Question 1

Hypersalivation is a sign of toxicity for which of the following agents?

Accepted Answer

Early signs of digoxin toxicity include anorexia,nausea and vomiting,and copious salivation.A reduction in the dose level of digoxin usually alleviates these adverse reactions.None of the other choices cause hypersalivation as a sign of toxicity.Clonidine is most likely to cause xerostomia and enalapril the least likely (oral manifestations include dry cough and dysgeusia).Nifedipine and hydrochlorothiazide can produce mild to moderate xerostomia.

Question 2

Dental patients with left heart failure may need to be positioned in the dental chair:

Accepted Answer

Full-reclining position may precipitate dyspnea or orthopnea (breathing difficulty experienced while lying flat).Elevation of one hip is indicated for some pregnant women requiring dental treatment during their third trimester.Lying in a flat position or with feet elevated above the head could precipitate orthopnea.

Question 3

Nitroglycerin (NTG)should be:

Accepted Answer

Nitroglycerin should be stored in its original glass container and kept at room temperature away from light and moisture. It should not be stored in plastic or the refrigerator. NTG should be administered every 5 minutes for a maximum of three doses during an anginal attack. It is important for the dental team to have NTG on hand for treatment of an acute anginal attack, but it should only be administered if the patient has been previously prescribed and instructed in its use by their physician.

Question 4

The cells of cardiac muscles have an intrinsic rhythm called:

Accepted Answer

The intrinsic rhythm of cardiac muscle cells is called automaticity, which refers to their ability to spontaneously generate action potentials. Spontaneity (A) is a similar concept but not as specific to the intrinsic rhythm of cardiac muscle cells. Anarchy (C) and hierarchy (D) are not applicable to this concept.

Question 5

A patient has a cardiovascular disorder for which a physician prescribes a local anesthetic drug. What might this cardiovascular disorder be?

Accepted Answer

Correct: Local anesthetic agents such as procainamide and lidocaine block Na⁺ channels in the heart and depress parts of the heart that are beating abnormally.
Incorrect choices: Local anesthetic agents are not used in the treatment of coronary artery disease, hypertension, or angina pectoris.

Question 6

Which of the following is true concerning what research has shown regarding the relationship between periodontal disease and cardiovascular disease?

Accepted Answer

Research on the relationship between periodontal disease and cardiovascular disease has shown mixed results, with some studies supporting a correlation and others not finding a significant link.

Question 7

MI refers to:

Accepted Answer

MI stands for myocardial infarction which is injury or necrosis (death) of the heart muscle due to a lack of blood supply.

Question 8

Nitroglycerine (NTG)is a(n)_____ that produces relaxation of vascular smooth muscle throughout the body.

Accepted Answer

Nitroglycerine is a powerful vasodilator that relaxes vascular smooth muscle throughout the body, resulting in increased blood flow to the heart and reduced workload on the heart. It is commonly used to treat angina, heart failure, and high blood pressure.

Question 9

Which of the following categories of drug is the best choice to relieve the acute symptoms of angina?

Accepted Answer

Nitroglycerin is the best choice to relieve the acute symptoms of angina because it is a fast-acting vasodilator that can quickly relieve chest pain and improve blood flow to the heart. Nitroglycerin is available in various forms, including tablets, sprays, and patches, and can be taken as needed for acute symptoms or as a prophylactic to prevent angina attacks.

Question 10

Nitroglycerine (NTG)is used for what cardiovascular disease?

Accepted Answer

NTG is a compound that releases nitrite and nitric oxide.These are very strong dilators to veins and arteries.This reduces workload to the heart and can reverse an anginal episode.NTG is not used for atherosclerosis,coronary artery disease,or arrhythmias.

Question 11

Which of the following classes of antiarrhythmics is associated with gingival enlargement?

Accepted Answer

Correct: Calcium channel blockers and phenytoin are associated with gingival enlargement. Verapamil is the most reported calcium channel blocker associated with gingival enlargement.
Incorrect choices: Amiodarone is associated with liver toxicity, blue skin discoloration, and photosensitivity. Disopyramide is associated with anticholinergic xerostomia. Procainamide is associated with a reversible lupus erythematosus-like syndrome, CNS depression, and xerostomia.

