INDBE Questions Flashcards by Anna Farrell

Which statements are true and/or false?

Statement 1: signs and symptoms of acute opioid intoxication are constricted pupils and depressed respiration

Statement 2: Naloxone is an opioid competitive antagonist used in medical emergencies to reverse a narcotic overdose

Both statements are true

How well did you know this?

Not at all

Perfectly

Which of the following medications is a short acting agent that is contraindicated in individuals with acute narrow angle glaucoma, shock, hypotension, head-injury, or children and adolescents under the age of 18?

Atropine

How well did you know this?

Not at all

Perfectly

An older adult with a history of moderate aortic stenosis is seen for a consultation prior to a dental procedure. The patient asks if they need antimicrobial prophylaxis for endocarditis prior to this procedure. What is the best response?

She does not require antibiotic prophylaxis against endocarditis since she has no history of endocarditis

How well did you know this?

Not at all

Perfectly

What is the average time a drug’s effects start after intramuscular administration?

5 minutes

How well did you know this?

Not at all

Perfectly

Which of the following drugs is known for causing skin photosensitivity and staining of
teeth if the mother took this medication during pregnancy?

Tetracycline

How well did you know this?

Not at all

Perfectly

A 44-year-old patient with history of severe, persistent asthma presents with scrapable
white patches on the tongue and inside of the mouth. Which of the following
medications is most likely responsible for their presentation?

Inhaled budesonide

How well did you know this?

Not at all

Perfectly

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

Metronidazole

How well did you know this?

Not at all

Perfectly

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

Uric acid depletion

How well did you know this?

Not at all

Perfectly

What is the primary rationale for adding vasoconstrictors to local anesthetics?

Increases duration of effect

How well did you know this?

Not at all

Perfectly

Which of the following is a sedative medication that is contraindicated for patients with
acute narrow-angle glaucoma, shock, hypotension, head injury, or children and
adolescents under the age of 18?

Benzodiazepines

How well did you know this?

Not at all

Perfectly

Acetaminophen overdose reaches toxicity at levels approximating _____ and primarily
affects the organ system of the ______

20 grams; liver

How well did you know this?

Not at all

Perfectly

All of the following are side effects of calcium channel blockers EXCEPT one. Which one
is the EXCEPTION?

Bronchoconstriction

How well did you know this?

Not at all

Perfectly

Dental pain is best managed by which of the following?

NSAIDs

How well did you know this?

Not at all

Perfectly

Which of the following classes of drugs is NOT known to cause gingival enlargement?

Beta-blockers

How well did you know this?

Not at all

Perfectly

Adrenergic receptors in the nervous system fall into 3 categories. These are:

Alpha 1 & Alpha 2
Beta

How well did you know this?

Not at all

Perfectly

All of the drugs listed are loop diuretics EXCEPT for which of the following?

Furosemide
Ethacrynic Acid
Bumetanide
Torsemide
Spironolactone

Spironolactone

How well did you know this?

Not at all

Perfectly

Which statements are true and/or false?

Statement 1: prophylactic antibiotics should be recommended in all individuals with a
history of joint replacement surgery before dental procedures.
Statement 2: if prophylactic antibiotics are recommended, they should be considered
only after consultation with the patient and orthopedic surgeon.

First statement is false, the second is true

How well did you know this?

Not at all

Perfectly

A patient presents with an acute dental infection. What appropriate management steps
should be undertaken?

Pain control
Drainage of abscess if present
Removal of the dental cause
Determination if antibiotics are needed
All of the above

All of the above

How well did you know this?

Not at all

Perfectly

Several combination analgesics are prescribed in dental clinics. Particularly, Tylenol 3
has been prescribed for pain management after surgical procedures. Which component
of Tylenol 3 is considered an adjuvant to analgesia?

caffeine

How well did you know this?

Not at all

Perfectly

Which of the following antibiotics is known to have about 10% cross-hypersensitivity
with penicillin allergic patients?

Cephalosporin

How well did you know this?

Not at all

Perfectly

A mandibular nerve block anesthetizes:

The body of the mandible & inferior portion of the ramus
The buccal mucoperiosteum & mucous membrane anterior to the mental
foramen
The anterior 2/3 of the tongue & floor of the mouth
The mandibular teeth on the same side to the midline
All of the above

All of the above

How well did you know this?

