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g Medically Compromised Patient,
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10th Edition by Craig Miller, Chapters 1 – 30.
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,Little: Dental Management of the Medically Compromised Patient, 10th Edition Test Bank
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Table of Contents
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PART ONE: PATIENT EVALUATION AND RISK ASSESSMENT
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Chapter 1: Patient Evaluation and Risk Assessment
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PART TWO: CARDIOVASCULAR DISEASE
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Chapter 2: Infective Endocarditis
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Chapter 3: Hypertension
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Chapter 4: Ischemic Heart Disease
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Chapter 5: Cardiac Arrhythmias
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Chapter 6: Heart Failure (or Congestive Heart Failure)
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PART THREE: PULMONARY DISEASE
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Chapter 7: Pulmonary Disease
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Chapter 8: Smoking and Tobacco Use Cessation
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Chapter 9: Sleep-Related Breathing Disorders
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PART FOUR: GASTROINTESTIAL DISEASE
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Chapter 10: Liver Disease
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Chapter 11: Gastrointestinal Disease
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PART FIVE: GENITOURINARY DISEASE
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Chapter 12: Chronic Kidney Disease and Dialysis
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Chapter 13: Sexually Transmitted Diseases
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PART SIX: ENDOCRINE AND METABOLIC DISEASE
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Chapter 14: Diabetes Mellitus
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Chapter 15: Adrenal Insufficiency
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Chapter 16: Thyroid Diseases
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Chapter 17: Pregnancy and Breast Feeding
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PART SEVEN: IMMUNOLOGIC DISEASE
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Chapter 18: AIDS, HIV Infection, and Related Conditions
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Chapter 19: Allergy
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Chapter 20: Rheumatologic and Connective Tissue Disorders
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Chapter 21: Organ and Bone Marrow Transplantation
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PART EIGHT: HEMATOLOGIC AND ONCOLOGIC DISEASE
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Chapter 22: Disorders of Red Blood Cells
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Chapter 23: Disorders of White Blood Cells
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Chapter 24: Acquired Bleeding and Hypercoagulable Disorders
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Chapter 25: Congenital Bleeding and Hypercoagulable Disorders
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Chapter 26: Cancer and Oral Care of the Patient
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PART NINE: NEUROLOGIC, BEHAVIORAL, AND PSYCHIATRIC DISORDERS
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Chapter 27: Neurologic Disorders
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Chapter 28: Anxiety, Eating Disorders, and Behavioral Reactions to Illness
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Chapter 29: Psychiatric Disorders
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Chapter 30: Drug and Alcohol Abuse
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Material
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Page 1 of 74
Chapter 01: Patient Evaluation and Risk Assessment
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Little: Dental Management of the Medically Compromised Patient, 10th Edition
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MULTIPLE CHOICE b-g
1. Elective dental care should be deferred for patients with severe, uncontrolled hypertension,
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meaning that the blood pressure is greater than or equal to
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a. 200/140
b. 180/140
c. 180/110
d. 160/110
ANSWER: C b -g
Elective dental care should be deferred for patients with severe, uncontrolled hypertension,
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which is blood pressure greater than or equal to 180/110 mm Hg, until the condition can
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be brought under control.
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2. The American Heart Association currently recommends antibiotic prophylaxis for a patient
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with which of the following cardiac conditions?
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a. Mitral valve prolapse b-g b-g
b. Prosthetic heart valve b-g b-g
c. Rheumatic heart disease b-g b-g
d. Pacemakers for cardiac arrhythmias b-g b-g b-g
ANSWER: B b -g
Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for
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many patients with heart murmurs caused by valvular disease (e.g., mitral valve prolapse,
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rheumatic heart disease) in an effort to prevent infective endocarditis; however, current
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guidelines omit this recommendation on the basis of accumulated scientific evidence. If a
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murmur is due to certain specific cardiac conditions (e.g., previous endocarditis, prosthetic
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heart valve, complex congenital cyanotic heart disease), the AHA continues to recommend
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antibiotic prophylaxis for most dental procedures.
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3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability of
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g the body to
b-g b-g certain drugs, including local anesthetics and analgesics.
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a. absorb
b. distribute
c. metabolize
d. excrete
ANSWER: C b -g
Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of liver
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function. This deficit may result in prolonged bleeding and less efficient metabolism of
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certain drugs, including local anesthetics and analgesics.
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4. Which of the following symptoms and signs is most consistent with allergy?
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a. Heart palpitations b-g
b. Itching
c. Vomiting
d. Fainting
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ANSWER: B b -g
Symptoms and signs consistent with allergy include itching, urticaria (hives), rash, swelling,
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wheezing, angioedema, runny nose, and tearing eyes. Isolated signs and symptoms such as
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nausea, vomiting, heart palpitations, and fainting generally are not of an allergic origin but
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rather are manifestations of drug intolerance, adverse side effects, or psychogenic reactions.
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5. Which of the following is true of the patient with a history of tuberculosis?
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a. A positive result on skin testing means that the person has active TB.
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b. Most patients who become positive skin testers develop active disease.
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c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of
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g tuberculosis.
d. A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
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ANSWER: b - g C
The potential coexistence of tuberculosis and acquired immunodeficiency syndrome (AIDS)
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should be explored because patients with AIDS have a high incidence of tuberculosis. A
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positive result on skin testing means specifically that the person has at some time been
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infected with TB, not necessarily that active disease is present. Most patients who become
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positive skin testers do not develop active disease. A diagnosis of active TB is made by chest
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x-ray, imaging, sputum culture, and clinical examination.
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6. Vasoconstrictors should be avoided in patients who cocaine or methamphetamine users b-g b-g b-g b-g b-g b-g b-g b-g b-g b-g b-
because these agents may precipitate
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a. severe hypotension b-g
b. severe hypertension b-g
c. respiratory depression b-g
d. cessation of intestinal peristalsis b-g b-g b-g
ANSWER: B b -g
Vasoconstrictors should be avoided in patients who are cocaine or methamphetamine users
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because the combination may precipitate arrhythmias, MI, or severe hypertension.
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7. It has been shown that the risk for occurrence of a serious perioperative cardiovascular event
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(e.g., MI, heart failure) is increased in patients who are unable to meet a -MET (metabolic
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equivalent of task) demand during normal daily activity.
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a. 4
b. 6
c. 8
d. 10
ANSWER: A b-g
Daily activities requiring 4 METs include level walking at 4 miles/hour or climbing a flight of
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stairs. Activities requiring greater than 10 METs include swimming and singles tennis. An
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exercise capacity of 10 to 13 METs indicates excellent physical conditioning.
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8. Which of the following alterations in the fingernails is associated with cirrhosis?
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a. Yellowing
b. Clubbing
c. White discoloration b-g
d. Splinter hemorrhages b-g
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