General Anesthesia Dr. Hong Someth (part1)

2. All are the contraindications of use of Midazolam, except:

σ� Patient with shock

σ� Patient with coma

σ� Patient with acute glaucoma

σ� Patient with epilepsy

3. All are drugs contraindicated with Midazolam, except:

σ� Nelfinavir

σ� Ritonavir

σ� Erythromycin

σ� Indinavir

4. Inadequate or excessive dosage or improper administration may result in all, except:

σ� Cerebral hypoxia

σ� Agitation

σ� Hyperactivity

σ� Voluntary movements

5. All are symptoms of overdose of Midazolam, except:

σ� Loss of coordination

σ� Drowsiness

σ� Confusion

σ� Unable to speak

6. Anxiolytic agents should:?

σ� Relieve pain

σ� Reduce anxiety and exert a calming effect

σ� Improve mood and behavior in patient with psychotic symptoms

σ� Produce drowsiness, encourage the onset and maintenance of a state of sleep

7. Anxiolytics are also useful for:?

σ� Treatment of epilepsy and seizures

σ� Insomnia

σ� Muscle relaxation in specific neuromuscular disorders

σ� All are corrected

8. Indicate the agents of choice in the treatment of most anxiety states:?

σ� Barbiturates

σ� Benzodiazepines

σ� Lithium salts

σ� Phenothiazines

9. The choice of benzodiazepines for anxiety is based on:?

σ� A relatively high therapeutic index

σ� Availability of flumazenil for treatment of overdose

σ� A low risk of physiologic dependence

σ� All are corrected

10. Which of the following anxiolitics is a benzodiazepine derivative:?

σ� Buspirone

σ� Clordiazepoxide

σ� Meprobamate

σ� Chloral hydrate

11. Indicate the benzodiazepine, which has the shortest elimination half-life:?

σ� Quazepam

σ� Triazolam

σ� Diazepam

σ� Clorazepate

12. Which of the following benzodiazepines has the shortest duration of action?

σ� Triazolam

σ� Clorazepate

σ� Prazepam

σ� Clordiazepoxide

13. Which of the following benzodiazepines is less likely to cause cumulative and residual effects with multiple doses?

σ� Clorazepate

σ� Quazepam

σ� Lorazepam

σ� Prazepam

14. Anxiolytic dosage reduction is recommended:?

σ� In patients taking cimetidine

σ� In patients with hepatic dysfunction

σ� In elderly patients

σ� All are corrected

15. What are the requirements for the provision of safe and effective conscious sedation?

σ� Regulation

σ� Education of the profession

σ� Education of the patients

σ� All of the above

16. Which one of the following sentences is NOT the Principles of Good Sedation Practice?

σ� Consider the range of non-pharmacological and pharmacological methods of anxiety management

σ� It is essential that conscious sedation is provided to the highest possible standards, respecting the rights of patients as individuals.

σ� There is no need any staff training about sedation and no need monitoring equipment

σ� The provision of safe and effective conscious sedation requires both regulation and, more importantly, education of the profession and patients.

17. Which of the following statement is NOT the dental fear?

σ� Needle/syringe

σ� Aggressive assistants

σ� Extraction

σ� Drilling

18. Which of the following statement about pain and anxiety is FALSE?

σ� Pain is a source of anxiety, anxiety is a factor that increases pain, & increased pain incites further anxiety

σ� When anxiety is reduced through psychosedation, the patient’s subjective experience of pain declines significantly

σ� Pain and anxiety is not inter-related

σ� Anxiety and pain can be reduced through non-pharmacological and pharmacological methods

19. Which of the following statement is TRUE?

σ� The dentist must exhibit compassion , reassurance, and understanding, and show respect for the phobia and patient

σ� The dentist may ignore the patient's reaction to rush the treatment

σ� Ignoring the presence of dental fears provokes many positive responses from the patient

σ� All are corrects

20. What are the symptoms and signs of anxiety?

σ� Tense posture, show excessive vigilance

σ� Move the hands and feet restlessly

σ� Speak with a strained

σ� All of the above

21. Which of the following statement is NOT the method of anxiety management?

σ� Communication skills

σ� Distraction Techniques

σ� Breathing & Relaxation techniques

σ� Taking anti-anxiety drug a week before the treatment

22. How do you recognize a patient with anxiety and fear?

σ� The patient looks alert & on guard at all time, arms & legs are tensed

σ� The patient clutches the arm rest of the dental chair tightly so that their knuckles turn white

σ� Profuse sweating of palms & forehead, quick actions, answer to questions too quickly

σ� All of the above

23. Which of the following statement is NOT the sign of severe anxiety?

σ� Increased blood pressure and heart rate

σ� Trembling

σ� Constriction of pupil

σ� Excessive sweating

24. Which medication is used for premedication for anxious patients a night before appointment?

σ� Diazepam

σ� Tegretol

σ� Tranexamic acid

σ� Tramadol

25. Which medication is used for premedication for anxious patients immediately before appointment?

σ� Codalgin

σ� Midazolam

σ� Dexamethasone

σ� Dilantin

26. Which of the following statement is NOT the stress reduction protocols?

σ� Minimize office waiting time

σ� Psychosedation during therapy

σ� Long appointment time

σ� Adequate pain control during therapy

27. Why do we need to spend a few moment with patients describing the planned procedure before starting the treatment?

σ� Because it is part of the code of ethic

σ� Because it can help reduce anxiety and stress for the patients

σ� Because it can help reduce pain

σ� All of the above

28. Which phrases that you should use before giving local anesthetic injection?

σ� I'm going to freeze your teeth

σ� I’m going to give a shot on your gums

σ� I'm going to inject local anesthetic on your gums

σ� All of the above

29. How to reassure the patients during dental treatments?

σ� By repeating: "You’ll be alright, no worry"

