Dental anesthesia (1)
1. Surface activity and low toxic potential?
σ� Cocaine
σ� Benzocaine
σ� Bupivacaine
σ� procaine
σ� Lidocaine
2. Which of the following drugs can cause methemoglonemia?
σ� Cocaine
σ� Lidocaine
σ� Bupivacaine
σ� Procaine
σ� Prilocaine
3. Vasoconstrictor in Local anesthetic solution is?
σ� Reduce toxic effects of LA solution
σ� Decreases depth & duration of LA
σ� Increase bleeding
σ� Increase toxic effects of LA
σ� Has no effect on efficacy LA solution
4. When injecting Local solutionin maxilla on buccal side. The technique is ?
σ� Sup periosteal
σ� Supra periosteal
σ� Sup mucosal
σ� Intra osseous
σ� Intra septal
5. Disto buccal root of upper first molar is supplied by:?
σ� Middle superior alveolar nerve
σ� Posterior superior alveolar nerve
σ� Infra orbital nerve
σ� Mental nerve
σ� Buccal nerve
6. Technique of anesthesia in which local anesthetic solution is injected into the vein is ?
σ� Nerve block
σ� Infiltration anesthesia
σ� Intra venous regional anesthesia
σ� Epidural anesthesia
σ� No such technique exists.
7. You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland?
σ� to be palpable intraorally
σ� to be palpable extraorally.
σ� To be palpable both intra- and extraorally
σ� only to be detectable by radiographical examination.
8. During an inferior alveolar nerve block the needle ideally passes?
σ� Posterior and medial to medial pterygoid.
σ� anterior and lateral to medial pterygoid
σ� through medial pterygoid
σ� Inferior to medial pterygoid.
9. You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the?
σ� Hard palate
σ� Hard palate and upper lip.
σ� Hard palate, upper lip and upper central incisor.
σ� hard palate, upper lip, upper central incisor and lower first molar
10. You notice a lesion on the labial alveolar mucosa of the lower right lateral incisor tooth of one of your patients and decide to take a biopsy to send for oral pathology report Which nerve would require local anesthesia in order to carry out a pain-free biopsy?
σ� The incisive nerve
σ� The buccal nerve
σ� The lingual nerve
11. The regional lymphatic drainage of the left side of the tip of the tongue is to the?
σ� left submental lymph node.
σ� left and right submental lymph nodes
σ� left submandibular lymph node.
σ� left and right submandibular lymph nodes.
12. A successful inferior alveolar nerve block will produce anesthesia of the?
σ� lower lip.
σ� lower lip and mandibular teeth
σ� lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth
σ� lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the posterior mandibular teeth.
13. The mucosa of the hard palate is?
σ� keratinised and has submucosa and minor salivary glands posterolaterally
σ� non-keratinised and has submucosa and minor salivary glands posteromedially
σ� keratinised and lacks submucosa and minor salivary glands.
σ� non-keratinised and lacks submucosa and minor salivary glands.
14. A successful infraorbital nerve block will produce anaesthesia of the?
σ� maxillary anterior teeth.
σ� maxillary anterior teeth and their labial gingivae.
σ� maxillary anterior teeth, their labial gingivae and the upper lip
σ� maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate
15. In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be?
σ� light pink in colour on both sides of the mucogingigival junction.
σ� light pink below the mucogingival junction and red above it.
σ� ed below the mucogingival junction and light pink above it
σ� red on both sides of the mucogingival junction
16. Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is?
σ� no local irritation
σ� even absorption
σ� no systemic toxicity
σ� higher melting point of combined drug than either lidocaine (Xylocaine) or prilocaine (Citanest) alone
σ� no local irritation, even absorption and no systemic toxicity
17. Local anesthetic used in greater than 50% of rhinolaryngologic cases:?
σ� prilocaine (Citanest)
σ� cocaine
σ� mepivacaine (Carbocaine
σ� bupivacaine (Marcaine)
σ� tetracaine (pontocaine)
18. Mechanism(s) of local anesthetic action in epidural anesthesia:?
σ� direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura
σ� diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
σ� direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
σ� neither
19. Rationale for adding epinephrine to a local anesthetic solution:?
σ� reduced local anesthetic systemic absorption
σ� increased anesthetic concentration near nerve fibers
σ� reduced duration of conduction blockade
σ� all of the above
σ� reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers
20. Zone of differential motor blockade may average up to four segments below the sensory level?
σ� epidural
σ� Spinal
σ� epidural and Spinal
21. Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia?
