Anesthesia

General Anesthesia
1) Thiopentone sodium (Pentothal) provides all
6) ln a safe general anesthetic mixture, the
of the following advantages EXCEPT
MINIMALLY acceptable percentate of oxygen
is
A. smooth pleasant induction.
B. good sleep production.
C. rapid recovery.
A. 5 percent.
D. acceptability for both young and old. B. 10 percent.
C. 20 percent.
E. adequate length of operating time.
D. 50 percent.
E. 80 percent.
2) Patient nausea during nitrous oxide
administration is an indication that the patient
7) A patient is premedicated prior to general

A. is nervous. anaesthesia in order to

B. has not eaten for some time.
C. is allergic to nitrous oxide.
L. lessen metabolic activitY.
D. has received the nitro.us oxide too
2. depress reflex irritabilitY.
quickly. 3. control excess salivation.
4. avoid haemorrhage.
3) The use of conscious sedation for a
A. (1)(2)(3)
restorative procedure in an office environment
B. (L)and (3)
C. (2) and (a)
A. requires the services of an anesthetist.
D. (4)only
B. is contraindicated in children.
C. precludes the use of local anesthesia.
E. All of the above
D. requires effective local anesthesia.
8) Cardiac arrhythmias are most commonly
E. may be used in conjunction with narcotics.
seen during administration of
4) For a patient with a history of glaucoma and
porphyria, the pharmaco-sedation technique A. thiopental.
preferred is B. halothane.
C. ethyl ether.
A. intravenous secobarbital.
D. nitrous oxide.
B. intravenous diazepam.
C. oral diazepam.
9)The majority of nitrous oxide is eliminated
D. nitrous oxide.
from a patient's circulatory system through the
E. intravenous thiopental.
A. lungs.

5) The primary use of nitrous oxide and oxygen

B. kidneys.
in dentistry today is as a(n) C. liver enzymes.
D. plasma enzymes.
A. substitute agent for local anesthesia. E. intestinal gas.
B. general anesthetic agent.
C. agent for conscious sedation.
D. agent for the management of chronic
obstructive pulmonary disease.
 Anesthesia

10) Which of the following does NOT influence 14) Signs and stages of anesthesia are most
the rate of induction during inhalation likely to be seen with a genera! anesthetic that
anesthesia? has a

A. Pulmonary ventilation. a. Low potency

B. Blood supply to the lungs. b. Slow rate of induction
C. Hemoglobin content of the blood. c. Low Ostwald coefficient
D. Concentration ofthe anesthetic in the d. High oil-water solubility coefficient
insplred e. High tissue-blood partition coefficient
mixture.
E. Solubility of the anesthetic in blood. 15) All of the following influence the rate of
induction during anesthesia EXCEPT:
11) When used ALONE, which of the following
agents will not produce satisfactory a. Pulmonary ventilation
anesthesia? b. Blood supply to the lungs
c. Hemoglobin content of the blood
A. Chloroform. d. Concentration ofthe anesthetic in the
B. Cyclopropane. inspired mixture
C. Nitrous oxide. e. Solubility of the anesthetic in blood (blood-
D. Fluothane. gas partition coefficient, Ostwald coefficient).

12) ln addition to analgesia, pentazocine
A. produces sedation.
B. reduces elevated temperature.
C. has anti-inflammatory properties.
D. produces peripheral vasoconstriction.
13) Nitrous oxide
15) The rapidity of onset of anesthesia with an
inhalation anesthetic agent is primarily related
to its
a. Molecular weight
b. Degree of blood solubility
c. Temperature in the gas phrase
d. Interaction with preoperative drugs

1. provides good muscle relaxation. 17) Which of the following forms of drug
2. is non-explosive and non-flammable toxicity is associated with the
3. is a potent anesthetic. halogenated hydrocarbon general anesthetics?
4. provides rapid induction and
recovery. a. Liver damage
b. Myocardial atrophy
A. t1)(2)(3) c. Peripheral neuritis
B. (2)and (3) d. Severe hypertension
C. (2) and (a)
D. (4)onty
E. All ofthe above.
 Anesthesia

18) The behavior of patients under general
anesthesia suggests that the most resistant
part of the central nervous system is the
a. Spinal cord
b. Medulla oblongata
c. Cerebral cortex (motor area)
d. Cerebral cortex (sensor area)
221 Nl of the following pertain to general
anesthesia induced by thiopental EXCEPT:
a. Fast induction
b. Decreased secretions
c. Low therapeutic index
d. Short duration of anesthesia
e. Predisposition to laryngospasm

Local Anesthetics Pharmacology

19) General anesthetics can do all of the
following EXCEPT:
1)Which of the following anesthetic agents
is/are metabolized by plasma
a. Produce delirium
cholinesterase?
b. Stimulate medullary centers
c. Produce a state of unconsciousness
1. Prilocaine (CitanestE).
d. Reduce perception of painful stimuli
2. Lidocaine (XylocaineB).
e. Decrease excitability of the motor cortex
3. Mepivicaine (CarbocaineE).

