M M M M M M M M
f the Medically Compromised Patient,
M M M M
10th Edition by Craig Miller,
M M M M M
Chapters 1 - 30 M M M
,Little:MDentalMManagementMofMtheMMedicallyMCompromisedMPatient,M10thMEditionMTestMB
ank
TableMofMContents
PARTMONE:MPATIENTMEVALUATIONMANDMRISKMASSESSMENT
ChapterM1:MPatientMEvaluationMandMRiskMAssessment
PARTMTWO:MCARDIOVASCULARMDISEASE
ChapterM2:MInfectiveMEndocarditis
ChapterM3:MHypertension
ChapterM4:MIschemicMHeartMDisease
ChapterM5:MCardiacMArrhythmias
ChapterM6:MHeartMFailureM(orMCongestiveMHeartMFailure)
PARTMTHREE:MPULMONARYMDISEASE
ChapterM7:MPulmonaryMDisease
ChapterM8:MSmokingMandMTobaccoMUseMCessation
ChapterM9:MSleep-RelatedMBreathingMDisorders
PARTMFOUR:MGASTROINTESTIALMDISEASE
ChapterM10:MLiverMDisease
ChapterM11:MGastrointestinalMDisease
PARTMFIVE:MGENITOURINARYMDISEASE
ChapterM12:MChronicMKidneyMDiseaseMandMDialysis
ChapterM13:MSexuallyMTransmittedMDiseases
PARTMSIX:MENDOCRINEMANDMMETABOLICMDISEASE
ChapterM14:MDiabetesMMellitus
ChapterM15:MAdrenalMInsufficiency
ChapterM16:MThyroidMDiseases
ChapterM17:MPregnancyMandMBreastMFeeding
PARTMSEVEN:MIMMUNOLOGICMDISEASE
ChapterM18:MAIDS,MHIVMInfection,MandMRelatedMConditions
ChapterM19:MAllergy
ChapterM20:MRheumatologicMandMConnectiveMTissueMDisorders
ChapterM21:MOrganMandMBoneMMarrowMTransplantation
PARTMEIGHT:MHEMATOLOGICMANDMONCOLOGICMDISEASE
ChapterM22:MDisordersMofMRedMBloodMCells
ChapterM23:MDisordersMofMWhiteMBloodMCells
ChapterM24:MAcquiredMBleedingMandMHypercoagulableMDisorders
ChapterM25:MCongenitalMBleedingMandMHypercoagulableMDisorders
ChapterM26:MCancerMandMOralMCareMofMtheMPatient
PARTMNINE:MNEUROLOGIC,MBEHAVIORAL,MANDMPSYCHIATRICMDISORDERS
ChapterM27:MNeurologicMDisorders
ChapterM28:MAnxiety,MEatingMDisorders,MandMBehavioralMReactionsMtoMIllness
ChapterM29:MPsychiatricMDisorders
ChapterM30:MDrugMandMAlcoholMAbuse
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Chapter 01: Patient Evaluation and Risk Assessment
M M M M M M
Little: Dental Management of the Medically Compromised Patient, 10th Edition
M M M M M M M M M
MULTIPLEMCHOICE
1. ElectiveMdentalMcareMshouldMbeMdeferredMforMpatientsMwithMsevere,MuncontrolledMhypertensi
on,MmeaningMthatMtheMbloodMpressureMisMgreaterMthanMorMequalMto mmMHg.
a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANSWER:M C
ElectiveMdentalMcareMshouldMbeMdeferredMforMpatientsMwithMsevere,MuncontrolledMhypertensi
on,MwhichMisMbloodMpressureMgreaterMthanMorMequalMtoM180/110MmmMHg,MuntilMtheMconditio
nMcanMbeMbroughtMunderMcontrol.
2. TheMAmericanMHeartMAssociationMcurrentlyMrecommendsMantibioticMprophylaxisMforMaMpati
entMwithMwhichMofMtheMfollowingMcardiacMconditions?
a. MitralMvalveMprolapse
b. ProstheticMheartMvalve
c. RheumaticMheartMdisease
d. PacemakersMforMcardiacMarrhythmias
ANSWER:M B
Previously,MtheMAmericanMHeartMAssociationM(AHA)MrecommendedMantibioticMprophylaxisMfo
rMmanyMpatientsMwithMheartMmurmursMcausedMbyMvalvularMdiseaseM(e.g.,MmitralMvalveMprolaps
e,MrheumaticMheartMdisease)MinManMeffortMtoMpreventMinfectiveMendocarditis;Mhowever,McurrentM
guidelinesMomitMthisMrecommendationMonMtheMbasisMofMaccumulatedMscientificMevidence.MIfMaM
murmurMisMdueMtoMcertainMspecificMcardiacMconditionsM(e.g.,MpreviousMendocarditis,Mprosthetic
MheartMvalve,Mcomplex McongenitalMcyanoticMheartMdisease),MtheMAHAMcontinuesMtoMrecommen
dMantibioticMprophylaxisMforMmostMdentalMprocedures.