Not at all

Perfectly

All of the following are true about morphine except one. Which one?

A. Morphine is a schedule I narcotic following the controlled substances act

B. morphine has a high affinity to delta receptors at high doses

C. Morphine activates the inhibitory pathways of the CNS

D. Morphine can be reversed by naloxone

A. Morphine is a schedule I narcotic following the controlled substances act

How well did you know this?

Not at all

Perfectly

Penicillin’s may cause anaphylactic (allergic) reactions. All of the following may be a
symptom of an anaphylactic reaction, EXCEPT:

High blood pressure
Urticaria
Rash
Bronchospasm
None of the above

High blood pressure

How well did you know this?

Not at all

Perfectly

Which of the following regarding epidural opioid administrations is TRUE?

Lipophilic opioids tend to penetrate the tissues at a slower rate

Hydrophilic opioids achieve higher concentrations in the spinal cord than hydrophobic opioids

Hydrophilic opioids are cleared from the spinal fluid at a faster rate

Lipophilic opioids may cause an early onset respiratory depression

Morphine tends to cause early ventilatory depression

Lipophilic opioids may cause an early onset respiratory depression

How well did you know this?

Not at all

Perfectly

Which of the following is a sedative medication that is contraindicated for patients with acute narrow-angle glaucoma, shock, hypotension, head injury, or children and adolescents under the age of 18? (can't find this question on our INDBE account)

Benzodiazepines

Which of the following drugs, when used with alcohol, will cause an Antabuse-like reaction? Fluconazole Metronidazole Midazolam Naloxone Flumazenil

Metronidazole

Which statements are true and/or false? Statement 1: For adequate pain control, the first dose of analgesic medication should be taken after local anesthesia begins to wear off. Statement 2: If one waits to give the first dose of analgesic medication until after the local anesthesia begins to wear off, the patient will experience a lower level of overall pain after extractions.

Both statements are false

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? Sildenafil Losartan Fluoxetine Nifedipine Celecoxib

Nifedipine

Which of the following anti-gingivitis agents has shown to decrease plaque scores the most? Essential oils Chlorhexidine Stannous Fluoride Triclosan and copolymer Certlpyridinium chloride

Chlorhexidine

32. The major site of action for opioid drugs in the CNS is:

the deep cortex

33. Which of the following regarding buprenorphine is FALSE? It is a partial agonist regarding pain relief It is considered a mixed agonist-antagonist It can cause respiratory depression It is a partial agonist at the mu-opiod receptors

It is a partial agonist regarding pain relief

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?

Rapid turnover of oral mucosal cells

This drug is an inhibitor of cytochrome P450 enzymes and cause GI problems as well as torsades de pointes. Which of the following drugs most likely fits with the description? Erythromycin Tetracycline Nystatin Diazepam Augmentin

Erythromycin

First-line pharmacotherapies for the reduction in tobacco use include:

Bupropion, nicotine gum, nicotine nasal spray

Which statements are true and/or false? Statement 1: Amides have the lowest incidence of allergic responses when administered in local anesthetics. Statement 2: Allergic reactions with amide local anesthetics occur in <1% of the population.

Both statements are true

High doses of carbenicillin can cause which of the following? - Hypokalemia - Hyperkalemia - Headaches - Syndrome of Inappropriate Antidiuretic Hormone Syndrome (SIADH) - Liver failure

Hypokalemia

Statement and reason - true and/or false? Statement: Upon administering epinephrine intravenously, one would expect a decrease in systolic pressure and heart rate. Reason: This occurs because epinephrine induces contraction of vascular smooth muscle and vasoconstriction.

