Centro Escolar University

School of Dentistry
PRE-BOARD THEORETICAL EXAMINATION

PHARMACOLOGY AND ANESTHESIOLOGY

Shade AE if the answer is none of the choices.

1. The pH of a local anesthetic containing epinephrine is about:

A. 4 B. 5.5 C. 6 D. 7 E. 7.4

2. Anesthetic technique used when the solution is deposited in the pterygomandibular space:
A. Topical anesthesia C. intraosseous
B. Local infiltration D. nerve block E. intraligamentary technique

3. Commercially available local anesthetics are usually:

A. Basic B. acidic C. hypertonic D. hypotonic E. neutral

4. Allergic reactions to local anesthetics are caused by:

A. Improper injection technique C. fast administration
B. Slow administration D. rapid absorption E. antigen-antibody reaction

5. Drug of choice to treat trigeminal neuralgia:

A. Carbachol B. clorazepam C. carbamazepine D. acetazolamide

6. Verapamil, is a calciblocker which could cause which periodontal problem?

A. Refractory periodontitis C. juvenile periodontitis
B. Gingival recession D. gingival enlargement E. interdental papilla necrosis

7. How many milligrams of epinephrine in a cartridge (1.8cc) of 2% lidocaine with 1:100,000

epinephrine?
A. 0.018 mg B. 0.18 mg C. 0.036 mg D. 0.36 mg

8. A fluoride solution at a concentration of 1ppm contain 1.0 mg of fluoride per__?__

A. 100 ml B. 1.0 ml C. 100 ml D. 1000 ml E. 0.1 ml

9. The maximal celling effect of a drug is also referred to as the drugs:

A. Efficacy B. potency C. specificity D. agonism

10. The following are requirements of an ideal anesthetic agent, except:

A. It must be non toxic C. it must be water soluble
B. It must be irreversible D. it must be easily administered

11. Which of this penicillin has a broader gram negative spectrum than penicillin G?
A. Penicillin V B. Methralin C. Ampicillin D. Both A & B

12. Which gingival retraction agent is not indicated for used in patients with cardiovascular disease?
A. dTannic acid B. zinc oxide C. epinephrine soaked cord D. gingi-pack with alum

13. The following nerves are anesthetized during removal of torus palatinus, except:
A. Nasopalatine nerve C. right anterior palatine nerve
B. Posterior superior alveolar nerve D. left anterior palatine nerve

14. Prolonged antibiotic therapy may develop what type of infection?

A. Staphylococcal infection C. candidiasis
B. Streptococcal infection D. viral infection

15. The total dose of the drug is 4.8 grams. It is dispensed in capsules and to be taken every 4 hours
for 6 days. What is the dose of the drug.
A. 125mg B. 150mg C. 100mg D. 200mg E. 250mg

16. Which of the following has the broadest spectrum of action?

A. Clindamycin C. erythromycin
B. Tetracycline D. ampicillin E. amoxicillin
17. The only sensory nerve among the branches of the anterior division of the mandibular nerve is:
A. Temporal nerve B. masseter nerve C. long buccal nerve D. pterygoid nerve

18. The smaller of the two terminals of the posterior division of the mandibular branch of the
trigeminal nerve:
A. Mental nerve B. inferior alveolar nerve C. lingual nerve D. long buccal nerve

19. Morphine is eliminated mainly by:

A. Conjugation B. hydrolysis C. reduction D. oxidation

20. Refers to loss of sensation of pain, temperature, pressure, motor function over a specific area
without a loss of consciousness:
A. Regional analgesia B. Regional anesthesia C. field block D. analgesia

21. Refers to the adverse effects of drugs taken by the mother and manifested by the fetus?
A. Idiosyncrasy B. teratogenic effect C. interference D. allergy

22. Which of the following is the local anesthetic of choice for patients with plasma cholinesterase
deficiency?
A. Mepivacaine B. propoxycaine C. procaine D. tetracaine

23. If atropine is prescribed to a patient, which of the following effects will the patient experience:
A. Bradycardia B. dryness of mouth and throat C. tachycardia D. blurred vision

24. STAT means:

A. Stature B. statistics C. statre D. immediately

25. First drug discovered that does not cause sedation and yet is effective in controlling epileptic
seizures:
A. Carbamazepine B. clomazepan C. phenytoin D. valproic acid

26. Which of the following is not a property of nitrous oxide?

A. It is tasteless, odorless and colorless C. it is a strong anesthesia
B. It is none irritating D. it is non flammable

27. Trismus following inferior alveolar nerve block most likely result from:
A. Failure to use aspirating syringe
B. Accidental injection of the solution near a branch of facial nerve
C. Allowing the needle tip to rest beneath the periosteum
D. Irrigation of masseter muscle.

