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Medical Emergencies In the Dental Office 6th Edition by Stanley F. Malamed – Test Bank
 
Sample  Questions      

 

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 1: Introduction

 

MULTIPLE CHOICE

 

  1. Factors that may increase the likelihood of a life-threatening emergency in the dental office include:
a. a pretreatment physical evaluation of each patient
b. therapeutic advances in the medical profession
c. a medical history questionnaire
d. modifications in dental treatment to minimize medical risks

 

 

  1. McCarthy has estimated that through the effective implementation of stress reduction procedures, all but about __% of life-threatening situations in the dental office can be prevented.
a. 40
b. 30
c. 25
d. 20
e. 10

 

 

  1. An entirely stress induced emergency situation that does not involve pre-existing medical conditions:
a. vasodepressor syncope
b. most acute cardiovascular emergencies
c. seizures
d. bronchospasm (asthma)

 

 

  1. The most commonly reported emergency in private practice dentistry is:
a. hyperventilation
b. syncope
c. postural hypotension
d. asthmatic attack (bronchospasm)

 

 

  1. According to Matsuura, when do most emergency situations related to dentistry occur?
a. In the waiting room before treatment
b. during or immediately following administration of local anesthetic
c. during dental treatment
d. in the office, but after treatment is completed
e. at home after treatment

 

 

  1. The dental treatment most commonly performed at the time of an emergency complication is:
a. apicoectomy
b. pulp extirpation
c. tooth preparation
d. tooth extraction

 

 

  1. Each year in the United States, 10% of all nonaccidental deaths occur suddenly and unexpectedly in relatively young persons believed to be in good health. The usual cause is:
a. stroke
b. cardiac dysrhythmia
c. acute myocardial infarction
d. hepatic lipidosis

 

 

  1. McCarthy estimates that _________ treatment-related deaths will occur throughout the career of the typical dental practitioner.
a. one or two
b. four
c. a half-dozen
d. sixteen

 

 

  1. Monitoring of which of the following major organ systems in older patients is of particular significance for the dental practitioner?
a. hepatic
b. renal
c. pulmonary
d. central nervous
e. cardiovascular

 

 

  1. The leading cause of death in persons over 65 years in the United States is:
a. malignant neoplasms
b. cerebrovascular diseases
c. diseases of the heart
d. chronic obstructive pulmonary disease
e. pneumonia and influenza

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 3: Preparation

 

           MULTIPLE CHOICE

 

  1. The author of the text recommends that each dentist:
a. purchase a stock, commercially available emergency kit
b. select items for the emergency kit based on that doctor’s training in emergency medicine
c. rely upon physicians who are also dental patients for advice concerning contents of an emergency kit
d. rely upon the local EMS team for provision of emergency medications

 

 

  1. The new wonder drug, propothiopentabarbitaldiazicon, which successfully reverses any and all emergency situations that may ever occur, is marketed in a 1-mL ampule as 80 mg/mL. What is the dose of this drug for a patient 25 years of age?
a. 10 mg
b. 20 mg
c. 40 mg
d. 80 mg
e. 160 mg

 

 

  1. The new wonder drug, propothiopentabarbitaldiazicon, which successfully reverses any and all emergency situations that may ever occur, is marketed in a 1-mL ampule as 80 mg/mL. What is the dose of this drug for a patient 6 months of age?
a. 10 mg
b. 20 mg
c. 40 mg
d. 80 mg
e. 160 mg

 

 

  1. Which of the following sites for injection of emergency drugs provides the most effective and rapid uptake?
a. intramuscular route into the anterolateral aspect of the thigh

 

b. intramuscular route into the mid-deltoid region of the upper arm
c. intramuscular route into the upper outer quadrant of the gluteal region
d. intralingual injection into the body of the tongue

 

 

  1. The author recommends that only __________ be available in a preloaded syringe for an emergency kit in a typical dental office.
a. hydrocortisone (Solu-Cortef)
b. epinephrine
c. diazepam (Valium)
d. diphenhydramine

 

 

  1. Which of the following is considered to be an essential (module 1) emergency drug?
a. anticonvulsant
b. antihypertensive
c. histamine-blocker
d. opioid antagonist
e. aromatic ammonia

 

 

  1. The single most important step in the management of all emergency situations, without exception, is:
a. administration of oxygen
b. summoning EMS
c. administration of aromatic ammonia
d. basic life support, as needed
e. none of the above

 

 

  1. What fraction of an adult emergency drug dose should be administered to an 8-month-old male?
a. 10% of the adult dose
b. 25% of the adult dose
c. 50% of the adult dose
d. 75% of the adult dose
e. 100% of the adult dose

