FREE NDEB Pharmacology and Therapeutics Questions and Answers

Question 1

A 68-year-old male patient with a history of hypertension, well-controlled with propranolol, requires a mandibular tooth extraction.
After administering a local anesthetic containing 1:100,000 epinephrine, the patient's blood pressure rises sharply, and their heart rate drops.
Which of the following best explains this reaction?

Accepted Answer

Unopposed alpha-adrenergic stimulation from epinephrine.

Answer

An allergic reaction to the amide anesthetic.

Answer

Anesthetic solution was injected intravascularly.

Answer

Anxiety-induced hypertensive episode.

Question 2

A patient reports post-operative dental pain following a procedure. You recommend an over-the-counter NSAID like ibuprofen. What is the primary mechanism of action by which ibuprofen reduces pain?

Accepted Answer

Preventing the synthesis of prostaglandins by inhibiting COX enzymes.

Answer

Blocking opioid receptors in the central nervous system.

Answer

Inhibiting the reuptake of serotonin and norepinephrine.

Answer

Stimulating the release of endogenous endorphins.

Question 3

According to the most recent American Heart Association (AHA) guidelines, which of the following patients requires antibiotic prophylaxis before an invasive dental procedure to prevent infective endocarditis?

Accepted Answer

A patient with a prosthetic cardiac valve.

Answer

A patient with mitral valve prolapse.

Answer

A patient with a history of rheumatic heart disease.

Answer

A patient with a bicuspid aortic valve.

Question 4

A patient scheduled for a simple tooth extraction reports they are taking warfarin. Their most recent INR reading, taken yesterday, was 2.8. What is the most appropriate course of action?

Accepted Answer

Proceed with the extraction using local hemostatic measures.

Answer

Cancel the procedure and refer the patient to their physician to stop warfarin.

Answer

Administer vitamin K to reverse the effects of warfarin before the procedure.

Answer

Proceed with the extraction but avoid using a local anesthetic with a vasoconstrictor.

Question 5

A patient who has been receiving intravenous bisphosphonate therapy for several years for the management of bone metastases is at an increased risk for which of the following adverse oral conditions, especially after a dental extraction?

Accepted Answer

Medication-related osteonecrosis of the jaw (MRONJ)

Answer

Gingival hyperplasia

Answer

Lichen planus

Answer

Stevens-Johnson syndrome

Question 6

A patient has a documented true allergic reaction to procaine. Which of the following local anesthetics would be most appropriate to use for this patient, assuming no other allergies?

Accepted Answer

Lidocaine

Answer

Tetracaine

Answer

Benzocaine

Answer

Cocaine