MFDS Part 1 - Membership of Faculty of Dental Surgery Pharmacology and Pain Control Questions and Answers

Question 1

A healthy 4-year-old child weighing 18kg requires post-operative analgesia following a dental extraction. According to the British National Formulary for Children (BNFC), what is the appropriate single oral dose of paracetamol for this child?

Accepted Answer

270 mg

Answer

The British National Formulary for Children (BNFC) recommends a standard oral paracetamol dose of 15 mg per kg of body weight for children aged 1 month to 18 years, administered every 4-6 hours (maximum 4 doses in 24 hours). For an 18 kg child, the calculation is 18 kg x 15 mg/kg = 270 mg.

Question 2

A 62-year-old patient requests analgesia for acute dental pain. Their medical history includes a peptic ulcer 5 years ago, well-controlled hypertension treated with ramipril, and asthma. Which of the following analgesics is generally contraindicated?

Accepted Answer

Ibuprofen 400mg

Answer

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). NSAIDs are contraindicated in patients with a history of peptic ulceration due to the risk of gastrointestinal bleeding. They can also exacerbate asthma and should be used with caution in patients taking ACE inhibitors like ramipril.

Question 3

A patient undergoing conscious sedation with intravenous midazolam becomes over-sedated and experiences significant respiratory depression. According to UK sedation guidelines (IACSD), which drug is the specific reversal agent for this situation?

Accepted Answer

Flumazenil

Answer

Flumazenil is a specific benzodiazepine receptor antagonist and is the correct agent to reverse the sedative and respiratory depressant effects of midazolam. Naloxone is an opioid antagonist, Adrenaline is used for anaphylaxis, and Atropine is used to manage bradycardia.

Question 4

A 35-year-old patient presents with a painful, localised, fluctuant swelling adjacent to a non-vital lower molar. There are no signs of systemic involvement or spreading infection. According to the Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance, what is the most appropriate initial management?

Accepted Answer

Establish drainage of the abscess without prescribing antibiotics

Answer

Current UK prescribing guidance, such as from SDCEP ('Drug Prescribing for Dentistry'), promotes antimicrobial stewardship. For a localised dental abscess without signs of spreading infection or systemic upset in a healthy patient, the definitive treatment is to establish drainage (e.g., via incision or root canal access). Antibiotics are not indicated as a first-line measure in this scenario.

Question 5

What is the maximum recommended dose (MRD) of 2% lidocaine with 1:80,000 adrenaline for a healthy 70 kg adult, according to the British National Formulary (BNF)?

Accepted Answer

7.0 mg/kg

Answer

The British National Formulary (BNF) and other authoritative sources state the maximum recommended dose of lidocaine with adrenaline for dental use is 7.0 mg/kg of body weight, with an absolute maximum not to exceed 500 mg. The dose of 4.4 mg/kg is the maximum for lidocaine without a vasoconstrictor.

MFDS Part 1 Practice Test

MFDS Part 1 Practice Test

MFDS Part 1 - Membership of Faculty of Dental Surgery Pharmacology and Pain Control Questions and Answers