ANESTHESIA BOARD REVIEW
QUESTIONS AND ANSWERS
An allergy to sulfites would be an absolute contraindication to the use of:
A. Mepivacaine 3%
B. Citanest Plain
C. Lidocaine 2%
D. Lidocaine 3% - Correct Answers -C. lidocaine 2%
Which of the following is a name for prilocaine?
A. xylocaine
B. septocaine
C. scandonest
D. citanest
E. marcaine - Correct Answers -D. citanest
Prilocaine is biotransformed by the:
A. liver
B. liver and blood
C. liver, kidneys, and lungs
D. liver, lungs, and large intestines - Correct Answers -C. liver, kidneys, and lungs
The anatomical landmark for the MSA injection is:
A. Above the maxillary first premolar
B. Above the maxillary second premolar
C. Above the mesiobuccal cusp of the maxillary first molar
D. None of the above - Correct Answers -B. above the maxillary second premolar
The long buccal injection anesthetizes which areas?
A. Maxillary tissue to the midline
B. Retromolar area
C. Tissue just buccal to the mandibular molars and premolars
D. Mandibular labial tissue from cuspid to cuspid - Correct Answers -C. tissue just
buccal to the mandibular molars and premolars
Which of the following agents would be best to administer, if one were to anticipate both
severe and prolonged post-operative dental pain?
,A. Mepivacaine (Carbocaine)
B. Prilocaine with epinephrine (Citanest Forte)
C. Bupivacaine with epinephrine (Marcaine)
D. Lidocaine with epinephrine (Xylocaine)
E. None of the above - Correct Answers -C. Bupivacaine with epinephrine (Marcaine)
Because the patient complains of inadequate "numbing," eight more cartridges of
lidocaine 2% with epinephrine 1:100,000 vasoconstrictor are injected. The patient then
begins talking incessantly, exhibiting restlessness and fasciculations (twitching) of the
extremities, and then becomes sleepy and suffers a convulsion. The blood pressure and
heart rate are depressed. These symptoms are most likely caused by:
A. A toxicity reaction to the local anesthetic agent
B. A toxic reaction to the vasoconstrictor
C. A fear reaction
D. The fact that the patient is epileptic
E. None of the above - Correct Answers -A. a toxicity reaction to the local anesthetic
agent
Local anesthetic dosages should be reduced for which of the following conditions?
A. Frail elderly
B. Very young children
C. Liver disease
D. All of the above
E. None of the above - Correct Answers -D. all of the above
What is the primary reason for a burning sensation when the anesthetic agent is
injected?
A. pH of the solution
B. Psychogenic
C. Developing hematoma
D. Contaminated solution - Correct Answers -A. pH of the solution
Your client is 75 years old and is of average height and weight. His health history
includes high blood pressure for which he takes medication, and arthritis for which he
takes aspirin daily. He is in the office for restorative treatment on the facial of #27, 28,
and 29. Which injection would be indicated?
A. RIA
B. LPSA
C. R Incisive
4. R mental - Correct Answers -C. R incisive
Your client is 75 years old and is of average height and weight. His health history
includes high blood pressure for which he takes medication, and arthritis for which he
takes aspirin daily. He is in the office for restorative treatment on the facial of #27, 28,
and 29.What anesthetic will you choose?
A. Mepivacaine 3%
,B. Prilocaine 4% w/epi.
C. Lidocaine 2% w/ epi
D. Bupivacaine - Correct Answers -C. lidocaine 2% with epi
How many milligrams of mepivacaine is in 3 cartridges of a 3% solution?
A. 30 mg
B. 30 mg
C. 72 mg
D. 108 mg
E. 162 mg - Correct Answers -E. 162 mg
[T:F] A rapid rate of injection will increase the rate of absorption at the site of injection,
thereby decreasing local anesthetic blood levels - Correct Answers -false: increasing
the rate increases local anesthetic blood levels
The most common emergency in relation to local anesthesia that will be encountered is:
A. Allergy to the anesthetic
B. Syncope
C. Hyperactivity
D. Shock - Correct Answers -B. syncope
What size and gauge needle is used most commonly for the MSA?
A. 30 gauge extra short
B. 27 gauge long
C. 25 gauge short
D. 27 gauge short - Correct Answers -27 gauge short
For the MSA injection to be successful, where should the anesthetic solution be
deposited?
