JEOPARDY (part 2)

Histology and Embryology

100

10.) The bottom of the gingival sulcus is marked by the: a.) Marginal gingiva ----------- b.) Junctional epithelium ---------- c.) Alveolar crest ------ d.) Sulcular epithelium------- e.) Periodontal ligament----------

B. The bottom of the sulcus is the junctional epithelium, and it is between the tooth and gingival connective tissue.

200

6.) Some loss of enamel is evident on the lingual aspects of the client’s maxillary central incisors because of their contact with the lingual piercing. The tooth structure loss that occurs from pathologic wear of teeth by foreign substance is called: ----------------------------------------- a.) Attrition ---------- b.) Erosion---------- c.) Abfraction-------- d.) Abrasion-------- e.) Dental caries--------

D. “Abrasion” is defined as pathological wear of tooth by foreign substance. It is pathologic loss of tooth structure by abnormal and repetitive mechanical wear.

300

20.) Hertwig’s epithelial root sheath is derived from the: --------------------------------- a.) Inner enamel epithelium ----------- b.) Reduced enamel epithelium -------- c.) Primary enamel cuticle -------- d.) Rests of Malassez ------- e.) Periodontal ligament

B. Hertwig’s epithelial root sheath is derived from the reduced enamel organ. Cells from the inner enamel epithelium and cells from the outer enamel epithelium migrate apically to form Hertwig’s epithelial root sheath.

400

39.) Embryonically, the mandible is derived from the: ----------------------------------------------- a.) Stomodeum ---------------- b.) First branchial arch ---------- c.) Frontal process ------------- d.) Second branchial arch ---------- e.) Third branchial arch -------

B. The first branchial arch gives rise to a large portion of the face and the intraoral structures. The mandible is derived from the first branchial arch.

500

47.) All of the following tooth tissues are derived from the mesoderm EXCEPT one. Which one is the EXCEPTION? ------------------------------------------- a.) Enamel ------- b.) Dentin -------- c.) Cementum ------- d.) Periodontal ligament ----- e.) Alveolar bone ------

47. A. Enamel is the only tooth tissue derived from the ectoderm.

Special Needs

100

2.) A genetically linked, chronic, demyelinating disease of the central nervous system best describes:---- A.) Multiple sclerosis---- B.) Cerebral palsy----- C.) Graves’ disease---- D.) Epilepsy---

A. Multiple sclerosis is a chronic demyelinating disease of the central nervous system that is genetically linked.

200

15.) A patient undergoing chemotherapy presents with signs and symptoms of mucositis. Which of the following interventions would best relieve symptoms?---- A.) Glycerin and water spray----- B.) Sodium fluoride rinses---- C.) Lidocaine topical spray---- D.) Sodium bicarbonate rinses-----

D. Sodium bicarbonate rinsing every two hours is recommended to relieve symptoms associated with mucositis by bathing the tissues and reducing acidity.

300

7.) Which of the following infectious diseases is a common postnatal cause of cerebral palsy?----- A.) Rubella---- B.) Mumps----- C.) Encephalitis----- D.) Herpes zoster----

C. Encephalitis is an infectious disease that may cause several postnatal brain disorders including cerebral palsy.

400

9.) Ms. Curet reports that she had a stroke three months ago. How long should elective dental care be postponed for this client?---- A.) Two weeks------ B.) One month------ C.) Two months----- D.) Three months----

D. Experts recommend waiting six months after a stroke before performing routine dental care.

500

31.) All of the following are important treatment guidelines when working with clients with developmental disabilities except one. Which one is this exception?---- A.) Obtain consent before using any type of immobilization or restraint---- B.) Educate the caregiver about the importance of daily oral hygiene---- C.) Determine a treatment plan for long appointments to accomplish more treatment per visit--- D.) Encourage as much independence as possible in daily oral hygiene----

C. A short appointment (not a long appointment) should be planned for clients with developmental disabilities.

Pharmacology

100

3.) Which one of the following drugs can result in oral candidiasis? -------- a.) Cetirizine --------- b.) Ibuprofen --------- c.) Acetaminophen -------- d.) Fluticasone --------

D. Fluticasone is a corticosteroid that is inhaled by clients with asthma and respiratory problems. Corticosteroids are known to result in oral candidiasis. The dental hygienist should teach asthmatic clients to make sure that they rinse after using their inhaler.

200

11.) What is meant by the term essential hypertension? ------ a.) Hypertension of unknown cause ---- b.) Iatrogenic hypertension ---- c.) Hypertension precipitated by another disorder --- d.) Developing form of hypertension, requiring aggressive therapy ---

A. Approximately 85% to 90% of clients diagnosed with hypertension have essential, idiopathic, or primary hypertension. All these terms stand for hypertension from an unknown cause.

300

22.) Which oral antidiabetic agent produces lactic acidosis as a significant adverse effect? ----- a.) Tolbutamide ----- b.) Metformin ---- c.) Repaglinide ---- d.) Acarbose -----

B. Biguanides such as metformin can cause lactic acidosis as a side effect. Predisposing factors to lactic acidosis include alcoholism, binge drinking, and renal or hepatic dysfunction. Metformin is contraindicated in clients with these conditions or who are fasting.

400

31.) Both opioid and nonopioid analgesics relieve pain by raising the pain threshold. Raising the pain threshold increases one’s reaction to pain. ---- a.) Both statements are TRUE ---- b.) The first statement is TRUE; the second statement is FALSE --- c.) The first statement is FALSE; the second statement is TRUE --- d.) Both statements are FALSE ---

B. The first statement is true, but the second statement is false. Raising the pain threshold actually decreases one reaction to pain. Both opioid and non-opioid analgesics raise the client’s pain threshold. Opioids alter one’s perception of pain and non-opioid analgesics block the pain pathway.

