Quiz

Question 1

Most prevalent aerobic micro-organisms associated with odontogenic infections

Answer 1

Streptococci

Question 2

An antibioma is:

Answer 2

A chronic inflammatory mass after prolonged antibiotic treatment alone

Question 3

Organism typically associated with facial cellulitis

Answer 3

Group A Streptococci

Question 4

What is fluctuance swelling?

Answer 4

Feeling of a fluid-filled balloon indicating an accumulation of pus in the underlying tissues

Question 5

What is an indurated swelling?

Answer 5

Swelling that has the same firmness as a tightened muscle

Question 6

Rate the most common to least common for odontogenic infections.
Aerobic, anaerobic, mixed

Answer 6

Mixed (60%) > Anaerobic (35%) > Aerobic (5%)

Question 7

Osteoradionecrosis occurs most commonly at what dose and which arch?

Answer 7

Mandible at 65 Gy

Question 8

The best restorations to restore teeth affected by caries after radiation are:

Answer 8

Amalgam and composites

Question 9

What dose of radiation is safe to place implants after radiation therapy?

Answer 9

implants may be placed

> 45 Gy –> hyperbaric oxygen therapy before and after implant surgery

Question 10

Should all impacted teeth be removed before irradiation?

Answer 10

No

Question 11

What should be removed before irradiation?

Answer 11

• All hopeless & questionable teeth
• implants with questionable prognosis
• root fragments and other bone pathologies.

Question 12

What is the optimal time between extraction of teeth and radiation?

Answer 12

3 weeks

Question 13

Chemotherapy drug that may present with constant, deep pain that is often bilateral and frequently mimics toothache (odontalgia):

Answer 13

Vincristine

Question 14

What are the pathological features of osteoradionecrosis?

Answer 14

• slow bone turnover rate
• non-vital bone within radiation beam
• resembles chronic suppurative osteomyelitis

Question 15

Does risk of osteoradionecrosis diminish 10 years after radiotherapy?

Answer 15

No

Question 16

After irradiation of the face and jaws, the underlying pathological event that leads to osteoradionecrosis is:

Answer 16

Endarteritis obliterans

Question 17

Risk factors of osteoradionecrosis:

Answer 17

• exposure > 6000 cGy
• posterior mandible exposed
• poor dentition and oral hygiene
• poor nutrition
• smoking
• ill-fitting prosthesis causing
• chronic trauma
• post-RT extraction

Question 18

What are the rationales for hyperbaric oxygen therapy?

Answer 18

• increase blood-tissue oxygen gradient
• stimulation of fibroblast proliferation, angiogenesis, collagen formation
• bactericidal & bacteriostatic

Question 19

Symptoms of oral mucositis after radiation resolve typically after:

Answer 19

6 months

Question 20

The Bosker transmandibular implant is indicated for:

Answer 20

A patient with a markedly resorbed mandibular ridge

Question 21

When is surgery best taken if patient is on dialysis?

Answer 21

DAY AFTER dialysis tx (this allows the heparin to disappear, and then patient still has “fresh” blood

Question 22

Which LAs in moderate amounts are least likely to harm fetus?

Answer 22

• Lidocaine

- Bupivacaine

Question 23

Which analgesics are least likely to harm fetus?

Answer 23

• acetaminophen

- codeine

Question 24

Which antibiotics are least likely to harm a fetus?

Answer 24

• penicillin

- cephalosporin

Question 25

A patient with angina should be given no more than 0.04 mg of epinephrine in local anaesthetic solution over a period of:

Answer 25

30 minutes

Question 26

List the components of antral regime.

Answer 26

- Broad spectrum antibiotics (amoxicillin) - Nasal decongestant - Antihistamine or nasal inhalations

Question 27

A healthy adult has a platelet count in the range per microliter of blood):

Answer 27

150,000 to 400,000

Question 28

Platelet function is assessed by which laboratory test?

Answer 28

Bleeding time

Question 29

What is intermittent claudication?

Answer 29

Intermittent claudication arises due to vascular insufficiency, and manifests as severe pain in the calf muscles on exertion.It is typical of smokers.

Question 30

What is the MOA of warfarin?

Answer 30

Warfarin inhibits the vitamin K-dependent synthesis of biologically active forms of the calcium-dependent clotting factors II, VII, IX and X.

Question 31

Who are patients at risk of adrenal insufficiency?

Answer 31

Those that take > 20mg daily for at least 2 weeks in the past year prior to surgery

Question 32

How do you handle adrenal insufficiency emergency situations?

Answer 32

- administer oxygen | - administer hydrocortisone 100 mg IV (or IM)

Question 33

How to handle TIA (ie. temporary numbness of extremities, loss of vision)?

Answer 33

- Termination of dental treatment - little can be done for patient other than reassurance - referral to physician

Question 34

Whereas cerebrovascular compromise from embolism develop slowly, ruptured vessel occurs quickly -- ptn will have "the worst headache of their life"

Answer 34

- monitor vital signs - call for medical assistance - Oxygen is contraindicated unless respiratory difficulty occurs - any narcotics the patient is on should be reversed - begin cardiopulmonary resuscitation if loss of consciousness

Question 35

What dose of epinephrine is given for severe anaphylaxis?

Answer 35

0.3 ml of 1:1,000

Question 36

Late manifestations of acute adrenal insufficiency:

Answer 36

- vomiting - pain in the abdomen - mental confusion

Question 37

What is the regime for patients currently taking corticosteroids?

Answer 37

Double the dose of steroid on the day before, the day of, and the day after surgery

Question 38

What is the regime for patients who has received at least 20 mg of hydrocortisone for more than 2 weeks in the past year?

Answer 38

hydrocortisone 60 mg on the day before and morning of surgery, then 40 mg x 2 days, and finally 20 mg for 3 days thereafter