Dental Anesthesia Preparation (Dr. Tong Leang) /200 0 Dental Anesthesia Preparation (Dr. Tong Leang) 1 / 200 1) Which one of the following local anesthetics causes methemoglobinemia? a. Prilocaine b. Procaine c. Ropivacaine d. Lidocaine 2 / 200 2) Frequently used amide-type local anesthetic for Bier block a. ropivacaine (Naropin) b. bupivacaine (Marcaine) c. chloroprocaine (Nesacaine) d. prilocaine (Citanest) 3 / 200 3) For therapeutic application local anesthetics are usually made available as salt for the reason of:? a. Higher stability and greater lipid solubility b. More stability and greater water solubility c. Less local tissue damage and more potency d. Less toxicity and higher potency 4 / 200 4) Afferent or sensory nerves conduct impulses to the a. CNS. b. Periphery of the body c. Pain stimulus d. Motor nerves of muscles 5 / 200 5) The primary mechanism of action of local anesthetics is:? a. Blockade the GABA-gated chloride channels b. Activation of ligand-gated potassium channels c. Blockade of voltage-gated sodium channels d. Stimulation of voltage-gated N-type calcium channels 6 / 200 6) This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase a. bupivacaine (Marcaine) b. procaine (Novocain) c. dibucaine (Nupercainal, generic) d. ropivacaine (Naropin) e. chloroprocaine (Nesacaine) 7 / 200 7) The first ever peripheral nerve block is performed by a. Nils Lofgren b. William Salk c. Alfred Einhorn d. William Halsted 8 / 200 8) Gow- Gate nerve block The trigeminal nerve is predominantly sensory, and motor nerve, who supplied for the three large trunks, originate from the ganglion. Which of the following nerves is supply related only sensory? a. the mandibular nerve b. the lingual nerve c. the infra-orbital nerve d. the maxillary nerves 9 / 200 9) When injecting Local anesthetic solution in maxilla on buccal side. Which of the following technique is used? a. intra osseous b. intra septal c. sub mucosal d. supra periosteal e. sub periosteal 10 / 200 10) Epinephrine added to a solution of lidocaine for local anesthesia will:? a. Increase the absorption of lidocaine b. Increase the duration of local anesthesia c. Cause cyanosis locally. d. Increase the risk of convulsion. e. Decrease the heart rate when absorbed. 11 / 200 11) Topical antiseptic does which of the following? a. Reduces the risk of a local anesthetic overdose b. Makes patient more comfortable during initial penetration c. Allows the clinician to practice their site of penetration d. Lessens the chance of inflammation or infection e. Numbs 2-3mm of tissue prior to injection 12 / 200 12) Agents not recommended for Bier block: a. chloroprocaine (Nesacaine b. mepivacaine (Carbocaine) c. bupivacaine (Marcaine) d. chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine) 13 / 200 13) The mucosa of the hard palate is? a. keratinised and lacks submucosa and minor salivary glands. b. non-keratinised and has submucosa and minor salivary glands posteromedially c. non-keratinised and lacks submucosa and minor salivary glands. d. keratinised and has submucosa and minor salivary glands posterolaterally 14 / 200 14) A patient attends for an extraction of a lower molar tooth. Following the administration of an inferior alveolar nerve block only, the patient complains of pain during the procedure.Which one of the following nerves is the most likely to be responsible for the perception of this pain? a. Long buccal nerve b. Marginal mandibular c. Incisive nerve d. Mental nerve e. Facial nerve 15 / 200 15) Vasoconstrictor in Local anesthetic solution is? a. Has no effect on efficacy LA solution b. Increase toxic effects of LA c. Decreases depth & duration of LA d. Reduce toxic effects of LA solution e. Increase bleeding 16 / 200 16) Individual nerve fibers(axons) are surround and separated from each other by a. Epineurium b. Edoneurium c. Perineurium d. Fasciculi 17 / 200 17) vasoconstrictor in local anesthetic(LA) solution is used to ? a. Increases toxic effects of LA b. Increases bleeding. c. Reduces toxic effects of LA d. Decreases depth & duration LA. 18 / 200 18) All of the following are acceptable ways of recapping a needle EXCEPT? a. Securing cap with fingers on vertical syringe b. Carefully direction the cap over needle with fingers c. Performing the one handed scoop technique d. Implementing cotton roll pliers or a hemostat e. Utilizing “Card” or other holding device 19 / 200 19) Lidocaine (Xylocaine) cardiotoxicity — electrophysiological characteristics a. increased conduction velocity b. All are not correct c. reduced automaticity d. ECG -PR interval prolongation e. reduced phase 4 depolarization 20 / 200 20) You notice that your patient’s submandibular lymph nodes are enlarged. You would look for potential infection sites in the? a. Hard palate, upper lip and upper central incisor. b. Hard palate and upper lip. c. hard palate, upper lip, upper central incisor and lower first molar d. Hard palate. 