WREB Local Anesthesia Exam Questions and Answers Graded A+
What happens in a anaphalactic reaction - Answers life-threatening causing bronchospam & drop in BP
what do you do for an immediate allergic reaction - Answers 1.call 911
2.Get preloaded Epi syringe in the emergency kit and inject pen in patient's deltoid,tongue, or lateral
thigh
re-administer Epi pen in 5 minutes ONLY IF SYMPTOMS PERSIST.
Chest pain (Angio Pectoris) - Answers patient has tight , heavy, or constricted chest pain and may clench
their fist against their chest
What to do when a patient develops Chest Pain - Answers 1.CALL 911 and position patient so he/she is
comfortable and ask if they have nitroglycerin tablets or spray on them. If not, give two sprays of
nitroglycerin(vasodilator)onto the patient's tongue.
2. Dental treatment can continue if patient and doctor are comfortable.
Note: important ; do not give spray/tablet if the patient has chest pain and feels dizzy (means BP is
dropping, or if patient took Viagra within 24hrs.
What to do if patient is experiences heart attack after chest pains, patient says they are getting worse,
patient has taken 3 doses of nitroglcerin in 5 min intervals and pain continues,or chest pain went away
and came back, or patient has no history of heart disease or chest pain.Crushing, intense, radiating pain
from chest to the stomach or to the left side of the neck, jaw, left arm, and/or pinkie finger (tingles). Skin
turns ashy gray and patient may sweat profusley. - Answers 1. CALL 911
2. Admin. 50 % nitrous oxide & 50 % oxygen (has same effect as morphine) for pain and delivers more
oxygen to the muscles/brain
3.give two sprays of nitroglycerin on patient's tongue and have the patient CHEW 1 tablet of adult dose
ASPRIN (325mg) EXCEPT if the patient is allergic to asprin, has bleeding disorder,or gastric/peptic ulcer,
Asprin prevents clot from getting bigger.
What do you do in case of cardiac arrest (uncounscious patient) - Answers 1. CALL 911 while dentist lays
the patient flat in dental chaior with feet elevated.
2.Dentist checks airway via head/chin lift and checks for breathing and carotid pulse (in groove under
the and to the side of the Adam's apple)
3. Dentist gives CPR (15 chest compressions for every 2 breaths) 15:2 ratio
What do you do when a patient exhibits diabetic shock (hypoglycemia = low blod sugar)- mental
confusion, patient feels cold, sweaty, and shakey. - Answers 1. before tx ask patient when did they take
, their insulin and eat last. if not recent, give patient 1/2 cup orange juice or non-diet soda wait 5 minutes,
then give another 1/2 cup. After 5 minutes, give last 1/2 cup within 15 minutes sign should subside
Unconscious Diabetic:
1.call 911 lay patient flat feet raised, check airway (head/chin lift), check breathing (look,listen,feel) and
check carotid pulse. DO CPR if not breathing/pulse) (15 compression for every 2 breaths) 15:2
2. DO NOT ADMINISTER DRUGS!
Syncope (fainting) - Answers can occur with emotional distress (nervous. Occurs when there is
temporary decress in bloodflow to the brain dure to the sudden drop in BP,HR,of blood volume change.
Can happen with anyone, but patient usually has an underlying medical condition like anemeia or heart
disease.
What do you do if a patient has signs that they may faint : light headed, nausea, heart palpatation -
Answers 1. lay pt in dental chair with legs elevated
2. place cold, wet towel over their forehead
3. Adim oxygen and aromatic ammmonia held under patients nose to stimulate bllod flow to the brain
via movement.
Why are inhaled ammonia used in syncope
How do you administer it
Do you administer oxygen - Answers Irratates trigeminal nerve sensory endings to cause a reflex
stimulation of the medullary respiratory and vasomotor centers.
An aromatic ammonia vaporole is crushed between the fingers and held near the patients nose.
Administation of oxygen help prevents tissue anoxia
symptoms of syncope
How to tx syncope - Answers beads of sweat on upper lip, weak thready pulse, cold clamy skin, pallor
and a dizzy feeling. Loss of normal vasomotor tonus produces pooling of blood peripherally so that
normal blood volumes become insuffient.
