MISC (2) and (4)

Which of the following hemostatic agents (4) only

is most likely to create a systemic All of the above.
reaction?

Aluminum sulphate (Pascord).

Aluminum chloride (Hemodent).
Epinephrine (Racord). Which of the following conditions can make an
Ferric sulphate (Astringedent). older patient short of breath on mild exertion?

Anemia.
According to the principles of ethics that are Cardiac failure.
generally accepted in Canada, a dentist may Obesity.
refuse to treat a patient with HIV infection for a Osteoarthritis.
specific procedure for the following reason(s).
(1) (2) (3)
Inadequate experience in the specific (1) and (3)
procedure. (2) and (4)
Inadequate knowledge of the specific (4) only
procedure. All of the above.
Lack of instruments or equipment for this
procedure.
Infection control procedures that are not Hypoglycemia in a diabetic patient can
designed for infectious patients. be characterized by

(1) (2) (3) nausea.

(1) and (3) palpitations.
(2) and (4) sweating.
(4) only mental confusion
All of the above.
(1) (2) (3)
(1) and (3)
As a dentist in Canada, it is ethical to refuse to (2) and (4)
treat a patient on the basis of (4) only
All of the above.
religious beliefs.
physical handicap.
infectious disease. The Silness-Le Index measures
recognition of lack of skill or knowledge.
periodontal disease.
(1) (2) (3) oral hygiene.
(1) and (3) attachment level.
(2) and (4) probing depth.
(4) only
All of the above.
The Fluorosis Index is used to measure the

degree of protection offered against dental

Which of the following drug groups can
caries by fluoride supplements.
cause xerostomia?
concentration of fluoride in public water
supplies.
Diuretics.
degree or severity of mottled enamel.
Antibiotics.
opposition to fluoridation by citizens'
Antidepressants.
groups.
Non-steroidal anti-inflammatory agents.
total amount of fluoride ingested.
(1) (2) (3)
(1) and (3)
In chewing, maximum contact between
teeth occurs in the position of
Epidemiology of disease is best described as
habitual occlusion.
the
lateral excursion on the non-working side.
protrusive excursion. data obtained from sickness surveys.
All of the above usual low level of disease normally found
within a population.
control of disease.
The fluoride ion study of disease patterns in a population

is excreted rapidly by the kidney.

passes the placental barrier. An increase of immunoglobulins is consistent
is deposited in teeth. with increased numbers of
is deposited in bone.
fibroblasts.
(1) (2) (3) neutrophils.
(1) and (3) lymphocytes.
(2) and (4) plasma cells.
(4) only
All of the above.

A diet survey can provide which of the

Abnormalities in blood clotting may be
following information for the prevention
of dental caries? associated with a deficiency of vitamin

Total carbohydrate consumption. B12.

Frequency of fermentable carbohydrate C.
consumption. E.
Total protein consumption. K.
Daily calcium intake.

Salivary secretion
DMF-S is an index for expressing
increases with age.
decreases with age. dental needs.
shows no difference with age. tooth mortality.
shows a decrease in mineral content in the extent of dental neglect.
elderly. dental caries.

Patient who is jaundiced because of liver

disease has an increased risk of In a young patient living in an area with
communal water fluoridation, the fluoride
postextraction bleeding. concentration of an erupted tooth is greatest
cardiac arrest. at the dentino-enamel junction.
postoperative infection. on the surface of the clinical crown.
anaphylactic shock. at the layer of dentin nearest the pulp
chamber.
(1) (2) (3)
evenly throughout the enamel.
(1) and (3)
(2) and (4) Which of the following viruses has the greatest
(4) only chance of transmission in an occupational
All of the above.
exposure to a vaccinated dental healthcare a ranula.
worker? (MISC) a blockage of Wharton's duct.
Ludwig's angina.
Hepatitis B. a blockage of Stensen's duct.
Hepatitis C. an epidemic parotitis.
HIV.
HPV.

In Canada, it is ethical for a dentist

Recurrent unilateral submandibular swelling to refuse to treat a patient on the
and pain just prior to meals is indicative of basis of the
(MISC)
patients religious beliefs.
an odontogenic infection. patients physical handicap.
sialolithiasis. patients infectious disease status.
ranula. complexity of the required treatment.
sarcoidosis.
Sjgrens syndrome Which of the following is directly
involved in the conversion of
For a patient allergic to penicillin, what is the
prothrombin to thrombin?
most appropriate drug for antibiotic
prophylaxis? (MISC) Sodium.
Calcium.
Ampicillin.
Fluoride.
Cephalexin.
Potassium.
Clindamycin.
Bicarbonate.
Erythromycin.
Metronidazole.

When epinephrine 1:1000 is administered Unconsciousness in syncope results from

intramuscularly for the management of
anaphylaxis in an adult, the most electrolyte imbalance.
appropriate volume for an initial dose is neurogenic shock.
(MISC) cerebral hyperemia.
cerebral hypoxia.
0.02 0.04ml.
0.3 0.5ml.
1.0 1.5ml.
1.6 1.8ml. Patients with a history of rheumatic fever and
known heart valve damage should be given
Which of the following is the most active prophylactic antibiotic coverage before dental
cell in synthesizing and secreting antibodies? extractions because of the risk of
(MISC)
myocardial infarction.
Mast cell. subacute bacterial endocarditis.
Macrophage. cardiac arrest.
Eosinophilic granulocyte. All of the above.
Plasma cell.
T-cell lymphocyte.
Which of the following is
the strongest stimulus to
Intermittent painful respiration?
swelling in the
submandibular region that Decrease in arterial pH.
increases at mealtime is Increase in arterial oxygen.
indicative of Decrease in arterial oxygen.
Increase in arterial carbon dioxide.
 Decrease in arterial carbon dioxide.
A. minimize publication bias.
In the treatment of an acute B. define who is at risk for a disease.
anaphylactic reaction, the C. guide statistical testing for clinical
first drug that should be procedures.
administered is D. provide a quantitative summary
measure from many studies.
hydroxyzine.
epinephrine.
hydrocortisone.
diphenhydramine. Which of the following studies provides the
best evidence for the possible association
The purpose of calibrating examiners in a between community water fluoridation and
randomized controlled clinical trial is to hip fracture? (MISC)
ensure (MISC)
A. Ecological.
A. consistent measurement of B. Case-series.
clinical outcomes. C. Cross-sectional.
B. similarity of experimental and D. Retrospective cohort.
control groups.
C. high ethical standards in conducting A physical sign of impending syncope is
the trial. (MISC)
D. measurement of all relevant
clinical outcomes. A. pallor.
B. elevation of blood pressure.
In addition to the advancement of C. tachycardia.
knowledge, health research is intended to
produce value for research subjects, for other A 25 year old female in her first trimester of
individuals, and/or for society as a whole. pregnancy presents with an acute dental
What ethical principle does this refer to? infection. Which of the following is
(MISC) CONTRAINDICATED for this patient?
(MISC)
A. Autonomy.
B. Non-maleficence. A. Take a radiograph.
C. Beneficence. B. Prescription of penicillin V.
D. Justice. C. Administration of 2%
xylocaine with 1:100,000
epinephrine.
D. Acetylsalicylic acid for pain control.
A survey of a random sample of 5,586
Canadians found that 63% of older adults
Antibiotic coverage should be provided
had visited a dentist in the last year. The
when performing periodontal surgery for
95% confidence interval was 56% to 70%.
patients with (MISC)
This means that (MISC)
A. myocardial infarction.
A. between 56% and 70% of older
B. dental implants.
adults account for 95% of the
C. prosthetic heart valve.
dental visits.
D. coronary artery disease.
B. there is 95% certainty that 63% of

older adults had dental visits.
C. no more than 70% of dental visits Which of the following is/are vital signs?
(MISC)
occurred in 95% of older adults.
D. there is 95% certainty that 56% to 70%
1. Blood pressure.
of older adults had dental visits.
2. Body temperature.

3. Pulse and respiratory rate.
Meta-analyses are important to the practice
4. Pupil size.
of dentistry because they (MISC)
 order to reduce his weight. During his 8:30
A. (1) (2) (3) a.m. appointment, his speech becomes
B. (1) and (3) slurred and he is less alert than usual. Which
C. (2) and (4) of the following is the most appropriate
(4) only management of this patient?
All of the above.
Make him drink 175ml of diet cola.
Which of the following is/are vital signs? Give him 15g of glucose as tablets or in a
(MISC) solution.
Make him eat a chocolate bar.
A. Pulse and respiratory rate. Dismiss the patient and advise him to eat.
B. Complete blood count.
C. Pupil size and reactivity. MISCThe Plaque Index of Silness and Loe
D. Height and weight. measures

MISCA 2cm, discrete, white lesion of the quantity of plaque at the gingival
buccal mucosa has not resolved after margin.
elimination of all local irritants. The most colony forming units of Gram-
appropriate management would be to negative bacteria.
weight of plaque obtained from
cauterize it. facial surfaces.
apply toluidine blue staining.
perform an incisional biopsy. MISCWhich one of the following is the most
re-examine at 6 month intervals. common tumour of the salivary glands?
refer patient to family physician.
A. Adenocystic carcinoma.
MISCIn which of the following patients can B. Adenoma.
you safely extract a tooth in a dental office C. Pleomorphic adenoma.
setting? D. Muco-epidermoid carcinoma.

