mock nbdhe case studies first 16

cs2

79 year old female

african american

hasnt been to dentist in 3 years

stroke 4 years ago

diabetic, GERD, hypertension, hyperglycemia, and osteoporosis.

HbA1C is 8.0-9.0%.

Blood Pressure: 120/80; Pulse: 85 bpm; Respiration: 20 breaths/minute

The patient reports she had the mandibular right first molar extracted 4 years ago due to an abscess and has received no dental treatment since.

She reports brushing her teeth twice a day with a fairly hard manual toothbrush. She does not floss and is uncertain whether she uses a fluoridated toothpaste. She poses the following questions:

She is curious about a power brush since her hands are weak.

She questions whether a mouth rinse will reduce the bleeding from her gums.

A large nevus is present on the left side of her face.

There is a large circular discoloration on the gingiva just above teeth numbers 10 & 11.

81 mg aspirin, daily insulin injections, (Omeprazole) Prilosec®, (Lovastatin) Mevacor®, (Atenolol) Tenormin®, (Ramipril) Altace®, (Clopidogrel bisulfate) Plavix® and (Risedronate sodium) Actonel®

cs 2

1. According to G.V. Black's classification of restorations, the classification for tooth #17 is:

class I

cs 2

All of the following home care regimens would prove beneficial for this patient except one. What is the EXCEPTION?

A. Interdental brush

B. Power toothbrush

C. Sodium fluoride dentifrice

D. 0.12% chlorhexidine gluconate rinse for 2 weeks

E. Dental floss

C

cs2

The left premolar bitewing radiograph lacks diagnostic quality due to:

A. Poor film placement

B. Incorrect horizontal angulation

C. Decreased kVp setting

D. Increased mA setting

A

cs2

The brown circular discoloration in the gingiva above teeth numbers 10 & 11, is most likely a:

A. Nevus

B. Melanin pigmentation

C. Melanoma

D. Kaposi's sarcoma

B

cs2

There is a radiolucency on the distal surface of the root on tooth # 2 adjacent to the impacted third molar. You would classify this as a(n):

A. Distortion

B. Restoration

C. An anomaly

D. Root caries

D

cs2

Based on the patient's daily medications, all of the following medical conditions are being treated except one. What is the EXCEPTION?

A. Cardiovascular disease

B. Hypertension

C. Osteoporosis

D. Rheumatoid arthritis

E. Type 1 diabetes

D

cs2

Based on the patient's clinical & radiographic findings, how would you classify her periodontal status according to the 2018 AAP classification of periodontal and peri-implant diseases and conditions?

A. Generalized Gingivitis

B. Stage 1 Grade A Periodontitis

C. Stage 1 Grade B Periodontitis

D. Stage 2 Grade C Periodontitis

D

cs2

Based on the patient's plaque score and bleeding index, the BEST course of action the dental hygienist should plan is:

A. Reducing the stress level at the dental visit

B. Assisting in a tobacco cessation intervention

C. Demonstrating proper toothbrushing and interproximal care

D. Demonstrating the proper technique for water irrigation

C

(Clopidogrel bisulfate) Plavix® is prescribed for the patient based on what medical condition?

A. Osteoporosis

B. GERD

C. Elevated cholesterol

D. Cerebrovascular accident

D

There are visible bilateral radio-opacities in front of tooth numbers 22 & 28. Upon intraoral inspection, you find some interesting rounded projections in those regions lingually which you classify as:

A. Salivary gland tumors

B. Mandibular tori

C. Bone cancer

D. Fibromas

B

81 mg aspirin is for

heart attack

(Omeprazole) Prilosec® is for

GERD

(Lovastatin) Mevacor® is for

high cholesterol

(Atenolol) Tenormin®, (Ramipril) Altace® are for

HBP

(Clopidogrel bisulfate) Plavix® is for

heart attack

(Risedronate sodium) Actonel® is for *********

OSTEOPOROSIS AND PAGET'S DISEASE

what is a normal hba1c for non diabetics

4-5.9%

what is hb1ac for diabetics uncontrolled usually at and whats target

above 7%

target for diabetics is below 7% and less than 180

What is HbA1c, how often is it taken

Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time

what is the blood glucose target range before meals

80-130

what is the blood glucose target range after meals

less than 180

cs 3

african amer female

65 years old

perio disease last seen 2 years ago

arthritis

surgery on each wrist due to carpal tunnel syndrome and subsequently experiences arthritic pain in her hands. She suffers from diverticulitis, GERD and stomach ulcers.

