ORAL SURGERY

Oral S urgery Exam - Firs t S emes ter

C h oos e the c orrec t ans wer:

1-Adverse effects of phenytoin:

a. Gingival hyperplas ia, Dec reas ed inc idenc e of infec tion and delayed healing.
b. Gingival bleeding because of leukopenia.
c. Osteoptosis
d -S tevens -Johns on s yndrome bec aus e of C N S.

2- If a patient with cardiac problem, on Aspirin, what will happen if you do an extraction;
a. Inc reas e PT.
b. Increase BT
c.Inc reas e toxic level of LA
d-Decrease PT

3-Erythromycin should not be administered to patients who are taking carbamazepine which, could lead to toxic
levels of antic onvuls ant bec ause of
a. Inc reas es the metabolis m of c arbamazepine.
b. Because it decreases the metabolism of carbamazepine
c . c -a &b
d. nor a neither b.
4- Which one of the following statements is correct regarding hypertension?
a-Essential hypertension is always due to an underlying ca use su ch a s intrinsic renal diseases.
b-Secondary hypertension may caus e by renovascular disease, Pheochromocytoma, Cushing's syndrome,
thyroid or parathyroid disease, heavy alcohol consumption.
c-Short use of corticosteroid therapy, chronic NSAIDS therapy, or long-term oral contraceptive use ca n lead to
secondary hypertension.
d-The secondary hypertension patient experiences symptoms quite later on compared to the primary/essential
hypertens ion patient and the s ymptoms are more s evere.
e-All patients with secondary hypertension may be cured after treatment of the underlying cause.

5-Bleeding tendency with Tegretol s o in dental management need the following lab tests:
a-(P.F.A)-100.
b- INR
c-Bleeding time
d-Clotting time
e-Prothrombin time.

6- After the s eizure:

a-Maintenance of a patent airway
b-Mouth suction should be not provided (to minimize aspiration of secretions).
c-Continue dental treatment.
d-Examine only for traumatic injuries (lacerations, fractures). In the event of avulsed or fractured teeth or fractured
appliance.
e-None of above
7- Which one of the following statements is correct regarding
hypertension?
a-Hypertension is an abnormal elevation in venous pressure
b-It cannot be fatal.
c. The blood pressure is the product of cardiac output and aortic resistance.
d. It dependent on the heart and vasculature, autonomic nervous system,
endocrine system and kidneys.
e-None of above

8- S igns and S ymptom s of Ins ulinReac tion:

a.MILD STAGE.. Hunger, Weakness bradycardia, Pallor. Sweating.
Paresthesias.
b. MODERATE STAGE, Lack of judgment, Uncooperativeness, Incoherence
,Good orientation
c. SEVERE STAGE ,Hypothermia, Hypotension,
Tonic or c lonic movements, Unc ons c iousne ss ,Rapid thready pulse
d-None of above
e-All the options
9-The clinical presentation of chronic bronchitis are;
a-Chronic cough with little
sputum.
b-Patients are usually under
weight
c-cyanotic, non oedematous
d-Breathless (blue bloaters).
10- The c linic
e-Patients haveal frequent
pres entation of Emphys
respiratory ema; it may progress to Cor pumonale (left sided heart failure).
infections,
a-Dyspnea on relaxation
b-Productive cough
c. patients are parrarel c hes ted,
d. weight gain,
e. Expiration with pursing lips to forcibly exhale the air (pink puffers).

11-For the diagnos is of C OPD;

a-Measuring forced vital capacity (FVC) and forced expiratory volume in one minute (FEV1) by spirometry.
b-FEV1/FVC ratio of les s than 70% indic ates CO PD.
c-Arterial blood gas measurement. In chronic bronchitis there is decreased partial pressure of CO2 (PCO2) and
reduced partial pressure of O2 (PO2),
d-While in emphysema there is reduced PCO2 and reduced PO2.
e-C.T. Scanning
12-Diabetic neuropathyinc lude;
a-Dysplasia
b-gastric tumor, diarrhea
c -mus c le s tiffnes s & c ramps
d-numbness, tingling
e-S uperfic ial burning pain.

13- Heart failure defined by (ACC\AHA) as:

a-A complex clinical syndrome
b-Can result from any structural cardiac disorder
c - C an res ult from any Func tional c ardiac dis order
d- That impairs the ability of the ventricle tofill with or eject blood which leads to blood output insufficient to meet the
body requirement
e-All of above

14- The followings are s igns and s ymptoms of heart failure:

a-C hronic pulmonary edema (cough or progres s ive dys pnea)
b-Exercise tolerance (inability to climb a flight of stairs)
c-Dependent central edema
d. Report of weight loss or decreased abdominal girth
e. Right upper quadrant pain (spleen congestion)
NOTE: The most accurate option is e. Yet, it should be liver instead of spleen because spleen is located in the
upper left quadrant.
15-The echocardiography determines the followings:
a-stroke volume (SV; the amount of blood that exits the ventricles with heart beat in a minute)
b- The end-diastolic volume (EDV; the amount of blood at the end of systole)
c-The SV in proportion to the EDV (the ejection fraction; EF).
d-Normally, the EF should lie between 50 and 70% but, in cardiac failure, it is > 40%.
e-None of above