20) ln general anesthesia, the last part ofthe 4. Procaine (NovocainE).

CNS to be depressed is the

A. (1) (2) (3)
B. (1) and (3)
a. Medulla
C. (2) and (a)
b. Cerebrum
D. (a)only
c. Midbrain
E. All of the above.
d. Cerebellum
e. Spinal cord
2)Lidocaine (Xylocaine)
21) General anesthesia with halothane is
1. is a local anesthetic agent.
commonly preceded by administration of
atropine to
2. has topical anesthetic properties.
3. is an antiarrhythmic agent.
a. inhibit vagal overactivity commonly caused by
4. has anticonvulsant properties.
haloth'ane
b. induce muscular relaxation by blocking
A. (1)(2)(3)
cholinergic receptors
B. (1)and (3)
c. reduce salivation and bronchial secretions
C. (2) and (a)
caused by halothane
D. (4)only
E. All ofthe above.
d. all of the above.
 Anesthesia

3)lt is difficult to obtain satisfactory anesthesia 5)What is the maximum number of artridges
in the presence of infection near the injection (1.8mtl of a 2% local anesthetic solution that
site because can be administered without exceeding a total
dose of 300mg?
A. the swelling causes increased pressure on the
nerves. A.2
B. increased blood supply carries the anesthetic 8.4
solution away too fast. c.6
C. acidity of the infected tissue inhibits action of D.8
the anesthetic agent. E. 10
D. alkalinity of the infected tissue inhibits action
of the anesthetic agent. 7)The first sensation lost after administration
of a local anesthetic is
4)In a standard dental cartridge (carpule)
containing l.8ml Zoh lidocaine with A. pain.
epinephrine 1/100,000, the amount of B. touch.
vasoconstrictor is C. pressure.
D. proprioception.
A. 18.0 mg.
B. 0.018 mg.
8)Which of the following local anesthetics is
C. 1.8 mg.
subject to inactivation by plasma esterases?
D.0.18 mg.
E. 180.0 mg.
A. Procaine.
B. Lidocaine.
5)Epinephrine in a local anaesthetic solution
C. Prilocaine.
will
D. Mepivacaine.
E. Bupivacaine.
1,. prevent rapid absorption of the
anaesthetic.
9)During drug-receptor interaction, local
2. assist haemostasis at the site of
anesthetics interfere with the transport of
injection.
which of the following ions?
3. prolong the action of the anaesthetic
agent. A. Sodium.
. 4. assist in post-operative healing. B. Calcium.
C. Chloride.
A. (1)(2)(3) D- Potassium.
B. (1) and (3) E. Magnesium.
C. (2) and (a)
D. (4)only 1.0)ln local anesthesia, depression of
E. All ofthe above. respiration is a manifestation of

A. puncture of a blood vessel.

B. use of non-isotonic solution.
C. toxic effects of the solution.
D. trauma to a nerve trunk by the
needle.
T

Anesthesia

11)Hydrolysis of anesthetic salts is facilitated

by 16)The first sign of a toxic reaction to an
injected localanesthetic solution would be
A. a tissue pH above 7.0.
B. a tissue pH below 5.0. A. convulsions.
C. a tissue pH between 5.0 and 7.0. B. erythematous rash.
D. lipophilic properties of the nerve C. asthmatic attack.
fibres. D. excitement.

l2)Cardiovascular collapse caused by a high l7)Which of the following is NOT a component

circulating dose of a local anesthetic is due to of a dental cartridge containing Z%olidocaine
with 1:100,fi)0 epiniphrine?
A. vagal stimulation.
B. histamine release. A. Methylparaben.
C. myocardial depression. B. Water.
D. medullary stimulation. C. Sodium metabisulphite.
D. Sodium chloride.
l3)Which of the following constituents of a
local anesthetic cartridge is most likely to be 18)Local anesthetic injected into dental
allergenic? abscesses is rarely effective because

A. Lidocaine. can metabolize the local anesthetic'

A. bacteria
B. Epinephrine. B. edema dilutes the local anesthetic.
C. Metabisulfite. C. the tissue is too acidic.
D. Hydrochloric acid. D. there is excessive vasoconstriction.