The statement is NOT correct, but the reason is correct

Refer to the information in the patient box. Patient: 65 year old male CC: "I am here for a filling" History: History of ischemic heart disease leading to congestive heart failure. His physician has placed him on a sympatholytic medication for management of his condition. Current Findings: MOD caries on #28 Which of the following drugs should be administered with caution or avoided in this patient? Mepivacaine 3% plain Lidocaine 2% with 1:50,000 epi Lidocaine 2% with 1:100,000 epi Mepivacaine 3% with 1:20,000 levonordefrin

Lidocaine 2% with 1:50,000 epi

The following list contains four consequences of chronic alcohol use disorder on the body and drug metabolism. Please select these four items: - decreased effectiveness of local anesthetic - deficiency of liver function - increased likelihood of polycythemia - delayed healing response time - decreased risk of liver cancer - increased likelihood of bleeding after extraction

Decreased effectiveness of local anesthetic Deficiency of liver function Delayed healing response time Increased likelihood of bleeding after extraction

Which of the following is TRUE regarding opioid-induced hyperalgesia (OIH)? its occurrence is rare after potent analgesic use such as remifentanil it is mediated by endogenous mu-opioid receptors a concurrent ketamine infusion may prevent its occurrence it can be prevented by rapid opioid dose escalation it should not be treated with morphine in the post operative setting

A concurrent ketamine infusion may prevent its occurrence

There are many chemical mediators of inflammation. What is the name of the substance that non-steroidal anti-inflammatory drugs (NSAIDs) affect the most?

prostaglandin

which of the following is a second-generation antihistamine? Loratidine Diphenhydramine Meclizine Promethazine Hydroxyzine

Loratidine

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 ______

Amide articaine, bupivacaine, etidocaine

When the nerve branches to the pulp are anesthetized, which cranial nerve is affected?

Trigeminal (V)

Statement and reason - true and/or false? Acidification of tissues increases local anesthetic effectiveness. Inadequate anesthesia occurs when local anesthetic is injected into inflamed or infected tissue.

The first statement is false, the second is true

The rapid turnover of cells in the mouth predisposes the oral cavity to increased drug-induced toxicity in patients undergoing treatment with:

Antineoplastic agents

Which of the following is NOT a type of B-lactam antibiotic? Penicillins Carbapenems Monobactams Carbacephems Streptogramins

streptogramins

Statement and reason - correlated and/or related? Structures innervated by the core bundles within the nerve fibers are anesthetized much more slowly than the structures innervated by the mantle bundles, because the rate of diffusion is governed most heavily on the concentration gradient of the local anesthetic.

Both the statement and the reason are correct and related

Statement and reason - true and/or false? Statement 1: Few if any analgesics are better than non-steroidal anti-inflammatories for pain management. Statement 2: The indications for using medications other than NSAIDs for dental pain management include involved surgical procedures like bony impactions, and contraindications for NSAID use like gastric ulcers or concurrent warfarin therapy.

Statements 1 & 2 are both true

All of the following are common uses of antihistamines EXCEPT? motion sickness anticholinergic syndrome sleeping disturbance nausea and vomiting serotonin syndrome

anticholinergic syndrome

Which of the following drugs is most likely to result in decreased metabolism of opioids that undergo hepatic metabolism? Carbamazepine (tegretol) Phenytoin (dilantin) St. John's wort Rifampicin (Rifadin) Diltiazem (cardizem)

Diltiazem (cardizem)

Which of the following antibiotics has a half-life of 0.5 hours and undergoes rapid excretion by the kidney? Metronidazole Fluoroquinolone Penicillin G Cephalosporins Ciprofloxacin

Penicillin G

All of the following are TRUE regarding the mechanism of action of antivirals for the treatment of oral herpes simplex virus except which choice? Conversion to monophosphates by virus-specific thymidine kinase conversion to triphosphate by cellular enzymes inhibition of DNA synthesis competitive inhibitor of viral DNA-dependent DNA polymerase inhibition of viral RNA-dependent DNA polymerase

Inhibition of viral RNA-dependent DNA polymerase

All of the following are acceptable in the treatment of HSV infections of the oral cavity EXCEPT Topical penciclovir for external cold sores oral acyclovir for primary infections topical acyclovir for external cold sores IV acyclovir for infections in immunocompromised patients topical acyclovir for extensive oral infections

Topical acyclovir for extensive oral infections

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

Fluconazole

Statements - true and/or false? Metformin is an oral hypoglycemic drug that is used to treat Type 2 diabetes. This drug is also effective in treating polycystic ovary diseases.

