & swollen at the injected site. Immediate tratment would be to:
a. use cold packs & pressure on this side
b. administer an antihistamine
c. incise & drain
d. apply heat |
|
Definition
| a. use cold packs & pressure on this side |
|
|
Term
The teeth innervated by the posterior superior alveolar nerve are:
a. maxillary third molar, second molar, & distobuccal & palatal roots of the first molar
b. maxillary third, second, & first molars
c. maxillary first premolar, second premolar & mesiobuccal root of the first molar |
|
Definition
| a. maxillary third molar, second molar, & distobuccal & palatal roots of the first molar |
|
|
Term
Oxygen should NOT be given in which of the following office emergency situations:
a. myocardial infarction
b. angina pectoris
c. hyperventilation
d. congestive heart failure |
|
Definition
|
|
Term
In a block injection
a. the solution is deposited on the periosteum opposite the apices of the roots of certain teeth
b. the solution is deposited so that it penetrates the nerve trunk at the point of deposit
c. the solution is carried by diffusion through the periosteum |
|
Definition
| b. the solution is deposited so that it penetrates the nerve trunk at the point of deposit |
|
|
Term
The inferior alveolar nerve is responsible for sensation to what oral structures?
a. lingual tissue from canine to canine
b. buccal tissue of molars & vestibular cheek in mandibular molar region
c. lingual & buccal tissues of one quadrant, anterior 2/3 of tongue, floor of mouth
d. mandibular teeth in one quadrant, labial tissue from premolar to midline |
|
Definition
| c. lingual & buccal tissues of one quadrant, anterior 2/3 of tongue, floor of mouth |
|
|
Term
If an individual is allergic to procaine, they should NOT be given
a. lidocaine
b. prilocaine
c. tetracaine
d. mepivacaine |
|
Definition
|
|
Term
Too much aesthetic has been administered & toxicity occurs; what signs will the patient exhibit?
a. depression
b. stimulation
c. stimulation then depression
d. depression then stimulation |
|
Definition
| c. stimulation then depression |
|
|
Term
Allergy to amide type local anesthetic is virtually non-existent
a. true
b. false |
|
Definition
|
|
Term
This injection is required for anesthesia of the buccal gingiva of the mandibular posterior teeth & buccal vestibule.
a. inferior alveolar
b. PSA
c. infiltration
d. naopalatine
e. long buccal |
|
Definition
|
|
Term
This injection should only be used on maxilla due to bone density when compared to the mandibular bone
a. inferior alveolar
b. PSA
c. infiltration
d. nasopalatine
e. long buccal |
|
Definition
|
|
Term
A frequent complication is a hematoma.
a. inferior alveolar
b. PSA
c. infiltration
d. nasopalatine
e. long buccal |
|
Definition
|
|
Term
To perform this injection: Locate landmarks-internal & external oblique ridge, coronoid notch, pterygo-mandibular raphe.
a. inferior alveolar
b. PSA
c. infiltration
d. nasopalatine
e. long buccal |
|
Definition
|
|
Term
During this injection, watch for blanching of tissue when administering anesthetic
a. inferior alveolar
b. PSA
c. infiltration
d. nasopalatine
e. long buccal |
|
Definition
|
|
Term
Lidocaine is the brand name ___ is the appropriate generic name.
a. carbocaine
b. citanest
c. novocaine
d. xylocaine |
|
Definition
|
|
Term
Mepivacaine is the brand name ___ is the appropriate generic name.
a. carbocaine
b. citanest
c. novocaine
d. xylocaine |
|
Definition
|
|
Term
Prilocaine is the brand name ___ is the appropriate generic name.
a. carbocaine
b. citanest
c. novocaine
d. xylocaine |
|
Definition
|
|
Term
Procaine is the brand name ___ is the appropriate generic name.
a. carbocaine
b. citanest
c. novocaine
d. xylocaine |
|
Definition
|
|
Term
Lidocaine is a ___ type of drug.
a. amide
b. ester |
|
Definition
|
|
Term
Mepivacaine is a ___ type of drug.
a. amide
b. ester |
|
Definition
|
|
Term
Prilocaine is a ___ type of drug.
a. amide
b. ester |
|
Definition
|
|
Term
Procaine is a ___ type of drug.
a. amide
b. ester |
|
Definition
|
|
Term
The immediate treatment for a hematoma is?
a. apply heat
b. apply cold |
|
Definition
|
|
Term
Using the most conservative recommendation, what is the MSD (max safe dosage) of lidocaine with epinephrine 1:100,000, for an average weight, middle aged adult?
a. 2 cartridges
b. 8 cartridges
c. 10 cartridges
d. 6 cartridges |
|
Definition
|
|
Term
The MSD of citanest plain 4% is ___ the MSD (max safe dose) of plain lidocaine 2%.
