CDCA OSCE Questions and answers, 2022 update, Graded A+ Document Content and Description Below

CDCA OSCE Questions and answers, 2022 update, Graded A+ Document Content and Description Below CDCA OSCE Questions and answers, 2022 update, Graded A+ bulging eyes (exophthalmos), weight loss, and Graves disease are all due to _____ - hyperthyroidism signs/symtoms of skinny, weigh t loss - Graves disease weight gain, dry hair, lower voice, feels cold - hypothyroidism Acute adrenal insufficnecy is also known as ____disease. A patient on steroids might have an attack if not supplmeneted by ___ the steroid dose before dental treatment due to thier inability to produce extra ___ in response to stress - addisons disease doubling the dose of steroids cortisol in response to stress patient with reduced or missing teeth on a pan - ectodermal dysplasia patient has supernumerary teeth (extra teeth) ... likely diagnosis? - cleiodcranial dysplasia : can cause hypercementosis of the roots, generalized skull and jaw enlragment with COTTON WOOL appearance of bone - Pagets disease hypercementosis will follow the ____ on a PAX - PDL Cleft lip is defection fusion of the ____ and _____ - medial nasal process maxillary process failure of the palatal shelves to fuse result in ____ BIFID UVULA - cleft palate, bifid uvula patient with cleft palate, mandibular micrognathia, glosspotopis (airway obstruction) - Pierre robin syndrome looks like white and brown spots on the teeth - hypocalcified teeth ___ cannot be reversed but microabrainsion and aching can improve aesthetics, but cannot reverse the condition - fluorosis flurosis can be caued by a patient living in a region wher the fluoride content in the water is ____ppm. Normal is ____ppm - 4ppm normal is 0.7ppm patient has no enamel on the teeth on bitewing or panx - amelognesis imperfecta can see OBLITERATED pulp chambers on radiogrpahs and teeth have a TRANSLUCENT or opalescent hue (greyish or blue) also known as osteogenisis imperfect associated with collagenn maturation problem, non systemic - dentogenisis imperfecta mulberry molars, screwdriver shaped incisors , maxillary anteriors with central depression - syphillis ___ also known as twinning is due to incomplete formation of two teeth, common on incisors, seen in maxillary laterals - gemination bull shaped crowns with shortened roots on PAN or fms What can be a 2 contributing factors? - taurodontism overweight, hypertension Tzanck test is to diagnose ________ (small painful ulcers that recure every 5-6 months with fever) Treatment is ___ with ____ and analgesics - acute herpactic gingivostomatitis pallative care with lidocaine rinses and analgesics long standing and heal with a scar, can see on the lip and palate, pemphoid can also heal with a scar - major apthous ulcers mucocele on the lower lip can be due to an ____ salivary gland, treat with _____. Inside the mucocel is ____ (mucus) - injured salivary gland treat with excision saliva,mucous A standard cartridge as ___ml of 2% lidcaine at ___mg. the active ingredient , and 1:100,000 (____) of EPI vasoconstrictor - 1.8ml 36mg 0.018mg of EP t/f: according to cdc regulations, you are not required to wash hands before and after removing gloves ? - true Sodium hypochlorite should be changed ___ - daily to test the autoclave to ensure that it is properly sterilizing by doing a ___ test using biological indicators ___ - spore test Tx for tetracycline staining? - best to leave alone ____ can cause rampant decay due to lack of saliva to buffer acidic PH - xerostomia ____: can cause rampant caries in todder/infant - baby bottle syndrome a patient on steriods will need ___ - supplemenation a MI can produce ___ symptoms while ___ does not - GI syncope does not induce GI symptoms T/F use retraction cord that contains epi for patient with recent MI - false correct sympotms of MI. The other two are more likely ____ chest pain upset stomach pounding heart beat left arm jaw jerk pain indigestion - all except indigestion and upset stomach angina patienttakes nitroglycerine tablet with no effect in 5 min, you give a second and third tablet and still nothing happens. Patient is most likley have a ____ - Myocaridal infarction angina perctoris symptoms .Usually precipitated by exertion of _____. commonly with see __ _and ___ occur - chest discomfort(not pain) epigrastrium area, usually preciptated by stress and exertion nasua and vomitting if a patient is sitting in dental chair with hands