4dd MCQs 200 Dental Anesthesia Dr. Tong Leang 2019

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Uhsdental

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Quizzes Created: 7 | Total Attempts: 16,269

Questions: 200 | Attempts: 274 | Updated: Jul 12, 2023

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4dd MCQs 200 Dental Anesthesia Dr. Tong Leang 2019 - Quiz

Questions and Answers

1.

Surface activity and low toxic potential?
- A.
  
  Benzocaine
- B.
  
  Cocaine
- C.
  
  Bupivacaine
- D.
  
  Procaine
- E.
  
  Lidocaine
Correct Answer
A. Benzocaine

Explanation
Benzocaine is the correct answer because it has surface activity and low toxic potential. Surface activity refers to the ability of a substance to interact with the surface of a material or tissue. Benzocaine is commonly used as a topical anesthetic, which means it is applied directly to the skin or mucous membranes to numb the area. It has a low toxic potential, meaning it is less likely to cause harmful effects compared to other options listed such as cocaine, bupivacaine, procaine, or lidocaine.

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2.

Which of the following drugs can cause methemoglonemia?
- A.
  
  Prilocaine
- B.
  
  Cocaine
- C.
  
  Lidocaine
- D.
  
  Bupivacaine
- E.
  
  Procaine
Correct Answer
A. Prilocaine

Explanation
Prilocaine is a local anesthetic that can cause methemoglobinemia. Methemoglobinemia is a condition where the iron in hemoglobin is converted to a non-functional form, leading to a reduced ability of the blood to carry oxygen. Prilocaine can cause this condition by oxidizing the iron in hemoglobin. This can result in symptoms such as cyanosis (bluish discoloration of the skin), shortness of breath, and fatigue. Prompt medical attention is required if methemoglobinemia is suspected.

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3.

Vasoconstrictor in Local anesthetic solution is?
- A.
  
  Reduce toxic effects of LA solution
- B.
  
  Decreases depth & duration of LA
- C.
  
  Increase bleeding
- D.
  
  Increase toxic effects of LA
- E.
  
  Has no effect on efficacy LA solution
Correct Answer
A. Reduce toxic effects of LA solution

Explanation
The vasoconstrictor in a local anesthetic solution is used to reduce the toxic effects of the solution. Vasoconstrictors work by constricting the blood vessels in the area where the anesthetic is applied, which helps to decrease the absorption of the anesthetic into the bloodstream. This reduces the risk of systemic toxicity and allows for a higher concentration of the anesthetic to remain at the site of application, increasing its effectiveness.

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4.

When injecting Local solutionin maxilla on buccal side. The technique is ?
- A.
  
  Supra periosteal
- B.
  
  Sup periosteal
- C.
  
  Sup mucosal
- D.
  
  Intra osseous
- E.
  
  Intra septal
Correct Answer
A. Supra periosteal

Explanation
The correct technique for injecting local solution in the maxilla on the buccal side is the supra periosteal technique. This involves injecting the solution just above the periosteum, which is the connective tissue covering the bone. This technique allows for effective anesthesia in the desired area while minimizing discomfort for the patient.

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5.

Disto buccal root of upper first molar is supplied by:?
- A.
  
  Posterior superior alveolar nerve
- B.
  
  Middle superior alveolar nerve
- C.
  
  Infra orbital nerve
- D.
  
  Mental nerve
- E.
  
  Buccal nerve
Correct Answer
A. Posterior superior alveolar nerve

Explanation
The disto buccal root of the upper first molar is supplied by the posterior superior alveolar nerve. This nerve is a branch of the maxillary nerve and provides sensory innervation to the maxillary molars. The other options listed are not responsible for supplying innervation to this specific area of the tooth.

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6.

Technique of anesthesia in which local anesthetic solution is injected into the vein is ?
- A.
  
  Intra venous regional anesthesia
- B.
  
  Nerve block
- C.
  
  Infiltration anesthesia
- D.
  
  Epidural anesthesia
- E.
  
  No such technique exists.
Correct Answer
A. Intra venous regional anesthesia

Explanation
Intra venous regional anesthesia is the technique of anesthesia in which a local anesthetic solution is injected into the vein. This allows for the anesthetic to be distributed throughout the body via the bloodstream, providing a localized numbing effect. This technique is commonly used for procedures that require anesthesia in a specific region of the body, such as limb surgeries or dental procedures.

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7.

You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland?
- A.
  
  To be palpable both intra- and extraorally
- B.
  
  To be palpable intraorally
- C.
  
  To be palpable extraorally.
- D.
  