16-For patients diagnosed and treatedfor heart failure:

a-C onfirm s tatus with patient relatives
b-Identify underlying cardiovascular disease (i.e., coronary artery disease, hypertension,
cardiomyopathy, valvular disease), and manage appropriately.
c-New York Heart Association (NYHA) class II patients (asymptomatic), routine care can be provided.
d- NYHA class I obtain consultation with physician for medical clearance and provide routine care.
e-NYHA (III and class IV) patients obtain consultation with physician; consider treatment in a special care
or hospital setting.
17-In dental management of patient has hypertension;
a. ≤120/80: Any treatment ca n be provided under supervision of physician.
b. ≥120/80 but < 140/90: Any treatment ca n be provided but order the patient to seek medical consultation.
c. ≥ 140/90 but < 160/100: Any treatment ca n be provided but order the patient to seek medical consultation.
d.≥ 160/100 but < 180/110: Any treatment; consider intraoperative monitoring of blood pressure for upper level
stage 2, treatment should be terminated if blood pressure rises above 179/109. The patient should be referred to
physician promptly.
e. ≥ 180/110: Any treatment could be done and the patient is referred to physician after that. But emergency treatment is
provided; the patient should be managed in consultation with the physician, and measures such a s intraoperative blood
pressure monitoring, electrocardiogram monitoring, establishment of an intravenous line, and sedation may be used.
The decision must always be made a s to whether the benefit of proposed treatment outweighs the potential risks.

18- For patients taking digitalis

a. , Avoid adrenalin; if considered essential, use cautiously (maximum 0.036 mg adrenalin or 0.20 mg levonordefrin),
which is no more than 2 cartridges containing 1:100.000 adrenalin or 1: 20.000 levonordefrine
b. Avoid gag reflex
c. Avoid intravas c ularinjec tion
d. Avoid erythromycin and clarithromycin
e-All of above
19- S igns and s ymptoms of IE are:
a-Osler’s nodes (small, non tender, subcutaneous nodules that develop in the pulp of the digits).. They are caused by
immune-complex deposition.
b.Janeway lesions (small, erythematous or hemorrhagic, macular, tender lesions on the palms and soles). They are
caused by septic emboli which deposit bacteria, forming microabscesses of the dermis with marked necrosis and
inflammatory infiltratenot involving the epidermis.
c. Splinter hemorrhages in the nail beds
d-Roth spots (oval retinal hemorrhages with pale off centre). Ca used by immune complex mediated vasculitis..
e-None of above

20- Minor criteria of Duke criteria:

a-Predisposing heart condition or IV drug use, and Fever. b-
Vascular phenomena, including embolic events.
c. Immunologic phenomena.
d. Mic robiologic evidenc e other than pos itive blood c ulture.
e-All of above

21- The oral manifestation Patients with severe hypertension have been reported to bleed excessively after surgical
proc edures or trauma.
a-Patients who take antihypertensive drugs, especially diuretics, may report over salivation
b. Lichenoid reactions have been reported with calcium channel blockers, methyldopa, propranolol, and labetalol.
c . A CE inhibitors may cause neutropenia, resulting in delayed healing or gingival bleeding, non-allergic angioedema
and burning mouth.
d-All calcium channel blockers may ca use mucosal pigmentation
e- All of above
22-Cardiac Conditions Associated with the Highest Risk of Adverse Outcome from endocarditis for which
Prophylaxis with Dental proc edures is rec ommended:
a-. Pros thetic dental work
b-. Future infec tive endoc arditis
c-Repaired cyanotic CHD, including those with palliative shunts and conduits.
d-Completely repaired C H D with prosthetic material or device by surgery or catheter intervention during the first 6
months after the procedure.
e-None of above

23-Cephalosporins should not be used in an individual with:

a-A his tory of anaphylaxis for penic illin
b-Angioedema with Aspirin
c - Urtic aria with Tetrac yc line
d-Urtic aria with Azithromyc in
e-None of above
24-patient has a history of congenital heart disease with prostatic valve, the suitable prophylactic antibiotic for him,
if the patient allergic to penicillin and has peptic ulcer, is:
a-Clarithromycin ca p 500mg 1 h preoperative
b-Clindamycin 600 mg oral root
c-Amoxicillin ca p 2g 1h preoperative
d. Clindamycin 600mg, I.V, preoperative
e. None of above
25-The diagnosis of rheumatic heart disease of a patient has the following signs and symptoms, is true if:
a-If he has Carditis and Arthralgia
b-Sub cutaneous nodules and previous rheumatic fever
c-Erythema marginatum and poly arthritis
d-C horea and pos itive EC G c hanges
e-All of them
 Oral Surgery Exam - Second Semester
Ǫ/Select the most appropriate answer?

