Dental Hygiene Care for Medically Compromised Patients
Exam Answer Key
Course Introduction
This course focuses on the specialized dental hygiene care required for patients with complex medical conditions, such as cardiovascular diseases, diabetes, cancer, immunocompromised states, and other systemic illnesses. Students will learn to assess medical histories, understand the implications of various diseases and their treatments on oral health, modify dental hygiene care plans accordingly, and collaborate effectively with other healthcare professionals. Emphasis will be placed on infection control, risk assessment, emergency preparedness, and ethical considerations in delivering safe, evidence-based care to medically compromised individuals.
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
Source URL: https://quizplus.com/study-set/1615
2
Chapter 1: Patient Evaluation and Risk Assessment
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10 Verified Questions
10 Flashcards
Source URL: https://quizplus.com/quiz/32075
Sample Questions
Q1) Which of the following is true of the patient with a history of tuberculosis?
A) A positive result on skin testing means that the person has active TB.
B) Most patients who become positive skin testers develop active disease.
C) Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of tuberculosis.
D) A diagnosis of active TB is made by a purified protein derivative (PPD) skin test.
Answer: C
Q2) Vasoconstrictors should be avoided in patients who are using cocaine or methamphetamine because these agents may precipitate _________.
A) severe hypotension
B) severe hypertension
C) respiratory depression
D) cessation of intestinal peristalsis
Answer: B
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Chapter 2: Infective Endocarditis
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) 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
Q2) Visible bleeding during a dental procedure is a reliable predictor of bacteremia.It is not clear which dental procedures are more or less likely to cause transient bacteremia or to result in a greater magnitude of bacteremia than that caused by routine daily activities such as chewing food,toothbrushing,or flossing.
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.
Answer: D
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4
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) It is estimated that about __% of all blood pressure-related deaths from coronary heart disease occur in persons with blood pressure in the prehypertensive range.
A) less than 1
B) 5
C) 15
D) 25
Answer: C
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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Page 5
Chapter 4: Ischemic Heart Disease
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10 Flashcards
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Sample Questions
Q1) Which of the following is true concerning the incidence and prevalence of ischemic heart disease in the United States?
A) About 50% of the population is estimated to have some form of cardiovascular disease.
B) Cardiovascular disease begins in middle life.
C) The annual mortality rate for cardiovascular diseases has been declining since 1940.
D) Cancer has replaced coronary heart disease as the leading cause of death in the United States after age 65.
Q2) Which of the following is the most important symptom of coronary atherosclerotic heart disease?
A) pitting edema
B) dysphagia
C) dyspnea
D) chest pain
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Chapter 5: Cardiac Arrhythmias
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) Which of the following sequences correctly depicts the normal pattern of sequential depolarization of the structures of the heart?
(1)right and left bundle branches (2)sinoatrial (SA)node (3)subendocardial Purkinje network (4)bundle of His (5)atrioventricular (AV)node
A) 5, 2, 4, 1, 3
B) 2, 5, 4, 1, 3
C) 2, 3, 4, 1, 5
D) 2, 5, 3, 1, 4
Q2) 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
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Chapter 6: Heart Failure or Congestive Heart Failure
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) 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
Q2) 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
Q3) Which of the following categories of drugs is considered to be first-line therapy for the treatment of heart failure?
A) digitalis glycosides
B) -adrenergic blockers
C) angiotensin-converting enzyme (ACE) inhibitors
D) angiotensin receptor blockers (ARBs)
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8
Chapter 7: Pulmonary Disease
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which of the following medications is associated with "triad asthmaticus"?
A) methotrexate
B) nonspecific beta blockers
C) aspirin
D) penicillin
Q2) Any time a patient demonstrates unexplained,persistent signs or symptoms that may be suggestive of TB,or has a positive result on skin testing or IGRA,and has not been given follow-up medical care,_________.