 

 

  1. What fraction of an adult emergency drug dose should be administered to an 8-year-old female?
a. 10% of the adult dose
b. 25% of the adult dose
c. 50% of the adult dose
d. 75% of the adult dose
e. 100% of the adult dose

 

 

  1. The proprietary name for epinephrine is:
a. Valium
b. Vasoxyl
c. Ventolin
d. Nitro-stat
e. not listed

 

 

  1. The proprietary name for albuterol is:
a. Solu-Cortef
b. Wyamine
c. Ventolin
d. Nitro-stat
e. not listed

 

 

  1. Which of the following is an antidotal drug for the reversal of a benzodiazepine-induced overdose?
a. flumazenil
b. aromatic ammonia
c. meperidine
d. oxygen
e. naloxone

 

 

  1. When injectable drugs are unavailable, which of the following basic emergency drugs may be administered sublingually or transmucosally to manage life-threatening elevations in blood pressure?
a. diazoxide (Hyperstat)
b. propranolol (Inderal)
c. nifedipine (Procardia)
d. nitroglycerin (Nitrolingual spray)
e. metoprolol (Lopressor)

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 5: Unconsciousness: General Considerations

 

           MULTIPLE CHOICE

 

  1. Which of the following steps should come last in management of unconsciousness?
a. P—position
b. A—airway
c. B—breathing
d. C—circulation
e. D—definitive care

 

 

  1. Which of the following is the most common cause of loss of consciousness in the dental environment?
a. seizures
b. orthostatic hypertension
c. hyperventilation
d. vasodepressor syncope
e. acute adrenal insufficiency

 

 

  1. Which of the following is a cardiogenic cause of syncope?
a. carotid sinus disease
b. pulmonary embolism
c. pheochromocytoma
d. hypertrophic cardiomyopathy

 

 

  1. Which of the following is not one of the three major categories of drugs used in dentistry?
a. analgesics
b. antianxiety agents
c. antiinflammatory agents
d. antibiotics

 

 

  1. Most adverse reactions to local anesthetics are:
a. emboli in the brain or heart
b. stress induced
c. overdose reactions
d. allergy

 

 

  1. _______________ is the most common mechanism producing syncope.
a. Transient ischemia
b. Bradycardia
c. Cerebral anoxia
d. Tardive dyskinesia

 

 

  1. __________ is the most common cause of loss of consciousness in humans.
a. Hypotension
b. Blunt force trauma
c. Tachypnea
d. Opioid overdose

 

 

  1. Physiologic disturbances that decrease the blood supply to the brain include:
a. constriction of the peripheral arterioles
b. an increase in cardiac output
c. failure of normal peripheral vasoconstrictor activity
d. dilation of cerebral vessels as carbon dioxide is lost through hyperventilation

 

 

  1. The human brain uses about __% of the total glucose the body consumes.
a. 2
b. 20
c. 65
d. 90

 

 

  1. The unconscious victim should be positioned:
a. in the Trendelenburg position
b. with the brain below the heart
c. with the feet elevated slightly (a 10- to 15-degree angle)
d. with pillows under the head

 

 

  1. The only sign of adequate ventilation after performing head tilt–chin lift is:
a. hearing and feeling air against your (the rescuer’s) cheek
b. seeing the victim’s chest rise with each ventilation
c. observing respiratory monitoring devices
d. all of the above are signs of adequate ventilation

 

 

  1. Which of the following sounds associated with partial airway obstruction is cause for use of positive-pressure oxygen?
a. snoring
b. gurgling
c. wheezing
d. crowing

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 7: Postural Hypotension

 

           MULTIPLE CHOICE

 

  1. Postural hypotension is defined as a disorder of the ______________________ system.
a. cardiovascular
b. integumentary
c. autonomic nervous
d. endocrine

 

 

  1. Postural hypotension is:
a. frequently associated with fear and anxiety
b. infrequently associated with fear and anxiety
c. associated with fear but not anxiety
d. associated with anxiety but not fear

 

 

  1. Predisposing factors for postural hypotension include:
a. advanced age
b. infancy
c. inadequate period of recumbency
d. Cushing’s syndrome

 

 

  1. Probably the most frequently encountered cause of postural hypotension in the dental office is in response to:
a. venous defects in the legs
b. the use of drugs
c. physical exhaustion
d. inadequate postural reflex

 

 

 

  1. Shy-Drager syndrome is associated with
a. chronic postural hypotension
b. anhidrosis in the lower trunk
c. diaphoresis in the lower trunk
d. A and B
e. A and C

 

 

