Clinical Dentistry
Midterm Exam
Course Introduction
Clinical Dentistry is a comprehensive course designed to provide students with in-depth knowledge and hands-on experience in the diagnosis, prevention, and treatment of oral diseases. Emphasizing practical skills, the course covers a wide range of procedures, including restorative dentistry, periodontics, endodontics, oral surgery, and prosthodontics. Students learn to assess patient needs, develop treatment plans, and execute clinical procedures under the supervision of experienced faculty. Through direct patient care, case discussions, and simulated practice, the course aims to foster clinical competence, professional ethics, and effective patient communication, preparing students for independent dental practice.
Recommended Textbook
Little and Falaces Dental Management of the Medically Compromised Patient 8th Edition by James
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30 Chapters
347 Verified Questions
347 Flashcards
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Chapter 1: Patient Evaluation and Risk Assessment
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Sample Questions
Q1) Which of the following is true of a patient classified ASA III according to the American Society of Anesthesiologists (ASA)Physical Status Classification System?
A) Patient has mild systemic disease.
B) Patient's disease has significant impact on daily activity.
C) Patient's disease is unlikely to have impact on anesthesia and surgery.
D) Patient is moribund.
Answer: B
Q2) It has been shown that the risk for occurrence of a serious perioperative cardiovascular event is increased in patients who are unable to meet a __-MET (metabolic equivalent of task)demand during normal daily activity.
A) 4
B) 6
C) 8
D) 10
Answer: A
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Chapter 2: Infective Endocarditis
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10 Flashcards
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Sample Questions
Q1) Which of the following is true regarding the efficacy of antibiotic prophylaxis?
A) Data show that a reduction in the incidence, nature, and duration of bacteria caused by antibiotic therapy reduces the risk of or prevents IE.
B) Antibiotics given to at-risk patients before a dental procedure will prevent or reduce a bacteremia.
C) Prospective randomized, placebo-controlled trials have been conducted to examine the efficacy of antibiotic prophylaxis for preventing IE in patients who undergo a dental procedure.
D) Investigators have concluded that dental or other procedures probably only caused a small fraction of cases of IE, and that prophylaxis would prevent only a small number of cases, even if it were 100% effective.
Answer: D
Q2) The leading cause of death due to infective endocarditis (IE)is __________.
A) chronic obstructive pulmonary disease
B) heart failure
C) pulmonary emboli
D) atheromas
Answer: B
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Chapter 3: Hypertension
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) In prehypertension,diastolic pressure ranges from ________ mm Hg.
A) 80 to 89
B) 90 to 99
C) 100 to 109
D) 110 to 119
Answer: A
Q2) Which of the following is an adverse drug interaction that may occur if a dental anesthetic containing a vasoconstrictor is administered to a patient being treated for hypertension with a non-selective -adrenergic blocking agent?
A) hypotension
B) hypertension
C) respiratory alkalosis
D) respiratory acidosis
Answer: B
Q3) Which of the following is the most common cardiac condition in America?
A) congestive heart failure
B) cardiac arrhythmia
C) hypertension
D) angina
Answer: C
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Chapter 4: Ischemic Heart Disease
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Sample Questions
Q1) Which of the following is true for an MI with ST segment elevation (STEMI)?
A) It is due to partial blockage of coronary blood flow.
B) It is due to complete blockage of coronary blood flow.
C) Early fibrinolytic therapy will improve the outcome for a patient with STEMI.
D) a and c
E) b and c
Q2) Which of the following is true when planning dental treatment for a patient with stable angina or a past history of MI without ischemic symptoms?
A) Administration of nitrous oxide should be avoided.
B) NSAIDs should be avoided in patients with established cardiovascular disease.
C) Nitroglycerin should be administered prophylactically.
D) A pulse oximeter should be used.
Q3) Which of the following is a serum enzyme determination used to establish the diagnosis of acute myocardial infarction (MI)and to determine the extent of infarction?