1- Which of the following is NOT related to the management myxedema com a?

A. Hydrocortisone 100mg
B . Administration of Parental levothyroxine, and glucose
C. Cold pack s
D. A, B
E. All of the above

2- All true about Hashimoto thyroiditis except

A. Autoimmune disorder
B. Mos t patients develop hyperthyroidis m.
C. Treatment involves thyroid replacement therapy.
D . S urgery may be indic ated in s ome c as es .
E. None of the above

3- if the patient receives a chemotherapy, what is the best timing to do routine dental care
A. 24 hours after c hemotherapy s es s ion
B. Few days after the s es s ion
C. 1 week after c hemotherapy s es s ion .
D. 17-20 days after c hemotherapy s es s ion
E. B and D
4- Highest level of viral titer can be found in
A. Ic teric phas e
B. Pre-icteric phase
C. Rec overyphas e
D. Pos t-ic teric phas e
E. Options C, and D

5- HBs Ab (+) means:

A. Immunity due to previous infection
B. Infec tious patient
C. Immunity due to vac c ination
D . C leared infec tion.
E. Very infec tious (high infec tivity)

6- All of the following tes ts are c ons is tent with C R F exc ept?
A. Increase serum creatinine.
B. Inc reas e of potas s ium
C. increase serum calcium
D. inc reas es of blood nitrogen
E. none of the above
7- Ac ute kidney failure:
A. Irreversible c ondition
B. Low GFR for 4 months
C. Progres s ive .
D. Treated by peritoneal dialys is
E. None of the above

8- Patient with latent TB can be treated as a normal patient.

A. True
B. Fals e

9- Patient develops thyroid storm at your dental practice. What is the best action?
A. Seek medical assistance, warm pack, 100-300 mg hydrocortisone injection, glucose solution injection.
B. Seek medical assistance, cold pack, 100-300mg hydrocortisone, parental levothyroxine.
C.Seek medical assistance, cold pack, 100-300 mg hydrocortisone, glucose solution injection, parental
propylthiouracil.
D. Seek medical assistance immediately, warm pack, 100-300 hydrocortisone injection, glucose solution injection.
E. Seek medical assistance, cold pack, 100-300 mg hydrocortisone, glucose solution injection, parental levothyroxine
10- GFR is 22, indicating a chronic renal failure. Identify which stage?
A . S tage 5
B . S tage 4
C . S tage 3
D . S tage 2
E . S tage 1

11- The best time for dental treatment to be delivered for a patient with chronic renal failure who have a
hemodialys is .
A. Immediately
B. Two hours later
C. Next day
D. Next week
E. None of the above

12- Hemodialysis does not require anticoagulant therapy as compared to peritoneal dialysis. Additionally, there
is an increased risk of viral transmission in the hemodialysis as compared to other.
A. The first s entenc e is c orrec t.
B. The first sentence is correct while the second statement is incorrect.
C. The second sentence is correct, while the first statement is incorrect
D. Both are correct.
E. Both are inc orrec t
13- Hyperthyroidism is not associated with.
A . Elevated of TS H
B. Tachycardia
C. Weight loss
D. Warm skin
E. None of the above

14- During the extraction procedure, you have got needle stick injury. What is the best action?
A. Was h it and c overit
B. Bleed it, was h it, c over it
C. Bleed it, was h it, c over it, report it
D. Bleed it, wash it, apply antiseptic and cover it
E. Bleed it, wash it, apply 70% ethanol alcohol, cover it, report it

15- Asymptomatic patient with a positive Mantoux test. What is the best approach?
A. Treat him as a normal patient.
B. Only urgent c are in a hos pital s etting.
C. He is highly infectious; routine care should be provided in a hospital setting.
D. Urgent care only at your practice
E. None of the above
16- If you get a needle stick injury, and there is an adequate level of HBs Ab, what is the appropriate option.
A. Nothing
B. B. Hb immunoglobulin with the initiation of vaccination
C. C. Hb immunoglobulin _vaccine booster
D. D. No postexposure vaccine is available
E. E. Boos ter vac c ine dos e only

17- All of the following are true about Hashimoto thyroiditis except
A. Autoimmune disorder
B. Most patients develop hyperthyroidism.
C. Treatment involves thyroid replac ement therapy.
D . S urgery may be indic ated in s ome c as es
E. None of the above

