Pharmacology and Anesthesiology Past Paper PDF

PHARMACOLOGY AND ANESTHESIOLOGY 1. This techinique of mandibular anesthesia is useful for patients suffering from trismus, fractured mandible and mentally-handicapped children. A. Gow-Gates Technique B. Vazirani-Akinosi Technique C. IAN Block D. Mandibular Nerve Block 2. Regarding local anaesthesi...

PHARMACOLOGY AND ANESTHESIOLOGY 1. This techinique of mandibular anesthesia is useful for patients suffering from trismus, fractured mandible and mentally-handicapped children. A. Gow-Gates Technique B. Vazirani-Akinosi Technique C. IAN Block D. Mandibular Nerve Block 2. Regarding local anaesthesia which of the following is true? A. Local anaesthetics act on large before small nerve fibres B. Their main toxic effects are seen on the central nervous and cardiovascular systems C. Preparations containing adrenaline are safe to use on digits and appendages D. Lignocaine has a longer duration of action than bupivicaine 3. Anesthesia performed with general anesthetics occurs in 4 stages which may or may not be ob- servable because they can occur very rapidly. Which stage is the one which skeletal muscles re- lax, and the patient's breathing becomes regular? A. Analgesia B. Excitement C. Surgical anesthesia D. Medullary anesthesia 4. The recommended gas combination dose for conscious sedations: A. 50% oxygen; 50% nitrous oxide B. 60% oxygen; 40% nitrous oxide C. 40% oxygen; 60% nitrous oxide D. 30% oxygen; 70% nitrous oxide E. varies according to the patient respond 5. Which of the following teeth could be removed without pain after administration of an inferior alveolar and lingual nerve block? A. All anterior teeth on the side of the injection B. Canine and first premolar on the side of the injection C. All teeth in that quadrant on the side ofthe injection D. Both premolars and first molar on the side ofthe injection 6. You are considering your choice of local analgesia for a surgical procedure which you anticipate will be ‘difficult’.Which one of the following agents provides the most prolonged analgesia? A. Articaine C. Bupivicaine 180 mins B. Lidocaine 45-75 D. Mepivicaine 45 - 70 7. 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 anaesthesia in order to carry out a pain-free biopsy? A. The incisive nerve C. The mental nerve B. The buccal nerve D. The lingual nerve 8. A successful inferior alveolar nerve block will produce anaesthesia of the A. lower lip. B. lower lip and mandibular teeth. C. lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth. D. lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the poste- rior mandibular teeth. 9. A successful infraorbital nerve block will produce anesthesia of what part: A. maxillary anterior teeth. B. maxillary anterior teeth and their labial gingivae. C. maxillary anterior teeth, their labial gingivae and the upper lip D. maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate 10. Which of the following structures travel through the substance of the parotid gland? A. The maxillary artery B. The maxillary artery and retromandibular vein C. The maxillary artery, retromandibular vein and facial artery D. The maxillary artery, retromandibular vein, facial artery and buccal branch of the mandibular nerve Le Fort midfacial fractures. (A) Le Fort I fracture 11. The following are innervated by PSAN, except: separating inferior portion of maxilla in hori- zontal fashion, extending from piriform aperture of nose to A. Buccal soft tissue of Maxillary molars pterygoid maxillary suture area. (B) Le Fort II fracture B. Mx 2nd Molar involving separation of maxilla and nasal complex from cranial base, zygomatic orbital rim area, and pterygoid C. Mesiobuccal root of Mx 1st Molar maxillary suture area. (C) Le Fort III fracture (i.e., craniofacial separation), which is a complete D. Distobuccal root of Mx 1st Molar separation of midface at level of naso-orbital-ethmoid complex and zygomaticofrontal suture area. The fracture also extends through orbits bilaterally. 