DIAGNOSTIC SKILLS OSCE FINAL PAPER
UPDATED COMPLETE QUESTIONS AND
CORRECT ANSWERS BUNDLED REVIEW
GUIDE
●● 41-yo woman, pregnant; prev rheumatic fever with heart murmur (no
valvular abnormality); allergy to penicillin. Positive history of infective
endocarditis. Does she need to pre med?
- yes
- no
Answer: yes
- REVIEW HEALTH HISTORY - on my exam, this patient had a
previous history of infective endocarditis. Pre-med IS indicated
- many of the OSCE quizlets say no....
●● Pre-med options for pregnant woman w/hx of infective endocarditis
and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin
Answer: *clarithromycin*
,I may not be correct, the correct option may be cephalexin. however I
chose clarithromycin due to penicillin allergy, cross reaction with
cephalosporins, and since clindamycin/erythromycin/azthromycin were
not options. Ciproflaxacin is contraindicated in pregnancy. article for
reference https://www.parents.com/pregnancy/my-body/is-it-
safe/antibiotics-and-pregnancy/
●● What procedure can a dentist perform without consulting MD if a
patient is currently taking bisphosphonates?
- endo therapy
- prophy and scaling
- extraction
- occlusal restoration
Answer: *occlusal restoration*
although the main HELL NO is extraction, completing endo therapy
increases risk if the apex is compromised/damaged during therapy. I
teetered on prophy and scaling, but since it did not specify
supragingival, decided that the risk of scaling can negatively affect the
periosteum of a bisphosphanate patient. ADA recommendations:
http://www.centreoms.com/admin/storage/news/ADA%20Recommendat
ions%20for%20Treatment%20of%20Patients%20on%20Bisphosphon.p
df
●● Pregnant person afraid of needles - stress management by putting
patient in what position when in your chair (BEFORE they even get to
the point of passing out)?
,- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- turn the patient, preferably to the left side
Answer: turn the patient, preferably to the left side
- Best preventative treatment for supine hypotension is to turn the
patient, preferably to the left side, to displace the uterus away from the
inferior vena cava. The patient can also be placed in a sitting position
with the knees flexed.
●● 6 months pregnant had bleeding gums and mobile teeth, how should
they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo
Answer: conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral
hygiene) to prevent plaque growth. The plaque can enter blood stream
and stimulate patient's immune system to produce prostaglandins, which
can trigger uterine contraction leading to early labor, premature birth,
and a small baby.
, ●● Pregnant lady with a diastema in between #8 and #9 with deep
probing depth and class 1 mobility on 8 and 9. What is the reason for
diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy
Answer: chronic perio
- increased incidence of periodontal disease during pregnancy => must
emphasize good oral hygiene, and remove all their plaque so it doesn't
lead to premature birth / low birth weight
●● Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
Answer: age 0-5 years
- remember that PERMANENT dentition does not begin calcification
until birth
●● Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type
of drugs?
- benzodiazepines
- NSAIDS
UPDATED COMPLETE QUESTIONS AND
CORRECT ANSWERS BUNDLED REVIEW
GUIDE
●● 41-yo woman, pregnant; prev rheumatic fever with heart murmur (no
valvular abnormality); allergy to penicillin. Positive history of infective
endocarditis. Does she need to pre med?
- yes
- no
Answer: yes
- REVIEW HEALTH HISTORY - on my exam, this patient had a
previous history of infective endocarditis. Pre-med IS indicated
- many of the OSCE quizlets say no....
●● Pre-med options for pregnant woman w/hx of infective endocarditis
and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciproflaxacin
Answer: *clarithromycin*
,I may not be correct, the correct option may be cephalexin. however I
chose clarithromycin due to penicillin allergy, cross reaction with
cephalosporins, and since clindamycin/erythromycin/azthromycin were
not options. Ciproflaxacin is contraindicated in pregnancy. article for
reference https://www.parents.com/pregnancy/my-body/is-it-
safe/antibiotics-and-pregnancy/
●● What procedure can a dentist perform without consulting MD if a
patient is currently taking bisphosphonates?
- endo therapy
- prophy and scaling
- extraction
- occlusal restoration
Answer: *occlusal restoration*
although the main HELL NO is extraction, completing endo therapy
increases risk if the apex is compromised/damaged during therapy. I
teetered on prophy and scaling, but since it did not specify
supragingival, decided that the risk of scaling can negatively affect the
periosteum of a bisphosphanate patient. ADA recommendations:
http://www.centreoms.com/admin/storage/news/ADA%20Recommendat
ions%20for%20Treatment%20of%20Patients%20on%20Bisphosphon.p
df
●● Pregnant person afraid of needles - stress management by putting
patient in what position when in your chair (BEFORE they even get to
the point of passing out)?
,- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- turn the patient, preferably to the left side
Answer: turn the patient, preferably to the left side
- Best preventative treatment for supine hypotension is to turn the
patient, preferably to the left side, to displace the uterus away from the
inferior vena cava. The patient can also be placed in a sitting position
with the knees flexed.
●● 6 months pregnant had bleeding gums and mobile teeth, how should
they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo
Answer: conservative debridement
.- pregnancy gingivitis: important to do ScRP (and stress good oral
hygiene) to prevent plaque growth. The plaque can enter blood stream
and stimulate patient's immune system to produce prostaglandins, which
can trigger uterine contraction leading to early labor, premature birth,
and a small baby.
, ●● Pregnant lady with a diastema in between #8 and #9 with deep
probing depth and class 1 mobility on 8 and 9. What is the reason for
diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy
Answer: chronic perio
- increased incidence of periodontal disease during pregnancy => must
emphasize good oral hygiene, and remove all their plaque so it doesn't
lead to premature birth / low birth weight
●● Permanent staining as a result of tetracyline; did this happen?
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
Answer: age 0-5 years
- remember that PERMANENT dentition does not begin calcification
until birth
●● Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type
of drugs?
- benzodiazepines
- NSAIDS
