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