1. To overcome local anesthetic failure sufficient local anesthetic solution should be deposited. In an adult patient requiring extraction: a. 2.

0 ml of solution is adequate for infiltration in the maxilla b. 0.5 ml of solution is adequate for infiltration in the maxilla c. 1.0 ml of solution is adequate for infiltration in the maxilla d. None of the above 2. To achieve regional block to extract a lower first molar in a 35 years old male healthy patient: a. 2.8 ml of solution is required for inferior alveolar nerve block b. 1.5 ml of solution is required for inferior alveolar nerve block c. 0.2 - 0.5 ml of solution is required for long buccal nerve block d. b&

3. Achieving adequate local anesthesia depends on the method of administration. For anesthesia of mandibular teeth: a. Infiltration is sufficient for all mandibular teeth b. Regional block is the only appropriate method of anesthesia c. None of the above d. All of the above 4. The Gold standard of local anesthetic solution: a. Lignocaine with xylocaine b. Lignocaine with vasopressin c. Lignocaine with adrenaline d. None of the above Most common causes why a local anesthetic injection fails: a. Factors related to the operator b. Drug interactions c. Patient dependent factors d. a&c

5.

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6. Operator factors which contribute to achieving adequate local anesthesia required for oral surgery: a. Using correct technique b. Administration of sufficient amount of solution c. Using appropriate method of administration d. All of the above 7. Intraligamentary anesthesia: a. Can be used in the mandible only b. May predispose to infective endocarditis in susceptible patients c. May be used both as primary or a secondary technique d. b&c

8. Anatomical factors that may be contribute to failure of local anesthetic injection include the following except: a. Variation in position of nerves and foramina b. Accessory nerve supply c. Barrier to anesthetic diffusion d. Low ph 9. Pathological causes of failed local anesthetic injection: a. Trismus b. Trauma c. Inflammation d. All of the above

10. The following technique may be used to help overcome failed anesthesia: a. Intraligamentary b. Intrapulpal c. None of the above d. a&b 11. For a righthanded dental student extracting the 4 |, which of the following is true a. Use infraorbital block only b. Stand in front of the patient facing him
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c. The patients eyes should be 18 cm below the students shoulder d. Use the right hand to support the alveolar ridge during extraction e. None of the above

Which of the following statements are TRUE and which are False: 12-Local Anaesthesia is loss of pain sensation unaccompanied by loss of other forms of sensibility. 13-Local Analgesia results in the loss of all pain, temperature, and touch sensations but does not anaesthetize the proprioceptive fibers of the involved nerves 14-lignocaine and prilocaine belong to the anesthetics Amide group of local

15-Bupivacaine is a long acting local anesthetic agent 16-Adrenaline and mepivacaine are vasoconstrictors 17-Vasoconstrictors in local anesthetic solution increase the duration of anesthesia 18-Adrenaline is the vasoconstrictor commonly used in local anesthesia 19-The length of the long needle used for regional block local anaesthesia is 5 cm. 20-The Vehicle used in local anesthetic solution is isotonic solution such as modified ringer solution t 21-Topical anesthesia can be produced using Submucosal and Subperiosteal techniques. 22-Infra-orbital and Intra-ligamentary are types of regional anesthesia 23-Infiltration may be unreliable in the mandible because of the dense outer cortical plate of bone
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24-Pulpal anesthesia of maxillary teeth after local infiltration lasts much shorter than does pulpal anaesthesia of mandibular teeth after block anaesthesia. 25-Pulpal anaesthesia disappears 60 to 90 minutes before soft tissue anaesthesia does. 26-Middle Superior Alveolar (Dental) Nerve supplies Incisors & Canines & labiobuccal soft tissues 27-Greater Palatine (Anterior palatine) nerve branches are Infra-orbital and Superior Alveolar (Dental) nerves 28-The mental nerve block produces anaesthesia of the premolar, canine and incisor teeth of the same side. 29-The duration of soft tissue anesthesia following injection of Bupivacaine 0.5% with 1: 200,000 adrenaline 2-3 hours f 30-The total dose of adrenaline must not exceed 500 g. i.e. not more than 40 ml of local anaesthesia containing adrenaline in a 1 80 000 solution 31-The Long Buccal nerve supplies soft tissue distal to the 2nd premolar 32-The Anterior Boundary of the pterygo-mandibular space is the Parotid gland 33-The Lateral wall of the pterygo-mandibular space is the Medial (inner) wall of ascending ramus 34-The Roof the pterygo-mandibular space is the Lateral pterygoid muscle 35-The maximum number of 2ml local anesthetic cartilages that can be given for an adult patient is 17.