  Only to be detectable by radiographical examination.
Correct Answer
A. To be palpable both intra- and extraorally

Explanation
When a submandibular salivary gland is enlarged, it can be palpable both intraorally (inside the mouth) and extraorally (outside the mouth). This means that the enlarged gland can be felt by touching it both from the inside and outside of the mouth. This is a characteristic feature of an enlarged submandibular salivary gland and helps in diagnosing the condition.

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8.

During an inferior alveolar nerve block the needle ideally passes?
- A.
  
  Anterior and lateral to medial pterygoid
- B.
  
  Posterior and medial to medial pterygoid.
- C.
  
  Through medial pterygoid
- D.
  
  Inferior to medial pterygoid.
Correct Answer
A. Anterior and lateral to medial pterygoid

Explanation
During an inferior alveolar nerve block, the needle ideally passes anterior and lateral to the medial pterygoid muscle. This is because the medial pterygoid muscle is located deep within the oral cavity, and passing the needle in this direction helps to avoid damaging the muscle and other important structures in the area. By going anterior and lateral to the medial pterygoid, the needle can effectively target the inferior alveolar nerve for anesthesia without causing unnecessary complications or discomfort for the patient.

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9.

You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the?
- A.
  
  Hard palate, upper lip, upper central incisor and lower first molar
- B.
  
  Hard palate.
- C.
  
  Hard palate and upper lip.
- D.
  
  Hard palate, upper lip and upper central incisor.
Correct Answer
A. Hard palate, upper lip, upper central incisor and lower first molar

Explanation
The correct answer is hard palate, upper lip, upper central incisor, and lower first molar. Enlarged submandibular lymph nodes can indicate an infection in the head and neck region. The submandibular lymph nodes drain lymph from the mouth and throat area. The hard palate, upper lip, upper central incisor, and lower first molar are all located in this region and can potentially be sources of infection that would cause the lymph nodes to become enlarged.

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10.

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 anesthesia in order to carry out a pain-free biopsy?
- A.
  
  The incisive nerve
- B.
  
  The buccal nerve
- C.
  
  The lingual nerve
Correct Answer
A. The incisive nerve

Explanation
The incisive nerve would require local anesthesia in order to carry out a pain-free biopsy. The incisive nerve is responsible for providing sensory innervation to the labial alveolar mucosa of the lower incisor teeth. By administering local anesthesia to the incisive nerve, the patient will not experience any pain during the biopsy procedure.

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11.

The regional lymphatic drainage of the left side of the tip of the tongue is to the?
- A.
  
  Left and right submental lymph nodes
- B.
  
  Left submental lymph node.
- C.
  
  Left submandibular lymph node.
- D.
  
  Left and right submandibular lymph nodes.
Correct Answer
A. Left and right submental lympH nodes

Explanation
The regional lymphatic drainage of the left side of the tip of the tongue is to the left and right submental lymph nodes. The submental lymph nodes are located beneath the chin, and they receive lymphatic drainage from the tongue. Since the question specifies the left side of the tongue, it is logical to assume that the drainage would occur to both the left and right submental lymph nodes. The submandibular lymph nodes, on the other hand, are located below the mandible and receive drainage from other areas of the oral cavity, but not specifically from the tip of the tongue. Therefore, the correct answer is left and right submental lymph nodes.

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12.

A successful inferior alveolar nerve block will produce anesthesia of the?
- A.
  
  Lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth
- B.
  
  Lower lip.
- C.
  
  Lower lip and mandibular teeth.
- D.
  
  Lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the posterior mandibular teeth.
Correct Answer
A. Lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth

Explanation
A successful inferior alveolar nerve block will produce anesthesia of the lower lip, mandibular teeth, and labial gingivae of the anterior mandibular teeth. This is because the inferior alveolar nerve supplies sensation to these areas. The other options are incorrect because they either exclude certain areas that should be anesthetized or include areas that are not affected by the inferior alveolar nerve block.

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13.

The mucosa of the hard palate is?
- A.
  
  Keratinised and has submucosa and minor salivary glands posterolaterally
- B.
  
  Non-keratinised and has submucosa and minor salivary glands posteromedially
- C.
  
  Keratinised and lacks submucosa and minor salivary glands.
- D.
  
  Non-keratinised and lacks submucosa and minor salivary glands.
Correct Answer
A. Keratinised and has submucosa and minor salivary glands posterolaterally

Explanation
The correct answer is "keratinised and has submucosa and minor salivary glands posterolaterally." The hard palate is the bony structure that forms the roof of the mouth. The mucosa of the hard palate is keratinised, meaning it has a tough outer layer of keratin cells. It also has a submucosa layer, which is a connective tissue layer beneath the mucosa. Additionally, there are minor salivary glands located posterolaterally on the hard palate, which contribute to saliva production.

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14.

A successful infraorbital nerve block will produce anaesthesia of the?
- A.
  