21 / 200 21) Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia: a. more lipophilic anesthetics benefit most by epinephrine in addition to local anesthetic solutions b. more lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions® 22 / 200 22) Most frequent local anesthetic clinical use:? a. management of cardiac arrhythmias b. treatment of grand mal seizure c. analgesia d. management of increased intracranial pressure e. regional anesthetia 23 / 200 23) Most commonly used local anesthetic for rhinolaryngologic cases a. cocaine b. ropivacaine (Naropin) c. bupivacaine (Marcaine) d. mepivacaine (Carbocaine) e. tetracaine (pontocaine) 24 / 200 24) The trigeminal nerve is the sensory fibres form the semilunar ganglion (the Gasserian ganglion). Where does these ganglion or Gasserian lie in the bottom of the following? a. the anterior cranial fossa b. the posterior cranial fossa c. the roof of the cranial fossa d. the middle cranial fossa 25 / 200 25) The maxillary nerve exclusively sensory, passes through the foramen rotundum to reach the pterygopalatine fossa, where it off a number of branches.How many branches will theses nerves passes through the sphenopalatine ganglion? a. two branches b. four branches c. three branches d. There two branches of maxillary nerve, which enter the sphenopalatine ganglion. e. five branches 26 / 200 26) The most widely help theory on nerve transmission attributes conduction of the nerve impulse to changes in the a. CNS b. Axoplasm. c. Axolemma. d. Cell body. 27 / 200 27) Needle used for infiltration is ? a. 27 gauge b. 30 gauge c. 25 gauge d. 18 gauge e. 16 gauge 28 / 200 28) Which of the following local anesthetics is used exclusively for its good surface activity and low toxic potential? a. Cocaine b. Lidocaine c. Bupivacaine d. Benzocaine e. Procaine 29 / 200 29) Factors that influence lidocaine (Xylocaine) metabolism:? a. pregnancy-induced hypertension b. volatile anesthetics c. reduced liver blood flow d. hepatic disease e. pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics 30 / 200 30) Commonly use local anesthetics for topical/surface application: a. chloroprocaine (Nesacaine) b. cocaine c. tetracaine (pontocaine) d. lidocaine (Xylocaine) e. lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine 31 / 200 31) The area of insertion needle of local anesthesia is about 1cm medial from 1st and 2nd maxillary molar on the hard palate foramen is called a. PSA nerve block b. Greater Palatine nerve block c. ASA nerve block d. MSA nerve block 32 / 200 32) Reducing agent local anesthetics solution is ? a. Sodium metabisulphite b. Adrenaline c. Thymol d. Methyl paraben e. Ringer lactate 33 / 200 33) The technique of insertion at mucobuccal fold in the area of 1st and 2nd premolars is called a. MSA nerve block b. Infraorbital nerve block c. ASA nerve block d. PSA nerve block 34 / 200 34) Indicate the anesthetic agent of choice in patient with a liver disease:? a. Lidocaine b. Eticaine c. Bupivacaine d. Procaine 35 / 200 35) Which one of the following local anesthetic agents (at the correct dosage) is the most likely to provide the most prolonged analgesia? a. Bupivacaine b. Mepivacaine c. Prilocaine d. Articaine e. Lidocaine (lignocaine) 36 / 200 36) A successful infraorbital nerve block will produce anaesthesia of the? a. maxillary anterior teeth and their labial gingivae. b. maxillary anterior teeth. c. maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate d. maxillary anterior teeth, their labial gingivae and the upper lip 37 / 200 37) If the Lidocaine 2% with Epinephrine 1:100,00 was used. Which one of the following is selected for the maximum dose recommendation? a. 7.0 mg/kg b. 8.0 mg/kg c. 2.0 mg/kg d. 6.6 mg/kg 38 / 200 38) Which of the following local anesthetics is used for infiltrative and regional anesthesia related to amide type? a. Cocaine b. Lidocaine c. Tetracaine d. Procaine 39 / 200 39) Most local anesthetics can cause:? a. Depression of abnormal cardiac pacemaker activity, excitability, conduction b. Cardiovascular collapse c. All of the above d. Depression of the strength of cardiac contraction 40 / 200 40) Which of the following local anesthetcs is a short-acting drug? a. Procaine b. Ropivacaine c. Bupivacaine d. Tetracaine 41 / 200 41) Unmeyelinated fiber is surround by a. Wrapping by artery b. A single wrapping c. Wrapping by nerve d. Plural wrapping 42 / 200 42) Indicate the local anesthetic agent, which has a shorter duration of action:? a. Articaine b. Procaine c. Lindocaine d. Bupivacaine 43 / 200 43) Lidocaine (Xylocaine) effect on ventilation response to hypoxia? a. enhanced response b. depressed response c. no effect d. enhanced response and no effect 44 / 200 44) The nerve that combines MSA and ASA block is called a. Greater palatine nerve block b. Infraorbital nerve block c. Naso palatine nerve block d. Posterior superior alveolar nerve block 45 / 200 45) The area used to anesthetized the pulp tissue corresponding alveolar bone and buccal gingival tissue to maxillary 1st, 2nd, 3rd is called a. Greater palatine nerve block b. PAS, nerve block c. MSA nerve block d. ASA nerve block 46 / 200 46) Biotransformation of amides take place where? a. bloodstream b. blood plasma c. liver d. spleen e. kidney 47 / 200 47) Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia? a. True b. False 48 / 200 48) Local anesthetic used in greater than 50% of rhinolaryngologic cases:? a. cocaine b. prilocaine (Citanest) c. bupivacaine (Marcaine) d. mepivacaine (Carbocaine) e. tetracaine (pontocaine) 49 / 200 49) Rationale for adding epinephrine to a local anesthetic solution:? a. reduced duration of conduction blockade b. reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers c. increased anesthetic concentration near nerve fibers d. reduced local anesthetic systemic absorption e. all of the above 50 / 200 50) Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia — may because by nonhomogeneous local anesthetic distribution? a. transient radicular irritation b. cauda equina syndrome c. anterior spinal artery syndrome 51 / 200 51) The technique of about 1.0 cc of local Anesthetic and continues to inject about 0.5 cc on removal from injection site to anesthetize the lingual branch, inject remaining anesthetic in to corrode notch region of mandible in the mucous membrance distal and buccal to most distal molar to perform a long buccal nerve block is called a. IAN, Long buccal, Lingual nerve block b. IAN,Long