18- Patients attend your practice. He is up to undergo radiotherapy treatment for parotid region and requires a
tooth extraction. What is the ideal timing before the initiation of radiotherapy?
A. 5 days
B. 1 week
C. 2 weeks .
D. 3 weeks
E. Not related
19- If you get a needle stick injury, and there is an inadequate level of HBs Ab, what is the appropriate option.
A. Nothing
B. Take Hb immunoglobulin with the initiation of vaccination!
C. Take Hb immunoglobulin vaccine booster
D. No postexposure vaccine is available.
E. Take vac c ine boos ter only

20- Whic h one is not c ons is tent with Os teoradionec ros is ,

A. Mandible is more susceptible.
B. Oc c ur due to radiation of 50-60 RADs
C. It resembles osteomyelitis radiographically.
D. It oc c urs by dental extrac tion or s pontaneous ly.
E. None of the above

21. Patient with history of asthma

a. Should receive prophylaxis bronchodilator if diagnosed with severe asthmatic condition
b. Should not receive prophylaxis bronchodilator if diagnosed with severe asthmatic condition
c. Should receive prophylaxis bronchodilator if diagnosed with mild asthmatic condition
d. All of the above
e. None of the above
22. Patient with history of angina pectoris develops chest pain on dental chair
a. Should receive sublingual nitroglycerin tablet
b. Should not receive sublingual nitroglycerin tablet
c. Should be dismissed home without any further management
d. All of the above
e. None of the above

23. Patient with thyrotoxicosis

a. Can receive any local anesthesia with adrenaline
b. local anesthesia with adrenaline should be avoided
c. local anesthesia with adrenaline can be used safely if given in hospital
d. none of the above
e. all of the above

24. Patient with fatty liver disease

a. The disease can be reversible
b. The disease could progress to liver cirrhosis
c. Can be caused by consuming alcohol
d. All of the above
e. None of the above
25. Patient with history of epilepsy
a. Should not receive dental treatment.
b. Can receive dental treatment if medically controlled.
c. Should not receive dental treatment even if medically controlled.
d. All of the above
e. None of the above

26. Patient with history of hypertension

a. Can not receive any dental treatment
b. Can receive emergency dental only treatment if not medically controlled
c. Can receive any dental treatment if not medically controlled
d. Can not receive any dental treatment even if medically controlled
e. All of the above

27. Patient with HIV

a. Should not receive any dental treat
b. Can receive dental treatment as any normal patient
c. Can receive dental treatment after good medical and dental management
d. All of the above
e. None of the above
28. Extraction of a tooth during pregnancy is safely carried out during:
A. First trimester
B. Middle trimester
C. Last trimester
D. None of the above

29. Which of the following is absolute contraindication for tooth extraction?

A. Hypothyroidism
B. Hypoparathyroidism
C. Hyperthyroidism
D. Hyperparathyroidism

30. Treatment of chronic osteomyelitis consists of:

A. Sequestrectomy
B. Saucerization
C. Both of the above
D. None of the above
31. Osteoradionecrosis of the jaw bone occurs as a complication of
A. Radiotherapy
B. Physiotherapy
C. Chemotherapy
D. All of the above
32. Which of the followings can cause hypotension?
A. Sever hemorrhage
B. Adrenocortical insufficiency
C. Hypoglycemia
D. All of the above

33. Which of the following is a signs or symptoms of hypoglycemia?

A. Hunger
B. Sweating
C. Uncooperativeness
D. All of the above

34. Hyperglycemia is characterized by which of the followings?

A Polydipsia
B. Polyuria
C. Polyphagia
D. All of the above

35-Anaphylactic shock can occur in which type of allergic reaction?

A. Type I
B. Type II
C. Type III
D. Type IV
36-Common sequela after cancer chemotherapy is myelosuppression, which is characteristic by
A. Thrombocytosis
B. Neutropenia & Thrombocytopenia
C. Leukocytosis
D. Lymphocytosis.

37-Abnormal coagulation time will occur in a patient with which of the following condition
A. Hemangioma
B. Hemophilia
C. Thalassemia
D. Pernicious anemia

38-The importance of chronic alcoholism prior to oral surgery is:

A. Predisposition to syncope
B. Absolute contraindication to local anesthesia
C. Prolonged bleeding secondary to liver dysfunction
D. Contraindication for use of retraction cord

39-A patient on recent prolonged steroid therapy may have:

A. Relative adrenal insufficiency
B. Intolerance to NSAIDs
C. Prolonged post extraction hemorrhage
D. Relative contraindication to analgesic
40-Glucocorticoids:
A. Enhances the repair
B. Decreases pain threshold
C. Maintenance of extracellular fluid
D. Decreases inflammation

41-History of polyuria, excessive thirst and low resistance to infection indicate the patient is most likely suffering from:
A. Diabetes mellitus
B. Rheumatoid arthritis
C. Iron deficiency anemia
D. Hypertension