Nizatidine) Axid®, (Acetaminophen) Tylenol®, (Ceterizine) Zyrtec®, (Naprosyn) Naproxen®, (Rosuvastatin calcium) Crestor®, (Metformin hydrochloride) Glucophage®

hba1c 6.5-6.8% range.

Vital Signs: Blood Pressure: 125/82; Pulse: 70 bpm; Respirations: 15 Breaths/Min.

several furcation involvements and multiple teeth missing.

brushes two to three times daily with a fluoridated tooth paste and rinses her mouth with salt water

bleeding on brushing

Submandibular and posterior cervical lymph nodes were palpable.

Which of the following anatomical structures can be observed in the maxillary left posterior periapical radiograph?

A. Ethmoid sinus

B. Walls of maxillary sinus

C. Nasopalatine foramen

D. Maxillary tuberosity

b

Taking into consideration, the patients's medical history, radiographic, and clinical findings, how would you classify her periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-Implant Diseases?

A. Stage II, Grade C

B. Stage III, Grade B

C. Stage IV, Grade B

D. Stage IV, Grade C

D

What is the primary factor that influenced your decision for the Staging in the above diagnosis?

A. Tooth loss due to periodontitis

B. Radiographic Bone Loss

C. Pocket Depth

D. Amount of CAL

A

Which of the following factors most influenced your Grading choice for your periodontal diagnosis?

A. Presence of risk factors

B. Molar/incisor pattern of bone loss

C. Destruction commensurate with amount of biofilm

D. Pocket depths

B

After reviewing brushing and flossing techniques with her, what home care recommendations would you make for the patient to address her bleeding gums?

A. Consider purchasing an electric toothbrush; use a proxabrush on posterior teeth & furcations; use a stannous fluoride toothpaste

B. Use a mouth rinse that contains Zinc; ensure that her toothpaste contains sodium fluoride; use a soft bristled toothbrush

C. Purchase a hard bristled toothbrush; use a toothpick to cleanse the furcations; use a mouthrinse containing cetyl pyridinium chloride (CPC)

D. Prescribe a 0.12% chlorhexidine rinse to replace her salt water rinses; continue using her manual brush as demonstrated; use a fluoridated toothpaste that contains a whitening agent

A

One of the patient's prescription medications is Glucophage® (Metformin HCL). Which of the following conditions is this medication prescribed for?

A. Diverticulitis

B. GERD

C. Diabetes

D. Stomach ulcers

C

The patient has reported intense stomach pain as well as excessive tiredness lately. These symptoms may be a side effect of which of her current medications?

A. (Nizatidine) Axid®

B. (Ceterizine) Zyrtec®

C. (Metformin hydrochloride) Glucophage®

D. (Rosuvastatin calcium) Crestor®

C

Based on the new American Heart Association/American College of Cardiology Blood Pressure Guidelines (2017), how would you classify this patient's blood pressure status?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

C

When examining the radiographs, what would be the BEST description for the furcation involvements that appear on all of the mandibular molars?

A. Greater than 1mm of bone loss

B. Some exposure with bone remaining between roots

C. Entrance between roots clearly visible

D. Complete loss of bone between roots

D

The radiographic bone loss noted in the following areas: distal #8, mesial #18, distal #25 and distal #26 are best classified as:

A. Horizontal

B. Vertical

C. Both vertical and horizontal

D. Circumferential

B

glucophage side effect

nausea stomach pain gas

29 year old african amer female

never had teeth cleaned, 10 years ago to have wisdom tooth out

good health

"My gums bleed when I brush. I have sensitivity to hot and cold most of the time and I have a sore on my tongue."