A) stress thallium-201 perfusion scintigraphy
B) 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA)
C) troponin I and troponin T
D) streptokinase (SK)
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6
Chapter 5: Cardiac Arrhythmias
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Sample Questions
Q1) If a vasoconstrictor in local anesthetic is deemed necessary,patients in the low to intermediate risk category and those taking nonselective beta blockers can safely be given up to ____ cartridge(s)containing 1:100,000 epinephrine.
A) one
B) two
C) three
D) zero-epinephrine is an absolute contraindication
Q2) Which of the following is a disorder of repolarization?
A) Mobitz type I (Wenckebach)
B) Wolff-Parkinson-White syndrome
C) long QT syndrome
D) torsades de pointes
Q3) Tachycardia in an adult is defined as a heart rate greater then ___ beats per minute,with otherwise normal findings on the ECG.
A) 100
B) 125
C) 150
D) 175
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Chapter 6: Heart Failure or Congestive Heart Failure
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Sample Questions
Q1) Most of the acquired disorders that lead to heart failure result in initial failure of the
A) bundle of His
B) mitral valve
C) right ventricle
D) left ventricle
Q2) Which of the following is the most common underlying cause of heart failure in the United States?
A) dilated cardiomyopathy
B) coronary heart disease
C) valvular heart disease
D) hypertension
Q3) Which of the following is the most common reason for decompensation of previously well-compensated heart failure during dental treatment?
A) tachycardia due to anxiety
B) failure to take medications as prescribed
C) orthopnea due to chair position
D) lack of sufficient oxygen saturation due to use of the rubber dam
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Chapter 7: Pulmonary Disease
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13 Flashcards
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Sample Questions
Q1) Which of the following is true of dental management for a patient with COPD?
A) The appointment should be rescheduled if pulse oximetry finds the oxygen saturation level to be less than 91%.
B) The patient should be placed in a supine position for treatment in the dental chair.
C) Prilocaine is the only local anesthetic that is recommended for use with this category of patient.
D) Nitrous oxide is preferred over diazepam (Valium) for a patient with severe COPD.
Q2) Which of the following medications is associated with "triad asthmaticus"?
A) methotrexate
B) nonspecific beta blockers
C) aspirin
D) penicillin
Q3) Which of the following is the drug of choice for relief of an acute asthma attack?
A) oral anticholinergic
B) inhalation corticosteroid
C) short-acting 2-adrenergic agonist
D) inhaled cromolyn sodium
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Chapter 8: Smoking and Tobacco Use Cessation
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Sample Questions
Q1) Which of the following is true concerning the benefits of quitting smoking?
A) The risk of dying of lung cancer is double among smokers than in those who have never smoked.
B) Persons who quit smoking before the age of 50 have half of the risk of dying in the next 15 years compared with those who continue to smoke.
C) The risk of dying of coronary heart disease for smokers is double that for lifetime nonsmokers, as is the risk of dying from a stroke.
D) a and b
E) b and c
Q2) Which of the following is true about interventions for smoking cessation?
A) Patients need to be "badgered" about quitting smoking.
B) The highest success rates are achieved by stopping "cold turkey."
C) The chance for success increases when more than one option is used.
D) Use of telephone quit lines does not increase chances of success.
Q3) Which of the following causes the most deaths in the United States?
A) motor vehicle crashes
B) acquired immunodeficiency syndrome (AIDS)
C) smoking
D) alcohol abuse and illicit drug use
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Page 10
Chapter 9: Sleep-Related Breathing Disorders
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8 Flashcards
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Sample Questions
Q1) Which of the following is true about primary snoring?
A) Primary snoring is associated with fragmentation of sleep architecture.
B) Primary snoring is not associated with disrupted sleep or complaints of daytime sleepiness.
C) Primary snoring is also known as upper airway resistance syndrome (UARS).
D) Primary snoring is characterized by episodes of complete cessation of breathing due to airway obstruction during sleep.
