Local Anesthetics
Another name for the elimination of the local anesthetic from the blood and tissues is:
1) Tachyphylaxis
2) Dissociation constant
3) Half-life
4) Distribution barriers
What is Half-Life?
The following anesthetics are combined with levonordefrin:
1) 2% lidocaine
2) 2% mepivacaine
3) 3% mepivacaine
4) 4% prilocaine
What is 2% mepivacaine?
The component of the local anesthetic molecule that improves the lipid solubility, facilitating the penetration of the anesthetic through the lipid-rich membrane where the receptor sites are located is:
1) Hydrophilic amino group
2) Intermediate hydrocarbon ester or amide chain
3) Lipophilic aromatic ring
4) All options listed
What is the Lipophilic aromatic ring?
The following are considered advantages for the use of topical anesthetic agents EXCEPT one. Which one is the EXCEPTION?
1) Minimize pain associated with needle insertion
2) Can be purchased over the counter
3) Useful in treatment of minor oral injuries
4) Reduce gag reflex during radiographic procedures
What is can be purchased over the counter?
The maximum recommended dose of epinephrine per appointment for a health patient is:
1) 0.04 mg
2) 0.2 mg
3) 1.0 mg
4) 0.004 mg
What is .04 mg?
The solution that was added to the cartridge of local anesthetic to prevent bacterial growth is:
1) Vasoconstrictor preservative
2) Sodium hydroxide
3) Sodium chloride
4) Methylparaben
What is Methylparaben?
Larger-gauge needles provide less tissue deflection during significant needle penetration because of the greater rigidity of larger gauge needles:
1) Both the statement and reason are correct and related.
2) Both the statement and reason are correct but NOT related.
3) The statement is correct, but the reason is NOT.
4) The statement is NOT correct, but the reason is correct.
5) NEITHER the statement NOR the reason is correct.
What is both the statement and reason are correct and related?
The primary factor that determines the onset of action with local anesthetics is:
1) pH of the tissues
2) pKa of the anesthetic agent
3) Administrative site
4) Anesthetic agent
5) None of the options listed
What is the pKa of the anesthetic agent?
The following are advantages of purchasing a single-dose unit of a topical anesthetic EXCEPT one:
1) Dose manageable
2) Cost-effective
3) Less cross-contamination
4) Less messy
What is cost-effective?
The vasoconstrictor that is the most widely used in dentistry and the most potent is:
1) Epinephrine
2) Levonordefrin
3) Felypressin
4) All options listed
What is Epinephrine?
The solution that is added to the cartridge of local anesthetic that can trigger bronchospasms.
What is Sodium bisulfite?
To deposit one cartridge of anesthetic, it should take:
1) At a rate of 1.7 mL per minute
2) At a rate of 1.8 mL per minute
3) At a rate of 1.8 mL per 2 minutes
4) At the rate that is comfortable for the patient
What is at a rate of 1.8 mL per 2 minutes?
Prilocaine is biotransformed in the liver only.
1) True
2) False
What is false?
The nerve which supplies innervation to the second and third maxillary molars:
1) ASA
2) MSA
3) PSA
4) Infraorbital
What is the PSA?
The body’s response to fear provokes symptoms that could include:
1) irritability.
2) muscular tension.
3) increased blood pressure.
4) All options listed.
What is all options listed?
The best practices to follow when administering local anesthesia of any kind in the dental office:
1) Review the patient’s health and dental history at all appointments
2) Use the lowest concentration of anesthesia to satisfy clinical requirements.
3) Limit the area of application.
4) Know the concentration of the drug being used.
5) All options listed.
What are all options listed?
The most potent local anesthetic is bupivacaine, which has the greatest degree of lipid solubility.
1) True
2) False
What is true?
Anesthetic recovery is a slower process than induction because the anesthetic binds to the receptor site in the sodium channel, releasing the anesthetic slowly into the systemic circulation:
1) Both the statement and the reason are correct and related.
2) Both the statement and reason are correct but NOT related.
3) The statement is correct, but the reason is NOT.
4) The statement is NOT correct, but the reason is correct.
5) NEITHER the statement NOR the reason is correct.
What is both the statement and the reason are correct and related?
