1
Q
1. What is the most common chronic disease of childhood? A. Asthma B. Seasonal allergies C. Dental caries D. Otitis media
A
C
2
Q
- The Patient Centered Medical Home is the ideal place for all of the following EXCEPT:
A. Application of fluoride varnish
B. Extraction of loose or abscessed teeth
C. Triage of oral emergencies
D. Managing diabetes mellitus to improve periodontal health
A
B
3
Q
3. Which condition is associated with periodontal disease? A. Asthma B. Preterm labor C. Sinusitis D. Hypothyroidism
A
B
4
Q
- What can a primary care clinician do to promote oral health?
A. Collaborate with dental and other health professionals
B. Apply dental sealants
C. Prescribe oral fluoride supplements to every patient
D. Apply fluoride varnish to the teeth of all adults
A
A
5
Q
- Which class of medications is NOT generally associated with decreased salivary flow? A. Antihistamines B. Antibiotics C. Corticosteroids D. Anticholinergics E.
A
B
6
Q
7. A patient undergoing chemotherapy for cancer is at risk for which of these oral complications due to the effects of chemotherapy? A. Osteonecrosis of alveolar bone B. Gingival hyperplasia C. Oral mucositis D. Tooth fractures
A
C
7
Q
8. Which of the following infections is NOT potentially caused by direct extension from a dental source? A. Otitis media B. Sinusitis C. Brain abscess D. Facial cellulitis
A
A
8
Q
9. What is the suggested common pathway linking chronic periodontitis and conditions such as diabetes, coronary artery disease and adverse pregnancy outcomes? A. Direct bacterial extension B. Poor nutrition C. Circulating antibodies D. Inflammation
A
D
9
Q
10. Which of the following is NOT a mechanism for inter-relationships between oral and systemic disease? A. Behavioral B. Iatrogenic C. Neurologic D. Inflammatory
A
C
10
Q
- Which dental procedure does NOT require prophylaxis for individuals at high risk of bacterial endocarditis?
A. Dental extractions
B. Periodontal procedures
C. Post-operative suture removal
D. Prophylactic cleaning of teeth if bleeding is anticipated
E. Re-implantation of avulsed teeth
A
C
11
Q
- Periodontal disease can be clinically distinguished from gingivitis in which of the following ways?
A. Inflammation of the gums
B. White discoloration of the permanent teeth
C. Enlarged pockets at the gum base
D. Gingival hypertrophy
A
C
12
Q
13. Which of the following is NOT a common site for oral cancers? A. The tongue B. Floor of mouth C. Hard palate D. Lower lip
A
C
13
Q
14. Which of the following is most likely to lead to poorer oral health in the elderly? A. Alzheimer's dementia B. Coronary artery disease C. Hypothyroidism D. All of the above
A
A
14
Q
15. Risk factors for adult caries may include all the following EXCEPT: A. Low socioeconomic status B. Existing tooth restoration C. Decreased salivary flow D. A vegetarian diet E. Physical disabilities
A
D
15
Q
- Which of the following patients require bacterial endocarditis antibiotic prophylaxis?
A A 26 year old woman with mitral valve prolapse undergoing routine teeth cleaning with no anticipated bleeding.
B A 64 year old man with a prosthetic mitral valve who is undergoing a tooth extraction.
C A 16 year old boy with a ventricular septal defect completely repaired in infancy who requires extraction of an impacted wisdom tooth.
D A 32 year old man who had bacterial endocarditis 5 years ago who is undergoing orthodontic appliance adjustment.
A
B
16
Q
- Which of the following is NOT a normal age-related tooth change?
A. Gingival recession
B. Root caries
C. Yellowing of teeth
D. Wearing away of teeth with exposed dentin
A
B
17
Q
- Which of the following statements concerning xerostomia, or dry mouth, is NOT true?
