of the Medically Compromised Patient,
10th Edition by Craig Miller,
Chapters 1 - 30
,Little:hDentalhManagementhofhthehMedicallyhCompromisedhPatient,h10thhEditionhTesthBank
TablehofhContents
PARThONE:hPATIENThEVALUATIONhANDhRISKhASSESSMENT
Chapterh1:hPatienthEvaluationhandhRiskhAssessment
PARThTWO:hCARDIOVASCULARhDISEASE
Chapterh2:hInfectivehEndocarditis
Chapterh3:hHypertension
Chapterh4:hIschemichHearthDisease
Chapterh5:hCardiachArrhythmias
Chapterh6:hHearthFailureh(orhCongestivehHearthFailure)
PARThTHREE:hPULMONARYhDISEASE
Chapterh7:hPulmonaryhDisease
Chapterh8:hSmokinghandhTobaccohUsehCessation
Chapterh9:hSleep-RelatedhBreathinghDisorders
PARThFOUR:hGASTROINTESTIALhDISEASE
Chapterh10:hLiverhDisease
Chapterh11:hGastrointestinalhDisease
PARThFIVE:hGENITOURINARYhDISEASE
Chapterh12:hChronichKidneyhDiseasehandhDialysis
Chapterh13:hSexuallyhTransmittedhDiseases
PARThSIX:hENDOCRINEhANDhMETABOLIChDISEASE
Chapterh14:hDiabeteshMellitus
Chapterh15:hAdrenalhInsufficiency
Chapterh16:hThyroidhDiseases
Chapterh17:hPregnancyhandhBreasthFeeding
PARThSEVEN:hIMMUNOLOGIChDISEASE
Chapterh18:hAIDS,hHIVhInfection,handhRelatedhConditions
Chapterh19:hAllergy
Chapterh20:hRheumatologichandhConnectivehTissuehDisorders
Chapterh21:hOrganhandhBonehMarrowhTransplantation
PARThEIGHT:hHEMATOLOGIChANDhONCOLOGIChDISEASE
Chapterh22:hDisordershofhRedhBloodhCells
Chapterh23:hDisordershofhWhitehBloodhCells
Chapterh24:hAcquiredhBleedinghandhHypercoagulablehDisorders
Chapterh25:hCongenitalhBleedinghandhHypercoagulablehDisorders
Chapterh26:hCancerhandhOralhCarehofhthehPatient
PARThNINE:hNEUROLOGIC,hBEHAVIORAL,hANDhPSYCHIATRIChDISORDERS
Chapterh27:hNeurologichDisorders
Chapterh28:hAnxiety,hEatinghDisorders,handhBehavioralhReactionshtohIllness
Chapterh29:hPsychiatrichDisorders
Chapterh30:hDrughandhAlcoholhAbuse
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Chapter 01: Patient Evaluation and Risk Assessment
h h h h h h
Little: Dental Management of the Medically Compromised Patient, 10th Edition
h h h h h h h h h
MULTIPLEhCHOICE
1. Electivehdentalhcarehshouldhbehdeferredhforhpatientshwithhsevere,huncontrolledhhypertension,h
meaninghthaththehbloodhpressurehishgreaterhthanhorhequalhto mmhHg.
a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANSWER:h C
Electivehdentalhcarehshouldhbehdeferredhforhpatientshwithhsevere,huncontrolledhhypertension,h
whichhishbloodhpressurehgreaterhthanhorhequalhtoh180/110hmmhHg,huntilhthehconditionhcanhbehb
roughthunderhcontrol.
2. ThehAmericanhHearthAssociationhcurrentlyhrecommendshantibiotichprophylaxishforhahpatienth
withhwhichhofhthehfollowinghcardiachconditions?
a. Mitralhvalvehprolapse
b. Prosthetichhearthvalve
c. Rheumatichhearthdisease
d. Pacemakershforhcardiacharrhythmias
ANSWER:h B
Previously,hthehAmericanhHearthAssociationh(AHA)hrecommendedhantibiotichprophylaxishforhm
anyhpatientshwithhhearthmurmurshcausedhbyhvalvularhdiseaseh(e.g.,hmitralhvalvehprolapse,hrheum
atichhearthdisease)hinhanhefforthtohpreventhinfectivehendocarditis;hhowever,hcurrenthguidelinesho
miththishrecommendationhonhthehbasishofhaccumulatedhscientifichevidence.hIfhahmurmurhishduehtoh
certainhspecifichcardiachconditionsh(e.g.,hprevioushendocarditis,hprosthetichhearthvalve,hcomplexh
congenitalhcyanotichhearthdisease),hthehAHAhcontinueshtohrecommendhantibiotichprophylaxishfo
rhmosthdentalhprocedures.
