Dental anesthesia (3)
121. All of the following methods will REDUCE the chance of needle breakage, EXCEPT one. Which one is the exception?
σ establishing a firm hand rest
σ Using a larger gauge needle
σ Burying the needle to the hub
σ Minimizing the need for redirection in tissue
σ Not bedding the needle excessively
122. The antioxidant used to preserve epinephrine in a local anesthetic solution is?
σ Sodium bisulfate
σ Sodium bicarbonate
σ Sodium chloride
σ Sodium pentanol
σ Sodium hydrochloride
123. A small bubble of approximately 1 to 2 mm diameter will frequently be found in the local anesthetic cartridge. These bubbles are cause by what?
σ The anesthetic solution being frozen
σ The cartridge was stored in a chemical disinfectant
σ Nitrogen gas being pumped in during manufacturing
σ Oxygen gas being trapped in the cartridge
σ Shaking the cartridge vigorously
124. Distilled water is added to the cartridge for what purpose?
σ To make the solution isotonic with the tissues of the body
σ To increase the safely and the duration of the anesthetic
σ To prevent the biodegradation of the vasopressor
σ To provide the volume of the solution
σ To prevent the probation of nerve impulses
125. Topical antiseptic does which of the following?
σ Numbs 2-3mm of tissue prior to injection
σ Makes patient more comfortable during initial penetration
σ Lessens the chance of inflammation or infection
σ Allows the clinician to practice their site of penetration
σ Reduces the risk of a local anesthetic overdose
126. What is the MOST important reason hemostats/cotton roll pliers are part of the armamentarium?
σ They are used to remove the Deptinpatch
σ They are used to place a cotton roll on the needle
σ They are used for the retrieval of a broken needle
σ They are used to place the plastic cap on the needle
σ they are used to unscrew the needle from the syringe
127. At what time are professionals MOST at risk for a needle stick
σ Disassembly of syringe
σ Recapping
σ Assembling the syringe
σ Giving the injection
σ Unsheathing the needle
128. All of the following are acceptable ways of recapping a needle EXCEPT?
σ Carefully direction the cap over needle with fingers
σ Utilizing “Card” or other holding device
σ Performing the one handed scoop technique
σ Implementing cotton roll pliers or a hemostat
σ Securing cap with fingers on vertical syringe
129. Stacey, a 18 year old soccer player, arrives for extraction of teeth #4,12, and 20, and she is given 5 cartridges of 4% Articaine with epi 1:100,000.Her mother calls 3 hours following the appointment stating that Stacey appears cyanotic and sluggish. Her nail beds look dark and the blood in the extraction sites is chocolate brown. What is MOST likely the condition presented?
σ A typical plasma cholinesterase
σ Methemoglobinemia
σ Malignant hyperthermia
σ Local anesthetic overdose
σ Local anesthetic allergy
130. A patient with epilepsy is scheduled for root planning and scaling with local anesthetic today. What should the dental hygienist know about this condition?
σ Epilepsy is a relative contraindication to ester type anesthetics
σ In low doses local anesthetic is an anti-convulsant
σ The patient should be pre-medicated prio to treatment
σ Epilepsy is an absolute contraindication to amide type anesthetics
σ Oxygen should be available to deliver in an emergency.
131. A patient attends for an extraction of a lower molar tooth. Following the administration of an inferior alveolar nerve block only, the patient complains of pain during the procedure.Which one of the following nerves is the most likely to be responsible for the perception of this pain?
Facial nerve
σ Incisive nerve
σ Long buccal nerve
σ Marginal mandibular
σ Mental nerve
132. Which one of the following local anesthetic agents (at the correct dosage) is the most likely to provide the most prolonged analgesia?
σ Articaine
σ Bupivacaine
σ Lidocaine (lignocaine)
σ Mepivacaine
σ Prilocaine
133. Which of the following local anesthetics is used exclusively for its good surface activity and low toxic potential?
σ Cocaine
σ Benzocaine
σ Bupivacaine
σ Procaine
σ Lidocaine
134. Which of the following drugs can cause methemoglobinnemia when used in larger doses for regional anesthesia?
σ Cocaine
σ Lidocaine
σ Bupivacaine
σ Procaine
σ Prilocaine
135. Epinephrine added to a solution of lidocaine for local anesthesia will:?
σ Cause cyanosis locally.
σ Increase the risk of convulsion.
