Pharmacology and Anesthesiology Questions 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 B. Lidocaine D. Mepivicaine 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 11. The following are innervated by PSAN, except: A. Buccal soft tissue of Maxillary molars B. Mx 2nd Molar C. Mesiobuccal root of Mx 1st Molar D. Distobuccal root of Mx 1st Molar 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 In performing normal dental diagnostic procedures, the operator receives the greatest hazard from which type of radiation? direct primary beam secondary scatter gamma secondary and scatter Ameloblastoma of the mandible is similar radiographically to which of the following conditions? Osteosarcoma Pindborg tumor Ameloblastic fibro-odontoma Central giant cell granuloma PHARMACOLOGY AND ANESTHESIOLOGY Which of the following is the best substitute drug for a patient allergic to penicillin? Lincomycin C. Sulfonamide Tetracycline D. Erythromycin E. Ampicillin The cardiac glycosides will reduce the concentration of which ion in an active heart muscle? Sodium C. Calcium Bromide D. Chloride E. Potassium Pretreatment with which of the following drug will potentiate the ability of an intravenous injection of acetylcholine to lower blood pressure? Methacholine C. Pilocarpine Epinephrine D. Physostigmine E. Pralidoxime An excess of which of the following hormones may be associated with increased sensitivity to epinephrine? Testosterone C. Insulin Parathyroid D. Thyroid E. both B & D 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? Otic ganglion D. Auriculotemporal nerve Capsule of the parotid gland E. Ophthalmic division of the trigeminal nerve Motor branches of the mandibular nerve supplying the masti- catory muscles The dentist, who planned to sedate a patient intravenously, first injects a test dose into the patient’s arm. Immedi- ately, 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 regu- lar, it is weaker than her unaffected side. Which of the fol- lowing might account for these findings? an injection into an artery an injection into the radial nerve an injection into the muscle compartment an impending anaphylactic reaction. The principal therapeutic action of the glucocorticoids is is: Antidiuretic C. anti-infective Antianabolic D. antihypertensive E. anti-inflam- matory The primary effect produced by digitalis therapeutic dose levels is: a slowing of the cardiac rate a decrease in the venous pressure a decrease in cardiac enlargement an increase in the force of myocardial contraction. The single most useful agent in resuscitation is: Oxygen C. an endotracheal tube E. aromatic spirits of ammonia a respiratory stimulant D. 1:1000 epinephrine for in- jection Inadvertently, an overdose of morphine is administered to a pa- tient. To treat this condition, a dentist should administer: oxygen and inject naloxone hydrochloride caffeine sodium, benzoate intravenously doxapram intramuscularly nalorphine and epinephrine intramuscularly The activity of benzalkonium chloride is markedly antagonized by: soap C. sodium chloride sodium nitrite D. cetypyridinium chloride E. alkylbenzyldimethyl ammonium chloride A patient informs his dentist that he has been taking mecamyla- mine regularly for the past year. Upon oral examination the dentist is most likely to find: ptyalism C. palatal petechiae xerostomia D. gingival hypertrophy E. bullous lesions on the buccal mucosa A patient receiving propranolol has an acute asthmatic attack while undergoing dental treatment. The most useful agent for management of the condition is: Morphine C. phentolamine Epinephrine D. aminophylline E. norepineph- rine The systemic activity of the ester (procaine) types of local anesthetics is terminated primarily by: elimination by the kidney metabolism in the liver only storage in adipose tissue metabolism in the liver and by pseudocholinesterase in the plasma If a patient requiring an extraction reports that he is on bishydroxycoumarin therapy, the laboratory test most valuable in evaluating the surgical risk is: clotting time C. sedimentation rate bleeding time D. complete blood count E. plasma prothrombin time The first clinically useful and systematically effective anti- nfective agent was: penicillin C. tetracycline sulfanilamide D. streptomycin E. bacitracin During visit to the dentist, a patient develops a severe, acute bronchial asthmatic attack. He should immediately receive: cortisone C. tripelennamine epinephrine D. 90% oxygen, 10% CO2 The most serious and life-threatening blood dyscrasia associ- ated with drug toxicity is: aplastic anemia C. thrombocytopenia agranulocytosis D. hemolytic anemia E. megaloblastic anemia When methohexital is used to induce general anesthesia, the in- itial effect wears off within a short time and the patient awakens. This occurs because the drug is: detoxified C. eliminated from the body biotransformed D. redistributed from the brain A dental patient on anticonvulsant therapy exhibits marked gin- gival hypertrophy. This patient , most likely, is regularly taking: primidone C. phenacemide mephobarbital D. Phenobarbital E. diphe- nylhydantoin Adrenergic neuron blocking drugs, such as guanethidine, are use- ful primarily in the treatment of:  mental disease C. cholinergic crisis cardiac arrest D. paroxysmal tachycardia E. es- sential (primary) hypertension The most important pharmacologic action of drug which suppress cardiac arrhythmias ia: blockage of the vagus nerve D. stimulation of cardiac ATP-ase activity blockage of the beta-adrenergic receptor E. stimulation of alpha-adrenergic receptor increased refractory period of cardiac muscle. Tolerance is least likely to develop with the use of: LSD B. marihuana C. Heroin D. metha- done E. amphetamines The principal danger associated with the use of nitrous oxide anesthesia in concentrations exceeding 80% is: hypoxia C. liver damage E. irritation of the respiratory tract. renal damage D. vomiting and nausea For treating most oral infections, penicillin V is preferred to penicillin G because penicillin V; is less allergenic D. is less sensitive to acid degradation has a greater gram-negative spectrum E. has a longer dura- tion of action is bactericidal, whereas penicillin G is not. When the combined action of two drugs is greater the sum of their individual action, this is: induction C. idiosyncrasy synergism D. hypersensitivity E. cumula- tive action With an overdose of a cholinergic drug, one would expect to see each of the following, except: Sweating C. mydriasis Urination D. bradycardia E. copious serious saliva Which of the following is a beta-adrenergic receptor blocking agent used for the treatment of hypertension? Prazosin (Minipress ®) C. Atenolol (Tenormin®) Clonidine (Catapres®) D. Hydralazine (Aprezoline®) E. Verapamil (Calan®) In which of the following categories are ephedrine, tyramine, and amphetamine classified? Anticholinesterases C. Alpha-adrenergic blocking agents  Indirect-acting sympathomimetics D. Direct-acting par- asympathomimetics Each of the following methods can be used to control pain, ex- cept: Cortical depression D. Psychosomatic (hypno- sis) methods Raising the pain threshold E. Blocking the sensory pathway Depression of the autonomic nervous system Thiazides, which are used in the treatment of hypertension, may require supplemental administration of: Sodium B. calcium C. Chloride D. potassium Which of the following dentrifice components is most likely to inactivate the fluoride ion? Anionic detergent C. Polyacrylic spheres Dicalcium phosphate D. Monofluorophosphate Which of the following adverse reactions of oral contraceptives is the most common and the most serious? Hypotension