When a patient has got wheezing, what happens to him/her?, He/she has got asthmatic attack,  His/her throat is obstructed by a foreign body,  He/she has got bronchospasm,  He/she has got hypopharyngeal obstruction by the tongue, How to manage a patient with wheezing?, Inject 1:1000 adrenalin,  Use bronchodilator medication,  Clear airway with a suction tip,  Repeat head-tilt, chin lift, What may happen when a patient is over-sedated?, Reduction in normal peripheral oxygen sedation (SpO2 < 95%) and respiratory depression is usually mild and transient, Increased heart rate,  Raised blood pressure (hypertension),  Nausea and vomiting, How do you manage the patient when oxygen saturation drops below 90%?, Ask the patient to take a few deep breaths, pinching the earlobe, If the SpO2 is still low give the Oxygen by facemask at 6-8L/min, Give IV reversal drug, Flumazenil if not better, All of the above, Who are the patients at risk with sedation?, Chronic respiratory diseases,  History of sleep apnea syndrome,  Extreme age and obesity,  All of the above, What type of patient that has got restricted airway?, Obese patients,  Down's Syndrome,  Heavy smokers,  Obese patients and Heavy smokers, How do you manage paradoxical reactions?, Inject adrenalin,  Inject Flumazenil,  Use Naloxone,  Use hydrocortine, Which one of the following is NOT the predisposing factors for paradoxical reactions?, Young and advanced age,  Alcoholism and drug abuse,  Patients who are allergic to local anesthetic,  Psychiatric disorders, How to manage haematoma formation at the IV injection site?, Remove the IV cuff to decrease the venous blood pressure,  Remove the needle and apply firm pressure for 5 minutes,  If the site is painful apply ice in the first few hours,  All of the above, Which one of the following is NOT the management of air embolism during IV sedation?, Withdraw air from the vein by using large needle and syringe,  Remove air bubbles from the IV tubing before connecting the IV,  Remove air bubbles from the syringe before injecting,  Periodically check the infusion bag to prevent it employing, How much small bubbles of air in the vein can a patient tolerate after IV sedation?, 0.2ml of air / kg weight,  0.5ml of air / kg weight, Up to 1ml of air /kg weight,  Over 2ml of air / kg weight, Which one of the following is NOT the symptoms of accidental intra-arterial injection?, A bright-red flash of blood in the cannula,  A dark red blood clots under the skin,  Pulsatile movement of blood in the IV line,  Intense pain or burning at the site of injection, How to prevent intra-arterial cannulation during IV sedation?, Always palpate a vessel before applying the IV cuff,  Check the colour of blood in the cannula and look for a pulse of blood in the IV tubing,  Ask the patient if there is pain or coldness going down the arm when you first inject a saline test,  All of the above, How to prevent extravascular drug administration during IV sedation?, Always test the IV by injecting first some saline or water for injection,  Inject a few drops of Diazepam into the vein first,  If a saline drip is being used, hold the IV bag below the patients' heart, Always test the IV by injecting first some saline or water for injection and . If a saline drip is being used, hold the IV bag below the patients' heart, Which one of the following is NOT the required equipment for IV sedation?, Pulse Oximeter,  Thermometer,  Blood pressure monitor,  Bag-valve-mask and oxygen cylinder, What are the required drugs for IV sedation?, Midazolam and Flumazenil,  Adrenalin 1:1000,  Other essential emergency drugs,  All of the above, Which one of the following is NOT the prerequisites for sedation?, Blood tests,  Knowledge of the agents to be used,  Consent,  Adequate equipment & materials, What are the guiding principles for sedation of children?, Supervision by medical personnel, Cooperative children,  Trained & skilled in both airway management and cardiopulmonary resuscitation, Supervision by medical personnel and Trained & skilled in both airway management and cardiopulmonary resuscitation, What advanced knowledge for primary practitioner in conscious sedation?, Capable of providing bag mask ventilation and, ultimately, endotracheal intubation,  Understand pharmacology of sedating medications,  Maintain advanced pediatric