σ� By telling how painful it is

σ� By saying: "when you want me to stop, please raise your hand. I’ll stop immediately"

σ� By repeating: "You’ll be alright, no worry" and By saying: "when you want me to stop, please raise your hand. I’ll stop immediately"

30. What is the calm colour which provides a warm, cheerful environment in the dental office?

σ� Yellow

σ� Green

σ� Earth colour

σ� Dark red

31. Which of the following statement is TRUE?

σ� Research has shown that dentists who wear white coat does not affect patients' emotion

σ� Research has shown that dental office design and hospitality design unite to create an ambience that reduces fear and anxiety

σ� Study has shown that music does not help patients during dental treatment

σ� Dentists are not supposed to talk to the patients during dental treatment

32. Apart from dentists, who else can help to establish line of communication with the patients?

σ� Receptionist

σ� Dental assistants

σ� Dental personnel/staff

σ� All of the above

33. What are the current advances in anxiety management?

σ� Music intervention

σ� Breathing techniques & relaxation techniques

σ� Imagery and distraction technique

σ� All of the above

34. What is the reason for patient to select a dentist?

σ� A dentist who has got high degrees

σ� The dentist who cares about his/her patients

σ� The dentist who has got nice clinic

σ� The dentist who talks a lot

35. What are the levels of sedation?

σ� Mild, moderate, and severe levels

σ� Shallow, medium, and high levels

σ� Mild, intermediate, and profound levels

σ� Minimum, moderate, dissociate, and deep levels

36. Which sedation level that requires assistance in maintaining a patent airway?

σ� Minimum level

σ� Moderate level

σ� Dissociated level

σ� Deep level

37. Which one of the following statements in NOT the contraindication to conscious sedation?

σ� Chronic obstructive pulmonary disease

σ� Gag reflex

σ� Psychosis

σ� Acute narrow-angle glaucoma

38. How much Midazolam 5mg/1ml solution mixed with Paracetamol syrup or sweet drink for 20kg child?

σ� 0.5 ml

σ� 1 ml

σ� 1.5 ml

σ� 2 ml

39. What is the half-life of Midazolam injectable used as oral solution in children?

σ� 15 minutes

σ� 20 minutes

σ� 30 minutes

σ� 1 hour

40. Which one of the following statement is NOT the suggested use of IM route?

σ� Disruptive children

σ� Patients with severe asthma

σ� Patients with gag reflex

σ� Patients with TMJ dysfunction

41. Which muscle that IM sedation is injected for children age 1 to 6 years old?

σ� Vastus lateralis (thigh)

σ� Deltoid (upper arm)

σ� Gluteal area (lower back)

σ� Ventrogluteal area (side of the upper thigh)

42. Which muscle that IM sedation is preferred for injecting for adults?

σ� Vastus lateralis (thigh)

σ� Ventrogluteal area (side of the upper thigh)

σ� Gluteal area (lower back)

σ� Deltoid (upper arm)

43. What is the Midazolam IM dosage for adults?

σ� 0.1mg - 0.5mg/kg

σ� 0.6mg - 0.9mg/kg

σ� 0.07 mg – 0.08mg/kg

σ� 1.5mg - 4.5mg/kg

45. Which one of the following statement is NOT the determinants of IM dose of Benzodiazepines?

σ� Gender

σ� Body weight

σ� Degree of anxiety

σ� Level of desired sedation

46. 32. Why children have got greater risk of airway obstruction than adults?

σ� Anatomic and physiologic differences in children

σ� Differences in basal metabolic and respiratory rate and cardiovascular parameters are different

σ� Reduced tolerance to respiratory obstruction

σ� All of the above

47. How many hours do the patients need to fast or not eating solid foods before IV sedation?

σ� 2 hours

σ� 3 hours

σ� 4 hours

σ� 6 hours

48. 34. How many hours do the patients need to fast or not drinking clear liquids before IV sedation?

σ� 1 hour

σ� 2 hours

σ� 3 hours

σ� 4 hours

49. Why can't the patients eat and drink (fasting) several hours before sedation?

σ� Because aspiration of foods may even lead to aspiration pneumonia

σ� Because the patient will be weighed for the sedative dosage

σ� To prevent emesis during / after a sedative procedure that can result in aspiration of stomach contents leading to laryngospasm or severe airway obstruction

σ� Because aspiration of foods may even lead to aspiration pneumonia and To prevent emesis during / after a sedative procedure that can result in aspiration of stomach contents leading to laryngospasm or severe airway obstruction

50. What is the benefit of IV sedation for hypertensive patients?

σ� It helps to prevent stroke

σ� It helps minimize risk of adverse cardiovascular and cerebrovascular events during treatment

σ� It decreases blood pressure and oxygen saturation

σ� It helps to prevent dizziness

General Anesthesia Dr. Hong Someth (part1)

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