Q2) Which of the following is the most successful surgical treatment for OSA in children?
A) uvulopalatopharyngoplasty (UPPP)
B) radiofrequency volumetric tissue reduction (RVTR)
C) adenotonsillectomy
D) laser-assisted uvulopalatoplasty (LAUP)
Q3) Which of the following components of a polysomnogram (PSG)is used to monitor eye movements?
A) ECG
B) EEG
C) EMG
D) EOG
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11
Chapter 10: Liver Disease
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which of the following is associated with immunity to hepatitis B?
A) HBsAg
B) HBcAg
C) HBeAg
D) Anti-HBs
E) Anti-HBe
Q2) Which of the following hepatitis viruses is second most likely (following hepatitis B)to be transmitted occupationally to a dental healthcare worker?
A) HAV
B) HCV
C) HEV
D) non-A-E
Q3) (A/An)_______________ syndrome develops during the preicteric phase in approximately 10% to 20% of patients with acute hepatitis.
A) chronic fatigue
B) irritable bowel
C) serum sickness-like
D) aspirin triad syndrome
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Chapter 11: Gastrointestinal Disease
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9 Flashcards
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Sample Questions
Q1) Which of the following is the most common cause of peptic ulcer disease?
A) cytomegalovirus infection
B) acid hypersecretion
C) H. pylori infection
D) use of nonsteroidal anti-inflammatory medication
Q2) Which of the following is characteristic of gastric peptic ulcers rather than duodenal peptic ulcers?
A) epigastric pain that is long-standing
B) diffuse rather than localized epigastric pain
C) symptoms rapidly relieved in most cases by ingestion of food, milk, or antacids
D) pain that most commonly manifests 90 minutes to 3 hours after eating
Q3) Which of the following is/are components of currently recommended therapy when a peptic ulcer is confirmed and H.pylori is present?
A) inhibitors of gastric acid secretion
B) dissection of the vagus nerves from the gastric fundus
C) antimicrobial agents
D) a, b, and c
E) a and c
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Chapter 12: Chronic Kidney Disease and Dialysis
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Sample Questions
Q1) Which of the following tests is a measure of muscle breakdown and filtration capacity of the nephron?
A) glomerular filtration rate (GFR)
B) blood urea nitrogen (BUN)
C) serum creatinine
D) creatinine clearance
Q2) Infective endocarditis occurs in 2% to 9% of patients receiving hemodialysis.The American Heart Association (AHA)2003 guidelines include a recommendation for prophylactic antibiotics before invasive dental procedures are performed on patients with intravascular access devices to prevent endarteritis or infective endocarditis.
A) Both statements are true.
B) Both statements are false.
C) The first statement is true, the second statement is false.
D) The first statement is false, the second statement is true.
Q3) How do most dialysis patients in the United States receive hemodialysis?
A) continuous cyclic peritoneal dialysis (CCPD)
B) chronic ambulatory peritoneal dialysis (CAPD)
C) through an arteriovenous graft, usually placed in the forearm
D) through a central catheter
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Page 14
Chapter 13: Sexually Transmitted Diseases
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) Which of the following is true of the HPV vaccine Gardasil?
A) It is approved for use in women but not men.
B) It is used to treat genital warts but will not prevent infection with human papilloma virus types 6, 11, 16, and 18.
C) It is most beneficial if administered before the onset of sexual activity.
D) It has been shown to eliminate and cure HPV infection.
Q2) Which of the following is a treponemal test for syphilis?
A) Venereal Disease Research Laboratory (VDRL) slide test
B) T. pallidum particle agglutination test (TP-PA)
C) rapid plasma reagin (RPR) test
D) automated reagin test (ART)
Q3) Which of the following areas of the oral cavity is most commonly affected by oral gonorrhea?
A) floor of the mouth
B) buccal mucosa
C) pharynx
D) soft palate
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Page 15
Chapter 14: Diabetes Mellitus
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Sample Questions
Q1) Which of the following is true of retinopathy as a consequence of diabetes?