airway skills,  All of the above, Which one of the following is NOT the basic knowledge for supported personnel?, Be trained in, and capable of providing basic life support,  Know how to do tracheotomy,  Assist in any supportive or resuscitation measures,  Know how to use resuscitation equipment & supplies in the event of an emergency, What happens when insulin is injected to a hypoglycaemic patient?, The patient will recover from hypoglycaemia,  Blood glucose level will rise up,  The patient might die,  The patient's blood pressure will go down, What does S O A P M E stand for?, Supply, Order, Accident, Pain, Management, Emergency,  Suction, Oxygen, Airway, Pharmacy, Monitors, Equipment,  Safe, Old, Analgesics, Prescription, Malignancy, Effectiveness,  Sedationists of Oral Association for Pediatric Malformation and Epilepsy, What is Naxolone used for?, For reversing Benzodiazepines,  For pain control,  For reversing opioids, eg. Morphine,  For anti-inflammatory, You have been asked to administer conscious sedation to a healthy, 25 year old female patient in the dental school clinic. She has dental phobia and requires a simple dental extraction. The most appropriate statements in this context include:?, The patient must be able to understand and respond purposefully to verbal commands, throughout the period of sedation, The end point is maintenance of a purposeful response after repeated or painful stimulation,  Sedation with IV Midazolam is unlikely to be associated with over-sedation if titrated slowly, Sedative drugs are administered as a single bolus, A 75 years old man of ASA (American Society of Anesthesiologists) III status is scheduled for surgical removal of retained roots in the maxilla under IV sedation. The most appropriate statements regarding this procedure include:?, After an initial dose of midazolam, an additional dose is recommended if analgesia is inadequate,  Administration of a specific analgesic agent is likely to be needed for pain, If midazolam and fentanyl are administered, then fentanyl should be given after the peak effect of midazolam is observed, Midazolam dose for elderly patient with ASA III should be reduced, Which one of the following statement is NOT TRUE in relation to the use oral sedation?, Patient commonly complain of post operative headache,  An acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively,  There is a profound amnesic action and no side affects,  Oral Midazolam is considered as minimal sedation, Which one of the following statement is TRUE about Midazolam?, It has interaction with orange juice,  Midazolam injectable solution can be mixed with sweet drinks or Paracetamol syrup,  Normally, we titrate Midazolam in 5mg (5ml) increments every 5 minute while we talk to the patient,  The half-life of Midazolam is 10 to 20 hours, Which one of the following statement is NOT TRUE about monitoring during sedation?, oximeter measures oxygen saturation in arterial blood using infrared light, Oxygen saturation (SpO2) is the amount of oxygen carried by hemoglobin, compared with the total oxygencarrying capacity of hemoglobin; expressed as percentage, Pulse oximeter with the alarm set is better than the finger-clip without the alarm,  Record pulse and oxygen saturation every 35 minutes, Dental extraction may be most appropriately performed under conscious sedation in the following patients:?, A patient with known allergy to local anaesthetic,  A cooperative patient for extraction of four impacted wisdom teeth,  A severely mentally handicapped adult,  A 3-yr-old child for extraction of a single tooth, During a minor procedure under sedation and analgesia, the patient is breathing slowly with some snoring, is not easily aroused, and does not respond to verbal commands. At which level of sedation is this patient?, Twilight sedation,  Moderate sedation,  Deep sedation, Irreversible sedation, Which of the following defines moderate sedation?, A medically controlled state of depressed consciousness from which the patient does not respond to verbal or tactile stimul, CNS depression produced by sedatives that allow patients to tolerate unpleasant procedures while maintaining the ability to respond to verbal or tactile stimuli, The administration of morphine to treat post-operative pain,  The administration of a sedative/hypnotic agent