Two weeks after a myocardial infarct. MISCSickle cell anemia is
Four months into pregnancy.
Suffering from Factor VIII deficiency. A. a genetic disease.
Presenting with bilateral B. caused by exposure to radiation.
submandibular space abcess. C. a viral infection.
D. a drug reaction.
MISCAn insulin-dependent diabetic patient E an auto-immune disease
has rushed in late for an early morning 1
hour long appointment. Which of the MISCAn abnormal decrease in the flow of
following should be verified? That saliva is
a low-carbohydrate snack is available in A. ptyalism.
case of an insulin reaction. B. sialometaplasia.
the patient has taken his regular dose of C. xerostomia.
insulin. D. pyroglossia.
the patient has eaten his regular morning
breakfast.
an extra dose of insulin is available in case
of a hypoglycemic reaction. MISCA salivary calculus is a

A. sialolith.
B. rhinolith.
MISCA 50 year old obese patient was C. phlebolith.
diagnosed with type 2 diabetes last year and D. thrombolith.
has recently started taking an oral
hypoglycemic. He frequently skips meals in MISCWhen a patient experiences
continuous pain in the maxillary premolar
 and molar areas and there is no evidence of MISCWhich of the following is/are
dental infection, the most likely diagnosis is associated with the presence of
microorganisms in the bloodstream?
A. trigeminal neuralgia.
B. acute maxillary sinusitis. A. Anachoresis.
C. impacted maxillary canine. B. Cavernous sinus thrombosis.
D. impacted maxillary third molar. C. Bacteremia.
glossopharyngeal neuralgia D. All of the above.
MISCA patient who uses nitroglycerine has
MISCA patient telephones and tells you he
A. rheumatic heart disease. has just knocked out his front tooth but that it
B. asthma. is still intact. Your instructions should be to
C. coronary artery disease.
A. put the tooth in water and come to
D. high blood pressure.
your office at the end of the day.
E. cardiac arrhythmia.
B. wrap the tooth in tissue and come to
your office in a week's time.
C. put the tooth in alcohol and come to
MISCThe term applied to a low white blood your office immediately.
cell count is D. place tooth under the tongue and
come to your office immediately.
A. leukocytosis. E. place the tooth in milk and come to
B. leukopenia. your office immediately.
C. thrombocythemia.
D. thrombocytopenia. MISCWhich of the following methods of
instrument sterilization uses the lowest
temperature?

MISCA decrease in the neutrophil count is A. Steam autoclave.

present in B. Dry heat oven.
C. Ethylene oxide method.
A. granulocytopenia (agranulocytosis). D. Glass bead sterilizer.
B. iron deficiency anemia. E. Alcohol autoclave.
C. myeloid leukemia.
D. leukocytosis.
E. thrombocytopenic purpura.

MISCAn anemia in which the red blood cells
are smaller and less intense in color than
normal is called a

A. microcytic hypochromic anemia.

B. microcytic hyperchromic anemia.
C. macrocytic hypochromic anemia.
D. macrocytic hyperchromic anemia.
E. None of the above.

MISCA decrease of which of the following
is indicative of hypoparathyroidism?

A. Serum phosphorus.
B. Serum calcium.
C. Thyroid activity.
D. Serum alkaline phosphatase.

as the


Epidemiology of disease is best described white blood cell count.
hemoglobin level.
erythrocyte sedimentation rate.
data obtained from sickness surveys. platelet count.
usual low level of disease normally found
within a population. (1) (2) (3)
control of disease. (1) and (3)
study of disease patterns in a population. (2) and (4)
(4) only
All of the above

Which of the following conditions may
develop as a result of juvenile diabetes
mellitus? The cells responsible for antibody
production are called
Ataxia.
Aphasia. polymorphonuclear leukocytes.
Deafness. mast cells.
Blindness. plasma cells.

Motor paralysis. macrophages.
megakaryocytes.




The inorganic ion that is implicated in In the presence of an acute bacterial
primary hypertension is infection, laboratory tests will show an
increase in
sodium.
fluoride. polymorphonuclear leukocytes.
potassium. plasma cells.
magnesium lymphocytes.
monocytes.
Eosinophils

The most common complication of a
venipuncture is MISC -Which of the following would
NOT be expected to cause
syncope. hypokalemia?
hematoma.
thrombophlebitis. Metabolic acidosis.
embolus. Lactate accumulation.
Increased plasma insulin.

Excess aldosterone secretion.
Beta-adrenergic stimulation of cells.



MISC Hypernatremia may be induced by
Bacterial infection may be confirmed by
elevated synthesis of atrial natriuretic

peptide.
excessive vasopressin secretion.
 impaired aldosterone secretion.
diabetes insipidus.
MISC A patient with a history of hypertension
presents for an emergency dental extraction.
His blood pressure is 158/100 mmHg. The
dentist intends to use lidocaine 2% with
1:100,000 epinephrine for local anesthesia.
The most appropriate management is to
direct the patient to a hospital
emergency room.
extract the tooth using a maximum of
four cartridges.
extract the tooth using a maximum of
two cartridges.
extract the tooth and advise the patient
to take additional antihypertensive
medication.
MISC A 6 year old has circumscribed
suppurative lesions that look like cigarette
burns on the left ear lobe and the right
knuckles. The parents are cooperative and
respond to the dentist in a coherent manner.
The most likely diagnosis is
battered child syndrome.
impetigo.
osteogenesis imperfecta.
Mnchhausen syndrome.
von Willebrand desease.
salivary contamination of clinic jackets.
manufacturing defects in gloves.
percutaneous injury.
MISC Patients with anemia have an increased
risk of
bacterial infections.
prolonged bleeding.
exercise intolerance.
MISC Patients with thrombocytopenia
have an increased risk of
bacterial infections.
prolonged bleeding.
exercise intolerance.
MISC A dentist must be prudent in deciding
how far to follow a patients informed choice
for suboptimal treatment because
the law protects a patients right to
make poor decisions.
a patients informed choice must always
be honoured.
the principle of do-no-harm overrides
the patients personal choice.

MISC A new patient is a heavy smoker and

has severe periodontitis. When asked if
interested in quitting smoking in the next
month, the patient replies, I dont smoke that
much so its not a big deal. What is the most
appropriate strategy to encourage behaviour
change?

Encourage the patient to identify MISC During cardiopulmonary resuscitation

an alternate date to stop smoking. (CPR), external chest compression of an adult
Explain the benefits of quitting smoking patient should be
as soon as possible.
Personalize the risk of continuing 1 - 2cm.
smoking to the patients oral health. 4 - 5cm.
Ask the patient what would be the easiest first 7 - 10cm.
step to take toward quitting
10 - 20cm.

MISC The greatest risk to dental health care

personnel for acquiring a blood-borne MISC The most radiosensitive salivary gland
pathogen is through is the

blood spatter on intact skin. sublingual.

 submandibular. The surgical risk for a patient with
parotid. organic heart disease depends upon

MISC The most likely complication following cardiac reserve.

surgery for a patient with thrombocytopenic blood pressure.
purpura would be respiration.
pulse rate.
angina. cardiac output.
hemorrhage.
alveolar osteitis.
delayed healing.
infection. MISC
Which of the following will produce
MISC Which of the following conditions hemostasis when applied topically?
is most likely to lead to thrombosis?
Oxidized cellulose.
Stasis of blood. Absorbable gelatin sponge.
Presence of bacteria in blood. Microfibrillar collagen.
Deficiency of circulating platelets. Topical bovine thrombin.
Increased concentration of plasma.
Lowered oxygenation of hemoglobin. (1) (2) (3)
(1) and (3)
(2) and (4)
(4) only
All of the above.
MISC Ethics is most concerned with

patient rights.
standard of right and wrong. MISC
legal liability. Properties of glutaraldehyde include
provincial codes of conduct.
rapid formation of cross linkages
which limit penetration of pulp tissue.
MISC In a healthy 75 year old, which of the
minimal effect on pulp tissues.
following would be considered normal blood excellent disinfection against oral flora.
pressure? minimal effectiveness against viruses
and spores.
175/95 mmHg.
135/86 mmHg. (1) (2) (3)
130/100 mmHg. (1) and (3)
185/94 mmHg. (2) and (4)
(4) only
All of the above.
MISC In the context of informed
consent, choice means the ability
MISC
to accept recommended The normal differential white cell count for
beneficial treatment voluntarily. neutrophils is
to refuse recommended
beneficial treatment voluntarily. 10-19.
to refuse recommmended beneficial treatment 20-29.
with an understanding of forseeable 30-39.
consequences. 40-65.
66-90.

MISC
MISC
Increased bleeding is associated with a
prolonged administration of

warfarin.
codeine.
acetylsalicylic acid.
acetaminophen.

(1) (2) (3)

(1) and (3)
(2) and (4)
(4) only
All of the above

MISC
To assess factors affecting the utilization of
dental services, a cross-sectional study
surveyed adults on a number of variables.
Considering the study design, which of the
following findings CANNOT be derived
from the results?

Satisfaction with the services.

Gender differences.
Caries incidence.
Utilization of dental services.

MISC
Patterns of exposure to a risk factor in a
population is important because it helps

understand where preventive

interventions can be targeted.
define the prevalence of a disease.
define the population attributable
fraction of a disease.
give an insight into what statistical tests
to use.

MISC
What is the most appropriate design for a
study that is started after the exposure to a risk
factor but before the disease started?