  1. Normally, standing systolic blood pressure should be within __ mm Hg of the supine blood pressure.
a. 10
b. 25
c. 40
d. 50

 

 

  1. Following a 30-minute dental appointment with you, the patient (a 20-year-old man; ASA I) is rapidly returned to an upright position prior to being dismissed from the chair.  He suddenly appears quite pale and reports extreme dizziness and of seeing “stars.”  What is your immediate treatment of this situation?
a. position upright and administer amyl nitrate vaporole
b. return to supine position and permit the patient to recover
c. activate EMS and administer nitroglycerin
d. position upright and administer oxygen
e. return to supine position and administer adrenalin sublingually

 

 

  1. Postural hypotension is usually associated with:
a. apnea
b. tachypnea
c. bradypnea
d. tachycardia
e. bradycardia

 

 

  1. Heart pulse rate increases about ____ beats per minute when the patient is standing.
a. 5 to 20
b. 10 to 30
c. 20 to 40
d. it does not increase at all

 

 

  1. Following an episode of postural hypotension, if the patient fails to regain consciousness within a few seconds:
a. administer a vasopressor
b. establish a patent airway
c. perform the Heimlich maneuver
d. call EMS

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 9: Unconsciousness: Differential Diagnosis

 

           MULTIPLE CHOICE

 

  1. Which of the following situations of unconsciousness will most likely involve hospitalization?
a. vasodepressor syncope
b. postural hypotension
c. acute adrenal insufficiency
d. A and C

 

 

  1. ___________________ is the most common non–stress-related cause of unconsciousness.
a. An allergic reaction
b. Postural hypotension
c. An hyperglycemic reaction
d. Epilepsy

 

 

  1. Restlessness, pallor, clammy skin, nausea, and vomiting may be signs of:
a. vasodepressor syncope
b. adrenal insufficiency
c. myocardial infarction
d. A, B, and C
e. A and C

 

 

  1. Tingling and numbness of the extremities are most closely associated with:
a. hypoglycemic reactions
b. hyperventilation
c. myocardial infarction
d. hypoglycemic reactions

 

 

 

  1. An intense headache is associated most closely with:
a. adrenal insufficiency
b. cerebrovascular accident
c. myocardial infarction
d. postural hypotension

 

 

  1. In most cases of unconsciousness, the heart rate ___________ baseline level, while the blood pressure __________.
a. rises above; increases
b. rises above; decreases
c. falls below; increases
d. falls below; decreases

 

 

  1. In vasodepressor syncope, the heart rate ___________ baseline level, while the blood pressure __________.
a. rises above; increases
b. rises above; decreases
c. falls below; increases
d. falls below; decreases

 

 

  1. An EMT, knowing neither the victim nor the medical history, will administer which of the following drugs in the field to an unconscious, but breathing, victim who does not respond to positioning, airway, and the administration of oxygen?
a. epinephrine
b. diazepam
c. diphenhydramine
d. 50% dextrose
e. none of the above

 

 

  1. Which of the following is most helpful in distinguishing vasovagal syncope from postural hypotension?
a. heart rate
b. respiratory rate
c. body temperature
d. mental status
e. blood pressure

 

 

  1. Which of the following is the single most important factor in management of the unconscious victim?
a. summon EMS stat
b. administration of aromatic ammonia
c. administration of positive-pressure oxygen
d. determination of the cause for loss of consciousness
e. administration of BLS, as indicated

 

 

  1. All of the following are methods of elevating blood pressure except:
a. administration of IV vasopressor
b. placing the patient in a semi-erect position (45 degrees upward tilt)
c. terminating anesthesia and administering 100% oxygen
d. intravenous fluid administration

 

 

  1. Which of the following problems does the following describe: cold and wet to the touch, mild tremor of extremities, mentally confused?
a. hypothyroidism
b. hyperthyroidism
c. acute adrenal insufficiency
d. hypoglycemia
e. hyperglycemia

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 11: Foreign Body Airway Obstruction

 

           MULTIPLE CHOICE

 

  1. When objects are swallowed they usually become lodged in the:
a. larynx and obstruct the trachea
b. gastrointestinal tract
c. left main stem bronchi
d. right main stem bronchi

 

 

  1. Swallowed objects that enter the gastrointestinal tract have produced:
a. peritoneal abscess
b. pneumonia
c. peritonitis
d. A, B, and C
e. A and C

 

 

  1. Use of a rubber dam is recommended in all possible situations; however, it is not feasible for ________ procedures.
a. oral surgery
b. operative dentistry
c. periodontal
d. A, B, and C
e. A and C

 

 

