Board Vitals Final

Question 1

A precursor to acetaminophen would be:

1. Glucuronide
2. Sulfate conjugate
3. N-acetyl-benzoquinoneimine
4. Acetanilide

Answer 1

Acetanilide

Question 2

Which of the following characteristics would NOT be an advantage to have in a class of sedative-hypnotics?

1. High margin of safety
2. Shallow dose-response profile
3. Well tolerated
4. Rapid onset of action
5. None of the above

Answer 2

None of the above

Question 3

Which of the following regarding antihistamines in anaphylaxis is TRUE?

1. Antihistamines inhibit anaphylactic reactions
2. Antihistamines compete with histamine at receptor sites
3. H1 antagonists are only indicated in some forms of anaphylaxis
4. The rapid parenteral administration of H1 antagonists may cause precipitous hypertension
5. H2 antagonists are clearly indicated after the onset of anaphylaxis

Answer 3

2. Antihistamines compete with histamine at receptor sites

Question 4

Which of the following drugs is recommended for use as prophylaxis in people who have come in close contact with individuals who have active Haemophilus influenzae type b (Hib) infections?

1. Amoxicillin
2. Ciprofloxacin
3. Rifampin
4. Doxycycline
5. Azithromycin

Answer 4

3. Rifampin

Question 5

A 45-year-old patient requires antibiotic prophylaxis prior to extraction of a tooth in an oral surgeon’s office, but is allergic to penicillin. Which of the following is the most appropriate 2ndantibiotic of choice to administer to the patient before this procedure?

1. Amoxicillin (2g 1 hour before appointment)
2. Clindamycin (600mg 1 hour before procedure)
3. Ampicillin (2g IV 30 minutes before procedure)
4. Cephalexin (2g 1 hour before procedure)
5. Cefazolin (1g IV 30 minutes before procedure)

Answer 5

2. Clindamycin (600mg 1 hour before procedure)

Question 6

A 6-year-old patient with an unrepaired ventricular septal defect (VSD) will need a routine teeth cleaning in the near future. Which of the following should be done with regards to this patient prior to their dental procedure?

1. Administer prophylactic amoxicillin
2. Administer prophylactic penicillin G
3. Administer prophylactic ampicillin
4. Administer prophylactic clindamycin
5. Prophylaxis is not necessary in this patient

Answer 6

5. Prophylaxis is not necessary in this patient

Question 7

All of the following drugs affect the thyroid except for which one?

1. Levothyroxine
2. Iodine
3. Methimazole
4. Thyroxine
5. Tolbutamide

Answer 7

5. Tolbutamide

Question 8

Because anticancer drugs cannot tell the difference between dividing malignant or normal cells, which property of the oral cavity increases the potential for developing drug-induced toxicity?

1. Presence of multiple species of microflora
2. Greater flow of saliva
3. Rapid turnover of oral mucosal cells
4. Decreased potential for micro-traumas

Answer 8

3. Rapid turnover of oral mucosal cells

Question 9

A 65-year-old male patient presents for dental treatment with a history of ischemic heart disease leading to congestive heart failure. His physician has placed him on a sympatholytic medication for management of his condition. Which of the following drugs should be administered with caution or avoided in this patient?

1. Mepivacaine 3% plain
2. Lidocaine 2% with 1:50,000 epinephrine
3. Lidocaine 2% with 1:100,000 epinephrine
4. Mepivacaine 3% with 1:20,000 levonordefrin

Answer 9

2. Lidocaine 2% with 1:50,000 epinephrine

Question 10

A 6-year-old patient with an unrepaired atrial septal defect (ASD) will need a routine teeth cleaning in the near future. Which of the following should be done with regards to this patient prior to their dental procedure?

1. Administer prophylactic amoxicillin
2. Administer prophylactic penicillin G
3. Administer prophylactic ampicillin
4. Administer prophylactic clindamycin
5. Prophylaxis is not necessary in this patient

Answer 10

5. Prophylaxis is not necessary in this patient

Question 11

Please select the TRUE statement from the following list regarding antihypertensive agents.

1. Aspirin increases the antihypertensive effect of ACE inhibitors
2. The use of vasoconstrictors is contraindicated in hypertensive patients
3. NSAIDs increase the antihypertensive effect of diuretics
4. NSAIDs often antagonize the effects of antihypertensive agents

Answer 11

4. NSAIDs often antagonize the effects of antihypertensive agents

Question 12

Which of the following is NOT a type of Beta-lactam antibiotic?

1. Penicillins
2. Carbapenems
3. Monobactams
4. Carbacephems
5. Streptogramins

Answer 12

5. Streptogramins

Question 13

Which of the following antibiotics will most likely have interactions with other drugs?

1. Cephalexin (Keflex)
2. Erythromycin (E-Mycin)
3. Metronidazole (Flagyl)
4. Doxycline (Vibramycin)

Answer 13

2. Erythromycin (E-Mycin)

Question 14

Which of the following is TRUE regarding opioid-induced hyperalgesia (OIH)?

1. Its occurrence is rare after potent analgesic use such as remifentanil.
2. It is mediated by endogenous mu-opioid receptors.
3. A concurrent ketamine infusion may prevent its occurrence.
4. It can be prevented by rapid opioid dose escalation.
5. It should not be treated with morphine in the post-operative setting.

Answer 14

3. A concurrent ketamine infusion may prevent its occurrence.

Question 15

In patients with a well-documented previous history of rheumatic fever, or those with evidence of rheumatic heart disease, long-term anti-streptococcal prophylaxis is indicted for secondary prevention. How long should this prophylaxis be administered in such patients (in the context of a planned invasive dental procedure)?

1. For the rest of the patient’s natural life
2. For at least ten years
3. For at least five years
4. For at least one year
5. For at least six months

Answer 15

2. For at least ten years

Question 16

All of the following are adverse effects of Loop Diuretics, except for:

1. Rapid reduction in blood volume
2. Magnesium depletion
3. Potassium depletion
4. Uric acid depletion
5. Ototoxicity

Answer 16

4. Uric acid depletion

Question 17

Unused nitroglycerin tablets should be discharged how long after the bottle has been opened?

1. 1 month
2. 2 months
3. 5 months
4. 9 months

Answer 17

2. 2 months

Question 18

AmpC-type beta lactamases (aka Class C) would render which of the following antibiotics ineffective?

1. Metronidazole
2. Rifampin
3. Tetracycline
4. Ceftriaxone
5. Methicillin
6. Oxacillin

Answer 18

4. Ceftriaxone

Question 19

Which of the following antibiotics has a t1/2 of 0.5 hours and has rapid excretion by the kidney?

1. Metronidazole
2. Fluoroquinolone
3. Penicillin G
4. Cephalosporins
5. Ciprofloxacin

Answer 19

3. Penicillin G

Question 20

Which of the following causes disulfiram-like reactions if taken with alcohol?

1. Amoxicillin
2. Penicillin G
3. Ciprofloxacin
4. Doxycycline
5. Metronidazole
6. Sulfamethoxazole

Answer 20

5. Metronidazole

Question 21

The endocrine system negotiates a careful homeostatic balance in the body. A 35-year-old female patient presents to your office with bronzing of the skin, weakness, fatigue and abnormal pigmentation of the oral mucosa. The patient had recently been diagnosed with an endocrine condition by her physician and had just begun taking corticosteroids for treatment. What is the condition?

1. Cushing’s disease
2. Addison’s disease
3. Hashimoto’s thyroiditis
4. Grave’s disease

Answer 21

2. Addison’s disease

Question 22

Which of the following is a second-generation antihistamine?

1. Loratidine
2. Diphenhydramine
3. Meclizine
4. Promethazine
5. Hydroxyzine

Answer 22

1. Loratidine

Question 23

Which of the following is true regarding the mechanism of action of local anesthetics?