A) it is appropriate to treat the patient using standard precautions
B) respiratory equipment should be used during provision of dental care
C) only treatment that utilizes a rubber dam should be provided
D) dental care should not be rendered, and the patient should be referred to a physician for evaluation
Q3) The most important cause of chronic obstructive pulmonary disease (COPD)in the world is ________.
A) occupational pollutants
B) environment pollutants
C) tobacco smoking
D) allergy
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Page 9
Chapter 8: Smoking and Tobacco Use Cessation
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) How long does it take nicotine blood levels to return to baseline after smoking a cigarette?
A) 1 minute
B) 25 to 30 minutes
C) 3 to 5 hours
D) 1 day
Q2) 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
Q3) 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.
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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) Most people who snore do not have OSA,but almost all patients with OSA snore.
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.
Q2) Which of the following is characteristic of REM sleep?
A) synchronous brain waves
B) low-voltage EEG waves
C) mental inactivity
D) physiologic stability
Q3) 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)
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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 thought to be the major factor in the pathogenesis of liver injury?
A) antibody-dependent cellular cytotoxicity
B) proinflammatory cytokines
C) cytotoxic T cell responses
D) natural killer cell activity
Q2) Which of the following tests is the best way to screen for problems before dental treatment of an alcoholic patient?
A) bilirubin total
B) alkaline phosphatase total
C) LDH total
D) a complete blood count (CBC)
Q3) Which of the following is the most common means by which hepatitis A is spread?
A) consumption of shellfish from contaminated waterways
B) fecal contamination of food or water
C) direct person-to-person exposure
D) blood transfusions
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12
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 is the most common location for peptic ulcers in Western populations?
A) stomach
B) duodenum
C) jejunum
D) ileum
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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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Which of the following is an oral manifestation of kidney disease?
A) increased salivary flow due to decreased renal filtration
B) blue discoloration of the cheeks due to reduced hemoglobin-carrying capacity of red blood cells
C) characteristic acetone-like odor of breath
D) pallor of oral mucosa related to anemia
Q2) Which of the following is the most common cause of end-stage renal disease (ESRD)?
A) polycystic kidney disease
B) diabetes mellitus
C) hypertension
D) chronic glomerulonephritis
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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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) A chancre is associated with ______ syphilis.
A) primary
B) secondary
C) tertiary
D) latent
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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Chapter 14: Diabetes Mellitus
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) What are recommendations to prevent insulin shock during a routine dental appointment in a patient with diabetes?
A) Skip their usual insulin dose prior to the appointment.
B) Schedule a morning appointment.
C) Skip their normal meal (fast) prior to the appointment.
D) a and b
E) b and c
Q2) The relative risk that patients with diabetes will require amputation of an extremity because of diabetic complications is more than ___ times that of normal persons.
A) 10
B) 20
C) 30
D) 40
Q3) Which of the following types of human insulin are used at meals for type 1 diabetes?
A) lispro and aspart
B) lente
C) ultralente
D) a and b
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Chapter 15: Adrenal Insufficiency
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) 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
Q2) Which of the following is true of the physiologic actions of cortisol?
A) insulin agonist
B) increases blood pressure
C) anti-inflammatory action
D) a and b
E) b and c
Q3) "Moon facies" is associated with ________.
A) mineralocorticoid excess
B) mineralocorticoid deficiency
C) glucocorticoid excess
D) glucocorticoid deficiency
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Chapter 16: Thyroid Diseases
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which of the following is characteristic of red blood cells in thyrotoxic patients?
A) pancytopenia
B) leukopenia
C) thrombocytopenia
D) polycythemia
Q2) Which of the following signs and symptoms are associated with Graves' disease?
1.weight loss
2.weight gain
3.rapid heartbeat
4.slow heartbeat
A) 1, 3
B) 2, 3
C) 1, 4
D) 2, 4
Q3) The term _____________ refers to an excess of T and T in the bloodstream.