σ Increase the duration of local anesthesia
σ Increase the absorption of lidocaine
σ Decrease the heart rate when absorbed.
136. Vasoconstrictor in local anesthetic(LA) solution is used to ?
σ Reduces toxic effects of LA
σ Decreases depth & duration LA
σ Increases bleeding.
σ Increases toxic effects of LA
137. Reducing agent local anesthetics solution is ?
σ Methyl paraben
σ Sodium metabisulphite
σ Thymol
σ Adrenaline
σ Ringer lactate
138. Needle used for infiltration is ?
σ 30 gauge
σ 25 gauge
σ 27 gauge
σ 16 gauge
σ 18 gauge
139. When injecting Local anesthetic solution in maxilla on buccal side. Which of the following technique is used?
σ sub periosteal
σ supra periosteal
σ sub mucosal
σ intra osseous
σ intra septal
140. Most common complication of posterior Superior alveolar nerve block is:?
σ Trismus
σ Hematoma
σ Infection
σ Facial palsy
σ Blanching of the area
141. Disto buccal root of upper 1st molar is supplied by:?
σ Middle superior alveolar nerve
σ Posterior superior alveolar nerve
σ infra orbital nerve
σ mental nerve
σ buccal nerve
142. Which of 2 nerves blocked when injection is given in pterygo mandibular space?
σ Buccal & lingual nerve
σ Lingual & inferior alveolar nerve
σ Buccal & inferior alveolar nerve
σ Buccal nerve & infra orbital nerve
σ inferior alveolar & posterior superior alveolar nerve
143. Blanching at the site of injection is caused by:?
σ Increased tissue tension
σ local effects of reducing agent in LA solution
σ Decreased tissue tension
σ Infection at the site of injection
σ Warm LA solution
144. What are the local anesthetic produce for:?
σ analgesia, amnesia, loss of consciousness
σ blocking pain sensation without loss of consciousness
σ alleviation of anxiety and pain with an altered level of consciousness
σ a stupor or somnolent state
145. A good local anesthetic agent shouldn’t cause:?
σ Local irritation and tissue damage
σ systemic toxicity
σ Fast onset and long duration of action
σ Vasodilation
146. Most local anesthetic agents is consist of :?
σ Lipophilic group (frequently an aromatic ring)
σ Intermediate chain (commonly including an ester or amide)