a. greater than
b. less than |
|
Definition
|
|
Term
The patient has a periodontal abscess on the distal of #15. You have given a PSA & additional anesthesia infiltration above the root into the abscessed area. The patient continues to have discomfort. The most likely reason for inadequate anesthesia is because:
a. The capillaries are in a hypotonic state becasue of the abscess
b. there is increased pressure on the nerves due to the swelling
c. the acidity produced by inflammation inhibits the action of the anesthetic
d. the anesthetic has been diluted by increased fluids in the area |
|
Definition
| c. the acidity produced by inflammation inhibits the action of the anesthetic |
|
|
Term
During the insertion phase of an injection, the patient complains of a momentary senstion of an electric shock. You have MOST likely:
a. contacted the nerve sheath with the needle
b. severed a small nerve fiber with the needle
c. injected too rapidly
d. injected before the topical anesthetic has taken effect |
|
Definition
| a. contacted the nerve sheath with the needle |
|
|
Term
Epinephrine is an antagonist to insulin & may produce hyperglycemia; therefore, epinephrine should be limited or not used in patients with Diabetes Mellitus
a. true.
b. false |
|
Definition
|
|
Term
This injection provides anesthesia to the tissues lingual to the maxillary anteriors.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
|
|
Term
This injection would anesthetize the buccal mucosa opposite tooth numbers 28, 27, 26, & 25
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
|
|
Term
This injection utilizes the inferior border of the zygoma, muco-buccal fold, & the maxillary tuberosity as penetration site landmarks.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
| posterior superior alveolar |
|
|
Term
The maxillary second molar is planned for root debridement, select the injection necessary to provide complete anesthesia.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
| posterior superior alveolar |
|
|
Term
The mandibular third molar is planned for root debridement, select the injection necessary to provide complete anesthesia.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
|
|
Term
The mandibular canine incisor is planned for root debridement, select the injection necessary to provide complete anesthesia.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
|
|
Term
The mandibular first molar is planned for root debridement, select the injection necessary to provide complete anesthesia.
a. nasopalatine
b. posterior superior alveolar
c. inferior alveolar
d. long buccal
e. mental |
|
Definition
|
|
Term
Which of the following may have an effect on the degree of anesthesia:
a. ph of the tissue
b. too rapid absorption of solution
c. use of a vasoconstrictor
d. all of the above |
|
Definition
|
|
Term
People with cholinesterase deficiency should NOT be given which type of local aesthetic
a. amide
b. ester |
|
Definition
|
|
Term
When an injection damages a muscle resulting in limitations of muxcle movement, the condition is known as:
a. fasciculation
b. tie douloureax
c. parastnesia
d. trismus |
|
Definition
|
|
Term
The BEST way to avoide systemic toxicity when using a local anesthtic solution is to:
a. reduce the amount of vasoconstrictor
b. inject slowly
c. use warmed anesthetic
d. aspirate before injection |
|
Definition
| aspirate before injection |
|
|
Term
The potency of an anesthetic agent is directly proportional to its:
a water solubility
b. protein solubility
c. lipid solubility
d. carbohydrate solubility |
|
Definition
|
|
Term
Amide local aesthetics are metabolized in which of the following:
a. liver
b. kidney's
c. blood plasma |
|
Definition
|
|
Term
When a patient is allergic to both ester & amide anesthetic agents, the drug with anesthetic properties that could be used is a (an):
a. antibiotic agent
b. anticoagulant agent
c. antihistamine agent
d. hypoglycemic agent |
|
Definition
|
|
Term
Local anesthetics work by producing a conduction block that decreases the premeability of the nerve membranes:
a. calcium ions
b. potassium ions
c. sodium ions |
|
Definition
|
|
Term
For a normal healthy adult patient, the max amount of vasoconstrictor would be .2 mg per appointment. Using a 1:100,000 concentration, the max # of milliliters of anesthetic solution recommended for this patient should be: (hint 1:100,000 contains .01 mg/ml)
a. 2 ml
b. 12 ml
c. 20 ml |
|
Definition
|
|
Term
Which cranial nerve is involved with the sensory innervation of the teeth, bone and soft tissues of the oral cavity:
1. Oculomotor
2. Trochlear
3. Trigeminal
4. Facial
5. Hypoglossal |
|
Definition
|
|
Term
After administering a left inferior alveolar nerve (IAN) block to your patient, #23 & #24 are still sensitive, even though the other teeth in the quadrant are numb. It appears these teeth have not received adequate anesthesia. What could be the cause of this:
1. overlap of sensory fibers from the right side.
