Pediatric Systemic DiseasesDentistry MCQs Pediatric Dentistry MCQs 0% Report a question What's wrong with this question? You cannot submit an empty report. Please add some details. 1234567891011121314151617181920212223242526272829 Pediatric Systemic Diseases 1 / 29 What dental material should be AVOIDED in poorly controlled asthmatic patients? Composite Acrylic/Dust Materials Glass Ionomer Amalgam Acrylic materials with dust because: 1) Can trigger bronchospasm, 2) Particulate matter irritates airways, 3) Risk of acute exacerbation, 4) Difficult to control exposure, 5) Better alternatives available, 6) Prevention better than management, 7) Safety concerns outweigh benefits 2 / 29 What emergency medication should ALWAYS be immediately available when treating an asthmatic patient? Antihistamine Oxygen Patient's Inhaler Epinephrine Patient's own bronchodilator inhaler because: 1) Most effective for that patient's specific condition, 2) Patient/parent familiar with usage, 3) Known response pattern, 4) Immediate accessibility crucial, 5) Legal requirement in many jurisdictions, 6) First line in emergency protocol, 7) Bridges gap until emergency services arrive 3 / 29 Which local anesthetic is MOST appropriate for asthmatic patients? Mepivacaine Plain Articaine with epi Lidocaine with 1:100,000 epi Prilocaine with epi Lidocaine without epinephrine 1:100,000 because: 1) Less likely to interact with beta-agonists, 2) Reduced risk of sulfite reaction, 3) Safer cardiovascular profile, 4) Better option for poorly controlled cases, 5) Shorter duration but safer profile, 6) Allows multiple administrations if needed, 7) Recommended by current guidelines 4 / 29 When is dental treatment CONTRAINDICATED in an asthmatic child? History of Attacks Controlled Asthma Active Wheezing Recent Mild Attack Active wheezing/acute attack because: 1) High risk of exacerbation during treatment, 2) Reduced respiratory reserve, 3) Increased anxiety can worsen condition, 4) Emergency management more difficult in dental chair, 5) Need to prioritize medical stabilization, 6) Risk outweighs benefit of dental treatment, 7) Legal implications of treating unstable patient 5 / 29 What is the MOST important piece of information to obtain from an asthmatic child's medical history? Frequency and Triggers Last Attack Date Medication List Emergency Contact Frequency of attacks and triggers because: 1) Determines risk level during treatment, 2) Guides appointment scheduling and length, 3) Helps identify potential triggers in dental environment, 4) Indicates severity of condition, 5) Determines need for premedication, 6) Helps assess if inhaler should be present, 7) Guides emergency preparation needs 6 / 29 Which inferior alveolar nerve block technique is safest in hemophilic patients? Multiple infiltrations High block technique Traditional block Intraligamental approach Intraligamental anesthesia preferred over blocks when possible. If block necessary: 1) Factor levels >30% 2) Use low-volume technique 3) Articaine preferred for infiltration 4) Avoid multiple injections. Risk of block: hematoma formation compromising airway. 7 / 29 What is the appropriate first response to post-extraction bleeding in a known hemophilic patient? Local measures then hematologist contact Immediate factor replacement Factor level testing first Direct hospital referral Local measures (pressure + tranexamic acid) first, then contact hematologist if persistent. Algorithm: 1) Direct pressure 20 minutes 2) If continues, tranexamic acid locally 3) Contact hematologist 4) Consider factor replacement. Early intervention prevents serious complications. 8 / 29 For a hemophilic child requiring multiple extractions, which approach reduces factor replacement needs? Single session extractions Alternate day extractions Quadrant-wise approach Weekly extractions Quadrant-wise extractions minimize factor replacement episodes. Multiple visits safer than single session. Benefits: better hemostasis control, reduced factor needed overall, easier post-op management. Consider: morning appointments, factor level monitoring, shorter appointments, reduced stress. 