Name: _______________________

Date: 00/00/2012

Local Anesthesia and Infection Control Examanation

1) Infiltration anesthesia is Not recommended for the lower molar teeth because :
a. The periostium act as a barrier to the diffusion of anesthetic fluid
b. The buccal cortex in that region does not have canaliculi that allows
diffusion of anesthetic fluid through the bone
c. Accessory innervations makes infiltration anesthesia ineffective
d. Extraction of the lower teeth is difficult and nerve block is preferred.
2) Mental nerve block should produce anesthesia in :
a. Lower lip
b. Cheek
c. Buccal mucosa
d. Lingual mucosa of incisors
3) During inferior alveolar nerve block the needle passes through which of the
following muscle:
a. Medial ptyregoid
b. Temporalis
c. Buccinator
d. Myelohyoid
4) To block pain sensation from the mucus membrane of the upper lip following
nerve should be block:
a. Anterior superior alveolar
b. Infraorbital
c. Nasopalatine
d. Greater palatine
5) During inferior alveolar nerve block the index finger of the operator should be
located at:
a. Coronoid process
b. External oplique ridge
c. Coronoid notch
d. Mandibular foramen
6) The buccal mucoperiosteum of the lower first premolar is supplied by:
a. Mental nerve
b. Long buccal nerve
c. Incisive nerve
d. Middle superior alveolar nerve.

7) The last sensation to be abolished after deposition of local anesthesia in an

area is:
a. Pain
b. Touch
c. Cold
d. Deep pressure.
8) During inferior alveolar nerve block the position of the needle in relation to the
pterygomandibular raphe will be:
a. Medial to the raphe
b. Lateral to the raphe
c. Superior to the raphe
d. Inferior to the raphe
9) For what purposes adrenaline is added to procaine?
a. Reduction of hemorrhage in the field of operation
b. Prevention of toxic effects from too rapid absorption
c. Prolongation of anesthesia
d. All of the above
10) The presser effect of b9th epinephrine and norepinephrine is increased by
which of the following local anaesthetic?
a. Procaine
b. Dibucaine
c. Cocaine
d. Lidocaine
11) Which of the following areas are anesthetized due to the anterior (greater)
palatine nerve block?
a. Incisors and canine on the injected side
b. Upper lip, nose and lower eyelid
c. Posterior portion of the hard palate and overlying structures up to the
first premolar on the injected side
d. Incisor to premolar on the injected side
12) A nerve is absolutely refractory during:
a. Depolarisation
b. After depolarisation
c. Hyperpolarisation
d. Firing level only
13) Amide group of local anaesthetic agents are dispensed as salts of strong
acids because:
a. They are not lipid soluble but stable in air
b. They are not water soluble but stable in air
c. They are not water soluble and unstable in air

d. They are lipid soluble but stable in air

14) In acidic medium (during pyogenic infections) local anaesthetics are less
effective because:
a. More uncharged particles are released
b. Less uncharged particles are released
c. Less charged particles are released
d. None of the above
15) Local anaesthetic agents with higher pka would have:
a. Shorter onset of action
b. Longer onset of action
c. No affect on onset of action
d. None of the above
16) Which characteristic of a LA agent is responsible for its penetration into the
nerve?
a. Lipid solubility
b. Water solubility
c. Its ionisation
d. None of the above
17) Addition of a vasoconstrictor to LA agents:
a. Increases alkalinity of the solution
b. Increases acidity of the solution
c. Has no effect on the pH
d. None of the above
18) Increasing the concentration of LA from 2 to 5% would have:
a. Rapid onset and prolonged action
b. Onset would not be affected but action would be prolonged
c. No change on action
d. Rapid onset and duration not affected
19) The efficacy of benzocaine in inflamed area would be:
a. Decreased
b. Not altered
c. Increased
d. Prolonged
20) The main barrier for diffusion of LA into the nerve is:
a. Epineurium
b. Perineurium
c. Endoneurium
d. Neural membrane