28. The most serious consequence of systemic local anesthetic toxicity is:
A. Hypertension C. post depressive CNS convulsions
B. Vertigo D. post convulsive CNS depression

29. Most useful drugs to induce salivation is:

A. Adrenergic B. adrenergic blocking C. ganglionic blocking D. cholinergic

30. Which of the following general anesthetic agents produces the best muscle relaxation?
A. Halothane B. cyclopropane C. ether D. nitrous oxide

31. Precautions must be taken when drugs are administered to geriatric patients because geriatric
patients:
A. May metabolize drugs less rapidly D. both A & B
B. May not be able to excrete drugs rapidly E. both B & C
C. Will usually require greater than average adult doses

32. Prolonged used of sulfa drugs may produce symptoms of vitamin K deficiency because sulfa
drugs:
A. Are detoxified in the liver
B. interfere with the conversion of prothrombin to thrombin
C. inhibit calcium absorption which is essential to enzyme systems
D. Combine chemically with vitamin K
E. Inhibit growth of intestinal bacteria
 33. “TID” on prescription pad means:
A. Three times daily B. twice daily C. once daily D. every 2 days

34. The following are actions of aspirin, except:

A. Analgesic B. obtundent C. antipyretic D. anti-inflammatory

35. Postoperative dressings placed after root planing may:

A. Inhibit the bacterial flora adjacent to the tooth C. accelerate healing
B. Increase the tendency for postoperative bleeding D. Reduce postoperative discomfort

36. Topical anesthetic agents are most effective when applied to:
A. Skin B. palatal mucosa C. nonkeratinized soft tissue D. areas of acute inflammation

37. Acute psychoses, peptic ulcers, chronic heart failure and edema are classic contraindications for
which of the following drugs?
A. Cortisone B. digitalis C. penicillin D. nitromersol

38. Tachycardia is characterized by:

A. Rise in body temperature C. increase in pulse rate
B. Decrease in pulse rate D. increase in blood pressure

39. Insulin acts to control diabetes mellitus by:

A. Inhibiting amino acid metabolism C. increasing cellular glucose utilization
B. Inhibiting lipogenesis D. stimulating urinary excretion of glucose.

40. Vitamin K is given to oral surgery patients in which of the following condition?
A. Patients under stress C. Patients under prolonged antibiotic therapy
B. Patients who are anemic D. To all oral surgery patients

41. Which medication could result in profuse hemorrhaging that fails to subside during root planing
procedures?
A. Steroids B. vitamin K C. amyl nitrate D. dicumarol E. thiazide diuretics

42. The drug of choice for immediate treatment of an anaphylactic reaction of a local anesthetic is:
A. Morphine B. pentobarbital C. diphenhydramine D. epinephrine E. Thiopental

43. Cause of leakage during injection:

A. ovoid perforation B. aspiration before injecting C. overheated cartridge .

44. Anesthetic of choice for patients with liver cirrhosis:

A. lidocaine B. bupivacaine C. procaine D. all of these

45. Developed the concepts of pain system as a straight channel through channel from skin to brain:
A. Von Frey B. Melzack and Wall C. Goldscheider D. Descartes

46. Refers to the patient’s ability to tolerate pain:

A. pain threshold B. pain reaction C. pain perception D. vascular pain

47. Why local anesthesia is not indicated for abscess site:

A. hematoma formation B. cause trismus C. anaphylaxis D. spread of infection

48. Too much anesthesia can result to:

A. paresthesia B. hematoma C. anaphylaxis D. localized osteitis E. allergy.

49. Hematoma after injection is common in blocking of:

A. nasopalatine nerve block C. PSAN
B. buccal nerve block D. greater palatine nerve block

50. Needle breakage can often result due to:

A. sudden puncture B. sudden removal C. sudden twist D. slow removal .

51. The mental nerve innervates the ffg, except:

A. skin of chin B. lower lip C. part of cheek D. lower bicuspid
 52. Reason for ¾ insertion of needle in IAN block:
A. less painful C. reach parotid gland
B. reach lingual nerve D. not to reach parotid gland.

53. A method securing anesthesia by depositing the solution within close proximity to the main nerve
trunk:
A. topical anesthesia B. nerve block C. local infiltration D. field block

54. The nerve that passes the greater palatine foramen to supply the hard palate and post palatine
gingival is:
A. ant. Palatine N. B. palatine N. C. nasopalatine N. D. lesser palatine N.

