ABOMS ORAL & MAXILLOFACIAL SURGERY
COMPREHENSIVE BOARD REVIEW QUESTION
BANK
2026–2027 | 210 ORIGINAL BOARD-STYLE PRACTICE QUESTIONS &
ANSWERS
OMS Board Exam Preparation • Surgical Cases • Clinical Decision-Making • Detailed Rationales
ASSESSMENT, ANESTHESIA & MEDICAL MANAGEMENT
Question 1: For a patient with a history of infective endocarditis, antibiotic prophylaxis
before certain dental procedures is generally considered because the patient is in which
category?
A. Anyone with a remote uncomplicated ankle fracture
B. Anyone with seasonal allergies
C. A group at highest risk of adverse outcome from infective endocarditis
D. All adults over age 40
CORRECT ANSWER: C. A group at highest risk of adverse outcome from infective
endocarditis
Rationale: Guidelines reserve prophylaxis for selected high-risk cardiac conditions and
qualifying procedures; confirm current guidance and the patient's exact diagnosis.
Question 2: A patient develops chest pressure, diaphoresis, and dyspnea in the clinic.
What should the team do first?
A. Stop treatment, activate emergency response, assess ABCs, and follow the chest-pain
protocol
B. Send the patient home alone
C. Continue the procedure quickly
D. Give an unprescribed sedative
CORRECT ANSWER: A. Stop treatment, activate emergency response, assess ABCs,
and follow the chest-pain protocol
Rationale: Possible acute coronary syndrome requires prompt emergency assessment and
activation of the facility response protocol.
Question 3: A patient has a history of malignant hyperthermia. Which anesthetic
planning principle is most important?
A. Use triggering agents because the history is remote
B. Avoid known triggering anesthetics and prepare according to an MH-safe protocol
C. Give prophylactic antibiotics instead
D. Use no monitoring
ABOMS OMS Board Review • Original Practice Questions | Page 1
,CORRECT ANSWER: B. Avoid known triggering anesthetics and prepare according to an
MH-safe protocol
Rationale: Malignant hyperthermia susceptibility requires avoidance of triggering agents and
readiness to follow the facility's MH protocol.
Question 4: Which action is most appropriate before administering an IV sedative to an
adult with obstructive sleep apnea?
A. Give the medication before reviewing the history
B. Avoid documenting the medication
C. Assume routine doses are always safe
D. Assess airway risk, comorbidities, and monitoring/rescue requirements
CORRECT ANSWER: D. Assess airway risk, comorbidities, and monitoring/rescue
requirements
Rationale: OSA increases risk of airway obstruction and respiratory depression; sedation
planning requires individualized assessment and appropriate monitoring and rescue capability.
Question 5: Which finding is most concerning for anaphylaxis after antibiotic
administration?
A. A brief metallic taste
B. Mild isolated nausea
C. Localized bruising at an injection site
D. Itchy rash with wheezing and hypotension
CORRECT ANSWER: D. Itchy rash with wheezing and hypotension
Rationale: Anaphylaxis may involve skin, airway, breathing, and circulation; prompt emergency
treatment with intramuscular epinephrine is first-line.
Question 6: Which preoperative finding most strongly suggests a need to evaluate for
possible adrenal suppression from chronic glucocorticoid use?
A. A short course of topical moisturizer
B. Use of fluoride toothpaste
C. A single dose of acetaminophen last month
D. Long-term systemic glucocorticoid therapy
CORRECT ANSWER: D. Long-term systemic glucocorticoid therapy
Rationale: Chronic systemic steroid exposure can suppress the hypothalamic-pituitary-adrenal
axis; assess dose, duration, stress level, and current guidance.
Question 7: During local anesthetic injection, a patient reports a sudden metallic taste
and circumoral numbness, followed by agitation. What complication should be
suspected?
A. Acute bacterial sinusitis
B. Vasovagal syncope only
C. Local anesthetic systemic toxicity
D. Delayed-onset penicillin allergy
CORRECT ANSWER: C. Local anesthetic systemic toxicity
Rationale: Early local anesthetic systemic toxicity may include circumoral numbness, metallic
taste, tinnitus, agitation, and can progress to seizures or cardiovascular collapse.
Question 8: What is the most appropriate purpose of a preoperative time-out?