Both statements are true

Therapeutic levels of nitrous oxide exert which of the following effects on the body? * Mild depression of the CNS * Slight depression in myocardial contraction * An increase in the activity of the kidneys * Depression of most forms of sensation (sight, hearing, touch, pain)

* Mild depression of the CNS * Slight depression in myocardial contraction * Depression of most forms of sensation (sight, hearing, touch, pain)

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

hypothalamus

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

Their side effects include headache, fatigue, and sedation

Antibiotic prophylaxis is critical for all of the following patients except one. Which one is the exception A patient with diabetes after contaminated surgery a healthy patient seeking root canal treatment a patient with a previous history of infective endocarditis a patient with recurrent local infection

A healthy patient seeking root canal treatment

All of the following additives prolong local anesthetic activity EXCEPT: epinephrine alkalization of local anesthetic solution opioids alpha-2 adrenergic agonists steroids

Alkalinization of local anesthetic solution

Side effects of narcotic administration include: drowsiness pain reduction constipation increased gastric upset

Drowsiness constipation increased gastric upset

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

Lower secretion of saliva, sweat, and bronchial excaudate

All of the following are considered aminoglycosides EXCEPT: Gentamicin Neomycin Tobramycin Azithromycin Amikacin

Azithromycin

All of the following are advantages of intramuscular drug administration EXCEPT which one? (can't find on INDBE site)

Prolonged duration of drug effect

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

nitrous oxide interacts with coal in cobalamin (vitamin B12) to oxidize and inactivate it

What is the correct order of the four plateaus of Stage I anesthesia (analgesia)?

Paresthesia, vasomotor, drift, dream

All of the following medications have been shown to cause gingival enlargement EXCEPT one. Which is that exception? Phenytoijn Cyclosporine Ethambutol Nifedipine Verapamil Diltiazem

Ethambutol

Penicillin V I sometimes preferred over penicillin G because penicillin V is: given intramuscularly less allergenic more stable in acidic conditions less cross-hypersensitivity with cephalosporins none of the above

more stable in acidic conditions

Statements - true and/or false? The maximum recommended dose of Lidocaine 2% with 1:100k epi for an 8-year-old child is 6.6 mg/kg. The average duration of soft tissue anesthesia for Lidocaine 2% with 1:100k epi is 3-8 hours.

Both statements are FALSE

An agonist for which of the following receptors is responsible for bronchial vessel dilation? Alpha 1 Alpha 2 Beta 1 Beta 2 none of the above

Beta 2

Which of the following regarding antihistamines in anaphylaxis is TRUE? Antihistamines inhibit anaphylactic reactions Antihistamines compete with histamine at receptor sites H1 antagonists are only indicated in some forms of anaphylaxis the rapid parenteral administration of H1 antagonists may cause precipitous hypertension H2 antagonists are clearly indicated after the onset of anaphylaxis

Antihistamines compete with histamine at receptor sites

Which of the following is NOT a cytochrome P450 3A4 inducers? St. John's wort Rifampicin Carbamazepine Phenobarbital Grapefruit juice

Grapefruit juice

Which of the following can provide innervation to the maxillary permanent first molar? * Anterior superior alveolar neve * Middle superior alveolar neve * Posterior superior alveolar nerve * Greater palatine nerve

* Middle superior alveolar neve * Posterior superior alveolar nerve * Greater palatine nerve

Which of the following is NOT a condition for which therapeutic use of systemic corticosteroids is indicated? Psoriasis Lupus erythematosus Chron's disease Rheumatoid arthritis Hashimoto's

Hashimoto's

Which of the anesthetic is indicated for long-lasting anesthesia during mandibular surgery? Lidocaine 2% 1:100k epi Lidocaine 2% 1:50k epi Articaine 4% 1:100k epi Bupivacaine 0.5% 1:200k epi Prilocaine 4% plain

Bupivacaine 0.5% 1:200k epi

The body’s inflammatory response due to tissue injury is mediated by

Histamine, prostaglandins and leukotrienes

A dentist may be the first health practitioner to suspect hypothyroidism in a young patient if which of the following signs are seen? Delayed eruption of the teeth Moist and warm skin weight loss profuse sweating

Delayed eruption of the teeth

Epinephrine auto-injectors, such as the EpiPen, can treat anaphylactic reactions. Which concentration of epinephrine is delivered by the EpiPen?

