INBDE PRACTICE EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
A patient takes reserpine to help control their hypertension. How does this medication
work to control high blood pressure?
A. It displaces norepinephrine from synaptic vesicles and destroys it
B. It inhibits the storage of neurotransmitters into synaptic vesicles
C. It blocks the neuronal reuptake of norepinephrine at the synaptic cleft
D. It antagonizes the alpha-1 receptors on vascular smooth muscle - Answer- B. It
inhibits the storage of neurotransmitters into synaptic vesicles
* Reserpine is a sympatholytic (rest and digest) medication that can be used to treat
mild to moderate hypertension. It inhibits the ATP/Mg2+ pump that is responsible for
transporting neurotransmitters into storage vesicles. By not staying safe within these
vesicles, the neurotransmitters are really metabolized by monoamine oxidase. Their
depletion from peripheral sympathetic nerve endings relaxes the heart. A describes
guanethidine, C describes cocaine (which would actually worsen hypertension), and D
describes guanfacine. The answer is B.
What is the mechanism of action of his antihypertensive medication?
Pt: Male, 50yp, CC: " I would like my teeth to be whitened"
Background/Pt Hx: Hypertension, Type II diabetes, Epilepsy
Medications:
lisinopril (zestril), glipizide (Glucotrol), carbamazepine (Carbatrol)
A. Block the formation of angiotensin II
B. Prevent the reabsorption of sodium in the kidney
C. Increase efflux of potassium to relax vascular smooth muscle
D. Antagonize the angiotensin II receptor - Answer- A. Block the formation of
angiotensin II
* Lisinopril is an angiotensin-converting enzyme inhibitor (as are all medications ending
in pril). ACE is a peptidyl dipeptidase enzyme that catalyzes the conversion of
angiotensin I to angiotensin II. Therefore, this drug works by blocking the formation of
angiotensin II which normally increases blood pressure by a number of mechanisms. B
describes a diuretic, C describes a vasodilator, and D describes an angiotensin II
receptor blocker. The answer is A.
What structure are the arrows pointing to in the below panoramic radiograph? (image)
A. Inferior border of the mandible
B. Calcified atheromatous plaque
C. Sialolith
,D. Hyoid bone - Answer- The arrows are pointing to the hyoid bone. The hyoid bone is a
horseshoe-shaped bone located between the chin and thyroid cartilage usually at the
level of the third cervical vertebra. It usually appears as a bilateral structure below the
inferior border of the mandible on a panoramic. The answer is D.
This patient's drug-induced gingival enlargement is primarily characterized by an
increase of which of the following?
A. Edema
B. Plasma cells
C. Keratinocytes
D. Collagen - Answer- D. Collagen
* Cyclosporine is an immunosuppressive drug that can be used after an organ
transplant to prevent rejection, or can be used to treated autoimmune conditions such
as rheumatoid arthritis or plaque psoriasis. The drug works by inhibiting the secretion of
matrix metalloproteinases (MMPs) by fibroblasts leading to an accumulation of
extracellular matrix components like collagen in the gingival connective tissue, causing
gingival overgrowth. The answer is D.
What structure are the arrows pointing to in the attached panoramic radiograph?
A. Dense bone island
B. Amalgam tattoo
C. Genial tubercles
D. Apical sclerosing osteitis - Answer- C. Genial tubercles
* This small radiopacity near the chin can be difficult to see due to superimposition of
other structures like the cervical spine, but is actually normal anatomy. The genial
tubercles (or mental spines) are tiny bony projections located in the midline where the
geniohyoid and genioglossus muscles originate from. A dense bone island or enostosis
is a benign radiopacity composed of dense calcified tissue without marrow spaces. An
amalgam tattoo would have the same radiodensity as an amalgam restoration (the
structure in question is not radiopaque enough) and would also be nearer to an
amalgam restoration. Apical sclerosing osteitis would occur around a root apex. The
answer is C.
Which is NOT an appropriate management strategy for this patient's chief complaint?
