CDCA Local Anesthesia Review with
Complete Solutions
. Which of the following injections should one apply pressure to the injection site after
administering an injection in order to provide better penetration into the bone by the
anesthetic solution? - ANSWER-Mental-incisive (MI) nerve block
. Which of the following local anesthetic agents has the shortest half-life?
A. articaine
B. lidocaine
C. mepivacaine
D. prilocaine - ANSWER-articaine
. Which of the following local anesthetics causes the least amount of vasodilation?
A. articaine
B. lidocaine
C. mepivacaine
D. prilocaine - ANSWER-mepivacaine
# of cartridges of bupivacaine needed to reach MRD - ANSWER-10
# of cartridges of lidocaine needed to reach MRD - ANSWER-13.8
# of cartridges of mepivacaine 2% needed to reach MRD - ANSWER-11.1
# of cartridges of mepivacaine plain needed to reach MRD - ANSWER-7.4
# of cartridges of prilocaine needed to reach MRD - ANSWER-8.3
1:100,000 contains how many mg? - ANSWER-0.018 mg
1:200,000 contains how many mg? - ANSWER-0.009mg
1:50,000 epinephrine contains how many mg? - ANSWER-0.36
2% lidocaine plain duration of action on pulpal tissue is _ and soft tissue is _ -
ANSWER-pulpal: 5-10 mins
soft tissue: 60-120 minutes
fastest duration of action
2% lidocaine with 1:100,000 epi duration of action on pulpal tissue is __ and soft tissue
is __ - ANSWER-pulpal: 60 mins
soft tissue: 180-300 mins
,2% lidocaine with 1:50,000 epi duration of action on pulpal tissue is _ and soft tissue is
_ - ANSWER-pulpal: 60 mins
soft tissue: 180-300 mins (same as 2% lidocaine with 1:100,000 epi)
20% Benzocaine topical anesthetic is what classification of local anesthetic drug? -
ANSWER-ester
A 25-gauge needle is recommended over a 30-gauge needle for administering most
dental injections
because there is less chance of needle breakage and less deflection with a 25 gauge
needle. - ANSWER-true
A 54 year old white male presents with a history of moderate heart disease and
hypertension. His ASA
classification is III. What is the maximum recommended dose of epinephrine this
patient should receive? - ANSWER-.04 mg
A bubble found in anesthetic cartridges that do not have an extruded rubber stopper is
________________. - ANSWER-nitrogen gas
A cartridge that leaks solution while administering an injection is most likely caused by
the needle
perforating end _____________. - ANSWER-piercing the cartridge diaphragm at the
junction of the aluminum cap
A concentration of 1:100,000 epinephrine means that there is ____ of epinephrine per 1
mL of solution. - ANSWER-.01 mg
A healthy 18 year old male who weighs 150 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-8.8
A healthy 20 year old female who weighs 100 lbs. presents to your office for dental
treatment. The MRD
for lidocaine is 2.0 mg/lb. What is the maximum number of 1.7 ml cartridges of 2%
lidocaine with
1:100,000 epinephrine that can be administered to this patient in one appointment? -
ANSWER-5.9
A healthy 20 year old female who weighs 120 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-7.1
,A healthy 9 year old female who weighs 80 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-4.7
A local anesthetics without a hydrophilic part in their molecular structure are only useful
as a __________ - ANSWER-topical
a patient calls a day after tx and cant open, what is the likely cause? - ANSWER-trismus
(most likely) or infection
a patients BP drops and they have immediate allergic reaction - ANSWER-administer
epi
a positive aspiration when administering a PSA is due to what? - ANSWER-aspirating
hemorrhage caused by injection
A red colored ring on the mylar strip around a local anesthetic cartridge indicates that it
is ___________. - ANSWER-2% Lidocaine with 1:100,000 epinephrine
A silver ring on the mylar label on a local anesthetic cartridge indicates that it contains
which of the
following local anesthetic agents? - ANSWER-4% Septocaine with 1:200,000
epinephrine
According to research, 50-80% of dental fear and anxiety is based on experiences that
occurred during a patient's childhood or adolescence - ANSWER-True
actions of vasopressor (vasoconstrictors) - ANSWER--increase duraition of LA,
hemostiasis, reduce chance of toxicity, decrease blood flow to site of administration,
slowed absorption resulting in lower blood levels
After administering an inferior alveolar (IA) nerve block with injection of two 3.6 ml
cartridges of local anesthetic tooth #19 is not profoundly anesthetized. Which of the
following injections should one consider administering next to attempt to achieve
profound anesthesia of tooth #19? - ANSWER-. Gow-Gates (GG) nerve block
or
Local infiltration on the lingual border of the mandible distal to tooth #19