21) Which fibres of the nerve are anaesthetised first:

a. Mantle fibres
b. Core fibres
c. Both are anaesthetised at the same time
d. None of the above
22) Which of the following block anesthesia procedure most likely to result in
hematoma?
a. Mental nerve block
b. Infraorbital nerve block
c. Inferior alveolar nerve block.
d. Posterior superior alveolar nerve block.
23) Allergy to anesthetic solution may be due to:
a. Procaine hydrochloride
b. Methylparaben
c. Propylparaben
d. All of the above
24) The initial toxic reaction to lidocaine injection is:
a. Twitching of muscles
b. Shivering
c. Talkativeness of patient
d. Sleepy feeling
25) Injury to inferior alveolar nerve during nerve block injection can result in:
a. Permanent anesthesia in the lower lip region
b. Temporary paresthesia of the lower lip
c. Inability to close the lips
d. Temporary anesthesia of anterior 2/3 of tongue
e. Difficulty in speech
26) In Gow Gates technique the anesthetic solution is deposited :
a. At the mandibular fossa
b. At the foramen ovale
c. At the anterior region of condyle
d. In pterygomaxillary space
27) Maximum dosage of 2% lingocaine with 1:100 000 Epinephrine in healthy adult
is:
a. 4,4 mg/kg body weight
b. 6,6 mg/kg body weight

c. 7,0 mg/kg body weight

d. 3,5 mg/kg body weight
28) In which of the following condition infiltration anesthesia is differed?
a. Infection
b. Renal failure
c. Patient under dialysis
d. All of the above
29) In a resting state the nerve membrane is:
a. Slightly permeable to Na+ ions
b. Not permeable to Na+ ions
c. Permeable to Na+ ions depending upon the concentration of K+ ions
d. It is freely permeable to Na+ ions
30) Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.
a. lidocaine (Xylocaine)
b. tetracaine (pontocaine)
c. mepivacaine (Carbocaine)
d. bupivacaine (Marcaine)
e. dyclonine (Dyclone)
31) Earliest sign of syncope is:
a. Pallor of face, tongue and mucous membrane
b. Sweating
c. Rapid breathing
d. Vomiting sensation
32) Hydrolysis of procaine anesthetic drug takes place:
a. Almost entirely in Plasma
b. Almost entirely in Liver
c. 60% occurs in plasma and 40% in liver
d. Major portion in plasma
33) Methemoglobinemia occurs in patients receiving large doses of:
a. Procaine
b. Mepivacaine
c. Prilocaine
d. Bupivacaine

34) Which of the following mandibular teeth causes slight pain during extraction
after anesthetizing the inferior alveolar nerve, lingual nerve and the long
buccal nerves on one side?
a. Canine tooth
b. 3rd molar tooth
c. Central incisor
d. Premolar teeth
35) Which condition amongst the following, use of local anesthetic is
contraindicated?
a. 3rd month of pregnancy
b. Patient on dialysis
c. Cirrhosis of liver
d. Hypersensitivity to the anesthetic drug
e. All of the above
36) Lidocaine as local anesthetic is preferred to procaine:
a. Since it causes less depression of CNS
b. Since it causes less cardiovascular collapse
c. Since it causes less incidence of allergic reactions
d. Since it is 50% more potent than procaine
37) Inferior alveolar nerve block injection without proper sterilization might result
in primary infection of the:
a. Pterigomandibular space
b. Buccal space
c. Masseteric space
d. Temporal space
38) During administration of inferior alveolar nerve block the following muscle is
pierced by needle?
a. Temporalis
b. Superior constrictor muscle of pharynx
c. Masseter
d. buccinators
39) Of the action of Epinephrine, which of the following is not true?
a. It produces increase in blood pressure.
b. Produces dilatation of coronary arteries.
c. Constrict smaller blood vessels.
d. Decreases incidence of dysarrhythmias.

40) Local anesthetic injections results in loss of functions in which order?

1. Touch
2. Temperature
3. Proprioception
4. Pain
5. Skeletal muscle tone
a.
b.
c.
d.

1,2,3,4,5
4,2,1,3,5
2,5,4,1,3
5,3,4,2,1

41) All of the following statements concerning injections are true except:
a. An intravascular injection can cause dizziness or blurred vision.
b. Injections should always be made slowly with aspiration to avoid intravascular
injection.
c. The presence of a vasoconstrictor prevents an intravascular injection or
systemic absorption.
d. The depression of respiration is manifestation of the toxic effect of the L.A.
42) Standard precautions integrate and expand universal precautions to include
organisms spread by all of the following except:
a. Blood.
b. All body fluids, secretions, and excretions except sweat
c. Intact skin.
d. Mucous membranes
43) The risk of infection with a bloodborne virus is largely determined by all of the
following except:
a. Its prevalence, or frequency, in the patient population.
b. he risk of transmission after an exposure to blood (risk varies by type of
virus).
c. The type and frequency of blood contacts.
d. If health care personnel are working with sharp objects such as needles,
their risk of exposure to a bloodborne virus would be lower than if they
come into contact with blood.
44) The concentration of HBV in various body fluids with the highest
concentration of virus are all the following except:
a. Blood
b. Serum
c. Saliva
d. Wound exudates

45) Which of the following is not heat sterilization method?

a. Steam under pressure
b. Dry heat sterilizers
c. Ethylene oxide gas sterilizers
d. Unsaturated chemical vapor sterilizers
46) Which of the following values is true when autoclave is used?
a. 116 C 34 min
b. 121 C 24 min
c. 132 C 14 min
d. 138 C 04 min
47) Which of the following is false?
a. Dry heat is most commonly used to sterilize glassware and bulky items that
can withstand heat but are susceptible to rust.
b. The advantages of dry heat are the relative ease of use and the unlikelihood
of damaging heat-resistant instruments.
c. The disadvantages are the time necessary and the potential damage to heatsensitive equipment.
d. Dry heat causes destructive protein coagulation, a process requiring
extremely high temperatures.
48) Which of the following is false?
a. Autoclave works by creating steam and then, through a series of valves,
increasing the pressure so that the steam becomes superheated.
b. Instruments placed into an autoclave should be packaged to allow the free
flow of steam to the equipment, such as by placing instruments in paper bags
or wrapping them in cotton cloth.
c. The disadvantages of sterilization with moist heat are the tendency of moist
heat to dull and rust instruments.
d. The advantages of sterilization with moist heat are its effectiveness,
speed, the relative availability of office proportioned autoclaving
equipment, and the cost of autoclaves is low.
49) Which of the following is false?
a. Substances acceptable for disinfecting dental instruments for surgery include
glutaraldehyde, iodophors, chlorine compounds, and formaldehyde.
b. If gaseous sterilization is not available and absolute sterility is not required,
chemical disinfection can be performed
c. Instruments must remain in contact with the solution for the designated
period, and no new contaminated instruments should be added to the solution
during that time.
d. All instruments must be washed free of blood or other visible material
before being placed in the solution. After disinfection the instruments
can be used immediately and used within a short period of time.

50) Which of the following is false?

a. In general cleaning recommendations we use appropriate protective barriers
such as heavy-duty utility gloves, masks, and protective eyewear when
cleaning and disinfecting surfaces.
b. In general, cleaning and removal of microorganisms is as important as the
disinfection process itself. Blood or other patient materials left on surfaces
can interfere with the disinfecting process.
c. The use of sterilants or high-level disinfectants on environmental
surfaces is recommended for quick and safe cleaning.
d. Because clinical contact surfaces come into direct contact with contaminated
gloves, instruments, spray or spatter, their risk of transmitting infection is
greater than for housekeeping surfaces.
51) Which of the following is false?
a. The primary cause of needle breakage is sudden unexpected movement by
patient as needle penetrates muscle or contact periosteum.
b. 25 gauge needles are more likely to break than 30 gauge needle.
c. If the needle is lost and cannot be readily retrieved we do not proceed with an
incision or probing.
d. If, despite broken needle's superficial location, attempted retrieval is
unsuccessful in a reasonable length of time, it is prudent to abandon the
attempt and allow the needle fragment to remain.
52) Which of the following is false?
a. Trauma to muscles or blood vessels in the infratemporal fossa in the most
common etiological factor in trismus associated with dental injections of L.A.
b. In the acute phase of trismus, pain produced by hemorrhage leads to muscle
spasm and limitation of movement.
c. We can prevent trismus by avoiding repeat injection and multiple insertions
into the same area through knowledge of anatomy and proper technique.
d. The patient should not be advised to initiate physiotherapy consisting
of opening and closing the mouth to treat trismus.
53) Which of the following is false?
a. Edema related to local anesthetic administration is seldom intense enough to
produce significant problems such as airway obstruction.
b. Trauma during injection, infection, allergy and hemorrhage can cause edema.
c. The management of edema is predicated on reduction of the swelling as
slowly as possible and on the cause of the edema.
d. Edema produced by infection will not resolve spontaneously but may become
progressively more intense if untreated.
54) Which of the following is false?
a. Idiosyncrasy is an abnormal reaction to a drug or group of drugs
exhibited when only a small amount or a nontoxic dose of the drug has
been used. It is toxic but non allergic condition.

b. Pallor, tachycardia, hypotension, decreased Heart rate and Collapse are the
main clinically symptoms of Idiosyncrasy.
c. We can prevent Idiosyncrasy by Injecting slowly and observing the patient
closely during injection.
d. Barbiturates are ineffective in the treatment or prevention of this condition.
55) which of the following is not a part of the dental syringe?
a. Finger grip
b. Piston
c. Hub
d. Harpoon

Good luck
Dr. Hazem Melad