Local Anesthesia Trivia Questions: Quiz

1. Which of the following injection types will provide the longest duration?

Nerve block

Field block

Supraperiosteal

Infiltration

Intrasseptal

A nerve block is a type of injection that involves injecting an anesthetic directly into or around a nerve to block pain signals. This method provides the longest duration of pain relief compared to the other options listed. Nerve blocks can provide pain relief for several hours or even days, depending on the specific procedure and the individual's response to the anesthetic. This is because the anesthetic directly affects the nerve, numbing the area and preventing pain signals from being transmitted to the brain.

Explanation

A nerve block is a type of injection that involves injecting an anesthetic directly into or around a nerve to block pain signals. This method provides the longest duration of pain relief compared to the other options listed. Nerve blocks can provide pain relief for several hours or even days, depending on the specific procedure and the individual's response to the anesthetic. This is because the anesthetic directly affects the nerve, numbing the area and preventing pain signals from being transmitted to the brain.

2. Trismus is best defined as what?

A low grade infection

A holiday in December

Anesthesia that doesn't "wear off"

Trauma to muscles and/or blood vessels

A flooding or pooling of blood

Can cause prolonged spasms and abnormal opening.

Explanation

Can cause prolonged spasms and abnormal opening.

3. Following the administration of a right PSA nerve block, the patient complains that tooth #3 is still sensitive. What is most likely the cause of this?

Deposition was too low

Deposition was too anterior

The mesiobuccal root of the 1st molar was not anesthetized with the PSA

Local anesthetic solution has probably expired

Insufficient amount of anesthetic deposited

Because the PSA does not get the mesial buccal root of the 1st molar, they need an MSA.

Explanation

Because the PSA does not get the mesial buccal root of the 1st molar, they need an MSA.

4. If a patient has an allergy to esters, which of the following topical anesthetics should not be used?

Lidocaine

Denti-patch

Benzocaine

Pressure

Betadine

Benzocaine, or any other drug that has only one "i" in the name.

Explanation

Benzocaine, or any other drug that has only one "i" in the name.

5. Of the following which is the MOST important prior to performing dental treatment including giving local anesthesia?

Vital signs to determine the baseline in the event of an emergency

Visual inspection to determine the overall physical state of the patient

Dialogue history, to ensure the patient has answered truthfully

Medical history questionnaire, thoroughly reviewed and updated

Treatment plan and patient consent forms completed

The most important prior to performing dental treatment, including giving local anesthesia, is to thoroughly review and update the patient's medical history questionnaire. This is crucial because it provides important information about the patient's overall health, any pre-existing medical conditions, allergies, medications, and previous surgeries. This information is vital for the dentist to assess any potential risks or complications during the dental procedure and to determine the appropriate treatment plan. It helps to ensure the safety and well-being of the patient during the dental treatment.

Explanation

The most important prior to performing dental treatment, including giving local anesthesia, is to thoroughly review and update the patient's medical history questionnaire. This is crucial because it provides important information about the patient's overall health, any pre-existing medical conditions, allergies, medications, and previous surgeries. This information is vital for the dentist to assess any potential risks or complications during the dental procedure and to determine the appropriate treatment plan. It helps to ensure the safety and well-being of the patient during the dental treatment.

6. The Vazirani-Akinosi mandibular technique is recommended for what type of patients?

Children

Large boned

Reduced opening

Enlarged tongue

Autistic

Patients who cannot open their mouths wide enough, or pain in the jaw joints.

Explanation

Patients who cannot open their mouths wide enough, or pain in the jaw joints.

7. What is the recommended amount of anesthetic deposited for the Gow-Gates injection technique?

1.5 ml

1.8 ml

1.2 ml

1.3 ml

1.0 ml

1.8-3.0 ml.

Explanation

1.8-3.0 ml.

8. Why do we implement "ideal patient positioning"?

To reduce the risk of syncope

To speed the onset of anesthesia

To keep the syringe out of a patient's sight

To ensure clinician caan obtain a firm hand rest

To slow the absorption of anesthetic into bloodstream

98% of office emergencies are related to the administration of anesthesia. 50% of those are syncope from patients passing out due to nervousness, etc.

Explanation

98% of office emergencies are related to the administration of anesthesia. 50% of those are syncope from patients passing out due to nervousness, etc.

9. Applying topical for longer than indicated can result in sloughing of the tissues - this is officially called what?

Epithelial desquamation

Sterile abscess

Cheek rot

White lacy striations

Epithelial dysplasia

Applying topical for longer than indicated can cause the sloughing of tissues, which is officially called epithelial desquamation. Epithelial desquamation refers to the shedding or peeling of the outermost layer of skin or mucous membranes. It can occur as a result of various factors, including prolonged use of certain topical medications or treatments.

