, Little: Dental Management of the Medically Compromised Patient, 8thE
p p p p p p p p p
dition
Chapterp01:pPatientpEvaluationpandpRiskpAssessmentp
TestpBank
MULTIPLEpCHOICE
1. Electivepdentalpcarepshouldpbepdeferredpforppatientspwithpsevere,puncontrolledphypertensi
on,pmeaningpthatpthepbloodppressurepispgreaterpthanporpequalpto
mmpHg.
A.p 200/140
B.p 180/140
C.p 180/110
D.p 160/110
ANS:p C
Electivepdentalpcarepshouldpbepdeferredpforppatientspwithpsevere,puncontrolledphypertensi
on,pwhichpispbloodppressurepofpgreaterpthanporpequalptop180/110pmmpHg,puntilpthepconditio
npcanpbepbroughtpunderpcontrol.
PTS: 1 REF: p.p4
2. ThepAmericanpHeartpAssociationpcurrentlyprecommendspantibioticpprophylaxispforpap
patientpwithpwhichpofpthepfollowingpcardiacpconditions?
A. mitralpvalvepprolapse
B. prostheticpheartpvalve
C. rheumaticpheartpdisease
D. pacemakerspforpcardiacparrhythmias
ANS:p B
Previously,pthepAmericanpHeartpAssociationp(AHA)precommendedpantibioticpprophylaxispf
orpmanyppatientspwithpheartpmurmurspcausedpbypvalvularpdiseasep(e.g.,pmitralpvalvepprolaps
e,prheumaticpheartpdisease)pinpanpeffortptoppreventpinfectivependocarditis;pcurrentpguidelines
pomitpthisprecommendationponpthepbasispofpaccumulatedpscientificpevidence.pIfpapmurmurpisp
dueptopspecificpcardiacpconditionsp(e.g.,ppreviouspendocarditis,pprostheticpheartpvalve,pcomp
lexpcongenitalpcyanoticpheartpdisease),pthepAHApcontinuesptoprecommendpantibioticpprophy
laxispforpmostpdentalpprocedures.pPatientspwithppacemakerspdopnotprequirepantibioticpproph
ylaxis.
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
, TestpBank 1-2
PTS: 1 REF: pp.p4-5
3. Onepconsequencepofpchronicphepatitisp(BporpC)porpcirrhosispofpthepliverpispdecreasedpabilitypo
fpthepbodypto certainpdrugs,pincludingplocalpanestheticspandpanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS:p C
Patientspwithpchronicphepatitisp(BporpC)porpcirrhosisphavepanpassociatedpimpairmentpofpliverp
function.pThispdeficitpmaypresultpinpprolongedpbleedingpandplesspefficientpmetabolismpofpcert
ainpdrugs,pincludingplocalpanestheticspandpanalgesics.
PTS: 1 REF: p.p6
4. Whichpofpthepfollowingpsymptomspandpsignspispmostpconsistentpwithpallergy?
A. heartppalpitations
B. itching
C. vomiting
D. fainting
ANS:p B
Symptomspandpsignspconsistentpwithpallergypincludepitching,purticariap(hives),prash,pswellin
g,pwheezing,pangioedema,prunnypnose,pandptearingpeyes.pIsolatedpsignspandpsymptomspsuchp
aspnausea,pvomiting,pheartppalpitations,pandpfaintingpgenerallyparepnotpofpanpallergicporiginpb
utpratherparepmanifestationspofpdrugpintolerance,padversepsidepeffects,porppsychogenicpreactio
ns.
PTS: 1 REF: p.p6
5. Whichpofpthepfollowingpisptruepofptheppatientpwithpaphistorypofptuberculosis?
A. AppositivepresultponpskinptestingpmeanspthatptheppersonphaspactivepTB.
B. Mostppatientspwhopbecomeppositivepskinptesterspdeveloppactivepdisease.
C. Patientspwithpacquiredpimmunodeficiencypsyndromep(AIDS)phavepaphighpi
ncidencepofptuberculosis.