C. Uterine neoplasia Hepatotoxicity D. Thromboembolic disorder E.De- creased resistance to infection In therapeutic doses, digitalis acts primarily on the cardiac muscle. It does so by increasing the: force of contraction C. refractory period of the atrial muscle refractory period of the ventricular muscle D.rate of conduction of impulses to the muscle. Each of the following is a pharmacologic effect of phenothia- zines , except: Sedation D. An antiemetic effect Alpha-adrenergic blackage E. Potentiation of the ac- tion of narcotics An anticonvulsant Which of the following represents the drug-of-choice in the treatment of candidiasis for an HIV-infected patient? Acyclovir B. AZT C. Nystatin D. Chlorhexidine Epinephrine antagonizes the effects of histamines by: preventing the release of histamine acting on the CNS producing physiologic actions opposite to that of histamine competitively blocking histamine at the cellular receptor site The extrapyramidal syndrome seen with the antipsychotic agents is due to their action on the :  Cerebellum C. hypothalamus E. cerebral cor- tex brain stem D. basal ganglia Which of the following is classified as an antianxiety drug? Methohexital C. Haloperidol Lorazepam D. Pentazocine E. Phenylpropanolamine Opiates are contraindicated for patients who have which of the following? Severe head injury C. Bronchial asthma Renal dysfunction D. Acute myocardial infarction The Therapeutic Index (T.I.) of a drug is defined as: ED50/LD50. C. LD1/ED99. ED1/LD99. D. LD99/ED1. E. LD50/ED50.. Which of the following classes of drugs, when combined with a narcotic analgesic, is the most likely to produce a fatal drug interaction? Cardiac glycosides D. Oral anticoagulants Tricyclic antidepressants E. Oral antidiabetic agents Monoamine oxidase inhibitors Aspirin is contraindicated with which of the following drugs? Coumarin (Coumadin®) D. Triazolam (Halcion®) Barbiturates (Phenobarbital®) E. Pentobarbital (Nembu- tal®) Methylprednisolone (medrol®) A 43-year old patient who has mitral stenosis, secondary to rheumatic fever requests extraction of two periodontally in- volved mandibular teeth. Initially, the dentist should premedicate the patient with cephalosporin premedicate the patient with amoxicillin premedicate the patient with ampicillin and gentamicin consult with the patient’s physician to determine the anti- biotic of choice Which of the following drugs is often administered intravenously to treat life-threatening ventricular arrhythmias? Quinidine B. Verapamil C. Lidocaine D. Propranolol A male patient who is receiving Coumadin® therapy presents for an elective extraction. His prothrombin time (PT) is pro- longed. Which of the following methods is preferred for re- ducing the PT to an acceptable level? Administering vitamin K (Aqua Mephyton®) Withdrawing Coumadin® for two days Reducing Coumadin® to one-half the usual dose for two days Administering a Coumadin® antagonist, such as heparin  Administering a platelet transfusion to enhance coagulabil- ity Each of the following drugs has a significant anti-inflammatory property, except: Aspirin C. Ibuprofen (Motrin®) Cortisol D. Indomethacin (indocin®) E. Ac- etaminophen Which of the following is an example of an enteral route of ad- ministration? Oral C. Inhalation E. Intramuscular Submucosal D. Subcutaneous Propranolol (Inderal®) exerts its major antianginal effect by: dilating coronary arteries. D. Dilating systemic blood vessels Increasing cardiac contractility E. Stimulating vagal slow- ing of the heart Blocking beta-adrenergic receptors of the heart. Which of the following side effects is seen most frequently with administration of nitrous oxide and oxygen? Hallucinations/dreams C. Tachycardia Respiratory depression D. Hand tremors E. Nausea A needle tract infection following an inferior alveolar block injection would initially involve which space? Pterygomandibular C. submandibular Sublingual D. Lateral pharyngeal Which pair of anesthetics is most likely to show cross-allergy? Lidocaine- mepivacaine Prilocaine- tetracaine D. Procaine- lidocaine Procaine- mepivacaine E. Lidocaine- benzocaine Which of the following antibiotics may cause discoloration of the teeth of the newborn if administered to the mother in the third trimester of pregnancy? Penicillin C. Streptomycin Tetracycline D. Clindamycin E. Erythromycin Which of the following drugs is most commonly employed in an at- tack of angina pectoris? Sodium nitrate C. Theophylline Epinephrine D. Nitroglycerine E. Isosorbide dinitrate Which of the following is a major reason for adding vasocon- strictors to local anesthetic injections? To decrease bleeding D. To reduce systemic toxicity To enhance the onset of action E. To decrease aller- gic reactions To prolong the duration of anesthesia What determines the maximum dose of local anesthesia for a child? Age C. the desired degree of pulpal anesthe- sia weight D. the procedure to be accomplished The only local anesthetic that increases the pressor activity of both epinephrine and norepinephrine is: Cocaine C. dibucaine Procaine D. lidocaine E. mepivacaine Each of the following, is a good reason for using sedation, ex- cept: To allay apprehension, anxiety or fear To decrease the amount of local anesthesia that is required for a given procedure To alleviate stress in a severely medically compromised pa- tient To accomplish certain procedures that a practitioner would not normally be able to do on an anxious patient. Which of the following is the first symptom that is usually per- ceived by the patient being administered nitrous oxide? Nausea B. Giddiness C. Euphoria D. Tingling of the hands The dentist uses a palatal flap to close an oroantral fistula in the area of tooth #15. This flap receives its principal blood supply from which of the following arteries? Facial C. Greater palatine Nasopalatine D. Posterior superior alveolar Each of the following side effects can occur as a result of sys- temic absorption of lidocaine, except: increased gastric motility C. decreased cardiac out- put tonic-clonic convulsions D. respiratory depression In an attempted venipuncture, each of the following indicates accidental intra-arterial injection, except: The needle moves with pulsation action. A vessel tends to collapse and obstruct. Aspirated blood is bright red in color. Injection of a small test dose of the agent is acutely painful.  Penetration of a vessel meets resistance and is painful. A patient has a history of significant cardiovascular impair- ment. The maximum safe close of epinephrine that can be ad- ministered to this patient is: 1cc, 1:50,000 C. 1cc, 1:100,000 C. 2cc, 1:50,000 D. 2cc, 1:100,000 A dentist is considering the use of nitrous-oxide conscious se- dation for a patient. However, this type of sedation will be contraindicated, should the patient have a history of which of the following? Dental anxiety C. both A & C Psychotic care D. none of these E. Controlled hypertension The correct total liter flow of nitrous oxide-oxygen is deter- mined by a standard 6 liter per minute flow. The patient’s metabolic oxygen requirements The amount necessary to keep the reservoir bag 1/3 to 2/3 full. The largest volume that the patient can exchange within 1 minute. Local anesthetics aid in reducing the flow of saliva during op- erative procedures by: blocking the cholinergic nerve endings blocking innervation to major salivary glands blocking efferent parasympathetic nerve pathways reducing sensitivity and anxiety during tooth preparation Trismus, secondary to an inferior alveolar injection, most likely results from failure to use an aspirating syringe accidental injection of the solution near a branch of the facial nerve allowing the needle tip to rest beneath the periosteum dur- ing injection passing the needle through the medial pterygoid muscle accidental injection of the solution near a major motor branch of the trigeminal nerve. A patient is allergic to both amide and ester anesthetic deriv- atives. For this patient, the dentist should find which of the following infiltrative local anesthetics to be safe and effective? Bupivacaine C. Nitrous oxide Phenylephrine D. Diphenhydramine E. Ethylaminobenzoate Of the following local anesthetics, which has intrinsic vaso- constrictive actions?  