Basic Sciences

A 27-year-old man develops a large cheek hematoma immediately after a posterior superior alveolar (PSA) nerve block.

A 33-year-old healthy woman receives 4 cartridges of 2% lidocaine with 1:100,000 epinephrine (1.8 mL/cartridge). She develops palpitations but remains stable.

A 58-year-old on warfarin (therapeutic INR 2.4) requires extraction of #36. Which coagulation factor group is reduced?

A 40-year-old with COPD asks about nitrous oxide sedation.

A 26-year-old develops persistent numbness of the tongue after a lingual nerve injury. Which fibers are primarily affected?

A 35-year-old presents with dry mouth after starting amitriptyline. Which receptor blockade explains this?

During an inferior alveolar nerve (IAN) block, the patient feels an “electric shock” sensation to the lower lip and tongue.

A 7-year-old has rampant caries; mutans streptococci detected at high levels. Which virulence factor most contributes to adhesion?

A 23-year-old receives 4% articaine for infiltration near #14. Which property explains superior diffusion through bone?

A 54-year-old with unstable angina presents in pain. Which local anesthetic vasoconstrictor strategy is safest?

A 31-year-old has immediate swelling of lips and wheeze minutes after amoxicillin.

A biopsy shows acute inflammation with abundant neutrophils in a pericoronal abscess. Which mediator is key for neutrophil chemotaxis?

A 60-year-old man with poorly controlled diabetes exhibits impaired wound healing. Which phase is most affected?

A 22-year-old has syncope during injection. Which physiologic change is most typical?

You counsel a patient on ibuprofen versus acetaminophen for dental pain. Which mechanism is correct for acetaminophen?

A 45-year-old alcoholic with liver disease needs analgesia. Which is safest short-term for moderate dental pain?

A patient on clindamycin for a dental infection develops profuse watery diarrhea.

A 29-year-old woman, 24 weeks pregnant, needs a periapical radiograph.

A 36-year-old with hyperthyroidism becomes agitated after receiving multiple cartridges with epinephrine.

A 30-year-old presents with facial pain referred from a maxillary molar. Which nucleus transmits pain from craniofacial structures?

A 25-year-old has difficulty abducting the vocal cords after thyroid surgery; which nerve was likely injured?

A 45-year-old man with iron deficiency anemia has a smooth, painful tongue. Which change explains the finding?

A 17-year-old athlete self-medicates with high-dose ibuprofen for 2 weeks before third molar surgery. What is the primary hemostatic effect?

A 62-year-old on metoprolol receives epinephrine-containing local anesthetic and experiences hypertensive response. Which receptor mechanism explains this?

A 12-year-old boy needs supplemental oxygen after a faint. Which device gives the highest FiO₂ noninvasively?

An adhesive dentistry question: Enamel etching with 37% phosphoric acid creates which microfeature?

A posterior composite shows marginal staining after 6 months. Which property most contributes to gap formation?

A GIC (glass ionomer cement) is chosen for a root caries lesion. What is its key advantage?

A 55-year-old experiences metallic taste and tinnitus during an IAN block with lidocaine.

A 42-year-old with renal impairment requires antibiotic therapy. Which drug requires dose adjustment?

A 29-year-old has persistent pain after a cold stimulus that lingers for 60 seconds. Which nociceptor fibers mediate sharp fast pain initially?

A 63-year-old with osteoporosis is on denosumab. What is the mechanism increasing MRONJ risk?

After bonding brackets, a patient shows white spot lesions. Which bacterial metabolic pathway drives demineralization?

A 47-year-old has a positive PPD and is on isoniazid (INH). Which oral complication is most likely prevented by pyridoxine supplementation?

A 50-year-old presents with burning mouth; labs reveal low serum ferritin. Which mechanism best explains symptoms?

A 32-year-old with hereditary angioedema presents for extraction. Which drug should be avoided for swelling prophylaxis?

A 28-year-old with G6PD deficiency needs an analgesic. Which should be used cautiously/avoided due to hemolysis risk in high doses?

A clinical study evaluates a new caries-detection device. Sensitivity is 90%, specificity 80%. What does 90% sensitivity mean?

You compare two composite brands for fracture strength; p=0.03 with t-test (α=0.05).

After RCT, periapical lesion size is monitored with standardized radiographs. Which measure best reflects clinical utility of the test to rule in disease?

A 3-year-old ingests an unknown amount of fluoride toothpaste and soon develops nausea and abdominal pain; mother brings the tube.

A 55-year-old post-radiation patient complains of severe xerostomia with rampant root caries.

During local anesthesia selection you need a fast onset for maxillary infiltration; options include bupivacaine, prilocaine, lidocaine, articaine.

A patient on nonselective beta-blocker (propranolol) receives several carpules with epinephrine and develops severe hypertension with reflex bradycardia.

After 30% nitrous oxide, an anxious adult remains calm, fully responsive to verbal commands, and ventilates normally.

A 25-year-old with odontogenic infection reports a history of immediate penicillin anaphylaxis.

Your published trial of a new varnish shows an absolute caries-risk reduction of 10% over one year.

A 60-year-old is taking clarithromycin while scheduled for oral midazolam sedation.

You plan to bond a composite soon after placing a eugenol-containing temporary cement.

A periapical radiograph reveals a smooth-surface incipient lesion; plaque sample shows Streptococcus mutans dominance.

A 45-year-old with unknown tetanus immunization suffers a contaminated lip laceration requiring suturing.

A child receives 2 cartridges of 2% lidocaine with 1:100,000 epinephrine (1.8 mL each). He asks how much medicine he got.

A 62-year-old anticoagulated with warfarin asks which lab reflects his anticoagulation level for dental surgery planning.

A 50-year-old with B12 deficiency neuropathy requests nitrous oxide sedation.

After a 40-minute N₂O session, the patient becomes lightheaded when the gas is stopped abruptly.

A 28-year-old collapses; glucometer reads 38 mg/dL; he is conscious but sweaty and shaky.

During anaphylaxis in the clinic, which epinephrine formulation/dose is correct initially?

You are pouring a Type III dental stone cast and consider water/powder ratio.

A 17-year-old has white spot lesions after orthodontics; you prescribe fluoride varnish.

You explain drug elimination to a patient curious about “how long meds stay in the body.”