Dental anesthesia (1)
1. Surface activity and low toxic potential?
σ½ Cocaine
σ¾ Benzocaine
σ½ Bupivacaine
σ½ procaine
σ½ Lidocaine
2. Which of the following drugs can cause methemoglonemia?
σ½ Cocaine
σ½ Lidocaine
σ½ Bupivacaine
σ½ Procaine
σ¾ Prilocaine
3. Vasoconstrictor in Local anesthetic solution is?
σ¾ Reduce toxic effects of LA solution
σ½ Decreases depth & duration of LA
σ½ Increase bleeding
σ½ Increase toxic effects of LA
σ½ Has no effect on efficacy LA solution
4. When injecting Local solutionin maxilla on buccal side. The technique is ?
σ½ Sup periosteal
σ¾ Supra periosteal
σ½ Sup mucosal
σ½ Intra osseous
σ½ Intra septal
5. Disto buccal root of upper first molar is supplied by:?
σ½ Middle superior alveolar nerve
σ¾ Posterior superior alveolar nerve
σ½ Infra orbital nerve
σ½ Mental nerve
σ½ Buccal nerve
6. Technique of anesthesia in which local anesthetic solution is injected into the vein is ?
σ½ Nerve block
σ½ Infiltration anesthesia
σ¾ Intra venous regional anesthesia
σ½ Epidural anesthesia
σ½ No such technique exists.
7. You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland?
σ½ to be palpable intraorally
σ½ to be palpable extraorally.
σ¾ To be palpable both intra- and extraorally
σ½ only to be detectable by radiographical examination.
8. During an inferior alveolar nerve block the needle ideally passes?
σ½ Posterior and medial to medial pterygoid.
σ¾ anterior and lateral to medial pterygoid
σ½ through medial pterygoid
σ½ 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?
σ½ Hard palate
σ½ Hard palate and upper lip.
σ½ Hard palate, upper lip and upper central incisor.
σ¾ 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?
σ¾ The incisive nerve
σ½ The buccal nerve
σ½ The lingual nerve
11. The regional lymphatic drainage of the left side of the tip of the tongue is to the?
σ½ left submental lymph node.
σ¾ left and right submental lymph nodes
σ½ left submandibular lymph node.
σ½ left and right submandibular lymph nodes.
12. A successful inferior alveolar nerve block will produce anesthesia of the?
σ½ lower lip.
σ½ lower lip and mandibular teeth
σ¾ lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth
σ½ 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?
σ¾ keratinised and has submucosa and minor salivary glands posterolaterally
σ½ non-keratinised and has submucosa and minor salivary glands posteromedially
σ½ keratinised and lacks submucosa and minor salivary glands.
σ½ non-keratinised and lacks submucosa and minor salivary glands.
14. A successful infraorbital nerve block will produce anaesthesia of the?
σ½ maxillary anterior teeth.
σ½ maxillary anterior teeth and their labial gingivae.
σ¾ maxillary anterior teeth, their labial gingivae and the upper lip
σ½ 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?
σ½ light pink in colour on both sides of the mucogingigival junction.
σ½ light pink below the mucogingival junction and red above it.
σ¾ ed below the mucogingival junction and light pink above it
σ½ red on both sides of the mucogingival junction
16. Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is?
σ½ no local irritation
σ½ even absorption
σ½ no systemic toxicity
σ½ higher melting point of combined drug than either lidocaine (Xylocaine) or prilocaine (Citanest) alone
σ¾ no local irritation, even absorption and no systemic toxicity
17. Local anesthetic used in greater than 50% of rhinolaryngologic cases:?
σ½ prilocaine (Citanest)
σ¾ cocaine
σ½ mepivacaine (Carbocaine
σ½ bupivacaine (Marcaine)
σ½ tetracaine (pontocaine)
18. Mechanism(s) of local anesthetic action in epidural anesthesia:?
σ½ direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura
σ½ diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
σ¾ 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
σ½ neither
19. Rationale for adding epinephrine to a local anesthetic solution:?
σ½ reduced local anesthetic systemic absorption
σ½ increased anesthetic concentration near nerve fibers
σ½ reduced duration of conduction blockade
σ½ all of the above
σ¾ 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?