Cocaine B. Xylocaine C. Procaine D. Bupivacaine Allergic reactions to local anesthetics are caused by: rapid absorption C. an antigen-antibody reaction slow detoxification D. improper administration technique A patient has a history of significant cardiovascular impair- ment. The maximum safe dose of epinephrine that can be admin- istered to this patient is: 1 cc, 1:50,000 C. 1 cc, 1:100,000 2 cc, 1:50,000 D. 2 cc, 1:100,000 A dentist would like to obtain block anesthesia of the entire second division of a patient’s trigeminal nerve. For this purpose, the dentist should administer an intraoral injection in which of the following? foramen ovale C. foramen spinosum pterygoid plexus D. infraorbital formane E. pterygopala- tine fossa After receiving one cartridge of a local anesthetic, a healthy adult patient became unconscious in the dental chair. The oc- currence of a brief convulsion is: pathognomonic of gland mal epilepsy consistent with a diagnosis of syncope usually caused by the epinephrine in the local anesthetic pathognomonic of intravascular injection of a local anes- thetic Epinephrine is added to local anesthetics because it: decreases the rate of absorption of the local anesthetic at the injection site prevents the rapid deterioration of the local anesthetic solution increases the rate of destruction of the local anesthetics potentiates the action of all local anesthetics. The most likely cause of trismus after block anesthesia for surgery in the mandibular molar area is: excessive edema damage to the medial pterygoid muscle on injection stretching of the pterygomandibular raphe myositis of the lateral pterygoid muscle submandibular cellulites The most common disorder causing pain about the masticatory ap- paratus including the TMJ, is: myofascial-pain-dysfunction D. traumatic arthritis trigeminal neuralgia E. temporal arteritis degenerative arthritis The patient has received an injection of 1.8ml of local anes- thetic containing 2% lidocaine with 1:100,000 epinephrine. Thirty seconds later he goes into syncope. The most probable cause is: Bradycardia D. a toxic reaction to the epi- nephrine Tachycardia E. an allergic reaction to the lidocaine. Cerebral hypoxia Nitrous oxide alone is not used as a general anesthetic agent because of the difficulty in maintaining an adequate oxygen concentration expense of the agent and its explosive hazard adverse effects on the liver poor analgesic properties all of the above. How many millimeter of nerve fibers should be in contact with the anesthetic solution for effective anesthesia: A. 1mm B. 2-3mm C. 4mm D. 5-6mm E. 8-10mm A branch of facial nerve with secretory function to the tongue and is associated with the lingual nerve: glossopharyngeal C. chorda tympani buccal nerve D. both A and C E. both B and C When attempting to achieve an intraoral palatal second division block anesthesia, the needle should enter the: greater palatine foramen C. foramen rotundum stylomastoid foramen D. mental foramen E. na- sopalatine foramen A deep level of general anesthesia is enhanced by a : high alveolar concentration of anesthetic agent C. loose-fitting mask nonirritating drug D. muscle relaxer Syncope is usually caused by: vasoconstriction C. cerebral hyperemia cerebral ischemia D. decease in the vascular bed The maximum recommended dosage of lidocaine HCI injected subcu- taneously when combined with 1:100,000 epinephrine is: A. 100mg B. 300mg C. 500mg D. 750mg E. 1gm. Cyanosis, dyspnea and elevated temperature following general anesthesia may indicate: atelectasis 3. pulmonary embolus pneumonia 4. acute renal shutdown A. 1 only B. 1,2 & 3 C. 2 & 3 D. 2 & 4 E. 4 only  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 Three minutes after receiving an inferior alveolar blokc for removal of a premolar, the patient develops paralysis of the muscles of his forehead, eyelids and upper and lower lips on the same side of the face. This is probably related to diffu- sion of the anesthetic solution into the: otic ganglion capsule of the parotid gland ophthalmic division of the trigeminal nerve motor branches of the mandibular nerve supplying the masti- catory muscles Needle aspiration of a central bone lesion is used to feel for root surfaces rule out of diagnosis of vascular lesion make a diagnosis of traumatic bone cyst determine the thickness of the buccal plate all of the above In local anesthesia, depression of respiration is a manifesta- tion of puncture of a blood vessel C. use of an isotonic so- lution toxic effects of the solution D. trauma to a nerve trunk by the syringe needle Comprises the inner nerve loop: ASAN, MSAN and PSAN C. Inferior alveolar and lingual nerves Greater palatine and nasopalatine nerves D. All of the above Branch of the maxillary nerve given off at the infraorbital canal: A. PSAN B. MSAN C. ASAN D. both A and B E. both B and C Mandibular nerve is considered as: motor nerve B. sensory nerve C. mixed nerve D. none of these. At which pH will the local anesthesia be effectively diffused: pH doesn’t matter B. below or above C. below 7 D. above 7 In larger myelinated nerves, conduction takes place at: dendrites B. neuron C. axons D. nodes of Ranvier  Which of the following nerve is not involved in an extra-oral infraorbital nerve block: inferior palpebral C. lateral nasal sphenopalatine D. infraorbital E. none of these. The most common syringe used in the dental practice is: H-D tuberculin Breech loading non-aspirating metallic cartridge Breech loading aspirating metallic cartridge Plastic disposable. Conducts the fast or first pain at the rate of up to 100 meter per second: A-beta fibers C. A-delta fibers C-fibers D. A beta and A delta fibers E. A- delta and C fibers Lidocaine (xylocaine) is an example of an: A. acid B. amide C. ester D. aldehyde The local anesthetic base is combined with hydrochloric acid to produce a water soluble salt solution. The anesthetic activ- ity of the injected local anesthetic solution is most related to: the anesthetic salt solution the osmotic pressure of the soluble solution its reactivity with electrolytes in the interstitial tissue the conversion of the soluble solution to its insoluble an- esthetic base-acid form. Anatomic ganglia associated with the mandibular nerve: A. otic B. submandibular C. submaxillary D. both A & B E. all of these PHARMACOLOGY AND ANESTHESIOLOGY 1. Local anesthetic agent contraindicated in A. Hyperthyroidism B. Asthma C. Diabetes Mellitus D. Hypertension 2. Local anesthetic agent having vasoconstrictor effect A. Lignocaine B. Cocaine C. Procaine D. Lidocaine 3. The antioxidant in Local anesthesia is A. Methylparaben B. Sodium Chloride C. Sodium Metabisul- fite D. Adrenaline 4. Bubbles seen in anesthetic cartridge are made up of A. Hydrogen B. Oxygen C. Nitrogen D. Carbon Dioxide 5. In fraorbital nerve block, the needle approximates: 1.beneath angular head of quadratus labii superioris 2. Below head quadrates labii superioris 3.parallel to zygomaticus minor 4. above origin of caninus muscle A. I & 2 B. I & 3 C. 2 & 4 D. I & 4 E. 2 & 3 6. in PSAN block, the needle approximates: 1.posterior