D. ApdiagnosispofpactivepTBpispmadepbypappurifiedpproteinpderivativep(PPD)pskinptest.
ANS:p C
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
, TestpBank 1-3
Theppotentialpcoexistencepofptuberculosispandpacquiredpimmunodeficiencypsyndromep(A
IDS)pshouldpbepexploredpbecauseppatientspwithpAIDSphavepaphighpincidencepofptuberculo
sis.pAppositivepresultponpskinptestingpmeanspspecificallypthatptheppersonphaspatpsomeptimep
beenpinfectedpwithpTB,pnotpnecessarilypthatpactivepdiseasepisppresent.pMostppatientspwhop
becomeppositivepskinptesterspdopnotpdeveloppactivepdisease.pApdiagnosispofpactivepTBpispm
adepbypchestpx-ray,pimaging,psputumpculture,pandpclinicalpexamination.
PTS: 1 REF: p.p6-7
6. Vasoconstrictorspshouldpbepavoidedpinppatientspwhoparepusingpcocaineporp
methamphetaminepbecausepthesepagentspmaypprecipitate .
A. severephypotension
B. severephypertension
C. respiratorypdepression
D. cessationpofpintestinalpperistalsis
ANS:p B
Vasoconstrictorspmaypprecipitatepcardiacparrhythmiasporpseverephypertensionpinppatientsp
whoparepusingpcocaineporpmethamphetamine.pRespiratorypdepressionpispassociatedpwithpt
hepusepofpopioids.
PTS: 1 REF: p.p8
7. Itphaspbeenpshownpthatpthepriskpforpoccurrencepofpapseriouspperioperativepcardiovascularpev
entpispincreasedpinppatientspwhoparepunableptopmeetpapppp -
METp(metabolicpequivalentpofptask)pdemandpduringpnormalpdailypactivity.
A. 4
B. 6
C. 8
D. 10
ANS:p A
Riskpispincreasedpinppatientspunableptopmeetpap4-
METpdemand.pDailypactivitiesprequiringp4pMETspincludeplevelpwalkingpatp4pmiles/hourporpcli
mbingpapflightpofpstairs.pActivitiesprequiringpgreaterpthanp10pMETspincludepswimmingpandpsi
nglesptennis.
PTS: 1 REF: p.p9
8. Whichpofpthepfollowingpalterationspinpthepfingernailspispassociatedpwithpcirrhosis?
A. yellowing
B. clubbing
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
p p p p p p p p p
dition
Chapterp01:pPatientpEvaluationpandpRiskpAssessmentp
TestpBank
MULTIPLEpCHOICE
1. Electivepdentalpcarepshouldpbepdeferredpforppatientspwithpsevere,puncontrolledphypertensi
on,pmeaningpthatpthepbloodppressurepispgreaterpthanporpequalpto
mmpHg.
A.p 200/140
B.p 180/140
C.p 180/110
D.p 160/110
ANS:p C
Electivepdentalpcarepshouldpbepdeferredpforppatientspwithpsevere,puncontrolledphypertensi
on,pwhichpispbloodppressurepofpgreaterpthanporpequalptop180/110pmmpHg,puntilpthepconditio
npcanpbepbroughtpunderpcontrol.
PTS: 1 REF: p.p4
2. ThepAmericanpHeartpAssociationpcurrentlyprecommendspantibioticpprophylaxispforpap
patientpwithpwhichpofpthepfollowingpcardiacpconditions?
A. mitralpvalvepprolapse
B. prostheticpheartpvalve
C. rheumaticpheartpdisease
D. pacemakerspforpcardiacparrhythmias
ANS:p B
Previously,pthepAmericanpHeartpAssociationp(AHA)precommendedpantibioticpprophylaxispf
orpmanyppatientspwithpheartpmurmurspcausedpbypvalvularpdiseasep(e.g.,pmitralpvalvepprolaps
e,prheumaticpheartpdisease)pinpanpeffortptoppreventpinfectivependocarditis;pcurrentpguidelines
pomitpthisprecommendationponpthepbasispofpaccumulatedpscientificpevidence.pIfpapmurmurpisp
dueptopspecificpcardiacpconditionsp(e.g.,ppreviouspendocarditis,pprostheticpheartpvalve,pcomp
lexpcongenitalpcyanoticpheartpdisease),pthepAHApcontinuesptoprecommendpantibioticpprophy
laxispforpmostpdentalpprocedures.pPatientspwithppacemakerspdopnotprequirepantibioticpproph
ylaxis.