  Maxillary anterior teeth, their labial gingivae and the upper lip
- B.
  
  Maxillary anterior teeth.
- C.
  
  Maxillary anterior teeth and their labial gingivae.
- D.
  
  Maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate
Correct Answer
A. Maxillary anterior teeth, their labial gingivae and the upper lip

Explanation
A successful infraorbital nerve block will produce anesthesia of the maxillary anterior teeth, their labial gingivae, and the upper lip. This is because the infraorbital nerve supplies sensory innervation to these areas.

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15.

In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be?
- A.
  
  Ed below the mucogingival junction and light pink above it
- B.
  
  Light pink in colour on both sides of the mucogingigival junction.
- C.
  
  Light pink below the mucogingival junction and red above it.
- D.
  
  Red on both sides of the mucogingival junction
Correct Answer
A. Ed below the mucogingival junction and light pink above it

Explanation
In a patient with a normal healthy mouth, the mucosa covering the alveolar process supporting the mandibular teeth would be expected to be light pink below the mucogingival junction and light pink above it. This indicates a healthy gingival tissue with proper blood supply. The presence of light pink color on both sides of the mucogingival junction suggests normal tissue appearance and good oral health.

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16.

Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is?
- A.
  
  No local irritation, even absorption and no systemic toxicity
- B.
  
  No local irritation
- C.
  
  Even absorption
- D.
  
  No systemic toxicity
- E.
  
  Higher melting point of combined drug than either lidocaine (Xylocaine) or prilocaine (Citanest) alone
Correct Answer
A. No local irritation, even absorption and no systemic toxicity

Explanation
The advantage of using 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is that it provides no local irritation, ensures even absorption, and has no systemic toxicity. This means that the cream can be applied to the skin without causing any irritation or discomfort. Additionally, the ingredients in the cream are absorbed evenly into the skin, ensuring consistent and effective numbing. Furthermore, there is no risk of any harmful effects or toxicity to the body as a whole.

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17.

Local anesthetic used in greater than 50% of rhinolaryngologic cases:?
- A.
  
  Cocaine
- B.
  
  Prilocaine (Citanest)
- C.
  
  Mepivacaine (Carbocaine)
- D.
  
  Bupivacaine (Marcaine)
- E.
  
  Tetracaine (pontocaine)
Correct Answer
A. Cocaine

Explanation
Cocaine is the correct answer because it is a local anesthetic that is commonly used in more than 50% of rhinolaryngologic cases. It is known for its fast-acting and potent numbing effects, making it a popular choice for procedures in this field. Prilocaine, mepivacaine, bupivacaine, and tetracaine are also local anesthetics, but they are not used as frequently in rhinolaryngologic cases compared to cocaine.

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18.

Mechanism(s) of local anesthetic action in epidural anesthesia:?
- A.
  
  Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
- B.
  
  Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura
- C.
  
  Diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
- D.
  
  Neither
Correct Answer
A. Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina

Explanation
The correct answer is direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina. This explanation suggests that the local anesthetic directly acts on the nerve roots and spinal cord after it diffuses across the dura. Additionally, the local anesthetic also diffuses into the paravertebral regions through the intervertebral foramina, further contributing to its action.

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19.

Rationale for adding epinephrine to a local anesthetic solution:?
- A.
  
  Reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers
- B.
  
  Reduced local anesthetic systemic absorption
- C.
  
  Increased anesthetic concentration near nerve fibers
- D.
  
  Reduced duration of conduction blockade
- E.
  
  All of the above
Correct Answer
A. Reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers

Explanation
Adding epinephrine to a local anesthetic solution can reduce the systemic absorption of the anesthetic, meaning that less of it will enter the bloodstream and potentially cause systemic side effects. Additionally, epinephrine can increase the concentration of the anesthetic near the nerve fibers, enhancing its effectiveness in blocking nerve conduction and providing local anesthesia. Therefore, the rationale for adding epinephrine to a local anesthetic solution is to achieve both reduced systemic absorption and increased anesthetic concentration near nerve fibers.

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20.

Zone of differential motor blockade may average up to four segments below the sensory level?
- A.
  
  Epidural
- B.
  
  Spinal
- C.
  
  Epidural and Spinal
Correct Answer
A. Epidural

Explanation
The zone of differential motor blockade refers to the area where the motor function is affected by the anesthesia. In this case, the question states that the zone may average up to four segments below the sensory level. This suggests that the epidural anesthesia is responsible for this effect, as it is known to provide a more extensive motor blockade compared to spinal anesthesia. Therefore, the correct answer is epidural.

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21.

Primary side effect/toxicities associated with local anesthetic use:?
- A.
  
  Allergic reactions and systemic toxicity
- B.
  
  Allergic reactions
- C.
  