Her family history includes diabetes, hypertension, oral cancer, alcoholism and substance abuse. She currently takes no medications. Her blood pressure was recorded at 138/89; her pulse was 80 bpm; and her respirations were 18. She considers herself to be in good health.

She rinses with a phenol mouthrinse several times daily but mixes it with water to reduce the burning sensation. She uses a medium bristled toothbrush once daily but has never flossed or used other interdental aids. She is not sure if her toothpaste contains fluoride.

She questions why her tongue has a white spot. She is worried as her grandmother had oral cancer 5 years ago.

She recently started smoking one pack of cigarettes daily.

A white circular lesion was noted on the lateral border of the tongue. She indicated it was painful upon palpation.

What MOST likely is the reason for the gingival appearance around the facial of #10, #11?

A. Traumatic habit

B. Food debris

C. Erosion

D. Plaque Biofilm

a

All of the following would be plausible inclusions in a differential diagnosis for the white circular lesion present on the lateral border of her tongue EXCEPT:

A. Lipoma

B. Apthous Ulcer

C. Fibroma

D. Hyperkeratosis due to chronic irritation

b

Given the patient's clinical and radiographic and historical findings, what would be the best diagnosis for her periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-implant diseases?

A. Stage 2, Grade B

B. Stage 2, Grade C

C. Stage 3, Grade B

D. Stage 3, Grade C

D

To address the patient's recent smoking habit, the four A's designed for a cessation initiative follow what order?

A. Ask, Advise, Arrange, Assist

B. Ask, Assist, Ask, Arrange

C. Ask, Advise, Assist, Arrange

D. Advise, Ask, Arrange, Assist

c

Following the new American Heart Association/American College of Cardiologists blood pressure guidelines, how would you categorize this patient's blood pressure?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

c

The following microorganisms will MOST likely be identified in this patient's microflora except one. What is the EXCEPTION?

A. P. gingivalis

B. C. albicans

C. T. forsythia

D. F. alosis

b

Using the patient's height and weight, her BMI calculation was 25.7. How would you categorize this?

A. Underweight

B. Normal

C. Overweight

D. Obese

c

The patient's maxillary central incisors are flared facially and the palatal shape is narrow and elongated as visible on the study models. What do you suspect may have contributed to this anatomical appearance?

A. Thumbsucking habit

B. Genetics

C. Childhood trauma

D. Tongue thrust habit

a

On the radiographs, which of the following teeth have visible calculus deposits?

A. 4, 5, 6, 14, 30, 18

B. 7, 8, 10, 18, 19

C. 30, 29, 14, 18, 19

D. 31, 30, 7, 8, 9, 14

c

71 yr old caucasian female

The patient indicates she had breast cancer three years ago which required a mastectomy. She received four months of chemotherapy and six weeks of radiation and reports no complications since. She is taking one prescription medication (letrozole) Femara® at this time. She also reports taking one baby aspirin daily to thin her blood. The patient has a history of stomach ulcers and hernias for which she took prescribed medications in the past, however she no longer has any GI difficulties. She reports she suffers with occasional arthritis/joint pain and takes Ibuprofen (Advil®) for pain relief. Her family history includes cardiovascular disease on both sides. Her vital signs are: Blood Pressure 135/79; pulse: 70 bpm; respirations: 15 bpm.

smoker 1 pack a day

Patient brushes her teeth twice daily with a manual hard bristled toothbrush using a circular motion and non-fluoridated toothpaste. She flosses once daily and remarked she needs assistance with her technique. She also tries to use a floss threader to clean under her bridge but gets frustrated as the floss often tears and then gets stuck under the bridge.

Submandibular and posterior cervical lymph nodes on the left side were palpable.

What radiographic error(s) is/are evident in the maxillary left posterior periapical radiographs?

A. Horizontal angulation & Cone cut

B. Elongation & Cone cut

C. Overlap & Film placement

D. Elongation & Film placement

b

The patient indicates she takes low dose aspirin daily to thin her blood plus Advil for her arthritic/joint pain. What should you indicate to the patient about this combination of over-the-counter medications?

