, Little:DentalManagement oftheMedicallyCompromisedPatient,8th Editi
f l#
on
l#
Chapter01:l#PatientEvaluationandRiskAssessmentl#Test
l# Bank
MULTIPLECHOICE
1. Electivedentalcareshould bedeferred forpatientsl#withsevere,l#uncontrolledhypertension,
f f
l#meaning thattheblood pressureisgreaterthanorequalto
f f
mm
l#Hg.
A. 200/140
B. 180/140
C. 180/110
D. 160/110
ANS: l # C
Electivedentalcareshould bedeferred forpatients l#withsevere, l#uncontrolledhypertension,
f f
l#w l#hichisbloodpressureofgreaterthanorequalto 180/110mm f l#Hg,
l#untilthecondition can bebro l#ughtundercontrol.
f f
PTS: 1 REF: p.l#4
2. The American HeartAssociation currentlyrecommendsantibiotic prophylaxisforapat
f f f f
l # ientwith whichofthe following cardiacconditions?
f f f
A. mitralvalveprolapse
B. prostheticheart valve f
C. rheumaticheartdisease
D. pacemakersforcardiacarrhythmias
ANS: l # B
Previously, l#theAmerican l#HeartAssociation(AHA)
l#recommendedantibioticprophylaxisfor
l#manypatientswithheart murmurscausedbyvalvulardisease(e.g., l#mitralvalveprolapse, l#rhe
f
l#umatic heartdisease)
f l#in an l#efforttopreventinfective endocarditis;
f f
l#currentguidelinesomitthi
l#s recommendationon thebasis ofaccumulated scientificevidence. l#If l#amurmurisduetospeci
f f f f
l#ficcardiac conditions(e.g.,
f l#previousendocarditis, l#prostheticheartvalve,
l#complexcongenital l#cyanoticheartdisease), l#the l#AHA
l#continuestorecommendantibioticprophylaxisformostde l#ntalprocedures. l#Patients
l#withpacemakersdonotrequireantibioticprophylaxis.
, Test 1-2
l#Bank
PTS: 1 REF: pp.l#4-5
3. Oneconsequenceofchronic hepatitis (Borl#C)l#orcirrhosisoftheliverisdecreasedabilityofth
f f
l # ebodytol# certaindrugs,l#includinglocalanestheticsandanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS: l # C
Patientswithchronichepatitis l#(B l#or l#C) l#orcirrhosishave l#an associated
f
l#impairmentofliverfun
l#ction.Thisdeficitmayresult inprolonged bleedingand lessefficientmetabolismofcertaindr
f f f
l # ugs,l#including locall#anestheticsandanalgesics.
f
PTS: 1 REF: p.l#6
4. Whichofthefollowingsymptomsandsignsismost consistent withallergy?
f f
A. heartpalpitations
B. itching
C. vomiting
D. fainting
ANS: l # B
Symptomsandsignsconsistentwithallergyincludeitching, l#urticaria(hives), l#rash, l#swelling,
l#wheezing, l#angioedema, l#runnynose, l#and tearingeyes. l#Isolatedsignsandsymptomssuch
f
l#as l#na l#usea, l#vomiting, l#heartpalpitations, andfaintinggenerallyarenot of
f f l#an allergic
f
l#origin butrather
f l#aremanifestationsofdrugintolerance, l#adversesideeffects,
l#orpsychogenicreactions.
PTS: 1 REF: p.l#6
5. Whichofthefollowingistrueofthepatientwithahistoryoftuberculosis?
A. Apositiveresultonskintesting meansthatthe personhasactiveTB.
f f
B. Mostpatientswhobecomepositiveskintesters developactivedisease.
f
C. Patientswithacquiredimmunodeficiencysyndrome(AIDS)haveahigh in f
l # cidenceoftuberculosis.