Case series.
Randomized trial.
Case-control.
Cohort.
MISC
An article reports that subjects receiving eosinophils. MISC-Coxsackie A virus is
chlorhexidine varnish had significantly lower the etiologic agent in
(p<0.05) Streptococcus mutans levels than thrush.
did those receiving fluoride varnish. What herpangina.
type of reporting error is of the most concern lichen planus.
when interpreting these results? aphthous stomatitis.
Type II () error.
Type I () error.
MISC-The finding of acid-fast
Type II () error. microorganisms in sputum suggests the
Type I () error. presence of
Mycobacterium tuberculosis.
Diplococcus pneumoniae.
Streptococcus pyogenes.
MISC Neisseria gonorrhoeae.
The findings from a meta-analysis of
24 clinical trials conducted over 20 MISC-Pernicious anemia may cause
years, involving vitamin D glossitis.
supplementation to prevent dental caries lingual ulceration(s).
in children aged 5-
parotid swelling.
14 years, reveal there is wide variation in
gastric hyperacidity
the results between the studies. Which of
the following differences is LEAST likely
responsible for this variation? MISC-A clinical finding common to
alcoholism, poorly-controlled diabetes
Age of the children. mellitus, uremia and liver disease is
Stage of dentition of children.
Years when the studies were conducted. smooth tongue.
Baseline caries levels of children. increased blood pressure.
coated tongue.
labial fissures.
MISC halitosis.
Patients with primary herpetic
gingivostomatitis should NOT receive MISC-A patient with a white blood cell
count of 34,000/mm3 has a differential
acetaminophen. of lymphocytes 62%, lymphoblasts 4%
acyclovir. and polymorphonuclear leukocytes
benzocaine. 34%. The most likely form of leukemia
prednisone.
is
chlorhexidine.
aleukemic.

granulocytic.
MISC MISC-Sickle cell anemia is
monocytic.
a genetic disease.
lymphocytic.
caused by exposure to radiation.
plasma cell.
a viral infection.
a drug reaction.
MISC-The cells responsible for
an auto-immune disease.
antibody production are called
polymorphonuclear leukocytes.
MISC-In the presence of an acute
mast cells.
bacterial infection, laboratory tests will
plasma cells.
show an increase in
macrophages.
polymorphonuclear leukocytes.
Megakaryocytes
plasma cells.
lymphocytes.
monocytes.
MISC-Intermittent painful swelling in the Mitral. MISC-The major stimulator of
submandibular region that increases at respiration is
mealtime is indicative of low blood pressure.
a ranula. high percentage of blood oxygen.
a blockage of Wharton's duct. low percentage of blood carbon dioxide.
Ludwig's angina. high percentage of blood carbon
a blockage of Stensen's duct. dioxide.
an epidemic parotitis.
MISC-The inorganic ion that is
MISC-Bacterial infection may be implicated in primary hypertension is
confirmed by sodium.
white blood cell count. fluoride.
hemoglobin level. potassium.
erythrocyte sedimentation rate. magnesium.
platelet count.
(1) (2) (3) MISC-Unconsciousness in syncope
(1) and (3) results from
(2) and (4) electrolyte imbalance.
(4) only neurogenic shock.
All of the above. cerebral hyperemia.
cerebral hypoxia.
MISC-A 20-year old male presents with a
three-day history of an acute generalized MISC-Early anoxia is characterized by
gingivitis. He has malaise, fever and cyanosis.
bilateral cervical lymphadenopathy. A bradycardia.
blood examination reveals tachycardia
Hb: 8.9g/100ml Platelets: 82,000/mm3 (1) only
Red blood cell count: 3,900,000/mm3 (1) and (2)
White blood cell count: 870,000/mm3 (1) and (3)
Normal Values: All of the above.
Hb: 14-18g/100ml
Platelets: 150,000-400,000/mm3
Red blood cell count: 4-5million/mm3 ETHICS
White blood cell count: 5,000-
10,000/mm3 It is ethical to replace amalgam restorations
The most likely diagnosis is
on request from an informed patient.
thrombocytopenic purpura.
to relieve symptoms of multiple sclerosis.
acute myelogenous leukemia.
to reduce the risk of developing
infectious mononucleosis. Alzheimers disease. ETHICS
acute necrotizing ulcerative gingivitis. to eliminate toxins from the patient.

MISC-Which of the following is NOT a It is ethical for a dentist in Canada to

sign of congenital heart disease? decline to treat a patient due to
Cyanosis.
Telangiectasia. a difference in religious beliefs.
Clubbing of the fingers and toes. the patients infectious status.
Heart murmur. a patient being physically challenged.
Right ventricular hypertrophy. a patient being mentally challenged.
MISC-Which valve is most commonly ETHICS
affected by rheumatic heart disease? the dentists lack of skill or
knowledge
Aortic.
Pulmonary.
Tricuspid.
MISC
A patient who is a hepatitis B carrier
presents for an extraction. The extraction
should be delayed and
rescheduled at the end of the day for
infection control. MISC
an antibiotic prescribed prophylactically.
the patient referred to a hospital dental
department.
an evaluation of liver function performed.
can be stored for up to 24 hours if placed in
an airtight container after sterilization.
can be stored for up to 7 days if placed in
sterile bags after sterilization.
can be stored for up to 1 year if wrapped
after sterilization.
must not be stored after sterilization. MISC
A patient is currently on warfarin. Before a
planned extraction of tooth 3.4, the
patients coagulation mechanism should be
evaluated using which test?

Oral signs and/or symptoms of vitamin B2 Bleeding time.

(riboflavin) deficiency may include Partial thromboplastin time.
Prothrombin time or INR.
glossitis. Von Willebrands Factor. MISC
angular cheilitis. MISC
pain. Xerostomia can result from
erythematous oral mucosa.
Sjgrens syndrome.
(1) (2) (3) radiation therapy for oral cancer.
(1) and (3) antidepressant drug therapy.
(2) and (4) anticholinergics (Atropine).
(4) only
All of the above. (1) (2) (3)
(1) and (3)
A gluteal intramuscular injection may be (2) and (4)
safely administered in which quadrant? (4) only
All of the above. MISC
Lower medial.
Upper medial. A 50 year old patient, who is a heavy
Lower lateral. smoker, has developed a barrel chest, has
Upper lateral. MISC difficulty breathing and has a bluish tinge
to his complexion. The most likely
Saliva is most effective in minimizing an acid diagnosis is
challenge by its
emphysema.
lubrication function. acute upper respiratory infection.
antimicrobial effect. primary cancer of the lung.
buffering action. cardiac insufficiency. MISC
fluoride concentration.
A patient with Alzheimers dementia
The single most important measure to reduce presents with his personal care worker. His
the risk of transmitting organisms to patients is daughter, who is his legal guardian, is
unavailable. What is required to obtain
use of personal protective barriers: masks, informed consent for an elective invasive
eyewear, outerwear and gloves. procedure?
sterilization of instruments and
disinfection of the operatory. The patients presence implies consent.
handwashing. Obtain written consent from the patient.
introduction of single use instruments and Obtain written consent from the personal
disposables. care worker.
MISC Obtain consent from the patients
daughter.
Unbagged sterilized instruments
Xerostomia can be
found in the elderly.
drug induced.
associated with diabetes.
predisposing to dental diseases.

(1) (2) (3)

(1) and (3)
(2) and (4)
(4) only
All of the above. MISC

miscUpon returning to the operatory, the dentist

notices the patient is looking at the dental chart.
Which of the following statements is correct?

The patient has a legal right to access

the chart at any time.
The dentist can charge an administrative
fee to the patient to view the chart.
A written request is required before
access to the chart can be granted
miscWhich of the following is NOT a
manifestation of hyperglycemia?

Moist skin.
Acetone breath.
Abdominal pain.
Decreased consciousness.

miscA 55 year old patient wants to maintain

bone mass following implant surgery and plans
to take extra calcium. Supplemental calcium is
most beneficial when consumed in

divided doses with meals.

divided doses between meals.
a single dose with meals.
a single dose between meals
miscA patient with bulimia who purges
several times a day should be advised to
increase intake of

lean chicken.
bananas.
whole wheat
bread.