σ amino group
σ All of the above
147. Which one of the following groups is responsible for the duration of the local anesthetic action?
σ Intermediate chain
σ Lipophilic group
σ Ionizable group
σ Nonionize group
148. Indicate the local anesthetic agent, which has a shorter duration of action:?
σ Lindocaine
σ Procaine
σ Bupivacaine
σ Articaine
149. Which one of the following groups is responsible for the potency and the toxicity of local anesthetic?
σ Inonizable group
σ Intermediate chain
σ Lipophylic group
σ Non Ionize group
150. Indicate the drug, which has greater potency of the local anesthetic action:?
σ Lidocaine
σ Bupivacaine
σ Procaine
σ Mepivacaine
151. Ionizable group is responsible for ?
σ The potency and the toxicity
σ The duration of action
σ The ability of diffuse to the site of action
σ All of the above
152. Which one of the following local anesthetics is an ester of benzoic acid:?
σ Lidocaine
σ Procaine
σ Ropivacaine
σ Cocaine
153. Indicate the local anesthetic, which is an ester of paraaminobezoic acid:?
σ Mepivacaine
σ Cocaine
σ Procaine
σ Lidocaine
154. Which of the following local anesthetics in an acetanilide derivative?
σ Tetracaine
σ Lidocaine
σ Cocaine
σ Procaine
155. Indicate the local anesthetic, which is a toluidine derivative:?
σ Lindocaine
σ Bupivacaine
σ Prilocaine
σ Procaine
156. Which of the following local anesthetics is a thiophene derivative?
σ Procaine
σ Ultracaine
σ Lidocaine
σ Mepivacaine
157. Local anesthetics are?
σ Weak bases
σ Weak acids
σ Salts
σ pH
158. For therapeutic application local anesthetics are usually made available as salt for the reason of:?
σ Less toxicity and higher potency
σ Higher stability and greater lipid solubility
σ Less local tissue damage and more potency
σ More stability and greater water solubility
159. Which of the following statements is NOT correct for local anesthetics?
σ In a tissue they exist either as an uncharged base or as a cation
σ A charge cationic form penetrates biologic membranes more readily than and uncharged form
σ Local anesthetics are much less effective in inflamed tissues
σ Low ph in inflamed tissues decreases the disscociation of nonionized molecules
160. Which one of the following statements about the metabolism of local anesthetics is incorrect?
σ Metabolism of local anesthetics occurs at the site of administration
σ Metabolism occurs in the plasma or liver but not at the site of administration
σ Ester group of anesthetics like Procaine, are metabolized systemically by pseudocholinesterae
σ Amides such as Lignocaine, are metabolized in the liver by microsomal mixed function oxidases
161. Indicate the anesthetic agent of choice in patient with a liver disease:?
σ Lidocaine
σ Bupivacaine
σ Procaine
σ Eticaine
162. Which of the following local anesthetics is preferable in patient with pseudocholinesterase difiency?
σ Procaine
σ Ropivacaine
σ Tetracaine
σ Benzocaine
163. The primary mechanism of action of local anesthetics is:?
σ Activation of ligand-gated potassium channels
σ Blockade of voltage-gated sodium channels
σ Stimulation of voltage-gated N-type calcium channels
σ Blockade the GABA-gated chloride channels
164. Which of the following local anesthetics is more water-soluble?
σ Tetracaine
σ Etidocaine
σ Procaine
σ Bupivacaine
165. Indicate the local anesthetic, which is more lipid-soluble:?
σ Bupivacaine
σ Lidocaine
σ Mepivacaine
σ Procaine
166. The more lipophilic drugs ?
σ Are more potent
σ Have longer duration of action
σ Bind more extensively to protein
σ All of the above
167. Which of the following fibers is the first to be blocked?
σ Type A alpha fibers
σ B and C fibers
σ Type A beta fibers
σ Type A gamma fibers
168. Indicate the function, which the last to be blocked:?
σ Paine, temperature
σ Muscle spindles
σ Motor function
σ Touch, pressure
169. Which of the following fibers participates in high-frequency pain transmission?
σ Type A delta and C fibers
σ Type A alpha fibers
σ Type B fibers
σ Type A beta fibers
170. Which of the following local anesthetics is an useful antiarrhythmic agent?
σ Cocaine
σ Lidocaine
σ Bupivacaine
σ Ropivacaine
171. Which of the following local anesthetcs is a short-acting drug?
σ Procaine
σ Tetracaine
σ Bupivacaine
σ Ropivacaine
172. Indicate the local anesthetic, which is a long-acting agent:?
σ Lidocaine
σ Bupivacaine
σ Procaine
σ Mepivacaine
173. The anesthetic effect of the agent of short and intermediate duration of action cannot be prolong by adding:?
σ Epinephrine
σ Norepinephrine
σ Dopamine
σ Phenylephrine
174. A vasoconstrictor does not :?
σ Retard the removal of drug from the injection site
σ Hence the chance of toxicity
σ Decrease the blood level
σ Reduce a local anesthetic uptake by the nerve
175. Vasoconstrictors are less effective in prolonging anesthetic properties of :?
σ Procaine
σ Bupivacaine
σ Lidocaine
σ Mepivacaine
176. Which of the following local anesthetics is only used for surface or topical anesthesia ?
σ Cocaine
σ Tetracaine
σ Procaine
σ Bupivacaine
177. Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia?