D. AdiagnosisofactiveTBismadebyapurifiedproteinderivative(PPD) skintest.f
ANS: l# C
, Test 1-3
l#Bank
Thepotentialcoexistenceoftuberculosisand acquiredimmunodeficiencysyndrome(AIDS) f
l#shouldbeexploredbecause patientswithAIDShaveahighincidenceoftuberculosis.Aposit
f
l#ive resultonskintesting means specificallythat the personhas
f f f l#at f f
l#sometime been infected wit
f f l# h l#TB, l#notnecessarilythatactivediseaseis present.
f f
l#Most patientswhobecomepositiveskin te
f f
l#stersdonotdevelopactive disease.Adiagnosisofactive TB l#is madebychestx-
f f f
ray, l#imaging, l#sputum culture, f
l# andclinicalexamination. l#PTS: l # 1 REF:
l # p.l#6-7
6. Vasoconstrictors should beavoidedinpatientswhoareusingcocaineorme
f f
l # thamphetaminebecausetheseagentsmayprecipitatel# .
A. severehypotension
B. severehypertension
C. respiratorydepression
D. cessationofintestinalperistalsis
ANS: l # B
Vasoconstrictors mayprecipitatecardiacarrhythmias orseverehypertensioninpatients l#wh
f f
l#oareusingcocaineormethamphetamine. l#Respiratorydepression isassociated withtheuse f f
l#ofopioids.
PTS: 1 REF: p.l#8
7. Itl#hasbeen shownthat theriskforoccurrenceofaserious perioperativecardiovascularevent
f f f
l # isincreased inpatientswho areunable tomeet a
f l # - f f f
MET(metabolicequivalentoftask) demandduring normaldailyactivity. f f
A. 4
B. 6
C. 8
D. 10
ANS: l # A
Riskisincreased inpatients unabletomeet a4-
f f f
METdemand. l#Dailyactivities requiring 4 l#METsincludelevelwalking at 4
f f f f
l#miles/hourorclimb l#ing a l#flightofstairs.Activitiesrequiringgreaterthan
f l#10
l#METsincludeswimmingandsingleste l#nnis.
PTS: 1 REF: p.l#9
8. Whichofthefollowingalterationsin thefingernailsisassociated withcirrhosis? f f
A. yellowing
f l#
on
l#
Chapter01:l#PatientEvaluationandRiskAssessmentl#Test
l# Bank
MULTIPLECHOICE
1. Electivedentalcareshould bedeferred forpatientsl#withsevere,l#uncontrolledhypertension,
f f
l#meaning thattheblood pressureisgreaterthanorequalto
f f
mm
l#Hg.
A. 200/140
B. 180/140
C. 180/110
D. 160/110
ANS: l # C
Electivedentalcareshould bedeferred forpatients l#withsevere, l#uncontrolledhypertension,
f f
l#w l#hichisbloodpressureofgreaterthanorequalto 180/110mm f l#Hg,
l#untilthecondition can bebro l#ughtundercontrol.
f f
PTS: 1 REF: p.l#4
2. The American HeartAssociation currentlyrecommendsantibiotic prophylaxisforapat
f f f f
l # ientwith whichofthe following cardiacconditions?
f f f
A. mitralvalveprolapse
B. prostheticheart valve f
C. rheumaticheartdisease
D. pacemakersforcardiacarrhythmias
ANS: l # B
Previously, l#theAmerican l#HeartAssociation(AHA)
l#recommendedantibioticprophylaxisfor
l#manypatientswithheart murmurscausedbyvalvulardisease(e.g., l#mitralvalveprolapse, l#rhe
f
l#umatic heartdisease)
f l#in an l#efforttopreventinfective endocarditis;
f f
l#currentguidelinesomitthi
l#s recommendationon thebasis ofaccumulated scientificevidence. l#If l#amurmurisduetospeci
f f f f
l#ficcardiac conditions(e.g.,
f l#previousendocarditis, l#prostheticheartvalve,
l#complexcongenital l#cyanoticheartdisease), l#the l#AHA
l#continuestorecommendantibioticprophylaxisformostde l#ntalprocedures. l#Patients
l#withpacemakersdonotrequireantibioticprophylaxis.