A. Xerostomia is caused by a decrease in the production of saliva.
B. Xerostomia can cause a burning sensation, change in taste, and difficulty swallowing.
C. Medications can contribute to xerostomia.
D. Xerostomia can increase the development of caries.
E. Xerostomia is rarely a problem for patients wearing complete dentures.
A
E
18
Q
19. Which of the following has been implicated in the development of recurrent aphthous ulcers? A. Trauma B. Vitamin C deficiency C. Sickle Cell Anemia D. Herpes simplex virus infection
A
A
19
Q
20. Which of the following factors is NOT involved in the development of "Meth Mouth"? A Poor oral hygiene B Increased carbohydrate consumption C Night time mouth breathing D Teeth grinding E Xerostomia
A
C
20
Q
- Your patient meets all of the DSM-5 criteria for insomnia but also has OSA. What is an appropriate initial treatment approach for this patient’s insomnia- like symptoms?
A. Begin behavioral interventions for insomnia; address OSA once sleep quality or quantity has improved.
B. Use conventional medications for insomnia; address OSA once sleep quality or quantity has improved.
C. Treat OSA; behavioral interventions for insomnia may be added concurrently.
D. Treat OSA alone; insomnia cannot be diagnosed in patients with this condition and therefore, should not be treated.
A
C
21
Q
- Which of the following is a component of the DSM-5 criteria for insomnia disorder?
A. Early-morning awakenings with inability to return to sleep
B. Inadequate opportunity and circumstances for sleep
C. The sleep difficulty occurs nightly for at least 3 months
D. The sleep disturbance is not associated with daytime somnolence
A
A
22
Q
- Which of the following is considered the most effective component of behavioral therapies for insomnia?
a. exercise
b. relaxation training
c. sleep restriction
d. stimulus control
A
C
23
Q
- Which of the following is an example of good sleep hygiene?
A. Avoiding bright lights (such as from televisions, phones, and computers) for 5 to 10 minutes before bedtime
B. Napping during the daytime to increase total daily sleep time.
C. Maintaining a regular exercise schedule and exercising no earlier than 6 hours before sleep
D. Maintaining a regular sleep-wake schedule during weekdays only.
A
A
24
Q
19. What mainstay of nonpharmacologic interventions for chronic insomnia combines sleep restriction, stimulus control, and cognitive therapy with additional practical skills for managing insomnia symptoms? A. CBT-I B. Mindfulness mediation C. Relaxation training D. Sleep hygiene modification
A
A
25
Which statement is correct about AMD?
Deterioration of the central portion of the retina occurs over time.
26
Which statement is correct about differentiating the two forms of AMD?
The wet form is the cause of up to 90% of cases of legal blindness caused by AMD
27
Which statement is recommended of the American Academy of Opthlaomology?
Patients over 40 should have a comprehensive eye examination every 5- 10 years
28
Which symptomatic complaint is characteristic for patient with AMD?
Straight lines appear wavy and doors or windows appear curved.
29
Which statement is correct about managing AMD?
Intravitreal VEGF inhibitor injections are first-line therapy for wet AMD
30
Which age group has the highest incidence of epistaxis?
Adults (age 45-65)
31
Bleeding from which of the following sources is most often difficult to control?
Internal maxillary artery
32
What is the first like treatment for a simple anterior septal nosebleed?
Constant compression of the fleshy part of the nose for 10 minutes.
33
Which method of nasal packing is the easiest to place and least traumatizing to the nose?
Nasal balloon catheters
34
A patient presents with uncontrolled epistaxis while taking anticoagulant medication. Which intervention below is part of the best management plan for this patient?
Determine individual patient risks of stopping anticoagulation.
35
Question #1 Which of the following is included in the DSM-5 criteria for a diagnosis of insomnia disorder?