0.3 mg epinephrine

Short local anesthetics include: Mepivacaine HCl 3% Prilocaine HCl 4% by infiltration Lidocaine HCl 2% + 1:100k epi Mepivacaine 2% + 1:20k levonordefrin

* Mepivacaine HCl 3% * Prilocaine HCl 4% by infiltration

All of the following are antituberculosis drugs (first-line) EXCEPT: Clindamycin Isoniazid Rifabutin Rifampin Ethambutol

Clindamycin

Which of the following cephalosporins are useful for odontogenic infections? Methicillin (staphcillin) and Amoxicillin (amoxil) Cefaclor (distractor) and Cefdinir (omnicef) Cephalexin (keflex) and Cefadroxil (duricef) Cefditoren (spectracef) and Cefprozil (cefzil) Clarithromycin (biaxin) and Erythromycin (erythrocin)

Cephalexin (keflex) and Cefadroxil (duricef)

Statements - true and/or false? Statement 1: Parkinson’s disease is an acute progressive wasting disease of the CNS. Statement 2: Treatment for Parkinson’s includes using drugs such as levodopa in conjunction with carbidopa.

Statement 1 is false; statement 2 is true

Which of the following drugs will cause the patient to experience gastrointestinal problems and gingival hyperplasia? Carbamazepine Phenytoin Acetaminophen Peniciliin Azithromycin

phenytoin

Which of the following antibiotics will most likely have interactions with other drugs? Cephalexin (keflex) Erythromycin (e-mycin) Metronidazole (flagyl) Doxycline (vibramycin)

Erythromycin (e-mycin)

All of the following factors affect the induction time of local anesthetics, EXCEPT: Dissociation constant (pKa) Lipid solubility Protein binding Vasoactivity All of the above affect induction time of local anesthetics

All of the above affect induction time of local anesthetics

The blood flow to the gastrointestinal tract and its pH both directly affect the ____ of oral administered drugs? distribution excretion bioavailability absorption

distribution bioavailability absorption

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 ____

0.5 mg ; 4 mg

Which of the following medications is associated with pseudomembranous colitis? Augmentin Penicillin Azithromycin Clindamycin Ciprofloxacin

Clindamycin

Statements - true and/or false? Statement 1: Nitrous oxide-oxygen sedation begins and ends with the patient receiving 100% oxygen Statement 2: Nitrous oxide-oxygen delivery systems are typically limited to a maximum of 60% nitrous oxide and 40% oxygen delivery

The first statement is true; the second is false

Which of the following NSAIDS inhibits only COX-2? Ketorolac Indomethacin Celecoxib Acetylsalicylic acid Acetaminophen

Celecoxib

Statements - true and/or false? Statement 1: Conscious sedation is defined as a drug-induced depression of consciousness during which patients cannot easily be aroused. Statement 2: During conscious sedation patients still respond purposefully to repeated or painful stimuli, though they may require assistance to maintain ventilatory function.

Both statements are false

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

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

Which analgesia medications provide the best pain management for the corresponding type of acute endodontic pain? Mild pain; ibuprofen 400mg plus acetaminophen 650-1000mg Moderate pain; acetaminophen 1000mg plus oxycodone 10mg Moderate pain; ibuprofen 400mg plus acetaminophen 650-1000mg Severe pain; ibuprofen 400mg

Moderate pain; ibuprofen 400mg plus acetaminophen 650-1000mg

Statements - true and/or false? Statement 1: Pure local anesthetics possess the ability to affect vascular beds and generally produce vasoconstriction in the tissues into which they are deposited. Statement 2: The only local anesthetic that does not fit this pattern is cocaine, which produces vasodilation instead.