12. In patients who have a Le Fort II fracture, a common finding is paresthesia over the distribution of the: A. Infraorbital nerve C. Inferior alveolar nerve B. Mylohyoid nerve D. Hypoglossal nerve 13. The anterior superior alveolar nerve arises as a branch of the: A. Sphenopalatine nerve C. Infraorbital nerve B. Posterior Superior alveolar nerve D. Greater palatine nerve E. Zygomatic nerve 14. The trigeminal provides sensory innervation for all of the following except the: A. Posterior third of the tongue B. Nasal cavity C. Oral Cavity D. Paranasal sinuses E. Skin of the face 15. The inferior alveolar nerve is a branch of the: A. Anterior trunk of the mandibular nerve B. Posterior trunk of the mandibular nerve C. Buccle nerve D. Masseteric nerve E. Deep temporal nerves 16. Branch of maxillary nerve given off before it enters the inferior orbital fissure. A. PSAN B. ASAN C. MSAN D. Na- sopalatine E. Greater Palatine Nerve 17. Branch of maxillary nerve given off at the cranium: A. nervusspinosus B. middle meningeal nerve C. zygomatic nerve D. auriculo-temporal nerve E. sphenopalatine nerve 18. Xerostomia is a complication of mandibular blocking which occurs due to the asso- ciation of lingual nerve to which of the the following? A. chorda tympani B. buccal nerve C. glossopharyngeal D. Mylohyoid nerve 19. Mental nerve innervates the following except: A. lower lip B. mucosa lower bicuspid C. chin D. lower bicuspid E. none 20. Injection in the area of mental nerve will also anesthetized the: A. lower lip B. mucosa lower bicuspid C. chin D. lower bicuspid E. none 21. Too much local anesthesia can result to: A. paresthesia B. trauma C. trismus D. xerostomia E. dry socket 22. Too much puncture injection in mandibular blocking can result to: A. paresthesia B. pain C. trismus D. xerostomia E. dry socket 23. Toxic symptoms of local anesthesia is: A. pain and swelling B.CNS stimulation C. cardiac arrest D. shock E. stroke 24. Injection technique that is more prone to hematoma: A. mandi block B. Gow Gates C. Akinosi D. MSAN block E. PSAN block 25. #47 buccal injection indicated for: A. RCT B. tooth extraction C. Composite restoration D. odontectomy E. none 26. Best alternative technique after mandi block for still painful #36 for access in rct: A. intraosseous B. intraseptal C. intrapulpal D.intraliga- mentary E. Gow Gates 27. Long lasting amide local anesthetics used for temporary relief of Tic Douloureux A. Prilocaine B. Hurricaine C. Bupivacaine D. Lidocaine E.Mepivacaine 28. Contents of the anesthetic cartridge. A. anesthetic drug B.epinephrine C.sodiummetabisulfite D.distilled water E. all 29. Node to node jumping of impulse A. synapse B. saltatory conduction C. neurotransmission D. none 30. Factor that determine the level of pain tolerance A. weight B. age C. fatigue D. height E. B and C 31. Method of controlling pain by taking analgesic drugs A. raising pain threshold B.block painful impulse C. removal cause D. psychosomatic methods E. pain prevention by cortical depression 32. Method of controlling pain by use of local anesthesia A. raising pain threshold B. block painful impulse C. removal of cause D. psychosomatic methods E. pain prevention by cortical depression 33. In the absence of MSAN , bicuspids can have innervation from what nerve A. ASAN B. PSAN C. Pterygoid plexus D. infraorbital E. Labial 34. Bell Palsy can best be prevented by A. use always long needle B. use short needle C. fast injection D. aspiration 35. Painful #44 for RCT even after three intrapulpal, two infiltration, one intraligamentary, one man- dibular blocking after two hours is best manage by A. second IAN block B. more intraligamentary C. change anesthesia D. IAN block opposite mandible E. general anesthesia 36. The cardiac glycosides will reduce the concentration of which ion in an active heart muscle? Sodium C. Calcium Bromide D. Chloride E. Potassium 37. Pretreatment with which of the following drug will potentiate the ability of an intravenous injec- tion of acetylcholine to lower blood pressure? A. Methacholine C. Pilocarpine B. Epinephrine D. Physostigmine E. Pralidoxime 38. An excess