Pt: Female, 62yo, CC: " I have a burning sensation on my tongue and lips and I'm not
sure what is causing it"
Background/Pt Hx: Type II diabetes
Medications: metformin (Glucophage)
Current Findings: HbA1c 8.2
A. Prescribe a topical dexamethasone rinse
B. Eliminate harsh toothpastes and mouthwashes
C. Refer to a physician for a complete blood count
D. Recommend over-the-counter alpha lipoic acid - Answer- A. Prescribe a topical
dexamethasone rinse
,* Burning mouth syndrome refers to a burning or scalding sensation that affects the lips,
tongue, gums, palate, or any other area of the mouth in the absence of clinical signs
that would justify the symptoms. It is most common in postmenopausal women and is
often associated with type II diabetes, malnutrition, and xerostomia. Management
techniques include increasing fluid intake, avoiding tobacco, and avoiding alcohol-
containing mouthwashes or harsh dentifrices that can irritate the oral mucosa. Getting a
complete blood count including iron, zinc, and B-vitamin levels can help shed some light
on a malnutrition related etiology. Supplementing with Vitamin B12 can help alleviate
symptoms if this is the case. Alpha lipoic acid is an antioxidant that has shown to help
reduce symptoms in some patients. A topical steroid elixir like dexamethasone would
not be appropriate for this condition. The answer is A.
Which of the following statements is FALSE regarding child and elderly abuse?
A. If you suspect elder abuse, report to and call the Department of Health and Human
Services
B. Multiple untreated injuries is a possible sign of abuse
C. Child abuse is most common over the age of 3
D. Elderly abuse is under-reported - Answer- C. Child abuse is most common over the
age of 3
* Multiple untreated injuries like bruises and burns are definitely a sign of potential
physical abuse. If child abuse is suspected, you should call Social Services. If elder
abuse is suspected, -72- you should call the Department of Health and Human
Services. Elderly abuse is generally under-reported. Child abuse is most common in
children under the age of 3. The answer is C.
What is the correct Kennedy classification for this patient's mandibular arch? (iamge)
Pt: Male, 44yo, CC: " I am having trouble chewing food and would like to get a partial
denture made ofr my missing bottom teeth"
A. Class I
B. Class II modification 1
C. Class II modification 2
D. Class III modification 1 - Answer- D. Class III modification 1
* Kennedy Class I refers to a bilateral distal extension (where all teeth distal to a tooth
are missing) and Kennedy Class II refers to a unilateral distal extension. Neither of
these is true in this case, since the third molars are still present. These areas are
instead referred to as bounded edentulous spaces and there is one on either side.
Having only one of these bounded edentulous spaces would lead to Kennedy Class III
and the addition of a second space means we have to add one "modification" to the
classification. Therefore, this patient's lower arch is Class III modification 1. The answer
is D.
The facial aspect of the attached gingiva extends apically to the
___________________.
, A. Alveolar mucosa
B. Free gingival margin
C. Junctional epithelium
D. Sulcular epithelium - Answer- A. Alveolar mucosa
* The attached gingiva extends coronally toward the tooth crown to meet the free
gingiva at the free gingival margin. The attached gingiva extends apically toward the
root apex to meet the alveolar mucosa at the mucogingival junction. The sulcular
epithelium lines the gingival sulcus and the junctional epithelium is immediately apical to
that and attaches directly to the tooth surface to seal off the oral cavity from the
underlying soft tissues. The answer is A.
What are the radiopaque structures that the arrows are pointing to? (image)
Pt: Female, 38yo, CC: "I have a chipped tooth on my left side"
Background/Pt. Hx: Hyperlipidimia, Hypothyroid
Medications: atorvastatin (Lipitor), levothyroxine (Synthroid)
Current Findings: Several well-defined round radiopaque lesions were revealed on the
panoramic radiograph near the patient's right coronoid process. There are no notable
symptoms reported by the the patient.
A. Tonsilloliths
B. Phleboliths
C. Sialoliths
D. Antroliths - Answer- B. Phleboliths
What is the microbial virulence factor that is exclusive to gram-negative bacterial
species and is implicated in tissue destruction of the periodontium?
A. Lipopolysaccharide
B. Hydrogen sulfide
C. Gingipains
D. Propionic acid
E. Treponemic acid - Answer- A. Lipopolysaccharide
* Lipopolysaccharide (LPS), also referred to as endotoxin, is a large molecule
composed of lipid A attached to a sugar core. It constitutes much of the outer
membrane of gram-negative bacteria like E. coli. Along with other inflammatory
mediators, LPS can lead to septic shock. The answer is A.
What is the diameter at point D0 and at point D16 for this file?
A. 0.20 mm at D0 and 0.36 mm at D16
B. 0.20 mm at D0 and 0.52 mm at D16
C. 0.02 mm at D0 and 0.18 mm at D16
D. 0.02 mm at D0 and 0.34 mm at D16 - Answer- B. 0.20 mm at D0 and 0.52 mm at
D16
WITH COMPLETE SOLUTIONS
A patient takes reserpine to help control their hypertension. How does this medication
work to control high blood pressure?
