Chapter 57 Wilkins

20. The emergency medical system should be activated if the seizure is still occurring or has reoccurred within: A) 5 minutes. B) 30 minutes. C) 1 hour. D) emergency medical systems should be activated immediately for all seizures.

A) 5 minutes.

15. What type of diet may be recommended for patients with epilepsy? A) Ketogenic B) Low calorie C) Vegetarian D) Macrobiotic

A) Ketogenic

17. Which of the following has been found to reduce the occurrence and severity of gingival overgrowth? A) Meticulous oral hygiene B) 3-month dental hygiene therapy visits C) Use of antimicrobial mouthrinse D) Use of power toothbrush

A) Meticulous oral hygiene

25. Scaling with a concentrated program of biofilm control may help early lesions regress. When tissue has become fibrotic, shrinkage be expected. A) Both statements are false. B) Both statements are true. C) The first statement is false and the second statement is true. D) The first statement is true and the second statement is false.

D) The first statement is true and the second statement is false.

23. Patients can use herbal supplements such _______ to control seizures. A) St. John's wart B) black cohosh C) elderberry D) fenugreek

A

11. Partial seizures are more common in which group of people? A) Adults B) Elderly C) Children D) Infants

A

4. Patients with recurrent seizures may be legally restricted from certain: A) licenses. B) recreational activities. C) public areas. D) hospitals.

A) licenses.

The goal of the ketogenic first it to include__metabolism, which has been shown to be an effective treatment for patients with epilepsy, particularly children A) protein B)fat C)carbohydrate D)insulin

B

Use the following to answer questions 6-10: Case Study 1 Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral examination the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. 8. Open and read the attached case to answer the following question. Gingival hyperplasia is caused by: A) edema and inflammation in gingival tissue. B) fibroblasts and osteoblasts depositing excessive extracellular matrix. C) an increase in size of the cells of the gingiva. D) an increased size in osteoclasts.

B) fibroblasts and osteoblasts depositing excessive extracellular matrix.

1. A seizure is a: A) state of continuous, unremitting action of muscular contraction. B) paroxysmal event that results from abnormal brain activity. C) sudden involuntary contraction of a muscle or group of muscles. D) rapid succession of epileptic spasms without intervals of consciousness.

B) paroxysmal event that results from abnormal brain activity.

5. When recognizing an aura, a patient may: A) go into a trance-like state. B) seek a safe place to sit or lie down. C) take medication. D) leave the treatment room.

B) seek a safe place to sit or lie down.

13. If a tonic-clonic seizure continues without recovery, it may progress to: A) postictal. B) status epilepticus. C) preictal. D) teratogenesis.

B) status epilepticus.

Use the following to answer questions 6-10: Case Study 1 Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral examination the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. 7. Open and read the attached case to answer the following question. What type of seizures does Bill describe? A) Simple B) Complex C) Absence D) Tonic-clonic

C) Absence

Use the following to answer questions 6-10: Case Study 1 Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral examination the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. 9. Open and read the attached case to answer the following question. What determines the severity of phenytoin-induced gingival enlargement? A) Amount of medication B) Length of use of medication C) Amount of biofilm D) Genetic factors

C) Amount of biofilm

16. The antiepileptic drug phenytoin can cause what oral changes? A) Gingivitis B) Fungal infection C) Gingival hyperplasia D) Radio-osteonecrosis

C) Gingival hyperplasia

Use the following to answer questions 6-10: Case Study 1 Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral examination the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. 6. Open and read the attached case to answer the following question. The strange smells Bill notices before his seizure are called: A) ataxia. B) hirsutism. C) aura. D) facies.

C) aura.

19. When a seizure occurs the dental hygienist should: A) call emergency medical services. B) restrain the patient. C) move all sharp objects out of the way. D) put a bite block between the teeth.

C) move all sharp objects out of the way.

14. When epilepsy is refractory to traditional antiepileptic drug therapy, treatment may include: A) herbal supplements. B) long-term hospitalization. C) functional neuroimaging. D) focused dose of radiation to the epileptogenic area of brain.

D

18. All of the following information should be obtained about a patient's seizures except: A) age of onset. B) frequency. C) herbal supplement use. D) characteristic motor movements.

D

3. A partial seizure affects the entire brain at the same time. A generalized seizure involves only a part of the brain. A) The first statement is true and the second statement is false. B) The first statement is false and the second statement is false C) both statements are true D) Both statements are false

D

Use the following to answer questions 6-10: Case Study 1 Bill, a 30-year-old patient, presents to the office for routine dental hygiene therapy. Bill has always reported that he has had seizures. This visit he indicates that he has been having a seizure about once a week. Since his seizures have been happening more frequently, his doctor has put him on phenytoin. The dental hygienist asks Bill about his seizures and he states that he usually notices very strong smells before his seizures. His seizures usually last about 10 seconds, he loses consciousness, and usually his eyelids twitch. He comes out of it quickly and usually does not remember what has happened. During the intraoral examination the dental hygienist notes that the gingiva in the upper anterior interdental area is enlarged and is somewhat fibrotic. Bill says he has noticed it but it is not painful. 10. Open and read the attached case to answer the following question. All of the following medications can cause gingival enlargement except: A) valproic acid. B) calcium channel blockers. C) cyclosporin. D) acetaminophen.

D) acetaminophen.

12. All of the following are clinical manifestations of partial seizures except: A) trance-like state with confusion that lasts for a few minutes to hours. B) dizziness at the start of the spell. C) jerking of muscles around the mouth. D) loss of consciousness beginning and ending abruptly in about 5 to 30 seconds. E) cessation of ongoing activity.

D) loss of consciousness beginning and ending abruptly in about 5 to 30 seconds.

21. A seizure of focal origin effects: A) all limbs. B) the opposite side of the body from the brain portion where the seizure is occurring. C) the entire brain. D) part of the brain.

D) part of the brain.

2. Diagnosis of epileptic syndromes are made from all of the following except: A) history. B) clinical signs and symptoms. C) functional neuroimaging. D) EEG. E) ECG.

E

22. The WHO estimates ___ million worldwide have epilepsy. A) 15 B) 25 C) 40 D) 45 E) 50

E) 50