55. The point of deepest depression of the anterior border of the ramus of the mandible:
A. the mandibular sulcus C. the coronoid notch
B. the mandibular foramen D. all of these

56. A histamine type reaction can be combated by administration of any of the following drugs
except...
A. penicillin C. prednisolone (or prednisone or methylprednisolone)
B. epinephrine D. diphenhydramine (Benadryl)

57. Which of the following is a drug reaction characterized by laryngeal edema, bronchoconstriction,
and severe hypotension (shock)?
A. pruritis (itching) C. urticaria (hives)
B. anaphylaxis or anaphylactic shock D. serum sickness

58. Which of the following drugs is used to treat an infection with CANDIDA ALBICANS (a fungal
infection):
A. nystatin (Mycostatin) B. gentamicin C. tetracycline D. penicillin G or V

59. Nerve that passes thru foramen rotundum:

A. mandibular B. maxillary C. ophthalmic D. mental E. infraorbital.

60. Anatomical landmark for Gow-gates technique, except:

A.anterior border of ramus C. corner of the mouth
B. intertragic notch D. retromolar triangle E. external ear.

61. Maxillary local anesthesia efficiency is increased because:

A. bone is porous C. muscle attachment are absent
B. small nerves present D. apical foramina are large .

62. A patient’s develops a Bell’s palsy within ten minutes, ffg an attempted IAN block on the same side.
The probable etiology was that the injection was into the:
A. maxillary artery C. parotid gland
B. masseter M. D. retromolar V. E. internal pterygoid M.

63. The cause of bubble in the cartridge is:

A. presence of O2 B. presence of N2 C. presence of vasoconstrictor

64. Paresthesia elicited during mandibular blocking are due to:

A. poor technique C. needle contact with nerve trunk
B. acid pH of solution D. sodium pump

65. The local anesthetic which counteracts the tendency of epinephrine to cause cardiac irregularities:
A. prilocaine B. procaine C. lidocaine

66. Landmarks of which includes mental foramen, pupil of the eye, supraorbital notch, infraorbital
notch, infraorbital foramen, bicuspid teeth.
A. PSAN C. incisive nerve block
B. Mental nerve block D. infraorbital nerve block E. maxillary nerve block
67. Which of the following is not anesthesized by PSAN block?
A. Distobuccal root of 16/26 C. mesiobuccal root of 17/27
B. Palatal root of 16/26 D. mesiobuccal root of 16/26

68. Landmarks include external oblique line, anterior border of ramus, pterygomandibular ligament,
internal oblique line:
A. Closed-mouth approach (akinosi) C. PSAN
B. Classical inferior alveolar nerve block D. infraorbital nerve block

69. Infiltration anesthesia where the anesthetic solution is deposited between the periosteum and the
cortical plate.
A. Submucous injection C. intraosseous injection
B. Supraperiosteal injection D. subperiosteal injection E. intraseptal injection

70. This type of injection is loosely referred to as infiltration:

A. Submucous injection C. intraosseous injection
B. Supraperiosteal injection D. subperiosteal injection E. intraseptal injection

71. This refers to the maxillary nerve block, tuberosity approach:

A. Similar to PSAN block, however, needle is inserted up to 30mm
B. Technically the most difficult of the intraoral approach
C. Either A or B

72. Main indication of topical anesthesia in paste form:

A. relieve pain in cases of ulceration of the oral mucosa C. minor surgical procedures
B. surface analgesic prior to injection D. For deep scaling

73. These are network of nerves that supply the individual roots of all teeth:
A. Outer nerve loop C. inner nerve loop
B. Superior dental plexus D. dental plexus E. inferior dental plexus

74. This is the foramen of exit for the terminal branches of maxillary nerve:
A. Foramen rotundum C. foramen ovale
B. Mental foramen D. superior orbital fissure E. infraorbital foramen

75. Classified as a mixed nerve originating from pons varolii.

A. Ophthalmic division C. trigeminal nerve
B. Maxillary division D. both B & C E. mandibular division

76. The behavior of patients under general anesthesia suggest that the most resistant part of the CNS
is the:
A. Medulla oblongata C. spinal cord
B. Cerebral cortex D,. cerebellum E. both C & D

77. Example of an enteral route of administration of drugs:

A. Inhalation B. subcutaneous C. oral D. intramuscular E. intravenous

78. The rate of urinary excretion of acidic drugs such as aspirin and barbiturates is increased by:
A. Keeping the urine at neutral pH C. administration of ammonium chloride
B. Administration of sodium D. administration of sodium bicarbonate

79. Parasympathomimetic drugs produce which of the following?

A. Cardiac condition B. Vasodilation C. vasoconstriction D. dry skin

80. The act of drawing up material at the tip of the needle into the syringe or cartridge:
A. Deposition B. aspirating C. both A & B

81. Advantage of using a 27-gauge needle:

A. It maintains an extremely sharp point
B. Inexpensive enough to be discarded after use
C. Aspiration is much easier and certain, larger lumen
D. Both A & B only.
82. Large bubbles in the anesthetic cartridge are:
A. Caused by freezing and may no longer be considered sterile
B. Usually nitrogen gas bubbled into the cartridge to prevent oxygen which would cause
deterioration of the vasoconstrictor
C. Either A or B

