Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 01: Patient Evaluation and Risk Assessment
Chapter 01: Patient Evaluation and Risk Assessment
1. Elective dental care should be deferred for patients with severe, uncontrolled
hypertension, meaning that the blood pressure is greater than or equal to ________
mm Hg.
a) 200/140
b) 180/140
*c) 180/110
d) 160/110
2. The American Heart Association currently recommends antibiotic prophylaxis for a
patient with which of the following cardiac conditions?
a) Mitral valve prolapse
*b) Prosthetic heart valve
c) Rheumatic heart disease
d) Pacemakers for cardiac arrhythmias
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased
ability of the body to _________ certain drugs, including local anesthetics and
analgesics.
a) absorb
b) distribute
*c) metabolize
d) excrete
4. Which of the following symptoms and signs is most consistent with allergy?
a) Heart palpitations
*b) Itching
c) Vomiting
d) Fainting
5. Signs and symptoms of diabetes can be recognized in the oral cavity. Which of the
following is not a sign or symptom?
a) periodontal disease
b) gingival enlargement
c) xerostomia
*d) oral candidiasis
1
,Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 01: Patient Evaluation and Risk Assessment
6. Vasoconstrictors should be avoided in patients who are cocaine or
methamphetamine users because these agents may precipitate _________.
a) severe hypotension
*b) severe hypertension
c) respiratory depression
d) cessation of intestinal peristalsis
7. It has been shown that the risk for occurrence of a serious perioperative
cardiovascular event (e.g., MI, heart failure) is increased in patients who are unable
to meet a __-MET (metabolic equivalent of task) demand during normal daily activity.
*a) 4
b) 6
c) 8
d) 10
8. Which of the following alterations in the fingernails is associated with cirrhosis?
a) Yellowing
b) Clubbing
*c) White discoloration
d) Splinter hemorrhages
9. The importance of taking vital signs with an initial exam establishes a baseline in
case of an emergency. Which of the following vitals may not be taken routinely in a
dental office?
*a) temperature
b) pulse rate
c) blood pressure
d) respiration
10. Which of the following is true of a patient classified ASA III according to the
American Society of Anesthesiologists (ASA) Physical Status Classification System?
a) Patient has mild systemic disease.
*b) Patient’s disease has significant impact on daily activity.
c) Patient’s disease is unlikely to have impact on anesthesia and surgery.
d) Patient is moribund.
2
,Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 02: Infective Endocarditis
Chapter 02: Infective Endocarditis
1. Which of the following is true concerning infective endocarditis (IE)?
a) IE is always due to a bacterial infection.
b) Since the advent of antibiotics, morbidity and mortality associated with IE have
been virtually eliminated.
c) IE is currently classified as acute or subacute, to reflect the rapidity of onset
and duration.
*d) Accumulating evidence questions the validity of antibiotic prophylaxis in an
attempt to prevent IE prior to certain invasive dental procedures.
2. Which of the following is currently the most common underlying condition
predisposing to infective endocarditis (IE)?
a) Aortic valve disease
b) Rheumatic heart disease (RHD)
*c) Mitral valve prolapse (MVP)
d) Tetralogy of Fallot
3. The leading cause of death due to infective endocarditis (IE) is __________.
a) chronic obstructive pulmonary disease
*b) heart failure
c) pulmonary emboli
d) atheromas
4. The interval between the presumed initiating bacteremia and the onset of
symptoms of infective endocarditis (IE) is estimated to be less than __________ in
more than 80% of patients with IE.
a) 1 week
*b) 2 weeks
c) 1 month
d) 2 months
5. Where are Janeway lesions located?
a) Tricuspid valve
*b) Palms of the hands and soles of the feet
3
, Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 02: Infective Endocarditis
c) Pulp of the digits
d) Nail beds
6. Which of the following is true of the magnitude of bacteremia required to cause
infective endocarditis (IE)?
a) The magnitude of bacteremias resulting from dental procedures is more likely
to cause IE than that seen with bacteremias resulting from normal daily activities.
*b) Cases of IE caused by oral bacteria probably result from frequent exposure to
low inocula of bacteria in the bloodstream due to daily activities and not a dental
procedure.
c) The quality of oral hygiene has no appreciable effect on the magnitude of
bacteremia after toothbrushing.
d) The magnitude of bacteremia resulting from dental procedures is greater than
that needed to cause experimental bacterial endocarditis (BE) in animals.
7. There are multiple randomized controlled trials to prove the efficacy of antibiotic
prophylaxis in preventing IE for a dental procedure. It is not clear which dental
procedures are more or less likely to cause transient bacteremia or to result in a
greater magnitude of bacteremia than that caused by routine daily activities such as
chewing food, tooth brushing, or flossing.
a) Both statements are true.
b) Both statements are false.
c) The first statement is true, the second statement is false.
*d) The first statement is false, the second statement is true.
8. Which of the following is true regarding the efficacy of antibiotic prophylaxis?
a) Data show that a reduction in the incidence, nature, and duration of bacteria
caused by antibiotic therapy reduces the risk of or prevents IE.
b) Antibiotics given to at-risk patients before a dental procedure will prevent or
reduce bacteremia.
c) Prospective randomized, placebo-controlled trials have been conducted to
examine the efficacy of antibiotic prophylaxis for preventing IE in patients who
undergo a dental procedure.
*d) Investigators have concluded that dental or other procedures probably only
caused a small fraction of cases of IE, and that prophylaxis would prevent only a
small number of cases, even if it were 100% effective.