A. Determine the patient's insurance status
ABOMS OMS Board Review • Original Practice Questions | Page 2
, B. Shorten the anesthesia record
C. Replace informed consent
D. Confirm patient, procedure, site, team readiness, and critical safety details
CORRECT ANSWER: D. Confirm patient, procedure, site, team readiness, and critical
safety details
Rationale: A time-out is a standardized final verification that helps prevent wrong-patient,
wrong-site, and wrong-procedure events.
Question 9: A patient with poorly controlled diabetes presents for elective surgery with
an active odontogenic infection. What is the best general approach?
A. Assess urgency, glycemic control, infection severity, and coordinate medical care
B. Prescribe antibiotics without examination
C. Cancel all dental treatment indefinitely
D. Ignore glycemic status because infection is local
CORRECT ANSWER: A. Assess urgency, glycemic control, infection severity, and
coordinate medical care
Rationale: Infection and poor glycemic control can worsen each other; urgent source control
and individualized medical coordination are important.
Question 10: Which measure is most useful for estimating functional capacity during
preoperative medical assessment?
A. Hair color
B. Dominant hand
C. Ability to perform ordinary activities such as climbing stairs, interpreted with clinical
context
D. Number of dental restorations
CORRECT ANSWER: C. Ability to perform ordinary activities such as climbing stairs,
interpreted with clinical context
Rationale: Functional capacity helps estimate perioperative risk, though symptoms and the
planned procedure also guide decisions.
Question 11: A patient taking warfarin presents for a dentoalveolar procedure. Which
factor most directly guides perioperative bleeding-risk planning?
A. The patient's shoe size
B. Recent INR, procedure bleeding risk, and thromboembolic indication
C. Whether the patient ate breakfast
D. The color of the tablets
CORRECT ANSWER: B. Recent INR, procedure bleeding risk, and thromboembolic
indication
Rationale: Anticoagulation decisions balance procedural bleeding risk against thrombosis risk;
use current INR and coordinate with the prescribing clinician when indicated.
Question 12: A patient reports taking apixaban and asks whether to stop it before
surgery. What is the safest response?
A. Make an individualized plan based on bleeding risk, renal function, and thrombotic risk
with the prescriber when needed
B. Advise doubling the next dose
C. Ignore the medication because it is not warfarin
ABOMS OMS Board Review • Original Practice Questions | Page 3
, D. Tell every patient to stop it for exactly 7 days
CORRECT ANSWER: A. Make an individualized plan based on bleeding risk, renal
function, and thrombotic risk with the prescriber when needed
Rationale: DOAC management varies by procedure, renal function, and thrombotic risk;
patients should not independently stop anticoagulation.
Question 13: Which medication history is especially important when assessing risk of
medication-related osteonecrosis of the jaw (MRONJ)?
A. A multivitamin alone
B. Occasional saline nasal spray
C. Antiresorptive or antiangiogenic therapy
D. Topical sunscreen
CORRECT ANSWER: C. Antiresorptive or antiangiogenic therapy
Rationale: Antiresorptive agents and some antiangiogenic therapies are associated with
MRONJ risk; indication, dose, route, duration, and comorbidities matter.
Question 14: A patient becomes pale, nauseated, and diaphoretic after seeing a needle,
with transient bradycardia. What is the most likely event?
A. Local anesthetic methemoglobinemia
B. Malignant hyperthermia
C. Anaphylaxis
D. Vasovagal episode
CORRECT ANSWER: D. Vasovagal episode
Rationale: A vasovagal response commonly causes pallor, diaphoresis, nausea, and
bradycardia; assess airway and circulation and position safely.
Question 15: Which sign during sedation most directly indicates inadequate ventilation?
A. A stable pulse with normal breathing
B. A normal preoperative blood pressure
C. Increasing end-tidal carbon dioxide or declining respiratory rate with poor air movement
D. A warm hand
CORRECT ANSWER: C. Increasing end-tidal carbon dioxide or declining respiratory rate
with poor air movement
Rationale: Capnography and direct respiratory assessment can detect hypoventilation earlier
than pulse oximetry alone in many settings.
LOCAL ANESTHESIA & SEDATION
Question 16: A patient has palpitations shortly after receiving epinephrine-containing
local anesthetic. Which assessment is most appropriate?
A. Give additional epinephrine immediately
B. Assess vital signs, symptoms, dose, and possible intravascular injection
C. Assume it is harmless without checking
D. Continue surgery without reassessment
CORRECT ANSWER: B. Assess vital signs, symptoms, dose, and possible intravascular
injection
Rationale: Transient palpitations may occur, but assess severity, cardiovascular status, and
possible inadvertent intravascular administration.