to posterior surface of maxilla 2.anterior to external pterygoid muscle 3.anterior to pterygoid plexus of veins 4.posterior to external pterygoid muscle A. I, 2, 3 & 4 B. I, 2 & 3 C. I, 3 & 4 D. 2, 2 & 4 E. 3 & 4 only 7. Which of the following is not anesthesied by PSAN block? A. distobuccal root of 16/26 C. palatal root of 16/26 B. mesiobuccal root of 17/27 D.mesiobuccal root of 16/26 8. In this technique, the anesthetic solution is deposited at the neck of the condyle. A.PSAN block B.long buccal nerve block C. Gow Gates D. A & B E. A,B&D 9. Classified as a mixed nerve originating from pons varolii. A. Opthalmic division B. Maxillary nerve C.Mandibular division D. both A and C 10.Which of the following structures is not supplied by maxillary division of 5th CN? A.nasal cavity B.side of nose C. tonsillar region D. parotid gland E. A and D 11. Branch of maxillary nerve given off before it enters the infe- rior orbital fissure. A. PSAN B. ASAN C. MSAN D. nasopalatine n. E. greater palatine n 12. Branch of maxillary nerve given off at the cranium: A. nervus spinosus C. middle meningeal nerve B. zygomatic nerve D. auriculo-temporal 13. Xerostomia is a complication of mandibular blocking which oc- curs due to the association of lingual nerve to which of the the following?  A. chorda tympani B. buccal nerve C.glossopha- ryngeal D. IAN 14. The term toxicity refers to: A. drug allergy C. overdosage E.. drug hypersensitivity B. poison D. anaphylaxis 15. Too much local anesthesia can result to: A. paresthesia B. hematoma C.anaphylaxis D. localized osteitis E. allergy 16. Area of bone resistance upo needle insertion in IAN block: A. external oblique ridge C. internal oblique ridge B. coronoid notch D. retromolar triangle 17. Sudden swelling of the face after MSAN injection: A. infection B. hematoma C. emphysema D.trauma E. none 18. Complications of infraorbital nerve block: A. ecchymosis B. blindness C.tachycardia D. edema E. all 19. Area anesthesized by an infraorbital nerve: A. Hard palate B. all teeth one side C. premax- illa D.ASAN one side 20. Extent of the greater palatine nerve block anesthesia: A. Soft tissue of the anterior hard palate adjacent to the anterior teeth B. Bone of the anterior hard palate adjacent to the ante- rior teeth C. Soft tissue and bone of the hard palate on one side of the midline up to canine D. Pulps of the upper molar teeth 21. Extent of the nasopalatine nerve block anesthesia: A. Soft tissue of the anterior hard palate adjacent to the bicuspid teeth B. Bone of the anterior hard palate adjacent to the ante- rior teeth C. Soft tissue and bone of the hard palate on one side of the midline to canine D. Pulps of the upper molar teeth E. Buccal gingival, periodontium and buccal, bone adjacent to the molars 22. Infiltration anesthesia where the anesthetic solution is de- posited between the periosteum and the cortical plate. A. submucous B. subperiosteal C.supraperiosteal D. intraseptal E. intraosseous 23. The following are the indications of intraligamentary injec- tions: 1.treatment of children 2. single tooth procedure 3. RCT 4. Long rooted teeth A. 1,2,3 B. 1,2,4 C. 1,3,4 D. 2,3,4 E. 3,4 24. Infraorbital nerve block, the needle approximates: 1. beneath angular head of quadratus labii superioris 2. beneath infraorbital head of quadratus labii superioris 3. parallel to zygomaticus minor 4. above origin of caninus A. 1 & 2 B. 1 & 3 C. 2 & 4 D. 1 & 4 E. 2 & 3 25. in PSAN block, the needle approximates: 1.posterior to posterior surface of maxilla 2. ante- rior to external pterygoid muscle 3.anterior to pterygoid plexus of veins 4. poste- rior to external pterygoid A. 1, 2, 3 & 4 B. 1, 2 & 3 C. 1, 3 & 4 D. 2, 3 & 4 E. 3 & 4 26. Which of the following is not anesthezied by PSAN block? A distobuccal root of 16/26 C. palatal root of 16/26 E. MB root 16,26 B. mesiobuccal root of 17/27 D none 27. This is the foramen of exit for the terminal branches of max- illary nerve: A. Foramen rotundum C. foramen ovale E. mental foramen B. Superior orbital fissure D. Infraorbital foramen 28. Classified as a mixed nerve originating from pons varolii. A. Opthalmic division B. Maxillary div. C. Mandibu- lar div. D. B and C 29. Which of the following is not supplied by maxillary division of 5th cranial nerve? A. nasal cavity B. tonsillar region C. side of nose D. parotid gland 30. Branch of maxillary nerve given off before it enters the in- ferior orbital fissure. A. PSAN B. ASAN C. MSAN D. Nasopalatine E. Greater Palatine Nerve 31. Branch of maxillary nerve given off at the cranium: A. nervus spinosus C. middle meningeal nerve E. zygomatic nerve B. auriculo-temporal nerve D. sphenopalatine nerve 32. Xerostomia is a complication of mandibular blocking which oc- curs due to the association of lingual nerve to which of the the following? A. chorda tympani B. buccal nerve C. glossopha- ryngeal D. Mylohyoid nerve 33. Mental nerve innervates the following except: A. lower lip B. mucosa lower bicuspid C. chin D. lower bicuspid E. none 34. 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 35. Too much local anesthesia can result to: A. paresthesia B. trauma C. trismus D. xerostomia E. dry socket 36. Too much puncture injection in mandibular blocking can result to: A. paresthesia B. pain C. trismus D. xerostomia E. dry socket 37. Toxic symptoms of local anesthesia is: A. pain and swelling B.CNS stimulation C.cardiac arrest D. shock E. stroke 38. Injection technique that is more prone to hematoma: A. mandi block B. Gow Gates C. Akinosi D. MSAN block E. PSAN block 39. #47 buccal injection indicated for: A. RCT B. tooth extraction C. Composite restoration D. odontectomy E. none 40. Best alternative technique after mandi block for still painful #36 for access in rct:  A. intraosseous B. intraseptal C. intrapulpal D.in- traligamentary E. Gow Gates 41. Long lasting amide local anesthetics used for temporary relief of Tic Douloureux A. Prilocaine B. Hurricaine C. Bupivacaine D. Lidocaine E. Mepivacaine 42. Contents of the anesthetic cartridge. A. anesthetic drug B.epinephrine C.sodium metabi- sulfite D.distilled water E. all 43. Node to node jumping of impulse A. synapse B. saltatory conduction C. neuro- transmission D. none 44. Factor that determine the level of pain tolerance A. weight B. age C. fatigue D. height E. B and C 45. Method of controlling pain by taking analgesic drugs A. raising pain threshold C. block painful impulse E. re- moval cause B. psychosomatic methods D. pain prevention by cor- tical depression 46. Method of controlling pain by use of local anesthesia A. raising pain threshold C. block painful im- pulse E. removal of cause B. psychosomatic methods D. pain prevention by cor- tical depression 47. In the absence of MSAN , bicuspids can have innervation from what nerve A. ASAN B. PSAN C. Pterygoid plexus D. infra- orbital E. Labial 48. Painful #31 even after two infiltration is best manage con- servatively by A. IAN block B. mental block C. intraligamentary D. intraosseous E. none 49. Bell Palsy can best be prevented by A. use always long needle B. use short needle C. fast injection D. aspiration 50. Painful #44 for RCT even after three intrapulpal, two infil- tration, one intraligamentary, one mandibular blocking after two hours is best manage by A. second IAN block C. more intraligamentary E. change anesthesia B. IAN block opposite mandible D. general anesthesia 51. Which non-narcotic analgesics would you most likely use in a patient taking anti-coagulant medication? A. Ibuprofen B. paracetamol C. Aspirin D. naproxen E. diclofenac 52. Which agent has anti-inflammatory properties? A. codeine B. paracetamol C. morphine D. ibuprofen E. fentanyl 53. 