A. It displaces norepinephrine from synaptic vesicles and destroys it
B. It inhibits the storage of neurotransmitters into synaptic vesicles
C. It blocks the neuronal reuptake of norepinephrine at the synaptic cleft
D. It antagonizes the alpha-1 receptors on vascular smooth muscle - Answer- B. It
inhibits the storage of neurotransmitters into synaptic vesicles
* Reserpine is a sympatholytic (rest and digest) medication that can be used to treat
mild to moderate hypertension. It inhibits the ATP/Mg2+ pump that is responsible for
transporting neurotransmitters into storage vesicles. By not staying safe within these
vesicles, the neurotransmitters are really metabolized by monoamine oxidase. Their
depletion from peripheral sympathetic nerve endings relaxes the heart. A describes
guanethidine, C describes cocaine (which would actually worsen hypertension), and D
describes guanfacine. The answer is B.
What is the mechanism of action of his antihypertensive medication?
Pt: Male, 50yp, CC: " I would like my teeth to be whitened"
Background/Pt Hx: Hypertension, Type II diabetes, Epilepsy
Medications:
lisinopril (zestril), glipizide (Glucotrol), carbamazepine (Carbatrol)
A. Block the formation of angiotensin II
B. Prevent the reabsorption of sodium in the kidney
C. Increase efflux of potassium to relax vascular smooth muscle
D. Antagonize the angiotensin II receptor - Answer- A. Block the formation of
angiotensin II
* Lisinopril is an angiotensin-converting enzyme inhibitor (as are all medications ending
in pril). ACE is a peptidyl dipeptidase enzyme that catalyzes the conversion of
angiotensin I to angiotensin II. Therefore, this drug works by blocking the formation of
angiotensin II which normally increases blood pressure by a number of mechanisms. B
describes a diuretic, C describes a vasodilator, and D describes an angiotensin II
receptor blocker. The answer is A.
What structure are the arrows pointing to in the below panoramic radiograph? (image)
A. Inferior border of the mandible
B. Calcified atheromatous plaque
C. Sialolith
,D. Hyoid bone - Answer- The arrows are pointing to the hyoid bone. The hyoid bone is a
horseshoe-shaped bone located between the chin and thyroid cartilage usually at the
level of the third cervical vertebra. It usually appears as a bilateral structure below the
inferior border of the mandible on a panoramic. The answer is D.
This patient's drug-induced gingival enlargement is primarily characterized by an
increase of which of the following?
A. Edema
B. Plasma cells
C. Keratinocytes
D. Collagen - Answer- D. Collagen
* Cyclosporine is an immunosuppressive drug that can be used after an organ
transplant to prevent rejection, or can be used to treated autoimmune conditions such
as rheumatoid arthritis or plaque psoriasis. The drug works by inhibiting the secretion of
matrix metalloproteinases (MMPs) by fibroblasts leading to an accumulation of
extracellular matrix components like collagen in the gingival connective tissue, causing
gingival overgrowth. The answer is D.
What structure are the arrows pointing to in the attached panoramic radiograph?
A. Dense bone island
B. Amalgam tattoo
C. Genial tubercles
D. Apical sclerosing osteitis - Answer- C. Genial tubercles
* This small radiopacity near the chin can be difficult to see due to superimposition of
other structures like the cervical spine, but is actually normal anatomy. The genial
tubercles (or mental spines) are tiny bony projections located in the midline where the
geniohyoid and genioglossus muscles originate from. A dense bone island or enostosis
is a benign radiopacity composed of dense calcified tissue without marrow spaces. An
amalgam tattoo would have the same radiodensity as an amalgam restoration (the
structure in question is not radiopaque enough) and would also be nearer to an
amalgam restoration. Apical sclerosing osteitis would occur around a root apex. The
answer is C.
Which is NOT an appropriate management strategy for this patient's chief complaint?