Question 12

Which of the following choices are effects of digoxin on the heart?

Accepted Answer

Digoxin prolongs the refractory period of the AV node, which helps in controlling heart rate in conditions like atrial fibrillation. It does not accelerate AV conduction or increase the rate of the SA node.

Question 13

Which of the following is the primary type of drug recommended for patients who have edema or fluid retention with heart failure (HF)?

Accepted Answer

Diuretics are the primary type of drug recommended for patients with edema or fluid retention in heart failure. They work by increasing the excretion of sodium and water from the body, which can reduce fluid buildup in the lungs and other tissues. Angiotensin converting enzyme inhibitors, angiotensin receptor antagonists, beta-blockers, and aldosterone antagonists may also be used in heart failure treatment, but they are not the primary choice for addressing fluid retention.

Question 14

In a normally functioning heart, the bundle of His receives its electrical input from the:

Accepted Answer

The bundle of His is a part of the electrical conduction system of the heart that serves to rapidly transmit electrical impulses throughout the ventricles. It receives its electrical input from the atrioventricular (AV) node, which is located between the atria and ventricles. The AV node serves as a gatekeeper, controlling the rate and timing of electrical impulses that pass from the atria to the ventricles. The SA node, located in the right atrium, serves as the primary pacemaker of the heart, initiating each heartbeat and setting the overall rhythm of the heart. The Purkinje fibers, located in the ventricles, are specialized fibers that rapidly distribute electrical impulses throughout the ventricular muscle. The cardiac muscle is the contractile tissue of the heart.

Question 15

How long should a person who has had a myocardial infarction wait before receiving dental care?

Accepted Answer

Patients who have suffered a myocardial infarction should wait 6 months before receiving any type of oral health care in order to give the heart a chance to heal.Bacteria from the mouth can enter the bloodstream and weaken an already weakened heart.If oral health care is necessary prior to the 6-month time period,one should consult with the patient's cardiologist or general practitioner to determine whether or not the patient's heart has healed sufficiently.The amount of time to wait prior to receiving dental care is specifically stated.

Question 16

The use of nitroglycerin (NTG)is contraindicated if sildenafil (Viagra)has been administered within 24 hours. This is because the NTG-sildenafil combination can precipitate a hypertensive crisis.

Accepted Answer

The first statement is true since the combination of NTG and sildenafil can indeed cause a dangerous drop in blood pressure. However, the second statement is false, as it should say that the combination can cause hypotension, not hypertension (a drop in blood pressure, not an increase).

Question 17

To prevent tolerance, prophylactic nitrates should be given with at least a(n):

Accepted Answer

Prophylactic nitrates should be given with an 8- to 12- hour "vacation" every day to prevent tolerance. This means that patients should have a period of time each day without nitrate exposure to prevent desensitization of the body's response to the medication. This can help ensure the effectiveness of nitrates over the long term. A week off every month or a day off every week may not be sufficient to prevent tolerance. A 1 hour "vacation" every 12 hours may not be long enough to prevent desensitization.

Question 18

Which of the following conditions is an absolute contraindication to dental treatment until a consultation with the patient's provider has determined any special treatment alterations that might be warranted?

Accepted Answer

A recent myocardial infarct (heart attack) is an absolute contraindication to dental treatment until a consultation with the patient's provider has determined any special treatment alterations that might be warranted. This is because the stress associated with dental treatment may increase the risk of another cardiac event. The other options listed are not absolute contraindications to dental treatment, although they may require special considerations or accommodations.

Question 19

Which of the following statements is true of heart failure?

Accepted Answer

If the left side of the heart fails, the blood backs up into the pulmonary circulation due to the inability of the left ventricle to eject blood effectively into the systemic circulation. This leads to symptoms such as shortness of breath and coughing up pink, frothy sputum.

Question 20

The _____ has the fastest rate of depolarization and therefore directs all the other cells of the heart.

Accepted Answer

The sinoatrial (SA) node has the fastest rate of depolarization and serves as the natural pacemaker to direct the other cells of the heart.

Quiz 14: Drugs for the Treatment of Cardiovascular Disease