2. a long buccal injection is needed to anesthetize #23 & #24
3. inadequate local anesthetic agent was administered
4. the area of insertion of the needle was too superior
5. the area of insertion of the needle was to inferior |
|
Definition
| 1. overlap of sensory fibers from the right side. |
|
|
Term
After administering a right inferior alveolar nerve (IAN) block to your patient, the first molar is still sensitive, even though the other teeth in the quadrant are numb. What could be the cause of this:
1. the are of insertion of the needle was too superior
2. the area of insertion of the needle was too inferior
3. the local anesthetic agent that was used lacked a vasoconstrictor
4. innervation of this tooth is being supplied by the mylohyoid nerve
5. there is cross-over innervation from the inferior alveolar nerve on the opposite side |
|
Definition
| 4. innervation of this tooth is being supplied by the mylohyoid nerve |
|
|
Term
Name the nerve which provides sensory innervation to the palatal gingiva of the maxillary first molar:
1. naopalatine
2. greater palatine
3. anterior superior alveolar
4. middle superior alveolar
5. lingual |
|
Definition
|
|
Term
Name the nerve which provides sensory innervation to the buccal gingiva of the mandibular molars & the mucobuccal fold in that region:
1. inferior alveolar
2. incisive
3. mental
4. long buccal
5. lingual |
|
Definition
|
|
Term
Name the nerve which provides sensory innervation to the lingual gingiva of the mandibular molars
1. inferior alveolar
2. lingual
3. mental
4. incisive |
|
Definition
|
|
Term
Name the nerve which provides sensory innervation to the pulp of the maxillary 1st molar:
1. posterior superior alveolar
2. anterior superior alveolar
3. infraorbital
4. mental |
|
Definition
| 1. posterior superior alveolar |
|
|
Term
If a hematoma appears after the posterior superior alveolar injection (PSA), it is most likely due to:
1. anesthetic agent injected too quickly
2. the lack of a vasoconstrictor in the anesthetic agent
3. needle inserted too far poteriorly into the pterygoid plexus of veins
4. a 25 gauge needle was used in place of a gauge needle |
|
Definition
| 3. needle inserted too far posteriorly into the pterygoid plexus of veins |
|
|
Term
A local anesthetic can safely be injected into areas of inflammation & infection, & adequate anesthesia will be achieved.
1. true
2. false |
|
Definition
|
|
Term
In areas of inflammation & infection, what can be done to maximize the effectiveness of the local anesthetic agent:
1. move away from the area of inflammation & inject further up the nerve branch
2. deposit a large amount of anesthetic agent than normal
3. deposit a smaller amount of anesthetic agent than normal
4. avoid using topical anesthetic
5. both 1 & 2
6. none of the above |
|
Definition
|
|
Term
The myelin sheath & the nodes of Ranvier on a myelinated nerve fiber enable a nerve's impusle to:
1. conduct impulses at a much faster rate than an unmyelinated nerve of equal size
2. conduct impulses at a much slower rate than an unmyelinated nerve of equal size
3. the myelin sheath & nodes of Ranvier have no effect on a nerve's impulse |
|
Definition
| 1. conduct impulses at a much faster rate than an unmyelinated nerve of equal size |
|
|
Term
When a stimulus excites a nerve, the following sequence of events occurs:
1. slow depolarization, followed by rapid depolarization, & then reversal of the electrical potential acorss the nerve membrane leaving the interior of the nerve electrically positive in relation to the negative exterior
2. slow depolarization, followed by a neutralization of the interior & the exterior of the nerve
3. rapid depolarization resulting in the nerve achieving its resting potential |
|
Definition
| 1. slow depolarization, followed by rapid depolarization, & then reversal of the electrical potential acorss the nerve membrane leaving the interior of the nerve electrically positive in relation to the negative exterior |
|
|
Term
Because the mandible consists of denser cortical bone than the maxilla, the incidence of clinically adequate anesthesia is higher in the mandible.
1. true
2. false |
|
Definition
|
|
Term
For a pediatric patient, in which of the following situations may it be difficult to achieve anesthesia:
1. inferior alveolar nerve block
2. nasopalatine nerve block
3. buccal nerve block
4. infiltration of maxillary first molars
5. infiltration of maxillary central incisors |
|
Definition
| 4. infiltration of maxillary first molars |
|
|
Term
The process of saltatory conduction:
1. is the manner in which impulse conduction occurs in myelinated nerves
2. produces faster & more energy efficient conduction
3. is more rapid in a thicker axon
4. progresses from one node to the next in a stepwise fashion
5. all of the above
6. 1 & 3 only
7. 2 & 4 only |
|
Definition
|
|
Term
The posterior superior alveolar nerve provides sensory innervation to:
1. pulp of the maxillary teeth to the midline
2. palatal gingiva to the midline
3. pulp of the maxillary molars excluding the mesiobuccal root of the maxillary first molar
4. buccal gingiva overlying the maxillary molars
5. anterior 2/3 of the tongu
a. 1 & 2
b. 2, 3 & 4
c. 3 & 4
d. 1, 2, & 3
e 5 only |
|
Definition
|
|
Term
Why is it critical to aspirate prior to depositing any anesthetic solution into a patient's tissues?