A) It is the leading cause of blindness in the United States.
B) Proliferative retinopathy is most common among patients with type 2 diabetes.
C) Cataracts occur at an earlier age and with greater frequency in those with type 1 diabetes.
D) a, b, and c
E) a and c
Q2) Sulfonylurea drugs are members of which of the following classes of drugs used to treat type 2 diabetes?
A) insulin sensitizer
B) insulin secretagogue
C) drugs that slow the absorption of carbohydrates in the gut
D) incretins
Q3) The American Diabetes Association recommends screening tests for diabetes mellitus for all persons who are __ years of age and older.
A) 35
B) 45
C) 55
D) 65
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Page 16
Chapter 15: Adrenal Insufficiency
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Sample Questions
Q1) Which of the following is the most reliable and most commonly used laboratory test to determine adrenal insufficiency?
A) dexamethasone suppression test
B) CRH test
C) synthetic ACTH (cosyntropin) stimulation test
D) insulin tolerance test
Q2) Which of the following is the predominant product of the zona glomerulosa of the adrenal cortex?
A) glucocorticoids
B) aldosterone
C) androgens
D) epinephrine
Q3) Which of the following stimulates secretion of aldosterone?
A) stress
B) hypoglycemia
C) a decrease in renal blood pressure
D) an increase in renal blood pressure
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Chapter 16: Thyroid Diseases
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Sample Questions
Q1) Which of the following is the correct sequence leading to the release of thyroid hormones?
1.Thyroid-stimulating hormone (TSH)is released.
2.T4 and T3 are secreted.
3.Thyrotropin-releasing hormone (TRH)is released.
A) 1, 2, 3
B) 1, 3, 2
C) 2, 1, 3
D) 3, 1, 2
Q2) Which of the following is a characteristic of hypothyroidism in older children and adults?
A) warm, moist skin
B) alopecia of the outer third of the eyebrows
C) increased size of the tongue
D) a and b
E) b and c
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Chapter 17: Pregnancy and Breast Feeding
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Sample Questions
Q1) Which of the following is the most common oral complication of pregnancy?
A) xerostomia
B) pyogenic granuloma
C) pregnancy gingivitis
D) dental caries
Q2) Which of the following is the analgesic of choice during pregnancy?
A) aspirin
B) acetaminophen
C) nonsteroidal anti-inflammatory
D) codeine
Q3) The gonadal/fetal dose incurred with two periapical dental films (when a lead apron is used)is __________ that for 1 day of average exposure to natural background radiation in the United States.
A) 700 times less than
B) 7 times less than
C) equal to
D) 7 times more than
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19
Chapter 18: Aids, HIV Infection, and Related Conditions
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Sample Questions
Q1) A person is defined as having AIDS when the CD4+ count is less than ____ cells/µL.
A) 400
B) 200
C) 100
D) 0
Q2) Which of the following is the most common method of sexual transmission of HIV in the United States?
A) transmission from injection drug use
B) anal intercourse in men who have sex with men (MSM)
C) male-to-female heterosexual transmission
D) female-to-male heterosexual transmission
Q3) The current definition of AIDS is the laboratory-confirmed evidence of HIV infection in a person who has stage 3 HIV infection,meaning that the CD4+ lymphocyte count is less than _______ cells/ L.
A) 400
B) 200
C) 100
D) 50
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Chapter 19: Allergy
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Sample Questions
Q1) How should a patient be positioned in the initial management of an allergic reaction?
A) seated upright in a chair
B) standing
C) prone
D) supine
Q2) Which of the following types of hypersensitivity reactions involves the cellular immune system?
A) type I
B) type II
C) type III
D) type IV
Q3) Which of the following groups of patients is most susceptible to allergic reactions caused by sulfites?
A) renal dialysis patients
B) people with emphysema
C) asthmatics
D) patients with chronic obstructive pulmonary disease
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21
Chapter 20: Rheumatologic and Connective Tissue Disorders
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Sample Questions
Q1) Giant cell arteritis (GCA)most commonly affects branches of the ___________ artery.