on heart, first thing you do is give the patient _____ - 0.4mg of nitroglycerine tablet if patient is having a myocradial infarction/chest pain, andminster anti anginal drugs such as _____. when to not give this to the patient as can cause severe drop in blood pressure - 0.4mg nitroglycerine/vasodilation viagra or cialis What does MONA stand for and when is it used? - morphine, oxygen, nitroglycerine, asprin angina treatment Norpace/disopyramide - Antiarrhythmic/antianginal agent Valium (diazepam) has metabolies for long duration and binds to ___ receptors to cause inhibtory effects . will have ___ channel opening It is a ___ used for anxiety, siezures ,and insomina - GABA Cl benzodiazapine Pottasium-sparing diuretics for hypertension and edema (2) WHEN IS IT NOT USED - TRAMETERNE AND SPIRONLACTONE NOT USED FOR IMPAIRED RENAL FUNCtion Stent has been placed for patient undergoing kidney dialysis . Does patient require medicaiton? - No, does not require medication if a patient has kidney disease, what can you prescribe and NOT prescribe - Tylenol (acetaminophen) NOT aspirin, advil or naproxen (nsaids are metabolzied in the kidney) t/f: If a patient has a kidney transplant, the patient may require antibiotic(stress dose) - true- due to anti rejection medications analgesic for mild to moderate pain: NOT USED IF PATIENT HAS KIDNEY FAULURE - PROPROXEPHINE antihistmine to prevent motion sickness and as a sedative for insomina when benzodiapenines are contacindicated. Can be used to treat allergic reactions common side effects are tardive dysinesia, xerostomia - promethazine bronchiodilater inhaler that relaxes muscles. Used for asthma - albuterol t/f: should administer nitrous oxide to an asthmatic - false angioedema of the upper lip has been dianosed as an allergic reaction with no other signs of allergy. The most apporpriate treatment is ? - oral administration of antihistmine (benedryl) a 60 year old female taking naproxene, one asprin dialy who is allergic to penicillin is most likely taking the naproxene for ___. Do not make a a precision attachment for her due to her lack of ___ as a result of the arthritis - arthritis lack of dexterity patient has malaise, lethargy, itching, may have an allergic reaction. Give ____ - benedryl the major difference between syncope and severe analphylatic shock is there can be ____ in anaphylatic shock - diffuculity in breathing patient undergoing anaphylatic shock. TX includes (4) - place patient in supine position administer oxygen manually monitor vitals give 0.3-0.5ml of EPI SC or IM the first thing to do if a patient experiences syndrome (fainting or hypotension) in the dental chair is to place patient in _____ position - place patient in trendelenburg position (supine) with feet higher than head by 15-30 degrees to increase cerebral perfusion pressure When is trendelenburg position contraindicated and instead would use just horizontal position? - hypovolumic shock (loss of blood volume) medical history of patient taking penicillin and has an allegic reaction on the lower lip. Tx? (2) - apply topical steriods or swithc antibiotics anaphylactic shock tx? (2) - Epi 1:1000, 0.5 ml SQ, repeat every 10-20 min PRN or steroid dentist has needlestick , have ht patient do an ____ test to detect _____ then do ___ to confirm ELISA - elisa test to convern HIV antibiodies Western blot AIDS patient treatment include ___ precautions, try to avoid invasive procedures and _____ treatment - univerisal precautions try to avoid invasive procedures no treatment A patient taking Isonizid, Rifampin or Pyaziminade has ___ - tuberculosis if you patient is having a seizure , first acition is to protect ___ and __ _form injurying themselves ,clear the area and _____ against the dental chair - yourself and patient from injury clear the are and hold hands against dental chair ____ or ____is the test to evaluate blood coagulation (clotting) time and to monitor response o oral anticoagualant therapy like COUMARIN and liver disease - Prothrobmin test (PT) INR Name this disease: pale gums due to decrease RBC count. diagnose by complete blood count test. What is sign of anemia RBC? - Anemia 2 million RBC normal RBC range ? - 4.7-5million name this disease : patient have low platelet count (poor clotting). Normal platelet count is ____-_____. Below 50,000 per microliter is _____ - thrmobocytopenia 150,000-450,000 thromboyctopenia name this diseaes: symtoms inlcude increased WBC above normal and