14)The selection of a vasoconstrictor for a 19)With respect to local anesthetic, which of

local anesthetic depends upon the following will elicit the most rapid
response in a patient?
A. the duration of the operation.
B. the need for hemostasis. A. Too large a dose.
C. the medical status of the patient. B. Rapid absorption.
o. all ofthe above. C. Slow elimination.
D. lntravascular injection.
15)Vasoconstrictors in a loca! anesthetic E. Slow biotransformation.
solution
20)Local anesthetics
1. retard absorption.
2. increase duration of action. A. do not readily pass the blood-brain barrier.
3. permit smaller volumes to be used. B. interfere with the propagation of action
4. have low toxicity when given potentials in nerve fibres.
intravenously. C. selectively interfere with the propagation of
action potentials in nociceptive fibres.
A. (1)and (a) D. do not have an effect on any other tissue
B. (2)and (a) than the nervous tissue.
c. (1) (2)t3)
D. All of the above.
 Anesthesia

21)Which of the following provide the longest 25)The local anesthetic lidocaine is an
duration of anesthesia?
A. amide.
A. Lidocaine2%wrth1:100,000epinephrine. B. ester.
B. Prilocaine 4%with 1:200,000epinephrine. C. aldehyde.
C. BupivacaineA.S%with 1:200,000 D. acid.
epinephrine.
D. Articaine 4%with 1:1"00,000 epinephrine. 27)Procaine (Novocaine@) is an example of a
d. all of the above. local anesthetic which is chemically classified
as an

22)Which of the foliowing is a sign of loca! A. amide.

anesthetic overdose? B. ester.
C. aldehyde.
A. Rash. D. ethamine.
B. Wheezing. E- aminide.
C. Fainting.
D. Convulsions. 28)Local anesthetics block nerve conduction by
E. Swelling. interfering with ionic movement of

lidocaine
23)One millilitre ol aZYo solution of A. calcium.
hydrochloride contains how many milligrams B. potassium.
of the drug? C. sodium.
D. chloride.
A.2
B. 20 29)Local anesthetics are less effective in
c. 200 inflamed tissue because they are
D. 2000
A. diluted by the edematous fluid.
2LlFor a patient with cardiovascular disease, B. rapidly redistributed by the increased blood
local anesthesia flow.
C. ionized by the acidic pH.
A. affects blood pressure more than general D. rapidly degraded by released enzymes.
anesthesia.
B. affects blood pressure less than general 30)Which local anesthetic formulation should
anesthesia. be used to achieve prolonged pain relief for a
C. is responsible for bacteremia. patient requiring the sur$ical extraction of
D. None ofthe above. tooth 3.8?

25)Extrusion of the rubber stopper of a local
anesthetic cartridge is most likely caused by
A. faulty manufacturing.
B. storage in a disinfectant solution.
C. exposure to excessive heat.
D. breakdown of the anesthetic solution.
A. Articaine 4o/o, with epinephrine 1:100,000.
B. BupivacaineO.5%o, with epinephrine
1:200,000.
C. Lidocaine Z%,with epinephrine 1:100,000.
D. Mepivacaine 3% plain.
E. Prilocaine 4%,with epinephrine 1:200,000
 Anesthesia
31)Which of the following complications might
occur after administration of a local anesthetic
agent?
1. Convulsions.
2. Nausea.
3. Respiratory depression.
4. Cardiovascular collapse.
A. (1) and (3)
B. (1)(3)(4)
C. (2) and (3)
D. (3)and (a)
E. All ofthe above.
32)An immediate toxic reaction to a local
anesthetic administration is
A. deterioration of the anesthetic agent.
B. hypersensitivity to the vasoconstrictor.
C. hypersensitivity to the anesthetic agent.
D. excessive blood level of the anesthetic
agent.
33)With respect to local anaesthetics, which of
the following statements isgare correct?
A. Certain nerve fibers are more susceptible.
B. ln mixed nerves, sensory fibers are more
susceptible.
C. Anaesthetics are marketed as water- soluble
acid salts.
D. They are capable of blocking every type of
nerve tissue.
E. All ofthe above.
TeChniqueS
1) The use of aspirating syringes for the
administration of local anesthetics is
recommended because
l-.the effectiveness of Jocal anesthesia is
increased.
2.aspiration of blood is proof that the
needle is in an intravascular
location.
3.their use removes the hazard of rapid
injection and provides a
Distinct saving of time.
4.their use reduces the frequency of
accidenta I intravenous injection.
A. (1) and (2)
B. (1)and (3)
C. (2) and (a)
D. All of the above.
2) Aspiration is carried out prior to a local
anaesthetic injection in order to reduce the
A. toxicity of local anaesthetic.
B. toxicity of vasoconstrictor.
C. possibility of intravascular administration.
D. possibility of paraesthesia.
3) During the administration of local
anesthesia, positive aspiration of blood witl
occur most often in a/an
A. mentalor incisive block.
B. posterior superior alveolar block.
C. inferior alveolar block.
D. anterior superior alveolar block.
E. long buccal nerve block.
4) tn a standard inferior alveolar nerve block,
which muscle is penetrated by the needle?
A. Buccinator.
B. Mylohyoid.
C. Superior constrictor.
D. Massetei.
E. Medial (internal) pterygoid.
 Anesthesia

