2
INBDE Prep Exam with verified detailed answers || || || || || ||
Patient75- years- old femaleChief Complaint"Bleeding gums and replace a
|| || || || || || || || ||
tooth"Background/Patient History ||
Hypertension, Type 2 diabetes. Mitral valve was replaced in 2012 with a mechanical valve.
|| || || || || || || || || || || || || ||
She has had successful hip joint replacement in 2015.
|| || || || || || || ||
Medications: benazepril, atenolol, metformin and glimepiride
|| || || || ||
Clinical Findings ||
Generalized gingivitis, #5 is missing, #12 non-restorable BP: 135/87.
|| || || || || || || ||
Recent HbA1c 7. Previous HbA1c 10
|| || || || ||
Is/are there any medical condition/s for which this patient requires antibiotic prophylaxis
|| || || || || || || || || || || ||
before certain dental procedures?
|| || ||
Mechanical valve and joint replacement || || || ||
Diabetes and joint replacement
|| || ||
Mechanical valve ||
Diabetes, joint replacement and mechanical valve
|| || || || ||
,2
Mechanical Valve ||
Based on the current evidence of the American Heart Association (AHA) guidelines
|| || || || || || || || || || || ||
2007/17/21 and supported by the American Dental Association (ADA), patients with a
|| || || || || || || || || || || ||
history of any type of valve replacement are at a higher risk of developing infective
|| || || || || || || || || || || || || || ||
endocarditis.Antibiotic prophylaxis (a single dose of antibiotic) is recommended to be used || || || || || || || || || || || ||
prior to dental procedures that involve manipulation of gingival tissue or the periapical
|| || || || || || || || || || || || ||
region of teeth, or perforation of the oral mucosa.
|| || || || || || || ||
The diabetes is controlled and the joint replacement did not have any complications hence
|| || || || || || || || || || || || || ||
the current evidence does not support the use of prophylaxis. Only the mitral valve
|| || || || || || || || || || || || || ||
replacement warrants the need for antibiotic prophylaxis. || || || || || ||
Currently her HbA1c is acceptable, but considering her previous values, all of the following
|| || || || || || || || || || || || || ||
are associated with uncontrolled diabetes EXCEPT one; which one is the exception?
|| || || || || || || || || || ||
Wound healing is impaired, an elevated blood sugar level decreases the function of red
|| || || || || || || || || || || || || ||
blood cells that carry nutrients to the tissue.
|| || || || || || ||
Wound healing is impaired ,narrowed blood vessels lead to decreased blood flow and
|| || || || || || || || || || || || ||
oxygen to a wound. || || ||
Patients are more susceptible to infections due to a reduced neutrophil's phagocytic capacity
|| || || || || || || || || || || ||
Patients are more susceptible to infections due to a low neutrophil count
|| || || || || || || || || || ||
Patients are more susceptible to infections due to a low neutrophil count
|| || || || || || || || || || ||
, 2
In patients with hyperglycemia the causes of increase in susceptibility to infections is that
|| || || || || || || || || || || || || ||
the mechanisms of innate immunity are impaired. That includes neutrophil migration,
|| || || || || || || || || || ||
phagocytosis and bactericidal activity. || || ||
The neutrophil number is not affected. In uncontrolled diabetes there is a failure in the
|| || || || || || || || || || || || || || ||
neutrophil function. ||
This patient is scheduled for an extraction next week. Which of the following diet
|| || || || || || || || || || || || || ||
recommendation is the the most appropriate for this patient? || || || || || || || ||
Ice cream for 3 days.
|| || || ||
Filet of salmon, || ||
Low-sodium wild rice and vegetable soup || || || || ||
Eggs and mashed potatoes
|| || ||
Eggs and mashed potatoes
|| || ||
Eggs and mashed potatoes, both options are soft and will be well tolerated post extraction.
|| || || || || || || || || || || || || || ||
The eggs provided protein and other essential vitamins and minerals essential for healing
|| || || || || || || || || || || || ||
and the mashed potatoes will reduce the risk for hypoglycemia. This option provides the
|| || || || || || || || || || || || || ||
essential macro and micronutrients needed post-extraction and for the patients risk for
|| || || || || || || || || || || ||
hypoglycemia.
