DSE OSCE - 2022 | questions and answers | instant
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41-yo woman, pregnant; prev rheumatic fever with heart yes
murmur (no valvular abnormality); allergy to penicillin. - on my exam, this patient had a previous history of infective endocarditis. Pre-med
Positive history of infective endocarditis. Does she need IS indicated
to pre med?
- yes
- no
Pre-med options for pregnant woman w/hx of infective *clarithromycin*
endocarditis and penicillin allergy I may not be correct, the correct option may be cephalexin. however I chose
- amoxicillin clarithromycin due to penicillin allergy, cross reaction with cephalosporins, and
- cephalexin since clindamycin/erythromycin/azthromycin were not options. Ciproflaxacin is
- clarithromycin contraindicated in pregnancy. article for reference
- ciproflaxacin
What procedure can a dentist perform without consulting *occlusal restoration*
MD if a patient is currently taking bisphosphonates? although the main HELL NO is extraction, completing endo therapy increases risk
- endo therapy if the apex is compromised/damaged during therapy. I teetered on prophy
- prophy and scaling and scaling, but since it did not specify supragingival, decided that the risk of
- extraction scaling can negatively affect the periosteum of a bisphosphanate patient. ADA
- occlusal restoration recommendations:
Pregnant person afraid of needles - stress management place her in Trendelburg position
by putting patient in what position when in your chair
(BEFORE they even get to the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup
,6 months pregnant had bleeding gums and mobile teeth, conservative debridement
how should they be treated? .- pregnancy gingivitis: important to do ScRP (and stress good oral hygiene) to
- immediate extractions prevent plaque growth. The plaque can enter blood stream and stimulate patient's
- do not treat until baby is born immune system to produce prostaglandins, which can trigger uterine contraction
- conservative debridement leading to early labor, premature birth, and a small baby.
- immediate endo
Pregnant lady with a diastema in between #8 and #9 chronic perio
with deep probing depth and class 1 mobility on 8 and 9. - increased incidence of periodontal disease during pregnancy => must emphasize
What is the reason for diastema? good oral hygiene, and remove all their plaque so it doesn't lead to premature
- chronic periodontitis birth / low birth weight
- distal drift
- normal during pregnancy
Permanent staining as a result of tetracyline; did this age 0-5 years
happen? - remember that PERMANENT dentition does not begin calcification until birth
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
Pentobarbital (Nembutal) and Secobarbital (Seconal) are barbituates
what type of drugs? - used primarily evening BEFORE appointment
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic
A patient has an allergic reaction to a barbiturate, how do benadryl (diphenhydramine)
you treat?
- epinephrine
- diphenhydramine
- send to ER
A patient is on a steroidal medication. What *dose and duration*
information do you need to obtain before treating - "The rule of twos": Ask whether the patient is currently on steroids or has been
them? on corticosteroids for 2 weeks or longer within the past 2 years. You must go
- dose and pharmacy that filled the RX back 2 years in the history because it can take 2 weeks to 2 years for the adrenal
- duration of prescription glands to bounce back to normal function.
- both dose and duration
What is the most important factor when calculation weight
medication dosage for a child
- age
- weight
- gender
- height
A patient is confirmed to have trisomy 21. What are you congenital heart defects
initially concerned about? Consider cardiac status and posibility of pre-medication:
- congenital heart defect - atrioventricular septal defect, patent ductus arteriosus, Tetralogy of Fallot
- Cushings
- cerebrovascular accident
, A patient has recently had a stroke. What is your first Are they on anticoagulants
concern? - Stroke patients could be on blood thinners, such as aspirin, dipyradamole
- when was their last cleaning (Persan- tine), clopidogrol (Plavix), or Coumadin, postrecovery. Prior to major
- are they on anticoagulants surgery, always consult with the patient's physician to determine whether and
- current blood pressure when the blood thinners can be stopped and subsequently restarted.
