Medical Emergencies Final

Administration of a full 1.8 mL cartridge of local anesthetic should take a minimum of:

1 minute

Considering a prothrombin time of 11 to 14 seconds to be normal, a level up to ___ times that amount is considered acceptable for surgical procedures.

2.5

Reports of adverse drug reactions (ADRs) in medical literature account for _____% of all hospital admissions.

3% to 20%

In the US, 1.8 mL of 2% lidocaine contains __mg of anesthetic.

36

The peak incidence of heart failure for women is between _____ years.

60 and 70

The most likely candidate for thyroid hypo function would be a:

70 year old women

Hypertension is responsible for more than __% of all cases of congestive heart failure.

75

Narrowing of atherosclerotic vessels must be about __% before blood flow drops to clinically significant levels.

80

Over ___% of deaths from anaphylaxis occur in patients over 19 years of age.

90

Which of the following statements are true of pitting edema?

A and B

Which of the following conditions are associated with cyanosis?

A and B Heart failure Severe asthma with hypoxia

Which of the following statements are true of allergy?

A and B An allergy requires previous exposure An individual develops antibodies to a foreign antigen

Which of the following are nonopioid analgesics used in the dental office?

A and C Acetaminophen Aspirin

An abrupt onset of signs and symptoms are clinical manifestations of CVAs associated with:

A and C Embolism Hemorrhage

A patient with exclusively right ventricular failure will exhibit signs and symptoms of:

A and C Systemic venous congestion Capillary congestion

Signs of epinephrine overdose include:

A and C Tachycardia Elevated blood pressure

Hypoglycemia is manifested by:

A cold, wet appearance Mental confusion

The clinically hypothyroid patient may have:

A large, thick tongue

Allergy most ofter presents as:

A skin reaction

Which of the following statements is/are true of diabetes mellitus?

A, B and C

Acute pulmonary edema is

A, B, and C

Stress:

A, B, and C

Wheezing may be present in patients with:

A, B, and C Paroxysmal nocturnal dyspnea Pulmonary edema Asthma

Signs and symptoms that appear ____ drug administration most probably represent allergy.

After

Urticaria and pruritus indicate:

An allergic reaction

Tachypnea is ____ of breathing.

An increase in the rate

Apoplexy is defined as:

An intracerebral hemorrhage

Clinically, hyperthyroidism may be characterized by:

An unusual sensitivity to catecholamines A lump or bump on the patients neck

Hyperventilation is associated with:

Anxiety

Respiratory distress in younger patients (under age 10) is most commonly related to:

Asthma

Patients with _____ usually do not experience chest pain along with other clinical symptoms.

B and C Asthma Heart failure

A ____ is most likely to die from a CVA.

Black man

A general principle of toxicology is that no drug ever exert a single action. All chemicals exert many actions, some desirable and others undesirable.

Both statements are true

Which of the following is the longest acting local dental anesthetic?

Bupivacaine

ASA III patients:

Can climb one flight of stairs or walk two level city blocks but must stop and rest before completing the task because of distress

The major threat to survival of a patient who has had a CVA is:

Cardiovascular disease

Which of the following body systems is most susceptible to the clinical effects of epinephrine in local anesthetics?

Cardiovascular system

A deficiency of thyroid hormone during early life can produce a clinical syndrome known as:

Cretinism

As the patient becomes more acidotic during a local anesthesia-induced seizure, the seizure threshold for that drug _____.

Decreases

Which of the following are signs of right ventricular failure?

Dependent edema

Which of the following systemic problems may manifest clinically as altered consciousness?

Diabetes mellitus Cerebrovascular ischemia and infarction Thyroid gland dysfunction

During heart failure:

Diastolic blood pressure is usually elevated to a greater degree than systolic blood pressure

Which of the following is the most common method by which drugs may produce ADRs?

Direct extension of a drugs pharmacologic actions

The most common cause of altered consciousness in the dental environment is:

Drug overdose

At what time during the dental "experience" do most medical emergency situations develop?

During or immediately following administration of local anesthetic

____ results in an increase in heart rate and blood pressure.

Epinephrine overdose

Hypothyroidism is associated with:

Fatigue

The patient with moderate to severe left ventricular failure:

Has dyspnea that is noticeable to an observer

Respiratory distress becomes progressively more severe for a dental patient with:

Heart failure as the dental chair is reclined toward the supine position.

Which of the following is the most significant risk factor in predicting stroke?

High blood pressure

Myxedema coma is associated with:

Hypercapnia

Acetone on the breath (ketoacidosis) indicates:

Hyperglycemia

Thyroid storm is associated with:

Hyperthyroidism

No clinical signs and symptoms of _____ are present between episodes of respiratory distress.

Hyperventilation

______ is the most common non drug cause of altered consciousness in dentistry.

Hyperventilation

Hypothyroid or hyperthyroid patients who have been treated and are currently euthyroid are ASA ____ risks.

II

A patient who has had a CVA is routinely classified according to the ASA as type __ for 6 months.

IV

The greater potential for serious ADRs is with the ____ route of drug administration.

IV

When a patent is ASA __ for congestive hear failure, dental treatment should be withheld for all elective procedures until the patients CVD is corrected or controlled.

IV

_____ injections usually possess the greatest potential for intravascular injection.

Inferior alveolar nerve block

Which of the following are parenteral routes of drug administration?

Inhalation

An individual usually notes the first expression of heard failure in the:

Left ventricle

____ is the leading cause of right ventricular failure.

Left ventricular failure

Most amide local anesthetics undergo biotransformation in the:

Liver

The major cause of drug related emergency situations in the dental office is the administration of:

Local anesthetics

Which is the most common cause of overdose in dentistry?

Local anesthetics

_____ are dentistry most commonly used drugs.

Local anesthetics

The highest occurrence category for vasodepressor syncope is:

Males from late teens to late 30s

Biotransformation of a drug occurs during:

Metabolism

Which of the following are often observed in a hyperthyroid rather than hypothyroid patient or in the general population?

Mitral valve prolapse

Which of the following statements is true of CVA and TIA?

Most TIAs last approximately 2 to 10 minutes

Most ADRs are related to:

Overdose

Secondary thyroid failure results from diseases of the:

Pituitary gland

If a patient has pre medicated with alcohol to the point of intoxication, dental treatment should be:

Postponed

After positioning an unconscious patient with a history of hypothyroidism:

Provide BLS, as needed

Respiratory distress associated with ____ may be associated with a frothy, pink tinged sputum and cough.

Pulmonary edema

Overdose of opioid analgesics is associated with:

Respiratory depression

It is recommended that the conscious TIA and CVA victim be placed in a comfortable ____ position.

Semi-Fowler

Full mouth anesthesia may be achieved in an adult with fewer than ____ cartridges of local anesthetics.

Six

At the onset of acute respiratory distress in a patent with pre-existing congestive heart failure, the appropriate team member should first:

Summon EMS

Stroke is the ____ leading cause of death in the US.

Third

Total airway obstruction is most often produced by the _____ in an unconscious patient.

Tongue

Ester type local anesthetics are used _____ in the dental office.

Topically but not parenterally

A negative result on an aspiration test during local anesthetic administration indicates that the needle tip is not within the lumen of a blood vessel and that the drug may be administered.

True

Patients ______ years of age make up most cases of hyperventilation.

Under 40

Hyperthyroidism may be characterized by:

Unexplained weight loss Ravenous appetite

Placing an unconscious patient into a supine position leads to rapid improvement for a patient with:

Vasodepressor syncope