Updated 2020

Endodontic Emergency
1. What is flare up:
A. Acute exacerbation after initiation of treatment or after it
B. Acute exacerbation before starting the tx
C. Chronic exacerbation after initiation of tx or after it
D. Chronic exacerbation before starting the tx

2. In incision and drainage:

A. Dissect gently, through the deeper tissues and thoroughly explore all parts extend to
offending root.
B. Horizontal incision in the swelling

3. 54 years old diabetic insulin dependent Patient, reported allergy to penicillin and
she has facial swelling related to her badly decayed lower left side:
A. Amoxacillin loading dose 500 mg then, and book her the nearest app
B. Amoxacillin loading does , then , and start RCT
C. Clarithromycin loading dose 500 mg then , and book her the nearest app
D. Clarithromycin loading does, then, and start RCT

4. Which pt. Require AB if you’re going to do I for D:

A. Localized swelling with swelling involving vestibule
B. Patient that has fibromyalgia, and taking immunosuppressive
C. Patient who has knee replacement 5 years ago

5. Which facial space, related to lower posterior teeth, close to buccal cortical plate,
the root of the teeth above the attachment of buccinators muscle:
A. Mandibular buccal vestibule
B. Submassetric
C. Temporal
D. Pterygomandibular

6. Which facial spaces could contribute to cavernous sinus thromobosis:

A. Mid face spaces
B. Para pharyngeal
C. Retropharangeal
D. No facial space could contribute to that

7. Which space related to impacted third molar where the exudate perforating Lingual
cortical plate:
A. Submassetric space
B. Temporal space
C. Submental space

8. Primary Goal of ER treatment for patient with facial cellulitis:

A. Prescribing AB to Prevent spread of infection
B. AB to relieve pain
C. Localized the source and..
D. Removing the source of infection and I and D to allow escape of inflammatory
exudates.

1
Updated 2020

9. Mature permanent tooth, patient came to ER w/ sever pain, Due to the limited time
the management is:
A. Complete RCT in single visit
B. Pulpotomy and remove tissue from the widest canal
C. Prescribe analgesics to relieve pain and book the pt as soon as possible
D. Prescribe AB and analgesics to relieve pain and book the pt as soon as possible

10. What is true regarding Crack in vital tooth:

A. Sharp sudden pain
B. Dull pain

11. A cellulitis between the superficial fascia requires treatment that include
A. Vigorous antibiotic and supportive measures
B. Endotoxins and drainage
C. Antibiotic and drainage
D. Rest , fluid and supportive measures

12. In order to control the incidence of post-treatment flare ups of previous periapical
area, it is recommended:
A. Use prophylactic antibiotic coverage
B. Instrumentation within the root canal system
C. Antibiotic coverage if symptoms develop
D. The use of antibiotic sensitivity testing

13. Management of cases with acute apical periodontitis and diffused swelling
A. I D and antibiotic
B. Canal debridment, Ca(OH)2 dressing and antibiotic and I D
C. Canal debridment, Ca(OH)2 dressing and antibiotic
D. I D only to decrease pain

14. The best antibiotic prescribed in cases of cellulites

A. Amoxicillin
B. b. Clindamycin
C. c. Metronidazole
D. d. Erythromycin
E. e. None of the above

15. Incision & drainage is done in:

A. Sinus tract.
B. Acute apical periodontitis.
C. Indurated & diffuse swelling.
D. d- All of the above

16. A 21 years old female Patient requires emergency treatment of a soft, fluctuant
swelling over the facial alveolar process of the maxillary, left, lateral incisor (tooth
no.12). The swelling is visible because of s high lip line. Which of the following
statements is correct regarding performing incision and drainage:

2
Updated 2020

A. The incision should be placed Vertically and go directly to the bone

B. The incision should be Horizontal in the attached gingival at the base of the swelling
C. If drainage occurs with the initial incision, blunt dissection is not necessary.
D. The placement of a drain is necessary for 24 to 48 hours.

17. Patient came with severe pain seeking an emergency treatment:

A. Standard of care management is to relieve pt’s acute symptoms
B. Schedule the pt for ASAP
C. Give him Analgesic.
D. ….

18. Flare up during root canal treatment more common with high prevalence in:
A. Symptomatic teeth of necrotic pulp
B. Vital pulp
C. Sinus tract and periradicula abscess
D. With single visit endo

19. Patient came to the ER with pain and swelling which is fluctuant. What is the
appropriate treatment?
A. Complete biochemical debridement.
B. I and D
C. Hot rinse after going home.
D. All of the above.

20. case: a lady with necrotic central & lateral with swelling in lip face puffy eyes with
redness & fever , what is your the management :
A. Root canal then antibiotic
B. antibiotic
C. incision & drainage

21. Drainage is done through:

A. Crown access + incision

22. Patient had RCT in tooth # 24 then he was given another appointment for
completion of the RCT next app pt came with acute pain on clinical examination
tooth was sensitive with percussion radiographically within normal what could be
the cause:
A. overinstrumentation
B. overfilling

23. Patient had a complain of severe lingering pain with thermal stimuli in upper right
side he gave a history of RCT in tooth # 15 what could be the cause of pain:
A. Remaining vital tissue in the buccal canal
B. Palatal canal with short filling.
C. ….

3
Updated 2020

D. Pain is from other tooth rather than # 15

24. Incision and drainage of an abscess may reduce pain by:

A. reducing the concentration of inflammatory mediators.
B. lowering tissues pressure.
C. sprouting terminal fibers in the inflamed tissues.
D. a and b.

25. Q about “Ludging Angina”

A. infection to sub-mental, sub-lingual & sub-mandibular
B. …
C. …
D. can spread to canine space

26. Patient with root canal done before 2 weeks, came to you with severe pain on
percussion. On radiographic there is an over extrusion of GP:

A. Give him more time and recall.

B. Give him systemic Antibiotic.

C. Perform apical surgery for him.

D. Give him strong Pain killer

27. Case scenario: sever pain on biting after 2 days of endo trx of upper premolar for a
female patient, reason behind that:
A. extruded debris

28. Occlusal reduction is indicated in cases with:

A. Irreversible pulpitis
B. Irreversible pulpitis with acute apical periodontitis
C. Chronic apical abscess
D. All of the above

29. The best treatment of irreversible pulpitis at the initial visit

A. Pulpotomy
B. Complete removal of the pulp
C. Single visit endodontics
D. Occlusal reduction to relieve pain
E. A and D

30. An emergency patient came with substandard RCT and pain Tx will be:
A. Give him analgesic & antibiotic
B. Retreatment
C. Surgery

4
Updated 2020

D. Not clear

31. Patient with 4 mm overfill and symptomatic Tx:

A. Extraction
B. Anagesic & book for surgery
C. Retreatment

32. Leaving the tooth open B/W visits:

A. Root and system contamination
B. nduce periapical infection.

33. What is the difference between a true Endodontic emergency and urgency :
A. true emergency may be rescheduled for convenience of the patient .
B. true emergency is a condition require unscheduled office visit.
C. An urgency indicates a more severe problem .
D. An urgency may need to be seen after no office hours .

34. Patient allergic to penicillin what is the best alternative:

A. Penicillin K 1g
B. Amoxiclin 500mg
C. Augmentin 1g
D. Clindamycin 150mg

35. Which is correct about post-operative emergency:

A. More common than interappointment
B. infrequent and usually subside
C. best management by complete cleaning and shaping
36. Scenario: Diabetic Patient is suffering from facial swelling, patient is allergic to
penicillin and psedumembranous colitis, need management of cellulitis?
A. Amoxicillin
B. RCT with clindamycin
C. clarithromycin
D. RCT with tetracycline

37. Scenario: 12 old male patient known of cardiac valve disease, went to GP and he did
RCT on Tuesday for his molar tooth and gave him amoxicillin 500mg, he come to u
on Thursday with a facial swelling & intraoral swelling opposite to the operated
tooth and he took prophylaxis 1 hour before, what is the diagnosis?
Necrotic w acute apical abscess (it should be previously initiated with acute apical
abscess but this choice was not included in the answers)

38. Scenario: what is ur management of the previous case?

A. Do nothing as he is on AB
B. Incision and Drainage
C. extraction

5
Updated 2020

39. Amoxicilin chose as first line drugs of choice because:

A. Most endodontic of bacterial species involved are susceptible to it

40. Maximum dose of acetaminophen?

A. 4g

41. AB is prescribed for Pt who:

A. Unstable cardiac disease (something like that)

42. Trephination is:

A. is the surgical perforation of the alveolar cortical plate to release, from between the
cortical plates, the accumulated inflammatory and infective tissue exudate that causes
pain.

43. Patient developed skin rash, itchy skin after application of latex rubber dam. Best
treatment:
A. Diphenylamine orally
B. Diclofenac orally
C. c.
D. Epinephrine IM

44. 21- Patient developed skin rash, itchy skin, wheezing & bronchospasm:
A. Diphenylamine orally
B. Diclofenac orally
C.
D. Epinephrine IM

45. cellulitis:
A. symptomatic edematous in ammatory process that spreads di usely through connective
tissue and fascial planes; frequently associated with an infection by invasive
microorganisms with subsequent breakdown of connective tissue

46. Patient on anticoagulant, what is the best analgesic:

A. Ibuprofen
B. Aspirin
C. Paracetamol
D. Naproxene.

47. Patient came with moderate pain on percussion had RCT one day before with
acceptable treatment, the management
A. Give antibiotic
B. Trephination.
C. Reassure and analgesic

48. Radiograph: long span bridge well fitted pt. came with sever lingering pain related
to #17, the management:
A. Access through the crown

6
Updated 2020

B. Remove the bridge

49. Radiograph: #47, #46 both have crown and for #46 through and through in the
furcation area
Upon examination #46 was vital, sensitive with lingual and buccal pocket
#47 was necrotic and severely sensitive to percussion which reproduce the chief
compliant of the pt. the emergency treatment?
A. Extraction of #46
B. RCT for #47
C. Pulpectomy for #47

50. Patient told you that he had fainted previously in dental clinic, when you are giving
the patient local anesthesia, he started to increase respiration, tingling and dizziness,
numbness lip what best describe the patient attack?
A. Vasovagal attack
B. Syncope
C. Asthma
D. Hyperventilation

51. When you are doing RCT #14 suddenly patient feels pain, due to NaOCl accident
what is the best management?
A. Abundant irrigation with saline and give Corticosteroid
B. Pain control, abundance irrigation with saline. antibiotic
C. Pain control, saline irrigation, analgesic, antibiotic
D. Abundance irrigation with saline and leave the tooth open

Scenario Pa of tooth #16 & 17 both have caries proximally

15 16 17
Cold Normal Positive Sensitive
not
lingering
Percussion Normal Normal Normal

52. Q. Patient came to you complain from pain you did test on the teeth
What is the treatment for tooth #17?
A. Pulpotomy
B. Conservative restorative
C. RCT

53. Q. Patient came to you complain from pain you did test on the teeth
15 16 17
Cold Normal -ve Sensitive
not
lingering
Percussion Normal Normal Normal

What is the treatment for tooth #16?

A. Pulpotomy
B. Conservative restorative

7
Updated 2020

C. RCT

54. What is the primary goal of facial cellulitis?

A. Leave the tooth open
B. Give antibiotic
C. Removing the source of infection and I and D to allow escape of inflammatory
exudates.

55. Patient came complaining from swelling and pain pointing to tooth #33, 33&31 both
have well fitted crown, the patient has controlled hypertension, what is the best
management in this case?
A. Incision, drainage and antibiotic
B. Pulpectomy and Antibiotic
C. Pulpotomy

56. Pt has severe pain on biting and especially when she opens, has recent MOD inlay
A. Galvanic reaction
B. Hyperocclusion
C. VRF
D. Leaky marginal ridge

57. Radiograph with severely distracted tooth #47 Came with severe pain, what is the
emergency treatment?
A. Extraction
B. Pulpectomy

58. Which bacteria is resistant to Penicillin:

A. E. Fecalis_
B. P. Ginigivalis
C. F. Nucleatum
D. P. Intermedia

59. Which bacteria cause infective endocarditis:

A. Staphylococcus Aures_
B. E. Fecalis_
C. Lactobacillus

60. Patient came complaining of pain. He has swelling in submandibular space. Tooth
#35 necrotic, pt. Has severe pain with percussion, what is you management:
A. Finish the RCT and prescribe Antibiotic and analgesics _
B. Prescribe Antibiotic and analgesics and reschedule for RCT
C. Incision for drainage and start RCT and prescribe analgesics
D. Incision for drainage and prescribe Antibiotic and analgesics

8
Updated 2020

61. Old female patient, #34 previously treated, pt. Complaining of severe pain from it,
you planned to retreatment. What is the best tx management: (RG showing bridge
connecting between #37(severely tilted maybe undermined with caries) to #34 (has
Gp filling), #36 missing & #35 has PA RL)
A. Do it through the crown _
B. Remove the bridge, then do the Root canal retreatment
C. Section the bridge distal to the #35
D. Periapical surgery

62. Patient diabetic type 2, fasting blood glucose level 300, came with severe pain:
A. Do the emergency treatment _
B. Prescribe analgesics_
C. Reschedule the pt.
D. Give insulin then proceed with the treatment

63. Patient appeared for appointment, apprehensive, flushed, perspiring

and very concerned about the procedure especially LA injection,
with history of fainting twice in dental clinic, after giving the LA he developed
increase in depth and rate of respiration, tremors, increase heart rate, numbness
and tingling of lips and Chest discomfort:
A. Hyperventilation
B. Vasovagal syncope
C. Syncope

64. Diabetic patient, he was sweeting, mood change, hunger, tonic clonic convulsion.
Considering patient is conscious, what is your management:
A. High sugar drink
B. Insulin
C. Epinephrine
D. Hydrocortisone

65. …………………… Patient went in to coma, which position you will put the patient?
A. Supine position
B. Recline position
C. Right angle
D. Leaning foreword

66. Scenario: Patient came to your clinic with flare up, what is the best management:
A. Local anesthesia, access cavity, irrigation with NaOCl, , calcium hydroxide,
temporary filling
B. Local anesthesia, access cavity, irrigation with saline, instrumentation to 2/3 of
working length to prevent debris extrusion, calcium hydroxide, temporary filling
C. Local anesthesia, access cavity, irrigation with saline, instrumentation to full length,
calcium hydroxide, temporary filling

67. Alves 2010: Endodontic flare-ups, percentage of flare ups with the presecence of
periradicular radiolucency:
A. 1.71%
B. 3 %

9
Updated 2020

10
Updated 2020

11
Updated 2020

12
Updated 2020

13
Updated 2020

14
Updated 2020

15
Updated 2020

16
Updated 2020

17