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TEST BANK - LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT 9TH EDITION (VERSION 2023/2024) | COMPLETE GUIDE | ALL CHAPTERS 1-34.

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TEST BANK - LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT 9TH EDITION (VERSION 2023/2024) | COMPLETE GUIDE | ALL CHAPTERS 1-34. TEST BANK - LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT 9TH EDITION (VERSION 2023/2024) | COMPLETE GUIDE | ALL CHAPTERS 1-34. Chapter 01: Patient Evaluation and Risk Assessment Little: Dental Management of the Medically Compromised Patient, 9th Edition MULTIPLE CHOICE 1. Elective dental care should be deferred for patients with severe, uncontrolled hypertension, meaning that the blood pressure is greater than or equal to mm Hg. a. 200/140 b. 180/140 c. 180/110 d. 160/110 ANS: C Elective dental care should be deferred for patients with severe, uncontrolled hypertension, which is blood pressure greater than or equal to 180/110 mm Hg, until the condition can be brought under control. 2. The American Heart Association currently recommends antibiotic prophylaxis for a patient with which of the following cardiac conditions? a. Mitral valve prolapse b. Prosthetic heart valve c. Rheumatic heart disease d. Pacemakers for cardiac arrhythmias ANS: B Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for many patients with heart murmurs caused by valvular disease (e.g., mitral valve prolapse, rheumatic heart disease) in an effort to prevent infective endocarditis; however, current guidelines omit this recommendation on the basis of accumulated scientific evidence. If a murmur is due to certain specific cardiac conditions (e.g., previous endocarditis, prosthetic heart valve, complex congenital cyanotic heart disease), the AHA continues to recommend antibiotic prophylaxis for most dental procedures. 3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability of the body to certain drugs, including local anesthetics and analgesics. a. absorb b. distribute c. metabolize d. excrete ANS: C Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of liver function. This deficit may result in prolonged bleeding and less efficient metabolism of certain drugs, including local anesthetics and analgesics. 4. Which of the following symptoms and signs is most consistent with allergy? a. Heart palpitations b. Itching c. Vomiting d. Fainting WWW.GRADESMORE.COM S - The Marketplace to Buy and Sell your Study Material Page 1 of 74 GRADESMORE.COM WWW.NURSYLAB.COM ANS: B Symptoms and signs consistent with allergy include itching, urticaria (hives), rash, swelling, wheezing, angioedema, runny nose, and tearing eyes. Isolated signs and symptoms such as nausea, vomiting, heart palpitations, and fainting generally are not of an allergic origin but rather are manifestations of drug intolerance, adverse side effects, or psychogenic reactions. 5. Which of the following is true of the patient with a history of tuberculosis? a. A positive result on skin testing means that the person has active TB. b. Most patients who become positive skin testers develop active disease. c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of tuberculosis. d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test. ANS: C The potential coexistence of tuberculosis and acquired immunodeficiency syndrome (AIDS) should be explored because patients with AIDS have a high incidence of tuberculosis. A positive result on skin testing means specifically that the person has at some time been infected with TB, not necessarily that active disease is present. Most patients who become positive skin testers do not develop active disease. A diagnosis of active TB is made by chest x-ray, imaging, sputum culture, and clinical examination. 6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine users because these agents may precipitate . a. severe hypotension b. severe hypertension c. respiratory depression d. cessation of intestinal peristalsis ANS: B Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine users because the combination may precipitate arrhythmias, MI, or severe hypertension. 7. It has been shown that the risk for occurrence of a serious perioperative cardiovascular event (e.g., MI, heart failure) is increased in patients who are unable to meet a -MET (metabolic equivalent of task) demand during normal daily activity. a. 4 b. 6 c. 8 d. 10 ANS: A Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a flight of stairs. Activities requiring greater than 10 METs include swimming and singles tennis. An exercise capacity of 10 to 13 METs indicates excellent physical conditioning. 