Pt: Female, 62yo, CC: " I have a burning sensation on my tongue and lips and I'm not
sure what is causing it"
Background/Pt Hx: Type II diabetes
Medications: metformin (Glucophage)
Current Findings: HbA1c 8.2
A. Prescribe a topical dexamethasone rinse
B. Eliminate harsh toothpastes and mouthwashes
C. Refer to a physician for a complete blood count
D. Recommend over-the-counter alpha lipoic acid - Answer- A. Prescribe a topical
dexamethasone rinse
,* Burning mouth syndrome refers to a burning or scalding sensation that affects the lips,
tongue, gums, palate, or any other area of the mouth in the absence of clinical signs
that would justify the symptoms. It is most common in postmenopausal women and is
often associated with type II diabetes, malnutrition, and xerostomia. Management
techniques include increasing fluid intake, avoiding tobacco, and avoiding alcohol-
containing mouthwashes or harsh dentifrices that can irritate the oral mucosa. Getting a
complete blood count including iron, zinc, and B-vitamin levels can help shed some light
on a malnutrition related etiology. Supplementing with Vitamin B12 can help alleviate
symptoms if this is the case. Alpha lipoic acid is an antioxidant that has shown to help
reduce symptoms in some patients. A topical steroid elixir like dexamethasone would
not be appropriate for this condition. The answer is A.
Which of the following statements is FALSE regarding child and elderly abuse?
A. If you suspect elder abuse, report to and call the Department of Health and Human
Services
B. Multiple untreated injuries is a possible sign of abuse
C. Child abuse is most common over the age of 3
D. Elderly abuse is under-reported - Answer- C. Child abuse is most common over the
age of 3
* Multiple untreated injuries like bruises and burns are definitely a sign of potential
physical abuse. If child abuse is suspected, you should call Social Services. If elder
abuse is suspected, -72- you should call the Department of Health and Human
Services. Elderly abuse is generally under-reported. Child abuse is most common in
children under the age of 3. The answer is C.
What is the correct Kennedy classification for this patient's mandibular arch? (iamge)
Pt: Male, 44yo, CC: " I am having trouble chewing food and would like to get a partial
denture made ofr my missing bottom teeth"
A. Class I
B. Class II modification 1
C. Class II modification 2
D. Class III modification 1 - Answer- D. Class III modification 1
* Kennedy Class I refers to a bilateral distal extension (where all teeth distal to a tooth
are missing) and Kennedy Class II refers to a unilateral distal extension. Neither of
these is true in this case, since the third molars are still present. These areas are
instead referred to as bounded edentulous spaces and there is one on either side.
Having only one of these bounded edentulous spaces would lead to Kennedy Class III
and the addition of a second space means we have to add one "modification" to the
classification. Therefore, this patient's lower arch is Class III modification 1. The answer
is D.
The facial aspect of the attached gingiva extends apically to the
___________________.
, A. Alveolar mucosa
B. Free gingival margin
C. Junctional epithelium
D. Sulcular epithelium - Answer- A. Alveolar mucosa
* The attached gingiva extends coronally toward the tooth crown to meet the free
gingiva at the free gingival margin. The attached gingiva extends apically toward the
root apex to meet the alveolar mucosa at the mucogingival junction. The sulcular
epithelium lines the gingival sulcus and the junctional epithelium is immediately apical to
that and attaches directly to the tooth surface to seal off the oral cavity from the
underlying soft tissues. The answer is A.
What are the radiopaque structures that the arrows are pointing to? (image)
Pt: Female, 38yo, CC: "I have a chipped tooth on my left side"
Background/Pt. Hx: Hyperlipidimia, Hypothyroid
Medications: atorvastatin (Lipitor), levothyroxine (Synthroid)
Current Findings: Several well-defined round radiopaque lesions were revealed on the
panoramic radiograph near the patient's right coronoid process. There are no notable
symptoms reported by the the patient.
A. Tonsilloliths
B. Phleboliths
C. Sialoliths
D. Antroliths - Answer- B. Phleboliths
What is the microbial virulence factor that is exclusive to gram-negative bacterial
species and is implicated in tissue destruction of the periodontium?
A. Lipopolysaccharide
B. Hydrogen sulfide
C. Gingipains
D. Propionic acid
E. Treponemic acid - Answer- A. Lipopolysaccharide
* Lipopolysaccharide (LPS), also referred to as endotoxin, is a large molecule
composed of lipid A attached to a sugar core. It constitutes much of the outer
membrane of gram-negative bacteria like E. coli. Along with other inflammatory
mediators, LPS can lead to septic shock. The answer is A.
What is the diameter at point D0 and at point D16 for this file?
A. 0.20 mm at D0 and 0.36 mm at D16
B. 0.20 mm at D0 and 0.52 mm at D16
C. 0.02 mm at D0 and 0.18 mm at D16
D. 0.02 mm at D0 and 0.34 mm at D16 - Answer- B. 0.20 mm at D0 and 0.52 mm at
D16