  Systemic toxicity
- D.
  
  Neither
Correct Answer
A. Allergic reactions and systemic toxicity

Explanation
Local anesthetics can cause allergic reactions and systemic toxicity as primary side effects. Allergic reactions can range from mild skin rashes to severe anaphylaxis. Systemic toxicity occurs when the local anesthetic is absorbed into the bloodstream in excessive amounts, leading to symptoms such as dizziness, confusion, seizures, and cardiac arrhythmias. These side effects can occur with the use of any local anesthetic, although the risk varies depending on the specific agent used and the individual patient.

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22.

Factors enhancing bupivacaine (Marcaine) toxicity?
- A.
  
  Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
- B.
  
  Pregnancy
- C.
  
  Presence of calcium channel blockers
- D.
  
  Arterial hypoxemia
- E.
  
  Acidosis and hypercarbia
Correct Answer
A. Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia

Explanation
Bupivacaine is a local anesthetic that can cause toxicity in certain situations. Pregnancy can enhance the toxicity of bupivacaine due to physiological changes in the body during pregnancy. Calcium channel blockers can also enhance bupivacaine toxicity by inhibiting the metabolism and elimination of the drug. Arterial hypoxemia, which is low oxygen levels in the blood, can increase the sensitivity to bupivacaine toxicity. Acidosis, an acidic pH in the body, and hypercarbia, high levels of carbon dioxide in the blood, can both decrease the effectiveness of bupivacaine metabolism and clearance, leading to increased toxicity.

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23.

Agents added to local anesthetics that prolonged local anesthetic duration of action?
- A.
  
  Epinephrine, phenylephrine (Neo-Synephrine) and dextran
- B.
  
  Epinephrine
- C.
  
  Phenylephrine (Neo-Synephrine)
- D.
  
  Dextran
Correct Answer
A. EpinepHrine, pHenylepHrine (Neo-SynepHrine) and dextran

Explanation
Epinephrine, phenylephrine (Neo-Synephrine), and dextran are all agents that can be added to local anesthetics to prolong their duration of action. Epinephrine is a vasoconstrictor that helps to decrease blood flow at the site of injection, thereby reducing the rate of absorption and prolonging the effects of the local anesthetic. Phenylephrine (Neo-Synephrine) also acts as a vasoconstrictor and can have similar effects. Dextran is a plasma expander that increases the volume of the local anesthetic solution, allowing for a slower release of the anesthetic and a longer duration of action.

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24.

Typically a zone of differential sympathetic nervous system blockade?
- A.
  
  Spinal
- B.
  
  Epidural
- C.
  
  Epidural and spinal
Correct Answer
A. Spinal

Explanation
A zone of differential sympathetic nervous system blockade typically occurs with a spinal anesthesia. This type of anesthesia involves injecting medication into the cerebrospinal fluid in the spinal canal, which blocks the transmission of nerve signals. The blockade affects a specific segment of the spinal cord, resulting in differential sympathetic blockade. This means that the sympathetic nerves, which control functions like blood pressure and heart rate, are selectively blocked in the area where the medication is injected. This allows for targeted pain relief and anesthesia while minimizing the side effects on other parts of the body.

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25.

Preferred local anesthetics for local infiltration:?
- A.
  
  Lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
- B.
  
  Lidocaine (Xylocaine)
- C.
  
  Ropivacaine (Naropin)
- D.
  
  Bupivacaine (Marcaine)
Correct Answer
A. Lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)

Explanation
The preferred local anesthetics for local infiltration are lidocaine (Xylocaine), ropivacaine (Naropin), and bupivacaine (Marcaine). These drugs are commonly used for their effectiveness in providing local anesthesia by blocking nerve signals in the area of administration. They have a rapid onset of action, provide sufficient anesthesia duration, and have a favorable safety profile. Lidocaine, ropivacaine, and bupivacaine are widely used in various surgical and dental procedures to ensure patient comfort and pain management.

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26.

Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia -- may because by nonhomogeneous local anesthetic distribution?
- A.
  
  Cauda equina syndrome
- B.
  
  Anterior spinal artery syndrome
- C.
  
  Transient radicular irritation
Correct Answer
A. Cauda equina syndrome

Explanation
The correct answer is cauda equina syndrome. This condition is characterized by sensory anesthesia, bowel and bladder sphincter dysfunction, and paraplegia. It is possible that the neurotoxicity associated with local anesthesia, specifically the nonhomogeneous distribution of the anesthetic, may be the cause of cauda equina syndrome.

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27.

Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain?
- A.
  
  Transient radicular irritation
- B.
  
  Cauda equina syndrome
- C.
  