83. Small bubbles (1-2mm) inside an anesthetic cartridge are:

A. Caused by freezing and may no longer be considered sterile
B. Usually nitrogen gas bubbled into the cartridge to prevent oxygen which would cause
deterioration of the vasoconstrictor
C. Either A or B

84. Which of the following is the drug of choice in neutralizing epilectic attack cause by an overdose of
local anesthetic?
A. Diazepam B. chlorpheniramine C. epinephrine D. phenobarbital

85. Ampicillin is superior to chloramphenicol for treatment of typhoid carriers because it:
A. Is more potent C. is less expensive
B. Has a broader spectrum D. is less toxic

86. Conduction of an impulse by a nerve depends on:

A. Intensity of stimulus C. excitability of the nerve
B. Electric potential D. number of nerve fibers

87. Which of the following mineral is particularly needed in the blood clotting mechanism?
A. Calcium B. iron C. potassium D. magnesium

88. Phase of drug action where the drug effects are experienced by the patient:
A. Pharmaceutical phase C. pharmacokinetic phase
B. Pharmacodynamic phase D. toxicology phase

89. The dissociation constant of lidocaine is:

A. 7.7 B. 7.9 C. 8 D. 8.1

90. Mineral that produces an increase in salivary secretion when given in excess?
A. Iron B. phosphorus C. iodine D. magsesium

91. Which of the following antibiotic has a depressant effect on the bone marrow?
A. Chloramphenicol B. streptomycin C. ampicillin D. amoxicillin

92. Which of the following drug acts to suppress the cough center?
A. Meperidine B. acetaminophen C. codeine D. ASA

93. Beverage with the highest caffeine content:

A. Instant coffee B. decaffeinated coffee C. brewed coffee D. coke

94. Passage of drugs through cell membrane is influenced by the following, except:
A. Its type of action B. its lipid solubility C. Its pH D. the amount of protein binding

95. The most common syringe used in dental practice is:

A. Breech loading aspirating metallic cartridge C. Jet injection
B. Breech loading non-aspiration metallic syringe D. plastic disposable

96. Vitamin C is used to prevent or treat:

A. Dentin resorption C. atrophy of odontoblast
B. Gums that become spongy & bleed easily D. all of these

97. Which of the following is the primary drug to administer to a patient with an allergic reaction
demonstrating urticarial and wheezing?
A. Steroids B. epinephrine C. atropine D. Benadryl

98. Drug overdose of acetaminophen would results to:

A. Cardiovascular problems B. idiosyncrasies C. Hepatic necrosis
 99. Route of drug administration which presents the most predictable drug response is:
A. Oral B. parenteral C. rectal D. both A & B

100. The acute life-threatening of allergic reaction to a drug is known as:

A. Idiosyncrasies B. anaphylaxis C. infections D. hepatic problems

1. Conducts the fast or first pain at the rate of up to 100 meter per second:
A. A-beta fibers C. A-delta fibers
B. C-fibers D. A beta and A delta fibers E. A-delta and C fibers

2. Lidocaine (xylocaine) is an example of an:

A. acid B. amide C. ester D. aldehyde

3. The local anesthetic base is combined with hydrochloric acid to produce a water soluble salt
solution. The anesthetic activity of the injected local anesthetic solution is most related to:
A. the anesthetic salt solution
B. the osmotic pressure of the soluble solution
C. its reactivity with electrolytes in the interstitial tissue
D. the conversion of the soluble solution to its insoluble anesthetic base-acid form.

4. Anatomic ganglia associated with the mandibular nerve:

A. otic B. submandibular C. submaxillary D. both A & B E. all of these
5. Three minutes after receiving an inferior alveolar blokc for removal of a premolar, the patient
develops paralysis of the muscles of his forehead, eyelids and upper and lower lips on the same
side of the face. This is probably related to diffusion of the anesthetic solution into the:
A. otic ganglion
B. capsule of the parotid gland
C. ophthalmic division of the trigeminal nerve
D. motor branches of the mandibular nerve supplying the masticatory muscles

6. Needle aspiration of a central bone lesion is used to

A. feel for root surfaces
B. rule out of diagnosis of vascular lesion
C. make a diagnosis of traumatic bone cyst
D. determine the thickness of the buccal plate
E. all of the above

7. In local anesthesia, depression of respiration is a manifestation of

A. puncture of a blood vessel C. use of an isotonic solution
B. toxic effects of the solution D. trauma to a nerve trunk by the syringe needle

8. Comprises the inner nerve loop:

A. ASAN, MSAN and PSAN C. Inferior alveolar and lingual nerves
B. Greater palatine and nasopalatine nerves D. All of the above

9. Branch of the maxillary nerve given off at the infraorbital canal:

A. PSAN B. MSAN C. ASAN D. both A and B E. both B and C

10. Mandibular nerve is considered as:

A. motor nerve B. sensory nerve C. mixed nerve D. none of these.

11. At which pH will the local anesthesia be effectively diffused:

A. pH doesn’t matter B. below or above C. below 7 D. above 7

12. In larger myelinated nerves, conduction takes place at:

A. dendrites B. neuron C. axons D. nodes of Ranvier

13. Which of the following nerve is not involved in an extra-oral infraorbital nerve block:
A. inferior palpebral C. lateral nasal
B. sphenopalatine D. infraorbital E. none of these.

14. A patient has a history of significant cardiovascular impairment. The maximum safe dose of
epinephrine that can be administered to this patient is:
A. 1 cc, 1:50,000 C. 1 cc, 1:100,000
B. 2 cc, 1:50,000 D. 2 cc, 1:100,000
15. A dentist would like to obtain block anesthesia of the entire second division of a patient’s trigeminal
nerve. For this purpose, the dentist should administer an intraoral injection in which of the following?
A. foramen ovale C. foramen spinosum
B. pterygoid plexus D. infraorbital formane E. pterygopalatine fossa

16. After receiving one cartridge of a local anesthetic, a healthy adult patient became unconscious in
the dental chair. The occurrence of a brief convulsion is:
A. pathognomonic of gland mal epilepsy
B. consistent with a diagnosis of syncope
C. usually caused by the epinephrine in the local anesthetic
D. pathognomonic of intravascular injection of a local anesthetic

17. Epinephrine is added to local anesthetics because it:

A. decreases the rate of absorption of the local anesthetic at the injection site
B. prevents the rapid deterioration of the local anesthetic solution
C. increases the rate of destruction of the local anesthetics
D. potentiates the action of all local anesthetics.

18. The most likely cause of trismus after block anesthesia for surgery in the mandibular molar area is:
A. excessive edema
B. damage to the medial pterygoid muscle on injection
C. stretching of the pterygomandibular raphe
D. myositis of the lateral pterygoid muscle
E. submandibular cellulites

19. The most common disorder causing pain about the masticatory apparatus including the TMJ, is:
A. myofascial-pain-dysfunction D. traumatic arthritis
B. trigeminal neuralgia E. temporal arteritis
C. degenerative arthritis

20. The patient has received an injection of 1.8ml of local anesthetic containing 2% lidocaine with
1:100,000 epinephrine. Thirty seconds later he goes into syncope. The most probable cause is:
A. Bradycardia D. a toxic reaction to the epinephrine
B. Tachycardia E. an allergic reaction to the lidocaine.
C. Cerebral hypoxia

21. Nitrous oxide alone is not used as a general anesthetic agent because of the
A. difficulty in maintaining an adequate oxygen concentration
B. expense of the agent and its explosive hazard
C. adverse effects on the liver
D. poor analgesic properties
E. all of the above.

22. How many millimeter of nerve fibers should be in contact with the anesthetic solution for effective
anesthesia:
A. 1mm B. 2-3mm C. 4mm D. 5-6mm E. 8-10mm

23. A branch of facial nerve with secretory function to the tongue and is associated with the lingual nerve:
A. glossopharyngeal C. chorda tympani
B. buccal nerve D. both A and C E. both B and C

24. When attempting to achieve an intraoral palatal second division block anesthesia, the needle should
enter the:
A. greater palatine foramen C. foramen rotundum
B. stylomastoid foramen D. mental foramen E. nasopalatine foramen

25. A deep level of general anesthesia is enhanced by a :

A. high alveolar concentration of anesthetic agent C. loose-fitting mask
B. nonirritating drug D. muscle relaxer

26. Syncope is usually caused by:

A. vasoconstriction C. cerebral hyperemia
B. cerebral ischemia D. decease in the vascular bed
27. The maximum recommended dosage of lidocaine HCI injected subcutaneously when combined
with 1:100,000 epinephrine is:
A. 100mg B. 300mg C. 500mg D. 750mg E. 1gm.

28. Cyanosis, dyspnea and elevated temperature following general anesthesia may indicate:
1. atelectasis 3. pulmonary embolus
2. pneumonia 4. acute renal shutdown
A. 1 only B. 1,2 & 3 C. 2 & 3 D. 2 & 4 E. 4 only

29. A dentist is considering the use of nitrous-oxide conscious sedation for a patient. However, this type
of sedation will be contraindicated, should the patient have a history of which of the following?
A. Dental anxiety C. both A & C
B. Psychotic care D. none of these E. Controlled hypertension

30. The correct total liter flow of nitrous oxide-oxygen is determined by

A. a standard 6 liter per minute flow.
B. The patient’s metabolic oxygen requirements
C. The amount necessary to keep the reservoir bag 1/3 to 2/3 full.
D. The largest volume that the patient can exchange within 1 minute.

31. Local anesthetics aid in reducing the flow of saliva during operative procedures by:
A. blocking the cholinergic nerve endings
B. blocking innervation to major salivary glands
C. blocking efferent parasympathetic nerve pathways
D. reducing sensitivity and anxiety during tooth preparation

32. Trismus, secondary to an inferior alveolar injection, most likely results from
A. failure to use an aspirating syringe
B. accidental injection of the solution near a branch of the facial nerve
C. allowing the needle tip to rest beneath the periosteum during injection
D. passing the needle through the medial pterygoid muscle
E. accidental injection of the solution near a major motor branch of the trigeminal nerve.

33. A patient is allergic to both amide and ester anesthetic derivatives. For this patient, the dentist
should find which of the following infiltrative local anesthetics to be safe and effective?
A. Bupivacaine C. Nitrous oxide
B. Phenylephrine D. Diphenhydramine E. Ethylaminobenzoate

34. Of the following local anesthetics, which has intrinsic vasoconstrictive actions?
A. Cocaine B. Xylocaine C. Procaine D. Bupivacaine
35. The dentist uses a palatal flap to close an oroantral fistula in the area of tooth #15. This flap
receives its principal blood supply from which of the following arteries?
A. Facial C. Greater palatine
B. Nasopalatine D. Posterior superior alveolar

36. Each of the following side effects can occur as a result of systemic absorption of lidocaine, except:
A. increased gastric motility C. decreased cardiac output
B. tonic-clonic convulsions D. respiratory depression

37. In an attempted venipuncture, each of the following indicates accidental intra-arterial injection,
except:
A. The needle moves with pulsation action.
B. A vessel tends to collapse and obstruct.
C. Aspirated blood is bright red in color.
D. Injection of a small test dose of the agent is acutely painful.
E. Penetration of a vessel meets resistance and is painful.
38. A needle tract infection following an inferior alveolar block injection would initially involve which
space?
A. Pterygomandibular C. submandibular
B. Sublingual D. Lateral pharyngeal

39. Which pair of anesthetics is most likely to show cross-allergy?

A. Lidocaine- mepivacaine
B. Prilocaine- tetracaine D. Procaine- lidocaine
C. Procaine- mepivacaine E. Lidocaine- benzocaine
40. Which of the following antibiotics may cause discoloration of the teeth of the newborn if
administered to the mother in the third trimester of pregnancy?
A. Penicillin C. Streptomycin
B. Tetracycline D. Clindamycin E. Erythromycin

41. Which of the following drugs is most commonly employed in an attack of angina pectoris?
A. Sodium nitrate C. Theophylline
B. Epinephrine D. Nitroglycerine E. Isosorbide dinitrate

42. Which of the following is a major reason for adding vasoconstrictors to local anesthetic injections?
A. To decrease bleeding D. To reduce systemic toxicity
B. To enhance the onset of action E. To decrease allergic reactions
C. To prolong the duration of anesthesia

43. What determines the maximum dose of local anesthesia for a child?
A. Age C. the desired degree of pulpal anesthesia
B. weight D. the procedure to be accomplished

44. The only local anesthetic that increases the pressor activity of both epinephrine and norepinephrine
is:
A. Cocaine C. dibucaine
B. Procaine D. lidocaine E. mepivacaine

45. Each of the following, is a good reason for using sedation, except:
A. To allay apprehension, anxiety or fear
B. To decrease the amount of local anesthesia that is required for a given procedure
C. To alleviate stress in a severely medically compromised patient
D. To accomplish certain procedures that a practitioner would not normally be able to do on an
anxious patient.

46. Which of the following is the first symptom that is usually perceived by the patient being
administered nitrous oxide?
A. Nausea B. Giddiness C. Euphoria D. Tingling of the hands
47. Opiates are contraindicated for patients who have which of the following?
A. Severe head injury C. Bronchial asthma
B. Renal dysfunction D. Acute myocardial infarction

48. The Therapeutic Index (T.I.) of a drug is defined as:

A. ED50/LD50. C. LD1/ED99.
B. ED1/LD99. D. LD99/ED1. E. LD50/ED50..

49. Which of the following classes of drugs, when combined with a narcotic analgesic, is the most likely
to produce a fatal drug interaction?
A. Cardiac glycosides D. Oral anticoagulants
B. Tricyclic antidepressants E. Oral antidiabetic agents
C. Monoamine oxidase inhibitors

50. Aspirin is contraindicated with which of the following drugs?

A. Coumarin (Coumadin®) D. Triazolam (Halcion®)
B. Barbiturates (Phenobarbital®) E. Pentobarbital (Nembutal®)
C. Methylprednisolone (medrol®)

51. A 43-year old patient who has mitral stenosis, secondary to rheumatic fever requests extraction of
two periodontally involved mandibular teeth. Initially, the dentist should
A. premedicate the patient with cephalosporin
B. premedicate the patient with amoxicillin
C. premedicate the patient with ampicillin and gentamicin
D. consult with the patient’s physician to determine the antibiotic of choice

52. Which of the following drugs is often administered intravenously to treat life-threatening ventricular
arrhythmias?
A. Quinidine B. Verapamil C. Lidocaine D. Propranolol
53. A male patient who is receiving Coumadin® therapy presents for an elective extraction. His
prothrombin time (PT) is prolonged. Which of the following methods is preferred for reducing the PT
to an acceptable level?
A. Administering vitamin K (Aqua Mephyton®)
B. Withdrawing Coumadin® for two days
C. Reducing Coumadin® to one-half the usual dose for two days
D. Administering a Coumadin® antagonist, such as heparin
E. Administering a platelet transfusion to enhance coagulability

54. Each of the following drugs has a significant anti-inflammatory property, except:
A. Aspirin C. Ibuprofen (Motrin®)
B. Cortisol D. Indomethacin (indocin®) E. Acetaminophen

55. Which of the following is an example of an enteral route of administration?

A. Oral C. Inhalation E. Intramuscular
B. Submucosal D. Subcutaneous

56. Propranolol (Inderal®) exerts its major antianginal effect by:

A. dilating coronary arteries. D. Dilating systemic blood vessels
B. Increasing cardiac contractility E. Stimulating vagal slowing of the heart
C. Blocking beta-adrenergic receptors of the heart.

57. Which of the following side effects is seen most frequently with administration of nitrous oxide and
oxygen?
A. Hallucinations/dreams C. Tachycardia
B. Respiratory depression D. Hand tremors E. Nausea
58. Thiazides, which are used in the treatment of hypertension, may require supplemental
administration of:
A. Sodium B. calcium C. Chloride D. potassium

59. Which of the following dentrifice components is most likely to inactivate the fluoride ion?
A. Anionic detergent C. Polyacrylic spheres
B. Dicalcium phosphate D. Monofluorophosphate

60. Which of the following adverse reactions of oral contraceptives is the most common and the most
serious?
A. Hypotension C. Uterine neoplasia
B. Hepatotoxicity D. Thromboembolic disorder E. Decreased resistance to infection

61. In therapeutic doses, digitalis acts primarily on the cardiac muscle. It does so by increasing the:
A. force of contraction C. refractory period of the atrial muscle
B. refractory period of the ventricular muscle D.rate of conduction of impulses to the muscle.

62. Each of the following is a pharmacologic effect of phenothiazines , except:

A. Sedation D. An antiemetic effect
B. Alpha-adrenergic blackage E. Potentiation of the action of narcotics
C. An anticonvulsant

63. Which of the following represents the drug-of-choice in the treatment of candidiasis for an HIV-
infected patient?
A. Acyclovir B. AZT C. Nystatin D. Chlorhexidine

64. Epinephrine antagonizes the effects of histamines by:

A. preventing the release of histamine
B. acting on the CNS
C. producing physiologic actions opposite to that of histamine
D. competitively blocking histamine at the cellular receptor site

65. The extrapyramidal syndrome seen with the antipsychotic agents is due to their action on the :
A. Cerebellum C. hypothalamus E. cerebral cortex
B. brain stem D. basal ganglia

66. Which of the following is classified as an antianxiety drug?

A. Methohexital C. Haloperidol
B. Lorazepam D. Pentazocine E. Phenylpropanolamine
67. The first clinically useful and systematically effective anti-nfective agent was:
A. penicillin C. tetracycline
B. sulfanilamide D. streptomycin E. bacitracin

68. During visit to the dentist, a patient develops a severe, acute bronchial asthmatic attack. He should
immediately receive:
A. cortisone C. tripelennamine
B. epinephrine D. 90% oxygen, 10% CO2

69. The most serious and life-threatening blood dyscrasia associated with drug toxicity is:
A. aplastic anemia C. thrombocytopenia
B. agranulocytosis D. hemolytic anemia E. megaloblastic anemia

70. When methohexital is used to induce general anesthesia, the initial effect wears off within a short
time and the patient awakens. This occurs because the drug is:
A. detoxified C. eliminated from the body
B. biotransformed D. redistributed from the brain

71. A dental patient on anticonvulsant therapy exhibits marked gingival hypertrophy. This patient , most
likely, is regularly taking:
A. primidone C. phenacemide
B. mephobarbital D. Phenobarbital E. diphenylhydantoin

72. Adrenergic neuron blocking drugs, such as guanethidine, are useful primarily in the treatment of:
A. mental disease C. cholinergic crisis
B. cardiac arrest D. paroxysmal tachycardia E. essential (primary) hypertension

73. The most important pharmacologic action of drug which suppress cardiac arrhythmias ia:
A. blockage of the vagus nerve D. stimulation of cardiac ATP-ase activity
B. blockage of the beta-adrenergic receptor E. stimulation of alpha-adrenergic receptor
C. increased refractory period of cardiac muscle.

74. Tolerance is least likely to develop with the use of:

A. LSD B. marihuana C. Heroin D. methadone E.
amphetamines

75. The principal danger associated with the use of nitrous oxide anesthesia in concentrations
exceeding 80% is:
A. hypoxia C. liver damage E. irritation of the respiratory tract.
B. renal damage D. vomiting and nausea

76. For treating most oral infections, penicillin V is preferred to penicillin G because penicillin V;
A. is less allergenic D. is less sensitive to acid degradation
B. has a greater gram-negative spectrum E. has a longer duration of action
C. is bactericidal, whereas penicillin G is not.

77. When the combined action of two drugs is greater the sum of their individual action, this is:
A. induction C. idiosyncrasy
B. synergism D. hypersensitivity E. cumulative action

78. With an overdose of a cholinergic drug, one would expect to see each of the following, except:
A. Sweating C. mydriasis
B. Urination D. bradycardia E. copious serious saliva

79. Which of the following is a beta-adrenergic receptor blocking agent used for the treatment of
hypertension?
A. Prazosin (Minipress ®) C. Atenolol (Tenormin®)
B. Clonidine (Catapres®) D. Hydralazine (Aprezoline®) E. Verapamil (Calan®)

80. In which of the following categories are ephedrine, tyramine, and amphetamine classified?
A. Anticholinesterases C. Alpha-adrenergic blocking agents
B. Indirect-acting sympathomimetics D. Direct-acting parasympathomimetics

81. Each of the following methods can be used to control pain, except:
A. Cortical depression D. Psychosomatic (hypnosis) methods
B. Raising the pain threshold E. Blocking the sensory pathway
 C. Depression of the autonomic nervous system
82. The first clinically useful and systematically effective anti-nfective agent was:
A. penicillin C. tetracycline
B. sulfanilamide D. streptomycin E. bacitracin

83. During visit to the dentist, a patient develops a severe, acute bronchial asthmatic attack. He should
immediately receive:
A. cortisone C. tripelennamine
B. epinephrine D. 90% oxygen, 10% CO2

84. The most serious and life-threatening blood dyscrasia associated with drug toxicity is:
A. aplastic anemia C. thrombocytopenia
B. agranulocytosis D. hemolytic anemia E. megaloblastic anemia

85. When methohexital is used to induce general anesthesia, the initial effect wears off within a short
time and the patient awakens. This occurs because the drug is:
A. detoxified C. eliminated from the body
B. biotransformed D. redistributed from the brain

86. A dental patient on anticonvulsant therapy exhibits marked gingival hypertrophy. This patient , most
likely, is regularly taking:
A. primidone C. phenacemide
B. mephobarbital D. Phenobarbital E. diphenylhydantoin

87. Adrenergic neuron blocking drugs, such as guanethidine, are useful primarily in the treatment of:
A. mental disease C. cholinergic crisis
B. cardiac arrest D. paroxysmal tachycardia E. essential (primary) hypertension

88. The most important pharmacologic action of drug which suppress cardiac arrhythmias ia:
A. blockage of the vagus nerve D. stimulation of cardiac ATP-ase activity
B. blockage of the beta-adrenergic receptor E. stimulation of alpha-adrenergic receptor
C. increased refractory period of cardiac muscle.

89. Tolerance is least likely to develop with the use of:

A. LSD B. marihuana C. Heroin D. methadone E.
amphetamines

90. The principal danger associated with the use of nitrous oxide anesthesia in concentrations
exceeding 80% is:
A. hypoxia C. liver damage E. irritation of the respiratory tract.
B. renal damage D. vomiting and nausea

91. For treating most oral infections, penicillin V is preferred to penicillin G because penicillin V;
A. is less allergenic D. is less sensitive to acid degradation
B. has a greater gram-negative spectrum E. has a longer duration of action
C. is bactericidal, whereas penicillin G is not.

92. When the combined action of two drugs is greater the sum of their individual action, this is:
A. induction C. idiosyncrasy
B. synergism D. hypersensitivity E. cumulative action

93. With an overdose of a cholinergic drug, one would expect to see each of the following, except:
A. Sweating C. mydriasis
B. Urination D. bradycardia E. copious serious saliva

94. Which of the following is a beta-adrenergic receptor blocking agent used for the treatment of
hypertension?
C. Prazosin (Minipress ®) C. Atenolol (Tenormin®)
D. Clonidine (Catapres®) D. Hydralazine (Aprezoline®) E. Verapamil (Calan®)

95. In which of the following categories are ephedrine, tyramine, and amphetamine classified?
A. Anticholinesterases C. Alpha-adrenergic blocking agents
B. Indirect-acting sympathomimetics D. Direct-acting parasympathomimetics

96. Each of the following methods can be used to control pain, except:
A. Cortical depression D. Psychosomatic (hypnosis) methods
B. Raising the pain threshold E. Blocking the sensory pathway
C. Depression of the autonomic nervous system