σ¾ epidural
σ½ Spinal
σ½ epidural and Spinal
21. Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia?
σ½ True
σ¾ False
22. Primary side effect/toxicities associated with local anesthetic use:?
σ½ allergic reactions
σ½ systemic toxicity
σ¾ allergic reactions and systemic toxicity
σ½ neither
23. Factors enhancing bupivacaine (Marcaine) toxicity?
σ½ Pregnancy
σ½ presence of calcium channel blockers
σ½ arterial hypoxemia
σ½ acidosis and hypercarbia
σ¾ Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
24. Agents added to local anesthetics that prolonged local anesthetic duration of action?
σ½ Epinephrine
σ½ phenylephrine (Neo-Synephrine)
σ½ dextran
σ¾ Epinephrine, phenylephrine (Neo-Synephrine) and dextran
25. Typically a zone of differential sympathetic nervous system blockade?
σ½ epidural
σ¾ spinal
σ½ epidural and spinal
26. Preferred local anesthetics for local infiltration:?
σ½ lidocaine (Xylocaine)
σ½ ropivacaine (Naropin)
σ½ bupivacaine (Marcaine)
σ¾ lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
27. Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfun
σ½ anterior spinal artery syndrome
σ¾ cauda equina syndrome
σ½ transient radicular irritation
28. Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain?
σ½ cauda equina syndrome
σ¾ transient radicular irritation
σ½ anterior spinal artery syndrome
29. Factors that influence lidocaine (Xylocaine) metabolism:?
σ½ pregnancy-induced hypertension
σ½ hepatic disease
σ½ reduced liver blood flow
σ½ volatile anesthetics
σ¾ pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
30. Most common cause of toxic plasma local anesthetic concentrations?
σ½ incorrect dosage during peripheral or block
σ¾ accidental direct intravascular injection during block
σ½ increase vasoconstrictors solution in the anesthetic
σ½ without solution of vasoconstrictors for anesthetic
31. Common eutectic mixture of local anesthetics (EMLA)?
σ½ tetracaine (pontocaine) and epinephrine
σ½ lidocaine (Xylocaine) and tetracaine (pontocaine)
σ½ prilocaine (Citanest) and bupivacaine (Marcaine)
σ½ tetracaine (pontocaine) and bupivacaine (Marcaine)
σ¾ lidocaine (Xylocaine) and prilocaine (Citanest)
32. Most frequent local anesthetic clinical use:?
σ½ treatment of grand mal seizure
σ½ analgesia
σ½ management of cardiac arrhythmias
σ¾ regional anesthetia
σ½ management of increased intracranial pressure
33. Lidocaine (Xylocaine) effect on ventilation response to hypoxia?
σ½ enhanced response
σ¾ depressed response
σ½ no effect
σ½ enhanced response and no effect
34. Clinical use(s) of EMLA applications:?
σ½ arterial cannulation
σ½ venipuncture
σ½ myringotomy
σ¾ lumbar puncture
35. Allergic reactions to local anesthetics:?
σ½ common > 10% of adverse reactions due to allergic mechanisms
σ½ high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds
σ½ cross-sensitivity between esters and amide-type local anesthetics are common
σ½ intradermal testing for possible allergy to local anesthetics should use preservative-free drug
σ¾ 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:?
σ½ Hypokalemia
σ½ rate of injection
σ½ patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used
σ½  high PaCO2 (reduced local anesthetic seizure threshold)
σ¾ 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.?
σ½ lidocaine (Xylocaine)
σ½ tetracaine (pontocaine)
σ½ mepivacaine (Carbocaine)
σ½ bupivacaine (Marcaine)
σ¾ dyclonine (Dyclone)
38. Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.?