of which of the following hormones may be associated with increased sensitivity to epinephrine? A. Testosterone C. Insulin B. Parathyroid D. Thyroid E. both B & D 39. Before extracting a patient’s premolar, the dentist administers an inferior alveolar block. Three minutes after receiving this block, the patient develops paralysis of his forehead muscles, of his eyelids, and of the upper and lower lips on the same side of his face. These findings are the most likely to be associated with the diffusion of the anesthetic solution into which of the following? A. Otic ganglion D. Auriculotemporal nerve B. apsule of the parotid gland E. Ophthalmic division of the trigeminal nerve C. Motor branches of the mandibular nerve supplying the masticatory muscles 40. The dentist, who planned to sedate a patient intravenously, first injects a test dose into the pa- tient’s arm. Immediately, upon receiving the injection, the patient experiences a severe, burning pain at the site of injection; it radiates distally. Simultaneously, her arm becomes blotchy with sev- eral blanched areas. Although her pulse in that arm is regular, it is weaker than her unaffected side. Which of the following might account for these findings? A. an injection into an artery B. an injection into the radial nerve C. an injection into the muscle compartment D. an impending anaphylactic reaction. 41. The principal therapeutic action of the glucocorticoids is is: A. Antidiuretic C. anti-infective B. Antianabolic D. antihypertensive E. anti-inflammatory 42. The primary effect produced by digitalis therapeutic dose levels is: A. a slowing of the cardiac rate B. a decrease in the venous pressure C. a decrease in cardiac enlargement D. an increase in the force of myocardial contraction. 43. The single most useful agent in resuscitation is: A. Oxygen C. an endotracheal tube E. aromatic spirits of ammonia B. a respiratory stimulant D. 1:1000 epinephrine for injection 44. Inadvertently, an overdose of morphine is administered to a patient. To treat this condition, a dentist should administer: A. oxygen and inject naloxone hydrochloride B. caffeine sodium, benzoate intravenously C. doxapram intramuscularly D. nalorphine and epinephrine intramuscularly 45. The activity of benzalkonium chloride is markedly antagonized by: A. soap C. sodium chloride B. sodium nitrite D. cetypyridinium chloride C. alkylbenzyldimethyl ammonium chloride 46. A patient informs his dentist that he has been taking mecamylamine regularly for the past year. Upon oral examination the dentist is most likely to find: A. ptyalism C. palatal petechiae B. xerostomia D. gingival hypertrophy E. bullous lesions on the buccal mucosa 47. A patient receiving propranolol has an acute asthmatic attack while undergoing dental treat- ment. The most useful agent for management of the condition is: A. Morphine C. phentolamine B. Epinephrine D. aminophylline E. norepinephrine 48. The systemic activity of the ester (procaine) types of local anesthetics is terminated primarily by: A. elimination by the kidney B. metabolism in the liver only C. storage in adipose tissue D. metabolism in the liver and by pseudocholinesterase in the plasma 49. If a patient requiring an extraction reports that he is on bishydroxycoumarin therapy, the labora- tory test most valuable in evaluating the surgical risk is: A. clotting time C. sedimentation rate B. bleeding time D. complete blood count E. plasma prothrombin time 50. The first clinically useful and systematically effective anti-nfective agent was: A. penicillin C. tetracycline B. sulfanilamide D. streptomycin E. bacitracin 51. During visit to the dentist, a patient develops a severe, acute bronchial asthmatic attack. He should immediately receive: A. cortisone C. tripelennamine B. epinephrine D. 90% oxygen, 10% CO2 52. The most serious and life-threatening blood dyscrasia associated with drug toxicity is: A. aplastic anemia C. thrombocytopenia B. agranulocytosis D. hemolytic anemia E. megaloblastic anemia 53. When methohexital is used to induce general anesthesia, the