Pharmacology and LA :

What drug causes gingival hyperplasia: Phenytoin

What drug causes lupoid reaction: isoniazid

NOTE: It is a drug for treating TB, often used with Rifampicin

What causes discoloration of saliva: Rifampicin

NOTE: Isoniazid and rifampin may cause temporary discoloration of your teeth, sweat, urine, saliva, and
tears (a yellow, orange, red, or brown color). This side effect is usually not harmful. However, soft contact lenses
may be permanently stained if you wear them while taking isoniazid and rifampin.

Fluconazole treats: chronic mucocutaneous candidiasis

20.2% tetracycline or chlortetracycline mouthwash is used:

to relieve pain related to bacterial infection

Latex allergy: 1% of population

Paracetamol is contraindicated in all except:

A. Porphyria
B. Kidney disease
C. Liver disease

In patient with asthma, which is contraindicated: NSAID

Which is a safe drug in breastfeeding mother:

A. Azithromycin
B. Metronidazole
C. Corticosteroid
D. Tetracycline
E. Aspirin

Which is not a cause of fever while administrating drug: decreased metabolic rate

All cause tachycardia except :

A. Digitalis
B. Atropine
C. Adrenaline
D. Caffeine
E. Nicotine

Patient on digoxin. We do not give him which antibiotic to prevent digitalis toxicity:
Erythromycin

Note:
* Digitalis toxicity (DT) occurs when you take too much digitalis (also known as digoxin or digitoxin)
* In case of heart disease, digoxin is a medication that helps your heart work better to send blood through your
body. It strengthens the heart muscle's contractions and slows your heart rate.
* Two common brands are Lanoxicaps and Lanoxin.
* Digoxin effect refers to the presence on the ECG of:
Down sloping, ST depression with a characteristic “Salvador Dali sagging” appearance.
Flattened, inverted, or biphasic T waves.
Shortened QT interval

* These are symptoms of digitalis toxicity:

Confusion.
Irregular pulse.
Loss of appetite.
Nausea, vomiting, diarrhea.
Fast heartbeat.
Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or
seeing spots.
Which antibiotic is ototoxic to babies:
Vancomycin, Macrolides, Aminoglycosides ( All these )

Which of the following will not need antibiotic prescription:

Suture removal.

Alcoholic patient who takes Metronidazole will have:

Nausea, vomiting, rapid heartbeat, low blood pressure, headaches & flushing of the
face. ( All these )

One of the following is true about patient chronic renal disease:

Doxycycline and azithromycin can be safely given

The mechanism of action of penicillin:

inhibit cell wall synthesis

Selective COX-2 inhibitor produce all these effects except:

Antiplatelet effect

The most common causes of sepsis:

Answer: Streptococcus pneumoniae, Neisseria meningitidis, and Staphylococcus aureus.

What is wrong about opioids:

Causes diarrhea

NOTE:
Rarely, patients taking opioids will complain of diarrhea and bloating rather than the anticipated constipation

The best antibiotic for G-ve bacteria

Two antibiotics that are active and commonly used against certain Gram negative
bacteria are ciprofloxacin and clindamycin.

Note: Ciprofloxacin is a fluoroquinolone antibiotic, with a broad spectrum of activity targeting aerobic
Gram-negative and Gram-positive bacteria but with low potency against many anaerobic bacteria
Drug that has the widest drug-drug interaction
Azithromycin

Mechanism of action of ciprofloxacin:

Inhibits DNA replication

False about NSAID’s :

NSAIDs can safely be given to patient with kidney disease without dose adjustment.

Which drug doesn’t cause gingival hyperplasia?

A/Valporic acid B/Cyclosperin C/Niphidipin

NOTE:
Gingival hyperplasia is a common disorder seen in patients with epilepsy treated with phenytoin. It is rarely seen
in patients taking sodium valproate therapy

Which of the following isn’t caused by prolonged steroids therapy in 55 years old female ?
A/Osteoporosis B/Osteosclerosis C/Hyperglycemia

What is the antagonist of benzodinzepines ?

Flumanzil

Inter ligamental anesthesia, all true except?

A/ONSET 30-40 minute
B/Useful if bilateral treatment needed
C/It can be used for primary tooth to avoid lip biting
D/If it’s used with primary it may affect permanent teeth bud

All are false about Tetracycline except?

A/bactericidal B/inhibit cell membrane C/50s

Which drug is not NSAID ?

A/aspirin B/opioid C/Voltaren

What is right about paracetamol ?

If used in high dose it is hepatotoxic

Anticoagulant drug ?
A/Aspirin B/heparin

Mechanism of action of local anesthesia?

inhibit Na+ channels

Can be used in patients with chronic renal disease without altering the dose?
Doxycycline

Local Anastasia toxicity in children is high, what is the most important thing to
reduce that:
a. Use with vasoconstrictor
b. Know about safe dose for all type of Anastasia
c. Needle aspiration
Cardiotoxic local anesthetic:
a. prilocaine
b. lidocaine
c. ropivacaine
d. bupivacaine

Contraindicated in pregnant patients :

Answer: Tetracycline

The importance of adding vasoconstriction to the local anesthesia

Note:
Addition of a vasoconstrictor to a local anesthetic may have several beneficial effects:
1. A decrease in the peak plasma concentration of the local anesthetic agent
2. Increase in the duration and the quality of anesthesia,
3. Reduction of the minimum concentration of anesthetic needed for nerve block
4. Decrease of blood loss during surgical procedures.