1. Local anesthetics bind to extracellular voltage-gated sodium channels
2. Local anesthetics cross cell membranes in their cationic form
3. Local anesthetics can interact with voltage-gated potassium channels and nicotine acetylcholine receptors
4. Repetitive stimulation of nerves does not influence the effect of the block
5. The ion gradient of neurons is maintained by a cyclic adenosine monophosphate dependent process

Answer 23

3. Local anesthetics can interact with voltage-gated potassium channels and nicotine acetylcholine receptors

Question 24

In the operating room, the dentist proceeds to place a block using local anesthetic. The patient reports metallic taste in her mouth and some dizziness. The patient then becomes unresponsive, and rhythmic tonic-clonic movements are seen. She experiences bladder incontinence. Which of the following is INCORRECT?

1. She may progress to generalized CNS depression and coma
2. Using lidocaine instead of ropivacaine would have decreased likelihood of CNS toxicity from local anesthetics
3. This adverse reaction is more common with epidural injections than peripheral nerve blocks
4. A decrease in protein binding would increase the likelihood of CNS toxicity
5. Administering a benzodiazepine decreases the likelihood of seizures

Answer 24

3. This adverse reaction is more common with epidural injections than peripheral nerve blocks

Question 25

Which of the following is FALSE regarding tramadol’s mechanism of action? 1. Tramadol acts at the dorsal horn spinal synapses of the nociceptive pathways 2. Tramadol has opioidergic, monoaminergic, and NMDA- receptor activity 3. Tramadol is responsible for 5-hydroxytryptamine (5HT) and norepinephrine accumulation in the synaptic cleft 4. Tramadol causes inhibition of reuptake 5. Tramadol is considered a weak opioid

Answer 25

2. Tramadol has opioidergic, monoaminergic, and NMDA- receptor activity

Question 26

All of the following characteristics are true regarding Metformin, except for which one? 1. It is used to treat type 2 diabetes 2. Should not be used with patients with kidney problems 3. Common side effect is mostly gastrointestinal irritation 4. Adverse effect of causing hypoglycemia 5. Used to treat polycystic ovary syndrome

Answer 26

4. Adverse effect of causing hypoglycemia

Question 27

Statement 1: Antibiotic prophylaxis is not routinely indicated for most dental patients with total joint replacements. Statement 2: Patients allergic to penicillin who need antibiotic prophylaxis should take 2 grams orally of Clindamycin 3 hours before their dental appointment. (Select the correct choice) 1. Both statements are TRUE 2. Both statements are FALSE 3. The first statement is TRUE and the second is FALSE 4. The first statement is FALSE and the second is TRUE 5. Both statements are true but NOT RELATED

Answer 27

3. The first statement is TRUE and the second is FALSE

Question 28

A 22-year-old patient with an unrepaired cyanotic congenital heart defect is scheduled for a routine teeth cleaning. The patient is allergic to penicillins. Which of the following should be done with regards to this patient prior to their dental procedure? 1. Administer oral prophylactic amoxicillin 2. Administer intravenous prophylactic cefazolin 3. Administer intravenous prophylactic ampicillin 4. Administer oral prophylactic clindamycin 5. Administer intravenous prophylactic clindamycin 6. Prophylaxis is not necessary in this patient

Answer 28

4. Administer oral prophylactic clindamycin

Question 29

Which of the following salicylates contain two carbon rings in their basic structure? 1. Acetylsalicylic acid 2. Sodium salicylate 3. Salsalate 4. Methyl salicylate

Answer 29

3. Salsalate

Question 30

All of the following are indications for diphenhydramine EXCEPT: 1. Sleep disturbance 2. Acute dystonic reaction 3. Pruritus 4. Stress ulcer prophylaxis 5. Allergic reactions

Answer 30

4. Stress ulcer prophylaxis

Question 31

Polyene antifungal agents include: 1. Ketoconazole 2. Amphotericin B 3. Clotrimazole 4. Itraconazole 5. All of the above

Answer 31

Amphotericin B

Question 32

Chronic inhalation of nitrous oxide gas may lead to pernicious anemia by the following mechanism: 1. Nitrous oxide binds to vitamin B12 in the lungs and depletes the body stores 2. Nitrous oxide blocks the action of intrinsic factor in gastric parietal cells 3. Nitrous oxide interacts with cobalamin (vitamin B12) to oxidize and inactivate it 4. Nitrous oxide causes the loss of vitamin B12 in the urine and stool

Answer 32

3. Nitrous oxide interacts with cobalamin (vitamin B12) to oxidize and inactivate it

Question 33

The blood flow to the gastrointestinal tract and its pH within both directly affect the ??? of oral administered drugs? 1. Distribution 2. Excretion 3. Bioavailability 4. Absorption 1. a and c 2. a, c and d 3. c and d 4. c only 5. All of the above

Answer 33

2. a, c, and d

Question 34

Which of the following medications is associated with pseudomembranous colitis? 1. Augmentin 2. Penicillin 3. Azithromycin 4. Clindamycin 5. Ciprofloxacin

Answer 34

4. Clindamycin

Question 35

Which of the following regarding histamine biochemistry is FALSE? 1. Antihistamines act by stimulating the histamine receptor to activate inhibitory G proteins 2. Histamine is secreted by enterochromaffin-like endocrine cells 3. Histamine is produced by the decarboxylation of histidine 4. Histamine receptor stimulation on parietal cells causes G protein to activate adenylate cyclase and cyclic adenosine monophosphate 5. Histamine release is stimulated from mast cells via C5a and C3a

Answer 35

1. Antihistamines act by stimulating the histamine receptor to activate inhibitory G proteins

Question 36

Lidocaine is a Class 1B antiarrhythmic. Class 1B antiarrhythmics reduce automaticity at abnormal pacemakers in the His-Purkinje system and ventricular myocardium. (Select the correct choice) 1. Both statements are true 2. Both statements are false 3. The first statement is true, the second is false 4. The first statement is false, the second is true

Answer 36

1. Both statements are true

Question 37

Which of the following local anesthetics is a thiophene-based anesthetic? 1. Lidocaine 2. Articaine 3. Mepivacaine 4. Bupivacaine

Answer 37

2. Articaine

Question 38

Your 8-year-old patient comes to you and needs full mouth radiographs for a check-up. He was born with a congenital heart defect that has been repaired with a prosthetic material. He is doing very well and is very healthy. Which of the following is the best reasoning for consideration of antibiotic prophylaxis? 1. Patient needs antibiotic prophylaxis because the radiographs may cut him and he is at risk for infective endocarditis 2. Patient needs antibiotic prophylaxis at every appointment without regard to what is being done at the appointment due to his medical history 3. Patient does not need antibiotic prophylaxis because his defect is repaired and he is doing well 4. Patient does not need antibiotic prophylaxis because it has been greater than 6 months since the procedure 5. Patient does not need antibiotic prophylaxis because although he has a condition where antibiotic prophylaxis would be indicated, the procedure is not invasive and therefore not indicated

Answer 38

4. Patient does not need antibiotic prophylaxis because it has been greater than 6 months since the procedure

Question 39

Which of the following will most likely be used to treat an overdose of benzodiazepines? 1. Naloxone 2. Flumazenil 3. Zolpidem 4. Zaleplon 5. Narcan

Answer 39

2. Flumazenil

Question 40

Which of the following antibiotics is considered the drug of choice for genitourinary infections with Chlamydia trachomatis? 1. Azithromycin 2. Ciprofloxacin 3. Ceftriaxone 4. Rifampin 5. Penicillin

Answer 40

1. Azithromycin

Question 41

All of the following medications, except one, have been shown to cause gingival enlargement. Which is that exception? 1. Phenytoin 2. Cyclosporine 3. Ethambutol 4. Nifedipine 5. Verapamil 6. Diltiazem

Answer 41

3. Ethambutol

Question 42

Which of the following antibiotics is used to treat mycobacterium infections and contraindicated with the use of antiretroviral agents? 1. Ampicillin 2. Tetracycline 3. Amoxicillin 4. Rifampicin 5. Ciprofloxacin