8. Which of the following alterations in the fingernails is associated with cirrhosis? a. Yellowing b. Clubbing c. White discoloration d. Splinter hemorrhages WWW.GRADESMORE.COM S - The Marketplace to Buy and Sell your Study Material Page 1 of 74 GRADESMORE.COM WWW.NURSYLAB.COM ANS: C Alterations in the fingernails, such as clubbing (seen in cardiopulmonary insufficiency), white discoloration (seen in cirrhosis), yellowing (from malignancy), and splinter hemorrhages (from infective endocarditis) usually are caused by chronic disorders. 9. A blood pressure cuff should be placed on the upper arm and inflated until . a. the radial pulse disappears b. the radial pulse disappears and then inflated an additional 20 to 30 mm Hg c. two fingers cannot fit comfortably under the cuff d. the pulse no longer can be heard with the stethoscope ANS: B While the radial pulse is palpated, the cuff is inflated until the radial pulse disappears (approximate systolic pressure); it is then inflated an additional 20 to 30 mm Hg. 10. Which of the following is true of a patient classified ASA III according to the American Society of Anesthesiologists (ASA) Physical Status Classification System? a. Patient has mild systemic disease. b. Patient’s disease has significant impact on daily activity. c. Patient’s disease is unlikely to have impact on anesthesia and surgery. d. Patient is moribund. ANS: B Patient with severe systemic disease is a constant threat to life (e.g., recent myocardial infarction, stroke, transient ischemic attach [<3 months], ongoing cardiac ischemia, severe valve dysfunction, respiratory failure requiring mechanical ventilation). Serious limitation of daily activity; likely major impact on anesthesia and surgery. WWW.GRADESMORE.COM S - The Marketplace to Buy and Sell your Study Material Page 1 of 74 GRADESMORE.COM WWW.NURSYLAB.COM Chapter 02: Infective Endocarditis Little: Dental Management of the Medically Compromised Patient, 9th Edition MULTIPLE CHOICE 1. Which of the following is true concerning infective endocarditis (IE)? a. IE is always due to a bacterial infection. b. Since the advent of antibiotics, morbidity and mortality associated with IE have been virtually eliminated. c. IE is currently classified as acute or subacute, to reflect the rapidity of onset and duration. d. Accumulating evidence questions the validity of antibiotic prophylaxis in an attempt to prevent IE prior to certain invasive dental procedures. ANS: D Antibiotics have been administered before certain invasive dental procedures in an attempt to prevent infection. Of note, however, the effectiveness of such prophylaxis in humans has never been substantiated, and accumulating evidence more and more questions the validity of this practice. 2. Which of the following is currently the most common underlying condition predisposing to infective endocarditis (IE)? a. Aortic valve disease b. Rheumatic heart disease (RHD) c. Mitral valve prolapse (MVP) d. Tetralogy of Fallot ANS: C Mitral valve prolapse, which accounts for 25% to 30% of adult cases of native valve endocarditis (NVE), is now the most common underlying condition among patients who acquire IE. Previously, rheumatic heart disease (RHD) was the most common condition predisposing to endocarditis. In developed countries, however, the frequency of RHD has markedly declined over the past several decades. 3. The leading cause of death due to infective endocarditis (IE) is . a. chronic obstructive pulmonary disease b. heart failure c. pulmonary emboli d. atheromas ANS: B The most common complication of IE, and the leading cause of death, is heart failure, which results from severe valvular dysfunction. This pathologic process most commonly begins as a problem with aortic valve involvement, followed by mitral and then tricuspid valve infection. Embolization of vegetation fragments often leads to further complications, such as stroke. Myocardial infarction can occur as the result of embolism of the coronary arteries, and distal emboli can produce peripheral metastatic abscesses. WWW.GRADESMORE.COM S - The Marketplace to Buy and Sell your Study Material Page 1 of 74 GRADESMORE.COM WWW.NURSYLAB.COM 4. The interval between the presumed initiating bacteremia and the onset of symptoms of infective endocarditis (IE) is estimated to be less than in more than 80% of patients with IE. a. 1 week b. 2 weeks c. 1 month d. 2 months ANS: B It is less than two weeks in more than 80% of patients with IE. In many cases of IE that have been purported to be due to dentally induced bacteremia, the interval between the dental appointment and the diagnosis of IE has been much longer than 2 weeks (sometimes months), so it is very unlikely that the initiating bacteremia was associated with dental treatment.