ABOMS OMS Board Review • Original Practice Questions | Page 4
COMPREHENSIVE BOARD REVIEW QUESTION
BANK
2026–2027 | 210 ORIGINAL BOARD-STYLE PRACTICE QUESTIONS &
ANSWERS
OMS Board Exam Preparation • Surgical Cases • Clinical Decision-Making • Detailed Rationales
ASSESSMENT, ANESTHESIA & MEDICAL MANAGEMENT
Question 1: For a patient with a history of infective endocarditis, antibiotic prophylaxis
before certain dental procedures is generally considered because the patient is in which
category?
A. Anyone with a remote uncomplicated ankle fracture
B. Anyone with seasonal allergies
C. A group at highest risk of adverse outcome from infective endocarditis
D. All adults over age 40
CORRECT ANSWER: C. A group at highest risk of adverse outcome from infective
endocarditis
Rationale: Guidelines reserve prophylaxis for selected high-risk cardiac conditions and
qualifying procedures; confirm current guidance and the patient's exact diagnosis.
Question 2: A patient develops chest pressure, diaphoresis, and dyspnea in the clinic.
What should the team do first?
A. Stop treatment, activate emergency response, assess ABCs, and follow the chest-pain
protocol
B. Send the patient home alone
C. Continue the procedure quickly
D. Give an unprescribed sedative
CORRECT ANSWER: A. Stop treatment, activate emergency response, assess ABCs,
and follow the chest-pain protocol
Rationale: Possible acute coronary syndrome requires prompt emergency assessment and
activation of the facility response protocol.
Question 3: A patient has a history of malignant hyperthermia. Which anesthetic
planning principle is most important?
A. Use triggering agents because the history is remote
B. Avoid known triggering anesthetics and prepare according to an MH-safe protocol
C. Give prophylactic antibiotics instead
D. Use no monitoring
ABOMS OMS Board Review • Original Practice Questions | Page 1
,CORRECT ANSWER: B. Avoid known triggering anesthetics and prepare according to an
MH-safe protocol
Rationale: Malignant hyperthermia susceptibility requires avoidance of triggering agents and
readiness to follow the facility's MH protocol.
Question 4: Which action is most appropriate before administering an IV sedative to an
adult with obstructive sleep apnea?
A. Give the medication before reviewing the history
B. Avoid documenting the medication
C. Assume routine doses are always safe
D. Assess airway risk, comorbidities, and monitoring/rescue requirements
CORRECT ANSWER: D. Assess airway risk, comorbidities, and monitoring/rescue
requirements
Rationale: OSA increases risk of airway obstruction and respiratory depression; sedation
planning requires individualized assessment and appropriate monitoring and rescue capability.
Question 5: Which finding is most concerning for anaphylaxis after antibiotic
administration?
A. A brief metallic taste
B. Mild isolated nausea
C. Localized bruising at an injection site
D. Itchy rash with wheezing and hypotension
CORRECT ANSWER: D. Itchy rash with wheezing and hypotension
Rationale: Anaphylaxis may involve skin, airway, breathing, and circulation; prompt emergency
treatment with intramuscular epinephrine is first-line.
Question 6: Which preoperative finding most strongly suggests a need to evaluate for
possible adrenal suppression from chronic glucocorticoid use?
A. A short course of topical moisturizer
B. Use of fluoride toothpaste
C. A single dose of acetaminophen last month
D. Long-term systemic glucocorticoid therapy
CORRECT ANSWER: D. Long-term systemic glucocorticoid therapy
Rationale: Chronic systemic steroid exposure can suppress the hypothalamic-pituitary-adrenal
axis; assess dose, duration, stress level, and current guidance.
Question 7: During local anesthetic injection, a patient reports a sudden metallic taste
and circumoral numbness, followed by agitation. What complication should be
suspected?
A. Acute bacterial sinusitis
B. Vasovagal syncope only
C. Local anesthetic systemic toxicity
D. Delayed-onset penicillin allergy
CORRECT ANSWER: C. Local anesthetic systemic toxicity
Rationale: Early local anesthetic systemic toxicity may include circumoral numbness, metallic
taste, tinnitus, agitation, and can progress to seizures or cardiovascular collapse.
Question 8: What is the most appropriate purpose of a preoperative time-out?
A. Determine the patient's insurance status
ABOMS OMS Board Review • Original Practice Questions | Page 2
, B. Shorten the anesthesia record
C. Replace informed consent
D. Confirm patient, procedure, site, team readiness, and critical safety details
CORRECT ANSWER: D. Confirm patient, procedure, site, team readiness, and critical
safety details
Rationale: A time-out is a standardized final verification that helps prevent wrong-patient,
wrong-site, and wrong-procedure events.
