, Little: Dental Management of the Medically Compromised Patient, 8th E
w w w w w w w w w
dition
Chapterw01:wPatientwEvaluationwandwRiskwAssessmentwTe
stwBank
MULTIPLEwCHOICE
1. Electivewdentalwcarewshouldwbewdeferredwforwpatientswwithwsevere,wuncontrolledwhyperte
nsion,wmeaningwthatwthewbloodwpressurewiswgreaterwthanworwequalwtow
mm
wHg.
A. 200/140
B. 180/140
C. 180/110
D. 160/110
ANS:w w C
Electivewdentalwcarewshouldwbewdeferredwforwpatientswwithwsevere,wuncontrolledwhypertensi
on,wwhichwiswbloodwpressurewofwgreaterwthanworwequalwtow180/110wmmwHg,wuntilwthewcondit
ionwcanwbewbroughtwunderwcontrol.
PTS: 1 REF: p.w4
2. ThewAmericanwHeartwAssociationwcurrentlywrecommendswantibioticwprophylaxiswforw
awpatientwwithwwhichwofwthewfollowingwcardiacwconditions?
A. mitralwvalvewprolapse
B. prostheticwheartwvalve
C. rheumaticwheartwdisease
D. pacemakerswforwcardiacwarrhythmias
ANS:w w B
Previously,wthewAmericanwHeartwAssociationw(AHA)wrecommendedwantibioticwprophylaxi
swforwmanywpatientswwithwheartwmurmurswcausedwbywvalvularwdiseasew(e.g.,wmitralwvalvewpr
olapse,wrheumaticwheartwdisease)winwanweffortwtowpreventwinfectivewendocarditis;wcurrentwg
uidelineswomitwthiswrecommendationwonwthewbasiswofwaccumulatedwscientificwevidence.wIfwa
wmurmurwiswduewtowspecificwcardiacwconditions w(e.g.,wprevious wendocarditis,wprostheticwhe
artwvalve,wcomplexwcongenitalwcyanoticwheartwdisease),wthewAHAwcontinueswtowrecommen
dwantibioticwprophylaxiswforwmostwdentalwprocedures.wPatientswwithwpacemakerswdownotwre
quirewantibioticwprophylaxis.
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
, TestwBank 1-2
PTS: 1 REF: pp.w4-5
3. Onewconsequencewofwchronicwhepatitisw(BworwC)worwcirrhosiswofwthewliverwiswdecreasedwabili
tywofwthewbodywtow certainwdrugs,wincludingwlocalwanestheticswandwanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS:w w C
Patientswwithwchronicwhepatitisw(BworwC)worwcirrhosiswhavewanwassociatedwimpairmentwofwli
verwfunction.wThiswdeficitwmaywresultwinwprolongedwbleedingwandwlesswefficientwmetabolism
wofwcertain wdrugs,wincludingwlocal wanestheticswandwanalgesics.
PTS: 1 REF: p.w6
4. Whichwofwthewfollowingwsymptomswandwsignswiswmostwconsistentwwithwallergy?
A. heartwpalpitations
B. itching
C. vomiting
D. fainting
ANS:w w B
Symptomswandwsignswconsistentwwithwallergywincludewitching,wurticariaw(hives),wrash,wswel
ling,wwheezing,wangioedema,wrunnywnose,wandwtearingweyes.wIsolatedwsignswandwsymptoms
wsuchwaswnausea,wvomiting, wheartwpalpitations,wandwfaintingwgenerallywarewnotwofwanwallergi
cworiginwbutwratherwarewmanifestationswofwdrugwintolerance,wadversewsideweffects,worwpsycho
genicwreactions.
PTS: 1 REF: p.w6
5. Whichwofwthewfollowingwiswtruewofwthewpatientwwithwawhistorywofwtuberculosis?
A. AwpositivewresultwonwskinwtestingwmeanswthatwthewpersonwhaswactivewTB.
B. Mostwpatientswwhowbecomewpositivewskinwtesterswdevelopwactivewdisease.
C. Patientswwithwacquiredwimmunodeficiencywsyndromew(AIDS)whavewawhig
hwincidencewofwtuberculosis.