42-Spider angioma spot on the skin of a patient are noted. He should have an examination to determine the condition of his:
A. Kidney
B. Liver
C. Lungs
D. Heart
43. A 13 years old girl has a history of severe sore throat, and swollen painful joints of the extremities. This history is
suggestive of:
A. Osteoarthrosis
B. Joints ankyloses
C. Rheumatic fever
D. Osteoarthritis
44-Patient history reveals dyspnea, orthopnea, cough, ankle edema, nocturnal dyspnea and irregular heartbeat, the most likely
diagnosis is:
A. Respiratory problem heart failure
B. Hepatic failure
C. Angina pectoris
D. Congestive

45-All of the following are signs of thyrotoxicosis except:

A. Slow pulse rate
B. Exophthalmos
C. Tremor
D. Temperature elevation

46-Patient present with thrombocytopenia is most likely to have which of the following post- operative complication?
A-Infection
B-Hemorrhage
C-Edema
D-Dry socket

47-Which cardiac condition require antibiotic prophylaxis before surgery?

A. Hypertension
B. Angina pectoris
C. Prosthetic cardiac valve
D. Congestive heart failure
48-Prophylactic antibiotic coverage for a patient with rheumatic heart disease is required prior to:
A-Periodontal surgery
B-Extraction of maxillary first molar
C- Periapical Surgery
D. All of the above

49-Allergic reactions may be characterized by:

A. Dyspnea
B. Tachycardia
C. Angioedema
D. All of the above

50-All of the following are risk factors for stroke except:

A-Physical activity
B- Uncontrolled hypertension
C- Heavy tobacco smoking
D-Diabetes mellitus
51-In dental management of patient with epilepsy:
A- Well controlled seizure pose no management problems
B-Bleeding susceptibility in patient on valproic acid treatment
C-Both A & B are true
D-None of the above are true
52-The following are noticed in clinical presentation of osteomyelitis except:
A-Fever
B- Dry mouth
C-Trismus
D. Pain

53-Which one is not an oral manifestation of hypertensive patient:

A-Dry mouth
B-Lichenoid reaction
C-Gingival hyperplasia
D-Microglossia

54-Among the following which patient will probably have bleeding problems postoperatively?
A-Leukemic patient
B-Hypertensive patient
C-Thrombocytopenic patient
D-All of the above

55-In patient receiving hemodialysis, dental management must include:

A-Hemostasis status determination
B-Assessment of liver function
C-Both A & B are correct
D- Both A & B are incorrect
56-In patient with rheumatoid arthritis (RA):
A-Morning joint stiffness lasting less than 15 minutes
B-Patient may complain of fatigue, weakness and malaise
C-Joint pain usually without inflammation
D-No systemic involvement or manifestations

57-In AIDS patient, Deep mycosis (histoplasmosis) can destroy the adrenal gland causing:
A-Addison's disease
B-Cushing's disease
C-Hyperthyroidism
D-Hepatitis
58. Most common cause of Infective endocarditis
a. Streptococci
b. Staphylococci
c. Actinobacillus
d. Pseudomonas aeruginosa
e. Cardiobacterium
59. In patient with Congenital heart disease, prophylactic antibiotics are not indicated in
a. Unrepaired cyanotic Congenital heart disease
b. Recent Completely repaired Congenital heart disease
c. Repaired Congenital heart disease with residual defects
d. a and c
e. None of the above
60. Nonsteroidal anti-inflammatory drugs should be avoided in (according to classification the New York Heart Association):
a. Class II, III and IV of heart failure
b. Class III and IV of heart failure
c. IV classes of heart failure
d. All classes of heart failure
e. It can be used safely in patients with heart failure.

61. As a student in College of Dentistry University of Baghdad, you can be provide any dental treatment when the patient
blood pressure (choose the most appropriate):
a. ≤120/80.
b. b. ≥120/80.
c. c. <140/90.
d. d. <160/100.
e. e. <180/110.
62. Regarding signs and symptoms of heart failure, one statement is incorrect
a. Dyspnea which means perceived shortness of breath.
b. Paroxysmal nocturnal dyspnea that awakens patient from sleep.
c. Pulsus alternans which is hyperventilation alternating with apnea during sleep.
d. Exercise intolerance.
e. None of the above.
63. In dental management of patient with heart failure, find the false statement:
a. Avoid adrenalin-impregnated retraction cord
b. Schedule short, stress-free appointments.
c. Use supine or upright chair position.
d. All statements are true
e. All statements are false

64. Cardiac arrhythmias can be caused by:

a. Myocardial infarction
b. Mitral valve diseases
c. Caffeine
d. Alcohol
e. All of the above

65. Oral Lichenoid lesions may be seen in patients taking medications for
a. Hypertension
b. Ischemic heart disease
c. Heart failure
d. All of the above
e. None of the above
66. Small, tender, subcutaneous nodules that develop in the pulp of the digits in patient with Infective Endocarditis are
called:
a. Osler's nodes
b. Janeway lesions
c. Roth spots
d. Splinter hemorrhages
e. None of the above.