ginival bleeding. Blood level example : RBC-2.2million, platelets-24,00, WBC-79,000 What is normal WBC count? How to diagnose(2) - lekuemia 4000-10,000 complete blood count, bone marrow examination Name this disease: can be caused by calcium channel blockers even after a few months. Treatment and last option? - gingival hyperplasia reduce or switch their medication gingivectomy patient with acid reflux and had mild dental pian. What can you prescribe? - acetominophin, no NSAIDS tetracycline and oral contraceptives _____ the antibiotics effectivness - WEAKEN penicillin allergic patient pre medication: ___ or ____ with dosages for adults - clindamycin 600mg/20mg/kg erythromycin 500mg/15mg/kg non allergic penicillin patient premedication with dosage for adult and kid and time - amoxcillin 1 hour prior to treatment adult: 2g kid: 50mg Hip joint replacent prohpylaix is only given the first ___ years after surgery only - 2 years t/f: No ab is need for patient with rheumatic heart disease - false true/false: should give antibiotic prophylaxis for a patient wit ha history of bacterial endocardtitis? - true true/false: antibiotic prophylaxis is premedication indicated for all dental procedures on indicated patients ? - false, only for those that will be invasive and cause gingival bleeding Name of disease: on a pan view looks like a bone under the angle of the mandible. It is elongation and clarification of the temporal ____ at the back of the throat that occurs after a tonsillectomy or trauma. - eagle syndome temporal styloid process name of disease : elongatoin and minerlaized of the styloid process that impinges on the carotid arteries and nerves. Patient ocmplains of aunilateral neck pain when turning thier head, possible sore throat, dysphagia. Tx? Mild cases:_____ severe cases:____ - carotid artery syndrome mild cases: none except reassurance or local corticosteroids to relieve pain severe caess: surgical intraoral excision of the process largest, least numerous arranged in inverted V shaped row at the back of the tongue? does or does not have taste bud? - circumvillate papillae does have taste buds smokless tocacco pouch keratosis - is the development of a white mucosal lesion in the area of tobacco contact Name the pathology: ca nbe caused by cheeck biting, dentures, orthodontic appliances, uneven teeth, and aggressive oral hygiene (benign hardening of the check mucosa due to excess kertain) Tx: - linea alba tx: remove the irritants is the proper treatment Name the pathology: viral infection causing oral ulcers and inflammtion. Mainly affects the children TX: (3) - herpetic stomatitis tx: acyclovir, liquid diet and numbing medication , lidocaine rinse if pain severe Name the pathology: PALATAL AND MUCCOBUCCAL FOLD LESIONS ARE OFTEN ASSOICATED WITH THIS - TOBACCO, SNUFF Name the pathology: picture of palate with numerous small raised areas with central red dots caused by pipe smoking This is not premalignant and is caused by the ____ form the smoke. Not the chemicals tx? - nicotonic stomatitis heat from the smoke, not the chemicals is reversible, need to stop smoking Name the pathology: can be seen on the palate in a pipe smoker - nicotonic stomatitis Name the pathology: Hepatitis that ca be caused by inoculation(serum, vaccination) iv drug use and blood transfusions - hepatitis C Name the pathology: occurs on the lower lip an lateral tongue borders. may have a crusted or cauliflower appearance - Squamous cell carcinoma patient comes in with hard palate swelling hat has been there for about 2 years. The patient tells you they had a similiar lesion removed some years ago tx? - surgical removal You see a swelling under the tongue on the floor of the mouth (ranula). What do you do for treatment ?(2) - surgical removal or masupialize Dense, firm ulcer with indurated borders is of 4 months duration. It has been gradually increasing in size and severely restricts tongue movement. What do you do? - perform incisional biopsy You see a hard palate with a midline swelling present for several years. Pt is concerned about this swelling because there is a family history of carcinoma. What do you do? - treatment: leave along and reassure the patient Name the pathology: occurs on the face (might see under eyes) patient has RAISED lesion under the ye present for about 2 years. TX? - basal cell carcinoma biopsy and surgica lremoval heptatis serum can be acute or chronic , prlonged incubaton 4-26 weeks? - hep b hepatitis