After administration of lidocaine with epinephrine, your patient becomes apprehensive,
talkative and
, exhibits slurred speech. In a few minutes, the patient reports feeling drowsy, circumoral
anesthesia and
soon becomes unconscious. This most likely represents ____________. - ANSWER-
local anesthesia overdose
after an infraorbital injection, the patients cheeks turn white. What happened? -
ANSWER-blanching or vasoconstriction of blood vessels in that areas
after an injection the patient complains of itching and their throat feeling swollen. what
treatment would you provide? - ANSWER-epinephrine
After exiting the infraorbital foramen, the second division of the trigeminal nerve (V-2)
divides into the __________________ nerves. - ANSWER-anterior superior alveolar
(ASA) and middle superior alveolar (MSA)
After giving a posterior superior alveolar (PSA) nerve block, the first molar remains
sensitive, but the
second and third molars are anesthetized. The best explanation would be that
________________. - ANSWER-the mesial buccal root of the 1st molar is innervated by
the MSA
after the infraorbital injection, the patient's cheek turns white. what happened? -
ANSWER-blanching or vasoconstriction of blood vessels in the area
all arteries leading to the oral cavity receive blood from what? - ANSWER-external
carotid (most are direct or indirect branches from the maxillary artery with the exception
of the lingula -- this is a direct branch from the external carotid)
allergic reaction management - ANSWER-epi for immediate, benadryl for deylayed
amide onset and duration - ANSWER-fast onset and longer duration
amides - ANSWER-biotransformed in liver by by hepatic microsomal enzymes
lidocaine,mepivicaine,prilocaine,articaine,bupivicaine
amount of epi in a solution - ANSWER-1% solution = 10 X 1.8 (1.7) =18 mg (17mg)
2% solution = 20 X 1.8 (1.7)= 36mg (34mg)
3% solution= 30 X 1.8 (1.7)= 54mg (51mg)
An anesthetic cartridge contains _______ ml of solution. - ANSWER-1.8 ml
anesthetic deposition rate - ANSWER-2 min a cartrigde or 1min a 1ml
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - ANSWER-middle oft he maxillary second molar
and the middle of the third molar in about 80-90% of patients.
Complete Solutions
. Which of the following injections should one apply pressure to the injection site after
administering an injection in order to provide better penetration into the bone by the
anesthetic solution? - ANSWER-Mental-incisive (MI) nerve block
. Which of the following local anesthetic agents has the shortest half-life?
A. articaine
B. lidocaine
C. mepivacaine
D. prilocaine - ANSWER-articaine
. Which of the following local anesthetics causes the least amount of vasodilation?
A. articaine
B. lidocaine
C. mepivacaine
D. prilocaine - ANSWER-mepivacaine
# of cartridges of bupivacaine needed to reach MRD - ANSWER-10
# of cartridges of lidocaine needed to reach MRD - ANSWER-13.8
# of cartridges of mepivacaine 2% needed to reach MRD - ANSWER-11.1
# of cartridges of mepivacaine plain needed to reach MRD - ANSWER-7.4
# of cartridges of prilocaine needed to reach MRD - ANSWER-8.3
1:100,000 contains how many mg? - ANSWER-0.018 mg
1:200,000 contains how many mg? - ANSWER-0.009mg
1:50,000 epinephrine contains how many mg? - ANSWER-0.36
2% lidocaine plain duration of action on pulpal tissue is _ and soft tissue is _ -
ANSWER-pulpal: 5-10 mins
soft tissue: 60-120 minutes
fastest duration of action
2% lidocaine with 1:100,000 epi duration of action on pulpal tissue is __ and soft tissue
is __ - ANSWER-pulpal: 60 mins
soft tissue: 180-300 mins
,2% lidocaine with 1:50,000 epi duration of action on pulpal tissue is _ and soft tissue is
_ - ANSWER-pulpal: 60 mins
soft tissue: 180-300 mins (same as 2% lidocaine with 1:100,000 epi)
20% Benzocaine topical anesthetic is what classification of local anesthetic drug? -
ANSWER-ester
A 25-gauge needle is recommended over a 30-gauge needle for administering most
dental injections
because there is less chance of needle breakage and less deflection with a 25 gauge
needle. - ANSWER-true
A 54 year old white male presents with a history of moderate heart disease and
hypertension. His ASA
classification is III. What is the maximum recommended dose of epinephrine this
patient should receive? - ANSWER-.04 mg
A bubble found in anesthetic cartridges that do not have an extruded rubber stopper is
________________. - ANSWER-nitrogen gas
A cartridge that leaks solution while administering an injection is most likely caused by
the needle
perforating end _____________. - ANSWER-piercing the cartridge diaphragm at the
junction of the aluminum cap
