ACTUAL QUESTIONS AND ANSWERS (A+
GUIDE SOLUTION.
Qs: 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 -
Answer:
yes
- on my exam, this patient had a previous history of infective endocarditis.
Pre-med IS indicated
Qs: Pre-med options for pregnant woman w/hx of infective endocarditis
and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin -
Answer:
*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
Qs: What procedure can a dentist perform without consulting MD if a
patient is currently taking bisphosphonates?
,- endo therapy
- prophy and scaling
- extraction
- occlusal restoration -
Answer:
*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:
Qs: 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 -
Answer:
place her in Trendelburg position
Qs: 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 -
Answer:
,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.
Qs: 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 -
Answer:
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
Qs: Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs -
Answer:
age 0-5 years
- remember that PERMANENT dentition does not begin calcification until birth
Qs: Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of
drugs?
, - benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic -
Answer:
barbituates
- used primarily evening BEFORE appointment
Qs: A patient has an allergic reaction to a barbiturate, how do you treat?
- epinephrine
- diphenhydramine
- send to ER -
Answer:
benadryl (diphenhydramine)
Qs: 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 -
Answer:
*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 history because it can take 2 weeks to 2 years
for the adrenal glands to bounce back to normal function.