67.Laboratory findings of acute rheumatic fever include;

a- Increase ESR.
b- Presence of C- reactive protein.
c. ECG changes
d- A and B
e-All of the above.

68.Most common predisposing conditions attributed to infective endocarditis are:

a. Mitral valve prolapse.
b. Aortic valve disease.
c. Congenital heart disease.
d. Prosthetic valve.
e. Intravenous drug abuse.
69. Which of the followings regarded as a major criteria for the diagnosis of Infective endocarditis
a. Positive blood cultures.
b. Presence of new valvular regurgitation.
c. Predisposing heart condition or IV drug use.
d. Vascular phenomena, including embolic events.
e. a and b.

70. dental treatment, including minor oral surgery, can be performed without stopping or altering the anticoagulant drugs
when the international normalized ratio (INR) rate between
a.1-2.5
b. 2-3.5
c. 3-4.5
d. 4-5.5
e. None of the above

71. Prior to radiotherapy in the treatment of head and neck cancer taking in consideration the following:
a. Partially erupted tooth that is associated with an inflammation (pericoronitis) should be extracted
b. Partially erupted tooth that is associated with an inflammation (pericoronitis) should be treated by heavy dose of antibiotic.
c. Teeth with severe periodontal disease must be treated carefully.
d. Ask the patient if he want to preserve his tooth.
e. intra-alveolar hemostatic packing agents should be used to stop bleeding
72. In Prodromal phase of patient with viral hepatitis
a. onset of clinical jaundice
b. It last from 2-4 weeks
c. Viral titers generally are highest at this phase
d. a and c
e. none of the above

73. Diminish sense test due to treatment of radiotherapy in patient has tumors in head and neck;
a. Result from atrophy of macrovilli taste cells.
b. Zinc supplementation improve test sensation.
c. Patient complains of unpleasant salty test.
d. Function will return to normal after few weeks after therapy.
e- None of the above

74. Following chemotherapy, the patient oral recall program

a. The once every 1 to 3 months during the first 2 years
b. At least every 3 to 6 months after 2 years
c. After 5 years, appointment only if the patient has a complaint.
d. a and b
e. None of the above
75. One statement about ejection fraction is incorrect
a. It is the stroke volume in proportion to the end diastolic volume.
b. It is important tool in diagnosis of heart failure.
c. Ejection fraction < 50% considered as heart failure.
d. Ejection fraction of 60% is normal.
e. All of the above

76. You do dental extraction for two patients at the same day, one of them is Simple construction worker and the other
one is General surgeon, what type of viral hepatitis that are most probable to transmit from each one:
a. Simple construction worker more liable for Hepatitis A
b. General surgeon more liable for Hepatitis B
c. Simple construction worker more liable for Hepatitis B
d. General surgeon more liable for Hepatitis C
e. All of the above except c

77. Regarding the Oral Complications and Manifestations in the AIDS patients, which of the following is true?
a. bluish purple or red lesion(s) that on biopsy as a candidiasis
b. hairy leukoplakia of the buccal mucosa is significant
c. Oral lesions are only late signs of HIV infection
d. linear gingival erythema and necrotizing ulcerative periodontitis may appear in those patients
e. none of the above
78. Regarding the General guidelines in the dental management of the patients with AIDS, which of the following is wrong?
a. Dental treatment may not be withheld if the patient refuses to undergo testing for HIV
b. A patient with AIDS who needs emergency dental treatment may not be refused care simply because the dentist does not
want to treat patients with AIDS
c. infected dentists inform their patients of their HIV serostatus and should receive consent or refrain from performing invasive
procedures.
d. routine dental care for AIDS patients should not be declined by the dentist, regardless the reasons
e. All of the above

79. Regarding the Occupational Exposure to Viruses, which of the following is true?
a. The risk of HIV transmission from infected patients to health care workers is very high
b. The risk of HIV transmission is about 0.03% with the needlestick or other sharp instrument transmitted blood from a patient to
a health care worker
c. the risk of infection from a needlestick is 0.3% for hepatitis C and
d. the risk of infection from a needlestick is 3% for hepatitis B
e. all of the above

80. To avoid development of the insulin shock, which of the following is true?
a. Patients should be told to take their usual insulin dosage and to eat normal meals before the appointment
b. Morning appointment
c. patients should be instructed to tell the dentist whether at any time during the appointment they are experiencing symptoms
of an insulin reaction.
d. A source of sugar such as orange juice, cake icing, or nondiet soft drink must be available in the dental office
e. All of the above
81. Regarding medical consideration of the pregnant women, which of the following is true?
a. volume of the lungs is increased in the resting state
b. increased rate of respiration
c. decreased appetite
d. decreased gag response
e. all of the above

82. Patient with rheumatoid arthritis may have all of the following, except.
a. Anterior open bite
b. Advanced TMJ Involvement with the disease can be solved by only physiotherapy.
c. Severe stomatitis
d. Radiographic changes of the TMJ, initially may show increased joint space
e. Inflammation in the joint.
f. None of the above.

