Simulation exam

The privacy rule under HIPPA does what

Gives pts rights to their health information and copies of their records

T/F: Nonmaleficence is knowing when to refer

T

What is the correct formula for determining the statistical power of a study

1 - type 2 error

T/F: If you are forewarned of a fire test and it goes off in the middle of a procedure, you do not need to stop tx

T

What does PICO stand for

Population/patient/problem, intervention, comparison, outcome

T/F: Extractions should proceed SRP

T

What type of cells are involved in multiple mylenoma

Plasma cells

Celecoxib, used to treat osteoarthritis, is an NSAID that functions how

Selective reversible inhibitor of COX-2

A p-value of 0.08 means what?

There is an 8% chance the differences were obtained by chance

T/F: Chlorhexidine is used as a treatment for candidiasis

T

T/F: Stainless steel files allow the file to be centered in the canal more than NiTi files

F

Serial extractions to fix mandibular crowding in peds patients utilizes what appliance?

Lower lingual holding arch

When are distal shoe appliances used?

Loss of primary second molar prior to the eruption of the permanent first molar

When are nance appliances used

Bilateral loss of primary molars in the maxillary arch when first permanent molars are present

When are band and loop appliances used

Unilateral or bilateral loss of primary teeth in either arch. Contraindicated when space loss is already present

T/F: No additional precautions are needed when prepping for dental treatment on a pt with HIV

T

What is the standard universal precautions for a dental tx

Single barriers and double wiping

Rank bisphosphonates from least potent to most potent

Etidronate < Pamidronate < Alendronate < Risedronate < Zolendronate/minodronate

“EPARZ”

What is a type 1 error

False positive result (rejecting a null hypothesis when it is actually true, like telling a man he is pregnant)

What is a type 2 error

False negative result (failing to conclude there was an effect when there actually was, like telling an obviously pregnant women she is not pregnant)

Denosumab is medication for rheumatoid arthritis which increases the risk for what

MRONJ

T/F: Even if a pt brings a personal family translator, you should still use a certified one

T

What is the mechanism of action for ibuprofen

Non-selective cyclooxygenase inhibitor (both COX 1 and 2)

What are the major criteria in pts with nevoid basal cell carcinoma syndrome/Gorlin-Goltz

Basal cell carcinomas, OKC of the jaws, 3 or more palmar or plantar pits, ectopic calcification or calcification of falx cerebri, first degree relative with the same condition

What type of bacteria is most commonly associated with peri-implantitis

Gram negative anaerobes

What are the proper steps when placing a liner

Liner → etch → bond

What is the ideal depth of chest compressions

2 inches

T/F: Provisional restorations can be used to maintain position but not to trial a new VDO

T

What root of a mandibular first molar most often has 2 canals

Mesial (always mesial root for all molars)

What is a common side effect of chlorhexidine

Yellow/brown tooth staining of the interproximal areas

What is the principle of beneficence

Provider has a duty to promote the patient’s welfare, including reporting abuse or neglect

What is the principle of veracity

Dentist has a duty to communicate truthfully

What is the principle of nonmaleficence

Dentist has a duty to not harm the patient

What is white sponge nevus?

Benign condition that manifests as patches of white, irregular plaques velvety and thickened in texture

What is the proper sequence in embryonic tooth development

Bud → cap → bell → apposition → calcification

Rank the types of studies from lowest scientific evidence to most

Case repots/studies < cross sectional studies < case control studies < cohort series < randomized control trials < meta-analysis/systemic reviews

What is the mechanism of action for metoprolol, a hypertension medication

Cardioselective (competitive) B1-adrenergic receptor blocker

What are the 2 types of epidemiological study and what are they

Observational: Without interfering

Experimental/interventional: Selecting specific group to recieve while another is the control

What is methotrexate and what is it used to treat

Chemotherapeutic and immunosuppressive drug to treat Sjogren’s, systempic lupus erythematosus, cancer, rheumatoid arthritis. MOA is a folate antagonist and inhibits DNA synthesis

In pts with chronic kidney disease, how should a dose of Amoxicillin be adjusted

Lower the maintenance dose

On a relative risk estimate graph, what does the shortest horizontal line signify?

Smaller range so there is less variation and it is more reliable. The longer the line the more uncertainty about it.

