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