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DSE OSCE – 2021/170 QUESTIONS AND ANSWERS (A+)
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DSE OSCE – 2021/170 QUESTIONS AND ANSWERS (A+)
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DSE OSCE – 2021/170QUESTIONS AND
ANSWERS (A+)
What are the ADA recommendations for when pre-
med is required - √Answer>- prosthetic cardiac
valves, including transcatheter-implanted
prostheses and homograft’s?
- prosthetic material used for cardiac valve repair,
such as annuloplasty rings and chords
- a history of infective endocarditis
- a cardiac transplant with valve regurgitation due
to a structurally abnormal valve
- the following congenital (present from birth) heart
disease
--unrepaired cyanotic congenital heart disease,
including palliative shunts and conduits
--any repaired congenital heart defect with residual
shunts or valvular regurgitation at the site of or
adjacent to the site of a prosthetic patch or a
prosthetic device
**ADA website**
https://www.ada.org/en/member-center/oral-
health-topics/antibiotic-prophylaxis
-41-yo woman, pregnant; prep rheumatic fever
with heart murmur (no valvular abnormality);
,allergy to penicillin. Positive history of infective
endocarditis. Does she need to pre med?
- yes
- no - √Answer>yes
- REVIEW HEALTH HISTORY - on my exam, this
patient had a previous history of infective
endocarditis. Pre-med IS indicated
- many of the OSCE quiz let’s say no....
-Pre-med options for pregnant woman w/hx of
infective endocarditis and penicillin allergy
- amoxicillin
- cephalexin
- clarithromycin
- ciprofloxacin - √Answer>*clarithromycin*
I may not be correct; the correct option may be
cephalexin. however, I chose clarithromycin due to
penicillin allergy, cross reaction with
cephalosporins, and since
clindamycin/erythromycin/azithromycin were not
options. Ciprofloxacin is contraindicated in
pregnancy. article for reference
https://www.parents.com/pregnancy/my-body/is-it-
safe/antibiotics-and-pregnancy/
-What procedure can a dentist perform without
consulting MD if a patient is currently taking
bisphosphonates?
- endo therapy
- prophy and scaling
,- extraction
- occlusal restoration - √Answer>*occlusal
restoration*
although the main HELL NO is extraction,
completing endo therapy increases risk if the apex
is compromised/damaged during therapy. I
teetered on prophy and scaling, but since it did not
specify supragingival, decided that the risk of
scaling can negatively affect the periosteum of a
bisphosphonate patient. ADA recommendations:
http://www.centreoms.com/admin/storage/news/
ADA%20Recommendations%20for%20Treatment
%20of%20Patients%20on%20Bisphosphon.pdf
-Pregnant person afraid of needles - stress
management by putting patient in what position
when in your chair (BEFORE they even get to the
point of passing out)?
- supply oxygen
- place in Trendelenburg
- make patient sit up straight
- tell them to suck it up buttercup - √Answer>place
her in Brandenburg position.
- supine hypotension in 3rd trimester usually
occurs (by compression Inf vena cava) => must
prevent this in dental chair by it can cause patient
to pass out.
- Best preventative treatment for supine
hypotension is to turn the patient, preferably to the
left side, to displace the uterus away from the
, inferior vena cava. The patient can also be placed
in a sitting position with the knees flexed.
-6 months pregnant had bleeding gums and
mobile teeth, how should they be treated?
- immediate extractions
- do not treat until baby is born
- conservative debridement
- immediate endo - √Answer>conservative
debridement
.- pregnancy gingivitis: important to do ScRP (and
stress good oral hygiene) to prevent plaque
growth. The plaque can enter blood stream and
stimulate patient's immune system to produce
prostaglandins, which can trigger uterine
contraction leading to early labour, premature
birth, and a small baby.
-Pregnant lady with a diastema in between #8 and
#9 with deep probing depth and class 1 mobility on
8 and 9. What is the reason for diastema?
- chronic periodontitis
- distal drift
- normal during pregnancy - √Answer>chronic
period
- increased incidence of periodontal disease
during pregnancy => must emphasize good oral
hygiene, and remove all their plaque so it doesn't
lead to premature birth / low birth weight
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