Explanation

Applying topical for longer than indicated can cause the sloughing of tissues, which is officially called epithelial desquamation. Epithelial desquamation refers to the shedding or peeling of the outermost layer of skin or mucous membranes. It can occur as a result of various factors, including prolonged use of certain topical medications or treatments.

10. The maxillary division of the Trigeminal nerve travels anteriorly and downward to exit the cranium through which foramen?

Ovale

Spinosum

Magnum

Rotundum

Superior orbital

The maxillary division of the Trigeminal nerve exits the cranium through the foramen rotundum.

Explanation

The maxillary division of the Trigeminal nerve exits the cranium through the foramen rotundum.

11. The nerve that can be inadvertently anesthetized during an IA injection is what?

Facial nerve

Trigeminal nerve

Zygomatic nerve

Middle meningeal nerve

Buccal nerve

Facial and parotid.

Explanation

Facial and parotid.

12. An epinephrine overdose reaction.

Usually requires formal management

Requires placing the patient in a supine position

May manifest as anxiety or restlessness

Minimally affects blood pressure and heart rate

Indicates an epinephrine allergy

Can cause fear, anxiety, increase BP and pulse, sweating, and headache.

Explanation

Can cause fear, anxiety, increase BP and pulse, sweating, and headache.

13. After administering topical Benzocaine 20% and 3% Mepivacaine with epinephrine 1:100,000, the patient complains of intense itching of the face and is feeling a tightening in the throat. What is most likely the cause of this reaction?

The patient is experiencing psychogenic anxiety

The anesthetic was injected too rapidly

The patient is having a reaction to the epinephrine

The patient is allergic to the Benzocaine

The patient is having an idiosyncratic reaction

The cause is most likely an allergy to the ester.

Explanation

The cause is most likely an allergy to the ester.

14. All of the following patients represent a potential for a local anesthetic overdose except one, which is the exception?

Pregnant women

Patients with hepatitis

A marathon runner

Highly anxious patients

A sweet little child

Just because a patient runs marathons does not make them at risk for potential local anesthetic overdose.

Explanation

Just because a patient runs marathons does not make them at risk for potential local anesthetic overdose.

15. Pressure syringes are primarily designed to deliver what type of injection?

Palatal

Intraosseous

Intraseptal

Periodontal ligament

Incisive/mental

PDL (also intraligamentary)

Explanation

PDL (also intraligamentary)

16. A patient suffering from local anesthetic overdose induced seizures should be given what?

Oxygen only

Glucose

Oxygen and diazepam

Oxygen and epinephrine

Oxygen and diphenhydramine

Diazepam (valium) IM and O2

Explanation

Diazepam (valium) IM and O2

17. Which of the following is the best patient positioning while delivering local anesthetic?

Knees above sea level

Heart and hands parallel to the floor

Head and heart parallel to the floor

Toes above the nose

Hear and heart parallel, toes slightly elevated

The best patient positioning while delivering local anesthetic is to have the head and heart parallel to the floor, with toes slightly elevated. This position helps to maximize blood flow to the brain and minimize the risk of complications such as fainting or dizziness. By keeping the head and heart at the same level, blood circulation is optimized, and elevating the toes slightly helps to further improve blood flow.

Explanation

The best patient positioning while delivering local anesthetic is to have the head and heart parallel to the floor, with toes slightly elevated. This position helps to maximize blood flow to the brain and minimize the risk of complications such as fainting or dizziness. By keeping the head and heart at the same level, blood circulation is optimized, and elevating the toes slightly helps to further improve blood flow.

18. What type of injection is contraindicated in primary teeth?

Intraosseous

Infraorbital

Periodontal ligament

Posterior superior alveolar

Inferior alveolar

The periodontal ligament injection is contraindicated in primary teeth. This type of injection involves injecting the anesthetic solution directly into the ligament surrounding the tooth. However, in primary teeth, the roots are not fully formed, and the periodontal ligament is not well developed. Therefore, this injection technique may cause damage to the developing tooth and surrounding structures. It is important to use alternative injection techniques, such as infiltration or nerve block, in primary teeth.

Explanation

The periodontal ligament injection is contraindicated in primary teeth. This type of injection involves injecting the anesthetic solution directly into the ligament surrounding the tooth. However, in primary teeth, the roots are not fully formed, and the periodontal ligament is not well developed. Therefore, this injection technique may cause damage to the developing tooth and surrounding structures. It is important to use alternative injection techniques, such as infiltration or nerve block, in primary teeth.

