LITTLE AND FALACE'S DENTAL
MANAGEMENT OF THE MEDICALLY
COMPROMISED PATIENT
9TH EDITION
TEST BANK
,Little: Dental Management of the Medically Compromised Patient, 9th Edition Test Bank
Table of Contents
PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
Chapter 1: Patient Evaluation and Risk Assessment
PART TWO: CARDIOVASCULAR DISEASE
Chapter 2: Infective Endocarditis
Chapter 3: Hypertension
Chapter 4: Ischemic Heart Disease
Chapter 5: Cardiac Arrhythmias
Chapter 6: Heart Failure (or Congestive Heart Failure)
PART THREE: PULMONARY DISEASE
Chapter 7: Pulmonary Disease
Chapter 8: Smoking and Tobacco Use Cessation
Chapter 9: Sleep-Related Breathing Disorders PART
FOUR: GASTROINTESTIAL DISEASE
Chapter 10: Liver Disease
Chapter 11: Gastrointestinal Disease
PART FIVE: GENITOURINARY DISEASE
Chapter 12: Chronic Kidney Disease and Dialysis
Chapter 13: Sexually Transmitted Diseases
PART SIX: ENDOCRINE AND METABOLIC DISEASE
Chapter 14: Diabetes Mellitus Chapter
15: Adrenal Insufficiency Chapter 16:
Thyroid Diseases
Chapter 17: Pregnancy and Breast Feeding
PART SEVEN: IMMUNOLOGIC DISEASE
Chapter 18: AIDS, HIV Infection, and Related Conditions Chapter 19:
Allergy
Chapter 20: Rheumatologic and Connective Tissue Disorders
Chapter 21: Organ and Bone Marrow Transplantation
PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
Chapter 22: Disorders of Red Blood Cells Chapter 23:
Disorders of White Blood Cells
Chapter 24: Acquired Bleeding and Hypercoagulable Disorders Chapter
25: Congenital Bleeding and Hypercoagulable Disorders Chapter 26:
Cancer and Oral Care of the Patient
PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
Chapter 27: Neurologic Disorders
Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness Chapter 29:
Psychiatric Disorders
Chapter 30: Drug and Alcohol Abuse
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Page 1 of 74
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
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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