Buccal nerve block only c. IAN, Long buccal nerve Block d. IAN, Mental nerve Block and Lingual nerve Block 52 / 200 52) Which of the following local anesthetics is only used for surface or topical anesthesia ? a. Bupivacaine b. Tetracaine c. Procaine d. Cocaine 53 / 200 53) All of the following methods will REDUCE the chance of needle breakage, EXCEPT one. Which one is the exception? a. Using a larger gauge needle b. Not bedding the needle excessively c. Burying the needle to the hub d. establishing a firm hand rest e. Minimizing the need for redirection in tissue 54 / 200 54) Which of the following local anesthetics is more water-soluble? a. Etidocaine b. Procaine c. Bupivacaine d. Tetracaine 55 / 200 55) Neurotoxicity — moderate/severe lower back, buttocks, posterior side pain? a. anterior spinal artery syndrome b. cauda equina syndrome c. transient radicular irritation 56 / 200 56) Which one are called local anesthesia nerve block? a. PSA , MSA, ASA b. Periodontal ligament injection c. Intraseptal injections d. Supraperiosteal injection 57 / 200 57) Indicate the function, which the last to be blocked:? a. Paine, temperature b. Touch, pressure c. Motor function d. Muscle spindles 58 / 200 58) Manifestation of systemic toxicity a. CNS toxicity, cardiovascular toxicity and neurological symptoms b. CNS toxicity c. neurological symptoms d. cardiovascular toxicity 59 / 200 59) The technique Provides sensory input for the lower lip skin, mucous membrane, pulpal and alveolar tissue for the premolar, canine and incisors on the side blocked is called a. Gow-Gate Nerve Block b. Akinosi Nerve block c. Mental Nerve Block d. IAN Block 60 / 200 60) Most local anesthetic agents is consist of 😕 a. Intermediate chain (commonly including an ester or amide) b. Lipophilic group (frequently an aromatic ring) c. amino group d. All of the above 61 / 200 61) Which one of the following agents is classified as the intermediate one? a. Prilocaine HCL 4% b. Articaine HCL 4% c. Mepivacaine 3% d. Bupivacaine HCL 0.5% 62 / 200 62) The axons of peripheral nerve is supported by a. Support by blood b. Support by muscle c. Supported by cell d. Support by Connective tissue 63 / 200 63) You notice a lesion on the labial alveolar mucosa of the lower right lateral incisor tooth of one of your patients and decide to take a biopsy to send for oral pathology report Which nerve would require local anesthesia in order to carry out a pain-free biopsy? a. The lingual nerve b. The buccal nerve c. The incisive nerve 64 / 200 64) A good local anesthetic agent shouldn’t cause:? a. systemic toxicity b. Vasodilation c. Fast onset and long duration of action d. Local irritation and tissue damage 65 / 200 65) A small bubble of approximately 1 to 2 mm diameter will frequently be found in the local anesthetic cartridge. These bubbles are cause by what? a. Shaking the cartridge vigorously b. The anesthetic solution being frozen c. Oxygen gas being trapped in the cartridge d. The cartridge was stored in a chemical disinfectant e. Nitrogen gas being pumped in during manufacturing 66 / 200 66) Clinical presentations suggestive of local anesthetic allergies: a. urticarial and possibly hypotension b. All are correct c. laryngeal edema d. Rash e. bronchospasm 67 / 200 67) Efferent or motor neurons conduct messages from: a. The CNS to the periphery. b. The pain stimulus to the periphery. c. The periphery of the body to the CNS. d. The cell body to the CNS. 68 / 200 68) Which of the following local anesthetics is an useful antiarrhythmic agent? a. Lidocaine b. Bupivacaine c. Ropivacaine d. Cocaine 69 / 200 69) Local Anesthetic deposited near a larger terminal branch of a nerve is called a. Periapical injection b. Field block c. Nerve Block d. Infiltration 70 / 200 70) Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution a. Hypertension b. Hypertension and Arrhythmias c. Arrhythmias d. Neither 71 / 200 71) A vasoconstrictor does not 😕 a. Hence the chance of toxicity b. Decrease the blood level c. Reduce a local anesthetic uptake by the nerve d. Retard the removal of drug from the injection site 72 / 200 72) Which layer is considered as anatomical barrier to the diffusion of local anesthetic substances a. Endoneurium b. Perineurium c. Epineurium d. Fasciculi 73 / 200 73) The technique palpate from extra orally and place thum or index finger on region with retract the upper lip and buccal mucosa and the area of injection is at the mucobuccal fold of the 1st premolar and canine area is called a. PSA nerve block b. Field block c. Middle superior alveolar nerve block d. Infraorbital nerve block 74 / 200 74) Correct statements concerning cocaine include all of the following EXCEPT:? a. Myocardial depression and peripheral vasodilation b. Cocaine is often used for nose and throat procedures c. Causes sympathetically mediated tachycardia and vasoconstriction d. Limited use because of abuse potential 75 / 200 75) When it is necessary to administer more than one anesthetic drug, a safe total should be determined by not exceeding what? a. Dental work being done in many more than on quadrant b. the maximum dose of each drug being administered c. the lower of the two maximum doses for the individual agents d. 35% of the maximum dose of each drug being administered e. 25% of the maximum dose of each drug being administered 76 / 200 76) Blanching at the site of injection is caused by:? a. Infection at the site of injection b. local effects of reducing agent in LA solution c. Decreased tissue tension d. Increased tissue tension e. Warm LA solution 77 / 200 77) Indicate the drug, which has greater potency of the local anesthetic action:? a. Lidocaine b. Procaine c. Mepivacaine