infectious required from raw steamed shellfish, contaiminated water or food - hep A T/f: a patient who has Hepatitis A over a year ago is okay to treat? When is Hepatitis A okay to treat: after _____ fro mthe onset of jaundice. How is it transmitted? - true, it resolves within a couple of weeks usually on its own after one 1 transmitted fecal oral route Name the pathology: looks like little dialted blood vessels (telangiectasis) on the tongue - multiple telangiestasias Median Rhomboid Glossitis (Central Papillary Atrophy) is type of ___ infection. Tx - candida nystatin Hairy tongue : looks nasty. treat by taking the patient of thier medicaitons , use ___ and improve oral hygiene (brush tongue) - mouthrinses, medications , and improve OH Oral hairy leukoplakia (AIDS) presents as white plaque usually on the lateral border of the tongue that does not rub off. Associated with __ and ___ - Presents as a white mucosal plaque that does not rub off, usually on the lateral border of the tongue; associated with EBV and AIDS Name the pathology: oral manfestation in aids patients. a malginant cnacer of the lining of blood vesels on the ______. May present as purple lesionson the palte. TX: ? - kaposi sarcoma hard palate tx: provide normal dntal treatment but NO invasive treatment Geographic tongue (migratory glossitis) caused by atrophy of the ___ papillae on tongue tx: ? - Pattern of normal coating interspersed with bright red, shiny, circular bald areas caused by atrophy of the filiform papillae, with raised pearly borders. Pattern resembles a map and changes with time. Not significant, and its cause is not known. tx: ressure patient and leave alone Fissured tongue aka Scrotal tongue tx? - deep furrows on the surface of the tongue that is considered a normal variant do nothing leukoplakia on the tongue or buccal mucosa must be ___ - biopsied asymptomatic finding on the tongue lateral border with a 5 year history during which time it has changed appearance repeatedly. TX? - reassurance, no treatment a keratotic linear formation on the tongue lateral border has been present for about 2.5 years. tx - biopsy Name the pathology: can see on PAX with translucent areas due to less striations in bone, decrease in trabecular bone density, enlarged bone marrow spaces, and stepladder appearance - sickle cell anemia Name the pathology: can see due an obvious step between teeth 24 and 25 on pan. Can show a step down in the occlusal plane - mildine mandibule fracture Name the pathology: idiopathic, can be due to nerves, or nutrition deficiency - burning mouth syndrome t/f: if lingual tonsils enlarged when sick this is pathologic? - false a younger teenager with swollen tonsils is an _____ condtion - inflammatory this muscle is the first pillar in front of the tonsils? - palatoglossus muscle t/f: pharngeal space on a pan is normal? - true cementoma affects ___ teeth. TX:? - vital teeth Treatment: no treatment, observe Name the pathology: affects non vital teeth, no radilucnet border, radiopacity is not seperated from the apex, the clincal expansion is present. Treatment: - condensing osteitis tx; eliminate infection source and inflammation tx for periapical bone scar? - none, observe Name the pathology: mandible has soap bubble appearance due to multilocular radiolucencies: - ameloblastoma Periapical film of mandibular first molar area with irregular shaped, periapical radiopacity Tx:? - leave alone Name the structure: carries saliva from the parotid gland to the mouth on the cheeck just behind the second molar. If there is a retrograde infectoin of the duct, could be be due to _____. Take a sialogram of the salivary ducts and glands to see if stone exisit. Can also ___ to see if saliva comes out. If there is no calcification, it is a ___ on a radiograph - stensons duct duct stones palpate radiolucent Name the structure: a submandibular duct that can become calcified. If a stone is presnet it will like like a radipaque on an occlusal film - whartons duct Film used to detect a sialolith of a submandibular gland? - occlusal Name the pathology: the most common SALIVARY gland neoplasm, can be see on the posterior palate as a PAINLESS SWELLING - pleomorphic adenoma Name the pathology: shows white WHICHMANS straie (rectillinear pattern) on the buccal mucosa. Treatment if sympotomatic/erosive vs asymptomatic? - lichen planus symptomatic tx: topical steroid asymptomatic: leave alone Name the pathology: ground glass appearance? -