9 / 29 What is the MOST appropriate local hemostatic protocol following extraction in a hemophilic child? Gelatin foam alone Combined tranexamic acid-gelatin foam with sutures Sutures only Direct pressure only Combined approach: tranexamic acid-soaked gelatin foam + sutures + pressure provides optimal hemostasis. Single measures insufficient. Protocol includes: mechanical barrier, antifibrinolytic action, and prolonged local effect. Post-op care includes: no rinsing 24 hours, soft diet 1 week, avoid negative pressure. Monitor 24-48 hours for delayed bleeding. 10 / 29 In a child with severe Hemophilia A (Factor VIII <1%), what minimum factor level should be achieved before dental extraction? >100% >50% >75% >30% Factor VIII levels must reach minimum 50% for minor oral surgery. Below this increases bleeding risk. Major surgery requires >75%. Understanding levels: Severe (<1%), Moderate (1-5%), Mild (5-40%). Coordination with hematologist essential before any invasive procedure. Factor replacement calculated based on weight and desired increase. 11 / 29 Which periodontal finding best indicates the need for more frequent recall in a diabetic child? Gingival recession Tooth mobility Gingival bleeding Rapid attachment loss Rapid progression of attachment loss despite good oral hygiene indicates need for 3-month recalls. Bleeding alone insufficient indicator. Mobility late finding. Recession can have multiple causes. Understanding progression rate crucial for maintenance planning. 12 / 29 What is the appropriate emergency management for severe hyperglycemia (>400 mg/dL) during treatment? Give oral glucose Administer insulin Discontinue and seek emergency care Continue with caution Discontinue treatment, contact emergency services and physician immediately. Mild hyperglycemia can be monitored, but >400 mg/dL risks ketoacidosis. Patient monitoring until help arrives essential. IV hydration may be needed. 13 / 29 In treating periodontal disease in a diabetic child, which antibiotic shows enhanced glycemic control benefits? Amoxicillin Metronidazole Doxycycline Azithromycin Doxycycline shows dual benefits: antimicrobial and MMP inhibition, improving both periodontal and glycemic control. Amoxicillin effective for infection only. Metronidazole limited spectrum. Azithromycin not first choice. 14 / 29 What HbA1c level indicates the need to defer elective oral surgery in a diabetic child? >10% >9% >7% >8% HbA1c >9% indicates poor control requiring medical consultation before elective procedures. >7% acceptable with precautions. >8% borderline, evaluate individual factors. >10% absolute contraindication for elective procedures. Understanding these values helps risk assessment. 15 / 29 Which sign indicates early hypoglycemia during dental treatment? Loss of consciousness Confusion Anxiety and sweating Seizures Anxiety and sweating are earliest signs of hypoglycemia, appearing before confusion or unconsciousness. Recognizing early signs prevents severe complications. Tremors follow anxiety. Loss of consciousness is late sign. 16 / 29 What is the maximum recommended epinephrine concentration in local anesthetic for a poorly controlled diabetic child? No epinephrine 1:100,000 1:50,000 1:200,000 1:100,000 epinephrine maximum recommended. 1:50,000 risks glucose fluctuations. Plain anesthetic insufficient for hemostasis. 1:200,000 may be inadequate for procedure length. Epinephrine affects glucose levels through glycogenolysis. 17 / 29 What blood glucose level requires immediate glucose administration before dental treatment? <70 mg/dL <60 mg/dL <80 mg/dL <100 mg/dL <70 mg/dL requires immediate glucose administration. <100 requires monitoring but treatment possible. <80 borderline but monitor. <60 severe hypoglycemia requiring emergency protocol. Understanding these values crucial for safe treatment. 18 / 29 Which oral manifestation MOST strongly suggests poor glycemic control in a diabetic child? Dental caries Periodontal pockets Oral ulcers Multiple periodontal abscesses Severe periodontal inflammation with multiple abscess formation disproportionate to local factors strongly suggests poor control. Candidiasis alone nonspecific, delayed healing can have other causes, caries multifactorial. Regular monitoring of periodontal status essential for diabetic patients. 