d. Bupivacaine 78 / 200 78) Which of the following local anesthetics is more likely to cause allergic reaction? a. Procaine b. Lidocaine c. Bupivacaine d. Ropivacaine 79 / 200 79) Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is? a. higher melting point of combined drug than either lidocaine (Xylocaine) or prilocaine (Citanest) alone b. no local irritation, even absorption and no systemic toxicity c. even absorption d. no local irritation e. no systemic toxicity 80 / 200 80) Which of 2 nerves blocked when injection is given in pterygo mandibular space? a. Lingual & inferior alveolar nerve b. Buccal & lingual nerve c. Buccal nerve & infra orbital nerve d. inferior alveolar & posterior superior alveolar nerve e. Buccal & inferior alveolar nerve 81 / 200 81) Which one are the three major types of local anesthesia can be performed in the maxillary for pain control? a. Field block, infraorbital , intraosseus b. Nerve block, field block, and topical c. Field block, infiltration , and intraseptal d. Infiltration, field block, and nerve block 82 / 200 82) Which techniques do not work in the adult mandible due to dense cortical bone the below technique is a. Nerve block b. Mental nerve block c. Field block d. Infiltration injection technique 83 / 200 83) The technique insertion of mucobuccal fold between apex of 2nd and 3rd molars at 45 degree is called a. MSA, nerve block b. Infraorbital nerve block c. ASA, nerve block d. PSA, nerve block 84 / 200 84) You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland? a. to be palpable extraorally. b. To be palpable both intra- and extraorally c. only to be detectable by radiographical examination. d. to be palpable intraorally 85 / 200 85) Inferior alveolar nerve block (IAN) mouth must be open for this technique, best to utilize mouth drop, the depth of injection is about a. 25 mm to 27mm b. 30 mm to 33 mm c. 29mm to 30 mm d. 27mm to 29mm 86 / 200 86) Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport: a. prilocaine (Citanest) b. dibucaine (Nupercainal, generic) c. lidocaine (Xylocaine) d. bupivacaine (Marcaine) e. procaine (Novocain) 87 / 200 87) A healthy patient weighing 155 lbs has been given 2 cartridges of 2% lidocaine with epinephrine 1:100,000. How many MORE cartridges of 3% arestocaine can they have? a. 4.2 b. 4.0 c. 4.4 d. 4.6 88 / 200 88) What is one important way that local anesthetic drugs differ from all other drugs used in dentistry? a. Route of administration b. Rate of uptake into bloodstream c. Blood levels must be sufficient to exert effect d. Action ceased when absorbed into bloodstream e. High potential of overdose 89 / 200 89) Factors which increase local anesthetic CNS toxicities:? a. rate of injection b. high PaCO2 (reduced local anesthetic seizure threshold) c. patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used d. Hypokalemia e. rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold) 90 / 200 90) Technique of anesthesia in which local anesthetic solution is injected into the vein is ? a. Intra venous regional anesthesia b. Nerve block c. No such technique exists. d. Epidural anesthesia e. Infiltration anesthesia 91 / 200 91) The area of insertion needle is at the incisive papilla into incisive foramen and inject 0.3cc to 0.5cc of local anesthetic is called a. Naso-palatine nerve block b. Infraorbital nerve block c. Posterior superior alveolar nerve block d. Greater palatine nerve block 92 / 200 92) Zone of differential motor blockade may average up to four segments below the sensory level? a. epidural and Spinal b. Spinal c. epidural 93 / 200 93) Mechanism(s) of local anesthetic action in epidural anesthesia:? a. neither b. direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina c. direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura d. diffusion of local anesthetic into paravertebral regions through the intervertebral foramina 94 / 200 94) Which one of the following maximum dosage recommendations is selected for the patient weigh 70kg, related to Lidocaine 2% with epinephrine 1:50,000? a. 350 mg/kg b. 420 mg/kg c. 500 mg/kg d. 490 mg/kg 95 / 200 95) Agents added to local anesthetics that prolonged local anesthetic duration of action? a. phenylephrine (Neo-Synephrine) b. dextran c. Epinephrine d. Epinephrine, phenylephrine (Neo-Synephrine) and dextran 96 / 200 96) The area used to anesthetized the maxillary premolars, corresponding alveolus, and buccal gingival tissue is called a. Naso palatine nerve block b. PSA nerve block c. MSA nerve block d. ASA nerve block 97 / 200 97) After properly loading the cartridge into the syringe, a few drops of local anesthetic should be expelled. Why? a. To ensure the needle has not been barded b. The ensure proper placement of the harpoon c. To ensure the ability to aspirate d. To ensure free flow of the solution e. The ensure the correct anesthetic has been used 98 / 200 98) The more lipophilic drugs ? a. Are more potent b. Have longer duration of action c. Bind more extensively to protein d. All of the above 99 / 200 99) What is the MOST important reason hemostats/cotton roll pliers are part of the armamentarium? a. They are used to remove the Deptinpatch b. They are used to place the plastic cap on the needle c. They are used to place a cotton roll on the needle d. they are used to unscrew the needle from the syringe e. They are used for the retrieval of a broken needle 100 / 200 100) During an inferior alveolar nerve block the needle ideally passes? a. anterior and lateral to medial pterygoid b. Posterior and medial to medial pterygoid. c. through medial pterygoid d. Inferior to medial pterygoid. 