miscWhat is the correct rate of ventilation
for an unconscious patient with a palpable
pulse?
4-6 breaths per minute.
6-8 breaths per minute.
8-10 breaths per minute.
10-12 breaths per minute.
12-14 breaths per minute.
miscDentists may choose NOT to provide
treatment for a patient when the
treatment cannot be completed in a
timely fashion.
patient has a serious
communicable disease.
dentist does not have sufficient training
for procedure.
treatment is for an urgent situation.
(1) and (3)
(2) and (4)
(1) (2) (3)
(4) only
All of the above.
miscThe presence of hepatitis B surface
antigen (HBsAg) and hepatitis B e antigen
(HBeAg) in blood indicates the individual
is infectious for hepatitis B.
has acquired immunity to hepatitis B.
is not infectious for hepatitis B and has
not acquired immunity to hepatitis B.
has never been infected with hepatitis B.
miscWhich of the following is the most
effective method of cleaning endodontic
instruments prior to sterilization?
Manual brushing.
High pressure water jet.
Washing with antimicrobial soap.
Washing in an ultrasonic bath for
5 minutes.
miscA 65 year old patient who has recovered
from a stroke 6 months previously and has a
history of endocarditis requires the extraction
of a mandibular molar. The vital signs are
Blood Pressure: 135/85 mmHg
Pulse: 76/min
Respiratory Rate: 16/min
The most appropriate immediate
management of this patient is to
proceed with the treatment.
use prophylactic antibiotics.
use local anesthetic with no epinephrine.
delay treatment for 3 months.
miscA 45 year old with insulin-dependent
diabetes mellitus has a morning dental
appointment. During the examination, the
patient complains of being lightheaded and
weak. Sweating is observed. The patient is
most likely experiencing
hyperglycemia.
hypoglycemia.
syncope.
hyperventilation.
cerebrovascular accident
miscA dentist who has been diagnosed as a
chronic Hepatitis B carrier can perform
exposure prone procedures
using Standard precautions.
in the absence of HBeAg.
following a review by an Expert Panel
miscWhich of the following statements
regarding physiologic changes in an elderly
patient is correct?
Creatinine production is reduced.
Plasma albumin is increased.
Relative tissue perfusion is unaltered
miscInfections transmitted in dental offices
have been documented
at a rate comparable to health care
associated infections in hospitals.
occasionally, primarily with hepatitis B.
with equal frequency for viruses
and bacteria.
primarily in offices, which do not control
bacterial levels in water from dental units.
miscAfter latex gloves have been put on,
washing the gloved hands with an
antimicrobial soap
adds a further layer of safety to
barrier protection.
is unnecessary but acceptable practice.
can compromise the integrity of the glove.
should be done if a surgical procedure
is planned.
MISCWhich of the following drugs inhibits
salivary flow?
Alendronate.
Pilocarpine.
Glycopyrrolate.
Nystatin.
miscWhich of the following statements hepatocytes.
regarding physiologic changes in an elderly
patient is NOT correct? miscDietary consumption of which of the
following inhibits the cytochrome P450 system?
Reduced gastric emptying can lead to
a decrease in drug absorption. Meat.
Renal blood flow is decreased. Broccoli.
Lipid soluble drugs remain in the body Decaffeinated tea.
for a longer period of time. Grapefruit juice
Relative tissue perfusion is unaltered. miscThe sensation of sour is mediated by

miscWhich of the following drugs inhibits transducin.

+
salivary flow? protons blocking K channels.
gustducin.
Penicillin V. activation of T1R3 receptors.
Loratadine.
Probantheline.
Nystatin.
miscA patient wants to reduce her caries risk
and asks her dentist to recommend an alternate Adrenal corticosteroids
sweetener that can be used in baking. Which of
the following should NOT be recommended? A. increase heart rate.
B. cause vasodilation.
Equal (aspartame). C. increase protein synthesis.
Splenda (sucralose). D. reduce inflammation.
Sugar Twin (sodium cyclamate).
Xyla (xylitol). MISC
The predominant immunoglobulin
isolated from saliva is

miscWhich of the following A. IgG.

statements about sodium is correct?
Salt-sensitive people should avoid
foods like oranges and bananas.
A high salt intake aggravates but does
not cause hypertension.
Renal sodium excretion varies
indirectly with total sodium intake.
The sodium recommendation is
increased during pregnancy.
miscWhich of the following
statements about chlorhexidine is
INCORRECT?
It disrupts bacterial cell membranes.
It binds tenaciously to oral surfaces.
It interferes with adherence of
plaque-forming microorganisms.
Mutans streptococci are
preferentially destroyed.
It is commonly used for long-term therapy
miscThe principal cellular sites of the
cytochrome P450 system are
cardiomyocytes.
pneumocytes.
splenocytes.
B. IgM.
C. IgA.
D. IgD.
MISC
Which of the following requires antibiotic
prophylaxis for a patient with a prosthetic
heart valve?
A. Inferior alveolar nerve block.
B. Endodontic instrumentation beyond
apex.
C. Restoration of occlusal caries.
D. Making an alginate impression.
MISC
The washing of hands must be performed
before putting on and after removing
gloves because it
1. reduces the number of skin bacteria
which multiply and cause irritation.
2. completely eliminates skin bacteria.
3. minimizes the transient bacteria which
could contaminate hands through
small pinholes.
4. allows gloves to slide on easier when D. Poor oral hygiene.
the hands are moist.
MISC
A. (1) (2) (3) Which statement best describes hand washing
B. (1) and (3) for the prevention of disease transmission?
C. (2) and (4)
D. (4) only A. Hands should be washed for at
E. All of the above. least 15 seconds, always with an
antimicrobial soap.
MISC B. Hands should be washed
Acquired immunodeficiency syndrome thoroughly and vigorously prior to
(AIDS) is caused by a/an placement and upon removal of
gloves.
A. adenovirus. C. Transient flora is more difficult to
B. retrovirus. remove during routine hand washing
C. picovirus. and needs vigorous scrubbing action.
D. coronavirus. D. An alcohol hand rub is an
acceptable alternative to hand
washing.
MISC
Type I hypersensitivity results from MISC
cross-linking of which immunoglobulin A 75 year old male patient whose wife died
on mast cells? 10 months ago presents for his recall
appointment. Looking wasted and fatigued, he
A. IgA. confirms he has lost about 6kg in the last 8
B. IgD. months but is otherwise in good health. The
C. IgE. most appropriate management for this patient
D. IgG. is to
E. IgM.

A. recommend that he drink 3 cans of

MISC a nutritional supplement each day.
A high neutrophil count is indicative of a/an B. refer him to a qualified
dietician/nutritionist and follow up
A. allergic reaction. after his appointment.
B. bacterial infection. C. refer him back to his physician
C. blood clotting defect. requesting a more thorough assessment.
D. decrease in antibody production. D. provide him with a copy of Canadas
Food Guide to Healthy Eating.

MISC The inorganic ion which is the chief offender

A patient with multiple small bruises in hypertension is
(purpura) most likely has a low count of
A. sodium.
A. lymphocytes. B. ammonium.
B. T-cells. C. magnesium.
C. platelets. D. potassium.
D. erythrocytes.
E. Eosinophils
Which of the following preoperative
MISC instructions are most appropriate for a well-
Which of the following may result in controlled insulin-dependent diabetic patient
acetone breath? who is scheduled at 9:00 a.m. for the
extraction of two teeth under local anesthesia?
A. Prolonged fasting.
A. Eat breakfast before the
B. High carbohydrate diet.
C. High protein diet. appointment and delay insulin
injection until after the appointment.
 B. Take insulin before the appointment
and delay breakfast until after the
extractions.
C. Eat breakfast before the
appointment and take insulin
according to the regime prescribed
by the physician.
D. Delay breakfast and insulin until
after the dental appointment
MISC
What type of insurance must a dentist carry
in order to practice dentistry in Canada?
Malpractice.
Office overhead.
General liability.
Long term disability.
Employment.
The most appropriate procedure when a
glove has been punctured during a
restorative appointment is to
wash the gloved hands using
antimicrobial soap and complete the
procedure.
change the glove as soon as possible.
put on an overglove and complete
the procedure.
complete the procedure as expeditiously
as possible.
An HIV-positive patient has white lesions on
the buccal mucosa. The lesions can be wiped
off to reveal an erythematous base. The
lesions are most likely caused by
Streptococcus viridans.
Epstein-Barr virus.
Candida albicans.
Straphylococcus aureus
Coxsackie A virus is the etiologic agent in
papilloma.
herpangina.
verruca vulgaris.
condyloma accunimatum.
Which of the following dental
procedures could be performed with
minimal risk for a 35 year old patient
with a severe bleeding disorder?
Mandibular block anesthesia.
Supragingival calculus removal.
Incisional biopsy.
Subgingival restoration.
The most common form of latex allergy is
a/an
immediate localized (Type 1) contact
urticaria and erythema.
immediate generalized (Type 1)
conjunctivitis and rhinitis.
immediate generalized (Type 1)
bronchospasm and
anaphylaxis.
delayed (Type IV) contact dermatitis.
A patient has a prosthetic heart valve and
is allergic to penicillin. The most
appropriate antibiotic to be used
prophylactically is
erythromycin.
metronidazole.
amoxicillin.
tetracycline.
clindamycin.
A new patient had an acute pulpitis.
Treatment included a pulpotomy and a
prescription for 30 tabs of Percocet. Known
to local police as a drug user, the patient
subsequently bragged to a police officer that it
was very easy to get narcotics from his new
dentist. Several weeks later, a police officer
attends the office explaining that he is
conducting an investigation into health
professionals complicit in narcotic trafficking.
Which of the following statements is correct?
There is a legal duty to assist in
any criminal investigation.
Patient files must be released to
police upon request.
A subpoena is required for the dentist
to present relevant documents.
A known insulin-dependent diabetic patient
feels unwell following the administration of a
local anesthetic and becomes pale and
sweaty. This condition does not respond to
placing the patient in a supine position. The Immunosuppressive therapy.
most likely cause is Organ transplant.

syncope.
adrenal insufficiency.
hyperglycemia.
hypoglycemia.
carotid sinus reflex.

The risk of contracting hepatitis B following

a percutaneous injury from an occupational
exposure to the contaminated blood of a
patient has been shown to be in the range of

6-30%.
35-66%.
72-90%.

The presence of more than 104 copies/mL

of hepatitis B DNA in blood is indicative
of

a past exposure to hepatitis B

with immunity.
recovery from hepatitis B with
liver damage.
a highly infectious individual.
an inconclusive immune status.