Both statements are false

What is the most significant pathology seen in this panographic x-ray? (can't put picture on here)

Fracture of the mandible

The therapeutic dosage range for codeine is usually ____; & side effects include _____

30-60mg; constipation and nausea

Please select the TRUE statement from the following list regarding antihypertensive agents Aspirin increases the antihypertensive effect of ACE inhibitors The use of vasoconstrictions is contraindicated in hypertensive patients NSAIDs increase the antihypertensive effect of diuretics NSAIDs often antagonize the effects of antihypertensive agents

NSAIDs often antagonize the effects of antihypertensive agents

Local anesthetics block pain by: Blocking nerve impulses conducting pain signals Absorbing calcium at the synapse Interfering with sodium ion movement Releasing magnesium at the synapse

Blocking nerve impulses conducting pain signals Interfering with sodium ion movement

Which of the following antibiotics will alter the effectiveness of oral contraceptive pills and Coumadin if combined together? Augmentin Tetracycline Amoxicillin Penicillin Erythromycin

Erythromycin

Which of the following medication is often used to treat an overdose of opioids? Naloxone Flumazenil Verapamil Ciprofloxacin Zolpidem

Naloxone

Which of the following points describes the mechanism of action of local anesthetics? Select all that apply Increased influx of sodium ions through the neuronal membrane Reversible binding to sodium channels in the neuronal membrane Expansion of the lipid bilayer in the neuronal membrane

Reversible binding to sodium channels in the neuronal membrane Expansion of the lipid bilayer in the neuronal membrane

In an effort to combat cancer cell function, scientists have created a new drug that targets the organelle responsible for completing the posttranslational modification of proteins synthesized in the rough endoplasmic reticulum. Which of the following organelles does this new drug target? Golgi apparatus Lysosome Nucleus Peroxisome Smooth ER

Golgi apparatus

Which of the following is FALSE regarding tramadol’s mechanism of action? Tramadol acts at the dorsal horn spinal synapses of the nociceptive pathways Tramadol has no monoaminergic activity Tramadol is responsible for 5HT and norepinephrine accumulation in the synaptic cleft Tramadol causes inhibition of reuptake Tramadol is considered a weak opioid

Tramadol has no monoaminergic activity

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

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

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

Histamine undergoes primarily hepatic transformation

Which of the following statements about Vitamin E is incorrect? Patients with pancreatic insufficiency are at risk of Vitamin E deficiency Serum Vitamin E levels correlate with serum lipid levels Patients with celiac disease are at risk of Vitamin E deficiency Vitamin E is a scavenger of oxygen free radicals

Vitamin E does not produce toxic effects at any dose

Which of the following is primarily used to treat oral Candidiasis albicans infections? Nystatin Terbinafine Amphotericin B Ketoconazole Naftifine

Nystatin

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?

Weakness, tachycardia

Acetylsalicylic acid has several desirable properties. Please choose four of these properties from the following list Anti-psychotic Analgesic Anti-inflammatory Anti-oxidant Anti-pyretic Anti-platelet Anti-histamine

Analgesic Anti-inflammatory Anti-pyretic Anti-platelet

All of the following are contraindications to the use of antihistamines EXCEPT: Acute asthma Serotonin syndrome Premature infants Breastfeeding

Serotonin syndrome

The long-acting barbiturate phenobarbital acts in the ____, and is mainly excreted by the ____

CNS; kidneys

What is the best topical anesthetic recommended for pediatric patients?

Lidocaine

Which of the following statements is INCORRECT regarding the properties of amide local anesthetics (LAs)? LAs are water-soluble LAs are affected by acidity of surrounding tissues LAs are metabolized primarily by the kidneys LAs affect some nerve fibers more than others LAs contain preservatives to prolong shelf life

LAs are metabolized primarily by the kidneys

Excessive salivation may be a sign of which of the following? Digoxin toxicity Methamphetamine use Diuretic drug OD Pathologic vomiting

Digoxin toxicity

Which of the following symptoms would indicate severe toxicity after administration of local anesthetics? Talkativeness Apprehension Excitability Seizures Slurred speech

Seizures

Which of the following antibiotics is known to cause tooth staining? Tetracycline Erythromycin Penicillin Vancomycin Clindamycin

Tetracycline

Statements - true and/or false? Statement 1: Modifications to dental treatment are NOT necessary for patients with Rheumatoid Arthritis. Statement 2: The most significant complication from Rheumatoid Arthritis is drug related

The first statement is false, the second is true

All of the following are parenteral vasodilators used in hypertensive emergencies EXCEPT one. Which one is the exception? Nitroprusside Propranolol Hydralazine Diazoxide