initial effect wears off within a short time and the patient awakens. This occurs because the drug is: A. detoxified C. eliminated from the body B. biotransformed D. redistributed from the brain 54. A dental patient on anticonvulsant therapy exhibits marked gingival hypertrophy. This patient , most likely, is regularly taking: A. primidone C. phenacemide B. mephobarbital D. Phenobarbital E. diphenylhydantoin 55. Adrenergic neuron blocking drugs, such as guanethidine, are useful primarily in the treatment of: A. mental disease C. cholinergic crisis B. cardiac arrest D. paroxysmal tachycardia E. essential (primary) hypertension 56. The most important pharmacologic action of drug which suppress cardiac arrhythmias ia: A. blockage of the vagus nerve B. stimulation of cardiac ATP-ase activity C. blockage of the beta-adrenergic receptor D. stimulation of alpha-adrenergic receptor E. increased refractory period of cardiac muscle. 57. Tolerance is least likely to develop with the use of: A. LSD B. marijuana C. Heroin D. methadone E. amphetamines 58. The principal danger associated with the use of nitrous oxide anesthesia in concentrations ex- ceeding 80% is: A. hypoxia C. liver damage E. irritation of the respiratory tract. B. renal damage D. vomiting and nausea 59. For treating most oral infections, penicillin V is preferred to penicillin G because penicillin V; A. is less allergenic D. is less sensitive to acid degradation B. has a greater gram-negative spectrum E. has a longer duration of action C. is bactericidal, whereas penicillin G is not. 60. When the combined action of two drugs is greater the sum of their individual action, this is: A. induction C. idiosyncrasy B.synergism D. hypersensitivity E. cumulative action 61. With an overdose of a cholinergic drug, one would expect to see each of the following, except: A. Sweating C. mydriasis B. Urination D. bradycardia E. copious serious saliva 62. Which of the following is a beta-adrenergic receptor blocking agent used for the treatment of hypertension? A. Prazosin (Minipress ®) C. Atenolol (Tenormin®) B. Clonidine (Catapres®) D. Hydralazine (Aprezoline®) E. Verapamil (Calan®) 63. In which of the following categories are ephedrine, tyramine, and amphetamine classified? A. Anticholinesterases C. Alpha-adrenergic blocking agents B. Indirect-acting sympathomimetics D. Direct-acting parasympathomimetics 64. Each of the following methods can be used to control pain, except: A. Cortical depression D. Psychosomatic (hypnosis) methods B. Raising the pain threshold E. Blocking the sensory pathway C. Depression of the autonomic nervous system 65. Thiazides, which are used in the treatment of hypertension, may require supplemental admin- istration of: A. Sodium B. calcium C. Chloride D. potassium 66. Which of the following dentrifice components is most likely to inactivate the fluoride ion? A. Anionic detergent C. Polyacrylic spheres B. Dicalcium phosphate D. Monofluorophosphate 67. Which of the following adverse reactions of oral contraceptives is the most common and the most serious? A. Hypotension D. Uterine neoplasia B. Hepatotoxicity E. Thromboembolic disorder C.Decreased resistance to infection 68. In therapeutic doses, digitalis acts primarily on the cardiac muscle. It does so by increasing the: A. force of contraction C. refractory period of the atrial muscle B. refractory period of the ventricular muscle D. rate of conduction of impulses to the muscle. 69. Each of the following is a pharmacologic effect of phenothiazines , except: A. Sedation D. An antiemetic effect B. Alpha-adrenergic blackage E. Potentiation of the action of narcotics C. An anticonvulsant 70. Which of the following represents the drug-of-choice in the treatment of candidiasis for an HIV- infected patient? A. Acyclovir B. AZT C. Nystatin D. Chlorhexidine 71. Epinephrine antagonizes the effects of histamines by: A. preventing the release of histamine B. acting on the CNS C. producing physiologic actions opposite to that of histamine D. competitively blocking histamine at the cellular receptor