DH LOCAL ANESTHESIA BOARD
REVIEW CORRECT 100%
What LA is metabolized by pseudocholinesterase? - ANSWEREsters
Where are ester LA's hydrolyzed? - ANSWERIn the blood plasma by th enzyme
pseudocholinesterase
Which antiseptic should not be used? - ANSWERLiquid Alcohol
Before using a cartridge you should:
1) wipe it w/ disinfectant
2) soak it in alcohol
3)autoclave it annd/or sterilize it? - ANSWERNone of the above
What part of the syringe indicates that it is an aspirating syringe? - ANSWERHarpoon
What is a possible cause of pain on removal of the needle? - ANSWERNeedle barb
from impaling bone
If there is no organic basis for pain - ANSWERPsychogenic pain
How does a self-aspirating syringe work? - ANSWERWhen you let off pressure from
injecting, it self-aspirates (negative pressure built into the syringe)
When do you aspirate? - ANSWERImmediately before you inject local anesthetic.
What is the action of vasodepressors in local anesthetic? - ANSWERIncreases depth
and duration of anesthetic, decreases absorption of local anesthetic and vasodepressor
Maximum doses of epinephrine - ANSWERNormal pt = 0.2mg
Cardiac pt = .04mg
How much epinephrine is in a cartridge of 1:50,000 epinephrine? - ANSWER.036mg
How much epinephrine is in a cartridge of 1:100,000 epinephrine? - ANSWER.018mg
How much epinephrine is in a cartridge of 1:200,000 epinephrine? - ANSWER.009mg
Hematoma common in: - ANSWERMost common in the pterygoid plexus of veins with a
PSA injection
What causes a hematoma? - ANSWERthe effusion of blood into extravascular spaces
and can result from nicking a blood vessel, artery or vein.
, Treatment of a hematoma? - ANSWERApply pressure for at least 2 minutes
Ice the area immediately 10 min on 10 min off for 48 hrs
After 48 hrs apply warm compress if neccessary
infiltration aka - ANSWERperiosteal
Which LA is an ester? - ANSWERProcaine (Novacain)
Why would you use caution with an amide if a patient has liver (cirrhosis) disease? -
ANSWERAmides are metabolized in the liver.
What is the most common thing that causes pain on injection? - ANSWERInjecting too
fast
Injection site for palatal infiltration of maxillary teeth? - ANSWER5-10mm from the free
gingival margin of the teeth (in the vicinity of the root apex)
What is the difference between a nerve block and an infiltration? - ANSWERNerve
Block = LA injected in close proximity to a nerve trunk
Infiltration = flooding the area you want to anesthetize with local anesthetic (above root
apex; 1-2 teeth anesthetize)
A sensation of burning on injection is caused by what? - ANSWERInjecting too fast
or injecting a local anesthetic containing a vasoconstrictor (lower pH)
If you need hemostasis only, what type of injection should you administer? -
ANSWERInfiltration
What topical anesthetic is not absorbed well systemically? - ANSWERBenzocaine
What occurs during depolarization? - ANSWERSodium passes into the axoplasm and
potassium is pumped out (reverse polarity)
What do myelinated nerves do? - ANSWERTransmits electrical impulses faster
Why do myelinated nerves transmit electrical impulses faster? - ANSWERSaltatory
conduction.
What is the effect of epi in a LA cartridge when injected into a pt taking non-specific
beta blockers (propranolol) to control hypertension? - ANSWERIncreases systolic blood
pressure
*use 1:200,000 epi w/ 1 carpule only
= vascon. w/o beta effects
REVIEW CORRECT 100%
What LA is metabolized by pseudocholinesterase? - ANSWEREsters
Where are ester LA's hydrolyzed? - ANSWERIn the blood plasma by th enzyme
pseudocholinesterase
Which antiseptic should not be used? - ANSWERLiquid Alcohol
Before using a cartridge you should:
1) wipe it w/ disinfectant
2) soak it in alcohol
3)autoclave it annd/or sterilize it? - ANSWERNone of the above
What part of the syringe indicates that it is an aspirating syringe? - ANSWERHarpoon
What is a possible cause of pain on removal of the needle? - ANSWERNeedle barb
from impaling bone
If there is no organic basis for pain - ANSWERPsychogenic pain
How does a self-aspirating syringe work? - ANSWERWhen you let off pressure from
injecting, it self-aspirates (negative pressure built into the syringe)
When do you aspirate? - ANSWERImmediately before you inject local anesthetic.
What is the action of vasodepressors in local anesthetic? - ANSWERIncreases depth
and duration of anesthetic, decreases absorption of local anesthetic and vasodepressor
Maximum doses of epinephrine - ANSWERNormal pt = 0.2mg
Cardiac pt = .04mg
How much epinephrine is in a cartridge of 1:50,000 epinephrine? - ANSWER.036mg
How much epinephrine is in a cartridge of 1:100,000 epinephrine? - ANSWER.018mg
How much epinephrine is in a cartridge of 1:200,000 epinephrine? - ANSWER.009mg
Hematoma common in: - ANSWERMost common in the pterygoid plexus of veins with a
PSA injection
What causes a hematoma? - ANSWERthe effusion of blood into extravascular spaces
and can result from nicking a blood vessel, artery or vein.
, Treatment of a hematoma? - ANSWERApply pressure for at least 2 minutes
Ice the area immediately 10 min on 10 min off for 48 hrs
After 48 hrs apply warm compress if neccessary
infiltration aka - ANSWERperiosteal
Which LA is an ester? - ANSWERProcaine (Novacain)
Why would you use caution with an amide if a patient has liver (cirrhosis) disease? -
ANSWERAmides are metabolized in the liver.
What is the most common thing that causes pain on injection? - ANSWERInjecting too
fast
Injection site for palatal infiltration of maxillary teeth? - ANSWER5-10mm from the free
gingival margin of the teeth (in the vicinity of the root apex)
What is the difference between a nerve block and an infiltration? - ANSWERNerve
Block = LA injected in close proximity to a nerve trunk
Infiltration = flooding the area you want to anesthetize with local anesthetic (above root
apex; 1-2 teeth anesthetize)
A sensation of burning on injection is caused by what? - ANSWERInjecting too fast
or injecting a local anesthetic containing a vasoconstrictor (lower pH)
If you need hemostasis only, what type of injection should you administer? -
ANSWERInfiltration
What topical anesthetic is not absorbed well systemically? - ANSWERBenzocaine
What occurs during depolarization? - ANSWERSodium passes into the axoplasm and
potassium is pumped out (reverse polarity)
What do myelinated nerves do? - ANSWERTransmits electrical impulses faster
Why do myelinated nerves transmit electrical impulses faster? - ANSWERSaltatory
conduction.
What is the effect of epi in a LA cartridge when injected into a pt taking non-specific
beta blockers (propranolol) to control hypertension? - ANSWERIncreases systolic blood
pressure
*use 1:200,000 epi w/ 1 carpule only
= vascon. w/o beta effects