The structures of the body that are most likely to experience the loss of sensation after the administration of an anesthetic agent to the lingual nerve:
1) Floor of the mouth
2) Body of the tongue
3) Lingual gingival tissue of the mandibular teeth
4) All options listed
What is all options listed?
The following may cause an endogenous release of epinephrine:
1) An injection of epinephrine
2) Anxiety related to a divorce
3) Apprehension about a dental appointment
4) All options listed
What is all options listed?
Since the syringe was introduced in 1921, the single most important improvement in dental local anesthetic has been:
1) The addition of the breech-loading window for visibility
2) The addition of the aspirating harpoon
3) The elimination of the needle
4) The computer-controlled anesthetic devices
What is the addition of the aspirating harpoon?
The factor/factors that determine the severity of an overdose reaction to local anesthetic is/are:
1) Degree of drop in blood pressure
2) Time lapse between the administering of the local anesthetic to the overdose
3) Number of symptoms patient experiences
4) All options listed
What is time lapse between the administering of the local anesthetic to the overdose?
Nodes of Ranvier are found along myelinated nerve fibers between adjacent Schwann cells:
1) True
2) False
True
The pterygoid venous plexus is an area of concern when administering the PSA because:
1) It is located so far distally.
2) It is a highly vascular area.
3) It has major nerve innervations.
4) There is no concern about the pterygoid venous plexus and administration of the PSA.
What is it is a highly vascular area?
Local anesthetic agents with vasoconstrictors are generally more acidic than plain formations because of the presence of sodium bisulfite.
1) Both the statement and reason are correct and related.
2) Both the statement and reason are correct but NOT related.
3) The statement is correct, but the reason is NOT.
4) The statement is NOT correct, but the reason is correct.
5) NEITHER the statement NOR the reason is correct.
What is both the statement and the reason are correct and related?
When the thumb ring of a syringe is pulled back by the clinician, a retraction of the rubber stopper occurs and produces:
1) Positive aspiration
2) Negative aspiration
3) Negative pressure
4) None of the options listed
What is negative pressure?
In dentistry, the pressure-type syringe is used for providing anesthetic for periodontal ligament injections. It provides reliable anesthesia for one tooth in the mandible:
1) Both statements are true.
2) Both statements are false.
3) The first statement is true; the second statement is false.
4) The first statement is false; the second statement is true.
What is both statements are true?
The part of the neuron that contributes to the main difference between motor neurons and sensory neurons is:
1) Axon
2) Dendritic zone
3) Cell body
4) Terminal arborization
What is the cell body?
The name of the most potent ester topical anesthetic.
1) 2.5% Lidocaine and 2.5% prilocaine cream
2) Dyclonine hydrochloride
3) Tetracaine hydrochloride
4) Benzocaine
What is Tetracaine hydrochloride?
The name of the largest contributor to the maxillary nerve trunk is:
• Infraorbital nerve
• Ophthalmic nerve
• Second division of the trigeminal nerve
• Third division of the trigeminal nerve
What is the Infraorbital nerve?
The harpoon of the syringe may become disengaged during aspiration because of:
1) Clinician technique
2) Dullness
3) Improper syringe
4) All options listed
What is all options listed?
Patient comfort can be increased by the sharpness of the bevel. The bevel of the needle should be turned toward the bone:
1) Both statements are true.
2) Both statements are false.
3) The first statement is true; the second statement is false.
4) The first statement is false; the second statement is true.
What is both statements are true?
At the synaptic knobs, the type of action that is required to have an electrical impulse cross the synapse of one cell to another cell is:
1) The action of electrical synapses
2) The action of chemical synapses
3) The action of either electrical or chemical synapses
4) Repolarization
What is the action of either electrical or chemical synapses
The onset of action for benzocaine is rapid. The duration of action for benzocaine is 5 to 15 minutes.
1) Both statements are true.
2) Both statements are false.
3) The first statement is true; the second statement is false.
4) The first statement is false; the second statement is true.
What is both statements are true?
The part of the maxilla that articulates with the zygomatic bone laterally, thus completing the infraorbital rim is:
1) Zygomatic process
2) Frontal process
3) Palatine process
4) Alveolar processes
What is the Zygomatic process?