LOCAL ANESTHESIA MOCK BOARD

Amides are metabolized by

liver

How many mg of epinephrine are in one cartridge of a 1:100,000 dilution?

0.018 mg

What is the cardiac dose for epinephrine?

0.04 mg

Levonordefrin has how many mg/mL of vasoconstrictor?

0.05 mg/mL

If the dental hygienist administered 105 mg of bupivacaine to a 150-pound patient, how many cartridges were administed?

11.6 cartridges

Which of the following vasoconstrictor dilutions provides the greatest hemostasis?

1:50,000 epinephrine

The dental hygienist administers 3 cartridges of articaine. How many mg of local anesthetic were administered?

200 mg

What is the recommended needle gauge for an inferior alveolar block?

25 gauge

Which of the following local anesthetics will provide the longest duration of action following a nerve block when a vasoconstrictor is absolutely contraindicated?

4% prilocaine, pain

How many cartridges could a patient from the answer in question #7 safely receive if administering a 1:200,000 epinephrine dilution?

4.4 cartridges

How should a clinician respond if after administering an inferior alveolar block the anesthesia is not adequate?

Administer a second inferior alveolar block more than superior than the first block.

Which of the following best describes the (long) buccal nerve?

Afferent nerve for the buccal gingival tissue of the mandibular posterior teeth.

______ carry nerve impulses from sensory stimuli towards the central nervous system and brain

Afferent nerves

Which anesthetic falls under pregnancy risk category B?

Articaine

Which anesthetic is primarily metabolized in the blood?

Articaine

Which of the following local anesthetics has the longest duration of action? A. Prilocaine 4% 1:200,000 epinephrine B. Articaine 4% 1:100,000 epinephrine C. Bupivacaine 0.5% 1:200,000 epinephrine D. Articaine 4% 1:200, 000 epinephrine

Bupivacaine 0.5% 1:200,000 epinephrine

Select the following anesthetic(s) available in the US that is(are) formulated with epinephrine 1:200,000 A. Lidocaine B. Mepivacaine C. Prilocaine D. Articaine E. C and D

C and D

Signs and symptons of a vasoconstrictor overdose are manifested as:

CNS stimulation

What is the primary reason that catecholamines are added to local anesthetic solutions?

Decrease the risk of toxicity

After the administration of a local anesthetic, what causes a droopy eyelid?

Depositing the solution in the parotid gland.

Nerve fibres that carry impulses away from the central nervous system

Efferent

What are the nerves that conduct signals away from the brain or spinal cord called?

Efferent nerves

What does the clinician need to know about a possible epinephrine overdose?

Epinephrine overdose produces overstimulation of adrenergic receptors

How much epinephrine does a 1:200,000 dilution contain compared with a 1:100,000 dilution?

Half

What part of the syringe indicates it is an aspirating syringe?

Harpoon

During manufacturing, local anesthetics are formulated as which of the following to render them water-soluable?

Hydrochloride salt

Which component of the local anesthetic molecule renders the molecule water-soluble?

Hydrophilic amino group

What is tachyphylaxis?

Increased tolerance to a drug that is administered repeatedly

What is the main reason anesthesia fails to occur near an abscessed tooth?

Infection causes a decrease in the pH of the tissue

The coronoid notch is a landmark for which nerve block?

Inferior alveolar block

Which nerve when anesthetized also anesthetizes BOTH the anterior and middle superior alveolar nerves?

Infraorbital

When a nerve is in its resting state, the:

K+ is concentrated outside the cell.

Prolonged parasthesia of the anterior part of the tongue is caused by which nerve being traumatized?

Lingual nerve

Which of the following anesthetics has the shortest duration when administering a local anesthetic block?

Mepivacaine 3%

Local anesthetics work by penetrating the nerve to inhibit:

Na+ efflux

You have administered 2% lidocaine, 1:50,000 mg/ml epinephrine to a healthy patient. The patient experiences restlessness and nausea and beings to hyperventilate. What should you suspect?

Overdose of epinephrine

Which of the following local anesthetic blocks can produce hematomas that cause severe swelling and extraoral bruising as a result of nicking a blood vessel? A. PSA B. IA C. GG D. Mental or Incisive

PSA

Which of the following local anesthetic blocks has the HIGHEST risk of hematoma for the patient after administration? A. PSA B. IA C. GG D. Mental or Incisive

PSA

Which of the following is responsible for allergic reactions to ester anesthetics?

Para-amino benzoic acid

Which of the following local anesthetics is metabolized in the lungs and liver?

Prilocaine

The dental hygienist successfully administers an inferior alveolar block, but the patient does not get numb. What is the possible reason why the patient does not get numb?

Solution deposited inferior to the mandibular foramen

Which of the following maintains the resting potential of a nerve fiber?

The Na+ pump

In the above question (If the dental hygienist administered 105 mg of bupivacaine to a 150-pound patient, how many cartridges were administed? 11.6 cartridges) ... what occurred?

The dental hygienist administered an overdose.

Delayed signs and symptoms of an allergic reaction are more intense and serious. If skin reactions develop immediately following the injection, anaphylaxis may occur.

The first statement is false, the second statement is true.

How can the clinician correct the problem of hitting bone while administering the PSA injection?

The syringe needs to be closer to the occlusal plane, thereby reducing the angle to less than 45 degrees.

What is the most common medical emergency observed in the dental office?

Vasodepressor syncope

When is lidocaine 1:50,000 epinephrine most effective?

When hemostasis is needed.

While administering the inferior alveolar local anesthetic block, the clinician contacts bone at a depth of 10mm on an adult patient. What should the clinician do?

Withdraw the needle almost completely and redirect the syringe barrel more anterior.

At the first indication of a hematoma, the clinician should:

apple pressure to the area

Undesirable side effects of incorporating sympathomimetic agents such as an epinephrine into local anesthetic solutions include:

increased rate and force of heart contractions

Supraperiosteal injections are less successful on the mandible because of the

density of the bone of the mandible.

Which characteristic enhances the onset and effectiveness of local anesthetics?

high lipid solubility

Which of the following nerves when anesthetized provides soft tissue anesthesia of the lower lip and chin?

mental nerve

Sodium bicarbonate is added to local anesthetic solutions:

only when a vasoconstrictor is added

Esters are metabolized by

plasma

What is the best explanation as to why a patient has a lesion on his or her lip the day after receiving an inferior alveolar block?

self-mutilation

When energy for conduction is derived from the nerve cell membrane itself and is no longer dependent on the stimulus for continuance, the conduction is considered to be:

self-propagating

During the inferior alveolar block the patient feels a sudden electrical shock. This is due to:

the needle touching the lingual nerve.

A barbed needle causes pain upon:

withdrawal