While the patient does have hypertension, a low sodium soup can still provide too much
|| || || || || || || || || || || || || || ||
sodium depending on the serving size. Rice may not be the best depending on the extraction
|| || || || || || || || || || || || || || ||
site and while vegetables do provide vitamins and minerals, this may not provide enough
|| || || || || || || || || || || || || || ||
protein for proper healing. || || ||
INBDE Prep Exam with verified detailed answers || || || || || ||
Patient75- years- old femaleChief Complaint"Bleeding gums and replace a
|| || || || || || || || ||
tooth"Background/Patient History ||
Hypertension, Type 2 diabetes. Mitral valve was replaced in 2012 with a mechanical valve.
|| || || || || || || || || || || || || ||
She has had successful hip joint replacement in 2015.
|| || || || || || || ||
Medications: benazepril, atenolol, metformin and glimepiride
|| || || || ||
Clinical Findings ||
Generalized gingivitis, #5 is missing, #12 non-restorable BP: 135/87.
|| || || || || || || ||
Recent HbA1c 7. Previous HbA1c 10
|| || || || ||
Is/are there any medical condition/s for which this patient requires antibiotic prophylaxis
|| || || || || || || || || || || ||
before certain dental procedures?
|| || ||
Mechanical valve and joint replacement || || || ||
Diabetes and joint replacement
|| || ||
Mechanical valve ||
Diabetes, joint replacement and mechanical valve
|| || || || ||
,2
Mechanical Valve ||
Based on the current evidence of the American Heart Association (AHA) guidelines
|| || || || || || || || || || || ||
2007/17/21 and supported by the American Dental Association (ADA), patients with a
|| || || || || || || || || || || ||
history of any type of valve replacement are at a higher risk of developing infective
|| || || || || || || || || || || || || || ||
endocarditis.Antibiotic prophylaxis (a single dose of antibiotic) is recommended to be used || || || || || || || || || || || ||
prior to dental procedures that involve manipulation of gingival tissue or the periapical
|| || || || || || || || || || || || ||
region of teeth, or perforation of the oral mucosa.
|| || || || || || || ||
The diabetes is controlled and the joint replacement did not have any complications hence
|| || || || || || || || || || || || || ||
the current evidence does not support the use of prophylaxis. Only the mitral valve
|| || || || || || || || || || || || || ||
replacement warrants the need for antibiotic prophylaxis. || || || || || ||
Currently her HbA1c is acceptable, but considering her previous values, all of the following
|| || || || || || || || || || || || || ||
are associated with uncontrolled diabetes EXCEPT one; which one is the exception?
|| || || || || || || || || || ||
Wound healing is impaired, an elevated blood sugar level decreases the function of red
|| || || || || || || || || || || || || ||
blood cells that carry nutrients to the tissue.
|| || || || || || ||
Wound healing is impaired ,narrowed blood vessels lead to decreased blood flow and
|| || || || || || || || || || || || ||
oxygen to a wound. || || ||
Patients are more susceptible to infections due to a reduced neutrophil's phagocytic capacity
|| || || || || || || || || || || ||
Patients are more susceptible to infections due to a low neutrophil count
|| || || || || || || || || || ||
Patients are more susceptible to infections due to a low neutrophil count
|| || || || || || || || || || ||
, 2
In patients with hyperglycemia the causes of increase in susceptibility to infections is that
|| || || || || || || || || || || || || ||
the mechanisms of innate immunity are impaired. That includes neutrophil migration,
|| || || || || || || || || || ||
phagocytosis and bactericidal activity. || || ||
The neutrophil number is not affected. In uncontrolled diabetes there is a failure in the
|| || || || || || || || || || || || || || ||
neutrophil function. ||
This patient is scheduled for an extraction next week. Which of the following diet
|| || || || || || || || || || || || || ||
recommendation is the the most appropriate for this patient? || || || || || || || ||
Ice cream for 3 days.
|| || || ||
Filet of salmon, || ||
Low-sodium wild rice and vegetable soup || || || || ||
Eggs and mashed potatoes
|| || ||
Eggs and mashed potatoes
|| || ||
Eggs and mashed potatoes, both options are soft and will be well tolerated post extraction.
|| || || || || || || || || || || || || || ||
The eggs provided protein and other essential vitamins and minerals essential for healing
|| || || || || || || || || || || || ||
and the mashed potatoes will reduce the risk for hypoglycemia. This option provides the
|| || || || || || || || || || || || || ||
essential macro and micronutrients needed post-extraction and for the patients risk for
|| || || || || || || || || || || ||
hypoglycemia.
While the patient does have hypertension, a low sodium soup can still provide too much
|| || || || || || || || || || || || || || ||
sodium depending on the serving size. Rice may not be the best depending on the extraction
|| || || || || || || || || || || || || || ||
site and while vegetables do provide vitamins and minerals, this may not provide enough
|| || || || || || || || || || || || || || ||
protein for proper healing. || || ||