101 / 200 101) Which one is the Amide anesthetics type a. Lidocaine b. Cocaine c. Procaine d. Movocaine 102 / 200 102) In the dental office, the MOST important consideration when selecting a syringe type is the ability of the following:? a. Be cost effective b. Aspirate c. Accept a 30 gauge needle d. Delivery anesthetic solution to a patient 103 / 200 103) When injecting Local solutionin maxilla on buccal side. The technique is ? a. Sup periosteal b. Intra osseous c. Sup mucosal d. Supra periosteal e. Intra septal 104 / 200 104) Preferred local anesthetics for local infiltration:? a. lidocaine (Xylocaine) b. bupivacaine (Marcaine) c. lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine) d. ropivacaine (Naropin) 105 / 200 105) The infraorbital nerve are supply for the front teeth both side left and right of the maxillary , especially for anterior superior alveolar nerve twigs and leave the trunk just before it exit of the infraorbital foramen and outside the foramen twigs to the skin between the nostril and eye.Which area is used for injection local anesthesia for these teeth? a. at the apex between the second and third molar b. at the apex between the canine and first premolar c. at the apex between the first and second molar d. at the apex between the second premolar and first molar 106 / 200 106) Disto buccal root of upper 1st molar is supplied by:? a. Posterior superior alveolar nerve b. buccal nerve c. mental nerve d. infra orbital nerve e. Middle superior alveolar nerve 107 / 200 107) Which one of the following of the maximum dose recommended for normal healthy individual patient per kilogram is.? a. 7.0 mg/kg b. 6 mg/kg c. 6.6 mg/kg d. 8.0 mg/kg 108 / 200 108) Factor(s) which determine extent of systemic local anesthetic absorption: a. injection site vascularity b. initial dose c. All are not correct d. intrinsic drug properties e. whether or not epinephrine was used to provide local vasoconstriction 109 / 200 109) Neurotoxicity following local anesthesia: lower extremity paresis– predisposing conditions may include advanced age and peripheral vascular disease a. transient radicular irritation b. cauda equina syndrome and anterior spinal artery syndrome c. anterior spinal artery syndrome d. cauda equina syndrome 110 / 200 110) The major factor influencing the ability to aspirate is what? a. Gauge of the needle b. Size of thumb ring c. Harpoon being sterile d. Site of injection e. Size of clinician hand’S 111 / 200 111) The antioxidant used to preserve epinephrine in a local anesthetic solution is? a. Sodium hydrochloride b. Sodium chloride c. Sodium bisulfate d. Sodium pentanol e. Sodium bicarbonate 112 / 200 112) Indicate the local anesthetic, which is a long-acting agent:? a. Lidocaine b. Procaine c. Mepivacaine d. Bupivacaine 113 / 200 113) Which of the following local anesthetics in an acetanilide derivative? a. Cocaine b. Tetracaine c. Lidocaine d. Procaine 114 / 200 114) The technique can be used to anesthetize the palatal soft tissue of the teeth posterior to maxillary canine and corresponding alveolus and hard palate is called a. Naso palatine nerve block b. PSA nerve block c. Infraorbital nerve block d. Greater palatine nerve block 115 / 200 115) The concentration of epinephrine that is optimal for hemostasis is what? a. 1:200,000 b. 1:100,000 c. 1:5000 d. 1:150,000 e. 1:50,000 116 / 200 116) Which one is NOT include in the type of infiltration technique? a. Supraperiosteal injections b. Intraseptal injections c. Periodontal ligament injections d. Infraorbital injection 117 / 200 117) When procaine undergoes metabolic breakdown, the major metabolic product (metabolite) is what? a. Pseudocholinesterase b. Para-aminobenzoic acid c. chloroprocaine d. Succinylcholine 118 / 200 118) Correct statements concerning lidocaine include all of the following EXCEPT:? a. It widely used as an antiarrhythmic agent b. It is metabolized in liver c. It is an universal anesthetic d. It has esteratic linkage 119 / 200 119) The technique Provides same area of anesthesia as the Inferior alveolar nerve block and useful for injected patients with trismus, fractured mandible are needs to be used a. IAN Block b. Akinosi nerve Block(R) c. Long Buccal nerve Block d. Lingual nerve Block 120 / 200 120) Indicate the local anesthetic, which is an ester of paraaminobezoic acid:? a. Lidocaine b. Procaine c. Mepivacaine d. Cocaine 121 / 200 121) The area of injection mucobuccal fold between the mandible premolars is called a. IAN Block b. Mental Nerve Block c. Long buccal Nerve block 122 / 200 122) Which one are the following technique used only on the mandibular nerve Block , please choice the best answer a. IAN, Long buccal nerve Block, infraorbital nerve block b. IAN, Akinosi, Gow-Gates, Mental nerve Block c. IAN, Akinosi, PSA, MSA, ASA, Greater palatine nerve block d. IAN, Lingual nerve Block , Gow-Gate nerve Block 123 / 200 123) Which one of the following agents is classified as the long one? a. Prilocaine 4% b. Bupivacaine HCL 0.5% c. Articaine HCL 4% d. Lidocaine HCL 2% 124 / 200 124) In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be? a. light pink in colour on both sides of the mucogingigival junction. b. light pink below the mucogingival junction and red above it. c. ed below the mucogingival junction and light pink above it d. red on both sides of the mucogingival junction 125 / 200 125) The technique that use the non-dominant hand to retract the buccal soft tissue at the area of coronoid notch of mandible , and index finger on posterior border of extra oral mandible is called a. Gow-Gate Nerve block b. IAN nerve block c. Mental Nerve Block d. Akinosi Nerve Block 126 / 200 126) If Articaine 4% with epinephrine 1:100,000 or 1:200,000 was used with patient 80kg. Which one of the following