Bhatia’s Dentogist | MCQs in Oral Surgery
Local vs General Anesthesia MCQs
Part 7: Oral and Maxillofacial Surgery
Bhatia’s Dentogist: MCQs in Dentistry
Part 7 : Oral and Maxillofacial Surgery (Local vs General Anesthesia MCQs)
- Nitrous oxide that is used as anaesthetic agent has mechanism of action as?
A. Gasserian ganglion block
B. Block peripheral nerves
C. Reversible (indirect) depression of CNS
D. None of the above - On administration of L.A in an area of infection, it is not effective because of?
A. Buffering action of L.A is decreased
B. Decreased concentration of changed cationic ions at the site of injection
C. Decreased concentration of unchanged base forms at the site of injection
D. None - Nitrous oxide that is used as anaesthetic agent has mechanism of action as?
A. Gasserian ganglion block
B. Block peripheral nerves
C. Reversible (indirect) depression of CNS
D. None of the above - On administration of L.A in an area of infection, it is not effective because of?
A. Buffering action of L.A is decreased
B. Decreased concentration of changed cationic ions at the site of injection
C. Decreased concentration of unchanged base forms at the site of injection
D. None - Which of the following general anesthetic techniques should be used for anesthesia in oral surgery
A. Open drop method
B. Anesthesia with nasopharyngeal airway
C. Nasoendotracheal tube with throat pack
D. I.v. anesthesia with nitrous oxide and oxygen - Each of the following statements about local anesthesia is correct except:
A. Lignocaine causes cardiac dysarrythmias
B. Procaine is more toxic than lignocaine
C. Prilocaine and lignocaine are components of the MIXA (eutectic mixture of local anesthesia)
D. Bupivacaine is given for obstetric epidural anesthesia - Inferior alveolar nerve block alone can be used in:
A. Pulpotomy of 3rd molar
B. Apicoectomy of 3rd molar
C. Extraction of 1st molar
D. Root resection of 1st molar - Longest acting local anaesthesia is:
A. Bupivacaine
B. Tetracaine
C. Lidocaine
D. Procaine - Sedation by which of the following routes can be reversed most rapidly:
A. Oral
B. Inhalational
C. Intravenous
D. Intramuscular - Lidocaine is an example of:
A. Acid type of local anaesthetic
B. Amide type of local anaesthetic
C. Ester type of local anaesthetic
D. Aldehyde type of local anaesthetic - Which of the following is the best indication for propofol as an intravenous induction agent:
A. Neurosurgery
B. Day care surgery
C. Patients with coronary artery disease
D. In neonates - Which of the following volatile anaesthetic agents should be preferred for induction of anaesthesia in children:
A. Enflurane
B. Isoflurane
C. Sevoflurane
D. Desflurane - The role of sodium metabisulfite in local anaesthetic agent is:
A. Preservative
B. Fungicide
C. Reducing agent
D. Vasoconstrictor - Hematoma formation during or immediately following a PSA block is most likely result of damage to?
A. Injection in pterygoid plexus
B. Injection in Facial artery
C. Injection into internal maxillary artery
D. Injection in small capillaries and arterioles - Concentration of Bupivacaine used in Dentistry is?
A. 0.5%
B. 2.0%
C. 4.0%
D. 5.0% - Most of the cases of hematoma occurs during which nerve block?
A. Inferior alveolar nerve block
B. Postero – superior nerve block
C. Infraorbital nerve block
D. Long buccal nerve block - Topical anesthetics used are effective upto the depth of?
A. 0.5-1.0 mm
B. 1.0-2.0 mm
C. 2.0-3.0 mm
D. 3.0-3.5 mm - Maximum available and effective concentration of LA for topical use is:
A. 2%
B. 5%
C. 10%
D. 15% - The role of sodium bisulphite in a LA solution is:
A. Reducing agent
B. Aesthetic agent
C. Vasoconstrictor
D. Preservative - During the administration of posterior superior alveolar nerve block, the landmarks that guide the operator are anterior border of coronoid process and:
A. Anterior border of the ramus
B. Mandibular 2nd premolar
C. Pterygomandibular raphae
D. Palatine tonsils - The sudden appearance of a “Dumb-bell” swelling after the administration of PSA block is due to penetration in:
A. Maxillary artery
B. Pterygoid plexus of veins
C. Greater palatine artery
D. Sphenopalatine artery - Following administration, nitrous oxide will become saturated in blood and physically dissolved in serum fraction of blood within?