  1. A pharyngeal curtain may be created by __________ across the posterior portion of the oral cavity.
a. ligating with dental floss
b. spreading gauze pads
c. placing a saliva ejector
d. placing a portion of the patient’s bib

 

 

  1. ___________ are the best device for retrieval of large and small objects from the distal regions of the oral cavity.
a. Cotton pliers
b. Hemostats
c. Needle holders
d. Intubation forceps

 

 

  1. When an object enters the oropharynx of a patient seated in the supine position and is still visible:
a. immediately put the chair into the most forward position and encourage the patient to sit up.
b. tell the patient to stand up and jump up and down
c. move the chair into a more reclined position while the assistant picks up intubation forceps
d. move the chair into a more reclined position while the assistant calls EMS

 

 

  1. If an object is swallowed, which medical specialty should be consulted first?
a. gastroenterology
b. pulmonology
c. anesthesiology
d. radiology

 

 

  1. Signs and symptoms that an object has entered the trachea include:
a. vomiting
b. sudden onset of coughing, choking, or wheezing
c. hoarseness
d. gastroesophageal reflux disease

 

 

  1. When it can be presumed that a foreign body has entered the trachea, the patient should:
a. sit straight up
b. be placed in the Trendelenburg position
c. be placed in the left lateral decubitus position
d. be placed in the right lateral decubitus position

 

 

  1. “Crowing” sound is associated with:
a. complete airway obstruction
b. partial airway obstruction with good air flow
c. partial airway obstruction with poor air exchange
d. B and C

 

 

  1. Which of the following remains an indication for use of the “back blow”?
a. partial airway obstruction in any patient
b. total airway obstruction in an adult
c. total airway obstruction in an infant
d. total airway obstruction in a child
e. none—back blows are no longer recommended for airway obstruction

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 13: Asthma and Bronchospasm

 

           MULTIPLE CHOICE

 

  1. Asthma affects an estimated __% of adults in the United States.
a. 2
b. 5
c. 12
d. 20

 

 

  1. Individuals with ______ asthma have histories of allergies.
a. extrinsic
b. intrinsic
c. either extrinsic or intrinsic
d. neither extrinsic nor intrinsic

 

 

  1. Intrinsic asthma:
a. usually develops in children
b. is precipitated by nonallergic factors
c. usually develops in adult older than 35 years
d. A and B
e. B and C

 

 

  1. Which of the following is a correct definition of status asthmaticus?
a. Bronchospasm that persists despite the administration of two doses of bronchodilator
b. A seizure that persists more than 5 minutes
c. A convulsion that is resistant to the usual drug therapy
d. Bronchospasm that ends promptly, but returns before the patient recovers

 

 

 

  1. Asthma is commonly treated with nebulized:
a. α-adrenergic agonists
b. α-adrenergic antagonists
c. β-adrenergic agonists
d. β-adrenergic antagonists

 

 

  1. Administration of ___________ for conscious sedation is a relative contraindication in asthmatic patients.
a. barbiturates or opioids
b. inhalation sedation with nitrous oxide and oxygen
c. oral sedation with benzodiazepines
d. A, B, and C
e. A and C

 

 

  1. Which of the following dental local anesthetics is recommended for use with an asthmatic patient?
a. lidocaine plain
b. lidocaine with 1/50,000 epinephrine
c. lidocaine with 1/100,000 epinephrine
d. lidocaine with 1/200,000 epinephrine

 

 

  1. Asthmatic patients may be sensitive to the __________ contained in dental local anesthetic cartridges?
a. anesthetic agent itself
b. bisulfite preservative for the vasoconstrictor
c. vasoconstrictor itself
d. isotonic agent

 

 

  1. Acute asthma is characterized by:
a. respiratory smooth muscle spasm
b. airway inflammation with edema
c. mucus hypersecretion
d. A, B, and C
e. A and C

 

 

  1. Bronchial smooth muscle tone is regulated by the ___ cranial nerve.
a. fifth
b. seventh
c. tenth
d. eleventh

 

 

  1. Airway resistance varies inversely to the ____ power of its radius.
a. first
b. second
c. third
d. fourth

 

 

  1. Normally, inspiration is a/an________ process, and expiration a/an _________ process.
a. active; active
b. passive; passive
c. active; passive
d. passive; active

 

 

  1. For an asthmatic patient, inspiration is a/an________ process, and expiration a/an _________ process.
a. active; active
b. passive; passive
c. active; passive
d. passive; active

 

 

  1. Which of the following is used by asthmatic patients to prevent acute episodes of bronchospasm?
a. albuterol inhaler
b. epinephrine inhaler
c. corticosteroid inhaler
d. ephedrine inhaler
e. oxygen via face mask