Which of the following conditions

CONTRAINDICATES treatment with
dental implants?

Uncontrolled diabetes mellitus.

Osteoporosis.
Anticoagulant therapy.
Age greater than 80 years.

Which of the following conditions

CONTRAINDICATES routine dental
treatment in the dental office?

Hypothyroidism.
Recent (15 days) myocardial infarct.
Second trimester pregnancy.
Insulin-dependent diabetes

Which of the following conditions would

NOT require antibiotic premedication before
endodontic therapy?

Valvular heart disease.

Cardiac prosthesis.
Persistent odontogenic fistula.

MISC
Which of the following plasma proteins has
the greatest ability to bind drugs?
Albumin.
Fibrinogen.
Hemoglobin.
Gamma globulin.
B-lipoprotein.
When given prophylactically to prevent
infective endocarditis, oral amoxicillin
should be taken
immediately prior to the dental procedure.
one hour prior to the dental procedure.
four hours prior to the dental procedure.
one day prior to the dental procedure.
two days prior to the dental procedure
A patient who is jaundiced because of
liver disease has an increased risk of
postextraction bleeding.
cardiac arrest.
postoperative infection.
anaphylactic shock.
pulmonary embolism
saliva production is increased when blood
flow to the salivary glands is
stimulated by parasympathetic activity.
stimulated by sympathetic activity.
inhibited by acetylcholine.
inhibited by cyclic AMP
An anaphylactic reaction to penicillin is
most likely to occur
when the drug is
administered parenterally.
in patients who have already experienced
an allergic reaction to the drug.
within minutes after drug administration.
when the drug is administered orally.
(1) (2) (3)
(1) and (3)
(2) and (4)
(4) only
All of the above.
An abused woman is most at risk of
being murdered when she
Argues with the abuser in front of their
children.
Separates from her abusive spouse.
Confides in friends and asks for help.
Reports the abuse to law enforcement
A patient on anticoagulant drugs who requires
an extraction has a prothrombin time of 20
seconds. The normal value is 15 seconds. The
most appropriate management is to
administer vitamin K after the extraction.
administer vitamin K before the
extraction.
extract the tooth and use local measures to
control bleeding.
discontinue anticoagulation drugs one
week before extraction.
Which of the following drug groups is
LEAST likely to cause xerostomia?
Diuretics.
Antibiotics.
Antidepressants.
Anticholenergics
What is the most appropriate action for a
dentist to take for a female patient
experiencing spousal abuse?
Speak to the alleged abuser to assess the
level of threat to the patient.
Offer resource materials and referrals to
community agencies to the patient.
Focus on dental matters and consider the
abuse issues in the future.
Counsel the patient to leave the abuser
misc
Daily fluid loss from a healthy individual at
rest in a temperate climate is approximately
250ml.
500ml.
1.0L.
2.5L.
5.0L.
misc
Which of the following is increased after
stimulating 1-adrenergic receptors?
Contractility of the heart.
SA node activity.
Blood vessel constriction.
Bronchial dilation.
misc
Heart rate is increased by
hyperkalemia.
reduced 1adrenergic receptor activity.
atropine.
acetylcholine.
elevated vagal tone.
misc
Rigor mortis is
2+
due to intracellular Ca ion depletion.
due to cellular ATP depletion.
mechanistically identical to a
tetanic contraction.
characterized by spastic paralysis.
an isotonic contraction.
misc
Muscle spindles associated with
stretch reflexes
are composed of extrafusal muscle
fibres.
are innervated by alpha motor neurons.
mediate autogenic inhibition of
muscle contraction.
possess fibres that are capable
of contraction.
contribute to the main force production
properties of muscle
Which of the following dental health
recommendations is consistent with the
general nutrition guidelines?
Diet soft drinks and potato chips are
an acceptable snack.
A piece of fruit and plain yogurt is
an acceptable snack.
Eat a bigger lunch and not snack.
Brush your teeth well after snacks
Which of the following symptoms are
consistent with an anaphylatic reaction
to penicillin?
Deafness, dizziness acute anemia
and bronchial constriction.
Crystalluria, nausea, vomiting, diarrhea,
and bronchial constriction.
Oliguria, hematuria, bronchial constriction,
and cardiovascular collapse.
Urticaria, diarrhea, bronchial constriction
and cardiovascular collapse.
misc
asthmatic patients using corticosteroid inhalers
may develop candidiasis on the dorsal surface
of the tongue because of
a systemic antibacterial action.
local destruction of normal oral flora.
prolonged local vasoconstriction.
cross-reacting antigens in the tongue.
local immunosupression.
misc
A 28 year old male patient works long days
that typically include numerous soft drinks and
candy bars, but no opportunity to brush his
teeth. He has continued to experience one to
two carious lesions per year and now wants
orthodontic treatment to straighten his teeth.
Which of the following is the most appropriate
initial step in addressing behavior modification
for this patient?
Providing a new toothbrush and sample
tube of dentifrice.
Illustrating, with the aid of drawings the
basic caries process.
Explaining how his present habits
increase his caries risk.
Explain that treatment cannot be initiated until
he can keep his teeth clean
misc
Assuming the daily maximum is not exceeded,
which of the following is/are appropriate for
pain management for an adult with a history of
severe asthma and nasal polyps following an
emergency pulpectomy?
Naproxen 250 mg, every 6 to 8 hours.
Acetylsalicylic acid 650 mg every 4
hours.
Ketorolac 10 mg every 4 hours.
Acetaminophen 1000 mg every 6 hours
misc
Which ethical principle is involved with a
dentists duty to recognize signs of abuse and
neglect and to know appropriate interventions?
Autonomy.
Beneficence.
 Justice. myocardial infarction.
Non maleficence. seizure.
Veracity. syncopal episode

misc
misc A patient on hemodialysis
For a patient taking warfarin, which
laboratory test provides the most accurate should receive dental treatment only on
information on coagulation time? the day of hemodialysis.
should not be administered lidocaine
Activated partial thromboplastin time. for local anesthesia.
Ivy bleeding time. is likely to have an increased red
Platelet count. blood cell count.
INR. is at greater risk for infection.
Thrombin time. misc
What is the most likely diagnosis for a In domestic violence cases, the highest risk
patient who exhibits elevated blood for victim fatality is associated with
pressure, swollen ankles, distended neck
veins and difficulty breathing when lying an actual or pending separation.
down? severe depression of the abuser.
prior threats to kill the victim.
Congestive heart failure. a new partner in the victims life.
Bronchitis. a history of abuse of the abuser as a child.
End stage renal disease. misc
Hypertension. The most common abuser of an elderly
person is a/an
misc
Which viral hepatitis does NOT have a friend or acquaintance.
chronic carrier state? adult child.
spouse.
Hepatitis A. sibling.
Hepatitis B. misc
Hepatitis C. The statute of limitations states that the period
Hepatitis D. during which an action in negligence against a
dentist can be initiated starts when the
misc
A patient had a coronary arterial stent placed patient first meets the dentist.
1 year ago following a myocardial infarction treatment is rendered.
and has been asymptomatic since. The most treatment is paid for.
appropriate management is to patient first becomes aware of the problem.
patient seeks a second opinion about
avoid using epinephrine the problem.
impregnated retraction cord. misc
use local anesthetics without Following the IV administration of a
epinephrine. benzodiazepine, a patient becomes apneic
perform only emergency dental
and unresponsive. Which of the following
treatment for 1 year.
drugs should be administered immediately?
not recline the patient more than
45 degrees. Naloxone.
prescribe antibiotics to prevent
Propranolol.
infective endocarditis.
Amphetamine.
misc Flumazenil.
The most common medical emergency in Atropine.
the dental office is a/an os
The most appropriate type of bone grafting
allergic reaction.
material for use in the maxillofacial region is
cerebrovascular accident.
 allogenic. admit the patient to hospital for
alloplastic. extraction with local anesthesia.
autogenous. admit the patient to hospital for
xenogenic. extraction with general anesthesia.
misc extract the tooth in the office using
Patients with resistance to activated protein preoperative sedation and local
C (factor V Leiden) are at risk for anesthetic without a vasoconstrictor.
treat the patient in the office as a
fibrinolysis. normal patient.
bleeding diatheses.
thrombocytopenia. MISCBiocompatibility tests conducted in
hypercoagulation. vitro
erythrocytosis
follow screening with an animal
misc model.
Gloves should
predict human cell growth or death.
be washed with mild soap and warm reproduce the in vivo environment.
water after a dental procedure before are more easily standardized than
treating the next patient. clinical studies.
be removed after use and replaced with
new gloves before treating another patient.
not be used if the patient reports a
latex allergy.
not be used in dental procedures
requiring fine tactile discrimination.
be placed on the hands before tying on
a mask.
misc
For sterilization to occur in an autoclave, all
of the following must be monitored
EXCEPT

chemical levels.
time.
pressure.
temperature

MISCAngular cheilitis in older

patients who wear complete dentures
is most likely associated with

antibiotic therapy.
decreased vertical dimension.
decreased salivary flow.
vitamin B deficiency.

