Pan Dental Surgery

Pan Dental Infection Control and Radiation Practice Exam.

This is intended to be practice for the upcoming exam. It is not compulsory, and its result does not contribute to the final exam result.

1 / 55

What is the first step in treating a needle stick injury of a finger?

Wash with soap and water, then apply antifungal ointment

Apply surgical disinfectant soap

Use soap and water to wash affected area as soon as possible following injury

Apply antibacterial ointment

2 / 55

What type of sterilization monitoring is used to determine if sterilization has actually occurred?

Physical monitoring

Chemical monitoring

Biological monitoring system

Physical and chemical monitoring

3 / 55

What is the term used for determining if sterilized instruments are still sterile before reuse?

Chemical indicator system

Terminal sterilization

Event-related packaging

Biological monitoring system

4 / 55

Frequent handwashing can cause dryness of the hands or dermatitis. What is the best way to treat this during the work day?

Use of cocoa butter-based lotion

Use of petroleum-based lotion

Avoid the use of any lotions during the work day

Use of water-based lotion

5 / 55

Why is decayed tooth structure darker then regular healthy dentine or enamel on the xray?

Bacteria eat away the tooth structure and replace it with a slimy, hard material called eubernoid, that appears dark on the xray.

Bacteria stain the tooth structure black, and so it appears black on the xray.

Tell the patient to ask the dentist.

Bacteria causes the tooth structure to become less hard by dissolving calcium metal ions, so it abosrbs less xrays and appears radiolucent.

6 / 55

Why is it important that patients bite exactly on the groove indicated on the bite block for panoramic xrays?

To make sure the head is in the correct anterior-posterior position, to prevent errors such as widening if they bite too posterior, and narrowing if they bite too anterior.

To prevent their heads and shoulders from rocking side to side and generating motion artifact.

To make sure their upper and lower teeth are touching each other, so the xray can examine occlusion.

To give patients something to bite on to manage the anxiety of the panoramic xray.

7 / 55

Four errors are listed: blurred images, elongated images, foreshortened images and cone cutting. Match the errors with their causes.

D.

A.

B.

C.

8 / 55

Please match the following intraoral xrays with their errors.

i.Cone cutting ii. Elongated image iii. Foreshortened image iv. Blurred image Cone cutting

i. Blurred image ii. Foreshortened image iii. Elongated image iv. Cone cutting

i. Foreshortened image ii. Blurred image iii. Cone cutting iv. Elongated image

i. Blurred image ii. Elongated image iii. Foreshortened image iv. Cone cutting

9 / 55

Dr. Shaluwa asks you to take an OPG and this is the result. Should you retake it? Why or why not?

No. The Xray is fine because the teeth are clearly visible, especially the orthodontic wire in the lower jaw. There is no need to expose the patient to more radiation.

Yes. The OPG clearly shows a dark “radiolucent” area on her left jaw that could potentially be cancer. Dr. Shaluwa needs to confirm it with another xray.

No. The MO filling on tooth 55 is clearly visible, as well as the impacted canines, which can only be seen on clear X-rays. There is no need to retake the xray.

Yes. There is a ghost image that could cover potential problem areas.

10 / 55

Shown in the image is a bony outgrowth of the lower jaw, called a mandibular torus, or exostosis. It is made up of normal bone. How does it impact a bitewing xray?

The parallel technique must be combined with the bisecting angle technique in this case.

The torus makes it difficult to take biteweings, so periapical xrays are indicated for the teeth one by one.

Care should be taken when placing the film in the region of the torus so as not to hurt the patient. Other extraoral forms of radiographs should be taken instead if needed.

It does not impact the process of taking bitewing xrays, only panoramic xrays.

11 / 55

An inquisitive patient wants to know why you are taking a periapical xray of 17 and placing the film very straight, which is uncomfortable, rather than gently against his palate like his previous dentist. This is your colleague’s answer:

“The film has to be placed parallel with the tooth long axis for the bisecting angle technique, BECAUSE it is generally more comfortable to use the bisecting angle technique, where the xray beam is aimed perpendicular to the half-angle between the tooth and the film.

Statement 1 is false, and statement 2 is false.

Statement 1 is false, and statement 2 is true.

Statement 1 is true and statement 2 is true, but statement 2 does not explain statement 1.

Statement 1 is true and statement 2 is true, and statement 2 explains statement 1.

12 / 55

Dr. Emmanuel asks you to take a periapical xray of tooth 21, because the patient has been experiencing pain on biting. The complete xray is found below. He asks you to retake it. Why?