Answer 42

4. Rifampicin

Question 43

Statement 1: Penicillins work by competitively inhibiting the transpeptidase enzyme, leading to disruption of cell wall synthesis. Statement 2: Penicillins are bacteriostatic. (Select the correct choice) 1. Both statements are true 2. Both statements are false 3. The first statement is true, the second is false 4. The first statement is false, the second is true

Answer 43

3. The first statement is true, the second is false

Question 44

Which of the following medication is often used to treat an overdose of opioids? 1. Naloxone 2. Flumazenil 3. Verapamil 4. Ciprofloxacin 5. Zolpidem

Answer 44

1. Naloxone

Question 45

Simvastatin is an example of a(n): 1. Bile acid sequestrant 2. Fibric acid derivative 3. Nicotinic acid 4. HMG-CoA reductase inhibitor 5. Cholesterol absorption inhibitor

Answer 45

4. HMG-CoA reductase inhibitor

Question 46

Antibiotic prophylaxis after dental surgical procedures is: 1. Known to be critical for the prevention of infection 2. Known to be ineffective in preventing infection or postoperative complications 3. Required only for extraction of impacted wisdom teeth 4. Required for all surgical procedures to prevent post-operative complications

Answer 46

2. Known to be ineffective in preventing infection or postoperative complications

Question 47

Which of the following is the best antibiotic for the treatment of primary syphilis? 1. Rifampin 2. Benzathine penicillin 3. Clindamycin 4. Doxycycline 5. Erythromycin

Answer 47

2. Benzathine penicillin

Question 48

Drugs of abuse can induce: amphetamines, benzodiazepines, and narcotics. What are some indicated legal uses for amphetamines? 1. Narcolepsy 2. Weight loss 3. To stay awake studying for an exam 4. Attention deficit disorder 1. a and c 2. a, b, and d 3. d only 4. All of the above 5. None of the above

Answer 48

2. a, b, and d

Question 49

A patient presents complaining of pain due to an abscessed tooth. You take a radiograph and examine the patient and discuss treatment options. The patient refuses treatment, but just asks for a prescription. What would be the most concerning cause of this behavior? 1. An extremely anxious patient, requiring sedation 2. The patient does not have the money for the treatment 3. The patient does not care to have treatment 4. A drug abuser seeking narcotics

Answer 49

4. A drug abuser seeking narcotics

Question 50

Which of the following antifungals is primarily used to treat oral Candidiasis albicans infections? 1. Nystatin 2. Terbinafine 3. Amphotericin B 4. Ketoconazole 5. Naftifine

Answer 50

1. Nystatin

Question 51

A dental student was seeing a forty-year-old male patient for the first time. As he was going over the patient’s medical history, the patient informed the student that his physician had recently placed him on a new medication but he could not recall the name. This medication was to treat his high blood pressure. The patient stated he had some adverse symptoms, which included light-headedness, and gout attacks: 1. Hydrochlorothiazide 2. Thiazolidinediones 3. Tolbutamide 4. Butyrophenones 5. Furosemide

Answer 51

1. Hydrochlorothiazide

Question 52

In a patient with a methicillin-resistant Staphylococcus aureus (MRSA) infection of the lungs, the best choice of antibiotic is which of the following? 1. Piperacillin 2. Cephalexin 3. Ceftriaxone 4. Daptomycin 5. Vancomycin

Answer 52

5. Vancomycin

Question 53

5-Fluorouracil is used significantly in the treatment of solid cancerous tumors. It is also known as: 1. An alkylating agent 2. A designer antimetabolite 3. An anti-tumor antibiotic 4. A mitotic inhibitor

Answer 53

2. A designer antimetabolite

Question 54

Which of the following statements about local anesthetics is TRUE? 1. Local anesthetics only block sensory nerves 2. Local anesthetics only block motor nerves 3. Local anesthetics block sensory nerves and can block motor nerves if concentration is sufficient 4. Local anesthetics block sensory nerves mildly and block motor nerves profoundly 5. Local anesthetics block both sensory and motor nerves profoundly

Answer 54

3. Local anesthetics block sensory nerves and can block motor nerves if concentration is sufficient

Question 55

Which factors do NOT influence the effects of drug administration? 1. Body composition 2. Age of patient 3. Medical status 4. Ambient temperature 5. None of the above

Answer 55

5. None of the above

Question 56

Which of the following is NOT characteristic of thiazide diuretics? 1. Result in hypoglycemia 2. Result in hypokalemia 3. Increase renal elimination of sodium 4. Increase renal elimination of chloride 5. Increase renal elimination of potassium

Answer 56

1. Result in hypoglycemia

Question 57

Which of the following antibiotic medications can lead to a Clostridium difficile- associated diarrhea (pseudomembranous colitis) of the gastrointestinal system? 1. Penicillins 2. Tetracyclines 3. Cephalosporins 4. Clindamycin 5. Metronidazole

Answer 57

4. Clindamycin

Question 58

A forty-year-old man walked into the dental office for the first time. As the dentist was going over his medical history, the man informed the dentist that he was recently diagnosed with Type 2 Diabetes and was on a few medications. Which of the following drugs is most likely not one of the drugs his physician prescribed? 1. Metformin 2. Rosiglitazone 3. Pioglitazone 4. Acetazolamide 5. Glipizide

Answer 58

4. Acetazolamide

Question 59

How soon after administration of levodopa dose should a Parkinson’s patient be scheduled for dental treatment? 1. 3 hours 2. 12 hours 3. 60-90 minutes 4. 1 day

Answer 59

3. 60-90 minutes

Question 60

Which of the following is FALSE regarding first generation antihistamine medications? 1. They have anticholinergic effects by acting on muscarinic receptor antagonists 2. They cross the blood brain barrier 3. They can produce sedation, coma and seizures 4. The dose must be weight-adjusted for children younger than 2 years of age 5. They can reduce nausea and vomiting

Answer 60

4. The dose must be weight-adjusted for children younger than 2 years of age

Question 61

A 72-year-old man with past medical history of end-stage renal disease receiving dialysis is in the post anesthesia care unit (PACU) after an uneventful total knee repair six hours age that lasted for three hours. The anesthesiologist is called by the nursing staff for altered mental status. His blood pressure is 99/65 mmHg, heart rate of 54 beats per minute, respiratory rate of 7 breaths a minute, and oxygen saturation of 89% on 2 liters nasal cannula. The patient is obtunded and difficult to arouse. Chart review reveals that the patient received a remifentanil infusion totaling 2.1mg intraoperatively, and morphine 10mg orally three times for 9/10 pain in the PACU. The cause of this patient’s respiratory depression is most likely: 1. Related to the intravenously administered intraoperative opioids 2. Due to opioid-induced hyperalgesia 3. Due to the slow passage of glucoronidated metabolites 4. Opioid metabolites with higher potency than the parent drug 5. Caused by increased context-sensitive half time of remifentanil

Answer 61

3. Due to the slow passage of glucoronidated metabolites

Question 62

Which of the following drugs does not have antagonist effects at the N-methyl-D-aspartate (NMDA) receptor? 1. Methadone 2. Dextra-propoxyphene 3. Ketobemidone 4. Hydromorphone 5. Morphine

Answer 62

4. Hydromorphone

Question 63

Excessive salivation may be a sign of: 1. Digoxin toxicity 2. Methamphetamine use 3. Diuretic drug overdose 4. Pathologic vomiting

Answer 63

1. Digoxin toxicity

Question 64

When administering local anesthetic containing the vasoconstrictor epinephrine, serious complications may be expected if the dose of epinephrine exceeds ??? and fatalities are likely to occur if the dose reaches ???. 1. 0.5mg; 4mg 2. 0.1mg; 4mg 3. 0.2mg; 5mg 4. 4mg; 10mg