What is the main symptom that differentiates anaphylaxis Bronchoconstriction
from syncope? - Anaphyalxis: intense itching, hives, flushing over the face and chest. Rhinitis,
- bronchoconstriction conjunctivitis, nausea, vomiting, abdominal cramps, and perspiration. Palpitation,
- clammy skin and pallor tachycardia, sub- sternal tightness, coughing, wheezing, and dyspnea. BP drops
- nausea, vomiting rapidly and loss of consciousness or cardiac arrest can occur in severe cases.
-Syncope: fight or flight response. Anxiety, tachycardia, perspiration, light-
headedness, and blurred vision are commonly experienced.
The Enzyme Linked Immune Absorbent Assay (ELISA) Test *the patient does not have HIV antibodies*
- a negative response for a person who had needle stick - consider that false negatives are a thing, life happens. We cannot definitively say
means what? they do not have HIV,but we can say that no Ab were detected.
- the patient definitely has an HIV infection
- the patient has antibodies to HIV-1 present
- the patient definitely does not have an HIV infection
- the patient has no antibodies to HIV-1 present.
14 year old presents with inflamed gingiva. Bloodwork leukemia
indicates abnormal RBC, WBC, and platelets. Diagnosis? -high WBC, lymphadenopathy, painful gingiva. Don't forget that WBC can be
- normal 14 year old elevated OR decreased in leukemia! Gingival hypertrophy is a common
- hypothyroidism sign/symptom
- leukemia
- anemia
Stem indicates patient has recently taken medications, Penicillin allergy
which one likely caused the rash present on their arm? - hives is a common response to penicillin allergies
- Acetamiophen
- Barbituates
- Penicillin
- diphenhydramine
Name the drugs that induce gingival hyperplasia "CDC"
Calcium channel blockers (amlodipine, nifedipine)
Dilantin (anticonvulsants)
Cyclosporines
Drugs that may have increased chance of periodontal Amlodipine (Ca Channel Blocker)
destruction
- "-statin"
- "-olol"
- "-ipril"
- "-ipine"
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41-yo woman, pregnant; prev rheumatic fever with heart yes
murmur (no valvular abnormality); allergy to penicillin. - on my exam, this patient had a previous history of infective endocarditis. Pre-med
Positive history of infective endocarditis. Does she need IS indicated
to pre med?
- yes
- no
Pre-med options for pregnant woman w/hx of infective *clarithromycin*
endocarditis and penicillin allergy I may not be correct, the correct option may be cephalexin. however I chose
- amoxicillin clarithromycin due to penicillin allergy, cross reaction with cephalosporins, and
- cephalexin since clindamycin/erythromycin/azthromycin were not options. Ciproflaxacin is
- clarithromycin contraindicated in pregnancy. article for reference
- ciproflaxacin
What procedure can a dentist perform without consulting *occlusal restoration*
MD if a patient is currently taking bisphosphonates? although the main HELL NO is extraction, completing endo therapy increases risk
- endo therapy if the apex is compromised/damaged during therapy. I teetered on prophy
- prophy and scaling and scaling, but since it did not specify supragingival, decided that the risk of
- extraction scaling can negatively affect the periosteum of a bisphosphanate patient. ADA
- occlusal restoration recommendations:
Pregnant person afraid of needles - stress management place her in Trendelburg position
by putting patient in what position when in your chair
(BEFORE they even get to the point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup
,6 months pregnant had bleeding gums and mobile teeth, conservative debridement
how should they be treated? .- pregnancy gingivitis: important to do ScRP (and stress good oral hygiene) to
- immediate extractions prevent plaque growth. The plaque can enter blood stream and stimulate patient's
- do not treat until baby is born immune system to produce prostaglandins, which can trigger uterine contraction
- conservative debridement leading to early labor, premature birth, and a small baby.