83. Regarding the dental management of patient with rheumatoid arthritis

a. Bleeding usually is not clinically significant and can be controlled easily in-patient taking aspirin and steroids
b. lichenoid reactions are possible in those patients taking many medications.
c. Those patients usually comfortable to supine position.
d. B&C
e. None of the above
84. Regarding patients with the prosthetic joint replacement
a. prophylactic antibiotics are highly recommended before dental procedures to prevent prosthetic joint infection.
b. dental procedures are highly associated with prosthetic joint implant infections.
c. Patients Not Allergic to Penicillin can take 2g of Amoxicillin given orally 30 minutes to 1 hour before the dental
procedure.
d. Patients Allergic to Penicillin can take ampicillin 2 g intramuscularly or intravenously 30 minutes to 1 hour before the
dental procedure.
e. All of the above.

85. All of the following considered high risk factors for the development of the prosthetic joint infection after dental
treatment, except
a. systemic lupus erythematosus
b. Insulin-dependent (type 1) diabetes
c. hypertension
d. Malnourishment
e. hemophilia

86. Which of the following is wrong regarding patient in the early symptomatic stage of the stage 2 of AIDS infection?
a. Without treatment, this stage can last for 10-30 years
b. ELISA and Western blot are positive.
c. The spectrum of disease changes as CD4+ cell count declines.
d. CD4+ cell count declines and often between 200 and 300/μL
e. None of the above
87. Which of the following is wrong regarding patient in the stage 3 of AIDS infection?
a. Opportunistic infections are common
b. High viral load: CD4+ cell count below 200/μL.
c. ELISA and Western blot are positive
d. The use of combination antiretroviral agents prevents death.
e. None of the above

88. all of the followings are expected complications in the pregnant women, except
a. Infection
b. inflammatory response
c. glucose abnormalities
d. hypotension in the late pregnancy
e. Insulin resistance

89. Regarding the dental management of pregnant patient, which of the following is true?
a. if systolic blood pressure increased by 15 mm or more compared with prepregnancy values, this can be a sign of
preeclampsia
b. exaggerated inflammatory response of gingival tissues to local irritants is highly expected in the pregnancy
c. first trimester is the safest period in the pregnancy for dental intervention
d. if diastolic blood pressure increased by 30 mm or more compared with prepregnancy values, this can be a sign of
preeclampsia
e. all of the above.
90. All of the following are true regarding the dental management of the pregnant patient after the middle of the third
trimester, except
a. elective dental care is best postponed (increasing feeling of discomfort). .
b. Prolonged time in the dental chair avoided to prevent supine hypotension.
c. If supine hypotension develops, rolling the patient onto her right side.
d. short appointments.
e. frequent changes of position.

91. Which of the following is false regarding the oral manifestation and complications in the pregnancy?
a. pregnancy gingivitis that started at the marginal and interdental gingiva
b. a pyogenic granuloma or "pregnancy tumor" may affects 1% of these ladies
c. Pregnancy usually cause periodontal disease by itself.
d. Hypersensitive, gag reflex and/or morning sickness is common
e. Caries incidence increases in the pregnant patients

92- Patient with renal disease stage II

a. Needs antibiotic cover.
b. Do not require antibiotic cover if not receiving(dialysis) for routine dental treatment
c. Requires antibiotic cover only
d- Requires antibiotic cover for elective dental treatment
e- None of the above
93. Patient with renal disease stage 4
a. Requires consultation with physician prior to invasive dental procedure
b. Require consultation with physician prior to any dental procedure
c. Can receive medication with normal doses
d. Is with GFR (30-59 mL/min)
e. All of the above

94. For patient with renal disease

a- erythropoietin or RBC transfusion used when infection develops in orofacial region
b-Conjugated estrogens used if bleeding anticipated and a longer duration of action is required
c- Desmopressin used if bleeding anticipated, and a longer duration of action is required
d- Local hemostatic agents should not be used of patients with uremia.
e- None of the above

95. In a patient with renal disease

a- drugs excreted by the kidneys are eliminated threefold less efficiently when the GFR drops to 50 mL/min
b- When GFR drops below 50 mL/min, drug dosage needs to be reduced and timing of administration prolonged
c- Can be prescribed acyclovir and aminoglycosides safely at all stages of the disease
d- Tramadol is considered nephrotoxic drug
e.None of the above
96. In managing patient for dental treatment with renal disease
a- NSAIDs potentiate uremic platelet defects, so should be avoided routine noninvasive procedure
b- Nitrous oxide and diazepam should not be used with ESRD
c. In uremia, narcotics best be avoided
d- antacids can help to correct electrolyte balance in uremia
e- none of the above