Propranolol

For pulpal infections, the class of antibiotic for the first line treatment is considered to be the Tetracyclines Cephalosporines Macrolides Penicillins Quinolones

Penicillins

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

Bupivacaine is less likely to produce myotoxicity compared to tetracaine

Which of the following macrolides have the most significant adverse effects? Azithromycin Dirithromycin Clarithromycin Erythromycin Clindamycin

Erythromycin

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

Calcium-channel blockers

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? Citrus products Acetaminophen Chlorthalidone Grapefruit juice Hydrocodone

Grapefruit juice

When a drug works by the mechanism of inhibition of cell wall synthesis, which of the following statements is correct? Murein hydrolase is not activated in cells treated with the drug A change in the structure of a transpeptidase may result in bacterial resistance to the drug An intact beta-lactam ring is not required for antibacterial activity The drug will act on the 50S ribosomal subunit The drug works by inhibition of mRNA synthesis

A change in the structure of a transpeptidase may result in bacterial resistance to the drug

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

Midazolam

Which of the following about endogenous opioid peptides and their receptors is correct? Mu-3 receptors are involved in opioid-induced immune suppression Beta-endorphins have a lower affinity for the mu-opioid receptors Dynorphin A has a lower affinity for the delta-opioid receptors Met- and leu-enkephalins have a lower affinity for the kappa-opioid receptors Delta-opioid receptors are involved in opioid-induced respiratory depression

Mu-3 receptors are involved in opioid-induced immune suppression

Which of the following clinical scenarios would warrant antibiotic prophylaxis prior to major dentistry? A patient with a prosthetic artificial heart valve A patient with previous history of endocarditis A patient with unrepaired cyanotic congenital heart defect A patient with a valvopathy after heart transplant All of the above

All of the above

Which of the following situations are contraindications for the use of ibuprofen? A stomach ulcer A patient on warfarin A patient in the third trimester of pregnancy Allergy to Tylenol

A stomach ulcer A patient on warfarin A patient in the third trimester of pregnancy

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

Ketoprofen

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: Decreased blood flow to the tissue site Increased flow of the local anesthetic into the bloodstream Minimizing the risk of toxicity from local anesthetic Decreased bleeding at the administration site

Decreased blood flow to the tissue site Minimizing the risk of toxicity from local anesthetic Decreased bleeding at the administration site

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

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

Which of the following is NOT a characteristic of thiazide diuretics? A result in hypoglycemia A result in hypokalemia Increase renal elimination of sodium Increase renal elimination of chloride Increase renal elimination of potassium

A result in hypoglycemia

Which of the following antibiotics is resistant to gastric acid? Penicillin G Penicillin V Procaine penicillin Carbenicillin Benzylpenicillin

Penicillin V

Which of the following antiviral medication would be most effective to treat recurrent herpes labialis? Rimantadine Interferon Penciclovir Ribavirin

Penciclovir

Statements - true and/or false? Statement 1: Penicillins work by competitively inhibiting the transpeptidase enzyme, leading to disruption of cell wall synthesis Statement 2: Penicillins are bacteriostatic

The first statement is true, the second is false

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? Erythromycin Doxycycline Clindamycin Vancomycin Isoniazid

Doxycycline

How soon after administration of levodopa dose should a Parkinson’s patient be scheduled for dental treatment?

60-90 minutes

Which of the following local anesthetics is characterized by a long duration of action? Lidocaine Articaine Bupivacaine Mepivacaine

Bupivacaine

Which of the following can lead to Vitamin B12 (cobalamin) deficiency? Omeprazole Villi destruction Increased meat consumption Decreased fish consumption Jejunal resection Duodenal resection

Omeprazole Villi destruction

Polyene antifungal agents include: Ketoconazole Amphotericin B Clotrimazole Itraconazole All of the above

Amphotericin B

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

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

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

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

Which of the following theories is considered to describe the way in which local anesthetics work on the nerve membrane? Acetylcholine theory Specific receptors theory Calcium displacement theory Surface charge (repulsion) theory Membrane expansion theory