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
, TestpBank 1-2
PTS: 1 REF: pp.p4-5
3. Onepconsequencepofpchronicphepatitisp(BporpC)porpcirrhosispofpthepliverpispdecreasedpabilitypo
fpthepbodypto certainpdrugs,pincludingplocalpanestheticspandpanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS:p C
Patientspwithpchronicphepatitisp(BporpC)porpcirrhosisphavepanpassociatedpimpairmentpofpliverp
function.pThispdeficitpmaypresultpinpprolongedpbleedingpandplesspefficientpmetabolismpofpcert
ainpdrugs,pincludingplocalpanestheticspandpanalgesics.
PTS: 1 REF: p.p6
4. Whichpofpthepfollowingpsymptomspandpsignspispmostpconsistentpwithpallergy?
A. heartppalpitations
B. itching
C. vomiting
D. fainting
ANS:p B
Symptomspandpsignspconsistentpwithpallergypincludepitching,purticariap(hives),prash,pswellin
g,pwheezing,pangioedema,prunnypnose,pandptearingpeyes.pIsolatedpsignspandpsymptomspsuchp
aspnausea,pvomiting,pheartppalpitations,pandpfaintingpgenerallyparepnotpofpanpallergicporiginpb
utpratherparepmanifestationspofpdrugpintolerance,padversepsidepeffects,porppsychogenicpreactio
ns.
PTS: 1 REF: p.p6
5. Whichpofpthepfollowingpisptruepofptheppatientpwithpaphistorypofptuberculosis?
A. AppositivepresultponpskinptestingpmeanspthatptheppersonphaspactivepTB.
B. Mostppatientspwhopbecomeppositivepskinptesterspdeveloppactivepdisease.
C. Patientspwithpacquiredpimmunodeficiencypsyndromep(AIDS)phavepaphighpi
ncidencepofptuberculosis.
D. ApdiagnosispofpactivepTBpispmadepbypappurifiedpproteinpderivativep(PPD)pskinptest.
ANS:p C
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
, TestpBank 1-3
Theppotentialpcoexistencepofptuberculosispandpacquiredpimmunodeficiencypsyndromep(A
IDS)pshouldpbepexploredpbecauseppatientspwithpAIDSphavepaphighpincidencepofptuberculo
sis.pAppositivepresultponpskinptestingpmeanspspecificallypthatptheppersonphaspatpsomeptimep
beenpinfectedpwithpTB,pnotpnecessarilypthatpactivepdiseasepisppresent.pMostppatientspwhop
becomeppositivepskinptesterspdopnotpdeveloppactivepdisease.pApdiagnosispofpactivepTBpispm
adepbypchestpx-ray,pimaging,psputumpculture,pandpclinicalpexamination.
PTS: 1 REF: p.p6-7
6. Vasoconstrictorspshouldpbepavoidedpinppatientspwhoparepusingpcocaineporp
methamphetaminepbecausepthesepagentspmaypprecipitate .
A. severephypotension
B. severephypertension
C. respiratorypdepression
D. cessationpofpintestinalpperistalsis
ANS:p B
Vasoconstrictorspmaypprecipitatepcardiacparrhythmiasporpseverephypertensionpinppatientsp
whoparepusingpcocaineporpmethamphetamine.pRespiratorypdepressionpispassociatedpwithpt
hepusepofpopioids.
PTS: 1 REF: p.p8
7. Itphaspbeenpshownpthatpthepriskpforpoccurrencepofpapseriouspperioperativepcardiovascularpev
entpispincreasedpinppatientspwhoparepunableptopmeetpapppp -
METp(metabolicpequivalentpofptask)pdemandpduringpnormalpdailypactivity.
A. 4
B. 6
C. 8
D. 10
ANS:p A
Riskpispincreasedpinppatientspunableptopmeetpap4-
METpdemand.pDailypactivitiesprequiringp4pMETspincludeplevelpwalkingpatp4pmiles/hourporpcli
mbingpapflightpofpstairs.pActivitiesprequiringpgreaterpthanp10pMETspincludepswimmingpandpsi
nglesptennis.
PTS: 1 REF: p.p9
8. Whichpofpthepfollowingpalterationspinpthepfingernailspispassociatedpwithpcirrhosis?
A. yellowing
B. clubbing
Copyrightp©p2013pbypMosby,panpimprintpofpElsevierpInc.