1. to determine if the operator has reached the correct depth
2. to verify that the operator isn't in a blood vessel prior to depositing the solution
3. to verify that the opeator isn't in CT prior to depositing the solution
4. It isn't critical to aspirate prior to depositing anesthetic sol. |
|
Definition
| 2. to verify that the operator isn't in a blood vessel prior to depositing the solution |
|
|
Term
What gauge needle has the smallest diameter?
1. 30-gauge
2. 27 gauge
3. 25 gauge |
|
Definition
|
|
Term
What is an advantage of using a larger gauge needle (such as a 25-gauge) over a smaller gauge needle (such as a 30-gauge):
1. There is less defection of the needle with larger gauge
2. Less deflection of tissues leads to greater accuracy of injecting at the proper site of deposition when using a larger gauge
3. Needle breakage is less likely to occur when a larger gauge is used
4. It is easier to perform aspiration with a larger gauge needle
a. 1, 3 & 4
b. 1, 2 & 3
c. 2 & 4
d. all of the above
e. none of the above |
|
Definition
|
|
Term
It is an acceptable practice when giving an injection to penetrate the tissues up to the hub of the needle.
a. true
b. false |
|
Definition
|
|
Term
How can the clinician easily determine the gauge of a needle:
1. 30-gauge blue, 27 gauge yellow, 25 gauge red
2. 30-gauge yellow, 27 gauge red, 25 gauge blue
3. 30 gauge red, 27 gauge blue, 25 gauge blue
4. 30 gauge green, 27 gauge yellow, 25 gauge red |
|
Definition
| 1. 30-gauge blue, 27 gauge yellow, 25 gauge red |
|
|
Term
Your patient requires anesthesia for multiple teeth in the mandibular left quadrant. What length needle should be used:
1. a short needle
2. a long needle
3. it doesn't matter-both will work equally well |
|
Definition
|
|
Term
The proper manner to dispose of a needle after it has been used is:
1. "scoop" the cap back into the needle, snap the cap on, & then dispose in a Sharp's container
2. place the cap on the needle, bend the needle at the hub, & then dispose in a Sharps' container
3. autoclave the needle & then dispose in a Sharp's container
4. autoclave the syringe with needle still attached & then dispose in the office trash receptacle |
|
Definition
| 1. "scoop" the cap back into the needle, snap the cap on, & then dispose in a Sharp's container |
|
|
Term
It is recommended that anesthetic cartridges be allowed to soak in either an alcohol or a sterilizing solution to assure asepsis:
1. true
2. false |
|
Definition
|
|
Term
Bubbles of approximately 1-2mm found in anesthetic cartridges are:
1. an indication that the cartridge has been contaminated
2. an indication that the cartridge has been dropped
3. unsafe to use as it indicates that oxygen has seeped into the cartridge
4. not a concern |
|
Definition
|
|
Term
The phase of conduction affected by local anesthetics is the repolarization phase.
1. true
2. false |
|
Definition
|
|
Term
When administering local anesthesia to a pediatric patient, the following is true:
1. maxillary & mandibular bones are less dese than in an adult patient, therefore the anesthetic solution will diffuse through the bone more rapidly
2. maxillary & mandibular bones are more dense than in an adult patient, therefore the anesthetic solution will not diffuse readily through the bone
3. an increased depth of penetration is necessary than in an adult patient
4. a decreased depth of penetration is necessary than in an adult patient
a. 1 & 3
b. 2 & 4
c. 1 & 4
d. 2 & 3 |
|
Definition
|
|
Term
The periodontal ligament injection (PDL) is contraindicated for deciduous teeth because:
1. the injection technique is too painful for children
2. innervation of the decduous teeth is unpredictable, therefore the PDL injection is unreliable
3. it can cause enamel hypoplasia in the permanent tooth that is developing just beneath the deciduous tooth
4. the decreased density of the bone surrounding deciduous teeth will not allow diffusion of the anesthetic solution |
|
Definition
| 3. it can cause enamel hypoplasia in the permanent tooth that is developing just beneath the deciduous tooth |
|
|
Term
What significance does the coronoid notch have when administering the inferior alveolar nerve block:
1. the operator places their index finger or thumb in the coronoid notch to help determine the height of the injection
2. the operator places their index finger or thumb in the coronoid notch to help determine the penetration depth of the injection
3. the coronoid notch helps determine the site to administer the lingual nerve block if that is to follow the inferior alveolar nerve block
4. the coronoid noth has no importance in determineing anything of significance for the inferior alveolar nerve block |
|
Definition
| 1. the operator places their index finger or thumb in the coronoid notch to help determine the height of the injection |
|
|
Term
The concentration of the local anesthetic drug (for example, lidocaine) found in topical anesthetics is usually greater than if that same agent were administered by injection.