Specific receptors theory

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

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

All of the following statements are TRUE regarding antibiotic prophylaxis for the prevention of infective endocarditis, EXCEPT: All patients undergoing an invasive dental procedure must take prophylactic antibiotics Only patients with heart conditions at the highest risk for ineffective endocarditis should take phophylactic antibiotics Patients with a previous history of ineffective endocarditis should take prophylactic antibiotics Patients with an unprepared cyanotic congenital heart defects should take prophylactic antibiotics Patients with prosthetic cardiac valves should take prophylactic antibiotics

All patients undergoing an invasive dental procedure must take prophylactic antibiotics

All of the following drugs are associated with gingival enlargement intraorally except for which one? Nifedipine Verapamil Dilantin Ethosuximide Cephalexin

Cephalexin

Which of the following factors does NOT affect the duration of a drug’s anesthetic action? Type of injection administered Accuracy in deposition of anesthetic Status of tissues at site of deposition Anatomic variation Orientation of needle bevel

Orientation of needle bevel

Which of the following medications is NOT necessary to keep in stick in the office for use in emergency situations? Diazepam Epinephrine Nitroglycerine Glucose Aspirin

Diazepam

Gingival enlargement is known to be modified by medications such as: Warfarin Insulin Phenytoin Aspirin

Phenytoin

All of the following are indications for diphenhydramine EXCEPT: Sleep disturbance Acute dystonic reaction Pruritus Stress ulcer prophylaxis Allergic reactions

Stress ulcer prophylaxis

Which of the following is NOT a mechanism of drug metabolism? Oxidation Reduction Hydrolysis Dehalogenation All of them

All of them

All of the following drugs affect the thyroid except for which one? Levothyronine Iodide Methimazole Thyroxine Tolbutamide

Tolbutamide

Which of the following local anesthetics is a thiophene-based anesthetic? Lidocaine Articaine Mepivacaine Bupivacaine

Articaine

Which channels are blocked in when local anesthetics are used?

Sodium

Which of the following will most likely be used to treat an overdose of benzodiazepines? Naloxone Flumazenil Zolpidem Zaleplon Narcan

Flumazenil

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

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

All of the following factors are inhibited by warfarin (Coumadin), EXCEPT: Factor II Factor VII Factor VIII Factor IX Factor X

Factor VIII

Which of the following would be unlikely to influence the duration of action of local anesthetics? Lipid solubility of the anesthetic Total dose of the anesthetic Presence of a vasoconstrictor Protein affinity All of the above are likely to influence the duration of action

All of the above are likely to influence the duration of action

Which of the following antibiotics is used to treat mycobacterium infections and contraindicated with the use of antiretroviral agents? Ampicillin Tetracycline Amoxicillin Ciprofloxacin Rifampicin

Rifampicin

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

Muscarinic receptor agonists

Which of the following drugs taken may cause adverse effects such as prolonged QT interval, jaundice, and gastrointestinal problems? Clarithromycin Chloral hydrate Clindamycin Diazepam Augmentin

Clarithromycin

The most effective means of preventing post-operative pain involves: Administering a sedative prior to surgery Giving the patient acetaminophen before the local anesthesia wears off Using a double dose of local anesthesia Ensuring the patient takes and NSAID prior to local anesthesia wearing off

Ensuring the patient takes and NSAID prior to local anesthesia wearing off

All of the following statements about antibiotic administration when oral infections is present are true EXCEPT: Prompt removal of the offending tooth/teeth in the presence of infection is encouraged Not all dental infections require antibiotic administration Patients who have decreased host resistance may require vigorous antibiotic therapy for minor infections A patient presenting with diffuse cellulitis is not indicated for antibiotic administration A patient who has a temperature higher than 101 degrees is indicated for use of antibiotics

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

Which of these medications does NOT cause drug-induced gingival pigmentation? Minocycline Chloroquine Cyclophosphamide Corticosteroids Azidothymidine

Corticosteroids

All of the following are considered amide linked local anesthetics, EXCEPT: Articaine Bupivicaine Butacaine Lidocaine All of the above are amides

Butacaine

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? Metronidazole Penicillin Erythromycin Ciprofloxacin Tetracycline

Metronidazole

Using a traditional intraligamentary injection, which of the following volumes of anesthetic is appropriate to achieve pulpal anesthesia in a single rooted tooth?

0.2 mL