5) The left infraorbital nerve block

anaesthetizes 10) Which of the following nerves are
anesthetized by an infraorbital nerve block?
A. all maxillary teeth on the left side.
B. the maxillary premolar on the left side, 1. Zygomatico-temPoral.
canine and incisor teeth. 2. Palpebral.
C. the left maxillary canine and incisor teeth 3. Zygomatico-facial.
only. 4. Lateral nasal.
D. the entire left maxillary sinus. 5. Labial.
E. the entire left naso-lacrimal duct.
A. (1) (2)(3)(4)
6) Which one of the following describes the B. (1) (2) (3)
position of the needle tip during c. (2) (3)(4) (s)
administration of local anesthetic for the D. (2)(3)(4)
inferior alveolar nerve block? E. (2) (4) (s)

A. Anterior to the pterygomandibular raphe. 11) Which of the following nerves should be
B. Medialto the medial pterygoid muscle. anesthetized for the removal of a maxillary
C. Superior to the lateral pterygoid muscle. first molar?
D. Lateralto the sphenomandibular ligament.
l-. Greater palatine.
7) The surgical removal of tooth 3.6 requires 2. Naso palatine.
anesthesia of the inferior alveolar nerve as 3. Middle superior alveolar.
well as which of the following nerves? 4. Anterior superior alveolar.
5. Posterior superior alveolar.
A. Lingual, cervical plexus.
B. Cervical, long buccal. A. (1)(2)(4)
C. Lingual, long buccal. B. (1)(3)(4)
D. Mental, long buccal. c. (1) (3) (s)
D. (2) (3)(s)
8) With respect to local anesthetic, which of E. (2) (4) (5)
the following will elicit the most rapid
response in a patient?

A. Too large a dose.

B. Rapid absorption.
C. Slow elimination.
D. lntravascular injection.
E. Slow biotransformation.

9) When performing a frenoplasty, a minimal

amount of anesthetic solution is used to
prevent

A. distortion of the tissues.

B. sloughing.
C. rebound bleeding.
D. irritation.
 Anesthesia

Complications
4) lmmediately following a posterior superior
alveolar block iniection, the patient's face
1) lmmediately following a left posterior
becomes quickly and visibly swollen. The
superior alveolar nerve block injection, the
immediate treatment should be to
patient's face becomes quickly and visibly
swollen on the teft side. The immediate
A. use pressure followed by cold packs over the
treatment should be to
swelling.
B. use hot packs over the swelling'
1. apply a cold comPress.
C. refer the patient to a hosPital'
2. administer 0.3mg ePinePherine
D. administer 100mg hydrocortisone
{sublingually).
intravenously.
3. apply pressure.
4. refer for immediate medical
E. administer diphenhydramine hydrochloride
(Benadryl@) 50mg intravenouslY'
treatment.

5) A patient suddenly becomes pale and

A. (1)(2)(3)
sweaty after an injection of 4ml of lidocaine
B. (1) and (3)
2% with epi nephri ne I :100,000. The radial pulse
C. (2) and (a)
is slow and steady. The respiration is slow. The
D. (a)only
blood pressure is 80/60. What is the most
E. All of the above.
probable diagnosis?
2) Local anesthetic toxicitY
A. to lidocaine.
A toxic reaction

A. is more likely to occur with the addition of

B. A toxic reaction to epinephrine'
C. An allergic reaction to the local anesthetic'
epinephrine.
D. lncipient syncope.
B. is more likely to occur in adults.
E. An impending adrenal insufficiency.
C. may manifest as a seizure.
6) After an inferior alveolar nerve block
3) Shortly after the administration of an
injection, a patient would develop seventh
inferior alveolar nerve block, a healthy adult
nerve paralysis if the injection was made into
patient rapidly develops a facial rash. Which of
the
the following signs and symptoms should be
watched for before initiating the planned
A. internal maxillary artery.
dental treatment?
B. retroparotid sPace.
C. internal pterygoid muscle.
1. Pallor and PersPiration.
D. retromandibular vein.
2. Shortness of breath.
E. pterygoid plexus of veins.
3. Hyperventilation.
4. Edema of the lips.

A. (1)(2) (3)
B. (1) and (3)
C. (2) and (a)
D. (4)only
E. All ofthe above.