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 54. Which of the following agents has little value in treating acute inflammation? A. ibuprofen B. paracetamol C. aspirin D. naproxen E. Diclofenac 55. 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 56. 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 57. Which of the following analgesics may interact with warfarin to cause increased bleeding? A. Acetaminophen B. ibuprofen B. paracetamol D. hydrocodone E. Morphine 58. Use of Opioid drugs in dentistry A. analgesics C. antiinflamma- tories E. antitussives B. preanesthetic medications D. antidiarrheals 59. Which drug is the standard to which all opiates are compared? A. Codeine C. meperidine B. oxycodone D. Morphine E. Fentanyl 60. The major disadvantage with the use of opioid analgesics is: A. allergic response C. nausea B. vomiting D. respiratory depression 61. Drug action that increase body activity : A. stimulant C. depressants  B. irritants D. supplements E. prophylactic. 62.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 C. R.A 6675 B. Generic Act of 1989 D. R.A. 6754 E. P.D. 825B 63. Drugs that can be used for what is lacking in the body. : A. stimulant C. depressants C. irritants D. supplements E. prophylactic. 64. Fundamental action of vaccines : A. stimulation C. prevention B. prophylaxis D. treatment E. diagnosis. 65. Sedatives and hypnotics are drugs which act as: A. stimulant B. depressants C. irritants D. supplements E. prophylactic 66. Group of drugs which acts on a mixed group of receptors: A. agonist C. antagonist B. pure antagonist D. partial agonist E. mixed agonist-antagonist 67. An intrinsic activity of < 1 is exhibited by. A. agonist C. antagonis B. pure antagonist D. partial agonist E. mixed agonist-antagonist 68. 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 69. An affinity for a receptor with no intrinsic activity is demonstrated by: A. agonist C. antagonist B. pure antagonist D. partial agonist E.mixed agonist-antagonist 70. Which of the following is NOT a site for drug metabolism: A. liver B. GIT C. skin D. placenta E. kidney 71. 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 72. 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 73. An unpleasant sensory and emotional experience associated with actual tissue damage: A. analgesia B. inflammation C. pain D. infection E. pus 74. It is the least stimulus intensity at which a subject perceives pain : A. pain threshold C. pain tolerance level B. analgesia D. high threshold E. second pain 75. The reaction of the body to high threshold mechanoreceptor : A. tolerance C. withdrawal reflex B. inflammation D. suppuration E. analgesia 76. 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 77. Which of the following is NOT a peripheral mediators of pain: A. histamine B. bradykinin C. prostaglandin D. amino acid E. leukptriennes 78. Drugs used as premedication to General Anesthesia to reduce secretions: A. Anticholinergic B. Antihistamine C. Anxiolytic D. Antipsychotics 79. Which of the following will produce neurolept analgesia? A. Neuroleptic agent + narcotic analgesic C. neuroleptic agent + nitrous oxide B. Neuroleptic agent + nitrous oxide D. narcotic analgesic + nitrous oxide 80. Warfarin and Dicumarol are classified as: A. antiplatelet agents; B. anticoagulants C. antirhythmics D. antianginal 81. Drugs that inhibit the development of a clot: A. non narcotics B. anticoagulant C. narcotics D. antifibrinolytics 82. Laughing gas A. chloroform B. nitrous oxide C. ether D. ethylene E. enflurane 83. Antiemetic drugs _____. A. dilates pupils C. causes nausea B. contracts uterus D. dries mouth E. prevents vomiting 84. Which penicillin are degraded in stomach acid and therefore must be used parenterally? A. Penicillin VK C. Methicillin E. amoxicillin D. Penicillin G D. Carbenicillin 85. The antibiotic of choice to standard prophylactic regimen of antibiotic coverage for the prevention of bacterial endocarditis is: A. Penicillin VK B. Tetracycline C. Erythromycin D. Amoxicillin 86. Which is the most preferable antibiotic forn the treatment of non- penicillinase producing gram-positive staphylococcal infections? A. tetracycline B. clindamycin C. ampicillin D. cefaclor E. Penicillin VK 88. Which penicillin has the widest spectrum of antibacterial activity? A. Penicillin VK B. Dicloxacillin C. Piperacillin D. amoxicillin E. Carbenicillin 89. Which of the following bacterial enzymes belong to the family of beta lactamases? A. Cephalosporinase B. Penicillinase C. ATPase D. Protein Kinase 90. A drug that acts in a way opposite to the sympathetic nerous system is called A. sympathomimetic B. sympatholytic C. sympathetic amine D. adrenergic 91. All of the following drugs are alpha blockers except: A. Doxazosin B. prazosin C. propanolol D. Terazosin 92. All of the following are centrally acting antihypertensive except: A. methyldopa B. Clonidine C. Tolazoline 93. Which of the following drugs are considered to be antidysrrhythmic agents? A. sodium channel blockers C. Beta- adrenergic blockers B. potassium channel blockers D. calcium channel blockers E. all of the above 94. Procainamide is an anti-arrhythmic agent A. true B. false 95. The barbiturates Phenobarbital, Mephobarbital, Primidone, are classified as what type of barbiturates? A. Ultrashort-acting B. Short-acting C. Intermediate acting D. long-acting 96. Which is the current drug of choice for the treatment of the manic phase of bipolar disorder? A. Phenobarbital B. Imipramine C. Lithium D. Haloperidol 97. Drug that induces calmness without inducing sleep A. sedatives B. hypnotics C. anxiolytics D. antispasmodic 98. Complex organic subs. From coal tar A. dyes B. Halogens C. iodine 99. Alters surface tension A. surface acting agents B. alcohols C. dyes D. iodine E. Halogens 100. Masses spread upon a suitable blocking material A.. ampule B.. infusion C. poultice D. bougies E. cerates PHARMACOLOGY AND ANESTHESIOLOGY Shade AE if the answer is not in the choices given. A needle tract infection following an inferior alveolar block injection would initially involve which space? Pterygomandibular B. submandibular C.Sublingual D. Lateral pharyngeal Which pair of anesthetics is most likely to show cross-allergy? Lidocaine- mepivacaine C. Prilocaine- tetracaine E. Procaine- lidocaine Procaine- mepivacaine D. Lidocaine- benzocaine Which of the following is a major reason for adding vasocon- strictors to local anesthetic injections? To decrease bleeding D. To reduce systemic toxicity To enhance the onset of action E. To decrease aller- gic reactions To prolong the duration of anesthesia 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? Otic ganglion D. Auriculotemporal nerve Capsule of the parotid gland E. Ophthalmic divi- sion of the trigeminal nerve  Motor branches of the mandibular nerve supplying the masti- catory muscles The dentist, who planned to sedate a patient intravenously, first injects a test dose into the patient’s arm. Immediately, upon receiving the injection, the patient experiences a se- vere, burning pain at the site of injection; it radiates dis- tally. Simultaneously, her arm becomes blotchy with several 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? an injection into an artery C. an injection into the radial nerve an injection into the muscle compartment D. an im- pending anaphylactic reaction. The most common syringe used in the dental practice is: H-D tuberculin C. Breech loading non-aspirating me- tallic cartridge Plastic disposable D. Breech loading aspirating me- tallic cartridge How many millimeter of nerve fibers should be in contact with the anesthetic solution for effective anesthesia: A. 1mm B. 2-3mm C. 4mm D. 