D. AwdiagnosiswofwactivewTBwiswmadewbywawpurifiedwproteinwderivativew(PPD)wskinwtest.
ANS:w w C
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
, TestwBank 1-3
Thewpotentialwcoexistencewofwtuberculosiswandwacquiredwimmunodeficiencywsyndromew(A
IDS)wshouldwbewexploredwbecausewpatientswwithwAIDSwhavewawhighwincidencewofwtubercul
osis.wAwpositivewresultwonwskinwtestingwmeanswspecificallywthatwthewpersonwhaswatwsomewtim
ewbeenwinfectedwwithwTB,wnotwnecessarilywthatwactivewdiseasewiswpresent.wMostwpatientswwh
owbecomewpositivewskinwtesterswdownotwdevelopwactivewdisease.wAwdiagnosiswofwactivewTBwi
swmadewbywchestwx-ray,wimaging,wsputumwculture,wandwclinicalwexamination.
PTS: 1 REF: p.w6-7
6. Vasoconstrictorswshouldwbewavoidedwinwpatientswwhowarewusingwcocainewo
rwmethamphetaminewbecausewthesewagentswmaywprecipitatew .
A. severewhypotension
B. severewhypertension
C. respiratorywdepression
D. cessationwofwintestinalwperistalsis
ANS:w w B
Vasoconstrictorswmaywprecipitatewcardiacwarrhythmiasworwseverewhypertensionwinwpatient
swwhowarewusingwcocaineworwmethamphetamine.wRespiratorywdepressionwiswassociatedww
ithwthewusewofwopioids.
PTS: 1 REF: p.w8
7. Itwhaswbeenwshownwthatwthewriskwforwoccurrencewofwawseriouswperioperativewcardiovascular
wevent wiswincreasedwinwpatientswwhowarewunablewtowmeetwaww w -
METw(metabolicwequivalentwofwtask)wdemandwduringwnormalwdailywactivity.
A. 4
B. 6
C. 8
D. 10
ANS:w w A
Riskwiswincreasedwinwpatientswunablewtowmeetwaw4-
METwdemand.wDailywactivitieswrequiringw4wMETswincludewlevelwwalkingwatw4wmiles/hourwor
wclimbingwawflightwofwstairs.wActivitieswrequiringwgreaterwthanw10wMETswincludewswimmingw
andwsingleswtennis.
PTS: 1 REF: p.w9
8. Whichwofwthewfollowingwalterationswinwthewfingernailswiswassociatedwwithwcirrhosis?
A. yellowing
B. clubbing
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
w w w w w w w w w
dition
Chapterw01:wPatientwEvaluationwandwRiskwAssessmentwTe
stwBank
MULTIPLEwCHOICE
1. Electivewdentalwcarewshouldwbewdeferredwforwpatientswwithwsevere,wuncontrolledwhyperte
nsion,wmeaningwthatwthewbloodwpressurewiswgreaterwthanworwequalwtow
mm
wHg.
A. 200/140
B. 180/140
C. 180/110
D. 160/110
ANS:w w C
Electivewdentalwcarewshouldwbewdeferredwforwpatientswwithwsevere,wuncontrolledwhypertensi
on,wwhichwiswbloodwpressurewofwgreaterwthanworwequalwtow180/110wmmwHg,wuntilwthewcondit
ionwcanwbewbroughtwunderwcontrol.
PTS: 1 REF: p.w4
2. ThewAmericanwHeartwAssociationwcurrentlywrecommendswantibioticwprophylaxiswforw
awpatientwwithwwhichwofwthewfollowingwcardiacwconditions?
A. mitralwvalvewprolapse
B. prostheticwheartwvalve
C. rheumaticwheartwdisease
D. pacemakerswforwcardiacwarrhythmias
ANS:w w B
Previously,wthewAmericanwHeartwAssociationw(AHA)wrecommendedwantibioticwprophylaxi
swforwmanywpatientswwithwheartwmurmurswcausedwbywvalvularwdiseasew(e.g.,wmitralwvalvewpr
olapse,wrheumaticwheartwdisease)winwanweffortwtowpreventwinfectivewendocarditis;wcurrentwg
uidelineswomitwthiswrecommendationwonwthewbasiswofwaccumulatedwscientificwevidence.wIfwa
wmurmurwiswduewtowspecificwcardiacwconditions w(e.g.,wprevious wendocarditis,wprostheticwhe
artwvalve,wcomplexwcongenitalwcyanoticwheartwdisease),wthewAHAwcontinueswtowrecommen
dwantibioticwprophylaxiswforwmostwdentalwprocedures.wPatientswwithwpacemakerswdownotwre
quirewantibioticwprophylaxis.
