DAANCE Managing Systemic Diseases 2

Question 1

A dental patient with Type 1 diabetes mellitus scheduled for morning sedation is MOST at risk for which perioperative complication?

Accepted Answer

Hypoglycemia due to fasting and insulin effects

Answer

Hyperglycemic hyperosmolar state

Answer

Diabetic ketoacidosis within 30 minutes of sedation

Answer

Increased bleeding due to platelet dysfunction

Question 2

For a patient on warfarin therapy, the dental team should review which laboratory value before a procedure involving significant bleeding risk?

Accepted Answer

International normalized ratio (INR)

Answer

Partial thromboplastin time (aPTT)

Answer

Platelet count only

Answer

Complete blood count (CBC) with differential

Question 3

A patient with severe obstructive sleep apnea (OSA) presents for IV sedation. The primary concern during sedation is:

Accepted Answer

Exaggerated upper airway obstruction and respiratory depression sensitivity

Answer

Increased bleeding from CPAP-related upper airway trauma

Answer

Seizure activity from hypoxia-induced cortical irritability

Answer

Hypertensive crisis from catecholamine release

Question 4

A patient with a known latex allergy requires dental sedation. The anesthesia team must:

Accepted Answer

Ensure the environment is latex-free, including gloves, IV tubing, and mask components

Answer

Premedicate with diphenhydramine and proceed normally

Answer

Only perform nitrous oxide sedation to avoid IV access

Answer

Reschedule the patient to a hospital setting

Question 5

Which modification is indicated for a patient with severe aortic stenosis (AS) scheduled for elective dental sedation?

Accepted Answer

Consult the cardiologist; sedation may require advanced monitoring or hospital-based care

Answer

Administer aggressive IV fluid loading to maintain high preload

Answer

Use low-dose vasodilators to compensate for the stenotic valve

Answer

Proceed with standard IV sedation without modification

Question 6

A patient with chronic renal failure on hemodialysis presents for sedation. Which pharmacokinetic alteration is most clinically important?

Accepted Answer

Reduced protein binding and accumulation of renally-cleared drug metabolites

Answer

Increased hepatic first-pass metabolism of IV opioids

Answer

Faster gastric emptying leading to altered oral drug absorption

Answer

Increased volume of distribution requiring higher initial doses