A. They could result in stomach ulcers and GI problems

B. Higher Ibuprofen dosages have been linked with a higher risk of heart attack

C. A & B

D. This combination of drugs is perfectly safe

c

According to the latest guidelines recently published by the American Heart Association and the American College of Cardiologists, how would you classify this patient's blood pressure?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

d

thats the answer but thats not accurate

With the Patient's concern about her weight gain and also her increased joint pain since her cancer diagnosis, what do you suspect may be the cause of these?

A. Stress

B. Letrozole

C. Hormonal changes

D. Lack of exercise

B

Which of the following could constrict the blood vessels sufficiently to reduce gingival bleeding?

A. Advil

B. Low dose aspirin

C. Tobacco

D. Letrozole

c

Based on the patient's clinical, radiographic and historical findings, how would you classify this patient's periodontal condition based on the 2018 AAP Classification of Periodontal and Per-implant diseases?

A. Stage 2, Grade B

B. Stage 3, Grade B

C. Stage 3, Grade C

D. Stage 4, Grade C

d

dont know how or why

In addition to correcting her circular brushing technique and reviewing her flossing technique, what additional recommendations would you make for this patient?

A. Purchase a power toothbrush; superfloss under bridge; proxabrush in molar regions; sodium fluoride toothpaste

B. Consider smoking cessation; purchase power toothbrush; superfloss under bridge; proxabrush; and stannous fluoride toothpaste

C. Use a stannous fluoride toothpaste; quit smoking; purchase a power toothbrush; use a proxabrush in between all teeth

D. Use of soft bristle toothbrush; a fluoridated dentifrice; either a floss threader or proxabrush for under her bridge and between her molars

b

During your extraoral examination, you found palpable submandibular and cervical lymph nodes present on the patient's left side. What radiographic finding would you attribute to being the cause?

A. Furcation on tooth #19

B. Radiolucency between tooth #'s 20 and 21

C. Radiolucency at the apex of the root of #10

D. Vertical bone loss on the mesial of tooth #22

c

What would be the first step in addressing the patient's tobacco use?

A. Ask the patient if she is interested in quitting

B. Determine if the patient has tried to quit before

C. Advise the patient about how smoking is a risk factor for periodontal disease

D. Assist the patient in finding a specialist who works in tobacco cessation

a

The appearance of the cervical margins on the facial aspects of tooth numbers 6 - 11 is MOST likely due to:

A. Abrasion

B. Erosion

C. Attrition

D. Radiation treatment

a

Letrozole is used for

breast cancer chemotherapy

Letrozole Side Effects

weight gain and joint pain

41 year old caucasian female

last seen 2 1/2 yr ago

front teeth sensitive to cold

The patient reported having a hysterectomy 2 years ago as well as bladder surgery nine years ago. She has a family history of type 2 diabetes. She reports a history of hepatitis B, hypertension and remarked she was frequently thirsty. She was prescribed an anti-anxiety medication after the birth of her last child 3 years ago. Her medications include: (Escitalopram oxalate) Lexapro®, (Enalapril maleate) Vasotec® and a daily 81 mg aspirin. Her blood pressure was recorded at 145/92; Pulse: 75 bpm; respirations: 16 bpm.

She has had extensive dental work in the past as she has numerous restorations, 2 bridges and root canals. She claims she lost her 2 front teeth when she was 15 after falling off a horse. She also indicates that she had her 4 wisdom teeth removed when she was 18 years old as they were impacted

uses a medium bristled toothbrush and was embarrassed to tell you that she does not floss. Her toothpaste is fluoridated but she is not sure what type of fluoride it contains. She occasionally rinses her mouth with a mouth rinse containing zinc if she feels she has bad breath. She indicates she was a former smoker, but quit 10 years ago

According to Angle's classification of malocclusion, the BEST classification for this patient is:

A. Class I

B. Class II, Division I

C. Class II, Division II

D. Class III

B

Which of the following characteristics describes the alveolar bone around the mandibular right second premolar?