A. in the mucobuccal fold
B. into the attached gingiva
C. at apex of premolars
D. at the infraorbital foramen - Correct Answers -C. apex of the premolars
[T:F] Vasoconstrictors are absolutely contraindicated in a well-controlled cardiovascular
patient. - Correct Answers -false
The action of epinephrine when combined with a local anesthetic is to:
A. increase the amount of local anesthetic needed for an effect
B. decrease the effective length of action of an anesthetic
C. enhanced circulation and wash the anesthetic from site of action more quickly
D. increase the duration of anesthesia - Correct Answers -D. increase the duration of
anesthesia
Epinephrine is added to local anesthetic solutions to:
, A. Prevent circulatory collapse if the local anesthetic is accidentally injected
intravenously
B. Prevent asthmatic attacks if the local anesthetic is accidentally injected intravenously
C. Increase the rate of diffusion and absorption from the injection site
D. Decrease the rate of diffusion and absorption from the injection site - Correct
Answers -D. Decrease the rate of diffusion and absorption from the injection site
Hematomas are most likely to occur with which of the following injections?
A. PSA
B. MSA
C. ASA
D. All of the above
E. None of the above - Correct Answers -A. PSA
To facilitate penetration of the needle, tissues at the site of an injection should typically
be:
A. Flaccid
B. Taut
C. Bunched
D. Depressed - Correct Answers -b. taut
For a healthy adult male patient of average size, what is the maximum safe dose of
mepivicaine 3% without epinephrine? - Correct Answers -400 mg
[T:F] The excretion of prilocaine is through the kidney - Correct Answers -true
What is the one absolute contradiction for the use of prilocaine?
A. periodontitis
B. anemia
C. allergy
D. asthma - Correct Answers -C. allergy
What is one of the symptoms of methemoglobinemia?
A. hyperactivity
B. anxiety
C. cyanotic appearance, usually in the nail beds and lips
D. depression - Correct Answers -C. cyanotic appearance, usually in the nail beds and
lips
A dental hygienist gives an inferior alveolar nerve block injection on the left side. The
left central and lateral incisors remain sensitive. What is the best explanation for this?
A. an insufficient amount of solution was given
B. the needle placement was incorrect
C. the sensitive teeth are receiving innervation from the right side
D. the sensitive teeth are receiving innervation from the cervical plexus - Correct
Answers -C. the sensitive teeth are receiving innervation from the right side
QUESTIONS AND ANSWERS
An allergy to sulfites would be an absolute contraindication to the use of:
A. Mepivacaine 3%
B. Citanest Plain
C. Lidocaine 2%
D. Lidocaine 3% - Correct Answers -C. lidocaine 2%
Which of the following is a name for prilocaine?
A. xylocaine
B. septocaine
C. scandonest
D. citanest
E. marcaine - Correct Answers -D. citanest
Prilocaine is biotransformed by the:
A. liver
B. liver and blood
C. liver, kidneys, and lungs
D. liver, lungs, and large intestines - Correct Answers -C. liver, kidneys, and lungs
The anatomical landmark for the MSA injection is:
A. Above the maxillary first premolar
B. Above the maxillary second premolar
C. Above the mesiobuccal cusp of the maxillary first molar
D. None of the above - Correct Answers -B. above the maxillary second premolar
The long buccal injection anesthetizes which areas?
A. Maxillary tissue to the midline
B. Retromolar area
C. Tissue just buccal to the mandibular molars and premolars
D. Mandibular labial tissue from cuspid to cuspid - Correct Answers -C. tissue just
buccal to the mandibular molars and premolars
Which of the following agents would be best to administer, if one were to anticipate both
severe and prolonged post-operative dental pain?
,A. Mepivacaine (Carbocaine)
B. Prilocaine with epinephrine (Citanest Forte)
C. Bupivacaine with epinephrine (Marcaine)
D. Lidocaine with epinephrine (Xylocaine)
E. None of the above - Correct Answers -C. Bupivacaine with epinephrine (Marcaine)
Because the patient complains of inadequate "numbing," eight more cartridges of
lidocaine 2% with epinephrine 1:100,000 vasoconstrictor are injected. The patient then
begins talking incessantly, exhibiting restlessness and fasciculations (twitching) of the
extremities, and then becomes sleepy and suffers a convulsion. The blood pressure and
heart rate are depressed. These symptoms are most likely caused by:
A. A toxicity reaction to the local anesthetic agent
B. A toxic reaction to the vasoconstrictor
C. A fear reaction
D. The fact that the patient is epileptic
E. None of the above - Correct Answers -A. a toxicity reaction to the local anesthetic
agent
Local anesthetic dosages should be reduced for which of the following conditions?