A. Insomnia classified as primary or secondary, depending on contributing factors.
B. Insomnia defined as difficulty getting to sleep rather than staying asleep.
C. Sleep difficulty occurs at least three times per week.
D. Sleep difficulty occurs for two or more months.
C
36
Question #2 The DSM-5 criteria for insomnia disorder include all of the following EXCEPT:
A. Insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder.
B. Sleep difficulty does not co-occur with a mental or other medical condition.
C. Sleep difficulty is present for at least three months.
D. Sleep difficulty occurs at least three nights per week.
B
37
Question #3 What is the most appropriate and complete set of questions to ask to assess a patient's sleep quality?
A. Questions about opportunities for sleep and typical number of hours of sleep each night.
B. Questions about the time it takes to get to sleep and ability to sleep through the night.
C. Questions regarding opportunities for sleep, difficulties with sleep onset or maintenance or early morning awakening, and frequency and duration of sleep problems.
D. Questions regarding the relationship between work/family worries and the occurrence of sleep difficulties.
C
38
Question #4 Which of the following is a component of good sleep hygiene?
A. Avoid getting out of bed if unable to fall asleep.
B. Go to bed at the same time each night and get up at the same time each morning.
C. Watch TV or read from an e-reader in bed for a half-hour before attempting to go to sleep.
D. Take a short nap during the day if possible (eg, during lunch hour).
B
39
Question #5 Which of the following statements regarding insomnia is CORRECT?
A. Insomnia affects daily functioning but rarely leads to physical or mental illnesses.
B. Insomnia is estimated to affect up to 10% of the primary care population.
C. Most patients with insomnia mention it to their primary care clinicians.
D. Patients with insomnia often experience weight gain
D
40
Question #6 Which of the following statements describes a physiologic process involved in the normal sleepwake cycle?
A. Alternation between sleep-promoting and wake-promoting systems.
B. Sleep onset promoted by activity of orexin.
C. Wakefulness promoted by GABA.
D. Wakefulness promoted by histamine.
A
41
Question #7 Which of the following statements regarding the role of the orexin system in the sleep-wake cycle is CORRECT?
A. Has actions similar to those of the GABA system.
B. Is active during both normal wake and normal sleep periods.
C. Promotes sleep.
D. Promotes wakefulness.
D
42
Question #8 Which of the following statements regarding GABA receptor agonists is CORRECT?
A. Benzodiazepines increase latency to sleep onset.
B. GABA receptor agonists target wakepromoting rather than sleep-promoting systems.
C. Nonbenzodiazepines bind specifically to α1 or α3 subunits on the GABAA receptor.
D. Nonbenzodiazepines should be taken at least two hours before bedtime.
C
43
Question #9 What are the effects of GABA receptor agonists in the treatment of insomnia?
A. Block activity of GABA in wake-promoting systems.
B. Impact wide range of brain functions in addition to sleep promotion.
C. Improve sleep onset but not sleep maintenance.
D. Shown to have low risk of next-day residual effects.
B
44
Question #10 Which of the following statements about orexin receptor antagonists in the treatment of insomnia is CORRECT?
A. Act by stimulating sleep-promoting systems.
B. Improve both sleep induction and sleep maintenance.
C. Indicated for sleep-maintenance insomnia only.
D. Indicated specifically for patients who cannot tolerate GABA receptor agonists.
B
45
Question #11 Which of the following statements is CORRECT?
A. Both benzodiazepines and nonbenzodiazepines can be associated with next-day "hangover" effects.
B. Immediate- and extended-release zolpidem have equivalent efficacy in maintaining sleep.
C. Melatonin receptor agonists are more effective than nonbenzodiazepines for sleep maintenance.
D. Sleep onset is improved by benzodiazepines but not nonbenzodiazepines.
A
46
Question #12 Which of the following statements regarding discontinuation of nonbenzodiazepines is CORRECT?
A. Nonbenzodiazepines have a potential for rebound insomnia on discontinuation.
B. Longer duration of use of clinical doses is associated with a greater risk of rebound on discontinuation.
C. Rebound insomnia is a symptom of withdrawal syndrome.
D. Withdrawal syndrome is characterized by a return of original insomnia symptoms.
A
Medicine I
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