You cannot visualise the relationship between tooth 22 and 23 very well.

The root canal was not cleaned well, and that is why it appears bright white on the xray.

The radiograph does not capture the apex or tip of the root, as well as surrounding bone.

Wrong kV settings mean there is not enough contrast to make a definitive periapical diagnosis.

13 / 55

In the process of X-ray generation, the ________ (1) is heated using an electric current to generate high-speed ________ (2) that are accelerated towards the __________ (3).

1. Anode. 2. Electrons. 3. Cathode

1. Cathode. 2. Anode. 3. Electrons

1. Vanadium. 2. Augmentin. 3. Tachyons.

1. Cathode. 2. Electrons. 3. Anode

14 / 55

Free radicals form when ionising radiation interacts with water in cells. The body fights against free radicals with the ____________.

Scavenger system.

Anti-water ion system.

Anti-free radical system.

Anti-ionisation system.

15 / 55

After the X-ray beam hits the patient, what happens?

All of the X-rays are blocked by the body: none reach the detector.

The X-rays may be scattered in all directions due to Compton scattering.

Pair production and the photoelectric effect are most commonly observed in dental X-rays.

It passes through the body without interacting with the patient's matter..

16 / 55

What is ALARA in full?

As Long As Rays Arrive

Always Legally Apply Radiation Appropriately

Angel Larry Apio Ruth Asiimwe

As Low As Reasonably Achievable

17 / 55

Overlapping on bitewing X-rays is acceptable, because we will always still see the tooth decay between the teeth. True or False.

False

True

18 / 55

The __________ is legally responsible for radiation safety, and creation of a radiation safety manual in a dental office.

Medical director, senior dentist or radiation safety officer.

The dental assistant.

The sterilisation officer.

19 / 55

X-rays have different energies due to braking radiation. We can stop the useless, low-energy X-rays from reaching the patient by_________?

Collimation.

Filtration.

Ionisation.

20 / 55

The process by which X-rays lose energy as they pass through objects of a given thickness is called _________?

Attenuation.

Collimation.

Filtration.

21 / 55

Moving away from the radiation source significantly reduces the dose received because of the inverse square law. Distance is one of the best ways to protect ourselves from radiation. True or false?

False

True

22 / 55

A _________ is a device used to measure radiation dose in an area over time. A pocket _________ is worn by a worker who is regularly exposed to radiation to monitor their doses received.

Dosimeter.

Length dose machine.

Chronodosoradometer.

23 / 55

What is the density of an X-ray?

It is the same as the contrast.

It relates to the darkness of a radiograph.

It is how dense the air around the radiograph is.

24 / 55

On the control panel, the current of the generating circuit is measured in mA, while the kilovoltage peak is measured in kV or keV (kiloelectron volts). True or False?

False

True

25 / 55

A film holder consists of an indicator rod, a bite block and an _____________.

Collimator.

Long spacer cone.

Aiming ring.

Short spacer cone.

26 / 55

How can we NOT solve a gag reflex?

Lidocaine spray.

Clenching a fist or breathing slowly.

Salt on the tip of the tongue.

Make sure the patient focuses on the feeling of the film in the mouth.

27 / 55

Using a film holder makes it easier to perform the parallel technique. True or false?

True

False

28 / 55

Where do the upper back teeth roots point towards?

Towards the cheek.

Towards the palate.

29 / 55

What causes elongation (an error in taking X-rays)?

Too much vertical angulation.

Too little vertical angulation.

30 / 55

Digital X-rays can modify images such that radiolucent structures can appear lighter (known as inverse or inverted images), or can use other colours. True or False?

False

True

31 / 55

The periodontal ligament space is radiopaque. True or False.

True

False

32 / 55

Most dental restorations are radiolucent. True or False?

False

True

33 / 55

Washing hands, wearing masks, and using gloves are examples of vertical infection control procedures. True or False?

False

True

34 / 55

Protozoa are single-celled animals that are also called _________.

Rickettsiae.

Amoeba.

Viruses.

Bacteria.

35 / 55

Which of the following is true about indirect transmission?

It commonly uses “vehicles” that transport pathogens from person to person.

Dirty instruments cannot transmit blood-borne infections indirectly.

This type of transmission requires skin-to-skin contact.

A mosquito is an example of a vehicle.

36 / 55

Patients get nosocomial infections from the hospital. True or False?

False

True

37 / 55

___________ are worn over regular gloves to perform tasks like mixing cement and taking X-rays without having to reglove and perform hand hygiene.