A. Frail elderly
B. Very young children
C. Liver disease
D. All of the above
E. None of the above - Correct Answers -D. all of the above
What is the primary reason for a burning sensation when the anesthetic agent is
injected?
A. pH of the solution
B. Psychogenic
C. Developing hematoma
D. Contaminated solution - Correct Answers -A. pH of the solution
Your client is 75 years old and is of average height and weight. His health history
includes high blood pressure for which he takes medication, and arthritis for which he
takes aspirin daily. He is in the office for restorative treatment on the facial of #27, 28,
and 29. Which injection would be indicated?
A. RIA
B. LPSA
C. R Incisive
4. R mental - Correct Answers -C. R incisive
Your client is 75 years old and is of average height and weight. His health history
includes high blood pressure for which he takes medication, and arthritis for which he
takes aspirin daily. He is in the office for restorative treatment on the facial of #27, 28,
and 29.What anesthetic will you choose?
A. Mepivacaine 3%
,B. Prilocaine 4% w/epi.
C. Lidocaine 2% w/ epi
D. Bupivacaine - Correct Answers -C. lidocaine 2% with epi
How many milligrams of mepivacaine is in 3 cartridges of a 3% solution?
A. 30 mg
B. 30 mg
C. 72 mg
D. 108 mg
E. 162 mg - Correct Answers -E. 162 mg
[T:F] A rapid rate of injection will increase the rate of absorption at the site of injection,
thereby decreasing local anesthetic blood levels - Correct Answers -false: increasing
the rate increases local anesthetic blood levels
The most common emergency in relation to local anesthesia that will be encountered is:
A. Allergy to the anesthetic
B. Syncope
C. Hyperactivity
D. Shock - Correct Answers -B. syncope
What size and gauge needle is used most commonly for the MSA?
A. 30 gauge extra short
B. 27 gauge long
C. 25 gauge short
D. 27 gauge short - Correct Answers -27 gauge short
For the MSA injection to be successful, where should the anesthetic solution be
deposited?
A. in the mucobuccal fold
B. into the attached gingiva
C. at apex of premolars
D. at the infraorbital foramen - Correct Answers -C. apex of the premolars
[T:F] Vasoconstrictors are absolutely contraindicated in a well-controlled cardiovascular
patient. - Correct Answers -false
The action of epinephrine when combined with a local anesthetic is to:
A. increase the amount of local anesthetic needed for an effect
B. decrease the effective length of action of an anesthetic
C. enhanced circulation and wash the anesthetic from site of action more quickly
D. increase the duration of anesthesia - Correct Answers -D. increase the duration of
anesthesia
Epinephrine is added to local anesthetic solutions to:
, A. Prevent circulatory collapse if the local anesthetic is accidentally injected
intravenously
B. Prevent asthmatic attacks if the local anesthetic is accidentally injected intravenously
C. Increase the rate of diffusion and absorption from the injection site
D. Decrease the rate of diffusion and absorption from the injection site - Correct
Answers -D. Decrease the rate of diffusion and absorption from the injection site
Hematomas are most likely to occur with which of the following injections?
A. PSA
B. MSA
C. ASA
D. All of the above
E. None of the above - Correct Answers -A. PSA
To facilitate penetration of the needle, tissues at the site of an injection should typically
be:
A. Flaccid
B. Taut
C. Bunched
D. Depressed - Correct Answers -b. taut
For a healthy adult male patient of average size, what is the maximum safe dose of
mepivicaine 3% without epinephrine? - Correct Answers -400 mg
[T:F] The excretion of prilocaine is through the kidney - Correct Answers -true
What is the one absolute contradiction for the use of prilocaine?
A. periodontitis
B. anemia
C. allergy
D. asthma - Correct Answers -C. allergy
What is one of the symptoms of methemoglobinemia?
A. hyperactivity
B. anxiety
C. cyanotic appearance, usually in the nail beds and lips
D. depression - Correct Answers -C. cyanotic appearance, usually in the nail beds and
lips
A dental hygienist gives an inferior alveolar nerve block injection on the left side. The
left central and lateral incisors remain sensitive. What is the best explanation for this?
A. an insufficient amount of solution was given
B. the needle placement was incorrect
C. the sensitive teeth are receiving innervation from the right side
D. the sensitive teeth are receiving innervation from the cervical plexus - Correct
Answers -C. the sensitive teeth are receiving innervation from the right side