option was selected? a. 350 mg/kg b. 560 mg/kg c. 650 mg/kg d. 490 mg/kg 127 / 200 127) Most serious toxic reaction to local anesthetics is:? a. All of the above b. Cardiovascular collapse c. Seizures d. Respiratory failure 128 / 200 128) Ionizable group is responsible for ? a. The potency and the toxicity b. The ability of diffuse to the site of action c. The duration of action d. All of the above 129 / 200 129) Stacey, a 18 year old soccer player, arrives for extraction of teeth #4,12, and 20, and she is given 5 cartridges of 4% Articaine with epi 1:100,000.Her mother calls 3 hours following the appointment stating that Stacey appears cyanotic and sluggish. Her nail beds look dark and the blood in the extraction sites is chocolate brown. What is MOST likely the condition presented? a. Malignant hyperthermia b. A typical plasma cholinesterase c. Local anesthetic overdose d. Methemoglobinemia e. Local anesthetic allergy 130 / 200 130) Vasoconstrictors are less effective in prolonging anesthetic properties of 😕 a. Procaine b. Mepivacaine c. Bupivacaine d. Lidocaine 131 / 200 131) Which one of the following groups is responsible for the duration of the local anesthetic action? a. Intermediate chain b. Nonionize group c. Lipophilic group d. Ionizable group 132 / 200 132) Local anesthetic deposited near the main nerve trunk and is usually distant form the operative site is called a. Nerve block b. Infiltration c. Field block d. Periapical injection 133 / 200 133) A successful inferior alveolar nerve block will produce anesthesia of the? a. lower lip. b. lower lip and mandibular teeth. c. lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the posterior mandibular teeth. d. lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth 134 / 200 134) All of the following are ways of caring for a syringe EXCEPT one. Which one is the EXCEPTION? a. Place in an ultrasonic bath b. Rinse syringe of saliva and foreign matter c. Sharpen or replace harpoon as needed d. clean with an ultrasonic instrument e. dismantle and lubricate every 5 uses 135 / 200 135) A patient with epilepsy is scheduled for root planning and scaling with local anesthetic today. What should the dental hygienist know about this condition? a. In low doses local anesthetic is an anti-convulsant b. The patient should be pre-medicated prio to treatment c. Epilepsy is an absolute contraindication to amide type anesthetics d. Oxygen should be available to deliver in an emergency. e. Epilepsy is a relative contraindication to ester type anesthetics 136 / 200 136) Nerve impulse travel in myelinated nerves by a process called what? a. Relative refractory b. Nodes of Ranvier c. Domino effect d. Salutatory conduction 137 / 200 137) When given nerve block , will also cause anesthetized to the lower eyelid, lateral aspect of nasal skin tissue, and skin of infraorbital region is called a. Anterior superior alveolar nerve block b. Middle superior alveolar nerve block c. Posterior superior alveolar nerve block d. Infraorbital nerve block 138 / 200 138) The area of insertion needle is at the mucous membrane of the medial border of the mandibular ramus at the intersection of a horizontal line and vertical line is called a. Lingual nerve block only b. Long buccal nerve block c. IAN block, lingual nerve block d. Akinosi or close mouth nerve block 139 / 200 139) Which of the following local anesthetics is called a universal anesthetic? a. Lidocaine b. Ropivacaine c. Procaine d. Bupivacaine 140 / 200 140) Common eutectic mixture of local anesthetics (EMLA)? a. prilocaine (Citanest) and bupivacaine (Marcaine) b. tetracaine (pontocaine) and bupivacaine (Marcaine) c. lidocaine (Xylocaine) and tetracaine (pontocaine) d. lidocaine (Xylocaine) and prilocaine (Citanest) e. tetracaine (pontocaine) and epinephrine 141 / 200 141) Correct statements concerning bupivacaine include all of the following EXCEPT? a. An intravenous injection can lead to seizures. b. It has amide linkage c. It is a long-acting drug d. It has low cardiotoxicity 142 / 200 142) Local anesthetic not recommended for peripheral nerve blockade: a. ropivacaine (Naropin) b. lidocaine (Xylocaine) c. bupivacaine (Marcaine) d. tetracaine (pontocaine) 143 / 200 143) which one of the following local anesthetics is an ester of benzoic acid:? a. Ropivacaine b. Procaine c. Lidocaine d. Cocaine 144 / 200 144) Which of the following drugs can cause methemoglobinnemia when used in larger doses for regional anesthesia? a. Prilocaine b. Bupivacaine c. Lidocaine d. Cocaine e. Procaine 145 / 200 145) The technique used to anesthetized the maxillary canine, lateral incisor, and central incisors and buccal gingival is called a. MSA nerve block b. PSA nerve block c. Greater palatine nerve block d. ASA nerve block 146 / 200 146) At what time are professionals MOST at risk for a needle stick? a. Recapping b. Disassembly of syringe c. Unsheathing the needle d. Assembling the syringe e. Giving the injection 147 / 200 147) Which technique is useful for infected patients with trismus, fractured mandibles, and mentally handicapped individuals a. IAN Block b. Akinosi Nerve Block(R) c. Mental nerve Block d. Lomng Buccal Nerve Block 148 / 200 148) Related to the maximum dose recommended when used Lidocaine 2% with Epinephrine 1:50,000. Which one of the following is selected for ASA? a. ASA 2 b. ASA 1 c. ASA 4 d. ASA 3 149 / 200 149) Clinical use(s) of EMLA applications:? a. venipuncture b. lumbar puncture c. arterial cannulation d. myringotomy 150 / 200 150) Typically a zone of differential sympathetic nervous system blockade? a. epidural b. spinal c. epidural and spinal 151 / 200 151) Prilocaine has all of the following properties EXCEPT:? a. It