Past Papers

Question 1

what are the 4 As and R of smoking cessation

Answer 1

ask
advise
assess
assist
refer

Question 2

what should you ask for a smoking history

Answer 2

do you smoke
what do you smoke
how many per day/ how long
why do you smoke
do you have kids in the house

Question 3

what should you advise the patient on during smoking cessation

Answer 3

smoking is harmful to general health (cardiovascular and respiratory)
smoking is detrimental to oral health (oral cancer/ gum disease)
very expensive, bad breath

Question 4

what questions should you ask when assessing an individual who wants to quit smoking

Answer 4

are you interested in giving up now
motivations to quit
have you previously tried to quit - how did that go

Question 5

why should you signpost patients to help when they are trying to stop smoking

Answer 5

increases likelihood of quitting 4 x
NRT (E-cigs, gum, patches)

Question 6

who can you refer patients to, to help them quit smoking

Answer 6

local cessation services (pharmacy, GP and stop smoking services)
Self referral at quit your way scotland
arrange follow up with patient

Question 7

how would you assess a fractured cheekbone extraorally

Answer 7

palpation of zygoma
examination of eye
examination of sensation of infra-orbial region

Question 8

how would you palpate zygoma in cheekbone fracture

Answer 8

gentle palpation bilaterally of supra-orbital rim, inferior orbital rim, zygomatic prominence and assessment of nasal bleeding and limitation of mandibular movement

Question 9

what would you find on examination of the eye in cheekbone fracture

Answer 9

circumorbital ecchymosis and subconjunctival haemorrhage
assess vision, mobility of eyeball and presence of double vision

Question 10

what three areas would you examine when checking for sensation in a cheekbone fracture

Answer 10

superior labial, lateral nasal and lower eyelid
these three areas are supplied by infra-orbital nerve

Question 11

what are four I/O features of cheekbone fracture

Answer 11

tenderness at buttress root of zygoma bone
bruising, swelling, haematoma
occlusal derangement
anaesthesia/ paraesthesia of teeth in the upper quadrant

Question 12

what further investigations would you want for suspected cheekbone fracture

Answer 12

occipitomental and CBCT/ CT views

Question 13

how would you manage a patient with fractured cheekbone

Answer 13

urgent phone referral to OMFS unit

Question 14

what would the surgical management of a patient with a fractured cheekbone be

Answer 14

open reduction and internal fixation (ORIF)

Question 15

what are the 6 handpiece safety checks

Answer 15

back cap does not spin
bur does not shake from side to side
bur does not get pulled from handpiece
bur rotates freely when rolled
handpiece does not detach from coupling
handpiece runs freely and does not make a weird sound (5 seconds at least)

Question 16

when a patient is on warfarin what should you ask them

Answer 16

what their INR is, when was it last done
ask to see INR book

Question 17

what is the guidance of when INR should be checked for extraction

Answer 17

SDCEP anticoagulation guidance
Check INR within 24 hours of procedure or 72 if INR is considered stable

Question 18

when is INR considered stable

Answer 18

when it has been less than 4 for 3 months

Question 19

what is the standard procedure for managing sharps injury applied to all patients

Answer 19

inform patient of injury - risk is to operator and not patient
requirement of blood sample from both participants but patient does not have to consent - no pressure to agree
undertake review of medical history
ask patient if they have any questions

Question 20

what would be the treatment of EDP # in 8 year old where the exposure is large

Answer 20

pulpotomy (open apex)
involves LA and rubber dam
partial removal of pulp
dressed with non-setting CaOH
aim is to keep undamaged pulp alive
so the tooth stays alive and continues to grow
restored with composite filling

Question 21

what patient information should be put on a path form

Answer 21

sticker with CHI, hospital number, name, sex, address and DOB
hospital department
date
time
consultant
requested by
phone numver

Question 22

what clinical details should be entered onto a path form

Answer 22

pain and swelling and provisional diagnosis
specimen details - site
investigation required

Question 23

how should a pus aspirate specimen be transported

Answer 23

sealed with red cap placed onto syringe hub - NEEDLE removed
syringe with hub cap labelled with pt details and placed in plastic bag attached to request form

Question 24

how do bisphosphonate drugs work

Answer 24

reduce turnover of bone
accumulate in sites of high bone turnover eg jaw

Question 25

what is the relevance of bisphosphonates to dentistry

Answer 25

risk of poorer wound healing following XLA need to remove any teeth of poor prognosis prior to beginning drug therapy reduced turnover of bone and reduced vascularity can lead to death of bone - osteonecrosis

Question 26

what is the risk of MRONJ in osteoporosis

Answer 26

low

Question 27

what are alcohol related health issues

Answer 27

increased cancer risk - oral and pancreatic liver damage/ cirrhosis increased risk of heart disease dental issues - dry mouth, poor wound healing, erosion, tooth decay

Question 28

what is the AVDR model for domestic abuse

Answer 28

ask - no judgement (ive noticed certain injuries, is everything okay at home? if you're not ready to talk we can revisit this at any time) validate - you do not deserve to be treated like this, it's not your fault document - if pt not ready to receive help write in notes what injuries made you suspicious and you discussed options for help refer - signpost to domestic abuse charities or if life threatening phone 999

Question 29

what is the complaints procedure

Answer 29

acknowledge complaint and provide pt with practice complaint procedure inform the dental defence organisation acknowledge the complaint in writing or telephone as soon as you receive it - 3 working days max but ideally 24 hours stage 1 - local level/ early resolution on the spot resolution within 5 working days stage 2 - investigation completed in 20 working days give patient details of ombudsmen

Question 30

what blood borne viruses are risks to dentists

Answer 30

hep B risk 30% hep C risk 3% HIV 0.3%

Question 31

what is sharps AWARE

Answer 31

Apply pressure to site and squeeze to encourage it to bleed Wash the site with warm soapy water Assess the injury Risk asses the exposure - pt risks Establish contact by reporting to senior member of staff, record in accident book, contact occupational health

Question 32

how is a sharps injury risk assessment done

Answer 32

not done by person who received sharps strictly confidential information from risk assessment not written in case notes - just say datix completed risk assessment destroyed after occupational health called