of the Medically Compromised Patient,
10th Edition by Craig Miller, Chapters 1 – 30.
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Chapter 01: Patient Evaluation and Risk Assessment
Little: Dental Management of the Medically Compromised Patient,
10th Edition
MULTIPLE CHOICE
1. Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, meaning that the blood pressure is greater
than or equal to mm Hg.
a.
200/140
b.
180/140
c.
180/110
d.
160/110
ANSWER: C
Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, which is blood pressure greater than or
equal to 180/110 mm Hg, until the condition can be brought under
control.
2. The American Heart Association currently recommends antibiotic
prophylaxis for a patient with which of the following cardiac conditions?
a.
Mitral valve prolapse
b.
Prosthetic heart valve
c.
Rheumatic heart disease
d.
Pacemakers for cardiac arrhythmias
ANSWER: B
Previously, the American Heart Association (AHA) recommended antibiotic
prophylaxis for many patients with heart murmurs caused by valvular
disease (e.g., mitral valve prolapse, rheumatic heart disease) in an effort
to prevent infective endocarditis; however, current guidelines omit this
recommendation on the basis of accumulated scientific evidence. If a
murmur is due to certain specific cardiac conditions (e.g., previous
endocarditis, prosthetic heart valve, complex congenital cyanotic heart
disease), the AHA continues to recommend antibiotic prophylaxis for most
dental procedures.
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is
decreased ability of the body to certain drugs, including local
anesthetics and analgesics.
a.
absorb
b.
distribute
c.
metabolize
d.
excrete
ANSWER: C
Patients also may have chronic hepatitis (B or C) or cirrhosis, with
impairment of liver function. This deficit may result in prolonged
bleeding and less 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?
a.
Heart palpitations
b.
Itching
c.
Vomiting
d.
Fainting
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ANSWER: B
Symptoms and signs consistent with allergy include itching, urticaria
(hives), rash, swelling, wheezing, angioedema, runny nose, and
tearing eyes. Isolated signs and symptoms such as nausea, vomiting,
heart palpitations, and fainting generally are not of an allergic origin
but rather are manifestations of drug intolerance, adverse side
effects, or psychogenic reactions.
5. Which of the following is true of the patient with a history of
tuberculosis?
a.
A positive result on skin testing means that the person has active
TB.
b.
Most patients who become positive skin testers develop active
disease.
c.
Patients with acquired immunodeficiency syndrome (AIDS)
have a high incidence of tuberculosis.
d.
A diagnosis of active TB is made by a purified protein derivative
(PPD) skin test.
ANSWER: C
The potential coexistence of tuberculosis and acquired
immunodeficiency syndrome (AIDS) should be explored because
patients with AIDS have a high incidence of tuberculosis. A positive
result on skin testing means specifically that the person has at
some time been infected with TB, not necessarily that active
disease is present. Most patients who become positive skin testers
do not develop active disease. A diagnosis of active TB is made by
chest x-ray, imaging, sputum culture, and clinical examination.
6. Vasoconstrictors should be avoided in patients who cocaine or
methamphetamine users because these agents may precipitate
.
a.
severe hypotension
b.
severe hypertension
c.
respiratory depression
d.
cessation of intestinal peristalsis
ANSWER: B
Vasoconstrictors should be avoided in patients who are cocaine or
methamphetamine users because the combination may precipitate
arrhythmias, MI, or severe hypertension.
7. It has been shown that the risk for occurrence of a serious
perioperative cardiovascular event (e.g., MI, heart failure) is
increased in patients who are unable to meet a -MET (metabolic
equivalent of task) demand during normal daily activity.
a.
4
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