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 15: Respiratory Distress: Differential Diagnosis

 

           MULTIPLE CHOICE

 

  1. Respiratory distress in younger patients (under age 10) is most commonly related to:
a. asthma
b. hyperventilation
c. heart failure
d. acute pulmonary edema

 

 

  1. The peak incidence of heart failure for women is between __________ years.
a. 40 and 50
b. 50 and 60
c. 60 and 70
d. 70 and 80

 

 

  1. Stress:
a. is present in most instances of respiratory distress
b. may acutely exacerbate asthma
c. causes the physical  conditions of patients with heart failure to progressively deteriorate
d. A, B, and C
e. A and C

 

 

  1. No clinical signs and symptoms of _____________ are present between episodes of respiratory distress.
a. heart failure
b. intrinsic asthma
c. extrinsic asthma
d. hyperventilation

 

 

 

  1. Respiratory distress becomes progressively more severe for a dental patient with:
a. heart failure as the dental chair is inclined toward a sitting up position
b. heart failure as the dental chair is reclined toward the supine position
c. asthma as the dental chair is reclined toward  the supine position
d. hyperventilation as the dental chair is reclined toward the supine position

 

 

  1. Wheezing may be present in patients with:
a. paroxysmal nocturnal dyspnea
b. pulmonary edema
c. asthma
d. A, B, and C
e. A and C

 

 

  1. Respiratory distress associated with __________ may be associated with a frothy, pink-tinged sputum and cough.
a. intrinsic asthma
b. extrinsic asthma
c. pulmonary edema
d. hyperventilation

 

 

  1. Hyperventilation is associated with:
a. exertion
b. peripheral edema
c. anxiety
d. cough

 

 

  1. Which of the following conditions is/are associated with cyanosis?
a. heart failure
b. severe asthma with hypoxia
c. hyperventilation
d. A and B
e. B and C

 

 

  1. Patients with __________ usually do not experience chest pain along with their other clinical symptoms.
a. hyperventilation
b. asthma
c. heart failure
d. A and B
e. B and C

 

 

  1. During heart failure:
a. systolic blood pressure is usually elevated to a greater degree than diastolic blood pressure
b. diastolic blood pressure is usually elevated to a greater degree than systolic blood pressure
c. systolic blood pressure is usually elevated and diastolic blood pressure falls
d. diastolic blood pressure is usually elevated and systolic blood pressure falls

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 18: Thyroid Gland Dysfunction

 

           MULTIPLE CHOICE

 

  1. A deficiency of thyroid hormone during early life can produce a clinical syndrome known as:
a. myxedema
b. cretinism
c. thyrotoxicosis
d. toxic goiter

 

 

  1. Secondary thyroid failure results from diseases of the:
a. thyroid gland
b. pituitary gland
c. hypothalamus
d. corpus callosum

 

 

  1. The most likely candidate for thyroid hypofunction would be a:
a. 70-year-old woman
b. 70-year-old man
c. 30-year-old woman
d. 30-year-old man

 

 

  1. Myxedema coma is associated with:
a. hyperthermia
b. hyperventilation
c. hypercapnia
d. hypertension

 

 

  1. Hyperthyroidism may be characterized by:

 

a. unexplained weight gain
b. unexplained weight loss
c. ravenous appetite
d. A and C
e. B and C

 

 

  1. Clinically, hyperthyroidism may be characterized by:
a. an unusual sensitivity to catecholamines
b. a lump or bump on the patient’s neck
c. an unusual sensitivity to opioids and other CNS depressants
d. A and B
e. B and C

 

 

  1. The clinically hypothyroid patient may have:
a. a large, thick tongue
b. wet skin with diaphoresis
c. tachycardia
d. markedly depressed blood pressure

 

 

  1. Hypothyroid or hyperthyroid patients who have been treated and are currently euthyroid are ASA __ risks.
a. I
b. II
c. III
d. IV

 

 

  1. Which of the following are often observed in a hyperthyroid rather than hypothyroid patient or in the general population?
a. cold intolerance
b. paresthesia
c. mitral valve prolapse
d. A, B, and C
e. A and C

 

 

  1. After positioning an unconscious patient with a history of hypothyroidism:
a. administer an opioid
b. provide an antianxiety agent
c. provide BLS, as needed
d. prescribe a sedative

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

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Chapter 20: Altered Consciousness: Differential Diagnosis

 

           MULTIPLE CHOICE

 

  1. _______________ most often occurs between the ages of 20 and 40.
a. Hyperventilation
b. Hyperthyroidism
c. Cerebrovascular disease
d. Drug overdose

 

 

