L.12,13,14-Radio, LA, Ext

Question 1

The most important point about Radiographs for a patient: there is no general indication for taking radiographs, a ________ is performed first, then other assessments. Then if there are indications, a _______ is taken.

Answer 1

clinical exam…radiograph

Question 2

SLOB RULE: If an object moves WITH the head (same) it is on the _______ (aka ______) side of the arch.

Answer 2

Lingual (Palatal)

Question 3

SLOB RULE: If an object moves OPPOSITE to the head of the x-ray beam, the object is on the ________ (aka ______) of the arch.

Answer 3

buccal…labial

Question 4

What is the nickname for a bitewing?

Answer 4

a “caries detecting” radiograph

Question 5

The recommendations for taking x-rays are subject to clinical judgment and may not apply to _____ patient.
They are to be used by dentists only after reviewing the patient’s health history and completing a clinical _______.

Answer 5

EVERY…EXAM

Question 6

Dental Radiation accounts for __% of al healthcare x-rays

Answer 6

1%

Question 7

Which gland is most susceptible to dental radiograph exposure?

Answer 7

thyroid

Question 8

In radiology: Know What You ______ to See Before You Shoot

Answer 8

EXPECT

Question 9

What are the 8 indications for dental x-rays in children?

Answer 9

1.Growth and Development (pano) 2.Caries 3.Pulp 4.Integrity 5. Bone 6.Post op 7.Anomalies 8. Pain/Swelling

Question 10

What % of carious lesions can be seen by X-ray?

Answer 10

40-50%

Question 11

Size 0 films are typically for children under ___ years of age. They can be used for what 2 views?

Answer 11

7…bitewings and PA

Question 12

Size 1 film is typically used for children over ___ years and for these two views:

Answer 12

7 years…bitewings and PA

Question 13

Size 2 film is considered for what age range and what position?

Answer 13

Adults and posterior (bitewings, PA, modified occlusal)

Question 14

Size __ film is used for LARGE occlusal shots and works for most children…they can be used for an ________ lateral view

Answer 14

4….extraoral

Question 15

What is the best behavioral control method to used for x-rays?

Answer 15

Tell, show, do

Question 16

How often do I take x-rays? every ______ as long as there is evidence of caries or High Risk Factors

Answer 16

6 months

Question 17

How often do I take x-rays? every ____-____ if no caries and no high risk factors

Answer 17

12-24 mo

Question 18

How often do I take x-rays? For an adolescent at LOW risk for caries take every ___-____

Answer 18

18-36 mo

Question 19

Interesting…how long does it take for caries to progress through the OUTER half of enamel on a PRIMARY tooth?

Answer 19

1 year

Question 20

Interesting…how long does it take for caries to progress through the INNER half of enamel on a PRIMARY tooth?

Answer 20

1 year

Question 21

Interesting…how long does it take for caries to progress through the enamel on a PERMANENT tooth?

Answer 21

3 years

Question 22

We never take routine ________ view films. There must always be a reason for these films.

Answer 22

occlusal

Question 23

How many views of a traumatized tooth do we take?

Answer 23

3

Question 24

The dose from a Pano is equivalent to how many PA’s?

Answer 24

4

Question 25

The main anatomical differences for kiddo's: 1. Short and narrow ________ 2. Mandibular foramen located ______ the mandibular occlusal plane 3. ________ bony structure 4. Bone is less _______, so infiltration has quick onset

Answer 25

1.ascending ramus 2.below 3.small 4.dense

Question 26

Which maxillary injection is ROUTINELY USED in pedo? When administering this shot, always start on the ______ side of the tooth...

Answer 26

infiltration...DISTAL

Question 27

What is a good supplemental injection on the maxillary to aid in numbing the palatal tissues?

Answer 27

interdental

Question 28

Mandibular infiltrations can be useful in pedo too! Mainly for which teeth?

Answer 28

incisors, cuspids, and minor operative on primary molars

Question 29

Which mandibular injection can anesthetize all 5 primary teeth?