Nitroglycerin absorption under the tongue by:

Sublingual artery
Sublingual vein

EN IN LA :
A. Decrease bleeding time
B. Give longer working time
C. Decrease systemic absorption
D. All of the above

DOESN’T CAUSE GINGIVAL HYPERPLASIA:

A. Valproic acid
B. Cyclosporin
C. Phenytoin
D. Prednisolone

Best antibiotic for aerobic bacteria:

Aminoglycosides
( Amikacin, Gentamicin, Neomycin, Netilmicin, Streptomycin, Tobramycin )
NOTE that Metronidazole - Ineffective

Pain from local anesthesia injection can be reduced by:

a. warming the local anaesthetic
b. using a needle with a small bore
c. slow injection
d. adding sodium bicarbonate in the local anaesthetic
e. all of the above

The following solutions are isotonic (same osmolarity as the plasma) except:
a. Harman's solution
b. 0.9% saline
c. 10% mannitol
d. 5% glucose
e. 4% glucose and 0.18% saline
With regard to antibiotics:
a. vancomycin and penicillin inhibit bacterial cell wall synthesis through the same
mechanisms.
b. vancomycin is poorly absorbed from the gut
c. metronidazole crosses the blood-brain barrier readily
d. sulphonamides crosses the blood-brain barrier readily
e. chloramphenicol is inactive against Pseudomonas bacteria

The following are true about local anaesthetics except:

a. they are weak bases
b. they are either amino-esters or amino-amides
c. they act faster on unmyelinated fibers than myelinated nerve fibres
d. they cause both sensory and motor paralysis
e. the potency and duration are increased by increasing the lipophilia of the compounds

True statements about metronidazole include the following except:

a. it is bactericidal
b. it inhibits bacterial DNA synthesis
c. it is most effective against Gram positive bacteria
d. it has a good penetration of the blood-brain barrier
e. alcohol should be avoided while taking metronidazole

A 1.8 cc dental cartridge of 2% lidocaine with 1: 100,000 epinephrine contains:

A. 20 mg lidocaine.
B. 18 mg lidocaine.
C. 22 mg lidocaine.
D. 36 mg lidocaine.
E. 44 mg lidocaine.

The ideal method for anesthesizing an area would be:

A. Use anesthesia without vasoconstrictor
B. Infiltrate into the site of infection
C. Utilizes the effect of a subperiosteal injection
D. Use regional nerve block anesthesia
E. All of the above

Mode of action of the interligamentary anaesthesia injection:

A. Block pulp microvasculature
B. Vessels of PDL
C. Lamina dura
D. Pressure

Category X drug:
A. Erythromycin
B. Ibuprofen
C. Thalidomide
D. Paracetamol

An alcoholic patient taking metronidazole , will probably suffer from:

A. Vomitting
B. Disulfiram like reaction
C. Nausea
Which of the following anesthesia can cause local irritation to the soft tissue:
A. Bupivacaine
B. Procaine
C. Lignocaine
D. Mepivacaine

Candida Albicans Fungal infection respond well to:

A. Miconazole
B. Fluconazole
C. Ketoconazole

A maximum dose of local anesthesia that you can give to children is:
A. One tenth of a cartridge per KG body weight
B. One and a half a cartridge per KG body weight
C. Kg body weight = ( age + 2 ) *4
D. Kg body weight = ( age+3 ) * 4
E. Two tenth a cartridge per KG body weight

When doing extractions , which of the following doesn’t need AB prophylaxis:

A. Mitral valve
B. Prosthetic valve
C. Congenital Cyanotic
D. Bypass graft

Endocarditis prophylaxis is recommended in one of the following before extraction :

Teratogy of fallot

Dose of EN given to people with cardiac issues : 0.04 mg

False about LA :
Felypressin and Lidocaine are not given to people taking antidepressants

Side effect of clindamycin : Pseudomembranous Colitis

Patient on Warfarin and has Penicillin allergy , you prescribe : Clindamycin

Drug contraindicated in Renal Failure : Itraconazole

Which is false about diazepam : Short half life

Single tooth extraction in a healthy adult with 100g aspirin:

Carry Treatment on and do nothing

Pt with Hx of angina and has chest pain : Nitroglycerine

All true about acyclovir except :

Oral route only

Amoxicillin all true except: Narrow spectrum

Metronidazole all true except: Oral route only

The first line of treatment in a patient with syncope due to LA administration is by:
A. Respiratory stimulant
B. O2
C. Diazepam
D. Adrenaline
E. Aminophylline

Which antibiotic is ototoxic to babies ? Gentamycin

BETA Lactam antibiotic ?

Inhibits cell wall synthesis

Flagyl + Alcohol = Disulfiram like reaction

Toxcitiy of fluconazole : Hepatotoxic

Articaine differ than Lidocaine except ?

Less efficancy

AB that works on the folic acid of bacteria is:

Sulfonamide

Anti-fungual and antibiotic:

a- Nystatin
b- Amphotericin B
c- Miconazole

Anti-viral drug that works on DNA :

Cyclosporin

Which of the following causes Methemoglobinemia ?

A. Prilocaine
B. Lidocaine
C. Benzocaine
D. EMLA
E. All

Mechanism of anti-histamine: reversible H1 histamine receptor blocker

Antidot to Paracetamol: Alpha- Acetylcysteine

Antidot to opioids: Naloxane

Vancomycin: Red Man Syndrome

Chloramphenicol: Grey Baby Syndrome