- immediate endo
Pregnant lady with a diastema in between #8 and #9 chronic perio
with deep probing depth and class 1 mobility on 8 and 9. - increased incidence of periodontal disease during pregnancy => must emphasize
What is the reason for diastema? good oral hygiene, and remove all their plaque so it doesn't lead to premature
- chronic periodontitis birth / low birth weight
- distal drift
- normal during pregnancy
Permanent staining as a result of tetracyline; did this age 0-5 years
happen? - remember that PERMANENT dentition does not begin calcification until birth
- During development (as fetus)
- 0-5yrs
- 5-10 yrs
- 10-15 yrs
Pentobarbital (Nembutal) and Secobarbital (Seconal) are barbituates
what type of drugs? - used primarily evening BEFORE appointment
- benzodiazepines
- NSAIDS
- barbituates
- atypical antipsychotic
A patient has an allergic reaction to a barbiturate, how do benadryl (diphenhydramine)
you treat?
- epinephrine
- diphenhydramine
- send to ER
A patient is on a steroidal medication. What *dose and duration*
information do you need to obtain before treating - "The rule of twos": Ask whether the patient is currently on steroids or has been
them? on corticosteroids for 2 weeks or longer within the past 2 years. You must go
- dose and pharmacy that filled the RX back 2 years in the history because it can take 2 weeks to 2 years for the adrenal
- duration of prescription glands to bounce back to normal function.
- both dose and duration
What is the most important factor when calculation weight
medication dosage for a child
- age
- weight
- gender
- height
A patient is confirmed to have trisomy 21. What are you congenital heart defects
initially concerned about? Consider cardiac status and posibility of pre-medication:
- congenital heart defect - atrioventricular septal defect, patent ductus arteriosus, Tetralogy of Fallot
- Cushings
- cerebrovascular accident
, A patient has recently had a stroke. What is your first Are they on anticoagulants
concern? - Stroke patients could be on blood thinners, such as aspirin, dipyradamole
- when was their last cleaning (Persan- tine), clopidogrol (Plavix), or Coumadin, postrecovery. Prior to major
- are they on anticoagulants surgery, always consult with the patient's physician to determine whether and
- current blood pressure when the blood thinners can be stopped and subsequently restarted.
What is the main symptom that differentiates anaphylaxis Bronchoconstriction
from syncope? - Anaphyalxis: intense itching, hives, flushing over the face and chest. Rhinitis,
- bronchoconstriction conjunctivitis, nausea, vomiting, abdominal cramps, and perspiration. Palpitation,
- clammy skin and pallor tachycardia, sub- sternal tightness, coughing, wheezing, and dyspnea. BP drops
- nausea, vomiting rapidly and loss of consciousness or cardiac arrest can occur in severe cases.
-Syncope: fight or flight response. Anxiety, tachycardia, perspiration, light-
headedness, and blurred vision are commonly experienced.
The Enzyme Linked Immune Absorbent Assay (ELISA) Test *the patient does not have HIV antibodies*
- a negative response for a person who had needle stick - consider that false negatives are a thing, life happens. We cannot definitively say
means what? they do not have HIV,but we can say that no Ab were detected.
- the patient definitely has an HIV infection
- the patient has antibodies to HIV-1 present
- the patient definitely does not have an HIV infection
- the patient has no antibodies to HIV-1 present.
14 year old presents with inflamed gingiva. Bloodwork leukemia
indicates abnormal RBC, WBC, and platelets. Diagnosis? -high WBC, lymphadenopathy, painful gingiva. Don't forget that WBC can be
- normal 14 year old elevated OR decreased in leukemia! Gingival hypertrophy is a common
- hypothyroidism sign/symptom
- leukemia
- anemia
Stem indicates patient has recently taken medications, Penicillin allergy
which one likely caused the rash present on their arm? - hives is a common response to penicillin allergies
- Acetamiophen
- Barbituates
- Penicillin
- diphenhydramine
Name the drugs that induce gingival hyperplasia "CDC"
Calcium channel blockers (amlodipine, nifedipine)
Dilantin (anticonvulsants)
Cyclosporines
Drugs that may have increased chance of periodontal Amlodipine (Ca Channel Blocker)
destruction
- "-statin"
- "-olol"
- "-ipril"
- "-ipine"
