Clinical Medicine Final Exam-Graded A+
When discussing ischemic heart disease, which of the following statements is TRUE?
A: Vasodilation of the coronary arteries may lead to ischemia of the myocardium.
B: Occlusion can be caused by the presence of a large intraluminal atherosclerotic
plaque.
C: Angina often arises during periods of decreased myocardial demand.
D: Commonly reported symptoms include seizures, hyperglycemia and wheezing. -
correct answer-B
The correct response when managing a patient with dental pain who presents with a
heart rate of 106 and a blood pressure of 165/101 would include:
A: recheck the patient's vital signs ensuring the use of a properly sized blood pressure
cuff.
B: anesthetize the patient using 2% lidocaine w/ 1:100,000 epinephrine and determine if
the vitals normalize afterwards.
C: have the patient take a double dose of their antihypertensive medication.
D: proceed with elective dental treatment, as long as it is not extremely invasive and
stimulating. - correct answer-A
Which of the following correctly matches the antihypertensive medication and the
associated fact?
A: Hydrochlorothiazide is a thiazide diuretic and has strong diuretic activity and causes
hypokalemia.
B: Metoprolol is a nonselective beta antagonist (blocker) and acts on β1 and β2
receptors.
C: ACE inhibitors like lisinopril prevent the production of angiotensin II.
D: Calcium channel blockers all have activity on vascular smooth muscle and the heart.
- correct answer-C
Which of the following statements is TRUE regarding hypotension?
A: Orthostatic hypotension occurs when progressive blood loss leads to impaired
systemic perfusion.
B: Vasovagal syncope is common and should be managed initially by sitting the patient
upright.
C: Pregnant patients in the 3rd trimester should be placed in the lateral decubitus
position to prevent compression of the ascending aorta.
D: Hypotension can result from non-neurogenic causes such as aortic stenosis or
congestive heart failure. - correct answer-D
,When discussing acute coronary syndromes, all of the following are true EXCEPT one.
Which one is the EXCEPTION?
A: The goals of managing a suspected ACS patient include minimizing damage to the
myocardium.
B: Immediate medical interventions may include thrombolytic therapy.
C: Routine dental care is contraindicated for at least one year following an STEMI.
D: The ADA recommendations for a patient post-ACS include a maximum dose of .04
mg epinephrine per visit. - correct answer-C
All of the following answers correctly pair the component of the cardiovascular system
with the appropriate function EXCEPT?
A: Blood vessels = conduits for fluid flow
B: Heart = pump to drive fluid
C: Kidneys = regulates systemic pressure and fluid volume
D: Blood = fluid responsible for transporting oxygen only - correct answer-D
The class of antihypertensive medications that is most likely to have a potentially
serious drug interaction when administering local anesthetics with vasoconstrictors is:
A. selective beta blockers.
B. nonselective beta blockers.
C. calcium channel blockers.
D. ACE inhibitors. - correct answer-B. nonselective beta blockers - due to unopposed
alpha1
What percent of victims survive with no impairment after a stroke?
A. 10%
B. 20%
C. 30%
D. 50%
E. 60% - correct answer-A
Thrombolysis and improved neurological outcome has been achieved when medication
is administered within how many hours of the onset of the stroke?
A. 1
B. 3
C. 5
D. 8 - correct answer-B
Weakness, tingling, numbness and speech disturbances that usually last less than 10
minutes are known as:
,A: reversible ischemic neurologic deficit.
B: transient ischemic attack.
C: stroke-in-evolution.
D: complete stroke.
E: RIND. - correct answer-B
What is the only approved medication for the acute management of a stroke?
A: Intra-arterial prourokinase
B: IV administration of rt-PA
C: Aspirin
D: IV administration of Heparin
E: Dipyridamole - correct answer-B
All elective dental treatment is deferred for up to how many months after a stroke?
A: 3 months
B: 6 months
C: 12 months
D: 15 months
E: 18 months - correct answer-B
A patient presents with a history of DM (diabetes mellitus), HTN (hypertension), and
CAD (coronary artery disease). He/she takes 100 units of insulin in divided doses daily.