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36-When extracting the lower first molar the nerves that must be anesthetized are the inferior dental and the Long buccal nerves. 37-In planning any surgical procedure the first step is always a thorough review of the patients medical history. 38-Thorough preoperative instruction and explanations for the patient are essential in preventing the majority of complications that occur in the postoperative period.

39-Myocardial infarction, heart block and stroke are cardiac causes of collapse 40-When Vasovagal Syncope (Fainting) occurs treatment should be finished very quickly 41- When giving anesthesia for the lower Left third molar, the Operator should stand in front of the patient 42- The local anesthetic agent is not effective once given in the presence of dental abscess because it doesnt work effectively in alkaline media 43. The mode of action of local anesthesia is by blocking Potassium channel

44-. The maximum number of local anaesthetic solution cartilages containing 2 ml of 2% lignocaine & 1: 80000 adrenaline that can be given to a patient is (12 )

45-Indications for surgical removal of a tooth or roots include: A. Multi-rooted teeth

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B. Ankylosed roots & hypercemented roots C.Teeth with apices at right to long axis of the teeth D. B &C E. All of the above

Question 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Answer

c.

1.0 ml of solution is adequate for infiltration in the maxilla d. b&c c. c. None of the above

Lignocaine with adrenaline d. d. a&c

All of the above d. d. d. d. b&c Low ph All of the above a&b

b-Stand in front of the patient facing him

TRUE TRUE TRUE

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15

TRUE FALSE

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

TRUE TRUE FALSE TRUE FALSE FALSE TRUE TRUE TRUE FALSE FALSE TRUE FALSE TRUE TRUE

FALSE 33 34 TRUE TRUE

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35 36 37 38 39 40 41 42 43 44 45

FALSE TRUE TRUE TRUE TRUE FALSE FALSE FALSE TRUE TRUE

D. B &C

1- For palatal injection , how many injection for 1st premolar , 1st molar ,2nd molar , 3rd molar : *One injection 2- If we want to extract lower central incisor we do : *Buccal and lingual infiltration 3- Local analgesia : loss of all forms of sensation including pain, touch , and temperature but doesn't anaesthesia *false
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4- u have to wait 5 minute for the local anesthetic to work 5- local anesthetic consist of strong acid and weak base *true 6- bupivacaine is long acting local anesthetic *true 7- regarding the lumen of the needle , the more the diameter the smaller the gauge *true 8- submucosal and subperiosteal are kind of topical anesthesia *false 9- maxillary bone : a -porous b- thick c-thin d-dense *answer : a +c 10- if we want to extract 1st molar , how many nerve involved : *3 nerves 11- If we want to block the ID nerve we go : *Lateral to the pterygomandibular raphe 12- In adult person , the mandibular foramen : *At the level of occlusal plane 13- long buucal nerve block : a- Distobuccal of the 1st molar b- Disto buccal of the 2nd molar c- Distobuccal of the 3rd d- Anyone *The answer c
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14- Adrenaline and mepivacaine are vasoconstrictor *False 15- Hematoma when we want to block ID: a- Permanent loss of function of masseter b- Perminant loss of sensation in the ipsilateral nerve on the same side c- Perminant loss of sensation in the contralateral nerve on the same side d- None of the above answer d Done By: Deema Hamarsheh

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