σ� True
σ� False
22. Primary side effect/toxicities associated with local anesthetic use:?
σ� allergic reactions
σ� systemic toxicity
σ� allergic reactions and systemic toxicity
σ� neither
23. Factors enhancing bupivacaine (Marcaine) toxicity?
σ� Pregnancy
σ� presence of calcium channel blockers
σ� arterial hypoxemia
σ� acidosis and hypercarbia
σ� Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
24. Agents added to local anesthetics that prolonged local anesthetic duration of action?
σ� Epinephrine
σ� phenylephrine (Neo-Synephrine)
σ� dextran
σ� Epinephrine, phenylephrine (Neo-Synephrine) and dextran
25. Typically a zone of differential sympathetic nervous system blockade?
σ� epidural
σ� spinal
σ� epidural and spinal
26. Preferred local anesthetics for local infiltration:?
σ� lidocaine (Xylocaine)
σ� ropivacaine (Naropin)
σ� bupivacaine (Marcaine)
σ� lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
27. Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfun
σ� anterior spinal artery syndrome
σ� cauda equina syndrome
σ� transient radicular irritation
28. Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain?
σ� cauda equina syndrome
σ� transient radicular irritation
σ� anterior spinal artery syndrome
29. Factors that influence lidocaine (Xylocaine) metabolism:?
σ� pregnancy-induced hypertension
σ� hepatic disease
σ� reduced liver blood flow
σ� volatile anesthetics
σ� pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
30. Most common cause of toxic plasma local anesthetic concentrations?
σ� incorrect dosage during peripheral or block
σ� accidental direct intravascular injection during block
σ� increase vasoconstrictors solution in the anesthetic
σ� without solution of vasoconstrictors for anesthetic
31. Common eutectic mixture of local anesthetics (EMLA)?
σ� tetracaine (pontocaine) and epinephrine
σ� lidocaine (Xylocaine) and tetracaine (pontocaine)
σ� prilocaine (Citanest) and bupivacaine (Marcaine)
σ� tetracaine (pontocaine) and bupivacaine (Marcaine)
σ� lidocaine (Xylocaine) and prilocaine (Citanest)
32. Most frequent local anesthetic clinical use:?
σ� treatment of grand mal seizure
σ� analgesia
σ� management of cardiac arrhythmias
σ� regional anesthetia
σ� management of increased intracranial pressure
33. Lidocaine (Xylocaine) effect on ventilation response to hypoxia?
σ� enhanced response
σ� depressed response
σ� no effect
σ� enhanced response and no effect
34. Clinical use(s) of EMLA applications:?
σ� arterial cannulation
σ� venipuncture
σ� myringotomy
σ� lumbar puncture
35. Allergic reactions to local anesthetics:?
σ� common > 10% of adverse reactions due to allergic mechanisms
σ� high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds
σ� cross-sensitivity between esters and amide-type local anesthetics are common
σ� intradermal testing for possible allergy to local anesthetics should use preservative-free drug
σ� high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug
36. Factors which increase local anesthetic CNS toxicities:?
σ� Hypokalemia
σ� rate of injection
σ� patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used
σ� high PaCO2 (reduced local anesthetic seizure threshold)
σ� rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)
37. Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.?
σ� lidocaine (Xylocaine)
σ� tetracaine (pontocaine)
σ� mepivacaine (Carbocaine)
σ� bupivacaine (Marcaine)
σ� dyclonine (Dyclone)
38. Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.?
