DSE OSCE EXAM QUESTIONS AND ANSWERS

What are the ADA recommendations for when pre-med is required - Answer- - prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts - prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords - a history of infective endocarditis - a cardiac transplanta with valve regurgitation due to a structurally abnormal valve - the following congenital (present from birth) heart disease --unrepaired cyanotic congenital heart disease, including palliative shunts and conduits --any repaired congenital heart defect with residual shunts or valvular regurgitation at the site of or adjacent to the site of a prosthetic patch or a prosthetic device **ADA website** 41-yo woman, pregnant; prev rheumatic fever with heart murmur (no valvular abnormality); allergy to penicillin. Positive history of infective endocarditis. Does she need to pre med? - yes - no - Answer- yes - REVIEW HEALTH HISTORY - on my exam, this patient had a previous history of infective endocarditis. Pre-med IS indicated - many of the OSCE quizlets say no.... Pre-med options for pregnant woman w/hx of infective endocarditis and penicillin allergy - amoxicillin - cephalexin - clarithromycin - ciproflaxacin - Answer- *clarithromycin* I may not be correct, the correct option may be cephalexin. however I chose clarithromycin due to penicillin allergy, cross reaction with cephalosporins, and since clindamycin/erythromycin/azthromycin were not options. Ciproflaxacin is contraindicated in pregnancy. article for reference What procedure can a dentist perform without consulting MD if a patient is currently taking bisphosphonates? - endo therapy - prophy and scaling - extraction - occlusal restoration - Answer- *occlusal restoration* although the main HELL NO is extraction, completing endo therapy increases risk if the apex is compromised/damaged during therapy. I teetered on prophy and scaling, but since it did not specify supragingival, decided that the risk of scaling can negatively affect t