Placing patient in surpine postition & elevating the feet gives the patient a transfusion of whole blood by
utilizing forces of gravity. The head should not be more than 10 degrees lower than the rest of the body.
types of syncope and tx - Answers Vasovagal, Neurogenis, & Orthostatic (tx all with high-flowing 100%
oxygen)
Hyperventilation Syndrome ( oxygen is not indicated)
What happens in a anaphalactic reaction - Answers life-threatening causing bronchospam & drop in BP
what do you do for an immediate allergic reaction - Answers 1.call 911
2.Get preloaded Epi syringe in the emergency kit and inject pen in patient's deltoid,tongue, or lateral
thigh
re-administer Epi pen in 5 minutes ONLY IF SYMPTOMS PERSIST.
Chest pain (Angio Pectoris) - Answers patient has tight , heavy, or constricted chest pain and may clench
their fist against their chest
What to do when a patient develops Chest Pain - Answers 1.CALL 911 and position patient so he/she is
comfortable and ask if they have nitroglycerin tablets or spray on them. If not, give two sprays of
nitroglycerin(vasodilator)onto the patient's tongue.
2. Dental treatment can continue if patient and doctor are comfortable.
Note: important ; do not give spray/tablet if the patient has chest pain and feels dizzy (means BP is
dropping, or if patient took Viagra within 24hrs.
What to do if patient is experiences heart attack after chest pains, patient says they are getting worse,
patient has taken 3 doses of nitroglcerin in 5 min intervals and pain continues,or chest pain went away
and came back, or patient has no history of heart disease or chest pain.Crushing, intense, radiating pain
from chest to the stomach or to the left side of the neck, jaw, left arm, and/or pinkie finger (tingles). Skin
turns ashy gray and patient may sweat profusley. - Answers 1. CALL 911
2. Admin. 50 % nitrous oxide & 50 % oxygen (has same effect as morphine) for pain and delivers more
oxygen to the muscles/brain
3.give two sprays of nitroglycerin on patient's tongue and have the patient CHEW 1 tablet of adult dose
ASPRIN (325mg) EXCEPT if the patient is allergic to asprin, has bleeding disorder,or gastric/peptic ulcer,
Asprin prevents clot from getting bigger.
What do you do in case of cardiac arrest (uncounscious patient) - Answers 1. CALL 911 while dentist lays
the patient flat in dental chaior with feet elevated.
2.Dentist checks airway via head/chin lift and checks for breathing and carotid pulse (in groove under
the and to the side of the Adam's apple)
3. Dentist gives CPR (15 chest compressions for every 2 breaths) 15:2 ratio
What do you do when a patient exhibits diabetic shock (hypoglycemia = low blod sugar)- mental
confusion, patient feels cold, sweaty, and shakey. - Answers 1. before tx ask patient when did they take
, their insulin and eat last. if not recent, give patient 1/2 cup orange juice or non-diet soda wait 5 minutes,
then give another 1/2 cup. After 5 minutes, give last 1/2 cup within 15 minutes sign should subside
Unconscious Diabetic:
1.call 911 lay patient flat feet raised, check airway (head/chin lift), check breathing (look,listen,feel) and
check carotid pulse. DO CPR if not breathing/pulse) (15 compression for every 2 breaths) 15:2
2. DO NOT ADMINISTER DRUGS!
Syncope (fainting) - Answers can occur with emotional distress (nervous. Occurs when there is
temporary decress in bloodflow to the brain dure to the sudden drop in BP,HR,of blood volume change.
Can happen with anyone, but patient usually has an underlying medical condition like anemeia or heart
disease.
What do you do if a patient has signs that they may faint : light headed, nausea, heart palpatation -
Answers 1. lay pt in dental chair with legs elevated
2. place cold, wet towel over their forehead
3. Adim oxygen and aromatic ammmonia held under patients nose to stimulate bllod flow to the brain
via movement.
Why are inhaled ammonia used in syncope
How do you administer it
Do you administer oxygen - Answers Irratates trigeminal nerve sensory endings to cause a reflex
stimulation of the medullary respiratory and vasomotor centers.
An aromatic ammonia vaporole is crushed between the fingers and held near the patients nose.
Administation of oxygen help prevents tissue anoxia
symptoms of syncope
How to tx syncope - Answers beads of sweat on upper lip, weak thready pulse, cold clamy skin, pallor
and a dizzy feeling. Loss of normal vasomotor tonus produces pooling of blood peripherally so that
normal blood volumes become insuffient.
Placing patient in surpine postition & elevating the feet gives the patient a transfusion of whole blood by
utilizing forces of gravity. The head should not be more than 10 degrees lower than the rest of the body.
types of syncope and tx - Answers Vasovagal, Neurogenis, & Orthostatic (tx all with high-flowing 100%
oxygen)
Hyperventilation Syndrome ( oxygen is not indicated)
