STUDENTRDH LOCAL ANESTHESIA
EXAM QUESTIONS AND ANSWERS
Which of the following symptoms can be caused by paresthesia?
a. Numbness
b. Pain
c. Swelling
D. All of the above - Correct Answers -D. All of the above
Paresthesia commonly reported with anesthesia with high concentrations (prilocaine &
articaine)
Which of the following drugs fall under pregnancy category B?
a. Carbocaine
b. Marcaine
C. Citanest
d. Septocaine - Correct Answers -C. Citanest
Citanest (Prilocaine) and Xylocaine (Lidocaine) are pregnancy B
Carbocaine, Marcaine and Septocaine are pregnancy category C
Which of the following does not help alleviate the symptoms of trismus?
a. apply heat for 20 min
b. use warm saline rinses
c. use muscle relaxants
d. use oraverse - Correct Answers -d. Use oraverse
oraverse increase amount of blood flow to target area which allows tissue to recover
more rapidly. Used to decrease duration of anesthesia, not trismus
What is the most common cause of needle breakage?
a. bending of needle
b. sudden pt movement
,c. forceful contact of bone
d. use of thin needles - Correct Answers -b. sudden pt movement
Which of the following can be an early sign of local anesthetic overdose?
a. drowsiness
b. loss of consciousness
c. respiratory arrest
d. twitching - Correct Answers -d. twitching
What can a clinician do to control a hematoma?
a. apply heat for 20 min
b. apply ice for 2 min
c. alternate ice and heat
d. all of the above - Correct Answers -b. apply ice for 2 min
direct pressure & ice for 2 min. Can use heat on next day
If a patient is allergic to red wine, which of the following precautions should be taken?
a. inject less anesthetic
b. inject drug more slowly
c. aspirate three times before injection
d. avoid local anesthetics within vasoconstrictors - Correct Answers -d. avoid local
anesthetics within vasoconstrictors
What can cause paresthesia?
a. forceful contact of needle to the bone
b. hemorrhage around the nerve
c. change of needle direction
d. bending of the needle - Correct Answers -b. hemorrhage around the nerve
Local anesthesia given in preparation for endo treatments can sometimes fail? What
could be the reason?
a. excessive bleeding at the site
b. patient is anxious
c. patient is experiencing overdose
d. the pH of the tissue has been lowered - Correct Answers -d. the pH of the tissue has
been lowered
Which of the following emergency conditions occurs the most frequently with local
anesthetic injections?
,a. heart attack
b. breathing problems
c. syncope
d. anaphylaxis - Correct Answers -c. syncope
Which of the following advice can help a patient prevent soft tissue injuries following
local anesthesia?
a. do not consume hot drinks for 4 hours
b. do not eat for 4 hours
c. keep a cotton roll attached to a floss in the mucobuccal fold
d. all of the above - Correct Answers -d. all of the above
Methemoglobinemia is a contraindication for which of the following local anesthetics?
a. prilocaine
b. mepivacaine
c. procaine
d. septocaine - Correct Answers -a. prilocaine
when metabolized, prilocaine forms methemoglobin which causes methemoglobinemia.
Why do ester drugs occasionally cause allergic reactions?
a. esters are biotransformed in the liver
b. esters reduce the oxygen carrying capacity of hemoglobin
c. esters diffuse through soft and hard tissues more readily
d. esters produce para-aminobenzoic acid - Correct Answers -d. esters produce para-
aminobenzoic acid
esters are biotransformed in the plasma
Which of the following is an absolute contraindication for using vasoconstrictors?
a. MI episode within past 6 yrs
b. Angina attack over 6 mos
c. Allergy to sodium bisulfite
d. HTN stage II - Correct Answers -c. Allergy to sodium bisulfite
preservative to vasoconstrictors
Which of the following injections is more likely to cause trismus?
a. PSA nerve block
b. MSA nerve block
c. ASA nerve block
, d. Infiltration - Correct Answers -PSA nerve block
Which of the following is true about the effect of local anesthetics on the CNS?
a. Local anesthetics do not cross the blood-brain barrier
b. Tonic-clonic convulsions always occur with overdose
c. toxicity is usually not observable within the first 10 min from injection
d. Overdose is expressed as CNS excitation followed by depression - Correct Answers -
d. Overdose is expressed as CNS excitation followed by depression
At the end of the dental appointment, you noticed that one side of the patient's face is
"drooping". What could have caused this change?
a. Local anesthetic was deposited into the parotid
b. muscles spasms occurred from opening the jaw for too long
c. the needle nicked a blood vessel
d. the patient is experiencing syncope - Correct Answers -a. Local anesthetic was
deposited into the parotid
Which of the following method can best resolve symptoms associated with trismus?
a. cold compressions
b. heat compression with normal eating
c. use of a straw when drinking liquids
d. restriction of the movement of the jaw for a week - Correct Answers -b. heat
compression with normal eating
When providing local anesthesia for a child, which of the following is not true?
a. use topical anesthetics instead of injections if possible
b. needle penetration depth is generally less deep
c. use less anesthetics compared to adults
d. use infiltrations rather than nerve blocks - Correct Answers -a. use topical anesthetics
instead of injections if possible
topical anesthesia must be given with caution b/c they are at higher concentrations
The patient is currently taking Elavil (tricyclic antidepressants). What should be avoided
when administering local anesthesia?