A. 3–5 min
B. 10 min
C. 10–15 min
D. 6–8 min - The agent of choice to reverse status epilepticus induced by local anaesthetic overdose is:
A. Oxygen
B. Diazepam
C. Epinephrine
D. Phenobarbital - The longest acting local anaesthetic is:
A. Prilocaine
B. Lignocaine
C. Bupivacaine
D. Ropivacaine - Nitrous oxide is a colourless, sweet smelling gas with a density of:
A. 1.5
B. 0.5
C. 2.5
D. 3.5 - Amide type local anaesthetics are metabolized in the:
A. Serum
B. Liver
C. Spleen
D. Kidneys - A nerve is absolutely refractory during:
A. Depolarisation
B. After depolarisation
C. Hyperpolarisation
D. Firing level only - A nerve can be stimulated during relative refractory period by:
A. Stronger than normal stimuli
B. Sustained normal stimuli
C. Subthreshold stimuli
D. None of the above - Local anaesthetic agents act by:
A. Increasing the rate of depolarisation
B. Shortening the rate of repolarisation
C. Decreasing the threshold potential
D. Increasing the threshold potential - The local anaesthetic agent acts on:
A. Nerve membrane
B. Axoplasm
C. Epineurium
D. Perineurium - The most acceptable theory which explains the actions of LA:
A. Surface charge theory
B. Calcium displacement theory
C. Membrane expansion theory
D. Receptor binding theory - The ultimate action of binding the receptor by LA agent is brought about by its:
A. Hydrophilic component
B. Lipophilic component
C. Intermediary chain
D. R group of amide agents - Amide group of local anaesthetic agents are dispensed as salts of strong acidic because:
A. They are not lipid soluble but stable in air
B. They are not water soluble but stable in air
C. They are not water soluble and unstable in air
D. They are lipid soluble but stable in air - In acidic medium (during pyogenic infections) local anaesthetics are less effective because:
A. More unchanged particles are released
B. Less unchanged particles are released
C. Less charged particles are released
D. None of the above - Local anaesthetic agents with higher pKa would have:
A. Shorter onset of action
B. Longer onset of action
C. No affect on onset of action
D. None of the above - Which characteristic of a LA agent is responsible for its penetration into the nerve?
A. Lipid solubility
B. Water solubility
C. Its ionisation
D. None of the above - Addition of a vasoconstrictor to LA agents:
A. Increases alkalinity of the solution
B. Increases acidity of the solution
C. Has no effect on the pH
D. None of the above - Sodium bisulfite has the following affect on the action of LA solution:
A. Slows down its onset of action
B. Decreases its duration of action
C. Increases its pH
D. Has no affect - Increasing the concentration of LA from 2% to 5% would have:
A. Rapid onset and prolonged action
B. Onset would not be affected but action would be prolonged
C. No change on action
D. Rapid onset and duration not affected - The efficacy of benzocaine in inflamed area would be:
A. Decreased
B. Increased
C. Not altered
D. Prolonged - The main barrier for diffusion of LA into the nerve is:
A. Epineurium
B. Perineurium
C. Endoneurium
D. Neural membrane - Which fibres of the nerve are anaesthetised first:
A. Mantle fibres
B. Core fibres
C. Both are anaesthesised at the same time
D. None of the above - The inadequate pulpal anaesthesia in presence of adequate soft tissue anaesthesia can be due to:
A. Faulty technique
B. Insufficient penetration of core fibres
C. Insufficient penetration of fasciculi
D. Insufficient penetration of mantle fibres - Prolonged duration of action of drugs like etidocaine and bupivacaine can be attributed to their:
A. Increased lipid solubility
B. Increased water solubility
C. Increased protein binding
D. Vasoconstrictor action - Tachyphylaxis occurs due to:
A. Increased dose of LA
B. Increased dose of vasoconstrictor
C. Repeated use of LA
D. Allergy to sodium metabisulfite - Which of the following belongs to ester group of local anaesthetics?
A. Bupivacaine
B. Benzocaine
C. Etidocaine
D. Mepivacaine - The only local anaesthetic with vasoconstrictor properties is:
A. Cocaine
B. Procaine
C. Benzocaine
D. Lidocaine - Which of the following is not a ester local anaesthetic?
A. Propoxycaine
B. Procaine
C. Prilocaine
D. Piperocaine - Which of the following local anaesthetics crosses the blood brain barrier:
A. Lignocaine
B. Etidocaine
C. Bupivacaine
D. All of the above - All of the local anaesthetics cross the placenta:
A. Except mepivacaine
B. Statement is true
C. Statement is false
D. Except lignocaine - Ester type local anaesthetics are metabolised in the:
A. Liver only
B. Kidney
C. Plasma
D. Lungs - A patient who had a history of prolonged apnoea during administration of muscle relaxant (succinylcholine) should not be given?
A. Ester local anaesthetics
B. Amide local anaesthetics
C. Vasoconstrictors
D. Sodium bisulfite - A patient complains of history of hepatitis one month ago should be preferably given which local anaesthetic agent?
A. Lignocaine
B. Bupivacaine
C. Procaine
D. Procainamide - One of the complications of prilocaine LA is:
A. Agranulocytosis
B. Hepatic dysfunction
C. Methemoglobinemia
D. None of the above - Local anaesthetics are excreted mainly by:
A. Lungs
B. Fecal route
C. Kidneys
D. Uterus - Blood level of >7 μg/ml of LA produces:
A. Anticonvulsive activity
B. Tonic clonic seizure
C. CVS stimulation
D. None of the above - The anticonvulsant activity of local anaesthetic agents occurs at:
A. < 4 μg/ml
B. 4-7 μg/ml
C. 7-10 μg/ml
D. 10-12 μg/ml - The differentiating factor between LA toxicity and developing syncope would be:
A. CNS stimulation
B. CNS depression
C. Pallor of skin
D. Light reflex - The level of 2% lidocaine which reaches blood after use of one or two cartridges is:
A. 0.5-2 μg/ml
B. 1.5-5 μg/ml
C. 5-10 μg/ml
D. No LA reaches blood if given safely after aspiration - A patient with known history of hyperthermia should be given:
A. Lignocaine
B. Procaine
C. Bupivacaine
D. Mepivacaine - With overdose of local anaesthetic agent one would observe:
A. Hypertension
B. Hypotension
C. No change in BP
D. Cardiac arrhythmias - Epinephrine (Adrenalin) which is used in dental cartridge of LA acts on:
A. α-receptors only
B. β-receptors only
C. α and β receptors but β predominantly
D. α and β receptors but α predominantly - When local anaesthetic agent with adrenalin is injected, the termination of activity of the vasoconstrictor is brought by:
A. Adrenergic nerve endings
B. Blood enzymes COMT and MAO
C. Excretion in urine (80%)
D. A and B - Use of norepinephrine in dental practice is not recommended because it causes:
A. Bradycardia
B. Intense peripheral vasoconstriction
C. Hypertension
D. Stimulation of myocardium - When one has to use the weakest vasoconstrictor (e.g., in patient with history of angina) one should consider:
A. Epinephrine
B. Norepinephrine
C. Phenylephrine
D. Levonordefrin - Rebound phenomenon is most commonly seen with use of:
A. Epinephrine
B. Norepinephrine
C. Phenylephrine
D. Levonordefrin - The absolute contraindication for use of adrenalin in LA is:
A. Myocardial infarction, 3-6 months ago
B. Angina pectoris
C. Hyperthyroidism
D. Pregnancy - Adrenalin should not be used when halothane is used during GA because halothane:
A. Sensitizes the myocardium to adrenalin
B. Increases the heart rate
C. Increases the blood pressure
D. Interferes with AV conduction - A cartridge of LA contains 1:200,000 adrenalin, it indicates that there is:
A. 0.005 mg/ml of adrenalin
B. 0.065 mg/ml of adrenalin
C. 0.0125 mg/ml of adrenalin
D. 0.02 mg/ml of adrenalin - Maximum dose of adrenalin which can be given to a patient with history of cardiovascular disease is:
A. 0.2 mg/ml
B. 0.2 mg
C. 0.04 mg
D. 0.005 mg/ml - To a patient of 50 kg wt how many cartridges of LA with 1:200,000 adrenalin can be given (considering patient is normal, healthy and lignocaine toxicity is not considered):
A. 10.5
B. 22
C. 32
D. 40 - Lidocaine was first prepared by:
A. Nils Lofgren
B. A. Ekenstam
C. A. Einhorn
D. None of the above - The duration and depth of pulpal anaesthesia with lignocaine (2%) added to 1:50,000 epinephrine as compared to 1:100,000 epinephrine would be:
A. Longer and profound
B. Duration would be two times longer but depth would be same
C. No much difference
D. Duration would be 4 times - 3% lignocaine indicates that there is:
A. 25 mg/ml of lignocaine
B. 30 mg/ml of lignocaine
C. 54 mg/ml of lignocaine
D. 27 mg/ml of lignocaine - How many cartridges of 2% lignocaine can be given to a 50 kg man (with adrenalin)?
A. 6
B. 12
C. 17
D. 25 - When vasoconstrictor is contraindicated, the ideal local anaesthetic would be:
A. Lignocaine
B. Mepivacaine
C. Cocaine
D. Bupivacaine - A patient with respiratory disease presents for treatment, which drug should not be used:
A. Lignocaine
B. Adrenaline
C. Prilocaine
D. Mepivacaine - Which of the following is least toxic LA?
A. Lignocaine
B. Mepivacaine
C. Propoxycaine
D. Bupivacaine - When injecting into relatively highly vascular area as in posterior superior alveolar nerve block, one should use needle with:
A. Smaller gauge
B. Larger gauge
C. Gauge does not matter
D. None of the above - One should use a needle which has:
A. Greatest angle of bevel
B. Minimum angle of bevel with tip lying in the centre of the lumen
C. No bevel at all
D. None of the above - Which of the following is a long acting LA agent?
A. Mepivacaine
B. Bupivacaine
C. Prilocaine
D. Propoxycaine - The safest local anaesthetic agent:
A. Cocaine
B. Procaine
C. Chloroprocaine
D. Propoxycaine - Which local anaesthetic agent when used topically interferes with sulphonamide actions:
A. Lidocaine base
B. Lidocaine
C. Benzocaine
D. Propoxycaine - Self-aspirating syringes, provide aspiration by:
A. Pulling the thumb ring
B. Negative pressure created due to elasticity of rubber diaphragm
C. Pressure release on thumb disc
D. All of the above - The jet injectors are used to obtain:
A. Pulpal anaesthesia
B. Topical anaesthesia
C. Infiltration anaesthesia
D. Nerve block anaesthesia - The gauge of needle used in dental syringes refers to:
A. Internal diameter of the lumen
B. External diameter of needle
C. Diameter of bevel only
D. Diameter of hub - Sodium bisulphite used in dental LA cartridge acts as:
A. Antioxidant for adrenalin
B. Antioxidant for lignocaine
C. Antibacterial for lignocaine
D. Not used any more - The allergic reactions commonly seen following use of cartridge of LA is due to:
A. Lignocaine
B. Vasoconstrictor
C. Methyl paraben