Question 9: A patient with poorly controlled diabetes presents for elective surgery with
an active odontogenic infection. What is the best general approach?
A. Assess urgency, glycemic control, infection severity, and coordinate medical care
B. Prescribe antibiotics without examination
C. Cancel all dental treatment indefinitely
D. Ignore glycemic status because infection is local
CORRECT ANSWER: A. Assess urgency, glycemic control, infection severity, and
coordinate medical care
Rationale: Infection and poor glycemic control can worsen each other; urgent source control
and individualized medical coordination are important.
Question 10: Which measure is most useful for estimating functional capacity during
preoperative medical assessment?
A. Hair color
B. Dominant hand
C. Ability to perform ordinary activities such as climbing stairs, interpreted with clinical
context
D. Number of dental restorations
CORRECT ANSWER: C. Ability to perform ordinary activities such as climbing stairs,
interpreted with clinical context
Rationale: Functional capacity helps estimate perioperative risk, though symptoms and the
planned procedure also guide decisions.
Question 11: A patient taking warfarin presents for a dentoalveolar procedure. Which
factor most directly guides perioperative bleeding-risk planning?
A. The patient's shoe size
B. Recent INR, procedure bleeding risk, and thromboembolic indication
C. Whether the patient ate breakfast
D. The color of the tablets
CORRECT ANSWER: B. Recent INR, procedure bleeding risk, and thromboembolic
indication
Rationale: Anticoagulation decisions balance procedural bleeding risk against thrombosis risk;
use current INR and coordinate with the prescribing clinician when indicated.
Question 12: A patient reports taking apixaban and asks whether to stop it before
surgery. What is the safest response?
A. Make an individualized plan based on bleeding risk, renal function, and thrombotic risk
with the prescriber when needed
B. Advise doubling the next dose
C. Ignore the medication because it is not warfarin
ABOMS OMS Board Review • Original Practice Questions | Page 3
, D. Tell every patient to stop it for exactly 7 days
CORRECT ANSWER: A. Make an individualized plan based on bleeding risk, renal
function, and thrombotic risk with the prescriber when needed
Rationale: DOAC management varies by procedure, renal function, and thrombotic risk;
patients should not independently stop anticoagulation.
Question 13: Which medication history is especially important when assessing risk of
medication-related osteonecrosis of the jaw (MRONJ)?
A. A multivitamin alone
B. Occasional saline nasal spray
C. Antiresorptive or antiangiogenic therapy
D. Topical sunscreen
CORRECT ANSWER: C. Antiresorptive or antiangiogenic therapy
Rationale: Antiresorptive agents and some antiangiogenic therapies are associated with
MRONJ risk; indication, dose, route, duration, and comorbidities matter.
Question 14: A patient becomes pale, nauseated, and diaphoretic after seeing a needle,
with transient bradycardia. What is the most likely event?
A. Local anesthetic methemoglobinemia
B. Malignant hyperthermia
C. Anaphylaxis
D. Vasovagal episode
CORRECT ANSWER: D. Vasovagal episode
Rationale: A vasovagal response commonly causes pallor, diaphoresis, nausea, and
bradycardia; assess airway and circulation and position safely.
Question 15: Which sign during sedation most directly indicates inadequate ventilation?
A. A stable pulse with normal breathing
B. A normal preoperative blood pressure
C. Increasing end-tidal carbon dioxide or declining respiratory rate with poor air movement
D. A warm hand
CORRECT ANSWER: C. Increasing end-tidal carbon dioxide or declining respiratory rate
with poor air movement
Rationale: Capnography and direct respiratory assessment can detect hypoventilation earlier
than pulse oximetry alone in many settings.
LOCAL ANESTHESIA & SEDATION
Question 16: A patient has palpitations shortly after receiving epinephrine-containing
local anesthetic. Which assessment is most appropriate?
A. Give additional epinephrine immediately
B. Assess vital signs, symptoms, dose, and possible intravascular injection
C. Assume it is harmless without checking
D. Continue surgery without reassessment
CORRECT ANSWER: B. Assess vital signs, symptoms, dose, and possible intravascular
injection
Rationale: Transient palpitations may occur, but assess severity, cardiovascular status, and
possible inadvertent intravascular administration.
ABOMS OMS Board Review • Original Practice Questions | Page 4