to facilitate sleep, Patients being evaluated for procedure-related sedation need: ?, A history and physical,  An ASA physical status assignment,  A consent,  all of the above, All of the following are monitoring requirements for the sedated patient EXCEPT?, Blood pressure,  Capillary refill,  Pulse oximetry,  respiratory rate, What parameter must be monitored continuously during sedation?, State of consciousness (breathing),  Pulse oximetry,  Blood pressure,  Cardiac output, The first and most important action when a patient starts to vomit during a procedure is to?, Apply restraints,  Give supplemental O2,  Give a reversal agent,  Reposition to lateral decubitus, The first response for an obstructed airway is to: ?, Suction the patient,  Tntubate the patient,  Insert an oral airway,  Perform a chin lift/neck extension, Guidelines for patients at discharge after sedation should include: ?, Written release of the hospital from responsibility, Discussion of all potential adverse effects of moderate sedation,  Discussion of the effects of sedation and a warning about operating a motor vehicle,  A mandatory follow-up visit with the physician who performed the procedure, Which of the following statements about the use of benzodiazepines for moderate sedation is true?, Adjustment in dosing is needed when giving an opioid,  Should always be reversed by flumazenil,  Should always be reversed by naloxone,  Should always be given by the oral route, Infants and small children are particularly susceptible to complications during sedation. The unique anatomy of which body system contributes to this susceptibility:?, Neurological,  Gastrointestinal,  Respiratory,  Renal, A Post-Anesthesia Recovery Score is: ?, An objective measure used to determine a patient's suitability for discharge,  The same as an ASA Physical Status Classification,  A neurological assessment of LOC,  A physician test of how well a patient will tolerate narcotics, When can the patients be discharged to home after procedure-related sedation?, After they can walk,  After they can drink water,  After all the vital signs have returned to normal,  All of the above, Phenolics of Antiseptics are the following EXCEPT:, Phenol,  Triclosan,  Orthocresol,  Chlorhexidine, Halogens of Antiseptics are the following EXCEPT:, Sodium hypochlorite,  Chloramine,  Formalin,  Iodine, Heavy Metals of Antiseptics are the following EXCEPT:, Phenol,  Zinc oxide,  Copper sulfate,  Silver nitrate, Quaternary Ammonium Compounds of Antiseptics are the following EXCEPT:, Cetylpyridinium chloride,  Formaldehyde,  Benzalkonium chloride,  Octenidine dihydrochloride, Oxidizing agents of Antiseptics are the following EXCEPT:, Hydrogen peroxide,  Peracetic acid,  Potassium permanganate,  Chlorhexidine, Physical methods of Disinfectants are the following EXCEPT:, Temperature,  Membrane filtration,  Radiation,  Chemicals, Temperature of Disinfectants are the following EXCEPT:, Autoclave,  Refrigeration,  Filtration,  Freezing, Temperature of Disinfectants are the following EXCEPT:, Hot air oven,  Pasteurization,  Boiling,  Osmotic pressure, Handwashing agents are the following EXCEPT:, Chlorhexidine,  Chloroform,  Triclosan,  Iodine, Skin & Mucosal Antiseptics agents are the following EXCEPT:, Ethanol,  Propanol,  Iodine,  Triclosan, Actions of NSAIDS are the following EXCEPT:, Anti-inflammatory,  Anti-histaminic,  Analgesic,  Antipyretic, Therapeutic uses of NSAIDS are the following EXCEPT:, Anti-inflammatory,  Dysmenorrhea,  Osteoarthritis,  Antacid, Side effects of NSAIDS are the following EXCEPT:, Hepatotoxicity, Gastric ulcers,  Urticaria,  Prolongation of labor, NSAID drugs are the following EXCEPT:, Ketorolac,  Ibuprofen,  Mefenamic acid,  Tramadol, NSAID drugs are the following EXCEPT:, Flurbiprofen,  Diclofenac,  Dexamethasone,  Piroxicam, NSAID drugs are the following EXCEPT:, Metronidazole,  Meloxicam,  Mefenamic acid,  Paracetamol, NSAID drugs are the following EXCEPT:, Betamethasone,  Aceclofenac,  Aspirin,  Indomethacin, NSAID drugs are the following EXCEPT:, Naproxen,  Meloxicam,  Celecoxib,  Fluconazole, Which one is the NSAID drugs:, Hyoscine, Cephalexin, Indomethacin, Ampicillin, Which one is the NSAID drugs:, Codeine,  Tramadol,  Aceclofenac,  Dextromethorphan, Corticoid drugs are the following EXCEPT:, Betamethasone,  Omeprazole,  