A. this insulin regimen is c/w a type 1 DM
B. this insulin regimen is c/w type 2 DM
C. the amount of insulin does not suggest either type 1 or 2 DM
D. a type 2 DM does not take insulin - correct answer-B
You decide to write a medical consult for a patient that tells you he has had 3 seizures
in the last week. What would be the most appropriate way to organize your medical
consultation for this patient?
A. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please advise if local anesthesia consisting of lidocaine with epinephrine is
contraindicated.
B. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Dental restorations are planned. Please advise if this patient can be treated in
my dental office.
C. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please provide what type of seizures he has and what can prevent them
D. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please provide a most recent history and physical including history of seizures,
me - correct answer-D
, Dental management considerations of patients with psychiatric disease will include all of
the following EXCEPT one. Which one is the EXCEPTION?
A. caries risk
B. antisialogogues
C. diet counseling
D. fluoride pastes and varnishes - correct answer-B
Which of the following oral agents can cause hypoglycemia?
A. Glipizide (sulfonylurea)
B. Metformin (biguanides)
C. Acarbose (gamma-glucosidase inhibitors)
D. Pioglitazone (thiazolidinediones) - correct answer-A
A 25 y.o female comes to your office for an initial consultation. She states she has
seizures. What would you most like to know when completing a review of systems?
A. what type of seizures does she have?
B. when was her last seizure?
C. does anything precipitate her seizures?
D. all of the above - correct answer-D
In Emergency Cardiac care (CPR), what maneuver comes first after a cardiac arrest?
A. give 2 breaths
B. open the airway with head-tilt
C. chest compressions
D. start an IV line - correct answer-C
Public Access Defibrillators ___________ the survival rate following out-of-hospital
cardiac arrest.
A. can quadruple
B. can triple
C. can double
D. has no effect on - correct answer-C
The most important part of the medical history to quantify medical risk is the:
A. chief dental complaint
B. social history
C. allergies
D. review of systems - correct answer-D
When discussing ischemic heart disease, which of the following statements is TRUE?
A: Vasodilation of the coronary arteries may lead to ischemia of the myocardium.
B: Occlusion can be caused by the presence of a large intraluminal atherosclerotic
plaque.
C: Angina often arises during periods of decreased myocardial demand.
D: Commonly reported symptoms include seizures, hyperglycemia and wheezing. -
correct answer-B
The correct response when managing a patient with dental pain who presents with a
heart rate of 106 and a blood pressure of 165/101 would include:
A: recheck the patient's vital signs ensuring the use of a properly sized blood pressure
cuff.
B: anesthetize the patient using 2% lidocaine w/ 1:100,000 epinephrine and determine if
the vitals normalize afterwards.
C: have the patient take a double dose of their antihypertensive medication.
D: proceed with elective dental treatment, as long as it is not extremely invasive and
stimulating. - correct answer-A
Which of the following correctly matches the antihypertensive medication and the
associated fact?
A: Hydrochlorothiazide is a thiazide diuretic and has strong diuretic activity and causes
hypokalemia.
B: Metoprolol is a nonselective beta antagonist (blocker) and acts on β1 and β2
receptors.
C: ACE inhibitors like lisinopril prevent the production of angiotensin II.
D: Calcium channel blockers all have activity on vascular smooth muscle and the heart.
- correct answer-C
Which of the following statements is TRUE regarding hypotension?
A: Orthostatic hypotension occurs when progressive blood loss leads to impaired
systemic perfusion.
B: Vasovagal syncope is common and should be managed initially by sitting the patient
upright.
C: Pregnant patients in the 3rd trimester should be placed in the lateral decubitus
position to prevent compression of the ascending aorta.
D: Hypotension can result from non-neurogenic causes such as aortic stenosis or
congestive heart failure. - correct answer-D
,When discussing acute coronary syndromes, all of the following are true EXCEPT one.
Which one is the EXCEPTION?
A: The goals of managing a suspected ACS patient include minimizing damage to the
myocardium.