1. false
2. true |
|
Definition
|
|
Term
Which of the following vasoconstrictors is found in topical anesthetic agents.
1. Epinephrine
2. Neo-Cobefrin
3. Levophed
4. none of the above |
|
Definition
|
|
Term
The most common topical anesthetic, benzocaine, falls under which drug classification;
1. amide
2. ester |
|
Definition
|
|
Term
Your patient is a 56-year old woman who informs you that she is allergic to PABA (para-aminobenzoic acid). Which of the following topical anesthetics could you use when treating her:
1. benzocaine
2. tetracaine
3. lidocaine
4. dyclonine hydrochloride
a. 1, 2 & 3
b. 2 & 3
c. 1 & 4
d. 3 & 4
e. 1, 2, 3, & 4 |
|
Definition
|
|
Term
For the same patient as in the preceding question (a 56-year old woman who informs you that she is allergic to PABA), you notice that she is experiencing pain as you are administering her last injection. She has received a PSA, MSA< ASA, GP & you are about to administer the NP. What are some things you should confirm prior to the next injection:
1. is the needle dull?
2. is there a barb on the end of the needle?
3. is she allergic to the local anesthetic you are using?
4. is she allergic to the topical anesthetic you are using?
a. all of the above
b. 1 & 2
c. 3 & 4
d. 1, 3 & 4 |
|
Definition
|
|
Term
The optimal temperature for the local anesthetic solution prior to injection is:
1. room temp.
2. warmed a few degrees above room temp.
3. cooled a few degrees below room temp.
4. any temp. for the solution is fine |
|
Definition
|
|
Term
The ideal seating position for a patient about to receive an injection is:
1. sitting upright
2. sitting upright with feet slightly elevated
3. laying so entire body is parallel to floor
4. laying with the head & heart parallel to the floor with the fee slightly elevated |
|
Definition
| 4. laying with the head & heart parallel to the floor with the fee slightly elevated |
|
|
Term
One key to obtaining an atraumatic injection is:
1. stretch the tissues taut prior to inserting the needle
2. jiggling the lip as the needle is inserted
3. pulling the soft tissues over the needle tip for insertion |
|
Definition
| 1. stretch the tissues taut prior to inserting the needle |
|
|
Term
For adequate aspiration, the thumb ring on the syringe must be pulled back:
1. 1-2 mm
2. 3-5 mm
3. 5-7 mm
4. 7-9 mm |
|
Definition
|
|
Term
The ideal rate at which to inject anesthetic solution is:
1. 1 ml in approx 15 sec
2. 1 ml in approx 20 sec
3. 1 ml in approx 25 sec
4. 1 ml in approx 60 sec |
|
Definition
|
|
Term
After 3 attempts, you administered a left IAN to your patient & spent 1 hour scaling & root planning that quadrant. As he got up to leave, he informed you that he couldn't open his mouth very wide at this time without experiencing pain. What is this condition called:
1. hematoma
2. trismus
3. parasthesia
4. facial nerve paralysis |
|
Definition
|
|
Term
For this same patient, what would you recomend as a treatment to alleviate his trismus:
1. aspirin
2. cold pack every 20 mins for 2 hrs on affected side
3. hot, moist towels for 20 mins every hour in affected side
4. warm salt water rinses on affected side
5. opening & closing the mouth for 5 mins every 3-4 hrs, including lateral movements
6. muscle relaxants if necessary
a. all of the above
b. 1 & 2
c. 1, 2, 3, & 5
d. 1, 3, & 5
e. 1, 3, 4, 5 & 6 |
|
Definition
|
|
Term
After administering a left PSA injection to apatient, swelling becomes evident on the left side of her face within a few minutes. What has most likely occurred to this patient:
1. the nerve has been damaged during the injection
2. contaminated anesthetic solution has been administered
3. the anesthetic solutions were administered to quickly
4. the needle inadvertently nicked the pterygoid plexus of veins |
|
Definition
| 4. the needle inadvertently nicked the pterygoid plexus of veins |
|
|
Term
For the preceding question, what was the most likely technique error that created this hematoma from the PSA injection:
1. the needle was inserted too far mesially
2. the needle was inserted too far distally
3. the needle was inserted at the height of the mucobuccal fold above the maxillary second molar
4. the bevel was turned toward bone |
|
Definition
| 2. the needle was inserted too far distally |
|
|
Term
For this same patient with the hematoma from the PSA injection, how would you recommend that she treat the area:
1. apply ice immediately to the area
2. hot, moist towels for 20 mins every hr on affected side
3. open & close her mouth for 5 mins every hour for 6 hrs
4. warm salt water rinses on the affected side |
|
Definition
| 1. apply ice immediately to the area |
|
|
Term