Answer 64

1. 0.5mg; 4mg

Question 65

The body’s inflammatory response due to tissue injury is mediated by 1. Histamine, prostaglandins, and leukotrienes 2. Prostaglandins, leukotrienes and salicylates 3. Histamine, salicylates and leukotrienes 4. Prostaglandins, salicylates and macrophage products 5. Histamine, macrophage products and salicylates

Answer 65

1. Histamine, prostaglandins, and leukotrienes

Question 66

Release of parathyroid hormone from the parathyroid gland induces: 1. Intestinal absorption of calcium by increasing vitamin D release from the kidneys 2. An increase in plasma phosphate concentration 3. Decreased bone turnover via RANKL activity 4. Kidney release of magnesium to increase bone resorption

Answer 66

1. Intestinal absorption of calcium by increasing vitamin D release from the kidneys

Question 67

Chemotherapy treatment for cancer is most effective in large tumor masses. This is the case because a greater proportion of tumor cells are in the stage of cell division, which allows the drug to act with more sensitivity. (Select the correct choice) 1. The statement and the reason are both correct and related 2. Both the statement and the reason are correct, but NOT related 3. The statement is correct, but the reason is NOT 4. The statement is NOT correct, but the reason is correct 5. NEITHER the statement NOR the reason is correct

Answer 67

4. The statement is NOT correct, but the reason is correct

Question 68

A patient requires prophylactic antibiotic treatment for a dental procedure. Immediately after the procedure is done, the dental assistant realizes he forgot to administer the antibiotic treatment to the patient. How long after the procedure is performed can the prophylactic treatment still be administered? 1. 30 minutes after the procedure 2. 1 hour after the procedure 3. 2 hours after the procedure 4. 5 hours after procedure 5. 3 days after the procedure

Answer 68

3. 2 hours after the procedure

Question 69

Which of the following is an antifungal medication that may cause prolonged QT intervals and is contraindicated with the use of selective serotonin reuptake inhibitor (SSRI) such as Fluoxetine and Sertraline? 1. Nystatin 2. Terbinafine 3. Fluconazole 4. Flagyl 5. Metronidazole

Answer 69

3. Fluconazole

Question 70

Which of the following would not be indicated in a patient with a penicillin allergy? 1. Vancomycin 2. Ketoconazole 3. Clindamycin 4. Cefaclor 5. Erythromycin

Answer 70

4. Cefaclor

Question 71

All of the following about endogenous opioid peptides and their receptors are true EXCEPT: 1. Mu-3 receptors are involved in opioid-induced immune suppression 2. Beta-endorphins have a higher affinity for the mu-opioid receptors 3. Dynorphin A has a higher affinity for the delta-opioid receptors 4. Met- and leu-enkephalins have a higher affinity for the kappa-opioid receptors 5. Delta-opioid receptors are involved in opioid-induced respiratory depression

Answer 71

5. Delta-opioid receptors are involved in opioid-induced respiratory depression

Question 72

Phentolamine is an alpha-adrenergic receptor agonist. Phentolamine is non-selective and works on both alpha-1 and alpha-2 receptors. (Select the correct choice) 1. Both statements are true 2. Both statements are false 3. The first statement is true, the second is false 4. The first statement is false, the second is true

Answer 72

4. The first statement is false, the second is true

Question 73

For a patient in whom the prophylactic use of antibiotics is warranted, how soon before their intended procedure should the first dose of treatment be administered 1. During the procedure 2. Between 30 and 60 minutes prior to the procedure 3. 24 and 48 hours prior to the procedure 4. 5 days before the procedure 5. 1 week before the procedure

Answer 73

2. Between 30 and 60 minutes prior to the procedure

Question 74

Vasoconstrictors in local anesthetics constrict the vessels in surrounding tissues and thereby help control perfusion of the local anesthetic into those tissues. Several reasons this is important are: 1. Decreased blood flow to the tissue site 2. Increased flow to the local anesthetic into the blood stream 3. Minimizing risk of toxicity from local anesthetic 4. Decreased bleeding at administration site 1. a, b, c 2. a and d 3. a, c, d 4. All of the above 5. None of the above

Answer 74

3. a, c, d

Question 75

Which of the following is NOT a mechanism of drug metabolism? 1. Oxidation 2. Reduction 3. Hydrolysis 4. Dehalogenation 1. a and c 2. a, b, c 3. d only 4. All of the above 5. None of the above

Answer 75

5. None of the above

Question 76

Left ventricular dysfunction over time ultimately leads to a condition known as congestive heart failure. Which of the following drugs is NOT a known treatment for this condition? 1. Digoxin 2. Spironolactone 3. Furosemide 4. Captopril 5. Morphine

Answer 76

5. Morphine

Question 77

Penicillin V is preferred over penicillin G because penicillin V is: 1. Given intramuscularly 2. Less allergenic 3. More stable in acidic conditions 4. Less cross-hypersensitivity with cephalosporins 5. None of the above

Answer 77

3. More stable in acidic conditions

Question 78

Which of the following medications is NOT considered a critical drug for use in emergency situations? 1. Diazepam 2. Epinephrine 3. Nitroglycerin 4. Glucose 5. Aspirin

Answer 78

1. Diazepam

Question 79

Which of the following penicillin-derived medications is considered the most effective against Pseudomonas aeruginosa? 1. Ampicillin 2. Amoxicillin 3. Carbenicillin 4. Penicillin G 5. Dicloxacillin

Answer 79

3. Carbenicillin

Question 80

Penicillins may cause anaphylactic (allergic) reactions. All of the following may be a symptom of an anaphylactic reaction, EXCEPT: 1. High blood pressure 2. Urticaria 3. Rash 4. Bronchospasm 5. None of the above

Answer 80

1. High blood pressure

Question 81

Which of the following antibiotics is resistant to gastric acid? 1. Penicillin G 2. Penicillin V 3. Procaine penicillin 4. Carbenicillin 5. Benzylpenicillin

Answer 81

2. Penicillin V

Question 82

Which of the following represents the mechanism of action of isoniazid? 1. Inhibition of cAMP synthesis 2. Inhibition of mycolic acid synthesis 3. Inhibition of DNA-dependent RNA polymerase 4. Inhibition of topoisomerase II 5. Inhibition of cell wall synthesis

Answer 82

2. Inhibition of mycolic acid synthesis

Question 83

A patient with a long-standing history of glucocorticoid treatment presents for routine dental care. Which of the following complications would you NOT expect in such a patient during the course of treatment? 1. Decreased resistance to infection 2. Acute adrenal insufficiency 3. Suppression of pituitary-adrenal function 4. Poor wound healing

Answer 83

2. Acute adrenal insufficiency

Question 84

Adrenergic receptors in the nervous system fall into three categories. These are: 1. Nicotinic 2. Muscarinic 3. alpha1 and alpha2 4. beta 1. a, b, d 2. b, c, d 3. a, b, c 4. c and d 5. None of the above

Answer 84

4. c and d

Question 85

What is the primary rationale for adding vasoconstrictors to local anesthetics? 1. Reduce bleeding 2. Reduce systemic toxicity 3. Increase heart rate 4. Increase blood pressure 5. Increase duration of effect

Answer 85

5. Increase duration of effect

Question 86

Which of the following classes of drugs is NOT known to cause gingival enlargement? 1. Calcium channel blockers 2. Beta-blockers 3. Anticonvulsants 4. Immunosuppressants

Answer 86

2. Beta-blockers

Question 87

All of the following are common uses of antihistamines EXCEPT? 1. Motion sickness 2. Anticholinergic crisis 3. Sleeping disturbance 4. Nausea and vomiting 5. Serotonin syndrome

