ABOMS Oral & Maxillofacial Surgery Exam
2026/2027
Practice Questions, Verified Answers and
Rationales latest update for guaranteed success
get it right
1. What is the maximum recommended dose of 2% lidocaine
with 1:100,000 epinephrine in a healthy adult?
A. 2 mg/kg, not to exceed 100 mg
B. 7 mg/kg, not to exceed 500 mg
C. 4.4 mg/kg, not to exceed 300 mg
D. 10 mg/kg, not to exceed 800 mg
Correct Answer: B. 7 mg/kg, not to exceed 500 mg
Rationale: Lidocaine with epinephrine has a maximum of 7 mg/kg
(absolute maximum 500 mg). Plain lidocaine is limited to about
4.4 mg/kg (300 mg) because the vasoconstrictor slows
absorption.
2. Which local anesthetic is classified as a hybrid, containing
an amide linkage and a thiophene ring with an ester side
chain?
A. Articaine
B. Lidocaine
C. Bupivacaine
D. Prilocaine
Correct Answer: A. Articaine
Rationale: Articaine contains a thiophene ring and an additional
ester group, which allows partial hydrolysis by plasma esterases
and a shorter half-life.
,3. Which early signs suggest local anesthetic systemic
toxicity (LAST)?
A. Bradycardia and miosis
B. Fever and tachypnea
C. Urticaria and wheezing
D. Circumoral numbness, metallic taste, tinnitus, and
lightheadedness
Correct Answer: D. Circumoral numbness, metallic taste,
tinnitus, and lightheadedness
Rationale: Early CNS excitation signs precede seizures and
cardiovascular collapse. Treatment includes airway support,
benzodiazepines for seizures, and 20% lipid emulsion (1.5 mL/kg
bolus followed by infusion).
4. What is the drug of choice for treating malignant
hyperthermia?
A. Flumazenil
B. Naloxone
C. Dantrolene 2.5 mg/kg IV
D. Ephedrine
Correct Answer: C. Dantrolene 2.5 mg/kg IV
Rationale: Dantrolene blocks calcium release from the
sarcoplasmic reticulum. Stop triggering agents (volatile
anesthetics and succinylcholine), hyperventilate with 100%
oxygen, and cool the patient. A rising end-tidal CO₂ is the earliest
sign.
,5. What is the first-line management of laryngospasm during
emergence from anesthesia?
A. Immediate cricothyrotomy
B. Positive pressure with 100% oxygen and jaw thrust
(Larson's maneuver)
C. Administration of flumazenil
D. Administration of naloxone
Correct Answer: B. Positive pressure with 100% oxygen and
jaw thrust (Larson's maneuver)
Rationale: If the spasm does not break, small-dose
succinylcholine (0.1–0.5 mg/kg) is given to relax the cords and
allow ventilation.
6. What is the mechanism of action of propofol?
A. Potentiation of GABA-A receptor activity
B. NMDA receptor antagonism
C. Mu-opioid receptor agonism
D. Alpha-2 receptor agonism
Correct Answer: A. Potentiation of GABA-A receptor activity
Rationale: Propofol enhances GABA-mediated chloride
conductance. Ketamine, in contrast, is an NMDA antagonist.
7. Which drug is the specific reversal agent for midazolam?
A. Naloxone
B. Neostigmine
C. Physostigmine
D. Flumazenil
Correct Answer: D. Flumazenil
Rationale: Flumazenil is a competitive benzodiazepine
antagonist. Its short half-life can allow re-sedation, so monitor
after reversal.
, 8. What is the first-line drug and dose for anaphylaxis in an
adult?
A. Diphenhydramine 50 mg IV
B. Methylprednisolone 125 mg IV
C. Epinephrine 0.3–0.5 mg IM (1 mg/mL) in the anterolateral
thigh
D. Albuterol nebulizer only
Correct Answer: C. Epinephrine 0.3–0.5 mg IM (1 mg/mL) in
the anterolateral thigh
Rationale: Epinephrine is the only first-line therapy;
antihistamines and steroids are adjuncts. Repeat every 5–15
minutes as needed.
9. Which ASA physical status classification describes a
patient with severe systemic disease that limits activity but is
not incapacitating?
A. ASA I
B. ASA III
C. ASA II
D. ASA IV
Correct Answer: B. ASA III
Rationale: ASA I is healthy, II mild systemic disease, III severe
systemic disease, IV severe disease that is a constant threat to
life, V moribund, and VI brain-dead donor.