  Anterior spinal artery syndrome
Correct Answer
A. Transient radicular irritation

Explanation
Transient radicular irritation is a condition characterized by moderate to severe lower back, buttocks, and posterior side pain. It is caused by irritation or inflammation of the nerve roots in the spinal canal, typically following spinal anesthesia or surgery. The pain is usually temporary and resolves on its own within a few days or weeks. Cauda equina syndrome is a more serious condition that involves compression of the nerve roots in the lower spine, leading to severe back pain, bowel or bladder dysfunction, and neurological symptoms. Anterior spinal artery syndrome is a rare condition caused by blockage of the blood supply to the spinal cord, resulting in paralysis and loss of sensation below the level of the injury.

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28.

Factors that influence lidocaine (Xylocaine) metabolism:?
- A.
  
  Pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
- B.
  
  Pregnancy-induced hypertension
- C.
  
  Hepatic disease
- D.
  
  Reduced liver blood flow
- E.
  
  Volatile anesthetics
Correct Answer
A. Pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics

Explanation
The factors that influence lidocaine (Xylocaine) metabolism include pregnancy-induced hypertension, hepatic disease, reduced liver blood flow, and volatile anesthetics. These factors can affect the metabolism of lidocaine in the body, potentially altering its effectiveness and duration of action. Pregnancy-induced hypertension may affect the clearance of lidocaine, while hepatic disease can impair the liver's ability to metabolize the drug. Reduced liver blood flow can also impact lidocaine metabolism, as the liver is responsible for metabolizing and eliminating drugs from the body. Additionally, volatile anesthetics can interact with lidocaine metabolism, potentially affecting its pharmacokinetics.

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29.

Most common cause of toxic plasma local anesthetic concentrations?
- A.
  
  Accidental direct intravascular injection during block
- B.
  
  Incorrect dosage during peripheral or block
- C.
  
  Increase vasoconstrictors solution in the anesthetic
- D.
  
  Without solution of vasoconstrictors for anesthetic
Correct Answer
A. Accidental direct intravascular injection during block

Explanation
The most common cause of toxic plasma local anesthetic concentrations is accidental direct intravascular injection during a block. This means that the local anesthetic intended for the peripheral or block is accidentally injected directly into a blood vessel, leading to higher concentrations of the anesthetic in the bloodstream. This can result in toxic effects on the body, such as cardiovascular and central nervous system toxicity. Incorrect dosage during peripheral or block, increase vasoconstrictors solution in the anesthetic, and using anesthetic without a solution of vasoconstrictors are not the most common causes of toxic plasma local anesthetic concentrations.

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30.

Common eutectic mixture of local anesthetics (EMLA)?
- A.
  
  Lidocaine (Xylocaine) and prilocaine (Citanest)
- B.
  
  Tetracaine (pontocaine) and epinephrine
- C.
  
  Lidocaine (Xylocaine) and tetracaine (pontocaine)
- D.
  
  Prilocaine (Citanest) and bupivacaine (Marcaine)
- E.
  
  Tetracaine (pontocaine) and bupivacaine (Marcaine)
Correct Answer
A. Lidocaine (Xylocaine) and prilocaine (Citanest)

Explanation
The common eutectic mixture of local anesthetics (EMLA) is lidocaine (Xylocaine) and prilocaine (Citanest). This combination is commonly used as a topical anesthetic to numb the skin before certain medical procedures or injections. Lidocaine and prilocaine work together to block nerve signals and temporarily numb the area, providing pain relief. This combination has been found to be effective and safe for use in various medical settings.

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31.

Most frequent local anesthetic clinical use:?
- A.
  
  Regional anesthetia
- B.
  
  Treatment of grand mal seizure
- C.
  
  Analgesia
- D.
  
  Management of cardiac arrhythmias
- E.
  
  Management of increased intracranial pressure
Correct Answer
A. Regional anesthetia

Explanation
The most frequent local anesthetic clinical use is regional anesthesia. This involves numbing a specific region of the body to block pain during surgical procedures or other medical interventions. Regional anesthesia can be administered through various techniques such as nerve blocks, epidurals, or spinal anesthesia. It is commonly used for surgeries involving the limbs, abdomen, or lower body, providing effective pain relief and allowing patients to remain awake and alert during the procedure. This type of anesthesia is preferred over general anesthesia in many cases as it carries fewer risks and has a faster recovery time.

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32.

Lidocaine (Xylocaine) effect on ventilation response to hypoxia?
- A.
  
  Depressed response
- B.
  
  Enhanced response
- C.
  
  No effect
- D.
  
  Enhanced response and no effect
Correct Answer
A. Depressed response

Explanation
Lidocaine, also known as Xylocaine, has been found to have a depressant effect on the ventilation response to hypoxia. This means that when exposed to low oxygen levels, the body's normal response of increasing ventilation (breathing rate) is reduced or suppressed when lidocaine is present. Therefore, lidocaine can inhibit the body's ability to respond effectively to low oxygen levels, potentially leading to respiratory complications.

