DSE OSCE - 2022
41-yo woman, pregnant; prev rheumatic fever with heart murmur (no valvular abnormality);
allergy to penicillin. Positive history of infective endocarditis. Does she need to pre med?
- yes
- no
yes
- on my exam, this patient had a previous history of infective endocarditis. Pre-med IS indicated
Pre-med options for pregnant woman w/hx of infective endocarditis and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin
*clarithromycin*
I may not be correct, the correct option may be cephalexin. however I chose clarithromycin due
to penicillin allergy, cross reaction with cephalosporins, and since
clindamycin/erythromycin/azthromycin were not options. Ciproflaxacin is contraindicated in
pregnancy. article for reference
Brainpower
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What procedure can a dentist perform without consulting MD if a patient is currently taking
bisphosphonates?
,- endo therapy
- prophy and scaling
- extraction
- occlusal restoration
*occlusal restoration*
although the main HELL NO is extraction, completing endo therapy increases risk if the apex is
compromised/damaged during therapy. I teetered on prophy and scaling, but since it did not
specify supragingival, decided that the risk of scaling can negatively affect the periosteum of a
bisphosphanate patient. ADA recommendations:
Pregnant person afraid of needles - stress management by putting patient in what position when
in your chair (BEFORE they even get to the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup
place her in Trendelburg position
6 months pregnant had bleeding gums and mobile teeth, how should they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo
conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral hygiene) to prevent plaque
growth. The plaque can enter blood stream and stimulate patient's immune system to produce
prostaglandins, which can trigger uterine contraction leading to early labor, premature birth, and
a small baby.
Pregnant lady with a diastema in between #8 and #9 with deep probing depth and class 1
mobility on 8 and 9. What is the reason for diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy
chronic perio
, - increased incidence of periodontal disease during pregnancy => must emphasize good oral
hygiene, and remove all their plaque so it doesn't lead to premature birth / low birth weight
Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
age 0-5 years
- remember that PERMANENT dentition does not begin calcification until birth
Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of drugs?
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic
barbituates
- used primarily evening BEFORE appointment
A patient has an allergic reaction to a barbiturate, how do you treat?
- epinephrine
- diphenhydramine
- send to ER
benadryl (diphenhydramine)
A patient is on a steroidal medication. What information do you need to obtain before treating
them?
- dose and pharmacy that filled the RX
- duration of prescription
- both dose and duration
*dose and duration*
- "The rule of twos": Ask whether the patient is currently on steroids or has been on
corticosteroids for 2 weeks or longer within the past 2 years. You must go back 2 years in the
41-yo woman, pregnant; prev rheumatic fever with heart murmur (no valvular abnormality);
allergy to penicillin. Positive history of infective endocarditis. Does she need to pre med?
- yes
- no
yes
- on my exam, this patient had a previous history of infective endocarditis. Pre-med IS indicated
Pre-med options for pregnant woman w/hx of infective endocarditis and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin
*clarithromycin*
I may not be correct, the correct option may be cephalexin. however I chose clarithromycin due
to penicillin allergy, cross reaction with cephalosporins, and since
clindamycin/erythromycin/azthromycin were not options. Ciproflaxacin is contraindicated in
pregnancy. article for reference
Brainpower
Read More
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
Full screen
What procedure can a dentist perform without consulting MD if a patient is currently taking
bisphosphonates?
,- endo therapy
- prophy and scaling
- extraction
- occlusal restoration
*occlusal restoration*
although the main HELL NO is extraction, completing endo therapy increases risk if the apex is
compromised/damaged during therapy. I teetered on prophy and scaling, but since it did not
specify supragingival, decided that the risk of scaling can negatively affect the periosteum of a
bisphosphanate patient. ADA recommendations:
Pregnant person afraid of needles - stress management by putting patient in what position when
in your chair (BEFORE they even get to the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup
place her in Trendelburg position
6 months pregnant had bleeding gums and mobile teeth, how should they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo
conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral hygiene) to prevent plaque
growth. The plaque can enter blood stream and stimulate patient's immune system to produce
prostaglandins, which can trigger uterine contraction leading to early labor, premature birth, and
a small baby.
Pregnant lady with a diastema in between #8 and #9 with deep probing depth and class 1
mobility on 8 and 9. What is the reason for diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy
chronic perio
, - increased incidence of periodontal disease during pregnancy => must emphasize good oral
hygiene, and remove all their plaque so it doesn't lead to premature birth / low birth weight
Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
age 0-5 years
- remember that PERMANENT dentition does not begin calcification until birth
Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of drugs?
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic
barbituates
- used primarily evening BEFORE appointment
A patient has an allergic reaction to a barbiturate, how do you treat?
- epinephrine
- diphenhydramine
- send to ER
benadryl (diphenhydramine)
A patient is on a steroidal medication. What information do you need to obtain before treating
them?
- dose and pharmacy that filled the RX
- duration of prescription
- both dose and duration
*dose and duration*
- "The rule of twos": Ask whether the patient is currently on steroids or has been on
corticosteroids for 2 weeks or longer within the past 2 years. You must go back 2 years in the