Examination gloves.

Overgloves.

Sterile gloves.

38 / 55

Antiretraction devices are an engineering control device that prevents oral bacteria from the patient from flowing back from the handpiece into the dental water unit lines. True or False?

True

False

39 / 55

Which of the following is true about respiratory cough ettiquette?

Mask protection increases over time.

Masks are effective at protection when wet.

Coughing into the elbow and sneezing into tissue helps to reduce the dispersal of droplets.

Coughing into the elbow and sneezing into tissue 100% prevent respiratory infection.

40 / 55

The main blood borne Viruses are:

Hepatitis A, B, C, D and E.

HIV, Herpes and Epstein-Barr.

Hepatitis B, C and HIV.

HIV, Tuberculosis and prions.

41 / 55

Long-term liver inflammation from hepatitis viruses B and C can lead to liver cirrhosis and even liver cancer. True or False?

False

True

42 / 55

We have established protocols for Post-Exposure Prophylaxis available for:

Hepatitis B and HIV.

Tuberculosis, HIV and Hepatitis C.

Hepatitis A, B, C, D and E.

Only HIV.

43 / 55

Tuberculosis can spread in asymptomatic patients. True or False?

False

True

44 / 55

What does an autoclave use for sterilisation?

Steam.

Plasma.

Steam under pressure.

Gas.

45 / 55

The most effective autoclave cycle is:

N

S

B.

46 / 55

Which of the following is FALSE about using an autoclave?

The machine gauge readings of temperature and pressure are examples of mechanical indicators of sterilisation.

Operator error is the main cause of failure of instrument sterilisation.

Daily air removal and steam penetration tests are recommended, for each day the machine is in use..

Extraction forceps should be placed into the autoclave closed.

47 / 55

Which of the following is true about instrument processing?

Presoaking, cleaning and wiping all help to remove bioburden on the surface of instruments.

Ultrasonic instrument cleaners and instrument washers can replace autoclave sterilisation.

Semi-critical instruments MUST arrive to the treatment room sterile in sterile packages.

Critical instruments should always be sterilised using priority/flash sterilisation.

48 / 55

Which of the following is true about the cavity disease process?

Vaccines against streptococcus mutans will completely prevent cavity formation.

Streptococcus mutans is the only bacteria required to form cavities.

Cavities are a communicable disease.

The bacteria involved in the cavity formation are transmissible.

49 / 55

Which of the following is true about the gum disease process?

Periodontitis is reversible, while gingivitis is irreversible.

Gum disease has a high chance of spreading through aerosol in the office.

Porphyromonas gingivalis is one of the periodontal pathogens involved in the process.

Periodontal plaque involves no shift from good bacteria to bad bacteria.

50 / 55

Which of the following is true about miscellaneous infections?

Prion diseases have a high chance of spreading in the dental office.

Influenza vaccines are given once in the life of a patient.

Herpes and Epstein-Barr prove that saliva itself is a potentially infectious material.

Vaccines against Streptococcus pneumonia are not recommended for babies because they are dangerous.

51 / 55

Which of the following is true about infection control of radiation?

Films should be transported to the darkroom in clothes' pockets.

The X-ray machine should be cleaned always with a high-level disinfectant to achieve cold sterilisation.

Barrier protection can be used for both digital and analogue X-rays.

Digital sensors are heat sterilisable.

52 / 55

Root canal hand files should be sterilised before use on another patient.

Yes.

No, they are single-use disposable.

53 / 55

Clinical contact surfaces that have been contaminated by blood should be disinfected using:

Intermediate-level EPA registered disinfectant

High-level EPA registered disinfectant

Low-level EPA registered disinfectant

Liquid chemical sterilant

54 / 55

A patient calls the morning of an appointment complaining of a fever, muscle aches, runny nose and headache. What is the appropriate action?

Tell the patient he may have the flu and should reschedule the appointment after the fever and cough subsides without the use of medication.

Tell the patient he needs to come for the appointment or he will be charged for a no-show.

Tell the patient the decision is his to make about whether he feels up to coming in for dental work.

Reschedule for the following day

55 / 55

What is the basic concept that Universal or Standard Precautions is based on?

Standard precautions apply to all patients and all bodily fluids should be treated as if infectious

Standard precautions only apply to blood and saliva based on the patient's history

Standard precautions only apply to those individuals who have a history of high-risk behavior such as drug abuse or sexual orientation.

Standard precautions only apply to those individuals who have a history of infectious disease

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