site 72. Cyanosis, dyspnea and elevated temperature following general anesthesia may indicate: 1. atelectasis 3. pulmonary embolus 2. pneumonia 4. acute renal shutdown A. 1 only B. 1,2 & 3 C. 2 & 3 D. 2 & 4 E. 4 only 73. How many milligrams of epinephrine are in each carpule (1.8cc) of 2% lidocaine with 1:100,000 epinephrine? A. 0.018mg. B. 0.036 mg. C. 0.18mg D. 0.36mg E. 3.6mg 74. Your patient has history of drug abuse. Which agent could be given with no liability to cause an addiction? A. Morphine B. ibuprofen C. codeine D. hydrocodone E. hydromorphone 75. Which of the following agents has little value in treating acute inflammation? A. ibuprofen B. paracetamol C. aspirin D. naproxen E. Diclofenac 76. Celecoxib is a member of which category of drugs? A. Salicylates C. Cox-2 selective inhibitors B. Opiates D. Non-selective Cox-inhibitors E Steroidal anti-inflammatories 77. Which category of drugs does not affect blood clotting and can be given to patients taking “ blood thinners”? A. Salicylates B. NSAID’s C. Aspirin D. cox-2 selective inhibitors 78. Which of the following analgesics may interact with warfarin to cause increased bleeding? A. Acetaminophen B. ibuprofen C. paracetamol D. hydrocodone E. Morphine 79. Use of Opioid drugs in dentistry A. analgesics B. antiinflammatories C. antitussives D. preanesthetic medications E.antidiarrheals 80. Which drug is the standard to which all opiates are compared? A. Codeine B. meperidine C. oxycodone D. Morphine E. Fentanyl 81. The major disadvantage with the use of opioid analgesics is: A. allergic response B. nausea C. vomiting D. respiratory depression 82. Drug action that increase body activity : A. stimulant C. depressants B. irritants D. supplements E. prophylactic. 83.This is an act to promote and ensure the production of an adequate supply, distribution, use and acceptance of the drug identified by their generic names is the: A. R.A. 6625 B. R.A 6675 C. Generic Act of 1989 D. R.A. 6754 E. P.D. 825B 84. Drugs that can be used for what is lacking in the body. : A. stimulant C. depressants C. irritants D. supplements E. prophylactic. 85. Fundamental action of vaccines : A. stimulation B. prevention C. prophylaxis D. treatment E. diagnosis. 86. Sedatives and hypnotics are drugs which act as: A. stimulant B. depressants C. irritants D. supplements E. prophylactic 87. Group of drugs which acts on a mixed group of receptors: A. agonist B. antagonist C. pure antagonist D. partial agonist E. mixed agonist-antagonist 88. An intrinsic activity of < 1 is exhibited by. A. agonist B. antagonis C. pure antagonist D. partial agonist E. mixed agonist-antagonist 89. Which of the following is a contraindication to the use of prilocaine? A.biliary tract disease B. Type II diabetes C. rheumatoid arthritis D.Hepatic disease 90. An affinity for a receptor with no intrinsic activity is demonstrated by: A. agonist B. antagonist C. pure antagonist D. partial agonist E.mixed agonist-antagonist 91. Which of the following is NOT a site for drug metabolism: A. liver B. GIT C. skin D. placenta E. kidney 92. These are reactions to drugs that cannot be explained by known mechanism. A. Side effects C. Idiosyncracies B. Allergic reaction D. Teratogenic effects E. Depressants 93. The metabolism of the drug en route from the gut lumen to the systemic circulation. A. Biologic half- life C. First pass effect B. Median effective dose D. portal circulation E. pharmacokinetics 94. An unpleasant sensory and emotional experience associated with actual tissue damage: A. analgesia B. inflammation C.pain D. infection E. pus 95. It is the least stimulus intensity at which a subject perceives pain : A. pain threshold B. pain tolerance level C. analgesia D. high threshold E. second pain 96. The reaction of the body to high threshold mechanoreceptor : A. tolerance C. withdrawal reflex B. inflammation D. suppuration E. analgesia 97. This is the pain theory that is based on the existence of a specific pain system : A. pattern B. central summation B. Gate control D. sensory interaction E. specificity