A) maxillary
B) carotid
C) superior thyroid
D) inferior thyroid
Q2) Which of the following is/are true of systemic lupus erythematosus (SLE)?
A) SLE is due to wheat gluten allergy.
B) SLE is more common in women than in men.
C) These patients should be premedicated with antibiotics prior to invasive dental treatment.
D) a and b
E) b and c
Q3) The 2003 joint advisory statement by the American Dental Association (ADA)and the American Academy of Orthopedic Surgeons (AAOS)indicated that antibiotic prophylaxis prior to dental treatment can be considered for ________.
A) all prosthetic joint patients to prevent prosthetic joint infection (PJI)
B) patients with pins, plates, and screws in joints
C) most patients with total joint replacement
Page 22
D) patients whose joint replacement has been in place for less than 2 years
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Chapter 21: Organ and Bone Marrow Transplantation
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Sample Questions
Q1) It is best to avoid any dental treatment for how long a period following transplantation?
A) 7 to 10 days
B) 2 to 4 weeks
C) 6 months
D) 2 years
Q2) During the immediate posttransplantation period,the patient will be started on immunosuppressive therapy to prevent which of the following types of cells from destroying the graft?
A) plasma cells
B) cytotoxic T cells
C) polymorphonuclear leukocytes (PMNs)
D) monocytes
Q3) The "implantation response" may be seen with which of the following types of transplantation?
A) kidney
B) spleen
C) heart-lung
D) liver
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Page 23
Chapter 22: Disorders of Red Blood Cells
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Sample Questions
Q1) What is the most common therapy for aplastic anemia?
A) long-term use of erythropoietin
B) cyanocobalamin injections
C) immunosuppression with antithymocyte globulin (ATG) alone or with cyclosporine
D) iron supplements
Q2) Which of the following is true of aplastic anemia?
A) It is most common in children.
B) It is caused by a deficiency of intrinsic factor.
C) It is the most common enzymopathy of humans.
D) It occurs when hematopoietic stem cells are unable to proliferate, differentiate, or give rise to mature blood cells.
Q3) Which of the following is the most common type of anemia among persons in the United States?
A) hemolytic anemia
B) iron deficiency anemia
C) folate deficiency anemia
D) sickle cell anemia
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Chapter 23: Disorders of White Blood Cells
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Sample Questions
Q1) Which of the following is the prominent radiographic feature of multiple myeloma?
A) "hair on end" pattern
B) "ground glass" pattern
C) "punched out" lesions
D) "sunburst" pattern
Q2) What are Reed-Sternberg cells?
A) B lymphocytes
B) T lymphocytes
C) Natural killer (NK) T lymphocytes
D) T suppressor lymphocytes
Q3) What is a sanctuary in relation to a patient with acute lymphoid leukemia (ALL)?
A) It relates to the use of high-dose chemotherapy prior to a peripheral blood stem cell transplant.
B) It is a second remission following a patient relapse.
C) It is an area where chemotherapeutic agents cannot reach leukemic cells.
D) It means that the number of blast cells has been reduced and the patient is in remission.
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25
Chapter 24: Acquired Bleeding and Hypercoagulable Disorders
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Sample Questions
Q1) A platelet count is very effective for identifying patients who have ________.
A) von Willebrand disease
B) Glanzmann disease
C) thrombocytopenia
D) uremia
Q2) Which of the following screening tests is used to check the extrinsic pathway (factor VII)and the common pathway (factors V and X,prothrombin,and fibrinogen)?
A) thrombin time
B) prothrombin time
C) partial thromboplastin time
D) platelet count
Q3) Which of the following clinical laboratory tests is used to screen patients for thrombocytopenia?
A) PT
B) aPTT
C) TT
D) platelet count
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Page 26
Chapter 25: Congenital Bleeding and Hypercoagulable Disorders
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Q1) Which of the following is an inherited platelet disorder?