σ½ Hypoxemia
σ½ Hyperkalemia
σ½ Acidosis
σ¾ Hypoxemia, Hyperkalemia and Acidosis
39. Local anesthetic which produces localized vasoconstriction and anesthesia?
σ½ tetracaine (pontocaine)
σ½ lidocaine (Xylocaine)
σ¾ cocaine
σ½ prilocaine (Citanest)
σ½ chloroprocaine (Nesacaine)
40. Agents not recommended for Bier block:
σ½ chloroprocaine (Nesacaine
σ½ mepivacaine (Carbocaine)
σ½ bupivacaine (Marcaine)
Chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
41. Manifestation of systemic toxicity
σ½ CNS toxicity
σ½ cardiovascular toxicity
σ½ neurological symptoms
σ¾ CNS toxicity, cardiovascular toxicity and neurological symptoms
42. Most commonly used local anesthetic for rhinolaryngologic cases
σ½ ropivacaine (Naropin
σ½ bupivacaine (Marcaine)
σ½ mepivacaine (Carbocaine)
σ¾ cocaine
σ½ tetracaine (pontocaine)
43. Commonly use local anesthetics for topical/surface application:
σ½ chloroprocaine (Nesacaine)
σ½ lidocaine (Xylocaine
σ½ tetracaine (pontocaine)
σ½ cocaine
σ¾ lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
44. Clinical presentations suggestive of local anesthetic allergies:
σ½ Rash
σ½ laryngeal edema
σ½ bronchospasm
σ½ urticarial and possibly hypotension
σ¾ All are correct
45. Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:
σ½ lidocaine (Xylocaine)
σ½ bupivacaine (Marcaine)
σ½ dibucaine (Nupercainal, generic)
σ¾ prilocaine (Citanest)
σ½ procaine (Novocain)
46. This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase
σ½ ropivacaine (Naropin)
σ½ bupivacaine (Marcaine)
σ¾ dibucaine (Nupercainal, generic)
σ½ procaine (Novocain)
σ½ chloroprocaine (Nesacaine)
47. Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution
σ½ Hypertension
σ½ Arrhythmias
σ¾ Hypertension and Arrhythmias
σ½ Neither
48. ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)
σ¾ true
σ½ false
49. Factor(s) which determine extent of systemic local anesthetic absorption
σ½ initial dose
σ½ injection site vascularity
σ½ intrinsic drug properties
σ½ whether or not epinephrine was used to provide local vasoconstriction
σ¾ All are not correct
50. Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics
σ½ ECG -PR interval prolongation
σ½ increased conduction velocity
σ½ reduced phase 4 depolarization
σ½ reduced automaticity
σ¾ All are not correct
51. Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia:
σ½ more lipophilic anesthetics benefit most by epinephrine in addition to local anesthetic solutions
σ¾ 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
σ½ transient radicular irritation
σ½ cauda equina syndrome
σ¾ anterior spinal artery syndrome
σ½ cauda equina syndrome and anterior spinal artery syndrome
53. Local anesthetic not recommended for peripheral nerve blockade:
σ½ lidocaine (Xylocaine)
σ½ bupivacaine (Marcaine)
σ½ ropivacaine (Naropin
σ¾ tetracaine (pontocaine)
54. Frequently used amide-type local anesthetic for Bier block
σ½ chloroprocaine (Nesacaine
σ¾ prilocaine (Citanest)
σ½ bupivacaine (Marcaine)
σ½ ropivacaine (Naropin)
55. The first ever peripheral nerve block is performed by
σ½ William Salk
σ½ Nils Lofgren
σ¾ William Halsted
σ½ Alfred Einhorn
56. The axons of peripheral nerve is supported by
σ¾ Support by Connective tissue
σ½ Supported by cell
σ½ Support by muscle
σ½ Support by blood
57. Unmeyelinated fiber is surround by
σ¾ A single wrapping
σ½ Plural wrapping
σ½ Wrapping by nerve
σ½ Wrapping by artery
58. The function organization of axon and schwann cell is called
σ¾ Nerve fiber
σ½ Nerve cell
σ½ Neuron cell
σ½ Call myelin sheath
59. The groups of the axon, the fasciculi, are enclosed in an additional connective tissue sheath called
σ¾ The perineurium
σ½ Endoneurium
σ½ Fasciculi
σ½ Epineurium
60. Individual nerve fibers(axons) are surround and separated from each other by
σ¾ Edoneurium
σ½ Perineurium
σ½ Epineurium
σ½ Fasciculi
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