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33.

Clinical use(s) of EMLA applications:?
- A.
  
  Lumbar puncture
- B.
  
  Arterial cannulation
- C.
  
  Venipuncture
- D.
  
  Myringotomy
Correct Answer
A. Lumbar puncture

Explanation
EMLA applications are used in clinical settings for various procedures. One of these procedures is a lumbar puncture, which involves inserting a needle into the lower back to collect cerebrospinal fluid for diagnostic purposes. EMLA, a topical anesthetic cream, can be applied to numb the skin and reduce pain during the procedure. This allows for a more comfortable experience for the patient and facilitates the successful completion of the lumbar puncture.

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34.

Allergic reactions to local anesthetics:?
- A.
  
  High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug
- B.
  
  Common > 10% of adverse reactions due to allergic mechanisms
- C.
  
  High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds
- D.
  
  Cross-sensitivity between esters and amide-type local anesthetics are common
- E.
  
  Intradermal testing for possible allergy to local anesthetics should use preservative-free drug
Correct Answer
A. High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug

Explanation
Allergic reactions to local anesthetics are more likely to occur with ester-type agents that are metabolized to p-aminobenzoic acid-related compounds. Intradermal testing for possible allergy to local anesthetics should use a preservative-free drug to minimize the risk of an allergic reaction. Cross-sensitivity between esters and amide-type local anesthetics is common. Allergic reactions account for more than 10% of adverse reactions to local anesthetics.

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35.

Factors which increase local anesthetic CNS toxicities:?
- A.
  
  Rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)
- B.
  
  Hypokalemia
- C.
  
  Rate of injection
- D.
  
  Patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used
- E.
  
  High PaCO2 (reduced local anesthetic seizure threshold)
Correct Answer
A. Rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)

Explanation
The factors that increase local anesthetic CNS toxicities are the rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used, and high PaCO2 (reduced local anesthetic seizure threshold). These factors can potentiate the toxic effects of the local anesthetic, leading to CNS toxicity. Rapid injection can result in a higher concentration of the drug reaching the CNS, increasing the risk of toxicity. Mexiletine can interact with lidocaine, prolonging its effects and increasing the risk of toxicity. High PaCO2 levels can lower the seizure threshold, making the CNS more susceptible to the toxic effects of the local anesthetic.

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36.

Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.?
- A.
  
  Dyclonine (Dyclone)
- B.
  
  Lidocaine (Xylocaine)
- C.
  
  Tetracaine (pontocaine)
- D.
  
  Mepivacaine (Carbocaine)
- E.
  
  Bupivacaine (Marcaine)
Correct Answer
A. Dyclonine (Dyclone)

Explanation
Dyclonine (Dyclone) is the least likely to exhibit cross-sensitivity with amide or ester local anesthetics. This means that individuals who are allergic to amide or ester local anesthetics are less likely to have an allergic reaction to dyclonine. Cross-sensitivity refers to the likelihood of developing an allergic reaction to a substance that is structurally similar to a known allergen. In this case, dyclonine is less structurally similar to amide or ester local anesthetics compared to the other options listed. Therefore, it is the least likely to cause an allergic reaction in individuals who are allergic to amide or ester local anesthetics.

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37.

Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.?
- A.
  
  Hypoxemia, Hyperkalemia and Acidosis
- B.
  
  Hypoxemia
- C.
  
  Hyperkalemia
- D.
  
  Acidosis
Correct Answer
A. Hypoxemia, Hyperkalemia and Acidosis

Explanation
Hypoxemia, hyperkalemia, and acidosis are all factors that can reduce the seizure threshold of lidocaine (Xylocaine). Hypoxemia refers to low levels of oxygen in the blood, which can impair brain function and increase the likelihood of seizures. Hyperkalemia is an elevated level of potassium in the blood, which can disrupt the normal electrical activity in the brain and lead to seizures. Acidosis is a condition characterized by increased acidity in the blood, which can also interfere with brain function and lower the seizure threshold. Therefore, the presence of any of these factors can make a person more susceptible to experiencing seizures when using lidocaine.

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38.

Local anesthetic which produces localized vasoconstriction and anesthesia?
- A.
  
  Cocaine
- B.
  
  Tetracaine (pontocaine)
- C.
  
  Lidocaine (Xylocaine)
- D.
  
  Prilocaine (Citanest)
- E.
  
  Chloroprocaine (Nesacaine)
Correct Answer
A. Cocaine

Explanation
Cocaine is a local anesthetic that produces localized vasoconstriction and anesthesia. It acts by blocking the transmission of nerve impulses, resulting in numbness and loss of sensation in the area where it is applied. Additionally, cocaine has vasoconstrictive properties, meaning it narrows the blood vessels in the area, which helps to reduce bleeding and prolong the effects of anesthesia.