19. In order to have a proper duration of a PSA, how much total anesthetic will you give?

0.6-0.9 ml

0.9-1.8 ml

1.5-1.8 ml

0.9-1.2 ml

.45-.9 ml

Half to a full cartridge.

Explanation

Half to a full cartridge.

20. If a right-handed clinician contacts bone too soon (one half penetration depth or less) on the left IA nerve block, what should be done?

Withdraw and select a penetration site more posterior

Immediately redirect needle/syringe more laterally

Withdraw slightly, redirect needle/syringe more medially

Withdraw and select a penetration site more medially

Withdraw slightly, redirect needle/syringe more laterally

Redirect syringe or pull out and go back in a little higher.

Explanation

Redirect syringe or pull out and go back in a little higher.

21. Persistent paresthesia following a local anesthetic injection.

Is always preventable

Is often caused by a needle penetrating the cheek

Is always reversible

Is desirable

Is the most common on the tip/side of the tongue

Can happen on the lower lip or the tip of the tongue, tip of the tongue is most common.

Explanation

Can happen on the lower lip or the tip of the tongue, tip of the tongue is most common.

22. All of the following are acceptable alternatives for an anesthetic-allergic patient except one, which is the exception?

Hypnosis

Electronic dental anesthesia

Use limited amounts of esters

Use general anesthesia

Use limited amounts of sterile Benadryl

Alternatives include amides, general anesthesia, histamine blockers, NO2, hypnosis, electric anesthesia.

Explanation

Alternatives include amides, general anesthesia, histamine blockers, NO2, hypnosis, electric anesthesia.

23. The main reason to inject slowly is to accomplish which of the following?

Make the injection as comfortable as possible

Not disturb the homeostasis of the tissues

Lessen the chance of anesthetic overdose

Ensure you are not in a blood vessel

Lessen the chance of a hematoma developing

Slowly injecting allows for decreased toxicity, safety, and slow absorption.

Explanation

Slowly injecting allows for decreased toxicity, safety, and slow absorption.

24. You administer 2% lidocaine with epinephrine 1:50,000 into the palate of your patient. Three days later, they call complaining of a large sore on the roof of their mouth. What is the sore MOST likely to be?

Herpes simplex virus

Aphthous ulcer

Epithelial desquamation

Sterile abscess

Necrotizing sialiometaplasia

The most likely explanation for the large sore on the roof of the patient's mouth is a sterile abscess. Lidocaine is a local anesthetic commonly used in dental procedures, and it is possible for a sterile abscess to occur as a result of the injection. This type of abscess is characterized by the accumulation of sterile fluid or pus, causing swelling and pain in the affected area.

Explanation

The most likely explanation for the large sore on the roof of the patient's mouth is a sterile abscess. Lidocaine is a local anesthetic commonly used in dental procedures, and it is possible for a sterile abscess to occur as a result of the injection. This type of abscess is characterized by the accumulation of sterile fluid or pus, causing swelling and pain in the affected area.

25. Your patient is a 190 lb man. He was scheduled with the dentist prior to seeing you today. The dentist used 3 cartridges of 4% Articaine with epinephrine 1:100,000. He is becoming sensitive during root planing and scaling. How many additional cartridges of 2% lidocaine with epinephrine 1:100,000 can he have?

2.3

4.5

7.3

3.8

1.9

The given correct answer is 2.3. This can be determined by calculating the maximum safe dose of lidocaine with epinephrine that the patient can have. The patient's weight of 190 lb is used to calculate the maximum safe dose, which is 7 mg/kg or 3.18 mg/lb. Multiplying this by the patient's weight gives 604.2 mg. Since each cartridge of 2% lidocaine with epinephrine contains 36 mg of lidocaine, dividing the maximum safe dose by this amount gives approximately 16.8 cartridges. Since the patient has already received 3 cartridges of 4% Articaine, subtracting this from the maximum safe dose gives 13.8 cartridges. Rounding down to the nearest tenth gives the answer of 2.3 additional cartridges.

Explanation

The given correct answer is 2.3. This can be determined by calculating the maximum safe dose of lidocaine with epinephrine that the patient can have. The patient's weight of 190 lb is used to calculate the maximum safe dose, which is 7 mg/kg or 3.18 mg/lb. Multiplying this by the patient's weight gives 604.2 mg. Since each cartridge of 2% lidocaine with epinephrine contains 36 mg of lidocaine, dividing the maximum safe dose by this amount gives approximately 16.8 cartridges. Since the patient has already received 3 cartridges of 4% Articaine, subtracting this from the maximum safe dose gives 13.8 cartridges. Rounding down to the nearest tenth gives the answer of 2.3 additional cartridges.