A. Vertical bone loss

B. Horizontal bone loss

C. Normal, no bone loss

D. Both vertical and horizontal bone loss

a

Based on the clinical, radiographic and historical findings, how would you classify the periodontal condition of this patient according to the 2018 AAP Classification of Periodontal and Peri-Implant diseases?

A. Stage II, Grade B

B. Stage III, Grade B

C. Stage III, Grade C

D. Stage IV, Grade C

b

When determining the "Grade" for the above question, all of the following criteria should have been taken into consideration EXCEPT:

A. Presence or absence of risk factors

B. Amount of tooth loss due to periodontal disease

C. Amount of radiographic bone loss

D. Rate of progression

b

To address the patient's chief complaint of tooth sensitivity, which of the following toothpastes would you recommend for her?

A. Use a toothpaste containing either stannous fluoride or potassium nitrate

B. Use a toothpaste containing sodium pyrophosphate

C. Use a toothpaste containing sodium lauryl sulphate

D. Use a toothpaste that has a low RDA value

a

Given the patient's height and weight, her BMI was calculated to be: 26.6. How would you classify her BMI?

A. Underweight

B. Normal

C. Overweight

D. Obese

c

In addition to evaluating and correcting the patient's brushing technique, what other home care recommendations would you make for her in order to arrest continued bone loss?

A. Dental floss, power toothbrush and essential oils mouthrinse

B. Dental floss, manual toothbrush, interdental brush

C. Powered flosser, power toothbrush, sodium fluoride toothpaste

D. Interdental brush, power toothbrush, stannous fluoride toothpaste

d

Based on the patient's blood pressure reading and in particular, since she is on an anti-hypertensive medication, what advice should you give her regarding this finding?

A. Your blood pressure reading indicates you have Stage I Hypertension and you should visit your physician for a possible medication adjustment

B. Your blood pressure reading indicates you have Stage II Hypertension and you should see a physician for a possible medication adjustment

C. Your blood pressure reading is high, however it is most likely due to "white coat syndrome" and should be taken again at your next appointment

D. Your blood pressure reading is normal for people your age

b

What potential side effects might the patient experience from her prescribed medications?

A. Insomnia and increased salivary flow

B. Weight gain and decreased salivary flow

C. Fatigue and headache

D. Xerostomia and increased plaque retention

d

Taking into consideration, the patient's current blood pressure, her BMI, frequent thirst and family history, which of the following conditions do you believe she is at highest risk for?

A. Type II Diabetes

B. Heart attack

C. Stroke

D. Mental illness

a

65 yr old caucasian male

he patient reports having a stroke eight years ago and now suffers with slurred speech and a reduction in salivary flow. Up until then, he said he had been in perfect health. His recovery from the stroke has been very good with the exception of his speech. He visits his physician regularly for check-ups and is currently on: (Enalapril) Vasotec; (Warfarin) Coumadin®; and (Atorvastatin) Lipitor®. His blood pressure was recorded at 130/80; Pulse was 72 BPM; Respirations were 18 bpm. He claims his last INR reading was 2.5. He was a smoker for over 40 years but was able to quit 2 years ago. He claims he feels much better now, although he does still miss smoking particularly if he has a drink.

He indicates he brushes twice daily with a hard toothbrush using a back and forth scrubbing motion and only flosses occasionally. He occasionally uses a mouthrinse but he hates the burning sensation.

Using Angle's classification of malocclusion, the patient's occlusal status can BEST be described as:

A. Class II, Division II

B. Class I

C. Class II, Division I

D. Class III

b

The patient complains of a loss of taste which could be related to his dry mouth. Which of his medications might this loss of taste be attributed to?

A. Lipitor

B. Enalapril

C. A & B

D. Coumadin

c

Based on the client's chief complaint, the dental hygienist should recommend all the following EXCEPT:

A. Encourage salivary stimulants

B. Physician consultation

C. Increase fluid intake

D. Increase saturated fats in diet

d

Based on this patient's clinical, radiographic and historical findings, how would you classify his periodontal status using the 2018 AAP Classification of Periodontal and Peri-Implant Diseases?