A) Ehlers-Danlos disease
B) Bernard-Soulier disease
C) Christmas disease
D) Osler-Weber-Rendu syndrome
Q2) What is a telangiectasia?
A) a bruise
B) a focal dilation of postcapillary venules with connections to dilated arterioles
C) a vesiculobullous lesion
D) a hyperkeratotic lesion with some dystrophic changes
Q3) What percentage of adults with hemophilia A is HIV positive?
A) 15
B) 35
C) 55
D) 75
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Chapter 26: Cancer and Oral Care of the Cancer Patient
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Sample Questions
Q1) The American Cancer Society (ACS)recommends a mammogram and professional clinical examination every year for women __ years of age and over.
A) 30
B) 40
C) 50
D) 60
Q2) Which of the following is used to make a diagnosis of breast cancer?
A) breast pain
B) nipple discharge
C) mammography
D) biopsy
Q3) Which of the following is the most common type of breast cancer?
A) infiltrating lobular carcinoma
B) infiltrating ductal carcinoma
C) mucinous carcinoma
D) tubular carcinoma
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28
Chapter 27: Neurologic Disorders
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Sample Questions
Q1) Reduction of systolic blood pressure by 10 mm Hg is associated with a __% reduction in the risk for ischemic stroke.
A) 3
B) 13
C) 23
D) 33
Q2) Which of the following is the only medication approved by the U.S.Food and Drug Administration (FDA)for the management of moderate to severe Alzheimer's disease?
A) rivastigmine (Exelon)
B) tacrine (Cognex)
C) memantine (Axura)
D) donepezil (Aricept)
Q3) A deferral of dental treatment is advised for ____________ when treating a patient with a history of stroke or transient ischemic attack (TIA).
A) 3 weeks
B) 6 weeks
C) 3 months
D) 6 months
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Chapter 28: Anxiety, eating Disorders, and Behavioral
Reactions to Illness
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Sample Questions
Q1) Which of the following is an example of a simple phobia?
A) fear of heights
B) fear of needles
C) fear of embarrassing symptoms on leaving home
D) a and b
E) b and c
Q2) Which part of the brain appears to be most closely involved in acute panic attacks?
A) corpus callosum
B) medulla oblongata
C) locus coeruleus
D) pons
Q3) The erosive process of perimylolysis primarily involves which of the following surfaces of the teeth?
A) facial and buccal surfaces of maxillary teeth
B) lingual surfaces of maxillary teeth
C) facial and buccal surfaces of mandibular teeth
D) lingual surfaces of mandibular teeth
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Page 30
Chapter 29: Psychiatric Disorders
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Sample Questions
Q1) Which of the following is an adverse effect associated with the administration of tricyclic antidepressants?
A) xerostomia
B) diarrhea
C) hypertension
D) bradycardia
Q2) It is suggested that no more than _____ cartridges of dental local anesthetic containing (1:100,000)epinephrine be used during an appointment when a patient is taking tricyclic antidepressants.
A) 2
B) 4
C) 6
D) 8
Q3) Antipsychotic drugs appear to work by antagonizing the effects of dopamine in the basal ganglia and limbic portions of the _________.
A) cerebellum
B) pons
C) forebrain
D) midbrain
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Page 31
Chapter 30: Drug and Alcohol Abuse
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Q1) How long should a dentist wait before administering dental local anesthetic containing epinephrine to a patient who is "high" on cocaine?
A) 3 hours
B) 6 hours
C) 12 hours
D) 24 hours
Q2) Naloxone is used for emergency treatment of an overdose of _________.
A) amphetamine
B) cocaine
C) opioids
D) sedative-hypnotics
Q3) Which of the following is the primary neurotransmitter involved in drug abuse?
A) endorphin
B) dopamine
C) norepinephrine
D) acetylcholine
To view all questions and flashcards with answers, click on the resource link above. Page 32