  1. In pediatric patients, the most likely cause of altered consciousness is:
a. hyperventilation due to anxiety
b. hyperglycemia due to excess ingestion of “sugar”
c. hypoglycemia secondary to type 1 diabetes mellitus
d. drug overdose from over-the-counter medication

 

 

  1. Which of the following conditions associated with altered consciousness occurs predominately in females?
a. Hyperthyroidism
b. Hyperventilation
c. Hyperglycemia
d. CVA

 

 

  1. Which of the following causes of altered consciousness are accompanied by a gradual onset of clinical manifestations?
a. hypoglycemia
b. hyperglycemia
c. hyperthyroidism
d. A and B
e. B and C

 

 

 

  1. The skin of the hyperglycemic diabetic patient is __________ to the touch.
a. cold and wet
b. cold and dry
c. hot and wet
d. hot and dry

 

 

  1. Agitation, perspiration, and possible fine tremor of the extremities (hands) give the appearance of nervousness and are apparent in patients who are:
a. hyperglycemic
b. hypothyroid
c. hyperventilating
d. A, B, and C
e. A and C

 

 

  1. Tingling, a “cool” sensation about the mouth, finger-tips, and toes, that may progress to carpopedal tetany are noted in which of the following?
a. bronchospasm
b. allergy to Lidocaine
c. local anesthetic overdose
d. hyperventilation
e. acute pulmonary edema

 

 

  1. A TIA may be differentiated from a CVA because:
a. a TIA exhibits unilateral paresthesia, while a CVA exhibits bilateral paresthesia
b. a TIA exhibits bilateral paresthesia, while a CVA exhibits unilateral paresthesia
c. signs and symptoms of TIA commonly subside with 10 minutes, while a CVA continues to progress
d. signs and symptoms of CVA commonly subside with 10 minutes, while a TIA continues to progress

 

 

  1. ______________ is most commonly associated with signs of mental confusion and bizarre behavioral patterns that may lead to a suspicion of alcohol or other drug use.
a. Hyperthyroidism
b. Hypothyroidism
c. Hyperglycemia
d. Hypoglycemia

 

 

  1. Severely ________________ patients may have the characteristic fruity, sweet smell of acetone on their breath.
a. hypoglycemic
b. hyperglycemic
c. hypothyroid
d. hyperthyroid

 

 

  1. The respiratory rate increases when ______________ is present.
a. hyperventilation
b. hyperthyroidism
c. hyperglycemia
d. A, B, and C
e. A and C

 

 

  1. Elevated blood pressure is associated with:
a. hyperthyroidism
b. hyperglycemia
c. hyperventilation
d. A, B, and C
e. A and C

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

Test Bank

 

Chapter 21: Seizures

 

TRUE/FALSE

 

  1. Most instances of injury to victims during seizures happen during the tonic-clonic phase when the victims hit their head against the floor.

 

 

MULTIPLE CHOICE

 

  1. About 1 in _____ of the U.S. population develops epilepsy each year in the general population.
a. 100
b. 200
c. 500
d. 1000

 

 

  1. More than ___% of patients with epilepsy experienced their first seizure before reaching 20 years of age.
a. 10
b. 50
c. 75
d. 90

 

 

  1. Which of the following is the most common type of seizure?
a. Petit mal epilepsy
b. Jacksonian epilepsy
c. Myotonic seizures
d. Generalized tonic-clonic convulsion
e. Absence attacks

 

 

 

  1. Which of the following seizure types is most common in younger patients and consists, usually, of a period of “absence” and increased blinking of the eyelids?
a. Jacksonian seizures
b. Petit mal seizures
c. Myoclonic seizures
d. Psychomotor seizures
e. Grand mal seizures

 

 

  1. Individuals with ___________ often exhibit automatisms, apparently purposeful movements, incoherent speech, turning of the head, shifting of the eyes, smacking of the lips, twisting and writhing movements of the extremities, clouding of consciousness, and amnesia.
a. grand mal epilepsy
b. petit mal epilepsy
c. Jacksonian epilepsy
d. psychomotor seizures

 

 

  1. ____________ represents the most common acquired cause of seizures between 35 and 55 years of age.
a. Metabolic and toxic disorders
b. Tumors
c. Vascular diseases
d. Infectious diseases

 

 

  1. All of the following statements are true, except:
a. The first priority of seizure therapy is to correct the underlying cause, if possible, and the second is to control the seizures, if necessary
b. The closed tonic jaw should be opened and a “bite block” inserted into the seizing patient’s mouth
c. Most seizure attacks are relatively benign and of short duration, with spontaneous termination and prompt recovery
d. The seizing patient should be placed in the lateral decubitus position, if possible, to avoid aspiration

