Kathryn R. is a well-nourished 57-year-old Caucasian woman. She is 5 feet 5 inches tall and weighs 190 pounds. She reports a history of mitral valve prolapse with regurgitation. She is allergic to penicillin and tetanus toxoid. Her medications include Inderal, Lasix, lisinopril, nifedipine, potassium, and an aspirin a day. Her blood pressure is 150/96 mm Hg, and her pulse rate is 100 bpm. She comes to your dental hygiene clinic wanting her teeth “cleaned” because she reports that she is afraid of dentists and has not seen one in 10 years. Because of her fear, your instructor suggests that periodontal debridement be performed under local anesthesia. On seating Kathryn in your chair, you notice that her ankles are quite swollen. Her gingival tissue is enlarged and bleeds readily on probing. She has moderate horizontal bone loss and generalized pocketing of 6 to 8 mm. Her oral hygiene is fair, but she says she cannot get the floss “all the way back.”Which of Kathryn’s medications could account for her gingival enlargement?, Propranolol/Inderal, Furosemide/Lasix, Aspirin, Potassium supplement, Nifedipine/Procardia, Which classification of medication is lisinopril?, β-Adrenergic blocker, Diuretic, Angiotensin receptor blockers, Angiotensin-converting enzyme inhibitor, Calcium channel blocker, Which medication is most likely to relieve the swelling in Kathryn’s ankles?, Aspirin, Furosemide/Lasix, Nifedipine/Procardia, Propranolol/Inderal, Potassium supplement, Does Kathryn need to be prophylactically premedicated because of her mitral valve prolapse?, No, mitral valve prolapse is a condition for which prophylactic premedication is not indicated., Yes, mitral valve prolapse is a condition for which prophylactic premedication is indicated., Kathryn has been diagnosed with moderate periodontitis. Which is the relationship between periodontal disease and cardiovascular (CV) disease?, Treatment of periodontal disease decreases the incidence of CV disease., Periodontal disease can cause CV disease., There is a possible relationship between periodontal disease and CV disease., No relationship has been found between periodontal disease and CV disease., Which local anesthetic agent would be safest for Kathryn based on her medical history?, Lidocaine 2% with 1:100,000 epinephrine, Lidocaine 2% with 1:50,000 epinephrine, Lidocaine 2%, plain, Mepivicaine 3%, plain, The dental hygienist has to stop the debridement procedure many times during the appointment because Kathryn has a dry, hacking cough. This is most likely an adverse drug effect of which medication?, Potassium supplement, Furosemide/Lasix, Propranolol/Inderal, Aspirin, Lisinopril (Prinivil), Nifedipine/Procardia, Kathryn calls a few hours after the periodontal debridement appointment complaining of postoperative pain. Which analgesic would be the best choice for her?, Tylenol II with codeine, Acetaminophen, Ibuprofen, Aspirin

Chapter 12

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