A. Stage 1 Grade B

B. Stage II, Grade B

C. Stage II, Grade C

D. Stage III, Grade C

b

In order to safely perform non-surgical periodontal therapy on this patient, you must confirm that his International Normalized Ratio (INR) reading is:

A. < 1.0

B. 1.0 - 2.0

C. 2.0 - 3.0

D. > 3.0

c

The mandibular central and right lateral incisor radiographs both demonstrate an error caused by:

A. Insufficient vertical angulation

B. Client movement

C. Film packet placement

D. Excessive vertical angulation

d

The patient's blood pressure reading was 130/80. Based on the most current American Heart Association and American College of Cardiologists blood pressure guidelines, how would you categorize his blood pressure?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

c

What might be the best explanation for the patient's current blood pressure reading?

A. White coat syndrome

B. His blood pressure is controlled by his medication

C. His medication may require adjustment

D. A & C

d

After reviewing the patient's brushing technique and making appropriate adjustments, what other recommendations would you suggest for him?

A. Use a tartar control toothpaste; interdental brush; and floss the anterior teeth

B. Use a tartar control toothpaste containing stannous fluoride; interdental brush; floss

C. Use a medium-soft bristled brush; tartar control toothpaste containing stannous fluoride; interdental brush; floss

D. Change to a soft-bristled toothbrush; tartar control toothpaste containing sodium fluoride; interdental brush

c

With the beginning of the furcation visible clinically on tooth # 19, you measure a recession of 2mm. In determining the amount of clinical attachment loss (CAL) your reading is:

A. 5mm

B. 6mm

C. 7mm

D. 8mm

c

what is INR used for

therapeutic range for people taking warfarin for disorders such as atrial fibrillation

INR associated with

warfarian

TARGET INR range

2.0-3.0

what is white collar syndrome

normal BP at home but elevates when at the doctors office

75-year old White Caucasian male

Palatal irritation ill fitting denture

History of cardiovascular disease

Uses a CPC rinse

Extensive restorative dentistry

(Metoprolol succinate) Toprol® and (Pravastatin sodium) Pravachol®; His only allergy is to bee and wasp stings and thus carries an Epi-pen. He has a family history of cardiovascular disease; however he considers himself in good health since his By-pass surgery. His blood pressure was 120/82; Pulse 70 BPM; respirations 18 bpm.

power toothbrush and brushes twice daily. Patient uses a CPC mouthrinse for 60 seconds prior to bedtime and also soaks his partial in the same mouthrinse. He has tried to use dental floss but finds it frustrating and thus has given up.

Vertical bitewing radiographs were exposed versus horizontal bitewing radiographs based on what justification?

A. Missing teeth

B. Ill-fitting partial denture

C. Suspected interproximal caries

D. Increased visibility of alveolar bone

D

Based on the 2018 AAP Classification of Periodontal and Peri-implant Diseases, how would you classify this patient's condition?

A. Stage II, Grade B

B. Stage III, Grade B

C. Stage III, GradeC

D. Stage IV, Grade C

B

Which of the following statements BEST describes the furcation involvement on tooth #19?

A. The probe can pass between the roots and through the entire furcation.

B. The probe can pass between the roots and through the entire furcation with clinical visibility due to tissue recession and is radiographically visible.

C. The probe can partially enter the furcation, usually radiographically visible, however, not always.

D. Greater than 1 mm of horizontal movement and can be depressed into the socket.

C

The radiolucency surrounding the apex of the maxillary right lateral incisor illustrates the presence of:

A. A fractured root

B. Bone loss

C. Artifact

D. Internal root resorption

b

Based on the study models, the molar relationship on both right and left sides is:

A. End to end bite

B. Normal occlusion

C. Over bite

D. Crossbite

D

Based on the patient's initial palatal intraoral image (image on the left), the dental hygienist should provide the patient with recommendations for his partial denture including all of the following except one. What is the EXCEPTION?