3. Onehconsequencehofhchronichhepatitish(BhorhC)horhcirrhosishofhthehliverhishdecreasedhabilityhofht
hehbodyhto certainhdrugs,hincludinghlocalhanestheticshandhanalgesics.
a. absorb
b. distribute
c. metabolize
d. excrete
ANSWER:h C
Patientshalsohmayhhavehchronichhepatitish(BhorhC)horhcirrhosis,hwithhimpairmenthofhliverhf
unction.hThishdeficithmayhresulthinhprolongedhbleedinghandhlesshefficienthmetabolismhofhc
ertainhdrugs,hincludinghlocalhanestheticshandhanalgesics.
4. Whichhofhthehfollowinghsymptomshandhsignshishmosthconsistenthwithhallergy?
a. Hearthpalpitations
b. Itching
c. Vomiting
d. Fainting
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ANSWER:h B
Symptomshandhsignshconsistenthwithhallergyhincludehitching,hurticariah(hives),hrash,hswelling,hw
heezing,hangioedema,hrunnyhnose,handhtearingheyes.hIsolatedhsignshandhsymptomshsuchhashnause
a,hvomiting,hhearthpalpitations,handhfaintinghgenerallyharehnothofhanhallergichoriginhbuthratherhareh
manifestationshofhdrughintolerance,hadversehsideheffects,horhpsychogenichreactions.
5. Whichhofhthehfollowinghishtruehofhthehpatienthwithhahhistoryhofhtuberculosis?
a. AhpositivehresulthonhskinhtestinghmeanshthaththehpersonhhashactivehTB.
b. Mosthpatientshwhohbecomehpositivehskinhtestershdevelophactivehdisease.
c. Patientshwithhacquiredhimmunodeficiencyhsyndromeh(AIDS)hhavehahhighhincidenceh
ofhtuberculosis.
d. AhdiagnosishofhactivehTBhishmadehbyhahpurifiedhproteinhderivativeh(PPD)hskinhtest.
ANSWER:h C
Thehpotentialhcoexistencehofhtuberculosishandhacquiredhimmunodeficiencyhsyndromeh(AIDS)hs
houldhbehexploredhbecausehpatientshwithhAIDShhavehahhighhincidencehofhtuberculosis.hAhpositi
vehresulthonhskinhtestinghmeanshspecificallyhthaththehpersonhhashathsomehtimehbeenhinfectedhwith
hTB,hnothnecessarilyhthathactivehdiseasehishpresent.h Mosthpatientshwhohbecomehpositivehskinhtest
ershdohnothdevelophactivehdisease.hAhdiagnosishofhactivehTBhishmadehbyhchesthx-
ray,himaging,hsputumhculture,handhclinicalhexamination.
6. Vasoconstrictorshshouldhbehavoidedhinhpatientshwhohcocainehorhmethamphetaminehusersh
becausehthesehagentshmayhprecipitate .
a. severehhypotension
b. severehhypertension
c. respiratoryhdepression
d. cessationhofhintestinalhperistalsis
ANSWER:h B
Vasoconstrictorshshouldhbehavoidedhinhpatientshwhoharehcocainehorhmethamphetaminehusershbe
causehthehcombinationhmayhprecipitateharrhythmias,hMI,horhseverehhypertension.
7. Ithhashbeenhshownhthaththehriskhforhoccurrencehofhahserioushperioperativehcardiovascularheventh(
e.g.,hMI,hhearthfailure)hishincreasedhinhpatientshwhoharehunablehtohmeethah-
METh(metabolichequivalenthofhtask)hdemandhduringhnormalhdailyhactivity.
a. 4
b. 6
c. 8
d. 10
ANSWER:h A
Dailyhactivitieshrequiringh4hMETshincludehlevelhwalkinghath4hmiles/hourhorhclimbinghahflighthofhstai
rs.hActivitieshrequiringhgreaterhthanh10hMETshincludehswimminghandhsingleshtennis.hAnhexercisehc
apacityhofh10htoh13hMETshindicateshexcellenthphysicalhconditioning.
8. Whichhofhthehfollowinghalterationshinhthehfingernailshishassociatedhwithhcirrhosis?
a. Yellowing
b. Clubbing
c. Whitehdiscoloration
d. Splinterhhemorrhages
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