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Test Bank For Little and Falace's Dental Management of
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vb the Medically Compromised Patient,
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10th Edition by Craig Miller,
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Chapters 1 - 30 vb vb vb

,Little: Dental Management of the Medically Compromised Patient, 10th Edition Test
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Bank
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Table of Contents
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PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
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Chapter 1: Patient Evaluation and Risk Assessment
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PART TWO: CARDIOVASCULAR DISEASE
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Chapter 2: Infective Endocarditis
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Chapter 3: Hypertension
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Chapter 4: Ischemic Heart Disease
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Chapter 5: Cardiac Arrhythmias
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Chapter 6: Heart Failure (or Congestive Heart Failure)
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PART THREE: PULMONARY DISEASE
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Chapter 7: Pulmonary Disease
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Chapter 8: Smoking and Tobacco Use Cessation
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Chapter 9: Sleep-Related Breathing Disorders
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PART FOUR: GASTROINTESTIAL DISEASE
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Chapter 10: Liver Disease
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Chapter 11: Gastrointestinal Disease
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PART FIVE: GENITOURINARY DISEASE
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Chapter 12: Chronic Kidney Disease and Dialysis
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Chapter 13: Sexually Transmitted Diseases
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PART SIX: ENDOCRINE AND METABOLIC DISEASE
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Chapter 14: Diabetes Mellitus
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Chapter 15: Adrenal Insufficiency
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Chapter 16: Thyroid Diseases
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Chapter 17: Pregnancy and Breast Feeding
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PART SEVEN: IMMUNOLOGIC DISEASE
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Chapter 18: AIDS, HIV Infection, and Related Conditions
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Chapter 19: Allergy
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Chapter 20: Rheumatologic and Connective Tissue Disorders
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Chapter 21: Organ and Bone Marrow Transplantation
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PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
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Chapter 22: Disorders of Red Blood Cells
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Chapter 23: Disorders of White Blood Cells
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Chapter 24: Acquired Bleeding and Hypercoagulable Disorders
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Chapter 25: Congenital Bleeding and Hypercoagulable Disorders
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Chapter 26: Cancer and Oral Care of the Patient
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PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
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Chapter 27: Neurologic Disorders
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Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness
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Chapter 29: Psychiatric Disorders
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Chapter 30: Drug and Alcohol Abuse
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, WWW.GRADESMORE.COM
Stuvia.com - The Marketplace to Buy and Sell your Studyvb vb vb vb vb vb vb vb vb

Material
vb



Page 1 of 74
Chapter 01: Patient Evaluation and Risk Assessment
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Little: Dental Management of the Medically Compromised Patient, 10th Edition
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MULTIPLE CHOICE vb




1. Elective dental care should be deferred for patients with severe, uncontrolled
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hypertension, meaning that the blood pressure is greater than or equal tomm Hg.
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a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANSWER: C vb



Elective dental care should be deferred for patients with severe, uncontrolled
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hypertension, which is blood pressure greater than or equal to 180/110 mm Hg, until the
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condition can be brought under control.
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2. The American Heart Association currently recommends antibiotic prophylaxis for a
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patient with which of the following cardiac conditions?
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a. Mitral valve prolapse vb vb



b. Prosthetic heart valve vb vb



c. Rheumatic heart disease vb vb



d. Pacemakers for cardiac arrhythmias vb vb vb




ANSWER: B vb



Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for
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many patients with heart murmurs caused by valvular disease (e.g., mitral valve prolapse,
vb vb vb vb vb vb vb vb vb vb vb vb vb