In the previous question involving facial nerve paralysis, what technique modification needs to be made to avoid this problem in the future:
1. when administering an IAN, be certain to contact bone prior to depositing any solution
2. when administering and IAN, avoid contacting bone prior to depositing any solution
3. use a short needle for an IAN injection to avoid going too deep with the needle |
|
Definition
| 1. when administering an IAN, be certain to contact bone prior to depositing any solution |
|
|
Term
What is deposition site for the IAN injection in relation to the mandibular foramen:
1. slightly inferior to the foramen
2. slightly superior to the foramen
3. distal to the foramen
4. medial to the foramen |
|
Definition
| 2. slightly superior to the foramen |
|
|
Term
What is the deposition site for the PSA injection in relation to the pterygoid plexus of veins:
1. poterior & superior to the pterygoid plexus of veins
2. anterior & superior to the pterygoid plexus of veins
3. anterior & inferior to the pterygoid plexus of veins
4. posterior & inferior to the pterygoid plexus of veins |
|
Definition
| 3. anterior & inferior to the pterygoid plexus of veins |
|
|
Term
Name 2 injections in which pressure anesthesia is used to enhance patient comfort:
1. PSA & MSA
2. MSA & GP
3. GP & NP
4. NP & ASA
5. ASA & GP |
|
Definition
|
|
Term
At which point does automatic aspiration occur while using a self-aspirating syringe:
1. whenever the thumb ring is depressed & then relased
2. whenever pressure is relased on the thumb ring
3. whenever the needle contacts resistance during an injection
4. whenever the needle is redirected during an injection |
|
Definition
| whenever the thumb ring is depressed & then released |
|
|
Term
The primary factor influencing the ability to aspirate successfully is:
1. the length of the needle
2. whether the injection requires bone to be contacted prior to the injection of solution
3. the gauge of the needle
a. all of the above
b. 1 & 2
c. 2 & 3
d. 3 only |
|
Definition
|
|
Term
In the unlikely event that an anesthetic needle breaks within the patient's tissues, the following steps should be taken:
1. keep the patient's mouth open either by keeping your fingers in the patient's mouth or by using a bite block
2. have the patient close their mouth immediately to avoid having the needle migrate
3. if the broken needle is visible, try to remove it with a hemostat
4. if the broken needle is not visible, have the dentist incise the area to locate the needle for easy removal
a. 1, 3 & 4
b. 2, 3 & 4
c. 1 & 3
d. 2 & 4 |
|
Definition
|
|
Term
Generally speaking, due to the thinner bone found in the maxilla, clinically adequate anesthesia is easier to achieve here than in the mandible.
1. true
2. false |
|
Definition
|
|
Term
After applying topical anesthetic to an injection site for 4 mins, the clinician notices that the epithelium is sloughing in the area where the topical was applied. This can be due to:
1. presence of vasoconstrictor in the topical anesthetic
2. topical anesthetic was held too long in the area
3. the high degree of water solubility of the topical anesthetic
4. the low degree of water solubility of the topical anesthetic |
|
Definition
| 2. topical anesthetic was held too long in the area |
|
|
Term
Name the 2 major classifications of local anesthetic agents:
1. lidocaine & epinephrine
2. injectable & infiltratable
3. amides & ester |
|
Definition
|
|
Term
Which of the following is true of the ester classification of local anesthetic agents:
1. the primary by-product of the metabolism of esters is methemoglobinemia
2. esters are metabolized in the plasma by the enzyme pseudocholinesterase
3. some metabolism of esters can occur in the lungs
4. examples of esters include Lidocaine 2% & Etidocaine 1.5% |
|
Definition
| 2. esters are metabolized in the plasma by the enzyme pseudocholinesterase |
|
|
Term
Generally speaking, the effect that most local anesthetic agents have on the vascular bed is:
1. vasodilating
2. vasoconstricting
3. they have no effect |
|
Definition
|
|
Term
Generally speaking, which classificatin of local anesthetic agents is the MOST vasodilating:
1. amides
2. esters
3. neither - they are both equally vasodilating |
|
Definition
|
|
Term
What are the important clinical effects of vasodilation of local anesthetics:
1. it will increase the rate of absorption of the local anesthetic agent into the blood
2. it will decrease the duration of pain control of the local anesthetic agent
3. it will increase the level of local anesthetic in the blood
4. it will increase the potentioal for overdose
5. all of the above |
|
Definition
|
|
Term
Local anesthetic agents readily cross the placenta & can then enter the circulatory system of the fetus.
