DSE OSCE Exam 2024/2025 Solved 100%
(Very grainy) picture of #10 and #11, lingual surfaces. What is wrong with the gingiva?
- edema
- artifact
- squamous cell carcinoma - ANSWER-edema - enlargement of marginal and
interproximal gingiva; smooth shiny surface, loss of stippling, diffuse redness
*Another version* Pernicious anemia is caused by:
- Decrease in intrinsic factor (required for absorption of B12)
- Chronic use of aspirin, NSAIDs, corticosteroids
- A variant of hemoglobin A (called hemoglobin S)
- Destruction of RBCs - ANSWER-decrease in intrinsic factor
- Schilling's test to evaluate B12 absorption; most commonly used to eval pts w/pernicious
anemia
*image*
Pt presents with shallow ulcerated lesion on the lower lip that has been present for several
months. Has been a farmer for several years. Likely diagnosis?
- squamous cell carcinoma
- traumatic burn
- apthous ulcer
- mucocele - ANSWER-Squamous cell carcinoma
- ALWAYS pay attention to medical history. Knowing that he is a farmer, you know that he
spends the majority of his time in the sun; also knowing that the lesion has been present for
an extended time (my question stem mentioned several months). SCC is more common
on the lower lip vs upper lip.
#1 present w/class III mobility, furcal involvement; #2 and #3 are missing. best way to
restore?
- fixed bridge #1-4
- place two implant-supported crowns for #2 and #3; frequent recall to re-eval #1
- ext#1; implants for #2, #3, or both - ANSWER-ext#1, implants for 2, 3, or both
- #1 has hopeless prognosis
#27 had root canal and there is a bridge from #27 to #25; What is the radiolucency? (RL not
at #25, no apparent apex involved)
- endodontic lesion
- cyst
- possible non-odontogenic lesion, re-evaluate at later date - ANSWER-Nothing to do with
#25, not a failed RCT on #27, re-evaluate in 3 months, or chronic cyst in between #25-#27
- remembered question, I did not have this one personally...
1-2mm reduction of probe depth after SRP. What caused this?
- deposition of alveolar bone
- reattachment
,- formation of long junctional epithelium - ANSWER-formation of long junctional epithelium
14 year old presents with inflamed gingiva. Bloodwork indicates abnormal RBC, WBC, and
platelets. Diagnosis?
- normal 14 year old
- hypothyroidism
- leukemia
- anemia - ANSWER-leukemia --> high WBC, lymphadenopathy, painful gingiva. Don't
forget that WBC can be elevated OR decreased in leukemia! Gingival hypertrophy is a
common sign/symptom
2 months after an RCT a RL is still present. How do you proceed?
- monitor
- retreat - ANSWER-monitor
- can take up to a year for bone to heal
2 years after RCT, RL still present at apex
- monitor
- retreat - ANSWER-retreat
- indicates failed RCT
41-yo woman, pregnant; prev 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 quizlets say no....
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 labor,
premature birth, and a small baby.
A baby or toddler presents with severe caries. What is the likely cause?
- baby bottle caries
- hypoplasia
- genetics - ANSWER-bottle rot/baby bottle caries
A patient has an allergic reaction to a barbiturate, how do you treat?
, - epinephrine
- diphenhydramine
- send to ER - ANSWER-benadryl (diphenhydramine)
- And discontinuation of the drug. Obviously if there are concerns with airway, treatment
may differ... but this was not indicated in the question stem. However, I did not have
answer choices that reflected this scenario nor was it addressed in the question stem
A patient has recently had a stroke. What is your first concern?
- when was their last cleaning
- are they on anticoagulants
- current blood pressure - ANSWER-Are they on anticoagulants
- Stroke patients could be on blood thinners, such as aspirin, dipyradamole (Persan- tine),
clopidogrol (Plavix), or Coumadin, postrecovery. Prior to major surgery, always consult
with the patient's physician to determine whether and when the blood thinners can be
stopped and subsequently restarted.- . Following a CVA that required significant
hospitalization, routine dental treatment must be delayed by 6 months.- Routine dental
treatment should be delayed by 3 months if the post-CVA recovery was uneventful and the
patient was admitted overnight just for observation.- Avoid epinephrine containing LAs
during the first 6 months of dental treatment. Subsequent use of epinephrine depends on
the patient's prognosis. Epinephrine containing LAs can be used starting 1 year after the
stroke, when the patient demonstrates progressive improvement of the CVA and absence
of TIAs.
A patient is confirmed to have trisomy 21. What are you initially concerned about?
- congenital heart defect
- Cushings
- cerebrovascular accident - ANSWER-congenital heart defects; however, early onset
periodontal disease is a significant oral health issue, but this was not an answer for those
who have had this question. Consider cardiac status and posibility of pre-medication
- atrioventricular septal defect, patent ductus arteriosus, Tetralogy of Fallot
A patient is on a steroidal medication. What information do you need to obtain before
treating them?
- dose and pharmacy that filled the RX
- duration of prescription
- both dose and duration - ANSWER-*dose and duration*
- "The rule of twos": Ask whether the patient is currently on steroids or has been on
corticosteroids for 2 weeks or longer within the past 2 years. You must go back 2 years in
the history because it can take 2 weeks to 2 years for the adrenal glands to bounce back to
normal function.
A patient was diagnosed with Hepatitis A, presentation of jaundice. How soon can you
treat?
- 1 day
- 1 week
- 1 month