theory 98. Which of the following is NOT a peripheral mediators of pain: A. histamine B. bradykinin C. prostaglandin D. amino acid E. leukptriennes 99. Drugs used as premedication to General Anesthesia to reduce secretions: A. Anticholinergic B. Antihistamine C. Anxiolytic D. Antipsychotics 100. Antiemetic drugs _____. A. dilates pupils B.causes nausea C. contracts uterus D.dries mouth E.prevents vomiting ENDODONTICS AND PERIODONTOLOGY 1. Generally speaking, the bacteria associated with periodontal health are characterized as: a. Gram-negative, motile, aerobes b. Gram-negative, non motile, anerobes c. gram-positive, nonmotile, facultative anaerobes d. Gram-positive, motile,aerobes 2.Endotoxins are the lipopolysaccharide component of the cell wall of : a. Gram-positive bacteria b. Gram-negative bacteria c. both gram-positive and gram-negative bacteria d. Neither Gram positive and gram-negative 3. In a healthy sulcus, which bacteria below are most abundant? a. A. actinomycetemcomitans and B. forsythus b. streptococcus species and actinomyces species c. Treponema and Capnocytophaga d. P. intermedia and P.gingivalis 4. Which of the following statements regarding periodontitis is incorrect? a. Periodontitis does not always begi Gingivitis n with gingivitis b. Gingivitis and periodontitis cannot be induced without bacteria c. There are no radiographic features of gingivitis d. The presence of pockets cannot be determined from radiographs e. Chronic gingivitis does not always lead to periodontitis 5. Which of the following is most significant in regard to the prognosis of a periodontally involved tooth? A. Pocket depth b. attachment loss c. anatomical crown length d. Bleeding upon probing 6. In the older patient, the exit of the canal is: a. Closer to the radiographic apex. c. easier to detect tactilely b. Closer to the true apex d. More variable because of cementum formation 7. Gingivitis is most often caused by: a. a hormonal imbalance b. inadequate oral hygiene c. occlusal trauma d. vitamin deficiency e. aging 8. Pseudopockets are most likely to be seen in a patient with: a. acute gingivitis b. advanced periodontitis c. Inflammatory gingival enlargement d. desquamative 9. The most important plaque retentive factor is: a. overhanging margins of restorations b. calculus c. crowded teeth d. furcations 10. Gingival changes evident during pregnancy probably result from the effect of: a. Estrogen b. Progesterone c. Histamine d. Vit. Deficiency 11. In the chronic stage of gingivitis which cells predominate? a. Mast cells b. Plasma cells c. Lymphocytes d. Macrophages 12. Which of the following cells participate in the early phase of inflammation (early lesion of gingi- vitis)? WBC A. Eosinophils b. kupffer’s cells c. Mast cells d. Epitheloid 13. The first leukocytes to arrive as a result of inflammation caused by plaque formation in the ini- tial lesion of gingivitis are the a. Eosinophils b. Lymphocytes c. Neutrophils d. Basophils e. Monocytes 14. Which local sign of acute inflammation is caused by the dilation of capillaries? a. Redness b. Heat c. swelling d. Pain 15. all of the following are diagnostic of occlusal trauma except: a. Periodontal pocket formation b. thickening of lamina dura c. Fremitus d. angular bone destruction e. tooth mobility 16. The collagen found in the gingival: a. Type 1 b. biochemically similar to the collagen found elsewhere c. accounts for 90% of the gingival protein d. has turn over rate as rapid as in the PDL 17. All of the following are clinical signs of bruxism except: a. TMJ symptoms b. Muscle soreness c. Periodontal pocket formation d. wear facets on teeth e. widened PDL space on radiograph 18. All of the following statements concerning B cells are true except: a. They mature in the bone marrow and migrate to lymphoid organs b. They are found in the germinal centers of the spleen and lymph nodes c. They are progenitors of plasma cells d. They are involved in humoral and cell mediated immunity 19. Which of the following is least affected by occlusal trauma? a. Alveolar bone