A) thyrotoxicosis
B) myxedema
C) cretinism
D) acropachy
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Page 18
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) What should a pregnant dental auxiliary or dentist do to protect herself and her baby from potential fetal exposure to x-radiation?
A) Stay in a remote area of the dental office, and avoid locations where x-radiation is utilized.
B) Wear a lead apron the entire time in the office, and avoid circumstances of exposing x-ray films.
C) Utilize digital radiography rather than film-based radiography.
D) Wear a film badge, stand more than 6 feet from the tubehead, and position herself at between 90 and 130 degrees of the beam, preferably behind a protective wall.
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Chapter 18: Aids, HIV Infection, and Related Conditions
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Sample Questions
Q1) Which of the following types of gingival erythema is associated with the HIV positive patient?
A) papillary gingivitis
B) diffuse gingivitis
C) linear gingival erythema
D) desquamative gingivitis
Q2) 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
Q3) 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
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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) Most patients with asthma who react to NSAIDs also have ______.
1.nasal polyps
2.type II diabetes
3.orthostatic hypotension
4.gout
A) 1, 3
B) 2, 4
C) 1
D) 2
Q3) Foreign substances that trigger hypersensitivity reactions are called ________.
A) antigens
B) pathogens
C) pyrogens
D) toxoids
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Chapter 20: Rheumatologic and Connective Tissue Disorders
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20 Flashcards
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Sample Questions
Q1) What is a pannus?
A) It is excessive proliferative and invasive granulation tissue.
B) It is a drug interaction that interferes with platelet function and causes excessive bleeding.
C) It is a sudden retrognathia and anterior open bite caused by destruction of the condylar heads and loss of condylar height.
D) It is worn subchondral bone that becomes polished and sclerotic.
Q2) Which of the following characteristics is used to distinguish fibromyalgia (FM)from myofascial pain syndrome (MFP)?
A) Regional rather than widespread muscular pain is associated with FM.
B) The pain in FM is relatively stable and consistent in contrast to MFP.
C) When the muscle pain is primarily due to the FM, it may not respond as well as the jaw pain from MFP because FM is a systemic and not a local condition.
D) a and b
E) b and c
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Chapter 21: Organ and Bone Marrow Transplantation
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Sample Questions
Q1) Which of the following is the standard immunosuppressive drug used to prevent organ graft rejection?
A) tacrolimus
B) cyclosporine
C) cyclophosphamide
D) daclizumab
Q2) 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
Q3) Which of the following types of transplant recipients has the highest reported 1-year patient survival rate?
A) liver
B) intestine
C) kidney
D) lung
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23
Chapter 22: Disorders of Red Blood Cells
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Sample Questions
Q1) 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.
Q2) Which of the following types of food contain folate?
A) red meat
B) grains
C) leafy vegetables
D) a and b
E) b and c
Q3) Which of the following dental local anesthetics should be avoided in a patient with sickle cell anemia?
A) lidocaine
B) mepivacaine
C) prilocaine
D) articaine
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24
Chapter 23: Disorders of White Blood Cells
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Sample Questions
Q1) What is the minimum time that should be allowed between a tooth extraction and the initiation of chemotherapy for a patient with a white blood cell disorder such as leukemia or lymphoma?
A) 1 week
B) 2 weeks
C) 4 weeks
D) 8 weeks
Q2) 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
Q3) Burkitt lymphoma that is found most often in Central Africa is known as ________.
A) essential
B) endemic
C) sporadic
D) idiopathic
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25
Chapter 24: Acquired Bleeding and Hypercoagulable Disorders
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Sample Questions
Q1) Warfarin anticoagulation therapy should be continued prior to minor oral surgery and other similarly invasive dental procedures if the INR is __ or less.
A) 2.5
B) 3.5
C) 4.5
D) 5.5
Q2) Activation of factor ___ serves as a common link between the component parts of the homeostatic mechanism: blood coagulation,fibrinolytic,kinin,and complement systems.