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39.

Agents not recommended for Bier block:
- A.
  
  Chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
- B.
  
  Chloroprocaine (Nesacaine
- C.
  
  Mepivacaine (Carbocaine)
- D.
  
  Bupivacaine (Marcaine)
Correct Answer
A. Chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
40.

Manifestation of systemic toxicity
- A.
  
  CNS toxicity, cardiovascular toxicity and neurological symptoms
- B.
  
  CNS toxicity
- C.
  
  Cardiovascular toxicity
- D.
  
  Neurological symptoms
Correct Answer
A. CNS toxicity, cardiovascular toxicity and neurological symptoms

Explanation
This answer suggests that the manifestation of systemic toxicity can include CNS toxicity, cardiovascular toxicity, and neurological symptoms. This means that when a person experiences systemic toxicity, it can affect their central nervous system, cardiovascular system, and result in various neurological symptoms.

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41.

Most commonly used local anesthetic for rhinolaryngologic cases
- A.
  
  Cocaine
- B.
  
  Ropivacaine (Naropin)
- C.
  
  Bupivacaine (Marcaine)
- D.
  
  Mepivacaine (Carbocaine)
- E.
  
  Tetracaine (pontocaine)
Correct Answer
A. Cocaine

Explanation
Cocaine is the most commonly used local anesthetic for rhinolaryngologic cases. This is because cocaine has vasoconstrictive properties, which helps reduce bleeding during surgery in this area. It also provides effective anesthesia and has a rapid onset of action. Ropivacaine, bupivacaine, mepivacaine, and tetracaine are also local anesthetics, but they are not specifically indicated or commonly used for rhinolaryngologic cases.

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42.

Commonly use local anesthetics for topical/surface application:
- A.
  
  Lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
- B.
  
  Chloroprocaine (Nesacaine)
- C.
  
  Lidocaine (Xylocaine)
- D.
  
  Tetracaine (pontocaine)
- E.
  
  Cocaine
Correct Answer
A. Lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
43.

Clinical presentations suggestive of local anesthetic allergies:
- A.
  
  All are correct
- B.
  
  Rash
- C.
  
  Laryngeal edema
- D.
  
  Bronchospasm
- E.
  
  Urticarial and possibly hypotension
Correct Answer
A. All are correct

Explanation
The correct answer is that all of the clinical presentations mentioned are suggestive of local anesthetic allergies. These symptoms include rash, laryngeal edema, bronchospasm, urticarial, and possibly hypotension.

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44.

Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:
- A.
  
  Prilocaine (Citanest)
- B.
  
  Lidocaine (Xylocaine)
- C.
  
  Bupivacaine (Marcaine)
- D.
  
  Dibucaine (Nupercainal, generic)
- E.
  
  Procaine (Novocain)
Correct Answer
A. Prilocaine (Citanest)

Explanation
Prilocaine is the most likely local anesthetic to cause cyanosis secondary to reduced oxygen transport. This is because prilocaine has a higher affinity for hemoglobin and can cause methemoglobinemia, a condition where the oxygen-carrying capacity of hemoglobin is reduced. Methemoglobinemia can lead to cyanosis, a bluish discoloration of the skin and mucous membranes due to inadequate oxygenation. Lidocaine, bupivacaine, dibucaine, and procaine do not have a significant risk of causing methemoglobinemia and therefore are less likely to cause cyanosis.

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45.

This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase
- A.
  
  Dibucaine (Nupercainal, generic)
- B.
  
  Ropivacaine (Naropin)
- C.
  
  Bupivacaine (Marcaine)
- D.
  
  Procaine (Novocain)
- E.
  
  Chloroprocaine (Nesacaine)
Correct Answer
A. Dibucaine (Nupercainal, generic)

Explanation
Dibucaine is a local anesthetic that belongs to the amide-type group. It is specifically used to assess the possible presence of atypical cholinesterase. Atypical cholinesterase is a genetic variant of the enzyme cholinesterase, which is responsible for breaking down certain medications including local anesthetics. Dibucaine is used as a diagnostic tool to determine if a patient has this genetic variant, as it has a unique ability to inhibit atypical cholinesterase more than other types of cholinesterase. Therefore, dibucaine is the correct answer for this question.

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46.

Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution
- A.
  
  Hypertension and Arrhythmias
- B.
  
  Hypertension
- C.
  
  Arrhythmias
- D.
  