3. OneMconsequenceMofMchronicMhepatitisM(BMorMC)MorMcirrhosisMofMtheMliverMisMdecreasedMabili
tyMofMtheMbodyMto certainMdrugs,MincludingMlocalManestheticsMandManalgesics.
a. absorb
b. distribute
c. metabolize
d. excrete
ANSWER:M C
PatientsMalsoMmayMhaveMchronicMhepatitisM(BMorMC)MorMcirrhosis,MwithMimpairmentMofMl
iverMfunction.MThisMdeficitMmayMresultMinMprolongedMbleedingMandMlessMefficientMmetab
olismMofMcertainMdrugs,MincludingMlocalManestheticsMandManalgesics.
4. WhichMofMtheMfollowingMsymptomsMandMsignsMisMmostMconsistentMwithMallergy?
a. HeartMpalpitations
b. Itching
c. Vomiting
d. Fainting
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ANSWER:M B
SymptomsMandMsignsMconsistentMwithMallergyMincludeMitching,MurticariaM(hives),Mrash,Mswellin
g,Mwheezing,Mangioedema,MrunnyMnose,MandMtearingMeyes.MIsolatedMsignsMandMsymptomsMsuch
MasMnausea,Mvomiting,MheartMpalpitations,MandMfaintingMgenerallyMareMnotMofManMallergicMorigi
nMbutMratherMareMmanifestationsMofMdrugMintolerance,MadverseMsideMeffects,MorMpsychogenicMre
actions.
5. WhichMofMtheMfollowingMisMtrueMofMtheMpatientMwithMaMhistoryMofMtuberculosis?
a. AMpositiveMresultMonMskinMtestingMmeansMthatMtheMpersonMhasMactiveMTB.
b. MostMpatientsMwhoMbecomeMpositiveMskinMtestersMdevelopMactiveMdisease.
c. PatientsMwithMacquiredMimmunodeficiencyMsyndromeM(AIDS)MhaveMaMhighMinciden
ceMofMtuberculosis.
d. AMdiagnosisMofMactiveMTBMisMmadeMbyMaMpurifiedMproteinMderivativeM(PPD)MskinMtest.
ANSWER:M C
TheMpotentialMcoexistenceMofMtuberculosisMandMacquiredMimmunodeficiencyMsyndromeM(AID
S)MshouldMbeMexploredMbecauseMpatientsMwithMAIDSMhaveMaMhighMincidenceMofMtuberculosis.
MAMpositiveMresultMonMskinMtestingMmeansMspecificallyMthatMtheMpersonMhasMatMsomeMtimeMbee
nMinfectedMwithMTB,MnotMnecessarilyMthatMactiveMdiseaseMisMpresent.MMostMpatientsMwhoMbec
omeMpositiveMskinMtestersMdoMnotMdevelopMactiveMdisease.MAMdiagnosisMofMactiveMTBMisMmad
eMbyMchestMx-ray,Mimaging,MsputumMculture,MandMclinicalMexamination.
6. VasoconstrictorsMshouldMbeMavoidedMinMpatientsMwhoMcocaineMorMmethamphetamineMus
ersMbecauseMtheseMagentsMmayMprecipitate .
a. severeMhypotension
b. severeMhypertension
c. respiratoryMdepression
d. cessationMofMintestinalMperistalsis
ANSWER:M B
VasoconstrictorsMshouldMbeMavoidedMinMpatientsMwhoMareMcocaineMorMmethamphetamineMuser
sMbecauseMtheMcombinationMmayMprecipitateMarrhythmias,MMI,MorMsevereMhypertension.
7. ItMhasMbeenMshownMthatMtheMriskMforMoccurrenceMofMaMseriousMperioperativeMcardiovascularMe
ventM(e.g.,MMI,MheartMfailure)MisMincreasedMinMpatientsMwhoMareMunableMtoMmeetMaM-
METM(metabolicMequivalentMofMtask)MdemandMduringMnormalMdailyMactivity.
a. 4
b. 6
c. 8
d. 10
ANSWER:M A
DailyMactivitiesMrequiringM4MMETsMincludeMlevelMwalkingMatM4Mmiles/hourMorMclimbingMaMflightM
ofMstairs.MActivitiesMrequiringMgreaterMthanM10MMETsMincludeMswimmingMandMsinglesMtennis.MA
nMexerciseMcapacityMofM10MtoM13MMETsMindicatesMexcellentMphysicalMconditioning.
8. WhichMofMtheMfollowingMalterationsMinMtheMfingernailsMisMassociatedMwithMcirrhosis?
a. Yellowing
b. Clubbing
c. WhiteMdiscoloration
d. SplinterMhemorrhages
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