of the Medically Compromised Patient,
10th Edition by Craig Miller,
Chapters 1 - 30
,Little: Dental Management of the Medically Compromised Patient, 10th Edition Test
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Bank
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Table of Contents
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PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
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Chapter 1: Patient Evaluation and Risk Assessment
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PART TWO: CARDIOVASCULAR DISEASE
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Chapter 2: Infective Endocarditis
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Chapter 3: Hypertension
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Chapter 4: Ischemic Heart Disease
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Chapter 5: Cardiac Arrhythmias
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Chapter 6: Heart Failure (or Congestive Heart Failure)
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PART THREE: PULMONARY DISEASE
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Chapter 7: Pulmonary Disease
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Chapter 8: Smoking and Tobacco Use Cessation
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Chapter 9: Sleep-Related Breathing Disorders
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PART FOUR: GASTROINTESTIAL DISEASE
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Chapter 10: Liver Disease
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Chapter 11: Gastrointestinal Disease
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PART FIVE: GENITOURINARY DISEASE
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Chapter 12: Chronic Kidney Disease and Dialysis
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Chapter 13: Sexually Transmitted Diseases
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PART SIX: ENDOCRINE AND METABOLIC DISEASE
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Chapter 14: Diabetes Mellitus
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Chapter 15: Adrenal Insufficiency
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Chapter 16: Thyroid Diseases
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Chapter 17: Pregnancy and Breast Feeding
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PART SEVEN: IMMUNOLOGIC DISEASE
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Chapter 18: AIDS, HIV Infection, and Related Conditions
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Chapter 19: Allergy
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Chapter 20: Rheumatologic and Connective Tissue Disorders
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Chapter 21: Organ and Bone Marrow Transplantation
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PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
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Chapter 22: Disorders of Red Blood Cells
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Chapter 23: Disorders of White Blood Cells
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Chapter 24: Acquired Bleeding and Hypercoagulable Disorders
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Chapter 25: Congenital Bleeding and Hypercoagulable Disorders
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Chapter 26: Cancer and Oral Care of the Patient
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PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
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Chapter 27: Neurologic Disorders
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Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness
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Chapter 29: Psychiatric Disorders
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Chapter 30: Drug and Alcohol Abuse
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Page 1 of 74
Chapter 01: Patient Evaluation and Risk Assessment
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Little: Dental Management of the Medically Compromised Patient, 10th Edition
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MULTIPLE CHOICE Qg
1. Elective dental care should be deferred for patients with severe, uncontrolled
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hypertension, meaning that the blood pressure is greater than or equal to mm Hg.
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a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANSWER: C Qg
Elective dental care should be deferred for patients with severe, uncontrolled
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hypertension, which is blood pressure greater than or equal to 180/110 mm Hg,
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until the condition can be brought under control.
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2. The American Heart Association currently recommends antibiotic prophylaxis for a
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patient with which of the following cardiac conditions?
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a. Mitral valve prolapse Qg Qg
b. Prosthetic heart valve Qg Qg
c. Rheumatic heart disease Qg Qg
d. Pacemakers for cardiac arrhythmias Qg Qg Qg
ANSWER: B Qg
Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis
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for many patients with heart murmurs caused by valvular disease (e.g., mitral valve
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prolapse, rheumatic heart disease) in an effort to prevent infective endocarditis;
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however, current guidelines omit this recommendation on the basis of accumulated
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scientific evidence. If a murmur is due to certain specific cardiac conditions (e.g.,
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previous endocarditis, prosthetic heart valve, complex congenital cyanotic heart
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disease), the AHA continues to recommend antibiotic prophylaxis for most dental
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procedures.
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3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased
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Qg ability of the body to
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a. absorb
b. distribute
c. metabolize
d. excrete
ANSWER: C Qg
Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment
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of liver function. This deficit may result in prolonged bleeding and less
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efficient metabolism of certain drugs, including local anesthetics and analgesics.
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4. Which of the following symptoms and signs is most consistent with allergy?
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a. Heart palpitations Qg
b. Itching
c. Vomiting
d. Fainting
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ANSWER: B Qg
Symptoms and signs consistent with allergy include itching, urticaria (hives), rash,
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swelling, wheezing, angioedema, runny nose, and tearing eyes. Isolated signs and
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symptoms such as nausea, vomiting, heart palpitations, and fainting generally are not
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of an allergic origin but rather are manifestations of drug intolerance, adverse side
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effects, or psychogenic reactions.
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5. Which of the following is true of the patient with a history of tuberculosis?
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a. A positive result on skin testing means that the person has active TB.
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b. Most patients who become positive skin testers develop active disease.
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c. Patients with acquired immunodeficiency syndrome (AIDS) have a high
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incidence of tuberculosis.
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d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
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ANSWER: Q g C
The potential coexistence of tuberculosis and acquired immunodeficiency syndrome
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(AIDS) should be explored because patients with AIDS have a high incidence of
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tuberculosis. A positive result on skin testing means specifically that the person has
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at some time been infected with TB, not necessarily that active disease is present.
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Most patients who become positive skin testers do not develop active disease. A
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diagnosis of active TB is made by chest x-ray, imaging, sputum culture, and clinical
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examination.
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6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine
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users because these agents may precipitate .
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a. severe hypotension Qg
b. severe hypertension Qg
c. respiratory depression Qg
d. cessation of intestinal peristalsis Qg Qg Qg
ANSWER: B Qg
Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine
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users because the combination may precipitate arrhythmias, MI, or severe
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hypertension.
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7. It has been shown that the risk for occurrence of a serious perioperative
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cardiovascular event (e.g., MI, heart failure) is increased in patients who are unable
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to meet a -MET (metabolic equivalent of task) demand during normal daily activity.
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a. 4
b. 6
c. 8
d. 10
ANSWER: A Qg
Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a
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flight of stairs. Activities requiring greater than 10 METs include swimming and
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singles tennis. An exercise capacity of 10 to 13 METs indicates excellent physical
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conditioning.
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8. Which of the following alterations in the fingernails is associated with cirrhosis?
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a. Yellowing
b. Clubbing
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