PEDIATRICS MIDTERM EXAM QUESTIONS AND ANSWERS 2025
GRADED A+
Which method of alternative behavior management technique has been used to reduce pain
and distress for needle-related procedural pain?
Hypnosis
If a patient has great rapport and compliance, what Frankl score would they be?
4
If a patient has compliance with treatment but is apprehensive or anxious, what Frankl score
would they be?
3
If a patient is reluctant and uncooperative, resulting in the treatment being compromised, what
Frankl score would they be?
2
If a patient refuses treatment or is unable to cooperate, what Frankl score would they be?
1
What is the mechanism of action of local anesthetics?
Binds to Na channel, blocking depolarization
,Lack of Na influx depresses the rate of depolarization so that the threshold potential is never
reached, blocking a nerve impulse (T/F).
True
In low pH, what form dominates in regards to local anesthetic?
Cationic form, RNH
In high pH, what form dominates in regards to local anesthetic?
Free base, RN + H
Inflammatory processes _______ pH, __________ anesthetic action because the free base form
of the anesthetic cannot cross.
Lowers ; inhibits
What type of LA is metabolized by pseudocholinesterase? Typically has what kind of duration
and onset?
Ester ; short acting, slow onset (10-15 mins)
What type of LA is metabolized by the liver? Typically has what kind of duration and onset?
Amide ; long acting, short onset (3-5 mins)
Patient suffering from what disease would have a difficult time eliminating LA?
,Renal diseases
Plain mepivacaine is recommended in children (T/F).
False
Patients with cardiovascular disease should not exceed how many milligrams of epinephrine?
0.04 mg
Why do vasoconstrictors decrease risk of toxic effects of LA?
They are absorbed into the circulatory system
Always use LA with vasoconstrictors when treating children (T/F).
True
What anesthetic is the gold standard?
2% Lidocaine with 1:100,000E
What anesthetic is not FDA approved for kids under 4?
4% Articaine with 1:100,000E
, What is the maximum recommended dose for lidocaine?
4.4mg/kg
What is the maximum recommended dose for articaine?
7mg/kg
What is the duration for lidocaine in pulpal and soft tissue?
60 mins ; 3-5 hrs
What is the duration for mepivacaine in pulpal and soft tissue?
20-40 mins ; 2-3 hrs
What is the duration for prilocaine in pulpal and soft tissue?
60-90 mins ; 3-8 hrs
What is the duration for articaine in pulpal and soft tissue?
60-75 mins ; 180-360 mins
How many pounds are in 1 kilograms?
2.2 lbs
What is the maximum amount of carpules of lidocaine you can give to a patient weighing 44
lbs?
GRADED A+
Which method of alternative behavior management technique has been used to reduce pain
and distress for needle-related procedural pain?
Hypnosis
If a patient has great rapport and compliance, what Frankl score would they be?
4
If a patient has compliance with treatment but is apprehensive or anxious, what Frankl score
would they be?
3
If a patient is reluctant and uncooperative, resulting in the treatment being compromised, what
Frankl score would they be?
2
If a patient refuses treatment or is unable to cooperate, what Frankl score would they be?
1
What is the mechanism of action of local anesthetics?
Binds to Na channel, blocking depolarization
,Lack of Na influx depresses the rate of depolarization so that the threshold potential is never
reached, blocking a nerve impulse (T/F).
True
In low pH, what form dominates in regards to local anesthetic?
Cationic form, RNH
In high pH, what form dominates in regards to local anesthetic?
Free base, RN + H
Inflammatory processes _______ pH, __________ anesthetic action because the free base form
of the anesthetic cannot cross.
Lowers ; inhibits
What type of LA is metabolized by pseudocholinesterase? Typically has what kind of duration
and onset?
Ester ; short acting, slow onset (10-15 mins)
What type of LA is metabolized by the liver? Typically has what kind of duration and onset?
Amide ; long acting, short onset (3-5 mins)
Patient suffering from what disease would have a difficult time eliminating LA?
,Renal diseases
Plain mepivacaine is recommended in children (T/F).
False
Patients with cardiovascular disease should not exceed how many milligrams of epinephrine?
0.04 mg
Why do vasoconstrictors decrease risk of toxic effects of LA?
They are absorbed into the circulatory system
Always use LA with vasoconstrictors when treating children (T/F).
True
What anesthetic is the gold standard?
2% Lidocaine with 1:100,000E
What anesthetic is not FDA approved for kids under 4?
4% Articaine with 1:100,000E
, What is the maximum recommended dose for lidocaine?
4.4mg/kg
What is the maximum recommended dose for articaine?
7mg/kg
What is the duration for lidocaine in pulpal and soft tissue?
60 mins ; 3-5 hrs
What is the duration for mepivacaine in pulpal and soft tissue?
20-40 mins ; 2-3 hrs
What is the duration for prilocaine in pulpal and soft tissue?
60-90 mins ; 3-8 hrs
What is the duration for articaine in pulpal and soft tissue?
60-75 mins ; 180-360 mins
How many pounds are in 1 kilograms?
2.2 lbs
What is the maximum amount of carpules of lidocaine you can give to a patient weighing 44
lbs?