D. Sodium metabisulphite - Glass LA cartridge should be sterilised by:
A. Autoclaving
B. Dry heat
C. Cold sterilisation
D. None of the above - If the diaphragm of cartridge is soaked in isopropyl alcohol for purpose of antisepsis, it may result in:
A. Reduced anaesthesia
B. No anaesthesia
C. Long-term paraesthesia
D. None of the above - Local infiltration should be:
A. Subperiosteal
B. Paraperiosteal
C. Transeptal
D. None of the above - Infiltration is not successful for anaesthetising buccal roots of:
A. Maxillary 1st permanent molar
B. Maxillary 1st deciduous molar
C. Mandibular 1st permanent molar
D. Deciduous maxillary 1st molar - For posterior superior alveolar nerve one should use:
A. Long needle (40 mm)
B. Short needle (25 mm)
C. Length not a criterion
D. Only bevel should be considered - Greater palatine foramen is present:
A. Between 1st and 2nd maxillary molars
B. Between 2nd and 3rd maxillary molars
C. Distal to 3rd maxillary molar
D. Mesial to 1st maxillary molar - In 80% of patients infraorbital nerve block is effective for buccal aspect of:
A. Central incisors and canines
B. Central incisors to 1st premolars
C. Central incisors to mesiobuccal root of 1st maxillary molar
D. Central incisors only - In greater palatine nerve block the needle should be:
A. Parallel to mucosa
B. Perpendicular to mucosa
C. 45° inclined to mucosa
D. Parallel to roots of molars - The two techniques used for maxillary block are:
A. Greater and lesser palatine approach
B. Greater palatine and high tuberosity approach
C. Greater tuberosity and retromolar approach
D. Gow gates and Akinosi technique - Inferior alveolar nerve block anaesthetics all (except):
A. Body of mandible lower part
B. Mandibular teeth
C. Mucous membrane anterior of first mandibular molar
D. Mucous membrane distal to 1st mandibular molar - The needle while giving inferior alveolar nerve block passes through:
A. Buccinator muscle
B. Pterygomandibular raphe
C. Buccal fat
D. Stylomandibular raphe - While giving inferior alveolar nerve block the needle is lateral to:
A. Lingual nerve
B. Sphenomandibular ligament
C. Medial pterygoid muscle
D. All of the above - If bone is not contacted before injecting local anaesthetic in inferior alveolar nerve block, there are chances of:
A. Lingual nerve anaesthesia
B. Transient facial palsy
C. Transient maxillary anaesthesia
D. None of the above - Inferior alveolar nerve block at times is not very effective because which of the nerves is not anaesthetised:
A. Mental nerve
B. Lingual nerve
C. Mylohyoid nerve
D. Incisal nerve - Gow Gates technique is for:
A. Mandibular nerve block
B. Inferior alveolar nerve block
C. Trigeminal ganglion block
D. V2 , V3 block - The target of Gow Gates technique is:
A. Coronoid notch
B. Sigmoid notch
C. Foramen ovale
D. Neck of condyle - In patients with reduced mouth opening which technique of mandibular anaesthesia should be used:
A. Gow gates
B. Akinosi
C. Labat’s
D. Williams - For extraoral maxillary nerve block the target area is:
A. Posterior to lateral pterygoid plate
B. Anterior to lateral pterygoid plate
C. Pterygomaxillary fissure
D. Pterygopalatine fossa - For extraoral mandibular nerve block the needle should be inserted from:
A. Above the zygomatic arch
B. Below the zygomatic arch
C. Coronoid notch
D. None of the above - If needle breaks during injecting LA and radiographically it appears to be deep in tissues, the advised management would be:
A. Removal of needle under LA
B. Removal of needle under GA
C. Leaving the needle in the tissue
D. None of the above - Use of which of the solutions relatively can have more burning sensation?
A. Plain lignocaine
B. Isotonic solution
C. Lignocaine and adrenalin
D. Hypotonic solution - Persistent anaesthesia can result most often in which of the nerves, after LA injection?
A. Inferior alveolar
B. Lingual nerve
C. Infraorbital nerve
D. Mental nerve - Aspiration should be carried out at least in:
A. One plane
B. Two planes
C. Three planes
D. Four planes - ECG changes can first be observed when level of lignocaine is more than:
A. 5-6 µg/ml
B. 10-12 µg/ml
C. 2-4 µg/ml
D. 1-2 µg/ml - To control tonic clonic seizures following lignocaine toxicity the drug of choice would be:
A. Pentobarbital
B. Diazepam
C. Succinylcholine
D. Antihistaminics - Succinylcholine can be used for control of tonic clonic seizures but along with this:
A. Pentobarbitone should be used
B. Artificial respiration is must
C. Atropine should be given
D. Neostigmine should be given to terminate its action - Postictal phase, which follows CNS toxicity with lignocaine should be managed by:
A. CNS stimulants
B. Analeptics
C. Supportive therapy only
D. Diazepam - During CVS depression in lignocaine toxicity, one should administer:
A. Vasoconstrictors
B. Atropine
C. Crystalloids
D. All of the above - Gingival retraction cords contain adrenalin in concentration of:
A. 1:200,000/inch
B. 0.3 µg/inch-1.0 µg/inch
C. 300 µg/inch-1000 µg/inch
D. 1000 µg/inch-2000 µg/inch - Extraction of deciduous teeth in dental clinic can be carried out in which stage of general anaesthesia:
A. Stage I
B. Stage II
C. Stage III
D. Stage III plane II - Surgical plane for major surgery during general anesthesia is during:
A. Stage III plane I
B. Stage III plane II
C. Stage III plane III
D. Stage III plane IV - Succinylcholine is administered during GA for:
A. Better control
B. Intubation
C. Prevention of apnoea
D. Decreasing respiratory rate and thus decreasing GA toxicity - Nowadays induction phase of GA has been reduced because of use of:
A. Halothane
B. Ether, halothane combination
C. Thiopentone sodium
D. Ether, N2O, halothane combination - If long acting muscle relaxants are used during GA their action is terminated by use of:
A. Neostigmine
B. Atropine
C. Ketamine
D. Succinylcholine - The N2O gas cylinder used in GA is:
A. White and black coloured
B. Blue coloured
C. Red and yellow coloured
D. White and blue coloured - For maxillofacial injuries one should always use which endotracheal tube for GA?
A. Non inflatable
B. Inflatable cuffed
C. Catheterized
D. None of the above - The endotracheal tube should be placed for GA:
A. In right bronchus
B. In left bronchus
C. Above carina
D. In laryngopharynx - Rota meter on Boyle’s trolley for GA is used to measure:
A. Pressure of gas in the cylinders
B. Pressure of halothane
C. Flow of gases in the tubes
D. None of the above - Goldman’s vapourizer is used for:
A. N2O
B. Halothane
C. Ether
D. Cyclopropane - Entonox is:
A. N2O + halothane mixture
B. 50% N2O + 20% O2 mixture
C. 50% N2O + 50% O2 mixture
D. 50% ether + 20% O2 mixture - In TMJ ankylosis patient, GA can be administered by:
A. Oral intubation
B. Blind nasal intubation
C. Fibreoptic assisted intubation
D. B and C - A patient who is being operated under halothane should not be given:
A. Lignocaine
B. Lignocaine + adrenalin
C. Propoxycaine
D. Mepivacaine - Glycopyrrolate is usually used during GA to:
A. Reduce heart rate
B. Increase BP
C. Reduce secretions
D. Control bleeding - In most surgical procedures, GA with N2O is given as:
A. 70% N2O + 30% O2
B. 70% N2O + 20-30% O2 + other GA agent
C. 50% N2O + 50% O2 + other GA agent
D. 70% O2 + 20% N2O - Which of the following is used as an dissociative anaesthetic agent:
A. Fentanyl
B. Thiopentone
C. Ketamine
D. Halothane + ether mixture - During GA oxygen concentration of blood should not fall below:
A. 90%
B. 60%
C. 40%
D. 20%