MISCA healthy 66 year old patient who

had a myocardial infarct eight years ago
requires an extraction. The most
appropriate management is to

MISCChlorhexidine is an effective
antiplaque agent due to its ability to
bind to the positively charged
pellicle.
damage the microbial cell
membrane.
neutralize the bacterial end-
products such as lactic acid.
non-selectively reduce the oral
microbial flora.
MISCA primary infection of syphilis
occurring on the tongue is referred to as
a/an
herpetic ulcer.
aphthous ulcer.
gumma.
chancre.
mucous patch.
MISCOne week following extraction of
teeth 1.8 and 4.8, an 18 year old male
returns to the dental office complaining
of persistent bleeding from the extraction
sites. The medical history is
unremarkable, except for episodes of
bruising and joint swelling as a child.
Subsequent blood tests show normal
bleeding time and a factor VIII level of
14%. The most likely cause of the
bleeding is
a dry socket.
ibuprofen intake.
hemophilia A.
cirrhosis of the liver.
vitamin K deficiency.
MISCWhich of the following tests
is/are specific in the diagnosis of
anemia?
A complete blood count.
Measuring the concentration
of hemoglobin.
White cell count and
hematocrit determination.
Hematocrit determination,
hemoglobin concentration and red
cell count.
MISCPatients with a history of ankle
swelling, shortness of breath and
orthopnea are most likely suffering
from
asthma.
emphysema.
congestive heart failure.
constrictive pericarditis.
MISCOsteomalacia is seen in
Vitamin C deficiency.
adult rickets.
protein deficiency.
hyperparathyroidism.
MISCThe physiopathology of sleep
apnea is most likely related to
excessive oropharyngeal muscular
tonus during sleep.
central nervous system
respiratory depression.
obstruction in lower airways.
a severe Angle Class III malocclusion
MISCIn a xerostomic patient, which
salivary glands are most likely
responsible for the lack of lubrication?
Accessory.
Labial.
Parotid.
Sublingual and submandibular.
MISCWhich of the following laws is the
LEAST relevant to the dental patient
record as a legal document?
Provincial.
Criminal.
 Consumer. MISCWhich of the following is NOT a
Common. recognized ethics-based principle?

Citizenship.
MISCIn Canada, the practice of dentistry Justice.
is regulated through the Non maleficence.
Autonomy.
Canadian Dental Association. Veracity.
Provincial Regulatory Authorities.
National Dental Examining MISCThe most frequent cause of
Board of Canada. hyposalivation in elderly patients is
Commision on Dental Accreditation.
Alzheimers disease.
MISCThe following violations provide multiple medications.
grounds for a criminal action in battery salivary gland atrophy.
EXCEPT Sjgrens syndrome.

intentional touching.
defamation causing harm.
treatment without consent.
harmful contact.

MISCWhich type of legal action can

result in the payment of damage?
MISCIn a patient with renal failure,
Causation.
which of the following does/do need a
Discipline.
dose interval adjustment?
Intention.
Tort. Penicillin V.
MISCThe legally set age for Metronidazole.
Erythromycin.
authorization of health care treatment
Clindamycin.
is 16 years of age.
(1) (2) (3)
indicates mature minor status.
(1) and (3)
presumes capacity.
(2) and (4)
applies universally.
(4) only
All of the above.

MISCLatex gloves should

MISCWhich of the following is NOT a be washed with plain soap before

recognized ethics-based principle? initial use.
be washed with plain soap when
Beneficence. used between patients.
Justice. be washed with a disinfectant
Non maleficence. solution only.
Autonomy. not be washed.
Scholarship.
MISCChlorhexidine is a

quaternary ammonium compound.

bisbiguanide compound.
phenol.
plant extract.

MISCGingival enlargement associated with use of cyclosporine is primarily characterized by an

increase of

plasma cells.
edema.
collagen.
keratinocytes.

MISCGingival enlargement associated with use of phenytoin is primarily characterized by an increase

of

plasma cells.
edema.
collagen.
keratinocytes.

MISCWhich of the following is used to verify the effectiveness of instrument sterilization?

Gram-negative bacteria.
Anerobic bacteria.
Spores.
Oral microorganisms.

MISCEthically, a dentist can

compensate a referring dentist.

collect the third party payment without requesting the patient's portion.
bill an insurance company a higher than usual fee, for the patients benefit.
charge different fees when warranted by clinical conditions.
MISCA 13 year old complains of red, bleeding and swollen gums. Clinical examination reveals this is
present only on the labial gingiva of the maxillary anterior teeth. What is the most likely etiologic
factor?

Blood dyscrasia.
Insulin-dependent diabetes mellitus.
Mouth breathing habit.
Pubertal hormones.

MISCSucralose

breaks down at high temperatures and cannot be used in baking.

is a derivative of sucrose.
is twice as sweet as table sugar.
causes constipation when ingested in excessive amounts.

MISCWhen given prophylactically to prevent infective endocarditis, oral amoxicillin should be taken

immediately prior to the dental procedure.

one hour prior to the dental procedure.
four hours prior to the dental procedure.
one day prior to the dental procedure.
two days prior to the dental procedure.

MISC
World epidemiological data indicates that periodontal disease is the most likely cause of tooth loss in the following
age group:

10 - 20 years.
20 - 30 years.
30 - 50 years.
65 - 75 years.
over 75 years.

MISC
Hypoglycemia is characterized by

mental confusion.
tachycardia.
sweating.
nausea.

(1) (2) (3)

(1) and (3)
(2) and (4)
(4) only
All of the above.
.

MISC
Diabetes mellitus is the result of

hypersecretion of the posterior pituitary.

atrophy of the islands of Langerhans.
destruction of the adrenal cortex.
destruction of the posterior pituitary or associated hypothalamic centres.
MISC 2. MISC-Which drug should be administered
Epinephrine is one drug used in the as the initial management for a patient with
management of an acute anaphylactic chest pain consistent with a myocardial
reaction (Type I allergic reaction) because it infarction?

relaxes bronchial muscles. Epinephrine.

stimulates heart muscle and increases heart Atropine.
rate. Diphenhydramine.
increases systolic blood pressure. Lidocaine.
produces vasoconstriction in many Acetylsalicylic acid.
vascular beds. 3.MISC-During dental treatment, a 45 year old
male patient complains of a tight constriction
(1) (2) (3) of his chest, becomes pale and sweaty, feels
(1) and (2) nauseous and attempts to vomit. The most
(2) and (4) likely diagnosis is
(4) only
All of the above. pulmonary embolus.
stroke.
MISC pneumonia.
Chronic alcoholism will myocardial infarction.

cause impairment of liver function.

increase tendency to hemorrhage.
delay healing.
decrease the effectiveness of local
anesthetics.

(1) (2) (3)

(1) and (3)
(2) and (4)
(4) only
All of the above.

MISC
Which is the LEAST effective method of
instrument sterilization?

Chemical solutions.
Dry heat.
Chemical autoclave.
Steam autoclave.

Miscellaneous.
1. MISC-During the intravenous administration
of diazepam, which of the following arteries may
accidentally be entered in the antecubital fossa?

Ulnar.
Radial.
Brachial.
Deep brachial.
Radial recurrent.
4. MISC-A dentist infected with Hepatitis Enamel staining.
C virus but without disease symptoms Dysgeusia.
should 8. MISC-Which of the following is the most
appropriate management for a well-controlled,
not be allowed to practice. type 1 diabetic patient?
be allowed to practice but should be excluded
from performing exposure prone Afternoon appointments should be
procedures. scheduled.
be allowed to practice but should be excluded Insulin should be increased to offset the
from performing exposure prone length of the appointment.
procedures after assessment and A medical consult is required prior to
agreement by an expert review panel and treatment.
if there is compliance with standard The patient should follow normal dietary and
precautions (routine practices). insulin regimen.
be allowed to practice after assessment and 9.MISC-Which of the following statements
agreement by an expert review panel and regarding Informed Consent is FALSE?
if there is compliance with standard It is
precautions (routine practices).
always necessary.
given only by the person receiving the
5. MISC-Post-immunization serological test treatment.
results for a health care worker who has able to be withdrawn.
completed the series of vaccinations against procedure specific.
hepatitis B reveals that their anti-HBsAg is
less than the value required for immunity. The 10.MISC-Creutzfeldt-Jacob disease is caused
by (a)
health care worker should

receive one additional vaccination followed virus.

by post-immunization testing. bacteria.
repeat the full series of hepatitis B fungus.
vaccinations followed by post- prion.
immunization testing.
refrain from performing any exposure-
prone procedures for a period of 3-6
months followed by a full series of 11.MISC-Which virus is the most likely to
hepatitis B vaccinations. cause an infection in a healthcare worker
have liver function tests performed to following exposure to blood from an
assess liver damage from a previous individual infected with the virus?
hepatitis B infection.
Hepatitis A.

6. MISC-For sterilization to occur in an Hepatitis B.
Hepatitis C.
autoclave, the packaged instruments are
Human immunodeficiency virus.
subjected to pressurized

steam.
chemical vapour. 12.MISC-Which is the LEAST common type
boiling water. of adverse reaction associated with the use of
heated air.
latex gloves?

Immediate type I allergic reaction.