σ� Hypoxemia
σ� Hyperkalemia
σ� Acidosis
σ� Hypoxemia, Hyperkalemia and Acidosis
39. Local anesthetic which produces localized vasoconstriction and anesthesia?
σ� tetracaine (pontocaine)
σ� lidocaine (Xylocaine)
σ� cocaine
σ� prilocaine (Citanest)
σ� chloroprocaine (Nesacaine)
40. Agents not recommended for Bier block:
σ� chloroprocaine (Nesacaine
σ� mepivacaine (Carbocaine)
σ� bupivacaine (Marcaine)
Chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
41. Manifestation of systemic toxicity
σ� CNS toxicity
σ� cardiovascular toxicity
σ� neurological symptoms
σ� CNS toxicity, cardiovascular toxicity and neurological symptoms
42. Most commonly used local anesthetic for rhinolaryngologic cases
σ� ropivacaine (Naropin
σ� bupivacaine (Marcaine)
σ� mepivacaine (Carbocaine)
σ� cocaine
σ� tetracaine (pontocaine)
43. Commonly use local anesthetics for topical/surface application:
σ� chloroprocaine (Nesacaine)
σ� lidocaine (Xylocaine
σ� tetracaine (pontocaine)
σ� cocaine
σ� lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
44. Clinical presentations suggestive of local anesthetic allergies:
σ� Rash
σ� laryngeal edema
σ� bronchospasm
σ� urticarial and possibly hypotension
σ� All are correct
45. Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:
σ� lidocaine (Xylocaine)
σ� bupivacaine (Marcaine)
σ� dibucaine (Nupercainal, generic)
σ� prilocaine (Citanest)
σ� procaine (Novocain)
46. This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase
σ� ropivacaine (Naropin)
σ� bupivacaine (Marcaine)
σ� dibucaine (Nupercainal, generic)
σ� procaine (Novocain)
σ� chloroprocaine (Nesacaine)
47. Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution
σ� Hypertension
σ� Arrhythmias
σ� Hypertension and Arrhythmias
σ� Neither
48. ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)
σ� true
σ� false
49. Factor(s) which determine extent of systemic local anesthetic absorption
σ� initial dose
σ� injection site vascularity
σ� intrinsic drug properties
σ� whether or not epinephrine was used to provide local vasoconstriction
σ� All are not correct
50. Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics
σ� ECG -PR interval prolongation
σ� increased conduction velocity
σ� reduced phase 4 depolarization
σ� reduced automaticity
σ� All are not correct
51. Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia:
σ� more lipophilic anesthetics benefit most by epinephrine in addition to local anesthetic solutions
σ� more lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions®
52. Neurotoxicity following local anesthesia: lower extremity paresis-- predisposing conditions may include advanced age and peripheral vascular disease
σ� transient radicular irritation
σ� cauda equina syndrome
σ� anterior spinal artery syndrome
σ� cauda equina syndrome and anterior spinal artery syndrome
53. Local anesthetic not recommended for peripheral nerve blockade:
σ� lidocaine (Xylocaine)
σ� bupivacaine (Marcaine)
σ� ropivacaine (Naropin
σ� tetracaine (pontocaine)
54. Frequently used amide-type local anesthetic for Bier block
σ� chloroprocaine (Nesacaine
σ� prilocaine (Citanest)
σ� bupivacaine (Marcaine)
σ� ropivacaine (Naropin)
55. The first ever peripheral nerve block is performed by
σ� William Salk
σ� Nils Lofgren
σ� William Halsted
σ� Alfred Einhorn
56. The axons of peripheral nerve is supported by
σ� Support by Connective tissue
σ� Supported by cell
σ� Support by muscle
σ� Support by blood
57. Unmeyelinated fiber is surround by
σ� A single wrapping
σ� Plural wrapping
σ� Wrapping by nerve
σ� Wrapping by artery
58. The function organization of axon and schwann cell is called
σ� Nerve fiber
σ� Nerve cell
σ� Neuron cell
σ� Call myelin sheath
59. The groups of the axon, the fasciculi, are enclosed in an additional connective tissue sheath called
σ� The perineurium
σ� Endoneurium
σ� Fasciculi
σ� Epineurium
60. Individual nerve fibers(axons) are surround and separated from each other by
σ� Edoneurium
σ� Perineurium
σ� Epineurium
σ� Fasciculi
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