97. In managing patient with epilepsy for dental treatment

a- Drowsiness, Slow mentation, Dizziness, Ataxia, Gastrointestinal upset, Allergic signs (rash, erythema multiforme) could
represent toxiist of local anesthesia
b. There is possibility of the results of PFA-100 test increase
c- Using a mouth prop is hazardous
d- 0.5 to 2 mg of lorazepam can be given sublingually at the start of appointment to prevent Seizure
e. All of the above

98. When is surgical extraction of impacted maxillary canines performed?

a. When a follicular cyst has developed
b. When there is resorption of the roots of adjacent teeth
c. Before construction of a dental prosthesis
d. When other options are unavailable
e. All of the above
99. What is an impacted tooth?
a. A tooth that has erupted but is misaligned
b. tooth that has failed to erupt into normal functional position beyond the expected time
c. A tooth that has been restored with a dental crown
d. A tooth that has cavities
e. A tooth that has been extracted

100. What are the main causes of tooth impaction?

a. Excessive tooth eruption
b. Perfect alignment of the teeth
c. Lack of space in the dental arch
d. Lack of dental hygiene
e. Excessive space in the dental arch

101- What is the most frequently required treatment option for impacted lower third molars in orthodontic
patients
a. Dental implants
b. Orthodontic braces
c. Tooth whitening
d. Root canal treatment
e. Surgical extraction
102. What should be demonstrated in the radiographic examination of impacted third molars?
a. Only the adjacent tooth
b. Only the inferior dental canal
c. Only the impacted tooth
d. Only the investing bone
e. The whole impacted tooth, the investing bone, the adjacent tooth, the inferior dental canal, the anterior border of
the ascending ramus, and the relation of the maxillary third molar with the maxillary sinus

103. What are the complications that can occur after surgical extraction of impacted third molars?
a. Temporary numbness
b. Tooth sensitivity
c. No complications
d. Minor discomfort
e. Pain, edema and trismus, postoperative hemorrhage, infection and abscess formation, alveolar osteitis (dry socket),
localized osteomyelitis, nerve dysfunction, fracture mandible, loss of tooth or root, oroantral fistula, displacement of
tooth or root, and fracture of tuberosity

104. What is the rate of impacted maxillary canines in the population?

a. 5%-10%
b. 50%-60%
c. 20%-30%
d. About 1%-3.5%
e. Less than 1%
105. What is the most common position of impacted maxillary canines?
a. Labially and palatally
b. Palatal
c. Crown on one side and the root on the other side
d. Within the alveolar ridge
e. Buccal

106. What are the options of treatment for impacted maxillary canines?
a. Retention or leave in situ, surgical exposure and orthodontic traction, transplantation
b. Retention or leave in situ, surgical exposure and orthodontic traction, transplantation, removal
c. Surgical exposure and orthodontic traction, transplantation, removal
d. Retention or leave in situ, transplantation, removal
e. Retention or leave in situ, surgical exposure and orthodontic traction, removal

107. Which tooth is the most commonly impacted in the mouth?

a. Maxillary second molar
b. Maxillary central incisor
c. Mandibular third molar
d. Maxillary canine
e. Mandibular second premolar
108. What are the surgical interventions that may be required in orthodontic treatment?
a. Orthodontic braces, retainers, and aligners
b. Extraction of erupted teeth, management of impacted, supernumerary and dilacerated teeth, corticotomy and excision
of labial frenum
c. Placement of dental implants, root canal treatment, and gum grafting
d. Gingivectomy, crown lengthening, and gum contouring
e. Teeth whitening, dental bonding, and veneers

109. What are the criteria for surgical exposure and orthodontic extraction of impacted maxillary canines?
a. Adequate space in the arch, unobstructed path of eruption, near to normal position after eruption
b. Adequate space in the arch, near to normal position after eruption, timing close to normal eruption time
c. Adequate space in the arch, unobstructed path of eruption, timing close to normal eruption time
d. Unobstructed path of eruption, near to normal position after eruption, timing close to normal eruption time
e. Adequate space in the arch, unobstructed path of eruption, near to normal position after eruption, timing close to
normal eruption time

110. What is the approach for surgical exposure of palatally positioned impacted maxillary canines?
a. Buccal flap
b. Excision of the overlying soft tissue
c. Palatal envelope flap
d. 3-sided buccal flap
e. None of the above
111. What is the success rate of transplantation of impacted maxillary canines?
a. Increased when the unerupted teeth still have open apex
b. Increased when the unerupted teeth still have open apex and when the handling of the root is kept to a minimum
c. Increased when the unerupted teeth still have closed apex and when the handling of the root is kept to a minimum
d. decreased when the handling of the root is kept to a minimum
e. none of the above

112. What is the most common position of impacted mandibular canines?

a. Buccal
b. Palatal
c. Within the alveolar ridge
d. Crown on one side and the root on the other side
e. Labially and palatally