Delayed hypersensitivity.
7.MISC-Which of the following is NOT
Type IV immunologic reaction.
associated with cancer chemotherapy in an
Irritant contact dermatitis.
adult? 13. MISC-When managing patients with true
latex allergies, which of the following
Candida infection.
statements is true?
Gingival bleeding.
The sterilization process effectively removes 1-2 hours of the injury.
latex proteins from instruments handled 1-2 days of the injury.
with latex gloves. 2 weeks of the injury.
Latex protein antigens can exist in the ambient 4 weeks of the injury.
air for a maximum of 10 minutes 19.MISC-Acute anaphylactic reactions to
following operative procedures. penicillin are LEAST likely to occur
Emergency kits should be available that
contain latex-free materials. in patients with a negative skin test to
Patients should be scheduled at the end of the penicillin.
day to avoid any exposure to latex within minutes after drug administration.
products in the dental office. in patients who have already experienced an
14. MISC-With respect to the use of gloves in allergic reaction to the drug.
dentistry, when the drug is administered
parenterally.
gloves may be reused on the same patient if 20.MISC-A syphilitic gumma is most
they can be removed without commonly found on the lip.
contaminating the operator. tongue.
utility gloves are appropriate for patient care palate.
when no other options are available. buccal mucosa.
gloves may be used on more than one patient gingiva.
as long as there are no identified risks in 20. MISC-During endodontic treatment,
that patients medical history. which of the following microorganisms is
sterile gloves should be used during a most likely to cause endocarditis in a patient
surgical procedure. with valvular heart disease?
15. MISC-Which of the following is the most
likely cause of osteoporosis, glaucoma, Hemolytic streptococci.
hypertension and peptic ulcers in a 65 year old Staphylococcus aureus.
with Crohns disease? Candida albicans.
Bacterodes fusiformis.
Uncontrolled diabetes.
Systemic corticosteroid therapy. 21. MISC-An acute oral infection is of most
Chronic renal failure. concern in a patient with
Prolonged NSAID therapy.
Malabsorption syndrome. pemphigus.
16. MISC-The most appropriate indication Crohn's disease.
for double gloving is otitis media.
a prosthetic heart valve.
patient-specific.
for a procedure on a patient with AIDS.
procedure-specific. 22. MISC-What should be the immediate
for a procedure that requires a high degree of management of an acute anginal episode?
tactile sensitivity.
17. MISC-Primary personal protective Oral ibuprofen.
equipment includes all of the following Sublingual nitroglycerin.
EXCEPT Subcutaneous epinephrine.
Inhaled salbutamol.
protective clothing.
gloves. 23 Systemic antibiotics may be indicated
masks. for patients presenting with generalized
protective eyewear.
glove liners. chronic periodontitis.
18. MISC-If post-exposure prophylaxis is aggressive periodontitis.
recommended following a significant gingivitis.
percutaneous injury from an HIV-positive gingival hyperplasia
patient, the antiviral drugs should ideally be
24. The etiologic agent for necrotizing
administered within ulcerative gingivitis (NUG) is

bacterial.
viral.
fungal.
protozoan.
Which of the following will result from a 2
week regimen of tooth whitening using a
10% carbamide peroxide gel in a custom tray
for 8 hours each night?

Moderate demineralization of enamel.

Significant incidence of irreversible
pulpitis.
Decreased bonding potential to enamel.
Decreased enamel surface porosity

Which of the following is NOT a

characteristic of cavity liners?

They are placed with minimal thickness.

They provide some type of therapeutic
benefit.
They are used as a dentin replacement.
They promote pulpal health.
 Report her injuries to an adult protection
Post-immunization serological test results for a agency.
health care worker who has completed the Forward all information, including the
series of vaccinations against hepatitis B is source of the injuries, to the specialist.
informed that their anti-HBsAg is less than the Report the situation to a relevant child
value required for immunity. The health care protection agency.
worker should In addition to iron, calcium and folate, which
of the following nutrients is of special concern
receive one additional vaccination followed by during pregnancy?
post-immunization testing.
undergo the full series of hepatitis B Vitamin B12.
vaccinations followed by post- Pyridoxine.
immunization testing. Vitamin D.
refrain from performing any exposure-prone Ascorbic acid.
procedures for a period of 3-6 months The most common sensory change in the
followed by a full series of hepatitis B healthy elderly is a decrease in
vaccinations.
have liver function tests performed to hearing.
assess liver damage from a previous taste.
hepatitis B infection. touch perception.
olfaction.
Which of the following dental procedures The most common barrier preventing elderly
could be performed with minimal risk for a
individuals from seeking dental treatment is
35 year old patient with a severe bleeding
disorder? the cost associated with receiving
treatment.
Mandibular block anesthesia.
difficulty getting to and from the dental
Supragingival calculus removal. office.
Incisional biopsy. a lack of perceived need for treatment.
Subgingival restoration. fear of being hurt.
A patient complains of fatigue, abdominal pain
and lack of appetite. The clinical examination Which of the following statements about
shows that the sclera of the eyes are yellow. alternate sweeteners is INCORRECT?
There is also a yellowish diffuse
discolouration of the oral mucosa. What is the Saccharin alone is not carcinogenic.
most likely diagnosis? Xylitol is a polyol with the same sweetness
as sucrose.
Viral hepatitis. Aspartame is a dipepitide of aspartic acid
Iron deficiency anemia. and glutamic acid.
Hypercarotenemia. Cyclamate is not approved as a food
Thrombocytopenic purpura. additive.
An adult female patient presents to the dental
office with fractured teeth, a lacerated lip and a
black eye. She is with her 6 year old son, who is The Dietary Reference Intake
crying and upset. The dentists receptionist
(DRI) recommendation for fat is
discretely reports that the child was asking his
mother Why was Daddy hurting you? Upon % Fat of Total Energy Intake
questioning, the patient confides that her Children (4-18 yr) Adult
husband was the source of her injuries and
A. 20-30% 20-30%
indicates that she would not be pursuing any
B. 20-35% 25-35%
action. She is referred to a specialist due to the
C. 25-35% 20-35%
complexity of her dental injuries, but she
25-40%20-30%
requests that the source of her injuries not be
disclosed. What is the dentists obligation?

Respect the patients request regarding

Vitamin D is activated in the
confidentiality.
 skin upon ultraviolet radiation from the
sun.
liver upon hydroxylation.
kidney upon hydroxylation.
intestinal mucosa upon absorption
Which of the following statements about the
nutritional management of diabetes is correct?
A diet planned according to Canadas
Food Guide to Healthy Eating must be
modified for a person with diabetes.
The Glycemic Index of foods should be
used when planning the diet.
The fat content of the diet should be 30-
35% of energy intake.
Sucrose up to 10% of total daily energy
intake (e.g. 50% of 2000 kcal/day) is
acceptable.
Tell-show-do technique when used for
behaviour management of pediatric patients
works best for children under 3 years of
age.
involves using scientific dental
terminology in all explanations.
will decrease a childs fear of the unknown
and their anticipation of pain.
A known insulin-dependent diabetic patient
feels unwell following the administration of a
local anesthetic and becomes pale and sweaty.
This condition does not respond to placing the
patient in a supine position. The most likely
cause is
syncope.
adrenal insufficiency.
hyperglycemia.
hypoglycemia.
carotid sinus reflex.
A Le Fort I or Guerin fracture is a
fracture of the zygomatic arch.
horizontal fracture of the maxilla.
fracture of the malar complex involving the
floor of the orbit.
pyramidal fracture of the maxilla.
craniofacial dysjunction.
Which of the following is/are associated with
an unerupted tooth?
Odontogenic adenomatoid tumor.
Periapical cemento-osseous dysplasia.
Calcifying epithelial odontogenic tumor.
Cementoblastoma.
(1) (2) (3)
(1) and (3)
(2) and (4)
(4) only
All of the above.
(MISC) Ideally, within how many hours
should one receive medical attention for
percutaneous exposure to blood borne
pathogens?
2.
4.
6.
8.
(MISC) Which of the following is common to
all forms of hemorrhagic shock?
Sepsis.
Hypovolemia.
Hypertension.
Vasoconstriction.
Impaired tissue perfusion
(MISC) Hemorrhagic shock is a circulatory
disturbance characterized by
increase in blood pressure.
alteration in circulating blood volume.
elevation of temperature.
decrease in amount of interstitial fluid.
(MISC) Hemorrhagic shock is a circulatory
disturbance characterized by
increase in blood pressure.
alteration in circulating blood volume.
elevation of temperature.
decrease in amount of interstitial fluid
(MISC) An alcoholic patient with bleeding
tendencies may require injection of which
vitamin prior to an extraction?
Vitamin B12.
Vitamin C.
Vitamin D.
Vitamin K.
 Geographic tongue.

(1) (2) (3)

(1) and (3)
(MISC) Following the injection of 1.8ml of 2% (2) and (4)
lidocaine with 1:100,000 epinephrine, a (4) only
nervous 22 year old male with well controlled All of the above.
insulin dependent diabetes states that he feels
dizzy and weak. Beads of sweat have MISC
accumulated on his forehead and upper lip. He An angina attack in a patient with a known
is quite pale. The initial management of this cardiac problem immediately after a tooth
patient is to extraction was most probably precipitated by

administer glucagon 1.0mg. a sudden repositioning of the patient into an

administer epinephrine 0.5mg. upright position.
administer diphenhydramine 50mg. a delayed allergic reaction to the
elevate the patient's legs and administer anesthetic agent.
100% oxygen. the stress resulting from the treatment.
call 911 and begin CPR. the use of a vasoconstrictor in the
anesthetic agent.