Dexamethasone,  Cortisol, Corticoid drugs are the following EXCEPT:, Methadone,  Triamcinolone,  Prednisolone,  Cortisone, Corticoid drugs are the following EXCEPT:, Prednisone,  Nabumetone,  Dexamethasone,  Fluocinolone, Corticoid drugs are the following EXCEPT:, Fluticasone,  Hydrocortisone,  Domperidone,  Mometasone, Corticoid drugs are the following EXCEPT:, Clobetasol,  Fluocinolone,  Halcinonide,  Naproxen, Corticoid drugs acting immediately are the following EXCEPT:, Prednisolone,  Betamethasone,  Triamcinolone,  Prednisone, Corticoid drugs acting immediately or long are the following EXCEPT:, Cortisone,  Methylprednisolone,  Dexamethasone,  Betamethasone, Corticoid drugs acting shortly or long the following EXCEPT:, Cortisone,  Dexamethasone,  Betamethasone,  Prednisolone, The common side effects of Corticoid drugs are the following EXCEPT:, Moon face,  Thinning of skin,  Buffalo hump,  Diarrhea, The common side effects of Corticoid drugs are the following EXCEPT:, Osteoporosis,  Peptic ulcer,  Sedation,  Hypokalemia, The common side effects of Corticoid drugs are the following EXCEPT:, Hirsutism,  Hypotension,  Peripheral edema,  Increased appetite, The common side effects of Corticoid drugs are the following EXCEPT:, Respiratory depression, Glaucoma,  Decrease growth in child,  Poor wound healing, The therapeutic uses Corticoid drugs are the following EXCEPT:, Addison’s disease,  Treatment of asthma,  Treatment of leukemia,  Analgesic, The therapeutic uses Corticoid drugs are the following EXCEPT:, Replacement therapy,  Treatment of Infection,  Treatment of Immunosuppression,  Treatment of allergic reaction, The therapeutic uses Corticoid drugs are the following EXCEPT:, Anti-inflammatory,  Treatment of peptic ulcer,  Treatment of Cancer,  Treatment of allergic reaction, Opioid Analgesic drugs are the following EXCEPT:, Oxycodone,  Codeine,  Dextropropoxyphene,  Mometasone, Opioid Analgesic drugs are the following EXCEPT:, Pentazocine,  Tramadol,  Propoxyphene,  Rabeprazole, Opioid Analgesic drugs are the following EXCEPT:, Morphine,  Fentanyl,  Diclofenac,  Methadone, Opioid Analgesic drugs are the following EXCEPT:, Codeine,  Morphine,  Heroin,  Chlorpheniramine, Which one is the Opioid Analgesic drugs:, Dextropropoxyphene,  Dexpanthenol,  Dextromethorphan,  Dextrose, Opioid Analgesic drugs are the following EXCEPT:, Tramadol,  Indomethacin,  Propoxyphene,  Morphine, Which one is the Opioid Antagonist:, Dexamethasone, Methadone,  Prednisone,  Naloxone, The therapeutic uses of Codeine are the following EXCEPT:, Analgesia,  Euphoria,  Dysphoria,  Dry cough, Antifungal Drugs are the following EXCEPT:, Amphotericin B,  Nystatin,  Roxithromycin,  Fluconazole, Antifungal Drugs are the following EXCEPT:, Clotrimazole,  Griseofulvin,  Miconazole,  Cefuroxime, Antifungal Drugs are the following EXCEPT:, Micafungin,  Fluconazole,  Metronidazole,  Miconazole, Imidazole group of Antifungals are the following EXCEPT:, Ketoconazole,  Fluconazole,  Flucytosine,  Clotrimazole, Antifungal Drugs are the following EXCEPT:, Itraconazole,  Fluconazole,  Omeprazole, Clotrimazole, Antifungal Drugs are the following EXCEPT:, Miconazole,  Ketoconazole,  Rabeprazole,  Clotrimazole, Antifungal Drugs are the following EXCEPT:, Itraconazole,  Miconazole,  Pantoprazole,  Ketoconazole, Which one is Antifungal Drugs:, Fluconazole,  Pantoprazole,  Rabeprazole,  Lansoprazole, Which one is Antifungal Drugs:, Esomeprazole,  Itraconazole,  Pantoprazole,  Lansoprazole, Which one is Antifungal Drugs:, Pantoprazole,  Esomeprazole,  Miconazole,  Lansoprazole, Therapeutic uses of Fluoroquinolones are the following EXCEPT:, Urinary tract infections,  Bacterial gastroenteritis,  Analgesic,  Typhoid fever, Side effects of Fluoroquinolones are the following EXCEPT:, Hepatotoxicity,  Nephrotoxicity,  Diarrhea,  Dizziness, Fluoroquinolones Drugs are the following EXCEPT:, Ciprofloxacin,  Norfloxacin,  Erythromycin,  Levofloxacin, Fluoroquinolones Drugs are the following EXCEPT:, Nalidixic acid,  Gemifloxacin,  Ofloxacin,  Gentamicin, Fluoroquinolones Drugs are the following EXCEPT:, Norfloxacin,  Levofloxacin,  Gemifloxacin,  Amoxicillin, Fluoroquinolones Drugs are the following EXCEPT:, Ciprofloxacin,  Roxithromycin,  Moxifloxacin,  Levofloxacin

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