Answer 29

The incisive nerve block

Question 30

Topical Anesthetic: Systemic absorption of a ________ topical anesthetic must be considered when calculating the total amount of anesthetic administered ________ topicals have little or no absorption potential

Answer 30

lidocaine....benzocaine

Question 31

******What is the most common complication to local anesthetic in pedo?*****

Answer 31

Self inflicted trauma from chewing of the lip

Question 32

What are the two ways you can overdose a pedo patient with LA? So what are the two methods for making sure this does not happen?

Answer 32

1.IV injection 2.large volumes...1.ASPIRATE 2.CALCULATE

Question 33

Local anesthetic toxicity develops when the blood level of the drug in the ______ or ______ becomes too high

Answer 33

brain...heart

Question 34

What are the 2 main effects of LA overdose? (IN ORDER PLEASE!)

Answer 34

1.CNS EXCITATION followed by seizure 2.CNS DEPRESSION followed by unconsciousness

Question 35

What are the final effects of LA overdose?

Answer 35

CardioRespiratory Arrest

Question 36

What is the key to handling a negative reaction to Local Anesthetic?

Answer 36

Make sure airway is open and administer O2!!!

Question 37

Two popular anesthetic solutions used in Pediatrics: ________ ___% and ________ __%...Both have Epinephrine 1:100,000....Anesthetic Cartridges are labeled 1.7 or 1.8ml depending on manufacture....You should calculate for ___ ml

Answer 37

Lidocaine 2%.....Septocaine 4%...Calculate for 1.8ml

Question 38

What does 2% mean? ___mg/ml and therefore ___ml (amount of liquid in vial) x ___mg/ml = ____mg of 2% lidocaine in a cartridge

Answer 38

20mg/ml....1.8ml x 20mg/ml = 36mg of 2% lidocaine in a cartridge

Question 39

****HOW MANY mg of 2% lidocaine is in a stopper full? (hint...0.2ml)

Answer 39

0.2ml x 20mg/ml = 4 mg of Lidocaine 2% in a stopper full

Question 40

How many mg of 2% lidocaine is in 1 ml of solution?

Answer 40

1ml x 20mg/ml = 20mg of Lidocaine 2% in a ml of solution

Question 41

How many mg of SEPTOCAINE 4% is in a 1.8ml solution?

Answer 41

1.8ml x 40mg/ml = 72mg of Septocaine 2%

Question 42

***How many mg of Septocaine 4% is in a stopper full?

Answer 42

0.2ml x 40mg/ml = 8mg of Septocaine 4%

Question 43

*** What is the MAX DOSE/Weight for Lidocaine 2% with Epi? (in BOTH mg/kg and mg/lb pleeeeze)

Answer 43

4.4mg/kg (or 2mg/lb)

Question 44

*** What is the max dose for Septocaine 4% with epi? (in both mg/kg and mg/lb pleeeze)

Answer 44

7mg/kg (or 3.18 mg/lb)

Question 45

What if a 100 lb child needs both Lido 2% and Septo 4%...what is the maximum dose for each and which number do you not exceed?

Answer 45

Lido 2% max = 200 mg....Septo 4% max = 318 lbs....dont exceed the lower number with overall amount of either drug

Question 46

Without looking at body weight (which needs to be done first), what are the ABSOLUTE MAXIMUM DOSAGES for Lidocaine 2% and Septocaine 4%?

Answer 46

Lido 2% = 300 mg... Sept 4% = 500mg

Question 47

What is the main problem with vasoconstrictor in the LA?

Answer 47

it prolongs numbness in the area and leads to more cheek/lip biting

Question 48

Calculate dosage of Epi 1:100,000..... How many mg/ml? how many mg/cartridge?

Answer 48

.01mg/ml x 1.8ml = .018 mg Epi/ cartidge

Question 49

What is the conversion for kg to lbs? What is the BADASS method for mentally converting lbs to kg?

Answer 49

1 kg = 2.2 lbs.....since were in America- (Lbs/2) - 10% = Kg....example: 100lbs/2 - 5 = 45kg when actual is 45.45)

Question 50

What is the major thing to look out for in an obese child/patient?

