Chapter 01: Patient Evaluation and Risk Assessment

Little: Dental Management of the Medically Compromised Patient, 9th Edition

MULTIPLE CHOICE

1. Elective dental care should be deferred for patients with severe, uncontrolled hypertension,

meaning that the blood pressure is greater than or equal to mm Hg.

a. 200/140

b. 180/140

c. 180/110

d. 160/110

ANS: C

Elective dental care should be deferred for patients with severe, uncontrolled hypertension,

which is blood pressure greater than or equal to 180/110 mm Hg, until the condition can be

brought under control.

2. The American Heart Association currently recommends antibiotic prophylaxis for a patient

with which of the following cardiac conditions?

a. Mitral valve prolapse

b. Prosthetic heart valve

c. Rheumatic heart disease

d. Pacemakers for cardiac arrhythmias

ANS: B

Previously, the American Heart Association (AHA) recommended antibiotic prophylaxis for

many patients with heart murmurs caused by valvular disease (e.g., mitral valve prolapse,

rheumatic heart disease) in an effort to prevent infective endocarditis; however, current

guidelines omit this recommendation on the basis of accumulated scientific evidence. If a

murmur is due to certain specific cardiac conditions (e.g., previous endocarditis, prosthetic

heart valve, complex congenital cyanotic heart disease), the AHA continues to recommend

antibiotic prophylaxis for most dental procedures.

3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is decreased ability of

the body to certain drugs, including local anesthetics and analgesics.

a. absorb

b. distribute

c. metabolize

d. excrete

ANS: C

Patients also may have chronic hepatitis (B or C) or cirrhosis, with impairment of liver

function. This deficit may result in prolonged bleeding and less efficient metabolism of

certain drugs, including local anesthetics and analgesics.

4. Which of the following symptoms and signs is most consistent with allergy?

a. Heart palpitations

b. Itching

c. Vomiting

d. Fainting