5-6mm E. 8-10mm A branch of facial nerve with secretory function to the tongue and is associated with the lingual nerve: glossopharyngeal C. chorda tympani buccal nerve D. both A and C E. both B and C Conducts the fast or first pain at the rate of up to 100 meter per second: A-beta fibers C. A-delta fibers C-fibers D. A beta and A delta fibers E. A- delta and C fibers Anatomic ganglia associated with the mandibular nerve: A. otic B. submandibular C. submaxillary D. both A & B E. all of these An excess of which of the following hormones may be associated with increased sensitivity to epinephrine? Testosterone C. Insulin Parathyroid D. Thyroid E. both B & D Each of the following side effects can occur as a result of sys- temic absorption of lidocaine, except: increased gastric motility C. decreased cardiac out- put tonic-clonic convulsions D. respiratory depression In an attempted venipuncture, each of the following indicates accidental intra-arterial injection, except: The needle moves with pulsation action. A vessel tends to collapse and obstruct. Aspirated blood is bright red in color. Injection of a small test dose of the agent is acutely painful. Penetration of a vessel meets resistance and is painful. A patient has a history of significant cardiovascular impair- ment. The maximum safe close of epinephrine that can be admin- istered to this patient is: 1cc, 1:50,000 B. 2cc, 1:50,000 C. 1cc, 1:100,000 D. 2cc, 1:100,000 A dentist is considering the use of nitrous-oxide conscious se- dation for a patient. However, this type of sedation will be contraindicated, should the patient have a history of which of the following? Dental anxiety B. Psychotic care C. Controlled hypertension D. both A & C The correct total liter flow of nitrous oxide-oxygen is deter- mined by a standard 6 liter per minute flow. The patient’s metabolic oxygen requirements The amount necessary to keep the reservoir bag 1/3 to 2/3 full. The largest volume that the patient can exchange within 1 minute. The principal therapeutic action of the glucocorticoids is is: Antidiuretic C. anti-infective Antianabolic D. antihypertensive E. anti-inflam- matory The primary effect produced by digitalis therapeutic dose levels is: a slowing of the cardiac rate C. a decrease in the venous pressure a decrease in cardiac enlargement D. an increase in the force of myocardial contraction. The systemic activity of the ester (procaine) types of local anesthetics is terminated primarily by: elimination by the kidney metabolism in the liver only storage in adipose tissue metabolism in the liver and by pseudocholinesterase in the plasma If a patient requiring an extraction reports that he is on bishydroxycoumarin therapy, the laboratory test most valuable in evaluating the surgical risk is: clotting time C. sedimentation rate bleeding time D. complete blood count E. plasma prothrombin time The first clinically useful and systematically effective anti- nfective agent was: Penicillin B. sulfanilamide C. tetracycline D. streptomycin E. bacitracin During visit to the dentist, a patient develops a severe, acute bronchial asthmatic attack. He should immediately receive: cortisone B. epinephrine C. tripelennamine D. 90% oxy- gen, 10% CO2 The most serious and life-threatening blood dyscrasia associ- ated with drug toxicity is: aplastic anemia C. thrombocytopenia agranulocytosis D. hemolytic anemia E. megaloblastic anemia When methohexital is used to induce general anesthesia, the in- itial effect wears off within a short time and the patient awakens. This occurs because the drug is: detoxified C. eliminated from the body biotransformed D. redistributed from the brain A dental patient on anticonvulsant therapy exhibits marked gin- gival hypertrophy. This patient , most likely, is regularly taking: primidone C. phenacemide mephobarbital D. Phenobarbital E. diphe- nylhydantoin Adrenergic neuron blocking drugs, such as guanethidine, are use- ful primarily in the treatment of: mental disease C. cholinergic crisis cardiac arrest D. paroxysmal tachycardia E. es- sential (primary) hypertension The most important pharmacologic action of drug which suppress cardiac arrhythmias ia: blockage of the vagus nerve D. stimulation of cardiac ATP-ase activity blockage of the beta-adrenergic receptor E. stimulation of the alpha-adrenergic receptor increased refractory period of cardiac muscle. Tolerance is least likely to develop with the use of: LSD B. marihuana C. Heroin D. methadone E. amphetamines The principal danger associated with the use of nitrous oxide anesthesia in concentrations exceeding 80% is: hypoxia C. liver damage renal damage D. vomiting and nausea E. irritation of the respiratory tract. For treating most oral infections, penicillin V is preferred to penicillin G because penicillin V; is less allergenic D. is less sensitive to acid degradation has a greater gram-negative spectrum E. has a longer duration of action is bactericidal, whereas penicillin G is not. When the combined action of two drugs is greater the sum of their individual action, this is: induction C. idiosyncrasy synergism D. hypersensitivity E. cumula- tive action With an overdose of a cholinergic drug, one would expect to see each of the following, except: Sweating C. mydriasis Urination D. bradycardia E. copious serious saliva Which of the following is a beta-adrenergic receptor blocking agent used for the treatment of hypertension? Prazosin (Minipress ®) C. Atenolol (Tenormin®) Clonidine (Catapres®) D. Hydralazine (Aprezoline®) E. Verapamil (Calan®) In which of the following categories are ephedrine, tyramine, and amphetamine classified? Anticholinesterases C. Alpha-adrenergic blocking agents Indirect-acting sympathomimetics D. Direct-acting par- asympathomimetics Each of the following methods can be used to control pain, ex- cept: Cortical depression D. Psychosomatic (hypnosis) methods Raising the pain threshold E. Blocking the sen- sory pathway Depression of the autonomic nervous system Thiazides, which are used in the treatment of hypertension, may require supplemental administration of:  Sodium B. Chloride C. calcium D. potassium Which of the following dentrifice components is most likely to inactivate the fluoride ion? Anionic detergent C. Polyacrylic spheres Dicalcium phosphate D. Monofluorophosphate Which of the following adverse reactions of oral contraceptives is the most common and the most serious? Hypotension C. Uterine neoplasia Hepatotoxicity D. Thromboembolic disorder E.Decreased resistance to infection In therapeutic doses, digitalis acts primarily on the cardiac muscle. It does so by increasing the: force of contraction C. refractory period of the atrial muscle refractory period of the ventricular muscle D. rate of conduction of impulses to the muscle. Each of the following is a pharmacologic effect of phenothia- zines , except: Sedation C. An antiemetic effect Alpha-adrenergic blackage D. Potentiation of the action of narcotics E. An anticonvulsant The only local anesthetic that increases the pressor activity of both epinephrine and norepinephrine is: Cocaine B. dibucaine C. Procaine D. lidocaine E. mepivacaine Each of the following, is a good reason for using sedation, ex- cept: To allay apprehension, anxiety or fear To decrease the amount of local anesthesia that is required for a given procedure To alleviate stress in a severely medically compromised pa- tient To accomplish certain procedures that a practitioner would not normally be able to do on an anxious patient. Which of the following is the first symptom that is usually per- ceived by the patient being administered nitrous oxide? Nausea B. Euphoria C. Giddiness D. Tingling of the hands The dentist