rheumatic heart disease) in an effort to prevent infective endocarditis; however, current
vb vb vb vb vb vb vb vb vb vb vb vb



guidelines omit this recommendation on the basis of accumulated scientific evidence. If a
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murmur is due to certain specific cardiac conditions (e.g., previous endocarditis, prosthetic
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heart valve, complex congenital cyanotic heart disease), the AHA continues to recommend
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antibiotic prophylaxis for most dental procedures.
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3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability
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of the body to
vb vb vb vb certain drugs, including local anesthetics and analgesics.
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a. absorb
b. distribute
c. metabolize
d. excrete
ANSWER: C vb



Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of
vb vb vb vb vb vb vb vb vb vb vb vb vb



liver function. This deficit may result in prolonged bleeding and less efficient
vb vb vb vb vb vb vb vb vb vb vb vb



metabolism of certain drugs, including local anesthetics and analgesics.
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4. Which of the following symptoms and signs is most consistent with allergy?
vb vb vb vb vb vb vb vb vb vb vb



a. Heart palpitations vb



b. Itching
c. Vomiting
d. Fainting




WWW.NURSYLAB.COM
GRADESMORE.COM

, WWW.GRADESMORE.COM
Stuvia.com - The Marketplace to Buy and Sell your Study
vb vb vb vb vb vb vb vb vb

Material
vb



Page 1 of 74
ANSWER: B vb



Symptoms and signs consistent with allergy include itching, urticaria (hives), rash, swelling,
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wheezing, angioedema, runny nose, and tearing eyes. Isolated signs and symptoms such as
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nausea, vomiting, heart palpitations, and fainting generally are not of an allergic origin but
vb vb vb vb vb vb vb vb vb vb vb vb vb vb



rather are manifestations of drug intolerance, adverse side effects, or psychogenic reactions.
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5. Which of the following is true of the patient with a history of tuberculosis?
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a. A positive result on skin testing means that the person has active TB.
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b. Most patients who become positive skin testers develop active disease.
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c. Patients with acquired immunodeficiency syndrome (AIDS) have a high
vb vb vb vb vb vb vb vb



incidence of tuberculosis.
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d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
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ANSWER: v b C
The potential coexistence of tuberculosis and acquired immunodeficiency syndrome
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(AIDS) should be explored because patients with AIDS have a high incidence of
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tuberculosis. A positive result on skin testing means specifically that the person has at
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some time been infected with TB, not necessarily that active disease is present. Most
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patients who become positive skin testers do not develop active disease. A diagnosis of
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active TB is made by chest x-ray, imaging, sputum culture, and clinical examination.
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6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine vb vb vb vb vb vb vb vb vb



users because these agents may precipitate
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a. severe hypotension vb



b. severe hypertension vb



c. respiratory depression vb



d. cessation of intestinal peristalsis vb vb vb




ANSWER: B vb



Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine usersvb vb vb vb vb vb vb vb vb vb vb



because the combination may precipitate arrhythmias, MI, or severe hypertension.
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7. It has been shown that the risk for occurrence of a serious perioperative cardiovascular
vb vb vb vb vb vb vb vb vb vb vb vb vb



event (e.g., MI, heart failure) is increased in patients who are unable to meet a -MET
vb vb vb vb vb vb vb vb vb vb vb vb vb vb vb vb



(metabolic equivalent of task) demand during normal daily activity.
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a. 4
b. 6
c. 8
d. 10
ANSWER: A vb



Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a flight of
vb vb vb vb vb vb vb vb vb vb vb vb vb vb vb



stairs. Activities requiring greater than 10 METs include swimming and singles tennis. An
vb vb vb vb vb vb vb vb vb vb vb vb vb



exercise capacity of 10 to 13 METs indicates excellent physical conditioning.
vb vb vb vb vb vb vb vb vb vb vb




8. Which of the following alterations in the fingernails is associated with cirrhosis?
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a. Yellowing
b. Clubbing
c. White discoloration vb



d. Splinter hemorrhages vb




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