19 / 29 What is the optimal appointment timing for a well-controlled Type 1 diabetic child? Midday Late afternoon Before breakfast Morning after breakfast Morning appointments after normal breakfast and insulin are optimal. Blood glucose levels most stable, stress hormones lower. Late afternoon risks hypoglycemia. Skipping breakfast disrupts control. Midday variable due to lunch timing. Understanding this helps prevent complications during treatment. 20 / 29 Which asthma medication MOST significantly impacts caries risk? Inhaled β2-agonists Inhaled steroids Oral steroids Anticholinergics Inhaled β2-agonists reduce salivary flow and pH significantly. Steroids affect immunity but less direct caries effect. Anticholinergics affect flow but less used. Preventive protocols essential with long-term β2-agonist use. 21 / 29 In actively seizing epileptic patient, what is the FIRST step in dental office management? Administer oxygen Position patient on side Give anti-seizure medication Call emergency services Clear immediate area and protect from injury while positioning on side (recovery position). Medication secondary. Calling emergency services important but not first step. Airway management follows positioning. 22 / 29 What is the most appropriate hemostatic agent for post-extraction bleeding in thalassemia? Gelfoam Direct pressure only Oxidized cellulose Thrombin powder Oxidized cellulose (Surgicel) preferred as it doesn't require removal and doesn't interfere with healing. Gelfoam second choice. Pressure alone insufficient. Thrombin products may be needed as adjunct. 23 / 29 Which dental procedure is contraindicated during the neutropenic phase of leukemia treatment? Simple restoration Emergency extraction Examination Periodontal surgery Elective periodontal surgery contraindicated during neutropenia (ANC <1000/mm³). Emergency treatment possible with prophylaxis. Routine exams safe with precautions. Simple restorations possible if atraumatic. 24 / 29 In a child with asthma, which local anesthetic is MOST appropriate? 1:50,000 epinephrine Pure lidocaine Mepivacaine 3% 1:100,000 epinephrine Lidocaine with 1:100,000 epinephrine is safe. Avoid sulfites (present in higher concentrations in 1:50,000). Pure lidocaine insufficient hemostasis. Higher epinephrine concentrations risk bronchospasm. 25 / 29 What is the appropriate timing for dental treatment in an epileptic child with frequent seizures? Midday Late afternoon Early morning Evening Early morning appointments reduce seizure risk due to better medication levels and less fatigue. Afternoon appointments increase risk due to fatigue. Midday variable. Evening highest risk due to medication wearing off. 26 / 29 For a hemophilic child requiring extraction, what factor level should be achieved pre-operatively? >40% >80% >30% 50-75% Factor level should reach 50-75% for minor surgery through factor replacement. <30% insufficient, >80% unnecessary for minor procedures, 40% inadequate safety margin. Coordination with hematologist essential. 27 / 29 In a child with thalassemia major, which craniofacial finding is pathognomonic? Gingival hyperplasia Enamel defects Chipmunk facies Delayed eruption "Chipmunk facies" due to maxillary expansion and prominent frontal bossing is pathognomonic. Results from marrow hyperplasia. Dental findings variable. Understanding helps in diagnosis and management planning. 28 / 29 What is the minimum platelet count required for routine dental extraction in a child with ALL under treatment? >50,000/mm³ >30,000/mm³ >100,000/mm³ >20,000/mm³ Platelet count >50,000/mm³ required for minor surgery. <50,000 requires platelet transfusion. <20,000 emergency only with transfusion. >100,000 safe for major procedures. Consultation with oncologist essential. Local measures still important regardless of count. 29 / 29 Which oral manifestation MOST strongly suggests the need for medical referral in undiagnosed leukemia? Isolated ulcers Gingival bleeding with petechiae Tooth mobility Mucosal pallor Early gingival enlargement with spontaneous bleeding and unexplained petechiae strongly suggests leukemia. Pallor alone nonspecific, ulcers have many causes, mobility usually later finding. Early recognition critical for prognosis. Key features: bleeding disproportionate to local factors, rapidly progressive enlargement, unexplained petechiae. Your score is 0% Restart quiz