Answer 50

blood volume does not necessarily relate to body weight!

Question 51

Every injection we do in Pedo uses 1/4 of a cartridge, EXCEPT Which two?

Answer 51

1. IA nerve block and 2. IA for canines...they both use 1/2 cartridge

Question 52

*****DOCUMENTATION OF LA*****Documentation must include the type and dosage of local anesthetic in ______. Vasoconstrictors, if any, must be noted either in _________ or concentration

Answer 52

mg....mg

Question 53

*****DOCUMENTATION OF LA***** Documentation may include the ____ of injection(s) given (eg, infiltration, block), _______ selection and patient’s reaction to the injection.

Answer 53

type...needle

Question 54

*****DOCUMENTATION OF LA*****__________ instructions (eg, behavioral and dietary precautions) should be given to the patient and/or caregiver.

Answer 54

Postoperative

Question 55

*****DOCUMENTATION OF LA*****If the local anesthetic was administered in conjunction with sedative drugs, the doses of all agents must be noted on a ____-based record.

Answer 55

TIME BASED (nitrous yo!)

Question 56

*****DOCUMENTATION OF LA*****in patients for whom the maximum dosage of local anesthetic may be a concern, the ______ should be documented preoperatively.

Answer 56

weight

Question 57

What are the optimal % of N20 and O2 during delivery?

Answer 57

30-50% N20 and 70-50% O2

Question 58

How long do you diffuse N2O with pure O2 for full recovery??

Answer 58

5 min

Question 59

What is the minimum ventilation (in L) for N20? (Hint it = 500mL Tidal Volume x 12 RR)

Answer 59

500ml TV x 12 RR = MI of 6L

Question 60

Contraindications for N2O: Which lung disease? Which inner ear pressure? Which trimester for Pregnancy?

Answer 60

1. COPD 2.Otitis Media 3.1st Trimester

Question 61

Is it safe to administer N2O to a patient with Asthma?

Answer 61

YES! even indicated for it

Question 62

We typically use _____ induciton in administering N20 to adults, and ______ induction when administering to kids..

Answer 62

titration...rapid

Question 63

In adults, what are the % ranges for N20?

Answer 63

40-60%!!! (Peds were 30-50%)

Question 64

EXAMPLE: Total Flow of N20...___L of O2/ ___L of N2O = 40% N2O...

Answer 64

3L of O2 / 2 L of N20 = 2/5 or 40% of N2O

Question 65

How much excess gas is excavated in a scavenging system?

Answer 65

97% of the gas is scavenged

Question 66

**IN BRODSKY's scale: Which classification would you never sedate? What % coverage do we have?

Answer 66

class 4 = more than 75% of airway covered by the tonsils

Question 67

VITALS: Pulse and Respiratory rate _______ with age. Blood Pressure ________.

Answer 67

decrease...increases

Question 68

What is the quickest way to estimate BP on a kiddo?

Answer 68

Systolic = 90 + (2xAge)...example-Systolic BP for a 5 year old = 90 + (5x2) =100

Question 69

What is the FIRST concern with PEDO ext?

Answer 69

the permanent successor

Question 70

Which forceps and what hand movements do you use for a primary anterior ext?

Answer 70

#1 and ROTATIONAL movement ONLY!! (don't Fx the buccal or ling plate!!)

Question 71

Which forceps and what hand movements do you use for maxillary primary molars?

Answer 71

#150small...palatal, buccal, palatal (NO rotation)

Question 72

**Separated Roots during Ext: Attempt to REMOVE when, clearly visible, accessible, and there is low risk of ______ the permanent tooth below!

Answer 72

damaging

Question 73

**Separated Roots during Ext: leave them when the fragment is ______ and immobile, and there is a high risk of damage or displacement of the permanent tooth

Answer 73

embedded

Question 74

Which size gauze to you leave at the extraction site with a pedo patient? (think about risk of aspiration)

Answer 74

4x4