500

32.) Following the dental procedure, the patient developed itching and urticaria after taking her acetaminophen with codeine. This response MOST likely represents: ---- a.) A pharmacologic action of codeine --- b.) A hypersensitivity reaction to codeine ---- c.) A placebo effect from receiving codeine --- d.) A reaction unrelated to codeine administration ---

A. Opioids can stimulate the release of histamine. Itching and urticaria can result from their administration.

Instrumentation

100

11.) If the clinician decides to use ultrasonic equipment instead of hand instruments, she needs to keep contraindications for ultrasonic use in mind. Which of the following is NOT a contraindication for use of ultrasonic equipment? ---- a.) Client with a communicable disease ----- b.) Client with difficulty swallowing or who is prone to gagging ---- c.) Client with primary or newly erupted teeth ---- d.) Client with multiple amalgam restorations ----

D. Use of ultrasonic equipment for a client who has multiple amalgam restorations is NOT contraindicated.

200

3.) Which one of the instruments listed below is the BEST choice for efficient removal of light subgingival calculus from the proximal surfaces of the client’s posterior teeth? ----- a.) A posterior sickle scaler ------ b.) A universal curet ----- c.) A set of standard Gracey curets ---- d.) An O’Hehir curet ------

B. A universal curet is the best choice for scaling subgingivally.

300

16.) The clinician is using hand instruments to remove moderate calculus deposits. After 30 minutes, the clinician’s hand muscles become noticeably fatigued. Potentially, all of the following can cause hand fatigue EXCEPT one. Which one is the EXCEPTION? ------- a.) Gloves that fit too tightly -------- b.) Using instruments with large-diameter, hollow handles ----- c.) Using an instrument that is not balanced ----- d.) Using finger motion instead of wrist motion activation ------

B. Large hollow handles are ergonomically designed to reduce muscle strain.

400

18. A clinician is having difficulty keeping the lower shank parallel to the long axis of tooth #3. The clinician is using a Gracey 13/14 curet with a miniature working end and an extended lower shank. Which of the following would MOST LIKELY improve access in this distolingual surface?------ a.) Switch to an advanced fulcrum--- b.) Use a straight, slim-diameter ultrasonic tip--- c.) Use a universal curet with an extended shank--- d.) Use a rigid Gracey curet instead---

A. An advanced fulcrum would facilitate maintaining the lower shank parallel to the tooth surface; note that tooth #3 has a deep periodontal pocket, making access more difficult.

500

22.) The client’s mandibular anterior teeth are in linguoversion and are crowded. The clinician is having difficulty accessing the lingual surfaces of these mandibular anterior teeth. Which of the following patient positioning suggestions is BEST to ensure an ergonomic instrumentation technique?----- a.) Ask the client to lower his chin (chin-down position)---- b.) Lower the back of the client’s chair until it is parallel to the floor---- c.) Ask the client to keep his chin in an upward position (chin-up position)---- d.) Stand up and work, with the client in an upright seated position----

A. The chin-down client position provides the best view of the lingual aspect of the mandibular anterior teeth, provides the best access to this treatment area, and facilitates parallelism of the lower shank to the tooth surface.

Medical Emergencies

100

8.) Insulin is normally produced in the: ----- a.) Gall bladder ------- b.) Liver ------ c.) Pancreas -------- d.) Small intestine -----

C. Insulin is produced in the pancreas.

200

31.) In which of the following emergency situations would you NOT administer oxygen to a conscious client?----- a.) Anaphylactic allergic reaction------ b.) Angina---- c.) Hyperventilation---- d.) Toxic overdose of anesthetic----

C. Oxygen would not be provided to a client who is hyperventilating. The client needs to slow down the breathing. The client should be reassured and coached to breathe slowly until the balance of oxygen and carbon dioxide is restored.

300

34. Which statement concerning management of convulsive seizures in the dental setting is MOST accurate?------------- a.) After the seizure is over, place the client in the Trendelenburg position------- b.) Terminate procedures, and place the client in a semi-supine position------- c.) Terminate procedures, and place the client in a supine position--------- d.) Terminate procedures, and restrain the client to prevent injury-------

C. In the dental setting, management of a client having a seizure includes terminating the procedure and placing the client in the supine position. The client should be prevented from injuring himself or herself by clearing the area of potentially injurious objects, , if possible, but the client should not be restrained. The airway should be established and maintained as much as possible. The client should remain in the chair, which should be lowered to the supine position.

400

40.) Determining if a pulse is present in a 15-year-old client before initiation of CPR is accomplished by palpation of the: a.) Aortic artery b.) Brachial artery c.) Carotid artery d.) Radial artery

C. The carotid pulse, obtained at the carotid sinus, is used to determine if a pulse is present when assessing the need to perform CPR on an adult.

500

49. Clinical death may be reversible. This is more likely if life support measures are initiated within 6 to 10 minutes.-------- a.) The first statement is TRUE; the second statement is FALSE--------- b.) The first statement is FALSE; the second statement is TRUE-------- c.) Both statements are FALSE------- d.) Both statements are TRUE------

A. The first statement is true, but the second statement is false. Clinical death, which is the cessation of breathing and heart function, may be reversible through life support measures, especially if they are initiated within 4 to 6 minutes.