DSE REMEMBERED EXAM SCRIPT SOLVED
QUESTIONS AND COMPLETE SOLUTIONS
◉ A patient has an allergic reaction to a barbiturate, how do you
treat?
- epinephrine
- diphenhydramine
- send to ER.
Answer: benadryl (diphenhydramine)
- And discontinuation of the drug. Obviously if there are concerns
with airway, treatment may differ... but this was not indicated in the
question stem. However, I did not have answer choices that reflected
this scenario nor was it addressed in the question stem
◉ A patient is on a steroidal medication. What information do you
need to obtain before treating them?
- dose and pharmacy that filled the RX
- duration of prescription
- both dose and duration.
Answer: *dose and duration*
- "The rule of twos": Ask whether the patient is currently on steroids
or has been on corticosteroids for 2 weeks or longer within the past
2 years. You must go back 2 years in the history because it can take 2
,weeks to 2 years for the adrenal glands to bounce back to normal
function.
◉ What is the most important factor when calculation medication
dosage for a child
- age
- weight
- gender
- height.
Answer: weight
◉ A patient is confirmed to have trisomy 21. What are you initially
concerned about?
- congenital heart defect
- Cushings
- cerebrovascular accident.
Answer: congenital heart defects; however, early onset periodontal
disease is a significant oral health issue, but this was not an answer
for those who have had this question. Consider cardiac status and
posibility of pre-medication
- atrioventricular septal defect, patent ductus arteriosus, Tetralogy
of Fallot
◉ A patient has recently had a stroke. What is your first concern?
,- when was their last cleaning
- are they on anticoagulants
- current blood pressure.
Answer: Are they on anticoagulants
- Stroke patients could be on blood thinners, such as aspirin,
dipyradamole (Persan- tine), clopidogrol (Plavix), or Coumadin,
postrecovery. Prior to major surgery, always consult with the
patient's physician to determine whether and when the blood
thinners can be stopped and subsequently restarted.- . Following a
CVA that required significant hospitalization, routine dental
treatment must be delayed by 6 months.- Routine dental treatment
should be delayed by 3 months if the post-CVA recovery was
uneventful and the patient was admitted overnight just for
observation.- Avoid epinephrine containing LAs during the first 6
months of dental treatment. Subsequent use of epinephrine depends
on the patient's prognosis. Epinephrine containing LAs can be used
starting 1 year after the stroke, when the patient demonstrates
progressive improvement of the CVA and absence of TIAs.
◉ What is the main symptom that differentiates anaphylaxis from
syncope?
- bronchoconstriction
- clammy skin and pallor
- nausea, vomiting.
Answer: Anaphylaxis is accompanied by wheezing,
bronchoconstriction
, - anaphyalxis: intense itching, hives, flushing over the face and chest.
Rhinitis, conjunctivitis, nausea, vomiting, abdominal cramps, and
perspiration. Palpitation, tachycardia, sub- sternal tightness,
coughing, wheezing, and dyspnea. BP drops rapidly and loss of
consciousness or cardiac arrest can occur in severe cases.- syncope:
fright and flight response. Anxiety, tachycardia, perspiration, light-
headedness, and blurred vision are commonly experienced.
◉ The Enzyme Linked Immune Absorbent Assay (ELISA) Test - a
negative response for a person who had needle stick means what?
- the patient definitely has an HIV infection
- the patient has antibodies to HIV-1 present
- the patient definitely does not have an HIV infection
- the patient has no antibodies to HIV-1 present..
Answer: *the patient does not have HIV antibodies*
- consider that false negatives are a thing, life happens. We cannot
definitively say they do not have HIV,but we can say that no Ab were
detected.
◉ 14 year old presents with inflamed gingiva. Bloodwork indicates
abnormal RBC, WBC, and platelets. Diagnosis?
- normal 14 year old
- hypothyroidism
- leukemia
QUESTIONS AND COMPLETE SOLUTIONS
◉ A patient has an allergic reaction to a barbiturate, how do you
treat?
- epinephrine
- diphenhydramine
- send to ER.
Answer: benadryl (diphenhydramine)
- And discontinuation of the drug. Obviously if there are concerns
with airway, treatment may differ... but this was not indicated in the
question stem. However, I did not have answer choices that reflected
this scenario nor was it addressed in the question stem
◉ A patient is on a steroidal medication. What information do you
need to obtain before treating them?
- dose and pharmacy that filled the RX
- duration of prescription
- both dose and duration.
Answer: *dose and duration*
- "The rule of twos": Ask whether the patient is currently on steroids
or has been on corticosteroids for 2 weeks or longer within the past
2 years. You must go back 2 years in the history because it can take 2
,weeks to 2 years for the adrenal glands to bounce back to normal
function.
◉ What is the most important factor when calculation medication
dosage for a child
- age
- weight
- gender
- height.
Answer: weight
◉ A patient is confirmed to have trisomy 21. What are you initially
concerned about?
- congenital heart defect
- Cushings
- cerebrovascular accident.
Answer: congenital heart defects; however, early onset periodontal
disease is a significant oral health issue, but this was not an answer
for those who have had this question. Consider cardiac status and
posibility of pre-medication
- atrioventricular septal defect, patent ductus arteriosus, Tetralogy
of Fallot
◉ A patient has recently had a stroke. What is your first concern?
,- when was their last cleaning
- are they on anticoagulants
- current blood pressure.
Answer: Are they on anticoagulants
- Stroke patients could be on blood thinners, such as aspirin,
dipyradamole (Persan- tine), clopidogrol (Plavix), or Coumadin,
postrecovery. Prior to major surgery, always consult with the
patient's physician to determine whether and when the blood
thinners can be stopped and subsequently restarted.- . Following a
CVA that required significant hospitalization, routine dental
treatment must be delayed by 6 months.- Routine dental treatment
should be delayed by 3 months if the post-CVA recovery was
uneventful and the patient was admitted overnight just for
observation.- Avoid epinephrine containing LAs during the first 6
months of dental treatment. Subsequent use of epinephrine depends
on the patient's prognosis. Epinephrine containing LAs can be used
starting 1 year after the stroke, when the patient demonstrates
progressive improvement of the CVA and absence of TIAs.
◉ What is the main symptom that differentiates anaphylaxis from
syncope?
- bronchoconstriction
- clammy skin and pallor
- nausea, vomiting.
Answer: Anaphylaxis is accompanied by wheezing,
bronchoconstriction
, - anaphyalxis: intense itching, hives, flushing over the face and chest.
Rhinitis, conjunctivitis, nausea, vomiting, abdominal cramps, and
perspiration. Palpitation, tachycardia, sub- sternal tightness,
coughing, wheezing, and dyspnea. BP drops rapidly and loss of
consciousness or cardiac arrest can occur in severe cases.- syncope:
fright and flight response. Anxiety, tachycardia, perspiration, light-
headedness, and blurred vision are commonly experienced.
◉ The Enzyme Linked Immune Absorbent Assay (ELISA) Test - a
negative response for a person who had needle stick means what?
- the patient definitely has an HIV infection
- the patient has antibodies to HIV-1 present
- the patient definitely does not have an HIV infection
- the patient has no antibodies to HIV-1 present..
Answer: *the patient does not have HIV antibodies*
- consider that false negatives are a thing, life happens. We cannot
definitively say they do not have HIV,but we can say that no Ab were
detected.
◉ 14 year old presents with inflamed gingiva. Bloodwork indicates
abnormal RBC, WBC, and platelets. Diagnosis?
- normal 14 year old
- hypothyroidism
- leukemia
