ABP Local Anesthesia, Sedation and Medical Emergencies

Question 1

What is the generally recommended maximum epinephrine dose for a patient with significant cardiovascular disease?

Accepted Answer

0.04 mg

Answer

A limit of 0.04 mg is recommended for cardiac-compromised patients. That is about two cartridges of 2% lidocaine with 1:100,000 epinephrine (0.018 mg each).

Question 2

What is the first-line treatment for anaphylaxis in the dental office?

Accepted Answer

Intramuscular epinephrine

Answer

Intramuscular epinephrine (0.3 to 0.5 mg of 1 mg/mL in adults, anterolateral thigh) is first-line, along with activating EMS and giving oxygen. Antihistamines and steroids are adjuncts only.

Question 3

A conscious diabetic patient shows signs of hypoglycemia. What is the appropriate first step?

Accepted Answer

Give about 15 g of oral fast-acting carbohydrate

Answer

A conscious patient who can swallow should receive about 15 g of fast-acting carbohydrate such as juice or glucose tablets. Glucagon or IV dextrose is reserved for unconscious patients.

Question 4

What is the maximum recommended dose of lidocaine with epinephrine in a healthy adult?

Accepted Answer

7 mg/kg, not exceeding 500 mg

Answer

Lidocaine with epinephrine has a maximum of 7 mg/kg and an absolute ceiling of 500 mg. Plain lidocaine is limited to about 4.4 mg/kg.

Question 5

Which ASA physical status class best describes a patient with poorly controlled diabetes and a stable history of angina who is not incapacitated?

Accepted Answer

ASA III

Answer

ASA III is severe systemic disease with functional limitation that is not incapacitating. ASA II is mild, well-controlled disease.

(ABP) American Board of Periodontology Practice Test

(ABP) American Board of Periodontology Practice Test

ABP Local Anesthesia, Sedation and Medical Emergencies