uses a palatal flap to close an oroantral fistula in the area of tooth #15. This flap receives its principal blood supply from which of the following arteries? Facial B. Nasopalatine C. Greater palatine D. Posterior superior alveolar Local anesthetics aid in reducing the flow of saliva during op- erative procedures by: blocking the cholinergic nerve endings blocking innervation to major salivary glands blocking efferent parasympathetic nerve pathways reducing sensitivity and anxiety during tooth preparation A dentist would like to obtain block anesthesia of the entire second division of a patient’s trigeminal nerve. For this pur- pose, the dentist should administer an intraoral injection in which of the following? foramen ovale C. foramen spinosum pterygoid plexus D. infraorbital formane E. pterygopala- tine fossa Which of the following represents the drug-of-choice in the treatment of candidiasis for an HIV-infected patient? Acyclovir B. Nystatin C. AZT D. Chlorhexidine Epinephrine antagonizes the effects of histamines by: preventing the release of histamine acting on the CNS producing physiologic actions opposite to that of histamine competitively blocking histamine at the cellular receptor site The extrapyramidal syndrome seen with the antipsychotic agents is due to their action on the : Cerebellum C. hypothalamus E. cerebral cortex brain stem D. basal ganglia Which of the following is classified as an antianxiety drug? Methohexital C. Haloperidol Lorazepam D. Pentazocine E. Phenylpropanolamine Opiates are contraindicated for patients who have which of the following? Severe head injury C. Bronchial asthma Renal dysfunction D. Acute myocardial infarction The Therapeutic Index (T.I.) of a drug is defined as: ED50/LD50. C. LD1/ED99. ED1/LD99. D. LD99/ED1. E. LD50/ED50.. Of the following local anesthetics, which has intrinsic vaso- constrictive actions? Cocaine B. Procaine C. Xylocaine D. Bupivacaine Which of the following classes of drugs, when combined with a narcotic analgesic, is the most likely to produce a fatal drug interaction? Cardiac glycosides C. Oral anticoagulants  Tricyclic antidepressants D. Oral antidiabetic agents E. Monoamine oxidase inhibitors Aspirin is contraindicated with which of the following drugs? Coumarin (Coumadin®) C. Triazolam (Halcion®) Barbiturates (Phenobarbital®) D. Pentobarbital (Nembutal®) E. Methylprednisolone (medrol®) Trismus, secondary to an inferior alveolar injection, most likely results from failure to use an aspirating syringe accidental injection of the solution near a branch of the facial nerve allowing the needle tip to rest beneath the periosteum dur- ing injection passing the needle through the medial pterygoid muscle accidental injection of the solution near a major motor branch of the trigeminal nerve. A patient is allergic to both amide and ester anesthetic deriv- atives. For this patient, the dentist should find which of the following infiltrative local anesthetics to be safe and effec- tive? Bupivacaine C. Nitrous oxide Phenylephrine D. Diphenhydramine E. Ethylaminobenzoate Allergic reactions to local anesthetics are caused by: rapid absorption C. an antigen-antibody reaction slow detoxification D. improper administration technique A patient has a history of significant cardiovascular impair- ment. The maximum safe dose of epinephrine that can be admin- istered to this patient is: 1 cc, 1:50,000 B. 2 cc, 1:50,000 C. 1 cc, 1:100,000 D. 2 cc, 1:100,000 A 43-year old patient who has mitral stenosis, secondary to rheumatic fever requests extraction of two periodontally in- volved mandibular teeth. Initially, the dentist should premedicate the patient with cephalosporin premedicate the patient with amoxicillin premedicate the patient with ampicillin and gentamicin consult with the patient’s physician to determine the anti- biotic of choice Which of the following drugs is often administered intravenously to treat life-threatening ventricular arrhythmias? Quinidine B. Lidocaine C. Verapamil D. Propranolol A male patient who is receiving Coumadin® therapy presents for an elective extraction. His prothrombin time (PT) is pro- longed. Which of the following methods is preferred for reduc- ing the PT to an acceptable level? Administering vitamin K (Aqua Mephyton®) Withdrawing Coumadin® for two days Reducing Coumadin® to one-half the usual dose for two days Administering a Coumadin® antagonist, such as heparin Administering a platelet transfusion to enhance coagulabil- ity Each of the following drugs has a significant anti-inflammatory property, except: Aspirin C. Ibuprofen (Motrin®) Cortisol D. Indomethacin (indocin®) E. Acetaminophen Which of the following is an example of an enteral route of ad- ministration? Oral B. Submucosal C. Inhalation D. Intramuscular E. Subcutaneous Propranolol (Inderal®) exerts its major antianginal effect by: dilating coronary arteries. D. Dilating systemic blood vessels Increasing cardiac contractility E. Stimulating vagal slowing of the heart Blocking beta-adrenergic receptors of the heart. Which of the following side effects is seen most frequently with administration of nitrous oxide and oxygen? Hallucinations/dreams C. Tachycardia Respiratory depression D. Hand tremors E. Nausea Which of the following is the best substitute drug for a patient allergic to penicillin? Lincomycin C. Sulfonamide Tetracycline D. Erythromycin E. Ampicillin Which of the following antibiotics may cause discoloration of the teeth of the newborn if administered to the mother in the third trimester of pregnancy? Penicillin C. Streptomycin Tetracycline D. Clindamycin E. Erythromycin Which of the following drugs is most commonly employed in an at- tack of angina pectoris? Sodium nitrate C. Theophylline Epinephrine D. Nitroglycerine E. Isosorbide dinitrate The cardiac glycosides will reduce the concentration of which ion in an active heart muscle?  Sodium C. Calcium Bromide D. Chloride E. Potassium Pretreatment with which of the following drug will potentiate the ability of an intravenous injection of acetylcholine to lower blood pressure? Methacholine C. Pilocarpine Epinephrine D. Physostigmine E. Pralidoxime The single most useful agent in resuscitation is: oxygen an endotracheal tube D. aromatic spirits of ammonia a respiratory stimulant E. 1:1000 epinephrine for injection Inadvertently, an overdose of morphine is administered to a pa- tient. To treat this condition, a dentist should administer: oxygen and inject naloxone hydrochloride C. caffeine sodium, benzoate intravenously doxapram intramuscularly D. nalorphine and epinephrine intramuscularly The activity of benzalkonium chloride is markedly antagonized by: soap C. sodium chloride sodium nitrite D. cetypyridinium chloride E. al- kylbenzyldimethyl ammonium chloride A patient informs his dentist that he has been taking mecamyla- mine regularly for the past year. Upon oral examination the dentist is most likely to find: ptyalism C. palatal petechiae xerostomia D. gingival hypertrophy E. bullous lesions on the buccal mucosa A patient receiving propranolol has an acute asthmatic attack while undergoing dental treatment. The most useful agent for management of the condition is: Morphine C. phentolamine Epinephrine D. aminophylline E. norepineph- rine What determines the maximum dose of local anesthesia for a child? Age C. weight the procedure to be accomplished D. the desired degree of pulpal anesthesia After receiving one cartridge of a local anesthetic, a healthy adult patient became unconscious in the dental chair. The oc- currence of a brief convulsion is: pathognomonic of gland mal epilepsy consistent with a diagnosis of syncope  usually caused by the epinephrine in