A) II
B) V
C) VII
D) XII
Q3) Which of the following medications is the best choice for postoperative pain control in a patient taking warfarin (Coumadin)?
A) celecoxib
B) acetaminophen
C) aspirin
D) ibuprofen
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Chapter 25: Congenital Bleeding and Hypercoagulable Disorders
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Sample Questions
Q1) A female carrier of hemophilia A will transmit the disorder to ____ of her sons and the carrier trait to _____ of her daughters.
A) half; half
B) none; half
C) half; none
D) none; none
Q2) Which of the following blood tests is used to measure the status of the intrinsic and common pathways of coagulation?
A) platelet count
B) aPTT
C) PT
D) TT
Q3) von Willebrand factor (vWF)is needed to ________________.
A) preserve the integrity of the capillary vessel wall
B) catalyze the fibrinolytic phase of clot lysis
C) attach platelets to damaged vascular wall tissues and to carry factor VIII in circulation
D) stimulate formation of platelets
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Chapter 26: Cancer and Oral Care of the Cancer Patient
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Sample Questions
Q1) Which of the following is the leading cause of cancer deaths in the United States?
A) colon cancer
B) breast cancer
C) lung cancer
D) bone cancer
Q2) Prophylactic antibiotics are often recommended for a neutropenic patient if the white blood cell count (WBC)is less than _____.
A) 2,000
B) 1,000
C) 500
D) 250
Q3) Which of the following is the preferred approach for evaluating a patient for colorectal cancer?
A) sigmoidoscopy
B) digital rectal examination
C) colonoscopy
D) barium enema with air contrast
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28
Chapter 27: Neurologic Disorders
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Sample Questions
Q1) Parkinson's disease is a disorder of neurons that produce which of the following neurotransmitters?
A) dopamine
B) acetylcholine
C) epinephrine
D) endorphin
Q2) Which of the following antibiotics should not be administered to a patient who is taking carbamazepine (Tegretol)for management of epilepsy?
A) penicillin
B) erythromycin
C) ciprofloxacin
D) cephalexin
Q3) Calcified atherosclerotic plaques seen in the carotid arteries of elderly and diabetic patients on panoramic images warrant referral to the patient's physician because they indicate an increased risk for _________.
A) cardiac arrhythmia
B) orthostatic hypotension
C) stroke
D) ventricular fibrillation
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Page 29
Chapter 28: Anxiety, eating Disorders, and Behavioral
Reactions to Illness
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Q1) Which of the following types of medications are the standard agents for antianxiety therapy?
A) sedative-hypnotics
B) antihistamines
C) beta blockers
D) benzodiazepines
Q2) Opioids used for dental sedation or pain control must be administered with caution and in decreased dosage in patients who are taking a benzodiazepine for an anxiety disorder in order to avoid _________.
A) cardiac stimulation
B) overdepression of the CNS
C) liver toxicity
D) renal failure
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
30
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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) Many over-the-counter (OTC)cold remedies should not be prescribed for patients taking monoamine oxidase (MAO)inhibitors because the cold remedies contain
A) phenylephrine
B) tyramine
C) allopurinol
D) epinephrine
Q3) 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
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Chapter 30: Drug and Alcohol Abuse
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Sample Questions
Q1) Gingival recession and erosion of the facial aspects of the maxillary teeth can occur with intraoral use of _________ due to persistent rubbing of the powder over these surfaces.
A) pseudoephedrine
B) benzodiazepine
C) cocaine
D) ecstasy
Q2) Why is disulfiram used for some patients during alcohol rehabilitation?
A) It reduces delirium tremens ("DTs") due to abrupt withdrawal of alcohol.
B) It causes nausea and vomiting when taken with alcohol.
C) It induces restful sleep patterns during withdrawal from alcohol.
D) It reduces elevated blood pressure and tachycardia.
Q3) 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
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