Ch. 4 - Evolve Quiz Questions Flashcards Preview

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Flashcards in Ch. 4 - Evolve Quiz Questions Deck (20):
1

The vasoconstrictor is responsible for which of the following?

a) A decreased duration of the anesthetic's effect
b) Increased blood flow
c) Decreased toxicity
d) All of the above

C) DECREASED TOXICITY

[A vasoconstrictor increases the duration of anesthetic's effect & decreases the blood flow, which then decreases the risk of toxicity.]

2

Which of the following is another term for vasoconstrictor?

a) Sympathomimetic drug
b) Adrenergic drug
c) Catecholamine
d) All of the above

D) ALL OF THE ABOVE

[Vasoconstrictors mimic the stimulation of adrenergic nerves & thus are referred to as sympathomimetic or adrenergic drugs. Catecholamine is also an appropriate term for vasoconstrictors.]

3

Although epinephrine is the most widely dental vasoconstrictor, it is NOT an ideal choice for patients with _____.

a) cardiovascular disease
b) high blood pressure
c) hyperthyroidism
d) all of the above

D) ALL OF THE ABOVE

[Patients with cardiovascular disease, high blood pressure, & hyperthyroidism may experience some harmful side effects related to the use of epinephrine.]

4

In response to inadequate anesthesia, the amount of endogenous epinephrine released in a patient's system is _____ than the exogenous amount introduced in a routine dental injection.

a) much greater
b) much less than
c) equal to
d) slightly less than

A) GREATER THAN

[Avoiding the exogenous use of epinephrine can backfire if the patient experiences stress or pain: in this case, the patient's body will naturally produce a much greater amount of epinephrine than it would have received from the local anesthesia. In a stressful situation, the human body will naturally produce a much greater amount of epinephrine than the amount delivered in dental anesthesia.]

5

Patients who have experienced a myocardial infarction, coronary bypass surgery, or a cerebrovascular accident within the past _____ should not be given a local anesthetic with a vasoconstrictor.

a) 6 weeks
b) 6 months
c) 12 weeks
d) 12 months

B) 6 MONTHS

[A local anesthetic with a vasoconstrictor is NOT recommended for patients who have experienced a myocardial infarction, coronary bypass surgery, or a cerebrovascular accident within the past 6 months.]

6

The amount of epinephrine in a cartridge of local anesthetic is identified by a _____.

a) percentage
b) fraction
c) ratio
d) whole number

C) RATIO

[The vasoconstrictor in a carpule of anesthetic is identified by a ratio (1:100,000). The percentage on the carpule refers to the amount of anesthetic in the solution (2%).]

7

On occasion, a local anesthetic may be used for hemostasis (ex: to control bleeding) in an area that is already numb. These higher concentrations of epinephrine (1:50,000) also prolong the duration of the anesthesia.

a) The 1st statement is TRUE; the 2nd statement is FALSE.
b) The 1st statement is FALSE; the 2nd statement is TRUE.
c) Both statements are TRUE.
d) Both statements are FALSE.

A) THE 1st STATEMENT IS TRUE; THE 2nd STATEMENT IS FALSE.

[Higher concentrations of epinephrine offer no advantage in prolonging the duration of anesthesia.]

8

Which of the following is an effect of the additive sodium bisulfite?

a) Prolonged shelf life
b) Hemostasis
c) Increased anesthetic duration
d) Pulpal anesthesia

A) PROLONGED SHELF LIFE

[Sodium prolongs the shelf life of the cartridge by preventing the oxidation of epinephrine. Sodium bisulfite is a preservative (not a vasoconstrictor), & is not involved in increasing the duration of the anesthetic.]

9

A patient with a sulfite allergy CAN be administered which of the following?

a) 3% mepivacaine
b) 2% lidocaine
c) 4% lidocaine
d) Both a & c

D) BOTH A & C

[3% mepivacaine & 4% prilocaine do not contain a vasoconstrictor. Carpules that do not have a vasoconstrictor DO NOT contain sodium bisulfite. 2% lidocaine contains a vasoconstrictor & the preservative, sodium bisulfite; it should NOT be administered to a patient with a sulfite allergy.]

10

Which of the following is considered a beneficial use of epinephrine?

a) Increasing cardiac efficiency
b) Treating anaphylactic attacks
c) Hemostasis
d) Both b & c

D) BOTH B & C

[Epinephrine decreases, rather than increases, overall cardiac efficiency. It is used in dentistry to control bleeding, but it is also beneficial in treating anaphylactic attacks.]

11

In the event of an inadvertent intravascular injection, the effects of epinephrine first begin to show _____.

a) within 30 seconds
b) within 1 minute
c) within 5 minutes
d) within 10 minutes

B) WITHIN 1 MINUTE

[Effects related to the unintended intravascular injection of epinephrine first begin to show within 1 minute.]