B: Immediate medical interventions may include thrombolytic therapy.
C: Routine dental care is contraindicated for at least one year following an STEMI.
D: The ADA recommendations for a patient post-ACS include a maximum dose of .04
mg epinephrine per visit. - correct answer-C
All of the following answers correctly pair the component of the cardiovascular system
with the appropriate function EXCEPT?
A: Blood vessels = conduits for fluid flow
B: Heart = pump to drive fluid
C: Kidneys = regulates systemic pressure and fluid volume
D: Blood = fluid responsible for transporting oxygen only - correct answer-D
The class of antihypertensive medications that is most likely to have a potentially
serious drug interaction when administering local anesthetics with vasoconstrictors is:
A. selective beta blockers.
B. nonselective beta blockers.
C. calcium channel blockers.
D. ACE inhibitors. - correct answer-B. nonselective beta blockers - due to unopposed
alpha1
What percent of victims survive with no impairment after a stroke?
A. 10%
B. 20%
C. 30%
D. 50%
E. 60% - correct answer-A
Thrombolysis and improved neurological outcome has been achieved when medication
is administered within how many hours of the onset of the stroke?
A. 1
B. 3
C. 5
D. 8 - correct answer-B
Weakness, tingling, numbness and speech disturbances that usually last less than 10
minutes are known as:
,A: reversible ischemic neurologic deficit.
B: transient ischemic attack.
C: stroke-in-evolution.
D: complete stroke.
E: RIND. - correct answer-B
What is the only approved medication for the acute management of a stroke?
A: Intra-arterial prourokinase
B: IV administration of rt-PA
C: Aspirin
D: IV administration of Heparin
E: Dipyridamole - correct answer-B
All elective dental treatment is deferred for up to how many months after a stroke?
A: 3 months
B: 6 months
C: 12 months
D: 15 months
E: 18 months - correct answer-B
A patient presents with a history of DM (diabetes mellitus), HTN (hypertension), and
CAD (coronary artery disease). He/she takes 100 units of insulin in divided doses daily.
A. this insulin regimen is c/w a type 1 DM
B. this insulin regimen is c/w type 2 DM
C. the amount of insulin does not suggest either type 1 or 2 DM
D. a type 2 DM does not take insulin - correct answer-B
You decide to write a medical consult for a patient that tells you he has had 3 seizures
in the last week. What would be the most appropriate way to organize your medical
consultation for this patient?
A. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please advise if local anesthesia consisting of lidocaine with epinephrine is
contraindicated.
B. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Dental restorations are planned. Please advise if this patient can be treated in
my dental office.
C. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please provide what type of seizures he has and what can prevent them
D. a 30 y.o male presents to my office stating he has had an increase in his seizure
activity. Please provide a most recent history and physical including history of seizures,
me - correct answer-D
, Dental management considerations of patients with psychiatric disease will include all of
the following EXCEPT one. Which one is the EXCEPTION?
A. caries risk
B. antisialogogues
C. diet counseling
D. fluoride pastes and varnishes - correct answer-B
Which of the following oral agents can cause hypoglycemia?
A. Glipizide (sulfonylurea)
B. Metformin (biguanides)
C. Acarbose (gamma-glucosidase inhibitors)
D. Pioglitazone (thiazolidinediones) - correct answer-A
A 25 y.o female comes to your office for an initial consultation. She states she has
seizures. What would you most like to know when completing a review of systems?
A. what type of seizures does she have?
B. when was her last seizure?
C. does anything precipitate her seizures?
D. all of the above - correct answer-D
In Emergency Cardiac care (CPR), what maneuver comes first after a cardiac arrest?
A. give 2 breaths
B. open the airway with head-tilt
C. chest compressions
D. start an IV line - correct answer-C
Public Access Defibrillators ___________ the survival rate following out-of-hospital
cardiac arrest.
A. can quadruple
B. can triple
C. can double
D. has no effect on - correct answer-C
The most important part of the medical history to quantify medical risk is the:
A. chief dental complaint
B. social history
C. allergies
D. review of systems - correct answer-D