 

 

  1. “Swallowing of the tongue” during a seizure may be prevented most effectively by which of the following:
a. prying mouth open and grabbing tongue of victim with fingers
b. prying mouth open and grabbing tongue with 2 × 2 gauze
c. prying mouth open and placing suture through tongue
d. prying mouth open and grabbing tongue with towel clamp
e. head tilt–chin lift

 

 

  1. The anticonvulsant drug of choice for management of generalized tonic-clonic seizure is a/an:
a. barbiturate
b. antihypertensive
c. benzodiazepine
d. phenytoin

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

Test Bank

 

Chapter 23: Drug Overdose Reactions

 

           TRUE/FALSE

 

  1. A negative result on an aspiration test during local anesthetic administration indicates that the needle tip is not within the lumen of a blood vessel and that the drug may be administered.

 

 

MULTIPLE CHOICE

 

  1. Biotransformation of a drug occurs during:
a. absorption
b. distribution
c. metabolism
d. excretion

 

 

  1. Which is the most common cause of overdose in dentistry?
a. local anesthetics
b. vasoconstrictors
c. sedative-hypnotics
d. opioid analgesics

 

 

  1. Most amide local anesthetics undergo biotransformation in the:
a. pancreas
b. spleen
c. plasma of blood
d. liver

 

 

  1. Which of the following is the longest-acting local dental anesthetic?
a. prilocaine

 

b. lidocaine
c. bupivacaine
d. mepivacaine

 

 

  1. Full-mouth anesthesia may be achieved in an adult with fewer than ______ cartridges of local anesthetics.
a. two
b. four
c. six
d. eight

 

 

  1. In the United States, 1.8 mL of 2% lidocaine contains __ mg of anesthetic.
a. 18
b. 36
c. 40
d. 44

 

 

  1. ____________ injections usually possess the greatest potential for intravascular injection.
a. Intraligamentary
b. Inferior alveolar nerve block
c. Mental nerve block
d. Posterior superior alveolar nerve block

 

 

  1. Administration of a full 1.8-mL cartridge of local anesthetic should take a minimum of:
a. 10 seconds
b. 30 seconds
c. 1 minute
d. 5 minutes

 

 

  1. As the patient becomes more acidotic during a local anesthesia-induced seizure, the seizure threshold for that drug _______________.
a. increases
b. remains the same
c. decreases

 

 

  1. Which of the following body systems is most susceptible to the clinical effects of epinephrine in local anesthetics?
a. CNS
b. respiratory system
c. cardiovascular system
d. genitourinary system
e. endocrine system

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

Test Bank

 

Chapter 25: Drug-Related Emergencies: Differential Diagnosis

 

           MULTIPLE CHOICE

 

  1. Over __% of deaths from anaphylaxis occur in patients over 19 years of age.
a. 25
b. 50
c. 75
d. 90

 

 

  1. The highest occurrence category for vasodepressor syncope is:
a. elderly males over age 65
b. middle-aged males age 40 to 65
c. males from late teens to late 30s
d. males age 6 and 12

 

 

  1. Placing an unconscious patient into a supine position leads to rapid improvement for a patient with:
a. drug overdose
b. vasodepressor syncope
c. allergy
d. A, B, and C
e. A and C

 

 

  1. Signs and symptoms that appear _____ drug administration most probably represent allergy.
a. just before
b. during
c. after

 

 

 

  1. At what time during the dental “experience” do most medical emergency situations develop?
a. just before treatment
b. during or immediately following administration of local anesthetic
c. during dental treatment
d. after treatment, in the office
e. after leaving the dental office

 

 

  1. Allergy most often presents as:
a. stomach upset
b. a skin reaction
c. tachycardia
d. bradycardia

 

 

  1. Urticaria and pruritus indicate:
a. a toxic reaction
b. an idiosyncrasy
c. an allergic reaction
d. anxiety

 

 

  1. Signs of epinephrine overdose include:
a. tachycardia
b. pallor
c. elevated blood pressure
d. A, B, and C
e. A and C

 

 

  1. Total airway obstruction is most often produced by the ________ in an unconscious patient.
a. tonsils
b. tongue
c. epiglottis
d. soft palate

 

 

  1. ________ results in an increase in heart rate and blood pressure.
a. Local anesthetic overdose
b. Epinephrine overdose
c. An allergic reaction
d. A, B, and C
e. A and C

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

Test Bank

 

Chapter 27: Angina Pectoris

 

           MULTIPLE CHOICE

 

  1. On average, the patient with stable angina experiences _______ of angina per week.
a. less than one episode
b. one or two episodes
c. between two and four episodes
d. fewer than six episodes