EXAM QUESTIONS AND ANSWERS
Which of the following symptoms can be caused by paresthesia?
a. Numbness
b. Pain
c. Swelling
D. All of the above - Correct Answers -D. All of the above
Paresthesia commonly reported with anesthesia with high concentrations (prilocaine &
articaine)
Which of the following drugs fall under pregnancy category B?
a. Carbocaine
b. Marcaine
C. Citanest
d. Septocaine - Correct Answers -C. Citanest
Citanest (Prilocaine) and Xylocaine (Lidocaine) are pregnancy B
Carbocaine, Marcaine and Septocaine are pregnancy category C
Which of the following does not help alleviate the symptoms of trismus?
a. apply heat for 20 min
b. use warm saline rinses
c. use muscle relaxants
d. use oraverse - Correct Answers -d. Use oraverse
oraverse increase amount of blood flow to target area which allows tissue to recover
more rapidly. Used to decrease duration of anesthesia, not trismus
What is the most common cause of needle breakage?
a. bending of needle
b. sudden pt movement
,c. forceful contact of bone
d. use of thin needles - Correct Answers -b. sudden pt movement
Which of the following can be an early sign of local anesthetic overdose?
a. drowsiness
b. loss of consciousness
c. respiratory arrest
d. twitching - Correct Answers -d. twitching
What can a clinician do to control a hematoma?
a. apply heat for 20 min
b. apply ice for 2 min
c. alternate ice and heat
d. all of the above - Correct Answers -b. apply ice for 2 min
direct pressure & ice for 2 min. Can use heat on next day
If a patient is allergic to red wine, which of the following precautions should be taken?
a. inject less anesthetic
b. inject drug more slowly
c. aspirate three times before injection
d. avoid local anesthetics within vasoconstrictors - Correct Answers -d. avoid local
anesthetics within vasoconstrictors
What can cause paresthesia?
a. forceful contact of needle to the bone
b. hemorrhage around the nerve
c. change of needle direction
d. bending of the needle - Correct Answers -b. hemorrhage around the nerve
Local anesthesia given in preparation for endo treatments can sometimes fail? What
could be the reason?
a. excessive bleeding at the site
b. patient is anxious
c. patient is experiencing overdose
d. the pH of the tissue has been lowered - Correct Answers -d. the pH of the tissue has
been lowered
Which of the following emergency conditions occurs the most frequently with local
anesthetic injections?
,a. heart attack
b. breathing problems
c. syncope
d. anaphylaxis - Correct Answers -c. syncope
Which of the following advice can help a patient prevent soft tissue injuries following
local anesthesia?
a. do not consume hot drinks for 4 hours
b. do not eat for 4 hours
c. keep a cotton roll attached to a floss in the mucobuccal fold
d. all of the above - Correct Answers -d. all of the above
Methemoglobinemia is a contraindication for which of the following local anesthetics?
a. prilocaine
b. mepivacaine
c. procaine
d. septocaine - Correct Answers -a. prilocaine
when metabolized, prilocaine forms methemoglobin which causes methemoglobinemia.
Why do ester drugs occasionally cause allergic reactions?
a. esters are biotransformed in the liver
b. esters reduce the oxygen carrying capacity of hemoglobin
c. esters diffuse through soft and hard tissues more readily
d. esters produce para-aminobenzoic acid - Correct Answers -d. esters produce para-
aminobenzoic acid
esters are biotransformed in the plasma
Which of the following is an absolute contraindication for using vasoconstrictors?
a. MI episode within past 6 yrs
b. Angina attack over 6 mos
c. Allergy to sodium bisulfite
d. HTN stage II - Correct Answers -c. Allergy to sodium bisulfite
preservative to vasoconstrictors
Which of the following injections is more likely to cause trismus?
a. PSA nerve block
b. MSA nerve block
c. ASA nerve block
, d. Infiltration - Correct Answers -PSA nerve block
Which of the following is true about the effect of local anesthetics on the CNS?
a. Local anesthetics do not cross the blood-brain barrier
b. Tonic-clonic convulsions always occur with overdose
c. toxicity is usually not observable within the first 10 min from injection
d. Overdose is expressed as CNS excitation followed by depression - Correct Answers -
d. Overdose is expressed as CNS excitation followed by depression
At the end of the dental appointment, you noticed that one side of the patient's face is
"drooping". What could have caused this change?
a. Local anesthetic was deposited into the parotid
b. muscles spasms occurred from opening the jaw for too long
c. the needle nicked a blood vessel
d. the patient is experiencing syncope - Correct Answers -a. Local anesthetic was
deposited into the parotid
Which of the following method can best resolve symptoms associated with trismus?
a. cold compressions
b. heat compression with normal eating
c. use of a straw when drinking liquids
d. restriction of the movement of the jaw for a week - Correct Answers -b. heat
compression with normal eating
When providing local anesthesia for a child, which of the following is not true?
a. use topical anesthetics instead of injections if possible
b. needle penetration depth is generally less deep
c. use less anesthetics compared to adults
d. use infiltrations rather than nerve blocks - Correct Answers -a. use topical anesthetics
instead of injections if possible
topical anesthesia must be given with caution b/c they are at higher concentrations
The patient is currently taking Elavil (tricyclic antidepressants). What should be avoided
when administering local anesthesia?