Answer 87

2. Anticholinergic crisis

Question 88

Statement 1: Parkinson’s disease is an acute progressive wasting disease of the central nervous system. Statement 2: Treatment for Parkinson’s includes using drugs such as levodopa in conjunction with carbidopa. Select the correct choice. 1. Statements 1 and 2 are both correct. 2. Statement 1 is correct; statement 2 is false 3. Statement 1 is false; statement 2 is correct 4. Both statements are false

Answer 88

3. Statement 1 is false; statement 2 is correct

Question 89

Which of the following procedures justifies the use of prophylactic antibiotics to prevent endocarditis in a patient with a heart condition? 1. Colonoscopy 2. Bronchoscopy 3. Placement of orthodontic braces 4. Esophagogastroduodenoscopy 5. Extraction of impacted third molars

Answer 89

5. Extraction of impacted third molars

Question 90

Which of the following medications is a short acting agent that is contraindicated in individuals with acute narrow angle glaucoma? 1. Midazolam 2. Verapamil 3. Naloxone 4. Captopril 5. Flumazenil

Answer 90

1. Midazolam

Question 91

Which of the following antibiotics is known to have about a 10% cross-hypersensitivity with penicillin allergic patients? 1. Clindamycin 2. Cephalosporin 3. Vancomycin 4. Azithromycin 5. Erythromycin

Answer 91

2. Cephalosporin

Question 92

Which of the following antibiotics require blood level-monitoring to avoid toxicity? 1. Nalidixic acid 2. Rifampin 3. Gentamicin 4. Metronidazole 5. Erythromycin

Answer 92

3. Gentamicin

Question 93

A 32-year-old patient with Ebstein’s anomaly must take prophylactic antibiotics prior to a dental procedure, however, he has a history of dysphagic. Which of the following is the best course of prophylactic treatment in this patient? 1. Oral amoxicillin 2. Intravenous ampicillin 3. Intravenous clindamycin 4. Intravenous azithromycin 5. Intravenous cefalexin

Answer 93

2. Intravenous ampicillin

Question 94

Acetylsalicylic acid has several desirable properties. Please choose four of these properties from the following list. 1. Anti-psychotic 2. Analgesic 3. Anti-inflammatory 4. Anti-oxidant 5. Anti-pyretic 6. Anti-platelet 7. Anti-histamine

Answer 94

2. Analgesic 3. Anti-inflammatory 5. Anti-pyretic 6. Anti-platelet

Question 95

Which of the following drugs an individual is taking will the patient experience gastrointestinal problems and gingival hyperplasia? 1. Carbamazepine 2. Dilantin 3. Acetaminophen 4. Penicillin 5. Azithromycin

Answer 95

2. Dilantin

Question 96

If a patient is taking citalopram as one of his medications to treat his depression, which of the following should the patient avoid consuming with the medication together? 1. Tryptophan 2. Tetracycline 3. Augmentin 4. Verapamil 5. Midazolam

Answer 96

1. Tryptophan

Question 97

Which of the following is the drug of choice for treatment of Rickettsia rickettsii infection? 1. Doxycycline 2. Oxacillin 3. Erythromycin 4. Rifampin 5. Clindamycin

Answer 97

1. Doxycyline

Question 98

This drug is an inhibitor of cytochrome P450 enzymes and causes gastrointestinal problems as well as torsades de pointes. Which of the following drugs most likely fits with the description? 1. Erythromycin 2. Tetracycline 3. Nystatin 4. Diazepam 5. Augmentin

Answer 98

1. Erythromycin

Question 99

Many diabetic patients are at risk of hypoglycemic events due to their medication or insulin use. What are the signs and symptoms of mild hypoglycemia? 1. Periodontal inflammation 2. Unconsciousness 3. Weakness, tachycardia 4. Incoherence, belligerence

Answer 99

3. Weakness, tachycardia

Question 100

Several combination analgesics are prescribed in dental clinics. Particularly, Tylenol 3 has ben prescribed for pain management after surgical procedures. Which component of Tylenol 3 is considered an adjuvant to analgesia? 1. Acetaminophen 2. Codeine 3. Caffeine 4. Ibuprofen

Answer 100

3. Caffeine

Question 101

The basic mechanism of action of opioid analgesics is: 1. By initiating a descending cascade of pain inhibition 2. By binding to opioid receptors in the CNS and PNS 3. By directly inhibiting the pain signals from the tissue site of injury 4. By inhibiting the ascending pain stimuli signals 1. a, b, c 2. a and b only 3. a, b, d 4. All of the above 5. None of the above

Answer 101

2. a and b only

Question 102

For therapeutic use in patients with moderate to severe xerostomia, which of the following classes of drugs would be most beneficial? 1. Muscarinic receptor antagonists 2. Nicotinic receptor antagonists 3. Adrenergic receptor agonists 4. Muscarinic receptor agonists

Answer 102

4. Muscarinic receptor agonists

Question 103

Which of the following regarding histamine action is FALSE? 1. Histamine undergoes primarily hepatic transformation 2. Histamine triggers smooth muscle constriction via endothelium-derived relaxing factor, nitric oxide 3. Histamine acts of H1, H2, H3 receptors 4. When injected subcutaneously, histamine produces a tissue edema from increased capillary permeability 5. Histamine binds to H2 receptors, resulting in gastric secretion

Answer 103

1. Histamine undergoes primarily hepatic transformation

Question 104

Which of the following macrolides have the most significant adverse effects? 1. Azithromycin 2. Dirithromycin 3. Clarithromycin 4. Erythromycin 5. Clindamycin

Answer 104

4. Erythromycin

Question 105

All of the following are considered aminoglycosides, EXCEPT: 1. Gentamicin 2. Neomycin 3. Tobramycin 4. Azithromycin 5. Amikacin

Answer 105

4. Azithromycin

Question 106

An agonist for which of the following receptors is responsible for bronchial vessel dilation? 1. Alpha-1 2. Alpha-2 3. Beta-1 4. Beta-2 5. None of the above

Answer 106

4. Beta-2

Question 107

Procaine is one of the only local anesthetics that are classified as an ester. The other category of local anesthetics is ???, and several examples are ???. 1. Amide; articaine, tetracaine, prilocaine 2. Alkene; lidocaine, prilocaine, and mepivacaine 3. Amide; lidocaine, tetracaine and mepivacaine 4. Amide; articaine, bupivacaine, etidocaine 5. Alkene; lidocaine, tetracaine and mepivacaine

Answer 107

4. Amide; articaine, bupivacaine, etidocaine

Question 108

Which of the following regarding allergic reactions to local anesthetics are TRUE? 1. Type I hypersensitivity reactions to local anesthetics most often present with delayed pruritus, papules, dermal erythema, or papules. 2. Local anesthetic allergic reactions are more likely in ropivacaine than procaine. 3. Amide local anesthetics are more likely to cause allergic reactions than ester local anesthetics due to the breakdown product of amide local anesthetics, para-aminobenzoic acid. 4. Skin pricks, intradermal injections, or subcutaneous testing dose challenges are recommended for patients with suspected local anesthetic allergic reactions. 5. Preservatives in local anesthetics never contribute to allergic reactions.

Answer 108

4. Skin pricks, intradermal injections, or subcutaneous testing dose challenges are recommended for patients with suspected local anesthetic allergic reactions.

Question 109

The following list contains four consequences of chronic alcoholism on the body and drug metabolism. Please select these four items. 1. Decreased effectiveness of local anesthetic 2. Deficiency of liver function 3. Increased likelihood of polycythemia 4. Delayed healing response time 5. Decreased risk of liver cancer 6. Increased likelihood of bleeding after extraction

Answer 109

1. Decreased effectiveness of local anesthetic 2. Deficiency of liver function 4. Delayed healing response time 6. Increased likelihood of bleeding after extraction

Question 110

A 44-year-old male with a history of severe, persistent asthma presents with white patches on his tongue and inside his mouth. Which medication is responsible for his presentation? 1. Overuse of an albuterol inhaler 2. Theophylline 3. Salmeterol inhaler 4. Beclomethasone inhaler 5. Omalizumab

Answer 110

4. Beclomethasone inhaler

Question 111

Which of the following regarding epidural opioid administrations is TRUE? 1. Lipophilic opioids tend to penetrate the tissues at a slower rate. 2. Hydrophilic opioids achieve higher concentrations in the spinal cord than hydrophobic opioids. 3. Hydrophobic opioids are cleared from the spinal fluid at a slower rate. 4. Lipophilic opioids may cause an early onset respiratory depression. 5. Morphine tends to cause early ventilatory depression.