  Neither
Correct Answer
A. Hypertension and Arrhythmias

Explanation
The correct answer is "Hypertension and Arrhythmias" because systemic absorption of epinephrine can lead to an increase in blood pressure (hypertension) and irregular heart rhythms (arrhythmias). Epinephrine, also known as adrenaline, is a vasoconstrictor that constricts blood vessels, leading to increased blood pressure. It can also affect the electrical conduction system of the heart, causing abnormal heart rhythms. Therefore, when epinephrine is included in a local anesthetic solution and gets absorbed into the bloodstream, it can potentially cause these toxicities.

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47.

Ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Ropivacaine (Naropin) is indeed less cardiotoxic than bupivacaine (Marcaine). Cardiotoxicity refers to the potential of a drug to cause harm to the heart. Ropivacaine has a lower risk of causing cardiac side effects compared to bupivacaine. This makes it a safer option for local anesthesia, especially in procedures where large doses or long-lasting effects are required.

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48.

Factor(s) which determine extent of systemic local anesthetic absorption:
- A.
  
  All are not correct
- B.
  
  Initial dose
- C.
  
  Injection site vascularity
- D.
  
  Intrinsic drug properties
- E.
  
  Whether or not epinephrine was used to provide local vasoconstriction
Correct Answer
A. All are not correct

Explanation
The extent of systemic local anesthetic absorption is not determined by any of the factors mentioned in the options. The factors that actually determine the extent of systemic local anesthetic absorption include the dose of the anesthetic, the vascularity of the injection site, the intrinsic properties of the drug, and whether or not epinephrine was used to provide local vasoconstriction. Therefore, all of the options provided in the question are incorrect.

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49.

Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics
- A.
  
  All are not correct
- B.
  
  ECG -PR interval prolongation
- C.
  
  Increased conduction velocity
- D.
  
  Reduced phase 4 depolarization
- E.
  
  Reduced automaticity
Correct Answer
A. All are not correct

Explanation
The given answer states that all of the options are not correct. This means that none of the mentioned electrophysiological characteristics are associated with Lidocaine (Xylocaine) cardiotoxicity.

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50.

Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia:
- A.
  
  More lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions®
- B.
  
  More lipophilic anesthetics benefit most by epinephrine in addition to local anesthetic solutions
Correct Answer
A. More lipopHilic anesthetics benef ileast by epinepHrine in addition to local anesthetic solutions®

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Current Version
Jul 12, 2023

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Mar 05, 2019

Quiz Created by
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4dd MCQs 200 Dental Anesthesia Dr. Tong Leang 2019

Surface activity and low toxic potential?

Which of the following drugs can cause methemoglonemia?

Vasoconstrictor in Local anesthetic solution is?

When injecting Local solutionin maxilla on buccal side. The technique is ?

Disto buccal root of upper first molar is supplied by:?

Technique of anesthesia in which local anesthetic solution is injected into the vein is ?

You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland?

During an inferior alveolar nerve block the needle ideally passes?

You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the?

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 anesthesia in order to carry out a pain-free biopsy?

The regional lymphatic drainage of the left side of the tip of the tongue is to the?

A successful inferior alveolar nerve block will produce anesthesia of the?

The mucosa of the hard palate is?

A successful infraorbital nerve block will produce anaesthesia of the?

In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be?

Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture) is?

Local anesthetic used in greater than 50% of rhinolaryngologic cases:?

Mechanism(s) of local anesthetic action in epidural anesthesia:?

Rationale for adding epinephrine to a local anesthetic solution:?

Zone of differential motor blockade may average up to four segments below the sensory level?

Primary side effect/toxicities associated with local anesthetic use:?

Factors enhancing bupivacaine (Marcaine) toxicity?

Agents added to local anesthetics that prolonged local anesthetic duration of action?

Typically a zone of differential sympathetic nervous system blockade?

Preferred local anesthetics for local infiltration:?

Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia -- may because by nonhomogeneous local anesthetic distribution?

Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain?

Factors that influence lidocaine (Xylocaine) metabolism:?

Most common cause of toxic plasma local anesthetic concentrations?

Common eutectic mixture of local anesthetics (EMLA)?

Most frequent local anesthetic clinical use:?

Lidocaine (Xylocaine) effect on ventilation response to hypoxia?

Clinical use(s) of EMLA applications:?

Allergic reactions to local anesthetics:?

Factors which increase local anesthetic CNS toxicities:?

Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.?

Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.?

Local anesthetic which produces localized vasoconstriction and anesthesia?

Agents not recommended for Bier block:

Manifestation of systemic toxicity

Most commonly used local anesthetic for rhinolaryngologic cases

Commonly use local anesthetics for topical/surface application:

Clinical presentations suggestive of local anesthetic allergies:

Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:

This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase

Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution

Ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)

Factor(s) which determine extent of systemic local anesthetic absorption:

Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics

Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia: