l \ A 3 year old requires the extraction of a

deciduous maxillary second molar. The toea!

anesthetic technique of choice is
A . anterior two-thirds of the tongue.
A. a posterior superior alvecla: l:Jlock. B. lingual gingivae.
B . buccal and palatal infiltTatw r.. C. posterior one-third of the tongue.
C. a tuberosity block plus subperiosteal D . floor of the mouth.
infiltration of the mesio-buccal root. E. parasympathetic fibers to the
D. an infra-orbital block. submaxillary salivary gland.

2\ A 57 year old man received 1Omg of 6\ A nasopalatin e nerve block will anesthetize ~ •\o.J",.. ...
diazepam intravenously. He becomes the ~er'" /~,,
unresponsive to verbal stimuli, and his ~ ,
respirations are depressed to 10 per mir:ute. A. maxillary incisors and canines. _.--- ·' , r' ,. "
Appropriate treatment is to ~ro~ .-.\ ;"=' B.labialalveolarplateofthemaxilla. ~ , r.\ ,. o
.'~).; ~·. r
r ( '•

C. upper lip, nose and lower eyelid. .-D ' r ()v o-\-
A. administer ephedrine. D. posterior portion of hard palate an~ q ,e-'~~ .f ' of '

B. observe the patient. overlying structures to the first Co-.J-'><~

C. force the patient to driiJ.k coffee. premolar.
D. support respiration with oxygen. E. mucosa of the anterior palate
/

-.,
3\ A child has received a successful inferior JXApatient has a proven allergy to para-amino
alveolar nerve block using l.5ml of v benzoic acid derivatives. Which local
lidocaine 2% with l: 100000 epinephrine. anesthetic solution can be used safely?
However, during placement of a rubber
dam clamp on the first permanent molar, A. Procaine hydrochloride (Novocaine).
the child ·complains that the "tooth ring" is B. Butethamine hydrochloride
hurting. Which of the following is the (Monocaine).
most ~ppropriate management? C. Tetracaine hydrochloride
(Pontocaine).
A. Wait 15 minutes until more profound D. Lidocaine hydroch1oride
anesthesia is achieved. (Xy!ocaine).
B. Anesthetize the lingual nerve with
the remaining lidocaine.
C. Anesthetize the long buccal nerve 8\ A patient is premedicated prior to general
with,the remaining lidocaine. anaesthesia in order to
D.- Proceed with treatment without
rubber dam. L iessen metabolic activity.
2. depress reflex irritability.
3. control excess salivation.
4\ A drug acting to keep potassium cha'1nels, C. 4. avoid haemorrhage.
opep will ..- ~ ~ Cs>,...d ·. <D'Seie.:l'vc l"'l6v ..u.l- <':!
l,.h.t \) A. (1)(2)(3)
A. depolarize neurons. ® 1:...-"" ""'"'" ~~1- B. (1) and (3)
B. hyperpolarize neurons. ~ u "' c.L C. (2) and (4)
C. have no effect on neuron membrane v- So """ 4~~ D . (4) only
potentiaL E. All ofthe above.
rg
D: shorten action otential duration.
----p;:..-:-
glutea mtramuscular injection may be
safely admi~istered in which quadrant? r.
t;~o ·r
~~ +<,.) 9\ A patient w ith pain, fever and unilateral 'v
parotid swelling following a general anesthetic
A. LOwer medial.
B. Upper medial.
C. Lower lateral.
(Jffi most likely has

A. Mumps. ~ b;\G.Jtl'-"1
D. Upper lateral. , ~· B. sialolithiasis. ~,._ ; ~ \
S (:<«.J '" ~ 0•· I .._ .,...._~

nerv-l ·
- -- Pagel
 LA,GA & SEDATION
P.'~"' ~"o"""' a. S'J.rq·,(Jf!.\ ?~·<(:,-\,'Tf.) , . .. . . .
C. acute bacterial sialadenitis.J 1w1 15\ An accidental mJectton of diazepam mto an
D~ Sjogren's'syndrome ..,. _ ec'" 10 ,,.,.,..\A..,c. _. c} ~ .,.,......,J•....t_(!.~c artery instead of a vein may cause
E. sarcoidosis. l'-~~ . . . i C)
A. pain on vessel puncture.
l 0\ A sedative drug should B. bright red blood on aspiration.
C. severe pain in the limb extremities.
D. gangrene of the limb.
A. cause excitement.
B. eliminate all sensation. D E. All of the above.
C. produce unconsciousness.
D. produce a mild state of central
nervous system depression. 16\ An apprehensive 77-year old patient, weighing
approximately 60kg, requires the removal of n
several mandibular teeth under local y
11\ A well controlled insulin dependent d iabetic anaesthesia. The appropriate modality to i ~be ~ "t<=.
patient requires two teeth extracted under G manage the anxiety is I~ c \~
local anesthesia at 9-a.m. Your instructions .\,.
would include *
1-1 ~~ ('. I.e ... 'b'uo.l A. 20rng of diazapam, intravenously.\ ~ ~ Gosc. ~ ....
S~S'-r Qc.•e' B. 20mg of diazapam, orally. J G\11 dr"'5~ -tXC<-f"+
A. eat breakfast, do not take insulin. f .... .._ + :; ...,,.. "' C. 1OOmg of secobarbital, orally. ~+: b ~ c:.t-~ c..>
B. take insulin, do not eat breakfast. . D. nitrous oxide and oxygen. Jo~ -~~ +-""" '"'-"-~
. !.
C. eat breakf:ast and ta ke msu m.
.,.. ~w.<e ca.,.\ .·h <. t
, o~~ _, ..1~ '",...,...: ... c \ () ; ,.,_Q , .:~
II \
y-e_ee.,._...,.,_.. <l"-«
"'~.... .,~... '-'
D. do not eat breakfast, do not take c_o-'t..-. il<.J
insulin. o .- ..,.....,_.,.,. ~ ""' '' ~ J 17\ An i_rnmediate toxic reaction to a local
c::lic. bc'1'£0. anesthetic administration is

12\ After an inferior alveolar nerve block A. deterioration of the anesthetic agent.
injection, a patient would develop seventh B. hypersensitivity to the
nerve paralysis if the injection was made vasoconstrictor.
into the C. hypersensitivity to the anesthetic
agent.
A. internal maxillary artery. D. excessive blood level of the
B. retroparotid space. anesthetic agent.
C. internal pterygoid muscle.
D. retromandibular vein.
E. pterygoid plexus of veins. 18\ Anesthetic solution deposited at the
infraorbital foramen will NOT anesthetize the

13\ After giving buccal infiltration anesthesia for A. skin and conjunctivum of the lower
the removal of a maxillary premolar, the eyelid.
patient complains of a sharp pain in the cheek B. skin and mucous membrane of the
which blanches. This is a result of upper lip.
C. median strip of skin of the nose.
A. injecting too m uch solution. D. maxillary anterior teeth.
B. injecting the ~el ution too rapidly. E. mucosa of the anterior wall of the
C. stimulating sympathetic nerves maxillary sinus.
around an artery.
D. intravenous inj ection.
19\ Aspiration is calTied out prior to a local
anaesthetic injection in order to reduce the
14\ Allergic reactions to amide-rype local
anesthetic ~olutions are most likely caused by A. toxicity of local anaesthetic.
sensitivity to B. toxicity of vasoconstrictor.
C. possibility of intravascular
A. lidocaine hydrochloride. administration.
B, epinephrine. D. possibility of paraesthesia.
C. methylparaben.
D . contaminants. .

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 LA,GA & SEDATION
20\ Aspiration prior to a local anesthetic D. (4) only
injection reduces the E. All of the above.

A. toxicity oflocal anesthetic.

B. toxicity of vasoconstrictor. 26\ During an injection at the mandibular
C. possibility of intravascular foramen, the needle passes through the
administration. buccal mucosa and the buccinator muscle
D. possibility of paresthesia. and is

fjlltA. external to the pterygomandibular

2 1\ Benzodiazepines have all the following
effects EXCEPT D r~phe and externa! to the ~1
(mternal) pterygoid mus_cfe-:-'J
A. anxiolytic. B. externan~pterygomandibular
B. sedative. raphe and internal to the medial
C. anticonvulsant. (internal) pterygoid muscle.
D. analgesic. C. internal to the pterygomandibular
raphe and internal to the medial
(internal) pterygoid muscle.
22\ Cardiac arrhythmias are most commonly seen !) D. internal to the medial (internal)
pterygoid muscle and lateral to the
during administration of
neck of the condyle.
A. thiopental. r--
B. halothane. ~
C. ethyl ether. 28\ During drug-receptor interaction, locat
D. nitrous oxide. anesthetics interfere with the transport of
which of the following ions?

A. Sodium.
23\ Cardiovascular collapse caused by a high
B. Calcium.
circulating dose of a local anesthetic is due to
C. Chloride.
D. Potassium.
A. vagal stimulation. E. Magnesium.
B. histamine release.
C. myocardial depression.
D. medullary stilnulation. 29\ During the administration of local
anesthesia, an intravascular injection will
occur most oft~I! in ai~m -

24\ Conscious sedation differs from general

anesthesia in that the
A. incisive block. 5· L.
'"
B. posterior superior alveolar block. ~ .../o
C. inferior alveolar block. \<\ · )c "L
A. patient retains all reflexes. D. anterior superior alveolar block. ~- -=t \.
f"'
B. patient is hot responsive. E. long buccal block. D. 5 "'/<:>
C. patient's pain threshold is not altered.
D. patient's heart rate is increased.
30\ Epinephrine in a local anesthetic solution will _}_.

25\ Diazepam (valium) 1. decrease absorption of the anesthetic.

2. assist hemostasis at the site of injection.
1. is a benzodiazepine. 3. prolong the action of the anesthetic agent.
2. is contraindicated in a •patient with =!!laucoma0 4. assist in post-operative healing.
3. is anxiolytk
4. produces muscle relaxation when given orally. A. (J) (2) (3)
B. (1) and (3)
C. (2) and (4)
A. (1) (3) (4) D. (4) only
B. (1) and (3) E. All of the above..
C. (2) and (4)

---·---------------·--··------- Page 3 - --- ----- - - -- - ·

"heP\.<-Ib~- ¥Y'b5 t (J,M~ ._.;,:-h. pc.Y:fe/ll'cSr" s~·'ar
C) )v-V6~-
 LA,GA & SEDATION
31\ Epinephrine is added to local anesrhetic C. hydrocortisone.
formulations in order to D. diphenhydramine . .

1. increase duration of anesthesia.

. 2. increase depth of anesthesia. 35\ Following the administration of a right
3. reduce likelihood of systemic toxicity. inferior alveolar nerve block, right facial
4. reduce likelihood of allergic reaction. paralysis is noted. This condition was caused
by inadvertent injection into the
A. (1)(2)(3)
B. (1) and (3) A. pterygopalatine fossa.
C. (2) and (4) B. facial canal.
D. (4) only C. parotid gland.
E. All of the above .. D. submandibular region.
E. sublingual gland..

32\ Epinephrine should NOT be used as a ~q,J,~k~ f)

vasoconstrictor for patients with _ "1~..1.;~~- ~ , 36\ Following the injection of 1.8ml of2%
uncontrolled _ ~e,.-~1\0~--ro oi.5·· · lidocaine with 1: 100,000 epinephrine, a
nervous 22-year old male with well controlled
A. hyperthyroidism. insulin dependent diabetes states that he feels
B. hyperparathyroidism. dizzy and weak. Beads of sweat have
C. myxedema. accwnulated on his forehead and upper lip.
D. asthma. He is quite pale. The initial management of
this patient is to
33\ ·Extrusio.n of the rubber stopper of a local
anesthetic cartridge is most likely caused by A. administer glucagon l.Omg.
B. administer epinephrine 0.5mg.
A. faulty manufacturing. C. administer Benadryl
B. storage in a disinfectant solution. (diphenhydramine) 50mg.
C. exposure to excessive heat. D. elevate the patient's legs and
D. breakdown of the anesthetic solution. administer WO% oxygen.
E. call 911 and begin CPR.

34\ Following adminjsrration of a posterior

superior alveolar nerve block, a hematoma 37\ For a patient with a history of glaucoma and 0-
occurs. Which of the following statements is porphyria, the pharmaco-sedation tecnnique
correct? preferred is

A. The formation of this hematoma indicates A. intravenous secobarbital.

poor injection technique. B. intravenous diazepam.
B. This nerve block is not commonly C. oral diazepam.
associated with hematoma formation. D. nitrous oxide.
C. Management of this hematoma includes E. intravenous thiopental.
immediate application of heat for at least
the ftrst 6 hours.
D. The patient may experience trismus the 38\ For a patient with cardiovascular disease,
next day. local anesthesia
v
<;,.

~
~
~
'\:$
c35\ Following injection of a local anesthetic, a
healthy patient suddenly experiences
difficulty breathing. You detect a rash and
!>Welling of the face and neck. The most
A. affects blood pressure more than
general anesthesia.
B. affects blood pressure less than
general anesthesia.
C. is responsible for bacteremia.
appropriate drug to administer first is D. None ofthe above.

A . hydroxycine.
B. epinephrine ·

Page4

- --- -- - - - - -- -
 LA,GA & SEDATION
39\ For either nitrous oxide analgesia or D. (4) only
intravenous sedation using diazepam (Valium) E. All ofthe above.
in a healthy adult patient, you would require
43\ Immediately following an inferior alveolar
1. that the patient be supine. nerve block, the patient exhibits facial
2 . that the patient have no food or drink for four paralysis. The needle has penetrated through
hours previously. which ligament?
3. that the patient possess an electrocardiogram.
4. that emergency drugs are available. A. Sphenomandibular.
5. that oxygen is available. B. Sty lomandibular.
C. Stylohyoid.
A. (I) (2) (5) D. Pterygomandibular.
B. (I) (2) (4) (5)
c. (I) (2) (3)
D. (2) (3) (4) (5)
E. All of the above.
44\ In a safe general anesthetic mixture, the
MfNIMALLYacceptable percentage of
oxygen is
c
A. 5 perce nt.
40\ Hydrolysis of anesthetic salts is facilitated by B. I 0 percent.
C. 20 percent.
A. a tissue pH above 7.0. D. 50 percent.
B. a tissue pH below 5.0. E. 80 percent.
C. a tissue pH between 5.0 and 7.0.
D. .lipophilic properties of the nerve 45\ In a standard dental cartridge (carpule)
fibres. containing 1.8ml 2% lidocaine w ith n
epinephrine Ill 00,000, the amount of D
vasoconstrictor is __..,
)<1:>.r-"41\ Immediately following a posterior superior ..--
/ alveolar block injection, the patient's face A. 18.0 mg.
~.t.- becomes quickly and visibly swollen. The B. 0.018 mg.
.__immediate treatment should be to C. 1.8 mg.
D. 0.18 mg.
A. use pressure followed by coiC! pack's -\<(~»~<~,~~ E. 180.0 mg.
over the swelling. ~'tX'l ~se.. ,.c. r _,sb· .c.h ,.,.
~ -· ecJ. \j ~0.._,... ..-
B. use hot .packs over the swelling. '1-W
C. referthe patient to a hospital. 46\ In a standard inferior alveolar nerve block,
0. administer lOOmg hydrocortisone which muscle is penetrated by the needle?
intravenously. ·
E. admiriister diphenhydramine A. Buccinator.
hydrochloride (Benadryl®) 50mg B. Mylohyoid.
intravenously. C. Superior constrictor.
D. Masseter.
E. Medial (internal) pterygoid.
i 42\ Immediately following a left posterior
y£ s~perior alveolar nerve block injection, the
-~ patient's face becomes quickly and visibly 47\ In administering an inferior alveolar nerve
t." J swollen on the left side. The immediate block, the needle penetrates the oral mucosa
"'{' treatment should be to and the
__.1

1. apply a cold compress. A . superior constrictor muscle lateral to

2. administer 0.3mg epinepherine (sublingually). the pterygomandibular raphe.
3. apply pressur~. B. buccinator muscle lateral to the
4. refer for immediate medical treatment. pterygomandibular raphe.
C. pterygomandibular raphe.
A. (I) (2) (3) D. superior consrrictor muscle medial to
B. (1) and (3) the pterygomandibular raphe.
C. (2) an9 (4) E. internal pterygoid muscle.

PageS
 LA,GA & SEDATION
48\ In administering an inferior alveolar nerve A . (1) (2) (3)
block, trismus may occur if the needle B. ( l ) and (3)
penetrates the C. (2) and (4)
D. (4) only
A. superior constrictor muscle lateral to E. All of the above.
the pterygomandibular raphe.
B. bucc inator muscle lateral to the
pterygomandibular raphe. 53\ [t is difficult to obtain satisfactory anesthesia
C. superior constrictor muscle medial to in the presence of infection near the injection
the pterygomandibular raphe. site because
D. buccinator muscle mesdial to the
pterygomandibular raphe. A. the swe lling causes increased
E. internal pterygoid muscle. pressure on the nerves.
B. increased blood supply carries the
anesthetic solution away too fast.
49\ In effecting hemostasis, external cold C. acidity of the infected tissue inhibits
application produces action of the anesthetic agent.
D. alkalinity of the infected tissue
A. positive chemotaxis. i..'1hibits action of the anesthetic
B. a transient vasoconstriction. agent.
C. increased vascular permeability.
D. accelerated healing.
54\ Lidocaine (Xylocaine)

50\ In local anesthesia, depression of respiration 1. is a local anesthetic agent.

is a manifestation of 2. has topical anesthetic properties.
3. is an antiarrhythmic agent. "e~ \"'."""' · ,.,,.t\
A. puncture of a blood vessel. 4. has anticonvulsant properties. -£)'\ !' "'c V"'<:Y...._, o.Lt' "~~.- '..(. •
~. (J ~.. 'r-\/
B. use ofnon-isotonic·solution. \{JoJ (;~ .,;- ~\ ()..{{
C. toxic effects of the solution. A . (1) (2) (3)
u->_t.~
D. trauma to a ner ve trunk by the B. (I) and (3) D-"-'
needle. C. (2) and (4)
D.(4) only
E. All ofthe above.
51\ In the pterygomandibular space, the inferior
alveolar nerve passes 55\ Lidocaine (Xylocaine®) is an example of
a local anesthetic which is chemically
A
A. anterior to the deep tendon of the classified as an
temporal muscle.
B. lateral to 'the 's phenomandibular A. amide.
ligament. B. ester.
C .. medial to the m edia l pterygoid C. aldehyde.
muscle. D. ethamine.
0 . medial to the pterygomandibular E. aminide.
raphe.

56\ Local anesthesia of the infraorbital nerve will

anesthetize which of the following groups? \)

52\ Intravenous administration of epinephrine A . Tip of the nose, lower eyelid, upper
results in lip .
B. Tip ofthe nose, skin of the cheek,
1. increased systolic pressure. upper lip.
2. increased heart rate. C. Side of the nose, lower eyelid, upper
3. palpitations. lateral incisor.
4. respiratory depression. D. Side of the nose, lower eyelid, upper
lip.

i~(?<.0 r b; f.d ~lot k ~so hl£( 1--\S c,w1()v-:r.y ~f~

Page6 - 0\,lv~lv--. ;.rd ~; J) le f,d((?)\:v a_( vm J;;r:

r
 LA,GA & SEDATION
57\ Local anesthetic injected into dental abscesses 2. removal of a torus mandibularis.
is rarely effective because c 3. an acute osteomyelitis of the
mandible.
A. bacteria can metabolize the local 4. an uncomplicated removal of a
anesthetic. mandibular second molar.
B. edema dilutes the local anesthetic.
C. the tissue is too acidic.
D. there is excessive vasoconstriction. A. (1) (2) (3)
B. (I) and (3)
C. (2) and (4)
58\ Local anesthetic toxicity D. (4) only
E. All ofthe above.
A. is more likely to occur with the
addition of epinephrine.
B. is more likely to occur in adults. 63\ Most anaphylactic reactions to penicillin
C. may manifest as a seizure. occur

1. when the drug is administered

59\ Local anesthetics parenterally.
2. in patients who have already
A. do not readily pass the blood-brain
barrier.
8 experienced an allergic reaction to the drug.
3. within minutes after drug
B. interfere with the propagation of administration.
action poten.t ials in nerve fibres. 4. when the drug is administered orally.
C. selectively interfere with the 5. in patients with a negative skin test to
propagation of action potentials in penicillin allergy.
nociceptive ·fibres.
D . .do not )lave an effect on any other A. (1) (2) (3)
tissue than the nervous tissue. B. (l) and (3)
C. (2) and (4)
D. (4) only
60\ Local anesthetics are less effective in
inflamed tissue because they are c E. All of the above.

64\ Needle deflection increases as

A. diluted by the edematous fluid.
a. rapidly redistributed by the increased A. depth of injection increases.
blood flow. B. needle length increases.
C. ionized by the acidic pH. C. needle gauge increases.
D. rapidly degraded by released D. All of the above.
enzymes.

65\ Nitrous oxide

61\ Local anesthetics block nerve conduction by
interfering with ionic movement of
s2:tl f\~~o-.~"' ~ ~-'-i'\oy',c..
1. provides good muscle relaxation.
2. is non-explosive and non-flammable.
A. calcium, 3. is a potent anesthetic.
B. potassium. 4. provides rapid induction and recovery.
C. sodium. .
D. chloride. A. (1) (2) (3)
B. (2) and (3)
C. (2) and (4)
62\ Loss of sensation over the distribution of the D. (4) only
inferior dental nerve is a possible E. All of the above.
complication from

1. removal of an impacted mandibular

third molar tooth.

Page 7
 LA,GA & SEDATION

66\ Nitrous oxide, when used as a sedative, A 5. suppression of white blood cells.
produces
A. (1) (2) (3)
A. euphoria. B. (l) (4) (5)
B. dizziness. c. (2) (3) (4)
C. lethargy. D. (1) (2) (5)
D. anesthesia. E. None of the above.

72\ Satisfactory local anesthesia is often difficu lt

67\ One millilitre of a 2 solution of lidocaine to obtain in the presence of infection near the
hydrochloride contains how many milligrams i11jection site because of
ofthe drug?
A. edema.
A.2 B. increased blood supply.
B.20 C. the acidity of the infected tissue.
C. 200 D. the alkalinity of the infected tissue.
D. 2000

73\ Shortly after the administration of a local

(5 68\ Oral flurazepam is su::>erior to oral diazepam ( anesthetic for the removal of tooth 2.8, the
as patient complains of a tense sensation in the D
left cheek and left cheek swelling is observed.
A. a sedative. The most likely diagnosis is
B: a tranquilizer.
C a hypnotic. A . surgical emphysema.
D. a muscle relaxant. B. immediate allergic reaction.
E. an amnesic. C. herniation of buccal fat pad.
D. hematoma.

69\ Patient nausea during nitrous oxide (')

administration is an indication that the patient ~<> l d 74\ Shortly after the administration of an inferior
~ '):l' alveolar nerve block, a healthy adult patient
~ l (), l... (}f·

)H'~:~-
o'l-'
rapidly develops a facial rash. Which ofthe
A. is nervous.
B. has not eaten for some time. following signs and symptoms should be L
'6 \) ~ ~0
C . is allergic to nitrous oxide. watched for before initiating the planned
D. has received the nitrous oxide too dental treatment?
quickly. ut/
1. Pallor and perspiration.
2. Shortness ofbreath.
3. Hyperventilation.
70\ Procaine (Novocaine) is an example of a local 4 . Edema of the lips.
anaesthetic which is chemically classified as
an A . (1) (2) (3)
B. (1) and (3)
A. amide. C. (2) and (4)
B. ester. D. (4) only
C. aldehyde. E. All of the above.
D. etham ine.
E. aminide. ·
75\ The first sensation lost after administration of
71\ Prolonged use of nitrous oxide has been 13 a local anesthetic is
shown to produce o f.s~ i t t?~l-V·&
,.-f,'\•e,., A . pain.
g 1.2 S1"' ce.cY B. touch.
.
1. a b orttons . fiemaIes. ~""''stP~c
m '.t
_.... nt..-·r-A!·
, "'" •
(}h. ,.e.""'.
C. pressure.
2. cancer in occupationally exposed females.
D . proprioception.
3. liver disease in occupationally exposed maies.
4. birth defects in exposed females.

---------------- - Page 8

----- -- -- --
 LA,GA & SEDATION
76\ The first sign·of a toxic reaction to an injected A. insufflation.
local anesthetic solution would be D B. open drop.
C. endotracheal intubation.
A. convulsions. D. intravenous barbiturate with nitrous oxide
B. erythematous rash. and oxygen.
C. asthmatic attack.
D. excitement. 83\ The most appropriate oral drugs for control of
anxiety in a dental patient are
77\ The immediate management of a hematoma
following a posterior superior alveolar nerve
B A. benzodiazepines.
block is to B. phenothiazines.
C. barbiturates.
A. incise into the buccal sulcus. D. tricyclic antidepressants.
B. apply firm direct pressure.
C. aspirate with a needle. 84\ The most common complication of a
D. place bot towels over the cheek. venipuncture is

78\ The left infraorbital nerve block anaesthetizes A . syncope.

B. hematoma.
A. all maxillary teeth on the left side. C. thrombophlebitis.
B. the maxillary premolar on the left D . embolus.
side, canine and incisor teeth.
C. the left maxillary canine and incisor 85\ The most likely complication following
teeth only.· .
[.
surgery for a patient with thrombocytopenic
D. the entire left maxillary sinus. purpma would be
E. the entire left naso-lacrimal duct.
A . angina.
79\ The local anesthetic lidocaine is an B. hemorrhage.
C. "dry socket".
A, amide. D. delayed healing.
B. ester. E. infection.
C. aldehyde.
D. acid. 86\ The most probable complication of a local -
anesthetic injection into the parotid gland l
is
80\ The majority of n itrous oxide is eliminated
from a patient's circulatory system through the A. infection.
B. trismus.
A. lungs. · C. diplopia.
B. kidneys. D. facial paralysis.
C. liver enzymes.
D. plasma enzymes. 87\ The position of a needle in the lumen of a
E. intestinal gas. vein is confitmed by

8 1\ The management of syncope following A. the color of the blood upon

local anesthetic administration does NOT aspiration.
include B. rapidity of filling of the syringe upon
aspiration.
A. elevating tl,J.e legs. C . pain associated with vessel puncture.
B. placing in a supine position. D. None o f the above.
C. administering oxygen.
D. ensuring the airway is open.
E. administering epinephrine.

82\ The most appropriate management rechnique

to avoid aspiration of blood or debris during
general anesthesia, is

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83\ The pr imary use of nitrous oxide and oxygen
in dentistry today is as a(n)
A. substitute agent for local anesthesia.
B. general anesthetic agent.
C. agent for conscious sedation.
D. agent for the management of chronic
obstructive pulmonary disease.
89\ The psychomotor recovery time from nitrous
oxide sedation is
B. is contraindicated in children.
c C. precludes the use of local anesthesia.
D . requires effective local anesthesia.
E. may be used in conjunction with
narcotics.
94\ There is an acute alveolar abscess on
tooth 1.3. The tooth must be extracted. In
addition to a palatine injection, the most
appropriate local anesthetic technique would
be

A. immediate. A. buccal infiltration.

B. l to 2 minutes. B. infraorbital.
C. lO minutes. C. middle superior alveolar.
D. 30 minutes. D . intraligamentary.

90\ The selection of a vasoconstrictor for a local
anesthetic depends upon
A . the duration of the operation.
B. the need for hemostasis.
C. the medical status of the patient.
D. aU of the above. .
91\ The surgica!'removal of tooth 3.6 requires
anesthesia ofthe inferior alveolar nerve as
well as·which of the following nerves?
c D. intraligamentary.
95\ There is an acute periradiuclar abscess on
tooth !.3. The tooth must be extracted. In
addjtion to a palatal injection, the most
appropriate local anesthetic technique would
be
A. vestibular infiltration.
B . infraorbital.
C. middle superior alveolar.

96\ Thiopentone sodium (Pentothal) provides all

A. Lingual, cervical plexus. ofthe following advantages EXCEPT
B . Cervical, long buccal.
C. Lingual, long buccal. A. smooth pleasant induction.
D. Mental, long buccal. . B. good sleep production.
C. rapid recovery.
92\ The use of asp irating syringes for the D. acceptability for both young and old.
administration of local anesthetics is E. adequate length of operating time.
recomm:ended because

1. the effectiveness of local anesthesia is

increased.
2. aspiration ofblood is proof that the needle is
97\ To avoid aspiration of blood or other debris,
the general anesthetic techn ique of choice is c
in an intravascul~ location. A. insufflation.
3. their use removes the hazard of rapid injection B. open drop .
and provides a distinct saving oftime. C. endotracheal intubation.
4. their use redu9es the frequency of accidental D . intravenous barbiturate with nitrous
intravenous inje9tion. oxide-oxygen.

A. (l) and (2)

B. (1) and (3)
98\ Tranquilizers and hypnotics
D
C. (2) and (4) A. are depressants of the respiratory
D. All of the above. centre.
B. are depressants of the cortex.
93\ The use of conscious sedation for a restorative C. may cause physical dependency.
procedure in an _office envimnment D. All of the above.

A. requires the services of an

anesthetist.

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 LA,GA & SEDATION
99\ Unconsciousness in syncope results from $ 1O?\ When used for conscious sedation, nitrous c
D ox!demay
A. electrolyte imbalance.
B. neurogenic shock. 1. produce signs of inherent myocardial
C. cerebral hyperemia. depression.
D. cerebral hypoxia. 2. produce an indirect sympathomimetic action.
3. cause the patient to sweat.
100\ Use of nitrous oxide analgesia produces 4. produce numbness of the extremities.
ringing in the ears as a result of

A. central nervous system reaction. A. (1) (2) (3)

B. peripheral action on the eardrum. B. (1) and (3)
C. increased pressure in the middle ear. C. (2) and (4)
D. cochlea effect. D. (4) only
E. dysphoria. E. All of the above.

101\ Vasoconstrictors in a local anesthetic solution 106\ Willch local anesthetic formulation should be
used to achieve prolonged pain relief for a
1. retard absorption. patient requiring a pulpectomy for tooth 3.6?
2. increase duration of action.
3. permit smaller volumes to be used.
4. have low toxicity when given intravenously. A . Articaine 4%, with epinephrine
1:100,000.
A. (1) and (4) B. Bupivacaine 0.5%, with epinephrine! :200,000.
B. (2) and (4) C. Lidocaine 2%, with epinephrine
c. (1) (2) (3) 1:100,000.
D, All ofthe above. D. Mepivacaine 3% plain.
E. Prilocaine 4%, with epinephr ine
1:200,000.
102\ What is the maximum number of cartridaes
( 1.8ml) of a 2% local anesthetic solution that"' 107\ Which local anesthetic formulation should be
can be administered without exceeding a total
dose of 300mg?
used to achieve prolonged pain relief for a
patient requiring the surgical extraction of E
J2.o '"5 I I "" t.. tooth 3.8?
A.2 .iU)(I ·&o. ,\.
3f, ofWjl I ..,L A. Articaine 4%, with epinephrine
B.4
c. 6 .1. 1:100,000.
B. Bupivacaine 0.5%, with epinephrine
-<..D. 8 ~~ - '3=-3
~b- 1:200,000.
E. 10
C. Lidocaine 2%, with epinephrine
103\ When performing a frenoplasty, a minimal 1:100,000.
amount of anes.thetic solution is used to D. Mepivacaine 3% plain.
preyep.t E. Prilocaine 4%, with epinephrine
1:200,000.
A. distortion of the tissues.
B. slouglting.
C .. re~ound bleeding.
D. irritation.
108\ Which of the following anesthetic agents are
104\ When used ALONE, which ofthe followina hydrolized by plasma cholinesterase?
;:.

agents will not produce satisfactory

anesthesia? 1. Prilocaine (citanest).
2. Lidocaine (xylocaine).
A. Chlorofonn, 3. Mepivicaine (carbocaine).
B. Cyclopropane. 4. Procaine.
C. Nitrous oxide.
D. Fluothane. A. (1) (2) (3)
 LA,GA & SEDATION
B. (1) and (3) B. Blood supply to the lungs.
C. (2) and·(4) C. Hemoglobin content of the blood.
D. (4) only D. Concentration of the anesthetic in the
E. All of the above. inspired mixture.
E. Solubility ofthe anesthetic in blood.
109\ Which ofthe following anaesthetic agents
is/are metabolized by plasma cholinesterase? i 14\ Which oftbe following drugs has/have
sedative properties?
1. Procaine.
2. Lidocaine (xylocaine). A. Benzodiazepines.
3. Mepivicaine (carbocaine). B. Barbiturates.
4. Prilocaine (citanest). C. Meperidine. --c..- ( 'QeY"'erv:-c \)
D. All of the above.
A. (1) (2) (3)
B. (1) and (2)
C. (1) only
115\ Which of the following drugs is used for
preoperative sedation?
c
D. All of the above.
A. Propoxyphene.
110\ Which of the following anatomic structures B. Phenylbutazone.
is/are potentially affected by administration of C. Diazepam.
local anesthesia? D. Atropine.

A. Internal maxillary artery. 116/ Which of the following drugs potentiates the
B. Pterygoid plexus of veins. action of sedative drugs? <( , , ,_- ~ "<'
C. Posterior superior alveolar nerve.
D. All ofthe above. A. Digitalis.
B. Phenothiazine. $ -
111\ Which ofthe following complications might C. Propranolol. \'.)
occur after administration of a local anesthetic D. Methyldopa. ___..,
agent? E. Spironolactone.

1. Convulsions. 117\ Which of the following is a sign oflocal

2. Nausea. anesthetic overdose?
3. Respiratory depression.
4. Cardiovascular collapse. A. Rash.
B. Wheezing.
C. Fainting.
A. (1) and (3) D. Convulsions.
B . (1) (3) (4) E. Swelling.
C, (2) and (3)
D. (3) and (4)
E. All of the above. 118\ Which of the following is NOT a component
of a dental cartridge containing 2% lidocaine
112\ Whi.c h. of the following constituents of a local with 1:100,000 epiniphrine?
anesthetic cartridge is most likely to be
allergenic? A. Methylparaben.
B. Water.
A. Lidocaine. C. Sodium metabisulphite.
B. Epinephrine. D. Sodium chloride. .
C. Metabisulfite.
D . .Hydrochloric acid.

113\ Which of the following does NOT influence

the rate of induction during inhalation
anesthesia?

A. Pulmonary ventilation.

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 LA,GA & SEDATION

119\ Which of the following is the most 4 . Anterior superior alveolar.

common reason f or the breakage of a local 5. Posterior superior alveolar.
anesthetic needle when performing an
inferior alveolar block? A. (1) (2) (4)
B. ( 1) (3) (4)
A. Use of25 gauge long needles. C. (1) (3) (5)
B. Too rapid injection of the local D. (2) (3) (5)
anesthetic. E. (2) (4) (5)
C. Use of 30 gauge short needles.
D. Manufacturer's defect. 124\ Which of the following provide the longest c
duration of anesthesia?
120\ Which of the following local anesthetics is
subject to inactivation by plasma esterases? A . Lidocaine 2% with 1:1 00,000
epinephrine.
A. Procaine. B. Prilocaine 4% with 1:200,000
B. Lidocaine. epinephrine.
C. Prilocaine. C. Bupivacaine 0.5% with 1:200,000
D. Mepivacaine. epinephrine.
E. Bupivacaine. D. A1ticaine 4% with 1:100,000
epinephrine.
121\ 'Which ofthe following nerves are
anesthetized by an infraorbital nerve block? 125\ Which of the following statements is/are true
regarding diazepam?
1. Zygomatico-temporal. \
2. Palpebral. i 'f'80' tay · \-l.,.}~ · 1. Its long duration of action is partly
3. Zygomatico-facial. due to active metabolites.
4. Lateral nasal: fl _ , , 2. It does not produce anti-anxiety
5. Labial. <;;~'V\.i.or ~,.,..\ effects after intramuscular administration.
3. Intravenous administration is more
A. (l) (2) (3) (4) reliable than oral.
B. (1) (2) (3) 4. Its sedative effect can be reversed by
C, (2) (3) (4) (5) naloxone. ~~~~·....(.
D. (2) (3) (4)
E. (2) (4) (5)
A. (1) (2) (3)
122\ Which of the following nerves should be B. (1) and (3)
anesthetized for extraction of a maxillary C. (2) and (4)
lateral incisor? D. (4) only .
E. All ofthe above.
L Nasociliary.
2. Nasopalatine.
3. Sphenopalatine.
126\ Which of the following will allay or minimize
the emotional factors which may predispose to
0
4. Anterior superior alveolar. syncope?

A. (l) (2) (3) A. Secobarbital.

B. (1) and (3) B. Diazepam.
C. (2) and (4) C. Phenobarbital.
D. (4) only . D . All of the above.
E. All ofthe above. E. None of the above.

123\ Which of the following nerves should be 127\ Which of the following would you prescribe
anesthetized for the removal of a maxillary for an anxious dental patient with a peptic
first molar? ulcer?

1. Greater palatine. A. Reserpine.

2. Naso palatine. B. Scopolamine.
3. Middle superior alveolar. C. Silica gel.

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 LA,GA & SEDATION

D. Diazepam. D. They are capable of blocking every

E. Calcium carbonate. type of nerve tissue.
E. All ofthe above.
128\ Which one of the following describes the
position of the needle tip during 132\ With respect to local anesthetic, which of Q
administration of local anesthetic for the the following will elicit the most rapid U
inferior alveolar nerve block? response in a patient?

A. Anterior to the pterygomandibular A. Too large a dose.

raphe. B. Rapid absorption.
B. Medial to the medial pterygoid C. Slow elimination.
muscle. D. Intravascular injection.
C. Superior to the lateral pterygoid E. Slow biotransformation.
muscle.
D. Lateral to the sphenomandibular
ligament.

129\ Which properties increase the tendency of a

drug to cross membranes?

A. Non-ionized and high lipid

solubility.
B . Non-ionized and low lipid solubilit'J.
C. Ionized and .low lipid solubility.
D. Ionized and water solubility.

130\ Which statement(s) is/are true about

diazepam?

1. It improves performance rating of

fme' motor skills.
2 . It is more toxic when taken with
ethyl alcohol.
3 .. It is available without prescription in
Canada.
4. It produces a typical dependence
syndrome.

A. (I) (2) (3)

B. (1) and (3)
C. (2). and (4)
D. (4) only
E, All of the above.

131\ With respect to local anaesthetics, which of f::

the following statements is/are correct?

A. Certain nerve fibers are more

susceptible.
B. In mixed nerves, sensory fibers are
more susceptible.
C. Anaesthetics are marketed as water
soluble acid salts.

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