Answer 111

4. Lipophilic opioids may cause an early onset respiratory depression.

Question 112

Which of the following is NOT a cytochrome P450 3A4 inducers? 1. St. John’s Wort 2. Rifampicin 3. Carbamazepine 4. Grapefruit juice 5. Phenobarbital

Answer 112

4. Grapefruit juice

Question 113

Which of the following antihypertensives is known to cause gingival hyperplasia in patients? 1. Calcium channel blockers 2. Alpha-adrenergic receptor blockers 3. ACE inhibitors 4. ATII receptor antagonists 5. Beta-adrenergic receptor blockers

Answer 113

1. Calcium channel blockers

Question 114

Which of the following antibiotics will alter the effectiveness of oral contraceptive pills and Coumadin if combined together? 1. Augmentin 2. Tetracycline 3. Amoxicillin 4. Penicillin 5. Erythromycin

Answer 114

5. Erythromycin

Question 115

An 18-year-old with Tetralogy of Fallot must visit the dentist to remove two impacted lower third molars in the near future. Which of the following should be done with regards to this patient prior to their dental procedure? 1. Administer prophylactic amoxicillin 2. Administer prophylactic cefazolin 3. Administer prophylactic ampicillin 4. Administer prophylactic clindamycin 5. Prophylaxis is not necessary in this patient

Answer 115

1. Administer prophylactic amoxicillin

Question 116

A fifty-five-year-old man was seen in the dental office for the first time. When asked questions about his medical history, the patient informed the dentist that he was recently diagnosed with pulmonary edema and was placed on a new drug. He states that he has had increased urination and noticed that his hearing was affected as well. Which of the following drugs is the patient most likely taking? 1. Furosemide 2. Metolazone 3. Spironolactone 4. Triamterene 5. Mannitol

Answer 116

1. Furosemide

Question 117

Which of the following correctly describes the mechanism of the antifungal agent, amphotericin B? 1. Inhibits mitosis 2. Inhibits ergosterol synthesis 3. Inhibits glucan synthesis 4. Combines with ergosterol to form membrane pores 5. None of the above

Answer 117

4. Combines with ergosterol to form membrane pores

Question 118

All of the following factors are inhibited by warfarin (Coumadin), EXCEPT: 1. Factor II 2. Factor VII 3. Factor VIII 4. Factor IX 5. Factor X

Answer 118

3. Factor VIII

Question 119

In a patient with an upper respiratory tract infection who is also allergic to penicillin, the most appropriate drug to administer would be which of the following? 1. Trimethoprim 2. Amoxicillin/clavulanic acid 3. Fusidic acid 4. Cefuroxime 5. Clarithromycin

Answer 119

5. Clarithromycin

Question 120

Nifedipine is an L-type calcium channel blocker used to treat patients with cardiac problems and hypertension. Which of the following should NOT be used with this medication? 1. Citrus products 2. Acetaminophen 3. Verapamil 4. Grapefruit juice 5. Vicodin

Answer 120

4. Grapefruit juice

Question 121

Which channels are blocked in order to cause anesthesia when local anesthetics are used? 1. Potassium 2. Sodium 3. Chloride 4. Hydrogen 5. Calcium

Answer 121

2. Sodium

Question 122

Which of the following drugs taken may cause adverse effects such as a prolonged QT interval, jaundice and gastrointestinal problems? 1. Clarithromycin 2. Chloral hydrate 3. Clindamycin 4. Diazepam 5. Augmentin

Answer 122

1. Clarithromycin

Question 123

What is the mechanism of action of spironolactone? 1. Decreases Na+ and Cl- cotransport 2. Decreases Na+/K+/2Cl- cotransport 3. Decreases Na+ reabsorption by blocking Na+ channels 4. Blocks aldosterone receptor 5. None of the above

Answer 123

4. Blocks aldosterone receptor

Question 124

An 18-year-old male presents with pain in his upper right quadrant. After examination and treatment planning, it is decided to extract his upper right second molar. Just before administration of anesthetic, the patient says he has an allergy to the freezing. After asking the patient what reaction he has had, and if he knew the name of the drug he was previously given, the patient says he had diagnosed methemoglobinemia. Which local anesthetic is the most potent induces or methemoglobinemia, and should therefore be avoided? 1. Lidocaine 2. Etidocaine 3. Novocaine 4. Prilocaine

Answer 124

4. Prilocaine

Question 125

All of the following are antituberculosis drugs (first-line) EXCEPT: 1. Clindamycin 2. Isoniazid 3. Rifabutin 4. Rifampin 5. Ethambutol

Answer 125

1. Clindamycin

Question 126

Which of the following is the elimination half-life of adenosine? 1. \<10 seconds 2. 0.2 hours 3. 1.5-2 hours 4. 4-10 hours 5. 12-27 hours

Answer 126

1. \<10 seconds

Question 127

The rapid turnover of cells in the mouth predisposes the oral cavity to increased drug-induced toxicity in patients undergoing treatment with: 1. Monoclonal antibodies 2. Glucocorticoids 3. Antineoplastic agents 4. Polyclonal antibody preparations

Answer 127

3. Antineoplastic agents

Question 128

In a pregnant patient who has a Streptococcus pneumoniae infection and is allergic to penicillin, the drug of choice would be which of the following? 1. Azithromycin 2. Metronidazole 3. Cephalexin 4. Doxycycline 5. Levofloxacin

Answer 128

1. Azithromycin

Question 129

Which of the following medications is a calcium channel blocker used to treat both hypertension and Raynaud’s phenomenon that is also associated with gingival hyperplasia? 1. Sildenafil 2. Losartan 3. Nifedipine 4. Celecoxib

Answer 129

3. Nifedipine

Question 130

Which of the following is FALSE? 1. The peak plasma level of local anesthetics for any given site of injection is directly proportional to the drug concentration. 2. The rate of systemic absorption of local anesthetics is greater in epidural blocks than brachial plexus blocks. 3. The peak plasma level of local anesthetics for any given site of injection is directly proportional to the dose of local anesthetics. 4. More potent, lipid soluble agents are generally associated with a slower rate of absorption compared to less potent, less lipid soluble agents. 5. The rate of systemic absorption of local anesthetics is greater in intercostal blocks than femoral blocks.

Answer 130

1. The peak plasma level of local anesthetics for any given site of injection is directly proportional to the drug concentration.