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
, TestwBank 1-2
PTS: 1 REF: pp.w4-5
3. Onewconsequencewofwchronicwhepatitisw(BworwC)worwcirrhosiswofwthewliverwiswdecreasedwabili
tywofwthewbodywtow certainwdrugs,wincludingwlocalwanestheticswandwanalgesics.
A. absorb
B. distribute
C. metabolize
D. excrete
ANS:w w C
Patientswwithwchronicwhepatitisw(BworwC)worwcirrhosiswhavewanwassociatedwimpairmentwofwli
verwfunction.wThiswdeficitwmaywresultwinwprolongedwbleedingwandwlesswefficientwmetabolism
wofwcertain wdrugs,wincludingwlocal wanestheticswandwanalgesics.
PTS: 1 REF: p.w6
4. Whichwofwthewfollowingwsymptomswandwsignswiswmostwconsistentwwithwallergy?
A. heartwpalpitations
B. itching
C. vomiting
D. fainting
ANS:w w B
Symptomswandwsignswconsistentwwithwallergywincludewitching,wurticariaw(hives),wrash,wswel
ling,wwheezing,wangioedema,wrunnywnose,wandwtearingweyes.wIsolatedwsignswandwsymptoms
wsuchwaswnausea,wvomiting, wheartwpalpitations,wandwfaintingwgenerallywarewnotwofwanwallergi
cworiginwbutwratherwarewmanifestationswofwdrugwintolerance,wadversewsideweffects,worwpsycho
genicwreactions.
PTS: 1 REF: p.w6
5. Whichwofwthewfollowingwiswtruewofwthewpatientwwithwawhistorywofwtuberculosis?
A. AwpositivewresultwonwskinwtestingwmeanswthatwthewpersonwhaswactivewTB.
B. Mostwpatientswwhowbecomewpositivewskinwtesterswdevelopwactivewdisease.
C. Patientswwithwacquiredwimmunodeficiencywsyndromew(AIDS)whavewawhig
hwincidencewofwtuberculosis.
D. AwdiagnosiswofwactivewTBwiswmadewbywawpurifiedwproteinwderivativew(PPD)wskinwtest.
ANS:w w C
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
, TestwBank 1-3
Thewpotentialwcoexistencewofwtuberculosiswandwacquiredwimmunodeficiencywsyndromew(A
IDS)wshouldwbewexploredwbecausewpatientswwithwAIDSwhavewawhighwincidencewofwtubercul
osis.wAwpositivewresultwonwskinwtestingwmeanswspecificallywthatwthewpersonwhaswatwsomewtim
ewbeenwinfectedwwithwTB,wnotwnecessarilywthatwactivewdiseasewiswpresent.wMostwpatientswwh
owbecomewpositivewskinwtesterswdownotwdevelopwactivewdisease.wAwdiagnosiswofwactivewTBwi
swmadewbywchestwx-ray,wimaging,wsputumwculture,wandwclinicalwexamination.
PTS: 1 REF: p.w6-7
6. Vasoconstrictorswshouldwbewavoidedwinwpatientswwhowarewusingwcocainewo
rwmethamphetaminewbecausewthesewagentswmaywprecipitatew .
A. severewhypotension
B. severewhypertension
C. respiratorywdepression
D. cessationwofwintestinalwperistalsis
ANS:w w B
Vasoconstrictorswmaywprecipitatewcardiacwarrhythmiasworwseverewhypertensionwinwpatient
swwhowarewusingwcocaineworwmethamphetamine.wRespiratorywdepressionwiswassociatedww
ithwthewusewofwopioids.
PTS: 1 REF: p.w8
7. Itwhaswbeenwshownwthatwthewriskwforwoccurrencewofwawseriouswperioperativewcardiovascular
wevent wiswincreasedwinwpatientswwhowarewunablewtowmeetwaww w -
METw(metabolicwequivalentwofwtask)wdemandwduringwnormalwdailywactivity.
A. 4
B. 6
C. 8
D. 10
ANS:w w A
Riskwiswincreasedwinwpatientswunablewtowmeetwaw4-
METwdemand.wDailywactivitieswrequiringw4wMETswincludewlevelwwalkingwatw4wmiles/hourwor
wclimbingwawflightwofwstairs.wActivitieswrequiringwgreaterwthanw10wMETswincludewswimmingw
andwsingleswtennis.
PTS: 1 REF: p.w9
8. Whichwofwthewfollowingwalterationswinwthewfingernailswiswassociatedwwithwcirrhosis?
A. yellowing
B. clubbing
Copyrightw©w2013wbywMosby,wanwimprintwofwElsevierwI
nc.