1. true
2. false |
|
Definition
|
|
Term
If the use of a certain local anesthetic agent is absolutely contraindicated for a patient, this means:
1. under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction
2. the agent may be administered to the patient after considering the risks & benefits from its use & if an alternative agent is not available
3. there is no risk whatsoever from the use of this local anesthetic agent |
|
Definition
| 1. under no circumstances should this agent be administered to the patient due to the risk of a potentially toxic or lethal reaction |
|
|
Term
The allergic reactions that occur from the use of esters are due to:
1. the type of ester that is used
2. the type of topical anesthetic that was used prior to injection
3. the degree of vasodilation of the ester that was used
4. the metabolic by-product of esters |
|
Definition
| 4. the metabolic by-product of esters |
|
|
Term
Explain what the term "half-life" means in relation to a local anesthetic agent:
1. the time it takes for the local anesthetic to reach half its potential effect on the patient
2. the time it takes for the local anesthetic in the cartridge to lose half its potency
3. the time required for a 50% reduction of the local anesthetic agent in the patient's blood level
4. the time required for the patient to lose 50% of the sensation in the targeted area |
|
Definition
| 3. the time required for a 50% reduction of the local anesthetic agent in the patient's blood level |
|
|
Term
What type of effect do local anesthetics have on the central nervous system (CNS):
1. they excite the CNS
2. they depress the CNS
3. they have no effect on the CNS |
|
Definition
|
|
Term
Vasoconstrictors are added to local anesthetics for which of the following reasons:
1. to counteract the vasodilating effects of the local anesthetic agent
2. to increse the blood flow to the site of the injection
3. to prolong vasodilation
4. to increase the rate at which the local anesthetic is absorbed into the cardiovascular system |
|
Definition
| 1. to counteract the vasodilating effects of the local anesthetic agent |
|
|
Term
The role of vasoconstrictors is to:
1. constrict blood vessels, thereby decreasing the blood flow to the site of injection
2. increase hemostasis
3. reduce allergic reactions
4. increase metabolism of the local anesthetic agent |
|
Definition
| 1. constrict blood vessels, thereby decreasing the blood flow to the site of injection |
|
|
Term
Vasoconstrictors will allow higher volumes of the local anesthetic to remain in & around the nerve for shorte periods of time which will decrease the duration of action of the local anesthetic agent.
1. true
2. false |
|
Definition
|
|
Term
While esters are more vasodilating than amides, there is one ester which is an exception & produces vasoconstriciton. This drug is:
1. procaine
2. cocaine
3. lidocaine
4. mepivacaine |
|
Definition
|
|
Term
Local anesthetics are absorbed readily when applied topically to intact skin.
1. true
2. false |
|
Definition
|
|
Term
Factors that influence the blood level of a local anesthetic agent after it has been injected include:
1. the health status of the individual
2. the rate that the drug is absorbed into the cardiovascular system
3. the amount of food the individual has eaten in the past 12 hours
4. 1 & 2
5. 1, 2 & 3
6. none of the above |
|
Definition
|
|
Term
|
Definition
|
|
Term
1:100,000=
1.0
0.4
0.01
0.005 |
|
Definition
|
|
Term
1:200,000=
0.005
1.0
0.4
0.01 |
|
Definition
|
|
Term
articaine mg/lb=
3.2
3.0
3.6
.9 |
|
Definition
|
|
Term
lidiocaine mg/lb?
.9
3.0
3.2
3.6 |
|
Definition
|
|
Term
mepivaine mg/lb?
.9
3.0
3.2
3.6 |
|
Definition
|
|
Term
bupivacaine mg/lb?
.9
3.0
3.2
3.6 |
|
Definition
|
|
Term
prilocaine mg/lb?