Question 131

A patient is being treated for Mycobacterium tuberculosis infection and begins to lose visual acuity, and, strangely, complains about no longer being able to see the color green. Which one of the antimycobacterial agents is likely causing these symptoms? 1. Isoniazid 2. Pyrazinamide 3. Rifampin 4. Ethambutol 5. Pyridoxal phosphate

Answer 131

4. Ethambutol

Question 132

A female patient presents for extraction with an unremarkable medical history. She has reported to be taking NO medications. You perform the extraction and observe prolonged bleeding, that has become difficult to manage. Which of the following herbal products could be responsible if taken in large quantities? 1. Astralagus 2. Kava-kava 3. Garlic 4. St. John’s Wort

Answer 132

3. Garlic

Question 133

Drug synergism involves: 1. A pairing of two or more drugs to produce a lesser effect than each drug alone 2. A pairing of two or more drugs to produce a greater effect than each drug alone 3. A drug accumulating in the body over time to increase its concentration 4. A drug using the kidneys to produce an effect greater than it could in vitro 5. The production of active metabolites within the liver

Answer 133

2. A pairing of two or more drugs to produce a greater effect than each drug alone

Question 134

All of the following additives prolong local anesthetic activity EXCEPT: 1. Epinephrine 2. Alkalinization of local anesthetic solution 3. Opioids 4. Alpha-2 adrenergic agonists 5. Steroids

Answer 134

2. Alkalinization of local anesthetic solution

Question 135

A dentist may be the first health practitioner to suspect hypothyroidism in a young patient is which of the following signs are seen? 1. Delayed eruption of the teeth 2. Moist and warm skin 3. Weight loss 4. Profuse sweating

Answer 135

1. Delayed eruption of the teeth

Question 136

All of the drugs listed are loop diuretics except for which of the following? 1. Furosemide 2. Ethacrynic acid 3. Bumetanide 4. Torsemide 5. Spironolactone

Answer 136

5. Spironolactone

Question 137

Syncope is: 1. A temporary loss of consciousness due to insufficient blood flow to the brain 2. A prolonged loss of consciousness due to increased perfusion to the brain 3. A temporary loss of consciousness due to inadequate blood flow leading to coma 4. A temporary loss of consciousness due to increased perfusion to the brain 5. A prolonged loss of consciousness due to inadequate blood flow leading to coma

Answer 137

1. A temporary loss of consciousness due to insufficient blood flow to the brain

Question 138

Which of the following drugs when used with alcohol will cause a disulfiram-like reaction? 1. Fluconazole 2. Metronidazole 3. Midazolam 4. Naloxone 5. Flumazenil

Answer 138

2. Metronidazole

Question 139

Upon administering epinephrine intravenously, one would expect a decrease in systolic pressure and heart rate. This occurs because epinephrine induces contraction of vascular smooth muscle and vasoconstriction. (Select the correct choice) 1. The statement and the reason are both correct and related. 2. Both the statement and the reason are correct, but NOT related. 3. The statement is correct, but the reason is NOT. 4. The statement is NOT correct, but the reason is correct. 5. NEITHER the statement NOR the reason is correct.

Answer 139

4. The statement is NOT correct, but the reason is correct.

Question 140

Which of the following regarding stress ulcer prophylaxis with H2 antihistamines is FALSE? 1. Famotidine and cimetidine are examples of antihistamines that act on the proton pumps of parietal cells to decrease gastric acid secretion 2. H2 antihistamines have been shown to reduce stress bleeding from gastric ulcers 3. Indications for gastric ulcer prophylaxis include patients with respiratory failure who have been mechanically ventilated for over 48 hours 4. Caution must be used in using antihistamines in elderly patients 5. Stress ulcer prophylaxis with H2 antihistamines can benefit patients with coagulopathy

Answer 140

1. Famotidine and cimetidine are examples of antihistamines that act on the proton pumps of parietal cells to decrease gastric acid secretion

Question 141

For a patient taking warfarin, which drug(s) should not be given concurrently? 1. Ketoprofen 2. Tylenol 3 3. Acetaminophen 4. Meperidine

Answer 141

1. Ketoprofen

Question 142

All of the following regarding second generation antihistamines is true EXCEPT: 1. They are used to treat seasonal allergic rhinitis 2. They are used to treat chronic idiopathic urticaria 3. Their side effects include headache, fatigue and sedation 4. Azelastine is a second-generation antihistamine 5. Compared to first generation antihistamines, second generation antihistamines are not associated with anticholinergic side effects

Answer 142

3. Their side effects include headache, fatigue and sedation

Question 143

Which of the following drugs is known for causing skin photosensitivity and staining of teeth if the mother took this medication during pregnancy? 1. Nystatin 2. Penicillin 3. Tetracycline 4. Celebrex 5. Diazepam

Answer 143

3. Tetracycline

Question 144

High doses of carbenicillin can cause which of the following? 1. Hypokalemia 2. Hyperkalemia 3. Headaches 4. Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) 5. Liver failure

Answer 144

1. Hypokalemia

Question 145

Which of the following correctly describes the mechanism of action of digoxin? 1. Inhibits angiotensin II (ATII) formation 2. Inhibits Na+/K+ ATPase and indirectly increases intracellular calcium 3. Inhibits NaCl cotransport 4. Inhibits Na+/K+/2Cl- cotransport 5. None of the above

Answer 145

2. Inhibits Na+/K+ ATPase and indirectly increases intracellular calcium

Question 146

Which of the following antibiotics is known to cause tooth staining in patients? 1. Tetracycline 2. Erythromycin 3. Penicillin 4. Vancomycin 5. Clindamycin

Answer 146

1. Tetracycline

Question 147

Metformin is an oral hypoglycemic drug that is used to treat Type 2 diabetes. This drug is also effective in treating polycystic ovary diseases. 1. Both statements are true. 2. Both statements are false. 3. The first statement is true, the second is false. 4. The first statement is false, the second is true.

Answer 147

1. Both statements are true.

Question 148

Which of the following medications is an L-type calcium channel blocker that will cause gingival hyperplasia and light headedness as adverse effects? 1. Amlodipine 2. Norvasc 3. Verapamil 4. Celebrex 5. Tetracycline

Answer 148

3. Verapamil

Question 149

All of the following statements about antibiotic administration when oral infection is present are true EXCEPT: 1. Prompt removal of the offending tooth/teeth in the presence of infection is to be encouraged. 2. A common misconception is that all infections, by definition require antibiotic administration. 3. Patients who have decreased host resistance, such as chemotherapy patients, may require vigorous antibiotic therapy for minor infections 4. A patient presenting with diffuse cellulitis is not indicated for antibiotic administration 5. A patient who has a temperature higher than 101 degrees F is indicated for therapeutic use of antibiotics.

Answer 149

4. A patient presenting with diffuse cellulitis is not indicated for antibiotic administration

Question 150

Which of the following drugs will a patient be given to treat acute mountain sickness? 1. Amiloride 2. Triamterene 3. Acetazolamide 4. Furosemide 5. Spironolactone

Answer 150

3. Acetazolamide

Question 151

A 68-year-old female patient presents for full mouth extractions. This patient has been placed on anticoagulant medication for a heart condition. At what INR level would you deem it safest to proceed with treatment? 1. 4.0 2. 3.5 3. 3.0 4. 2.5

Answer 151

4. 2.5

Question 152

Which of the following cephalosporins are useful for odontogenic infections? 1. Methicillin (Staphcillin) and Amoxicillin (Amoxil) 2. Cefaclor (Distraclor) and Cefdinir (Omnicef) 3. Cephalexin (Keflex) and Cefadroxil (Duricef) 4. Cefditoren (Spectracef) and Cefproxil (Cefzil) 5. Clarithromycin (Biaxin) and Erythryomycin (Erythocin)

Answer 152

3. Cephalexin (Keflex) and Cefadroxil (Duricef)

Question 153

Which of the following represents the mechanism of action of sulfonamides? 1. Inactivation of DNA gyrase 2. Inhibition of dihydropteroate reductase 3. Inhibition of dihydropteroate synthase 4. Inactivation of cyclooxygenase 5. Inhibition of bacterial transpeptidases

Answer 153

3. Inhibition of dihydropteroate synthase

Question 154

Which type of seizure is classified as a partial seizure? 1. Jacksonian 2. Myoclonic 3. Atonic 4. Absence

Answer 154

1. Jacksonian

Question 155

Which of the following drugs has a generally low toxicity level but leads to staining of developing teeth if given to children or to pregnant or lactating women? 1. Erythromycin 2. Doxycycline 3. Clindamycin 4. Vancomycin 5. Isoniazid

Answer 155

2. Doxycycline

Question 156

Histamine is typically stored within mast cells or basophils in the body. A small number of other sites store histamine as well, including: 1. The liver 2. The hypothalamus 3. The pancreas 4. The adrenal cortex