A concentration of 1:100,000 epinephrine means that there is ____ of epinephrine per 1
mL of solution. - ANSWER-.01 mg
A healthy 18 year old male who weighs 150 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-8.8
A healthy 20 year old female who weighs 100 lbs. presents to your office for dental
treatment. The MRD
for lidocaine is 2.0 mg/lb. What is the maximum number of 1.7 ml cartridges of 2%
lidocaine with
1:100,000 epinephrine that can be administered to this patient in one appointment? -
ANSWER-5.9
A healthy 20 year old female who weighs 120 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-7.1
,A healthy 9 year old female who weighs 80 lbs. presents to your office for dental
treatment. What is the
maximum number of 1.7 ml cartridges of 2% lidocaine with 1:100,000 epinephrine that
can be
administered to this patient in one appointment? - ANSWER-4.7
A local anesthetics without a hydrophilic part in their molecular structure are only useful
as a __________ - ANSWER-topical
a patient calls a day after tx and cant open, what is the likely cause? - ANSWER-trismus
(most likely) or infection
a patients BP drops and they have immediate allergic reaction - ANSWER-administer
epi
a positive aspiration when administering a PSA is due to what? - ANSWER-aspirating
hemorrhage caused by injection
A red colored ring on the mylar strip around a local anesthetic cartridge indicates that it
is ___________. - ANSWER-2% Lidocaine with 1:100,000 epinephrine
A silver ring on the mylar label on a local anesthetic cartridge indicates that it contains
which of the
following local anesthetic agents? - ANSWER-4% Septocaine with 1:200,000
epinephrine
According to research, 50-80% of dental fear and anxiety is based on experiences that
occurred during a patient's childhood or adolescence - ANSWER-True
actions of vasopressor (vasoconstrictors) - ANSWER--increase duraition of LA,
hemostiasis, reduce chance of toxicity, decrease blood flow to site of administration,
slowed absorption resulting in lower blood levels
After administering an inferior alveolar (IA) nerve block with injection of two 3.6 ml
cartridges of local anesthetic tooth #19 is not profoundly anesthetized. Which of the
following injections should one consider administering next to attempt to achieve
profound anesthesia of tooth #19? - ANSWER-. Gow-Gates (GG) nerve block
or
Local infiltration on the lingual border of the mandible distal to tooth #19
After administration of lidocaine with epinephrine, your patient becomes apprehensive,
talkative and
, exhibits slurred speech. In a few minutes, the patient reports feeling drowsy, circumoral
anesthesia and
soon becomes unconscious. This most likely represents ____________. - ANSWER-
local anesthesia overdose
after an infraorbital injection, the patients cheeks turn white. What happened? -
ANSWER-blanching or vasoconstriction of blood vessels in that areas
after an injection the patient complains of itching and their throat feeling swollen. what
treatment would you provide? - ANSWER-epinephrine
After exiting the infraorbital foramen, the second division of the trigeminal nerve (V-2)
divides into the __________________ nerves. - ANSWER-anterior superior alveolar
(ASA) and middle superior alveolar (MSA)
After giving a posterior superior alveolar (PSA) nerve block, the first molar remains
sensitive, but the
second and third molars are anesthetized. The best explanation would be that
________________. - ANSWER-the mesial buccal root of the 1st molar is innervated by
the MSA
after the infraorbital injection, the patient's cheek turns white. what happened? -
ANSWER-blanching or vasoconstriction of blood vessels in the area
all arteries leading to the oral cavity receive blood from what? - ANSWER-external
carotid (most are direct or indirect branches from the maxillary artery with the exception
of the lingula -- this is a direct branch from the external carotid)
allergic reaction management - ANSWER-epi for immediate, benadryl for deylayed
amide onset and duration - ANSWER-fast onset and longer duration
amides - ANSWER-biotransformed in liver by by hepatic microsomal enzymes
lidocaine,mepivicaine,prilocaine,articaine,bupivicaine
amount of epi in a solution - ANSWER-1% solution = 10 X 1.8 (1.7) =18 mg (17mg)
2% solution = 20 X 1.8 (1.7)= 36mg (34mg)
3% solution= 30 X 1.8 (1.7)= 54mg (51mg)
An anesthetic cartridge contains _______ ml of solution. - ANSWER-1.8 ml
anesthetic deposition rate - ANSWER-2 min a cartrigde or 1min a 1ml
Antero-posteriorly, the greater palatine foramen is located between the
___________________________. - ANSWER-middle oft he maxillary second molar
and the middle of the third molar in about 80-90% of patients.
