Diagnostic Skills Exam OSCE (DSE OSCE)
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Pre-Med required for? - CORRECT ANSWER✔✔- - Prosthetic heart valves, or prosthetic
material used for cardiac valve repair.
- