NBDE General Practice 2

Question 1

A patient on warfarin requires a routine extraction. The INR is 2.8. What is the most appropriate management?

Accepted Answer

Use local hemostatic measures and proceed

Answer

For INR values up to 3.5, dental extractions can proceed safely with local hemostatic measures such as suturing, oxidized cellulose, and pressure packs.

Question 2

Which organism is most commonly associated with Ludwig's angina?

Accepted Answer

Streptococcus viridans

Answer

Streptococcus viridans is the most frequently isolated organism in Ludwig's angina, a life-threatening bilateral submandibular and sublingual space infection.

Question 3

A 45-year-old patient presents with trismus, fever, and swelling in the pterygomandibular space. What is the most likely diagnosis?

Accepted Answer

Pterygomandibular space abscess

Answer

Trismus combined with pterygomandibular space swelling and systemic signs indicates a pterygomandibular space abscess, typically arising from a lower molar.

Question 4

Which local anesthetic has the longest duration of action for pulpal anesthesia?

Accepted Answer

Bupivacaine 0.5%

Answer

Bupivacaine 0.5% provides the longest pulpal anesthesia duration (up to 90 minutes) due to its high lipid solubility and protein binding.

Question 5

A patient taking bisphosphonates for osteoporosis requires an extraction. Which complication is of greatest concern?

Accepted Answer

Medication-related osteonecrosis of the jaw (MRONJ)

Answer

Bisphosphonates impair osteoclast activity and bone remodeling, leading to MRONJ, characterized by exposed necrotic bone that fails to heal after 8 weeks.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE General Practice 2