MISC
. The risk of latex allergy increases with a/an
(MISC) In a dental office, what is the most
common cause of respiratory distress? increased exposure to latex.
history of spina bifida.
Anaphylaxis. history of allergy to bananas, chestnuts or
Bronchospasm. avocado.
Hyperventilation. history of eczema.
Myocardial infarction
(1) (2) (3)
(MISC) What is the minimum CD4 count to (1) and (3)
perform elective dental treatment? (2) and (4)
(4) only
3
100 cells/mm . All of the above.
3
200 cells/mm .
3
300 cells/mm .
3
400 cells/mm . The washing of hands must be performed
3
1000 cells/mm . before putting on and after removing
gloves because it

(MISC) During CPR, if a patient is not reduces the number of skin bacteria which
breathing but has a pulse, how often should a multiply and cause irritation.
breath be given? Every completely eliminates skin bacteria.
minimizes the transient bacteria which
3-4 seconds. could contaminate hands through small
5-6 seconds. pinholes.
7-8 seconds. allows gloves to slide on easier when the
9-10 seconds hands are moist.

MISC (1) (2) (3)

Which conditions are associated with Acquired (1) and (3)
Immunodeficiency Syndrome (AIDS)? (2) and (4)
(4) only
Acute marginal periodontitis. All of the above.
Hairy leukoplakia.
Candidiasis. MISC
Which of the following statements concerning Which of the following dental procedures
the airway is correct? could be performed with minimal risk for a
35-year old patient with a severe bleeding
Sympathetic fibres constrict the disorder?
bronchioles.
The trachea is membranous posteriorly to Mandibular block anesthesia.
accommodate the pulsations of the aorta. Supragingival calculus removal.
The right primary bronchus forms two Incisional biopsy.
secondary bronchi. Subgingival restoration.
An aspirated foreign body would likely fall
into the right primary bronchus. MISC
A 24 year old patient complains of abdominal
MISC pain, frequent diarrhea and weight loss. The oral
One function of the striated ducts in the parotid clinical examination shows linear mucosal ulcers
and submandibular glands is to with hyperplastic margins in the buccal
add Na+ ions to saliva. vestibule. What is the most likely diagnosis?
help form a hypertonic saliva ( relative to
Crohns disease.
serum ).
Leukemia.
add bicarbonate ions to saliva.
AIDS.
remove K+ ions from saliva.
Diabetes mellitus.
add salivary amylase to saliva.

MISC
MISC A patient complains of irritability, fatigue and
The risk of transmission of Hepatitis B Virus weakness. She is losing weight and has
(HBV) is greater than that of Human diarrhea. The clinical examination shows
Immunodeficiency Virus (HIV) because diffuse brown macular pigmentation of the
HBV is oral mucosa. The pigmentation appeared
recently. The most likely diagnosis is
more resistant than HIV.
transmissible through saliva. iron deficiency anemia.
in higher numbers in blood than HIV. Addisons disease.
autoclave resistant. acute myeloid leukemia.
Crohns disease.
(1) (2) (3)

(1) and (3)
MISC
(2) and (4)
(4) only The current recommended regimen of
All of the above. antibiotic prophylaxis for a patient with
a prosthetic heart valve and an allergy to
MISC penicillin is
The risk of transmission of Hepatitis B Virus
amoxicillin 3g orally one hour before
(HBV) is greater than that of Human
procedure; then 1.5g six hours after initial
Immunodeficiency Virus (HIV) because
dose.
HBV is
amoxicillin 2g orally one hour before
more resistant than HIV. procedure only.
clindamycin 300mg orally one hour before
transmissible through saliva.
procedure; then 150mg six hours after initial
in higher numbers in blood than HIV.
dose.
autoclave resistant.
clindamycin 600mg orally one hour
(1) (2) (3) before procedure only.
erythromycin stearate, 2g orally two hours
(1) and (3)
before procedure only.
(2) and (4)
(4) only
All of the above.
MISC
MISC
Epinephrine should be administered
immediately upon recognizing which one of
the following emergencies?
MISC
A severe angina attack. Generalized malaise and
A mild asthmatic attack. elevated body temperature may
Severe anaphylaxis.
be associated with
Severe hypotension.

asymptomatic (chronic) apical
MISC periodontitis.
Nitrous oxide
acute apical abscess.
may supplement behavioural management of
an anxious patient. symptomatic irreversible
is a substitute for behavioural pulpitis.
management of an anxious patient.
is a substitute for local anesthesia for a asymptomatic irreversible
dental extraction. pulpitis.
would have no analgesic effect at a dose of
60%.

MISC

Which of the following require
MISC
prophylactic antibiotics prior to dental
Elective root canal therapy may be safely
procedures causing a bacteremia?
and successfully undertaken for all of the
following
Implanted cardiac pacemakers.
EXCEPT
Prosthetic cardiac valves.
hemophiliacs.
Coronary artery bypass grafts.
patients with a history of
Cardiac stents one year after
rheumatic fever.
placement.
pregnant patients during first
trimester.

pregrant patients during second

MISC
trimester.
Which of the following procedures
requires antibiotic prophylaxis for a
MISC
patient with a prosthetic heart valve?
Which of the following conditions would
Inferior alveolar nerve block.
NOT require antibiotic premedication
before endodontic therapy?
Postoperative suture removal.
Valvular heart disease.
Restoration of occlusal caries.
Cardiac prosthesis.
Making an alginate impression.
Persistent odontogenic fistula.

Total joint replacement.

MISC
A very apprehensive patient experiencing extract the tooth in the office
pain may be prescribed a barbiturate, using local anesthesia with a
chloral hydrate or an antihistamine to vasoconstrictor.
control the anxiety. In which of the
following would you expect an
exaggerated response to the use of these
drugs? MISC
Which of the following conditions may
A diabetic. result from horizontally brushing the
teeth?
An arthritic patient.
Erosion.
A patient with chronic renal
disease. Abrasion.

Attrition.

Hypoplasia.
MISC
A patient has a history of shortness of
breath and ankle edema. You would
suspect MISC
Which of the following conditions
asthma. is/are associated with AIDS?

emphysema. Acute marginal periodontitis.

rhinophyma. Hairy leukoplakia.

cardiac insufficiency. Candidiasis.

Geographic tongue.

(1) (2) (3)

(1) and 3)

(2) and (4)

MISC (4) only

A healthy 66 year old patient who had
a myocardial infarct eight years All of the above.
previously requires an extraction. The
most appropriate management is to

admit the patient to hospital for

extraction with local anesthesia.
MISC
admit the patient to hospital for An odour of acetone on the breath can be
extraction with general anesthesia. found in patients with
extract the tooth in the office
using preoperative sedation and local bronchiectasis.
anesthesia without a vasoconstrictor.
rhinitis.
 salicylate poisoning. Submandibular.
Submaxillary.
Sublingual.
diabetes mellitus.
Parotid.

Lacrimation and flushing of the face are
Miscellaneous autonomic phenomena that are occasionally
associated with trigeminal neuralgia involving
the maxillary nerve. This can be explained by
Hypothyroidism in adults is associated with the nerves association with which ganglion?

exophthalmos. Pterygopalatine.
weight loss. Submandibular.
generalized edema. Trigeminal.
tachycardia. Otic.
mental defects. Nasociliary.

A 45 year old with insulin dependent

diabetes mellitus comes for a morning dental
appointment. During the examination, the
patient complains of being lightheaded and
weak. Sweating is observed. The patient is
most likely experiencing Which of the following is necessary
for collagen formation?
hyperglycemia.
hypoglycemia. Vitamin A.
syncope. Vitamin C.
hyperventilation. Vitamin D.
cerebrovascular accident. Vitamin E.
Vitamin K.

In a dental office, all of the following should For which of the following reasons would
be used to reduce the risk of Hepatitis B a dentist administer an aqueous solution of
infection for staff and patients EXCEPT epinephrine hydrochloride?
steam sterilization. Hemostasis.
chemical sterilization. Vasocontriction.
standard precautions. Acute adrenal insufficiency.
medical history. Anaphylaxis.
staff education.

Which of the following would maximize

A bacterial infection causes the vitamin E intake following osseous surgery?
most significant increase in
Lettuce.
basophils. Wheat germ.
neutrophils. Eggs.
lymphocytes. Fish.
monocytes.
eosinophils.

Upon stimulation of salivary flow, which gland

is the main source of salivary volume?
The washing of hands must be performed before putting on and after removing gloves because it

reduces the number of skin bacteria which multiply and cause irritation.
completely eliminates skin bacteria.
minimizes the transient bacteria which could contaminate hands through small pinholes.
allows gloves to slide on easier when the hands are moist.

(1) (2) (3)

(1) and (3)
(2) and (4)
(4) only
All of the above.

MISCAs a dentist in Canada, it is ethical to refuse to treat a patient on the basis of

1. religious beliefs.
2. physical handicap.
3. infectious disease.
4. recognition of lack of skill or knowledge.

A. (1) (2) (3)

B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.

MISCA 30 year old HIV positive patient presents for the removal of an abscessed second molar. The most
appropriate management is to

A. refer to another dentist because universal infection control procedures are insufficient.
B. schedule appointments at the end of the day.
C. treat the patient in the same way as all other patients.
D. double glove before starting any surgical procedures.
MISCDuring dental treatment, a 62 year old insulin- dependent diabetic, suddenly complains of severe, crushing,
retrosternal pain. The appropriate initial management would be to stop treatment and

1. administer sublingual nitroglycerin.

2. administer 100% oxygen.
3. monitor the patient.
4. administer 50% dextrose intravenously.

A. (1) (2) (3)

B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.