.9
3.0
3.2
3.6 |
|
Definition
|
|
Term
| Two Important Principles? |
|
Definition
Any drug that is administered has desirable actions which are clinically beneficial
Any drug that is administered has undesirable actions which are additional and not sought for |
|
|
Term
| Preconvulsive Signs and Symptoms of CNS Toxicity? |
|
Definition
Slurred speech
Shivering
Muscular twitching
Tremor of muscles of face and extremities
Generalized lightheadedness
Dizziness
Visual disturbances
Auditory disturbance
Numbness of tongue circumoral region
Warm, flushed feeling of skin
Pleasant dreamlike state |
|
|
Term
|
Definition
Terminate procedure
Assess patient’s signs and symptoms
Initiate PABCD
P = positioning
A = airway
B = breathing
C = circulation
D = definitive care (Call for emergency care) |
|
|
Term
| Categories of Emergencies? |
|
Definition
Unconsciousness
Respiratory distress
Altered consciousness
Seizures
Drug-related emergencies
Chest pain
Cardiac arrest |
|
|
Term
|
Definition
Place patient in supine position
Regain consciousness rapidly, recover slowly |
|
|
Term
|
Definition
Place in supine position
Regain consciousness rapidly, recover rapidly |
|
|
Term
| what to do when Seizures? |
|
Definition
Place in supine position
If partial leave patient alone until it ceases |
|
|
Term
| what to do if Hypoglycemia? |
|
Definition
Position patient to their wishes if conscious
Administer oral carbohydrate and observe
BLS if not responsive |
|
|
Term
| what to do if Hyperglycemia? |
|
Definition
Supine position
Activate BLS |
|
|
Term
| Accessing conditions that lead to unconsciousness: |
|
Definition
Position of patient
If supine - hypoglycemia, adverse drug reaction, epileptic seizures, hyperglycemia, cardiovascular disorders, cerebral vascular accident
Upright position –syncope and any of the above mention list. (if you place patient in to supine position and they do not respond it is likely one of the above mention situations)
No Symptoms
Postural hypotension, cardiac diso |
|
|
Term
Tingling and numbness of extremities
Hyperventilation –? |
|
Definition
| – slow the patients rate of oxygen inhalation |
|
|
Term
|
Definition
| Alcohol, acetone (sweet, fruity: ketoacidosis of diabetics) |
|
|
Term
| Heart Rate and Blood Pressure? |
|
Definition
Hypoglycemia or hyperglycemia- HR increase, BP decrease
Syncope – HR decreases, BP decreases |
|
|
Term
Respiratory distress
Causes: |
|
Definition
Hyperventilation (most common)
Reassure patient and increase CO2 level in body
Syncope (most common)
Asthma (common)
Bronchspasm treatment (Albuterol)
Heart failure
Hypoglycemia
Overdose reaction |
|
|
Term
|
Definition
(common in topical)
Usually local erythema and edema |
|
|
Term
|
Definition
| Depression, drowsiness, tremor, tonic seizures |
|
|
Term
Amides
Method of overdose? |
|
Definition
Excessive total dose (5-30 minute onset, lasts 5-30 minutes) (most common)
Rapid intravascular injection (rapid onset, lasts 5-30 minutes) (common) |
|
|
Term
Local Anesthetic (continued)
Mild reaction is? |
|
Definition
Highly talkativeUneasiness
Muscle twitching
Elevated heart rate, BP, and respirations |
|
|
Term
| Vasoconstrictors Drug Reactions? |
|
Definition
| Acute anxiety response with increase in BP and HR |
|
|
Term
|
Definition
| Several antibiotics cause allergic reactions |
|
|
Term
|
Definition
| Opiods, Aspirin, Acetaminophen, NSAIDS |
|
|
Term
|
Definition
| very uncommon. Most common clinical side effect is nausea and orthostatic hypotension |
|
|
Term
|
Definition
| – allergies uncommon; Overdose results in CNS, respirator and CV depression |
|
|
Term
|
Definition
| – allergies uncommon; Overdose results in CNS depression, over sedation, and drowsiness |
|
|
Term
|
Definition
| – Overdose results in over sedation, usually accompanied with nausea and vomiting |
|
|
Term
Chest Pain
Angina pectoris Treatment: ? |
|
Definition
| have nitroglycerin tablets or spray available. Apply as needed 3 times. If no resolution activate PABCD |
|
|
Term
| Myocardial infarction – treatment? |
|
Definition
|
|
Term
| Cardiac Arrest treatment? |
|
Definition
|
|
Term
| Two General rules for medical treatments? |
|
Definition
Primary thought needs to go to PABCD
2) If you do not know how to use it do not administer medications |
|
|
Term
| Facial Nerve Paralysis Cause? |
|
Definition
| Introduction of local anesthetic into the capsule of the parotid gland |
|
|
Term
| Facial Nerve Paraly Problem? |
|
Definition
| Patient temporarily experiences unilateral paralysis of muscles innervated by the facial nerve |
|
|
Term
| Facial Nerve Paralysis Prevention? |
|
Definition
| If you contact bone before depositing anesthetic you have virtually eliminated risk of depositing |
|
|
Term
|
Definition
|
|
Term
| hyperglycemia- HR ?, BP ? |
|
Definition
| - HR increase, BP decrease |
|
|
Term
|
Definition
| HR decreases, BP decreases |
|
|
Term
|
Definition
|
|
Term
| postual hypotenison HR? BP? |
|
Definition
|
|
Term
|
Definition
| very uncommon. Most common clinical side effect is nausea and orthostatic hypotension |
|
|
Term
| Nitrous oxide – Overdose? |
|
Definition
| results in over sedation, usually accompanied with nausea and vomiting |
|
|
Term
| Barbiturates – allergies ? |
|
Definition
| uncommon; Overdose results in CNS, respirator and CV depression |
|
|
Term
| Benzodiazepines – allergies ? |
|
Definition
| uncommon; Overdose results in CNS depression, over sedation, and drowsiness |
|
|