has ester linkage b. It is relatively short-acting c. It readily penetrates the skin and mucosa d. Its metabolic product can inhibit the action of sulfonamides 152 / 200 152) In local anesthetic dissociation, tissues with a low pH would have effect on base(RN) and cation(RNH+) in the solution? a. A lower portion of RN and higher portion of RNH+ b. Decrease potency of local anesthetic c. Increase duration of local anesthetic d. Rapid onset of local anesthetic e. A lower portion of RNH+ and a higher portion of RN 153 / 200 153) Distilled water is added to the cartridge for what purpose? a. To prevent the probation of nerve impulses b. To prevent the biodegradation of the vasopressor c. To provide the volume of the solution d. To increase the safely and the duration of the anesthetic e. To make the solution isotonic with the tissues of the body 154 / 200 154) Which one of the following statements about the metabolism of local anesthetics is incorrect? a. Ester group of anesthetics like Procaine, are metabolized systemically by pseudocholinesterae b. Metabolism of local anesthetics occurs at the site of administration c. Amides such as Lignocaine, are metabolized in the liver by microsomal mixed function oxidases d. Metabolism occurs in the plasma or liver but not at the site of administration 155 / 200 155) Which of the following fibers participates in high-frequency pain transmission? a. Type A beta fibers b. Type B fibers c. Type A delta and C fibers d. Type A alpha fibers 156 / 200 156) Allergic reactions to local anesthetics:? a. high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug b. common > 10% of adverse reactions due to allergic mechanisms c. cross-sensitivity between esters and amide-type local anesthetics are common d. high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds e. intradermal testing for possible allergy to local anesthetics should use preservative-free drug 157 / 200 157) The technique used to anesthetizes the maxillary 1st and 2nd premolars, canine, lateral incisor, central incisor, corresponding alveolar bone, and buccal gingiva is called a. PSA nerve block b. Infraorbital nerve block c. MAS nerve block d. ASA nerve block 158 / 200 158) Primary side effect/toxicities associated with local anesthetic use:? a. allergic reactions b. systemic toxicity c. neither d. allergic reactions and systemic toxicity 159 / 200 159) Local anesthetics are? a. Weak acids b. Weak bases c. Salts d. pH 160 / 200 160) The regional lymphatic drainage of the left side of the tip of the tongue is to the? a. left and right submandibular lymph nodes. b. left submandibular lymph node. c. left and right submental lymph nodes d. left submental lymph node. 161 / 200 161) Which of the following statements is NOT correct for local anesthetics? a. A charge cationic form penetrates biologic membranes more readily than and uncharged form b. Low ph in inflamed tissues decreases the disscociation of nonionized molecules c. In a tissue they exist either as an uncharged base or as a cation d. Local anesthetics are much less effective in inflamed tissues 162 / 200 162) Most common cause of toxic plasma local anesthetic concentrations? a. without solution of vasoconstrictors for anesthetic b. increase vasoconstrictors solution in the anesthetic c. accidental direct intravascular injection during block d. incorrect dosage during peripheral or block 163 / 200 163) Surface activity and low toxic potential? a. Benzocaine b. Cocaine c. procaine d. Bupivacaine e. Lidocaine 164 / 200 164) ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine) a. true b. false 165 / 200 165) The technique of insertion at mucobuccal fold in the area of lateral incisor and canine on maxillary is called a. ASA nerve block technique b. PSA nerve block technique c. Greater palatine nerve block technique d. MSA nerve block technique 166 / 200 166) The injection that able to perform in maxilla with thin cortical nature of bone, to tissue immediately surgical site is called. a. Inferior alveolar nerve block b. Field block c. Infiltration d. Nerve block 167 / 200 167) Disto buccal root of upper first molar is supplied by:? a. Buccal nerve b. Mental nerve c. Middle superior alveolar nerve d. Posterior superior alveolar nerve e. Infra orbital nerve 168 / 200 168) Which of the following local anesthetics is more cardiotoxic? a. Mepivacaine b. Bupivacaine c. Procaine d. Lidocaine 169 / 200 169) Which of the following fibers is the first to be blocked? a. Type A alpha fibers b. Type A beta fibers c. B and C fibers d. Type A gamma fibers 170 / 200 170) If the two percent of Lidocaine 2% with Epinephrine 1:100,000 are suggested for American Society of Anesthesia. Which one of the following categories of the American Society of Anesthesia was selected? a. ASA 4 b. ASA 1 c. ASA 2 d. ASA 3 171 / 200 171) The technique that the mouth must be open widely during injection and the area of injection from contralateral premolar region is called a. Gow-Gate nerve Block b. IAN block c. Akinosi Nerve Block d. Mental Nerve Block 172 / 200 172) The anesthetic effect of the agent of short and intermediate duration of action cannot be prolong by adding:? a. Norepinephrine b. Epinephrine c. Dopamine d. Phenylephrine 173 / 200 173) Which one is the best answer for nerve block of local anesthesia in the maxillary nerve block? a. PSA, MSA,ASA, Infraorbital , Greater palatine , and Naso palatine nerve b. Supraperiosteal injection, infraseptal injection and periodontal ligament injection c. PSA,MSA,ASA, Greater Palatine and Lingual Nerve block d. PSA,MSA,ASA, Mental Nerve, Inferior Alveolar Nerve Block and lingual nerve block 174 / 200 174) Which of the following drugs