σ Dibucaine
σ Bupivacaine
σ Tetracaine
σ Cocaine
178. Which of the following local anesthetics is used for infiltrative and regional anesthesia related to amide type?
σ Procaine
σ Lidocaine
σ Cocaine
σ Tetracaine
179. Which of the following local anesthetics is called a universal anesthetic?
σ Procaine
σ Ropivacaine
σ Lidocaine
σ Bupivacaine
180. Most serious toxic reaction to local anesthetics is:?
σ Seizures
σ Cardiovascular collapse
σ Respiratory failure
σ All of the above
181. Correct statements concerning cocaine include all of the following EXCEPT:?
σ Cocaine is often used for nose and throat procedures
σ Limited use because of abuse potential
σ Myocardial depression and peripheral vasodilation
σ Causes sympathetically mediated tachycardia and vasoconstriction
182. Which of the following local anesthetics is more cardiotoxic?
σ Procaine
σ Bupivacaine
σ Lidocaine
σ Mepivacaine
183. Most local anesthetics can cause:?
σ Depression of abnormal cardiac pacemaker activity, excitability, conduction
σ Depression of the strength of cardiac contraction
σ Cardiovascular collapse
σ All of the above
184. Which one of the following local anesthetics causes methemoglobinemia?
σ Prilocaine
σ Procaine
σ Lidocaine
σ Ropivacaine
185. Prilocaine has all of the following properties EXCEPT:?
σ It has ester linkage
σ Its metabolic product can inhibit the action of sulfonamides
σ It readily penetrates the skin and mucosa
σ It is relatively short-acting
186. Correct statements concerning lidocaine include all of the following EXCEPT:?
σ It is an universal anesthetic
σ It has esteratic linkage
σ It widely used as an antiarrhythmic agent
σ It is metabolized in liver
187. Which of the following local anesthetics is more likely to cause allergic reaction?
σ Lidocaine
σ Bupivacaine
σ Procaine
σ Ropivacaine
188. Correct statements concerning bupivacaine include all of the following EXCEPT?
σ It has low cardiotoxicity
σ It has amide linkage
σ It is a long-acting drug
σ An intravenous injection can lead to seizures.
189. The duration of action of local anesthetics agents are divided in short, intermediate and long. Which one of the following is classified as the short one?
σ Articaine HCL 4%
Prilocaine HCL 4%
Lidocaine HCL 2%
σ Bupivacaine HCL 0.5%
190. Which one of the following agents is classified as the intermediate one?
σ Prilocaine HCL 4%
σ Articaine HCL 4%
σ Mepivacaine 3%
σ Bupivacaine HCL 0.5%
191. Which one of the following agents is classified as the long one?
σ Bupivacaine HCL 0.5%
σ Lidocaine HCL 2%
σ Articaine HCL 4%
σ Prilocaine 4%
192. Which one of the following maximum dosage recommendations is selected for the patient weigh 70kg, related to Lidocaine 2% with epinephrine 1:50,000?
σ 490 mg/kg
σ 420 mg/kg
σ 500 mg/kg
σ 350 mg/kg
193. Related to the maximum dose recommended when used Lidocaine 2% with Epinephrine 1:50,000. Which one of the following is selected for ASA?
σ ASA 1
σ ASA 2
σ ASA 3
σ ASA 4
194. If the two percent of Lidocaine 2% with Epinephrine 1:100,000 are suggested for American Society of Anesthesia. Which one of the following categories of the American Society of Anesthesia was selected?
σ ASA 1
σ ASA 2
σ ASA 3
σ ASA 4
195. If the Lidocaine 2% with Epinephrine 1:100,00 was used. Which one of the following is selected for the maximum dose recommendation?
σ 7.0 mg/kg
σ 6.6 mg/kg
σ 8.0 mg/kg
σ 2.0 mg/kg
196. If the two percent of Lidocaine 2% with Epinephrine 1:100,000 were used for patient 60kg. Which one of the following was selected for the 60kg patient?
σ 420 mg/kg
σ 350 mg/kg
σ 490 mg/kg
σ 500 mg/kg
197. As with all local anesthetics, the dose varies depending on the area to be anesthetized, the vascularity of tissues, individual tolerance, and the techniques of anesthesia. Which type of the following patient should be decreased the dose for them?
σ debilitate or elderly patient
σ adult patient
σ young patient
σ children patient
198. If Articaine 4% with epinephrine 1:100,000 or 1:200,000 was used with patient 80kg. Which one of the following option was selected?
σ 490 mg/kg
σ 560 mg/kg
σ 350 mg/kg
σ 650 mg/kg
199. Which one of the following of the maximum dose recommended for normal healthy individual patient per kilogram is.?
σ 7.0 mg/kg
σ 6.6 mg/kg
σ 8.0 mg/kg
σ 6 mg/kg
200. In 1980, when the first edition of Stanley F. Malamed, and the Sixth edition of Hand book of local anesthetic were available in dental cartridge form include: Lidocaine, Articaine, Prilocaine, Mepivacaine, and Bupivacaine. Which one of the following was selected for the maximum dose recommendation related to the Articaine 4% with epinephrine 1:100,000 per kilogram of the patient weight?
σ 6.6 mg/kg
8.0 mg/kg
σ 7,0 mg /kg
σ 2.0 mg/kg
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