4
Compromised Patient, 10e
Chapter 01: Patient Evaluation and Risk Assessment
Chapter 01: Patient Evaluation and Risk Assessment
1. Elective dental care should be deferred for patients with severe, uncontrolled
hypertension, meaning that the blood pressure is greater than or equal to ________
mm Hg.
a) 200/140
b) 180/140
*c) 180/110
d) 160/110
2. The American Heart Association currently recommends antibiotic prophylaxis for a
patient with which of the following cardiac conditions?
a) Mitral valve prolapse
*b) Prosthetic heart valve
c) Rheumatic heart disease
d) Pacemakers for cardiac arrhythmias
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased
ability of the body to _________ certain drugs, including local anesthetics and
analgesics.
a) absorb
b) distribute
*c) metabolize
d) excrete
4. Which of the following symptoms and signs is most consistent with allergy?
a) Heart palpitations
*b) Itching
c) Vomiting
d) Fainting
5. Signs and symptoms of diabetes can be recognized in the oral cavity. Which of the
following is not a sign or symptom?
a) periodontal disease
b) gingival enlargement
c) xerostomia
*d) oral candidiasis
1
,Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 01: Patient Evaluation and Risk Assessment
6. Vasoconstrictors should be avoided in patients who are cocaine or
methamphetamine users because these agents may precipitate _________.
a) severe hypotension
*b) severe hypertension
c) respiratory depression
d) cessation of intestinal peristalsis
7. It has been shown that the risk for occurrence of a serious perioperative
cardiovascular event (e.g., MI, heart failure) is increased in patients who are unable
to meet a __-MET (metabolic equivalent of task) demand during normal daily activity.
*a) 4
b) 6
c) 8
d) 10
8. Which of the following alterations in the fingernails is associated with cirrhosis?
a) Yellowing
b) Clubbing
*c) White discoloration
d) Splinter hemorrhages
9. The importance of taking vital signs with an initial exam establishes a baseline in
case of an emergency. Which of the following vitals may not be taken routinely in a
dental office?
*a) temperature
b) pulse rate
c) blood pressure
d) respiration
10. Which of the following is true of a patient classified ASA III according to the
American Society of Anesthesiologists (ASA) Physical Status Classification System?
a) Patient has mild systemic disease.
*b) Patient’s disease has significant impact on daily activity.
c) Patient’s disease is unlikely to have impact on anesthesia and surgery.
d) Patient is moribund.
2
,Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 02: Infective Endocarditis
Chapter 02: Infective Endocarditis
1. Which of the following is true concerning infective endocarditis (IE)?
a) IE is always due to a bacterial infection.
b) Since the advent of antibiotics, morbidity and mortality associated with IE have
been virtually eliminated.
c) IE is currently classified as acute or subacute, to reflect the rapidity of onset
and duration.
*d) Accumulating evidence questions the validity of antibiotic prophylaxis in an
attempt to prevent IE prior to certain invasive dental procedures.
2. Which of the following is currently the most common underlying condition
predisposing to infective endocarditis (IE)?
a) Aortic valve disease
b) Rheumatic heart disease (RHD)
*c) Mitral valve prolapse (MVP)
d) Tetralogy of Fallot
3. The leading cause of death due to infective endocarditis (IE) is __________.
a) chronic obstructive pulmonary disease
*b) heart failure
c) pulmonary emboli
d) atheromas
4. The interval between the presumed initiating bacteremia and the onset of
symptoms of infective endocarditis (IE) is estimated to be less than __________ in
more than 80% of patients with IE.
a) 1 week
*b) 2 weeks
c) 1 month
d) 2 months
5. Where are Janeway lesions located?
a) Tricuspid valve
*b) Palms of the hands and soles of the feet
3
, Test Bank For Little and Falace's Dental Management of the Medically
Compromised Patient, 10e
Chapter 02: Infective Endocarditis
c) Pulp of the digits
d) Nail beds
6. Which of the following is true of the magnitude of bacteremia required to cause
infective endocarditis (IE)?
a) The magnitude of bacteremias resulting from dental procedures is more likely
to cause IE than that seen with bacteremias resulting from normal daily activities.
*b) Cases of IE caused by oral bacteria probably result from frequent exposure to
low inocula of bacteria in the bloodstream due to daily activities and not a dental
procedure.
c) The quality of oral hygiene has no appreciable effect on the magnitude of
bacteremia after toothbrushing.
d) The magnitude of bacteremia resulting from dental procedures is greater than
that needed to cause experimental bacterial endocarditis (BE) in animals.
7. There are multiple randomized controlled trials to prove the efficacy of antibiotic
prophylaxis in preventing IE for a dental procedure. It is not clear which dental
procedures are more or less likely to cause transient bacteremia or to result in a
greater magnitude of bacteremia than that caused by routine daily activities such as
chewing food, tooth brushing, or flossing.
a) Both statements are true.
b) Both statements are false.
c) The first statement is true, the second statement is false.
*d) The first statement is false, the second statement is true.
8. Which of the following is true regarding the efficacy of antibiotic prophylaxis?
a) Data show that a reduction in the incidence, nature, and duration of bacteria
caused by antibiotic therapy reduces the risk of or prevents IE.
b) Antibiotics given to at-risk patients before a dental procedure will prevent or
reduce bacteremia.
c) Prospective randomized, placebo-controlled trials have been conducted to
examine the efficacy of antibiotic prophylaxis for preventing IE in patients who
undergo a dental procedure.
*d) Investigators have concluded that dental or other procedures probably only
caused a small fraction of cases of IE, and that prophylaxis would prevent only a
small number of cases, even if it were 100% effective.
4