Answer 156

2. The hypothalamus

Question 157

Acetaminophen overdose reaches toxicity at levels approximating ??? and primarily affects the organ system of the ???. 1. 2 grams; liver 2. 20 grams; kidney 3. 2 grams; gastrointestinal tract 4. 20 grams; liver 5. 20 grams; lungs

Answer 157

4. 20 grams; liver

Question 158

Rituximab is a(n): 1. Monoclonal antibody 2. Proteasome inhibitor 3. Histone deacetylase inhibitor 4. Tyrosine kinase inhibitor

Answer 158

1. Monoclonal antibody

Question 159

Which of the following is NOT a condition for which the therapeutic use of corticosteroids is indicated? 1. Psoriasis 2. Lupus erythematous 3. Crohn’s disease 4. Rheumatoid arthritis 5. Hashimoto’s

Answer 159

5. Hashimoto's

Question 160

Which of the following antibiotics are used to treat against anaerobic bacterial species but will cause xerostomia and a metallic taste in an individual’s mouth? 1. Metronidazole 2. Penicillin 3. Erythromycin 4. Ciprofloxacin 5. Tetracycline

Answer 160

1. Metonidazole

Question 161

Which of the following drugs is most likely to result in decreased metabolism of opioids that undergo hepatic metabolism? 1. Carbamazepine 2. Phenytoin 3. St. John’s Wort 4. Rifampicin 5. Diltiazem

Answer 161

5. Ditiazem

Question 162

Which of the following regarding buprenorphine is FALSE? 1. It is a partial agonist regarding pain relief. 2. It is considered a mixed agonist-antagonist. 3. It can cause respiratory depression. 4. It is a partial agonist at the mu-opioid receptors. 5. It is a full agonist at the nociception/orphanin FQ receptor and delta-receptors.

Answer 162

1. It is a partial agonist regarding pain relief.

Question 163

All of the following drugs are associated with gingival enlargement intraorally except for which one? 1. Nifedipine 2. Verapamil 3. Dilantin 4. Ethosuximide 5. Cephalexin

Answer 163

5. Cephalexin

Question 164

Which of the following is FALSE? 1. Myotoxicity can be seen in muscle biopsies as hypercontracted myofibrils as lysis of striated muscle sarcoplasmic reticulum 2. Bupivacaine is less likely to produce myotoxicity compared to tetracaine. 3. Myotoxicity from local anesthetics is dose-dependent. 4. Most myotoxic injuries are reversible. 5. Myotoxic injuries may be the result of local-anesthetic induced disturbances in the oxidative function of mitochondria.

Answer 164

2. Bupivacaine is less likely to produce myotoxicity compared to tetracaine.

Question 165

All of the following statements are true regarding antibiotic prophylaxis for the prevention of infective endocarditis, EXCEPT: 1. All patients undergoing an invasive dental procedure must take prophylactic antibiotics. 2. Only patients with heart conditions at the highest risk for infective endocarditis should take prophylactic antibiotics. 3. Patients with a history of infective endocarditis should take prophylactic antibiotics. 4. Patients with an unrepaired cyanotic congenital heart defects should take prophylactic antibiotics. 5. Patients with prosthetic cardiac valves should take prophylactic antibiotics.

Answer 165

1. All patients undergoing an invasive dental procedure must take prophylactic antibiotics.

Question 166

One of your diabetic patients came into her appointment in the afternoon. She stated she did not have time for a lunch break and rushed to the dentist to avoid being late. She informs you she feels fine and had taken her medication and would like to proceed with her treatment. Which of the following drugs will most likely have a risk of causing hypoglycemia? 1. Glipizide 2. Metformin 3. Acarbose 4. Miglitol 5. Pioglitazone

Answer 166

1. Glipizide

Question 167

Which of the following piperidine opioid is NOT metabolized in the liver? 1. Fentanyl 2. Alfentanil 3. Sufentanil 4. Remifentanil 5. All of the above are metabolized by the liver

Answer 167

4. Remifentanil

Question 168

When administering antimuscarinic medication, which of the following functions is the first to wane, even at low doses? 1. Loss of parasympathetic control of bladder and GI smooth muscle 2. Mydriasis, cycloplegia, tachycardia 3. Lower secretion of saliva, sweat and bronchial exudate 4. Inhibition of gastric secretion

Answer 168

3. Lower secretion of saliva, sweat and bronchial exudate

Question 169

All of the following are contraindications to the use of antihistamines EXCEPT: 1. Hypersensitivity 2. Acute asthma 3. Serotonin syndrome 4. Premature infants 5. Breastfeeding

Answer 169

3. Serotonin syndrome

Question 170

The long-acting barbiturate phenobarbital acts in the ???, and is mainly excreted by the ???. 1. CNS; large intestine 2. PNS; sudoriferous glands 3. CNS; kidneys 4. CNS; liver 5. CNS; small intestine

Answer 170

3. CNS; kidneys

Question 171

Statement 1: Coumarin compounds are related to a group of anticoagulants known as indanediones. Statement 2: The mechanism by which these compounds act is by the competitive inhibition of vitamin K epoxide reductase. Select the correct choice. 1. Statements 1 and 2 and both correct 2. Statement 1 is correct; statement 2 is false 3. Statement 1 is false; statement 2 is correct 4. Both statements are false

Answer 171

1. Statements 1 and 2 and both correct

Question 172

Which of the following is NOT a class of endogenous opioids? 1. Alkaloids 2. Endomorphins 3. Endorphins 4. Enkephalins 5. Dynorphins

Answer 172

1. Alkaloids

Question 173

Which of the following regarding opioid pharmacokinetics and pharmacodynamics is FALSE? 1. The context-sensitive half-time of fentanyl is relatively independent of the duration of infusion due to its rapid clearance. 2. Respiratory alkalosis can potentiate the effects of morphine. 3. One mechanism of termination of action of lipophilic opioids’ loss of analgesic effect is due to redistribution. 4. Remifentanil has a relatively low volume of distribution. 5. Drugs with high protein binding have a lower volume of distribution.

Answer 173

1. The context-sensitive half-time of fentanyl is relatively independent of the duration of infusion due to its rapid clearance.

Question 174

Which of the following antiviral medications would be most effective to treat recurrent herpes labialis? 1. Rimantadine 2. Interferon 3. Penciclovir 4. Ribavirin

Answer 174

3. Penciclovir

Question 175

The major site of action for opioid drugs in the central nervous system is: 1. The limbic system 2. The reticular formation 3. The basal ganglia 4. The deep cortex

Answer 175

4. The deep cortex

Question 176

If a urethral swab is cultured and reveals Gram-negative diplococci, treatment with which of the following would be most appropriate? 1. Azithromycin 2. Amoxicillin 3. Clindamycin 4. Ceftriaxone 5. Sulfamethoxazole

Answer 176

4. Ceftriaxone

Question 177

All of the following can be considered outpatient antibiotics of choice for odontogenic infections, EXCEPT: 1. Amoxicillin 2. Clindamycin 3. Azithromycin 4. Ampicillin + sulbactam 5. Moxifloxacin

Answer 177

4. Ampicillin + sulbactam

Question 178

Which of the following is FALSE regarding local anesthetic induced cardiovascular toxicity? 1. The systemic local anesthetic dose required for cardiovascular toxicity is greater than the systemic dose required for CNS toxicity. 2. Cardiovascular toxicity would have been less likely if this patient had received lidocaine instead of bupivacaine. 3. Cardiovascular toxicity would have been more likely if this patient had received ropivacaine instead of bupivacaine. 4. Accidental intravascular local anesthetic administration can result in cardiovascular collapse due to a dose-dependent block of sodium channels. 5. Prolongation of the PR interval and duration of the QRS complex are signs of local anesthetic cardiovascular toxicity.

Answer 178

3. Cardiovascular toxicity would have been more likely if this patient had received ropivacaine instead of bupivacaine.