the local anesthetic pathognomonic of intravascular injection of a local anes- thetic Epinephrine is added to local anesthetics because it: decreases the rate of absorption of the local anesthetic at the injection site prevents the rapid deterioration of the local anesthetic solution increases the rate of destruction of the local anesthetics potentiates the action of all local anesthetics. Lidocaine (xylocaine) is an example of an: A. acid B. amide C. ester D. aldehyde The local anesthetic base is combined with hydrochloric acid to produce a water soluble salt solution. The anesthetic activity of the injected local anesthetic solution is most related to: the anesthetic salt solution the osmotic pressure of the soluble solution its reactivity with electrolytes in the interstitial tissue the conversion of the soluble solution to its insoluble an- esthetic base-acid form. Syncope is usually caused by: vasoconstriction C. cerebral hyperemia cerebral ischemia D. decease in the vascular bed The maximum recommended dosage of lidocaine HCI injected subcu- taneously when combined with 1:100,000 epinephrine is: A. 100mg B. 300mg C. 500mg D. 750mg E. 1gm. Cyanosis, dyspnea and elevated temperature following general anesthesia may indicate: atelectasis 3. pulmonary embolus pneumonia 4. acute renal shutdown A. 1 only B. 1,2 & 3 C. 2 & 3 D. 2 & 4 E. 4 only 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 Three minutes after receiving an inferior alveolar blokc for removal of a premolar, the patient develops paralysis of the muscles of his forehead, eyelids and upper and lower lips on the same side of the face. This is probably related to diffu- sion of the anesthetic solution into the: otic ganglion capsule of the parotid gland ophthalmic division of the trigeminal nerve  motor branches of the mandibular nerve supplying the masti- catory muscles Needle aspiration of a central bone lesion is used to feel for root surfaces D. rule out of diag- nosis of vascular lesion make a diagnosis of traumatic bone cyst E. determine the thickness of the buccal plate all of the above In local anesthesia, depression of respiration is a manifesta- tion of puncture of a blood vessel C. use of an isotonic so- lution toxic effects of the solution D. trauma to a nerve trunk by the syringe needle Comprises the inner nerve loop: ASAN, MSAN and PSAN C. Inferior alveolar and lingual nerves Greater palatine and nasopalatine nerves D. All of the above Branch of the maxillary nerve given off at the infraorbital canal: A. PSAN B. MSAN C. ASAN D. both A and B E. both B and C When attempting to achieve an intraoral palatal second division block anesthesia, the needle should enter the: greater palatine foramen C. foramen rotundum stylomastoid foramen D. mental foramen E. nasopalatine foramen The most likely cause of trismus after block anesthesia for sur- gery in the mandibular molar area is: excessive edema damage to the medial pterygoid muscle on injection stretching of the pterygomandibular raphe myositis of the lateral pterygoid muscle submandibular cellulites The most common disorder causing pain about the masticatory ap- paratus including the TMJ, is: myofascial-pain-dysfunction C. traumatic arthritis trigeminal neuralgia D. temporal arteritis E. degenerative arthritis The patient has received an injection of 1.8ml of local anes- thetic containing 2% lidocaine with 1:100,000 epinephrine. Thirty seconds later he goes into syncope. The most probable cause is: Bradycardia C. a toxic reaction to the epinephrine  Tachycardia D. an allergic reaction to the lidocaine. E. Cerebral hypoxia Nitrous oxide alone is not used as a general anesthetic agent because of the difficulty in maintaining an adequate oxygen concentration expense of the agent and its explosive hazard adverse effects on the liver poor analgesic properties all of the above. A deep level of general anesthesia is enhanced by a : high alveolar concentration of anesthetic agent C. loose-fitting mask nonirritating drug D. muscle relaxer Mandibular nerve is considered as: motor nerve B. mixed nerve C. sensory nerve D. none of these. At which pH will the local anesthesia be effectively diffused: pH doesn’t matter B. below 7 C. below or above D. above 7 In larger myelinated nerves, conduction takes place at: dendrites B. axons C. neuron D. nodes of Ranvier Which of the following nerve is not involved in an extra-oral infraorbital nerve block: inferior palpebral C. lateral nasal sphenopalatine D. infraorbital E. none of these. PHARMACOLOGY AND ANESTHESIOLOGY Which of the following may result from an overdose of insulin? A. glycosuria B. convulsions C. hyperglycemia D. diabetes insipidus A drug that causes xerostomia is a cholinergic agent D. a cholinesterase inhibitor an anticholinergic agent E. an antiadrenergic agent an alpha-adrenergic blocking drug Precautions must be taken when drugs are administered to geriatric patients because elderly people may metabolize drugs less rapidly may not be able to excrete drugs as rapidly will usually require greater than average adult doses  all of the above only (1) and (2) above Protracted use ("prolonged use") of sulfa drugs may produce symptoms of vitamin K deficiency because sulfa drugs are detoxified in the liver combine chemically with vitamin K inhibit growth of intestinal bacteria interfere with the conversion of prothrombin to thrombin inhibit calcium absorption which is essential to enzyme systems Which of the following is not an action of aspirin? analgesic B. obtundent C. antipyretic D. anti-inflammatory Salicylates are NOT the drug of choice for patients 1. with gastric ulceration 3. with rheumatoid arthritis 2. with hemorrhagic disorders 4. on anticoagulant therapy 1,2,3 B. 2,3,4 C. 3,4 D. 3 only E. 1,2,4 Which of the following is NOT a reason to premedicate patients before induction of general anesthesia relieve anxiety prolong induction potentiate or supply an effect not produced by the anesthetic prevent adverse effects of the anesthetic agent shorting duration of anesthesia from a single injection Of the following, nitrous oxide-oxygen analgesic is contraindicated in a patient who 1. is overweight 4. has an upper respiratory infection 2. has hypertension 5. has just ingested a large meal 3. has a history of emphysema 1,2,3 B. 2,3,4 C. 3,4,5 D. 1,2 E. all of these A patient taking digitalis probably has: angina pectoris or atherosclerosis atheroslerosis or congestive heart failure congestive heart failure or atrial fibrillation atrial fibrillation or essential hypertension Acute psychoses, peptic ulcers, chronic heart failure and edema are classic contraindi- cations for which of the following drugs? cortisone B. digitalis C. penicillin D. nitromersol The cause of death from overdose of any central nervous system depressant is usu- ally renal failure C. hepatic necrosis E. cardiovascular depression thromboembolism D. respiratory depression A patient who is allergic to penicillin will have an allergic reaction to which of the fol- lowing drugs?  neomycin B. cefalexin C.erythromycin D. both A and C Tachycardia is characterized by rise in body temperature C. an increase in pulse rate decrease in pulse rate D. an increase in blood pressure Which medication could result in profuse hemorrhaging that fails to subside during root planing procedures? Steroids C. amyl nitrate vitamin K D. dicumarol E. thiazide diuretics Which of the following is the initial treatment of syncope in a dental office? administer 100% oxygen administer aromatic spirits of ammonia position the head lower than the feet position the patient's head upright and slightly tilt it Gelatin sponge (Gelfoam) a useful hemostatic agent because it