 

 

  1. Nitroglycerin and rest characteristically relieve the discomfort of angina in approximately ___________.
a. 10 seconds
b. 2 to 4 minutes
c. 10 minutes
d. 1 hour

 

 

  1. Which of the following are classified as ASA IV risks?
a. unstable angina
b. exertional angina
c. vasospastic angina
d. all of the above
e. B and C only

 

 

  1. The maximal dose of epinephrine recommended for administration in the cardiac risk patient (ASA III) at one appointment is ___ mg.
a. 0.01
b. 0.04
c. 0.08
d. 1.0

 

 

 

  1. A feeling of a “pressing sensation” or of a “weight” on the chest is frequently mentioned by the patient who is experiencing:
a. hypoglycemia
b. postural hypotension
c. acute pulmonary edema
d. hyperventilation
e. none of the above

 

  1. When administering Nitrolingual spray it is recommended that no more than three metered doses be given in a _______ period.
a. 15-second
b. 3-minute
c. 15-minute
d. 30-minute

 

 

  1. Amyl nitrate:
a. is administered by injection
b. causes profound peripheral arterial vasodilation
c. causes profound peripheral dilation of veins
d. increases cardiac output

 

 

  1. Myocardial infarction should be suspected in all of the following situations except:
a. first-ever onset of chest pain occurring during treatment
b. chest pain relieved by nitroglycerin that does not return
c. chest pain that is not relieved by three doses of SL nitroglycerin
d. chest pain relieved by nitroglycerin that does return

 

 

  1. What is the effect of nitroglycerin administration on the pain of crescendo angina?
a. pain is alleviated within 5 minutes but might return
b. pain is alleviated within 2 minutes and does not return
c. nitroglycerin does not alleviate the pain of crescendo angina
d. response of crescendo angina to nitroglycerin is variable—any of the above choices may be correct

 

 

  1. A patient with Prinzmetal’s angina is classified as ASA _____.
a. I
b. II
c. III
d. IV
e. V

 

 

  1. Chest “pain” that is relieved by nitroglycerin and does not return is most likely:
a. cardiac arrest
b. hyperventilation
c. noncardiac in origin
d. stable angina pectoris
e. myocardial infarction

Malamed: Medical Emergencies in the Dental Office, 6th Edition

 

Test Bank

 

Chapter 30: Cardiac Arrest and Cardiopulmonary Resuscitation

 

           TRUE/FALSE

 

  1. Effective chest compressions can be applied with the victim lying in the dental chair.

 

 

MULTIPLE CHOICE

 

  1. Of the victims of cardiac arrest, __% do not exhibit clinical signs or symptoms before the onset of sudden death.
a. 10
b. 25
c. 50
d. 75

 

 

  1. The ultimate goal of emergency cardiac care is:
a. restoring normal sinoatrial rhythm
b. providing cerebral resuscitation
c. preventing ventricular fibrillation
d. preventing atrial fibrillation

 

 

  1. Which of the following is the proper sequence of the “chain of survival”?
a. early BLS à early access à early defibrillation à early ACLS
b. early ACLS à early access à early BLS à early defibrillation
c. early BLS à early defibrillation à early access à early ACLS
d. early defibrillation à early BLS à early ACLS à early access
e. early access à early BLS à early defibrillation à early ACLS

 

 

  1. Which of the following statements is true concerning early access and CPR?
a. EMS should be notified after 1 minute of BLS in children

 

b. EMS should be notified before the start of BLS in children
c. EMS should be notified before the start of BLS in adults
d. A and C
e. B and C

 

 

  1. An AED:
a. may be used for rapid defibrillation
b. will cause premature ventricular contractions if used to shock a patient who has a normal pulse
c. must be used exclusively by an allopathic or osteopathic physician
d. will relieve an anginal attack

 

 

  1. BLS consists of:
a. airway management
b. artificial ventilation
c. external chest compression
d. A, B, and C
e. A and C

 

 

  1. Concerning pulmonary and cardiac arrest:
a. cardiac arrest may develop in the absence of respiratory arrest
b. in most instances, respiratory arrest precedes cardiac arrest
c. respiratory arrest may develop in the absence of cardiac arrest
d. A, B, and C
e. A and C

 

 

  1. Cardiac arrest may result from:
a. pulseless electrical activity
b. ventricular tachycardia
c. ventricular fibrillation
d. A, B, and C
e. A and C

 

 

  1. If cardiac arrest has existed for __ minutes or more, it is unlikely that the victim’s CNS will be restored to its precardiac arrest state.
a. 2
b. 4
c. 10
d. 20