can cause methemoglonemia? a. Procaine b. Lidocaine c. Bupivacaine d. Prilocaine e. Cocaine 175 / 200 175) Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.? a. Acidosis b. Hypoxemia, Hyperkalemia and Acidosis c. Hypoxemia d. Hyperkalemia 176 / 200 176) Which one of the following groups is responsible for the potency and the toxicity of local anesthetic? a. Intermediate chain b. Lipophylic group c. Inonizable group d. Non Ionize group 177 / 200 177) Indicate the local anesthetic, which is more lipid-soluble:? a. Mepivacaine b. Bupivacaine c. Lidocaine d. Procaine 178 / 200 178) Which one is the ester type of local anesthetic a. Mepivacaine( or carbocaine) b. Procaine c. Bupivacaine(or Marcaine) d. Prilocaine ( or citanest) 179 / 200 179) How many major types of Local Anesthesia can be performed in the maxillary for pain control? a. One major type b. Three major types c. Two major types d. Four major types 180 / 200 180) Which of the following local anesthetics is a thiophene derivative? a. Procaine b. Lidocaine c. Ultracaine d. Mepivacaine 181 / 200 181) The groups of the axon, the fasciculi, are enclosed in an additional connective tissue sheath called a. The perineurium b. Fasciculi c. Endoneurium d. Epineurium 182 / 200 182) All of the following are reasons to include a vasoconstrictor, ECEPT one.Which one is the EXCEPTION? a. lower anesthetic toxicity b. lower blood flow to injection site c. improve field of vision for treatment d. increase anesthetic blood levels e. increase duration of local anesthetic 183 / 200 183) Most common complication of posterior Superior alveolar nerve block is:? a. Blanching of the area b. Facial palsy c. Infection d. Hematoma e. Trismus 184 / 200 184) The duration of action of local anesthetics agents are divided in short, intermediate and long. Which one of the following is classified as the short one? a. Bupivacaine HCL 0.5% b. Articaine HCL 4% c. Lidocaine HCL 2% d. Prilocaine HCL 4% 185 / 200 185) Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.? a. tetracaine (pontocaine) b. bupivacaine (Marcaine) c. mepivacaine (Carbocaine) d. dyclonine (Dyclone) e. lidocaine (Xylocaine) 186 / 200 186) One of the many proprietary names for lidocaine is what? a. Candicaine HCL b. Mepivacaine c. Sandonest HCL d. Xylocaine HCL e. 35%Polocaine 187 / 200 187) Factors enhancing bupivacaine (Marcaine) toxicity? a. arterial hypoxemia b. acidosis and hypercarbia c. Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia d. presence of calcium channel blockers e. Pregnancy 188 / 200 188) Which portion of the nerve do local anesthetics work on? a. Neuron b. Schawann cellS c. Dendrites d. Nerve membrane e. Myelinated sheath 189 / 200 189) The technique can be used to anesthetize the soft and hard tissue of the maxillary anterior palate from canine to canine is called a. Greater palatine nerve block b. Naso palatine nerve block c. Infraorbital nerve block d. Posterior superior alveolar nerve block 190 / 200 190) The function organization of axon and schwann cell is called a. Call myelin sheath b. Nerve cell c. Neuron cell d. Nerve fiber 191 / 200 191) Which of the following local anesthetics is preferable in patient with pseudocholinesterase difiency? a. Procaine b. Tetracaine c. Benzocaine d. Ropivacaine 192 / 200 192) Which of the following nerves are entering the sphenopalatine ganglion? a. The greater palatine nerve, and the middle superior alveolar nerve b. The greater palatine nerve, and the anterior superior alveolar nerve c. The greater, the nasopalatine nerve and posterior nasal nerve twigs. d. The greater palatine nerve, and the posterior superior alveolar nerve 193 / 200 193) For a local anesthetic to be clinically useful is a. It’s action should be completely reversible b. It’s action should be temporary c. All to the above. d. It should be compatible with the tissues 194 / 200 194) Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia? a. Tetracaine b. Bupivacaine c. Cocaine d. Dibucaine 195 / 200 195) Indicate the local anesthetic, which is a toluidine derivative:? a. Procaine b. Lindocaine c. Prilocaine d. Bupivacaine 196 / 200 196) what are the local anesthetic produce for:? a. analgesia, amnesia, loss of consciousness b. a stupor or somnolent state c. alleviation of anxiety and pain with an altered level of consciousness d. blocking pain sensation without loss of consciousness 197 / 200 197) As with all local anesthetics, the dose varies depending on the area to be anesthetized, the vascularity of tissues, individual tolerance, and the techniques of anesthesia. Which type of the following patient should be decreased the dose for them? a. children patient b. debilitate or elderly patient c. adult patient d. young patient 198 / 200 198) If the two percent of Lidocaine 2% with Epinephrine 1:100,000 were used for patient 60kg. Which one of the following was selected for the 60kg patient? a. 490 mg/kg b. 500 mg/kg c. 350 mg/kg d. 420 mg/kg 199 / 200 199) Local anesthetic which produces localized vasoconstriction and anesthesia? a. prilocaine (Citanest) b. chloroprocaine (Nesacaine) c. cocaine d. tetracaine (pontocaine) e. lidocaine (Xylocaine) 200 / 200 200) In 1980, when the first edition of Stanley F. Malamed, and the Sixth edition of Hand book of local anesthetic were available in dental cartridge form include: Lidocaine, Articaine, Prilocaine, Mepivacaine, and Bupivacaine. Which one of the following was selected for the maximum dose recommendation related to the Articaine 4% with epinephrine 1:100,000 per kilogram of the patient weight? a. 2.0 mg/kg b. 6.6 mg/kg c. 7,0 mg /kg d. 8.0 mg/kg Your score isThe average score is 0% Facebook 0% Restart quiz Any comments? Send feedback