A. Continue to nightly rinse and soak his partial in an alcohol based antimicrobial agent.

B. Daily remove the partial denture and clean with a soft toothbrush.

C. Pursue fabrication of a new partial denture.

D. Avoid chemical and mechanical cleansers that can scratch surfaces of the denture teeth.

A

After discussing and reviewing the patient's brushing technique with his power toothbrush, what other home care recommendations would you make for him?

A. Use a rubber Rubber-tip stimulator to reach under his bridges; use an stannous fluoride toothpaste.

B. Use an interproximal brush to clean in-between and under his bridges; use a sodium fluoride toothpaste.

C. Use an end-tufted toothbrush to reach under his bridges; a fluoridated toothpaste and dental floss.

D. Use Floss with a floss threader to clean under his bridges; a stannous fluoride toothpaste and an interdental brush.

D

The patient's oral medication, (Metoprolol succinate) Toprol® is prescribed to treat:

A. Elevated cholesterol

B. Hypertension

C. Candidiasis

D. Cardiac arrythmias

b

The BEST description for the patient's gingiva around the facial of tooth #22 is:

A. Fibrotic

B. Stippled

C. Blunted

D. Festooned

D

The patient's blood pressure was recorded at 120/82. According to the new AHA/ASC guidelines for blood pressure, how would you classify his blood pressure?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

c

67-year old White Caucasian male

History of periodontal disease

Former smoker

Allergic to penicillin

Furcation involvement

under a physician's care for cluster headaches as well as high blood pressure. He underwent hernia surgery 24 years ago and has encountered no problems since. The patient currently takes Amlodipine (Norvasc®); Ramipril (Altace®); and Omeprazole (Prilosec®). He also takes OTC (Ibuprofen) Motrin® for his cluster headaches which occur every few days. His Blood Pressure was 140/88; Pulse: 70; Respirations: 12.

rushes his teeth 2-3 times daily with a medium bristled toothbrush and uses a fluoridated toothpaste. He also adds that he flosses daily. He demonstrates a vertical and horizontal scrubbing motion when brushing.

experiences crepitus bilaterally but wears a night guard whenever he remembers

gets painful ulcers in his mouth that seem to come in numbers and last from 7-14 days in areas such as the lips, gingiva and tongue. He reports these ulcerations began to occur when he discontinued smoking.

has vascular hyperemia commonly found in edentulous areas where the width of keratinized mucosa is decreased.

If anesthesia were to be required to debride the teeth with furcations and deeper pockets, what would be the best choice of an anesthetic agent for this patient, taking into consideration, his medical history?

A. Lidocaine HCL 2% with epinephrine 1:100,000

B. Articaine HCL 4% without epinephrine

C. Prilocaine HCL 4% Plain

D. Bupivicaine HCL 0.5% with epinephrine 1:200,000

A

Taking into consideration, the patient's clinical, radiographic and historical findings, how would you classify his periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-Implant Diseases?

A. Stage II, Grade B

B. Stage III, Grade B

C. Stage III, Grade C

D. Stage IV, Grade B

B

Given the patient's blood pressure reading, how would you classify it based on the new AHA/ACC Guidelines?

A. Normal

B. Elevated

C. Stage 1

D. Stage 2

D

Of the medications that the patient is currently taking, which might be responsible for his current blood pressure reading?

A. Prilosec should not be taken with Amlodipine

B. Motrin should not be taken with Prilosec

C. Amlodipine and Ramipril should not be taken with Ibuprofen

D. Ramipril and Amlodipine should not be taken together

C

Given the amount of deposit, pocket depths, and bleeding index, what would be the best approach for a dental hygiene care plan?

A. Quadrant scaling with local anesthesia, using both ultrasonics and hand instruments, polishing of the teeth

B. Ultrasonic scaling throughout the mouth, followed by some hand scaling if necessary, selective polishing

C. Hand scaling of all areas of the mouth, polishing of all teeth and topical fluoride application

D. Local anesthesia for #2 & # 31, ultrasonic scaling of all areas of the mouth followed by hand scaling if necessary

D