b. gingival attachment c. Periodontal ligament d. Cementum 20. Supragingival plaque: a. Is unattached or loosely adherent b. is dominated by gram-negative organisms c. acquires nutrition from saliva and host diet d. Is dominated by anaerobes 21. The key etiologic agent in the initiation of gingivitis and PD is: a. calculus b. plaque c. toothbrush abrasion d. saliva 22. The bacteria that form plaque & calculus release toxins that stimulates the immune system to over produce powerful infection-fighting factors called: a. Free radicals b. cytokines c. amides d. Lymphokines 23. Which of the following is the single major preventable risk factor for PD? A. smoking b. diabetes c. genetics d. pathogenic bacteria 24. Gingiva which is free from significant accumulation of inflammatory cells: a. Normal b. clinically healthy c. pristine d. free gingival 25. Risk factors for gingivitis, except a. plaque b. hormones c. drugs d. occlusal trauma 26. When using the balanced-force technique for canal preparation, which of the following state- ments is accurate? a. The cutting stroke involves apical pressure and a counterclockwise rotation. b. Clock- wise rotation balances the tendency of the file to be drawn into the canal during the cutting stroke. c. Dentin is engaged with a counterclockwise rotation and cut with a 45-to 90-degree, clockwise rotation d. It requires the use of a crown down technique. 27. A problem with nickel-and-titanium (NiTi) spreaders is which of the following? a. Tendency to buckle under compaction pressure. b. Tendency to break during condensation. c. Creation of greater wedging forces, leading to root fracture. d. They do not penetrate as deeply as stainless spreaders under equal force. 28. A fragment of a barbed broach is broken off and wedged in the middle third of a canal in a maxillary incisor. A radiolucency is present at the apex. The fragment cannot be bypassed or re- moved. Treatment of choice includes: 1. extracting the tooth 2. preparing and obturating to the point of blockage 3. performing an apicoectomy and retrofilling 4. placing formocresol to permeate and fix necrotic tissue. a. 1, 2 & 3 b. 1 & 2 c. 2 & 3 d. 2, 3 & 4 e. 3 only 29. Erratic and inconsistent results from electric pulp testing may be caused by: 1. saliva on the tooth 2. secondary dentin obliterating the pulp chamber 3.multiple canals presenting various stages of pulp pathosis a. 1 & 2 b. 1 & 3 c. 2 & 3 d. 1 only e. 1,2 & 3 30.Which of the following are considerations in coronal pretreatment of an endodontic case 1. removing caries 2.removing occlusal contacts 3. preventing leakage during therapy 4. providing for secure position of the rubber-dam clamp a. 1, 2 & 3 b. 1, 2 & 4 c. 1, 3 & 4 d. 2 & 3 only e. 2, 3 & 4 30. Leukotoxin is a product of which bacteria a. P. gingivalis b. B.forsythus c A. actinomycetemcomitans d. P. intermedia 31. The following are innate responses, except: a. saliva b. gingival epithelium c. GCF d. B cells e. PMN  rubor - redness calor- increased heat tumor- swelling dolor- pain functio laesa 32. Which of the following is not a sign of inflammation: a. loss of function b. pain c. tumor d. infection e. redness 33. Responsible for remodeling and degradation of matrix components: a. proteinases b. MatrixMetalloPproteinases c. cytokines d. LipoTeichoicAcid e.LipoPolySaccharide 34. Products of Subgingival microorganisms that activate chemical mediators of inflammation: a. proteinases b. MatrixMetalloPproteinases c. cytokines d. LipoTeichoicAcid e. LipoPolySaccharide 35. Stimulates bone resorption a. cytokines b. interleukins c. LipoPolySaccharide d. LipoTeichoicAcid e. MatrixMetalloPproteinases 36. acts as messenger molecules transmitting signals to other cells: a. cytokines b. interleukins c. LipoPolySaccharide d. LipoTeichoicAcid e. MatrixMetalloPproteinases 37. Localized aggressive periodontitis is confined in a. incisor and canine area b. premolars c. first molar and incisor d. molara area 38. Circumpubertal onset: a. Localized Aggressive Periodontitis b. Generalized Aggressive Periodontitis >30 y/o or