T/F: Invasive dental procedures that leave bone exposed like crown lengthening or extraction are contraindicated in pts taking bisphosphonates

T

What is a p-value

The probability of the sample data arising by chance

What are Tzanck cells dx of and where does this virus lay dormant

HSV-1 on the trigeminal ganglion

What do odontoblasts do

Form dentin

What do odontoclasts do

Resorb dentin and cementus

What is a key radiographic finding of multiple mylenoma

Punched out radiolucencies

What is a buccal exostosis

Benign, painless, smooth, raised mass around the gingiva, hard, bony protrusion prevelant in bruxers

What does sensitivity measure

Proportion of individuals with the disease that are correctly identified as having it

What does specificity measure

Proportion of individuals without the disease that are correctly identified as not having it

A pt presenting with missing teeth, pitted enamel hypoplasia, tetany, brown tooth striations, and paresthesia indicated what

Hypoparathyroidism, meaning less parathyroid hormone

Mesiodens are most commonly located where

Between 9 and 9 on the palate

Pemphigus vulgaris causes separation of the epithelium above the basal layer, intraoral blisters, erythemous gingiva, and positive Nikolsky sign. Pt’s with this condition should be referred to who

Dermatologist

What is the main side effect of Albuterol

Xerostomia

What is Albuterol

Beta-2 agonist and a bronchodilator medication (relaxes smooth muscle). Also inhibits release of histamine from mast cells. Can cause tachycardia

When there is a high suspicion of malignancy, or when the lesion is bigger than 1cm, what type of biopsy is done?

Incisional

What are the functions of A-gamma fibers

Lower motor neuron and muscle contraction

What are the functions of A-beta fibers

Touch, pressure, vibration

What are the functions of A-delta fibers

Sharp, prickling, fast pain, cold

What are the functions of C fibers

Burning, aching, slow pain, heat

What are signs of oversedation with nitrous oxide?

Drowsiness, laughing, nausea

If a crown breaks when trying to extract and leaves behind the roots, what should be done?

Raise a full thickness flap

What is the difference between abrasion and abfraction

Abrasion: Rounded notch caused by mechanical wear

Abfraction: V shaped notch caused by masticatory stress

What are key cytokines for an implant osseointegration?

Transforming growth factor beta-1. Tumor necrosis factor-alpha. Bone morphogenetic protein-4

T/F: Lichen planus is non-wipeable and contains Civatte bodies

T

What should you do if your employee is strongly suspected of abusing opioids?

Report her if it is in line with the state law

How much demineralization must occur in a tooth for a lesion to be visible on a radiograph

40-50%

What department provides funding for most of the healthcare systems including medical and dental in the USA

Health and human services (HHS)

What do longitudinal studies measure

Risk and association

What do cross-sectional studies measure

Disease prevalence

What do case-control studies measure

Exposure status

Median rhomboid glossitis is caused by atrophy of which papilla on the tongue

Filiform

The strawberry tongue appearance in pts with scarlet fever is due to what

Enlarged fungiform papilla

Pts with autism spectrum disorder respond well to what type of tx

Tell-show-do

The most common muscle that experiences TMD and TMJ pain is what

Masseter

All primary teeth have typically exfoliated by which age

12

Which muscles attach to the maxilla

Buccinator and medial pterygoid

What does HbA1c measure?

Glycated hemoglobin

What is Valsartan and how does it work

Angiotensin 2 receptor blocker medication to tx high bp by selectivey binding to angiotensin receptor 1

T/F: Angiotensin receptor blockers typically end in -sartan, while the names of ACE inhibitors end in -pril

T

Which pontic is most likely to cause gingival blanching

Ovate

Which type of study observes 2 groups of people with different health outcomes and compares the groups to find previous risk factors

Case-control

What is unique about the histology for peripheral ossifying fibroma

Dispersed mineralized tissues and fibrous proliferation

Staff salaries are considered to be what type of expense in a dental practice

Fixed

What is herpetic gingivostomatitis

Primary infection of HSV. Seen in kids with fever, malaise, widespread vesicular lesions and ulcers that look like bubbles

T/F: The acute phase of tx can include emergency root canal

T

What is the principle of justice and why would double gloving for a pt with HIV violate this

Concept that we have a duty to be fair. Because pts with HIV does not require extra precautions

What type of saliva would cause the biggest increase in caries risk

High viscosity, low flow rate, low pH

T/F: Pt’s with hepatic cirrhosis should avoid taking NSAIDs even over fent

T

T/F: Even if a pt is clearly opioid seeking, you still should prescribe ibuprofen and tylenol if the pain is real

T

What is the chance of infection for Hep B

30%

What is the chance of infection for Hep C

0.2%

What is the chance of infection for HIV

0.3%

What permanent tooth is most likely to have 2 canals with 2 foramina

Mand central incisor

What type of insurance allows the patient to get directly reimbursed from the insurance provider

PPO

What is the MOA for tylenol/acetaminophen

Inhibits COX 1 and 2

What microorganism is spread through aerosolized droplets in saliva

Mycobacterium tuberculosis

T/F: Fluoride, essential oils, and cetylpyridinium chloride are common mouthwas ingrediants

T

HIV allows for the most common opportunistic infection of what

Candidiasis

What are the most common symptoms of an allergic reaction to penicillin

Maculopapular rash, raised hives, ocular pruritus, and edema of the lips/tongue/face