12

Which of the following is a recommendation set forth by the American Heart Association (AHA) in regard to the administration of local anesthesia?

a) Inject the anesthetic as quickly as possible
b) Administer no more than the maximum recommended dose of 0.5 mg of epinephrine per visit (healthy patient)
c) Administer the lowest possible effective dose
d) Both b & c

C) ADMINISTER THE LOWEST POSSIBLE EFFECTIVE DOSE

[The AHA recommends that the lowest possible effective dose of local anesthetic always be used. A maximum recommended dose of 0.2 mg of epinephrine is the guideline set forth by the AHA. Injecting SLOWLY is the guideline set forth by the AHA.]

13

Levonordefrin is a _____ vasoconstrictor and is _____ as potent as epinephrine.

a) synthetic, one-tenth
b) naturally produced, one-half
c) naturally produced, one-third
d) synthetic, one-sixth

D) SYNTHETIC, ONE-SIXTH

[The synthetic vasoconstrictor levonordefrin is one sixth as potent as epinephrine.]

14

Levonordefrin is available with 2% mepivacaine. These car pules of mepivacaine also contain sodium bisulfite to preserve the levonordefrin.

a) The 1st statement is TRUE; the 2nd statement is FALSE.
b) The 1st statement is FALSE; the 2nd statement is TRUE.
c) Both statements are TRUE.
d) Both statements are FALSE.

C) BOTH STATEMENTS ARE TRUE.

[Cartridges of 2% mepivacaine with levonordefrin contain the preservative sodium bisulfite.]

15

Which of the following vasoconstrictors is no longer used in dentistry, due to the possibility of tissue necrosis?

a) Levonordefrin
b) Norepinephrine
c) Felypressin
d) Phenylephrine

B) NOREPINEPHRINE

[Norepinephrine is no longer used in dentistry because its intense vasoconstriction is likely to indue tissue necrosis. Levonordefrin is regularly used in dentistry. Felypressin, available in 3% prilocaine in Great Britain, is not associated with intense vasoconstriction/tissue necrosis. Phenylephrine is not used in dentistry but is also not associated with intense vasoconstriction/tissue necrosis.]

16

The adverse effects of a vasoconstrictor overdose last approximately _____.

a) 5 to 10 minutes
b) 10 to 15 minutes
c) 60 to 80 minutes
d) 120 minutes

A) 5 TO 10 MINUTES

[Vasoconstrictors are removed quickly from the blood stream; effects of an overdose last only 5 to 10 minutes.]

17

Before using a vasoconstrictor, a physician's consult is recommended for which of the following conditions?

a) A patient with a history of a myocardial infarction (within 2 years)
b) A patient who underwent coronary bypass surgery within 12 months
c) A patient with controlled hypertension
d) A patient with uncontrolled hyperthyroidism

D) A PATIENT WITH UNCONTROLLED HYPERTHYROIDISM

[A physician's consult is recommended for patients who indicate a condition of uncontrolled hyperthyroidism, before administering a local anesthetic with a vasoconstrictor. A physician's consult is only necessary if the heart attack or coronary bypass surgery occurred within 6 months. A physician's consult is NOT necessary for patients with a history of controlled hypertension.]

18

Read the following statement & select the best choice below: Only the minimum effective dose should be administered without exceeding the maximum recommended dose.

a) This statement ONLY applies to vasoconstrictors.
b) This statement ONLY applies to local anesthetic agents.
c) This statement applies to both vasoconstrictors & local anesthetic agents.
d) None of the above

C) THIS STATEMENT APPLIES TO BOTH VASOCONSTRICTORS & LOCAL ANESTHETIC AGENTS.

[The minimum effective dose of both the local anesthetic agent & vasoconstrictor should be administered, without exceeding the maximum recommended dose.]

19

In which of the following anesthetic cartridges is epinephrine available in a 1:50,000 concentration?

a) 2% lidocaine
b) 3% mepivacaine
c) 4% prilocaine
d) 0.5% bupivacaine

A) 2% LIDOCAINE

[2% lidocaine is available with a 1:50,000 epinephrine concentration. 3% mepivacaine is available only with a 1:100,000 epinephrine concentration. 4% prilocaine & 0.5% bupivacaine are available only with a 1:200,000 epinephrine concentration.]

20

Immediately after being administered a local anesthetic with epinephrine, your patient complains of a throbbing headache, increased feelings of anxiety, and a "racing heart". Which of the following would explain this reaction?

a) Your patient is experiencing a sodium bisulfite overdose.
b) Your patient is experiencing a vasoconstrictor overdose.
c) Your patient is exhibiting signs of dental phobia.
d) There is nothing abnormal about your patient's response: all patients have this response to local anesthesia.

B) YOUR PATIENT IS EXPERIENCING A VASOCONSTRICTOR OVERDOSE.

[Increased heart rate, throbbing headache, and anxiety are all responses related to vasoconstrictor overdose.]