2026/2027
Practice Questions, Verified Answers and
Rationales latest update for guaranteed success
get it right
1. What is the maximum recommended dose of 2% lidocaine
with 1:100,000 epinephrine in a healthy adult?
A. 2 mg/kg, not to exceed 100 mg
B. 7 mg/kg, not to exceed 500 mg
C. 4.4 mg/kg, not to exceed 300 mg
D. 10 mg/kg, not to exceed 800 mg
Correct Answer: B. 7 mg/kg, not to exceed 500 mg
Rationale: Lidocaine with epinephrine has a maximum of 7 mg/kg
(absolute maximum 500 mg). Plain lidocaine is limited to about
4.4 mg/kg (300 mg) because the vasoconstrictor slows
absorption.
2. Which local anesthetic is classified as a hybrid, containing
an amide linkage and a thiophene ring with an ester side
chain?
A. Articaine
B. Lidocaine
C. Bupivacaine
D. Prilocaine
Correct Answer: A. Articaine
Rationale: Articaine contains a thiophene ring and an additional
ester group, which allows partial hydrolysis by plasma esterases
and a shorter half-life.
,3. Which early signs suggest local anesthetic systemic
toxicity (LAST)?
A. Bradycardia and miosis
B. Fever and tachypnea
C. Urticaria and wheezing
D. Circumoral numbness, metallic taste, tinnitus, and
lightheadedness
Correct Answer: D. Circumoral numbness, metallic taste,
tinnitus, and lightheadedness
Rationale: Early CNS excitation signs precede seizures and
cardiovascular collapse. Treatment includes airway support,
benzodiazepines for seizures, and 20% lipid emulsion (1.5 mL/kg
bolus followed by infusion).
4. What is the drug of choice for treating malignant
hyperthermia?
A. Flumazenil
B. Naloxone
C. Dantrolene 2.5 mg/kg IV
D. Ephedrine
Correct Answer: C. Dantrolene 2.5 mg/kg IV
Rationale: Dantrolene blocks calcium release from the
sarcoplasmic reticulum. Stop triggering agents (volatile
anesthetics and succinylcholine), hyperventilate with 100%
oxygen, and cool the patient. A rising end-tidal CO₂ is the earliest
sign.
,5. What is the first-line management of laryngospasm during
emergence from anesthesia?
A. Immediate cricothyrotomy
B. Positive pressure with 100% oxygen and jaw thrust
(Larson's maneuver)
C. Administration of flumazenil
D. Administration of naloxone
Correct Answer: B. Positive pressure with 100% oxygen and
jaw thrust (Larson's maneuver)
Rationale: If the spasm does not break, small-dose
succinylcholine (0.1–0.5 mg/kg) is given to relax the cords and
allow ventilation.
6. What is the mechanism of action of propofol?
A. Potentiation of GABA-A receptor activity
B. NMDA receptor antagonism
C. Mu-opioid receptor agonism
D. Alpha-2 receptor agonism
Correct Answer: A. Potentiation of GABA-A receptor activity
Rationale: Propofol enhances GABA-mediated chloride
conductance. Ketamine, in contrast, is an NMDA antagonist.
7. Which drug is the specific reversal agent for midazolam?
A. Naloxone
B. Neostigmine
C. Physostigmine
D. Flumazenil
Correct Answer: D. Flumazenil
Rationale: Flumazenil is a competitive benzodiazepine
antagonist. Its short half-life can allow re-sedation, so monitor
after reversal.
, 8. What is the first-line drug and dose for anaphylaxis in an
adult?
A. Diphenhydramine 50 mg IV
B. Methylprednisolone 125 mg IV
C. Epinephrine 0.3–0.5 mg IM (1 mg/mL) in the anterolateral
thigh
D. Albuterol nebulizer only
Correct Answer: C. Epinephrine 0.3–0.5 mg IM (1 mg/mL) in
the anterolateral thigh
Rationale: Epinephrine is the only first-line therapy;
antihistamines and steroids are adjuncts. Repeat every 5–15
minutes as needed.
9. Which ASA physical status classification describes a
patient with severe systemic disease that limits activity but is
not incapacitating?
A. ASA I
B. ASA III
C. ASA II
D. ASA IV
Correct Answer: B. ASA III
Rationale: ASA I is healthy, II mild systemic disease, III severe
systemic disease, IV severe disease that is a constant threat to
life, V moribund, and VI brain-dead donor.