, Test 1-2
l#Bank
PTS: 1 REF: pp.l#4-5
3. Oneconsequenceofchronic hepatitis (Borl#C)l#orcirrhosisoftheliverisdecreasedabilityofth
f f
l # ebodytol# certaindrugs,l#includinglocalanestheticsandanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS: l # C
Patientswithchronichepatitis l#(B l#or l#C) l#orcirrhosishave l#an associated
f
l#impairmentofliverfun
l#ction.Thisdeficitmayresult inprolonged bleedingand lessefficientmetabolismofcertaindr
f f f
l # ugs,l#including locall#anestheticsandanalgesics.
f
PTS: 1 REF: p.l#6
4. Whichofthefollowingsymptomsandsignsismost consistent withallergy?
f f
A. heartpalpitations
B. itching
C. vomiting
D. fainting
ANS: l # B
Symptomsandsignsconsistentwithallergyincludeitching, l#urticaria(hives), l#rash, l#swelling,
l#wheezing, l#angioedema, l#runnynose, l#and tearingeyes. l#Isolatedsignsandsymptomssuch
f
l#as l#na l#usea, l#vomiting, l#heartpalpitations, andfaintinggenerallyarenot of
f f l#an allergic
f
l#origin butrather
f l#aremanifestationsofdrugintolerance, l#adversesideeffects,
l#orpsychogenicreactions.
PTS: 1 REF: p.l#6
5. Whichofthefollowingistrueofthepatientwithahistoryoftuberculosis?
A. Apositiveresultonskintesting meansthatthe personhasactiveTB.
f f
B. Mostpatientswhobecomepositiveskintesters developactivedisease.
f
C. Patientswithacquiredimmunodeficiencysyndrome(AIDS)haveahigh in f
l # cidenceoftuberculosis.
D. AdiagnosisofactiveTBismadebyapurifiedproteinderivative(PPD) skintest.f
ANS: l# C
, Test 1-3
l#Bank
Thepotentialcoexistenceoftuberculosisand acquiredimmunodeficiencysyndrome(AIDS) f
l#shouldbeexploredbecause patientswithAIDShaveahighincidenceoftuberculosis.Aposit
f
l#ive resultonskintesting means specificallythat the personhas
f f f l#at f f
l#sometime been infected wit
f f l# h l#TB, l#notnecessarilythatactivediseaseis present.
f f
l#Most patientswhobecomepositiveskin te
f f
l#stersdonotdevelopactive disease.Adiagnosisofactive TB l#is madebychestx-
f f f
ray, l#imaging, l#sputum culture, f
l# andclinicalexamination. l#PTS: l # 1 REF:
l # p.l#6-7
6. Vasoconstrictors should beavoidedinpatientswhoareusingcocaineorme
f f
l # thamphetaminebecausetheseagentsmayprecipitatel# .
A. severehypotension
B. severehypertension
C. respiratorydepression
D. cessationofintestinalperistalsis
ANS: l # B
Vasoconstrictors mayprecipitatecardiacarrhythmias orseverehypertensioninpatients l#wh
f f
l#oareusingcocaineormethamphetamine. l#Respiratorydepression isassociated withtheuse f f
l#ofopioids.
PTS: 1 REF: p.l#8
7. Itl#hasbeen shownthat theriskforoccurrenceofaserious perioperativecardiovascularevent
f f f
l # isincreased inpatientswho areunable tomeet a
f l # - f f f
MET(metabolicequivalentoftask) demandduring normaldailyactivity. f f
A. 4
B. 6
C. 8
D. 10
ANS: l # A
Riskisincreased inpatients unabletomeet a4-
f f f
METdemand. l#Dailyactivities requiring 4 l#METsincludelevelwalking at 4
f f f f
l#miles/hourorclimb l#ing a l#flightofstairs.Activitiesrequiringgreaterthan
f l#10
l#METsincludeswimmingandsingleste l#nnis.
PTS: 1 REF: p.l#9
8. Whichofthefollowingalterationsin thefingernailsisassociated withcirrhosis? f f
A. yellowing
