Case 17
Your patient is a 60-year old Caucasian male who is a sales representative for a national company and is on the road most of the time. He is
... [Show More] married and has adult children who live in another state.
If anesthesia were to be required to debride the teeth with furcations and deeper pockets, what would be the best choice of an anesthetic agent for this patient, taking into consideration, his medical history?
A. Lidocaine HCL 2% with epinephrine 1:100,000
B. Articaine HCL 4% without epinephrine
C. Prilocaine HCL 4% Plain
D. Bupivicaine HCL 0.5% with epinephrine 1:200,000 - correct answer A
Taking into consideration, the patient's clinical, radiographic and historical findings, how would you classify his periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-Implant Diseases?
A. Stage II, Grade B
B. Stage III, Grade B
C. Stage III, Grade C
D. Stage IV, Grade B - correct answer B
Given the patient's blood pressure reading, how would you classify it based on the new AHA/ACC Guidelines?
A. Normal
B. Elevated
C. Stage 1
D. Stage 2 - correct answer D
Of the medications that the patient is currently taking, which might be responsible for his current blood pressure reading?
A. Prilosec should not be taken with Amlodipine
B. Motrin should not be taken with Prilosec
C. Amlodipine and Ramipril should not be taken with Ibuprofen
D. Ramipril and Amlodipine should not be taken together - correct answer C
Given the amount of deposit, pocket depths, and bleeding index, what would be the best approach for a dental hygiene care plan?
A. Quadrant scaling with local anesthesia, using both ultrasonics and hand instruments, polishing of the teeth
B. Ultrasonic scaling throughout the mouth, followed by some hand scaling if necessary, selective polishing
C. Hand scaling of all areas of the mouth, polishing of all teeth and topical fluoride application
D. Local anesthesia for #2 & # 31, ultrasonic scaling of all areas of the mouth followed by hand scaling if necessary - correct answer D
Upon observing the patient's study models, how would you BEST describe the patient's centric occlusion?
A. Open bite
B. Overjet
C. End-to-end
D. Crossbite - correct answer B
The posterior bitewing radiographs on the right side demonstrate a technique error due to:
A. Insufficient vertical angulation
B. Excessive vertical angulation
C. Film packet placement
D. Horizontal angulation of the cone - correct answer C
The facial characteristics at the gingival margins observed on both teeth #8 and #9 are most likely due to what?
A. Bruxism habit
B. Sucking on acidic lozenges
C. Clenching habit
D. Scrub brushing - correct answer B
The patient indicated that he has been getting recurrent painful ulcers in his mouth since he quit smoking, what do you suspect these ulcers might be?
A. Herpetic lesions
B. Traumatic ulcers
C. Apthous ulcers
D. Acid reflux - correct answer C
After discussing his brushing and flossing technique with him, what other home care recommendations would you make for him?
A. Purchase a power toothbrush; use a toothpaste with stannous fluoride; use a proxabrush between the posterior teeth
B. Use an air flosser; sodium fluoride toothpaste; and an alcohol-based mouthrinse
C. Switch to a soft bristled toothbrush; a desensitizing toothpaste; and use a toothpick in the deeper pockets and furcations
D. Use a stannous fluoride toothpaste; an essential oils mouthrinse; and a floss threader - correct answer A
Case 18
The patient is a 68-year old Caucasian male who is semi-retired from farming. He has been a smoker for almost 40 years and has had a few health issues. He is reluctant to totally quit farming as he is helping his son take over the farm. He is 5'10" tall and weighs 185 lbs.
Despite being on an antihypertensive medication, this patient's blood pressure is still in Stage II. What is the most likely explanation for this occurrence?
A. The combination of Diltiazem and Aleve elevates blood pressure
B. BMI falls within the "obese" category
C. The combination of aspirin and Aleve elevates blood pressure
D. He is overweight and smokes - correct answer A
The patient's daily use of NSAIDs and aspirin can increase his risk for:
A. Xerostomia
B. GI side effects
C. Kidney problems
D. Bleeding problems - correct answer B
What BEST identifies the cause for loss of tooth structure observed in the maxillary occlusal intraoral image?
A. Abrasion
B. Erosion
C. Attrition
D. Abfraction - correct answer C [Show Less]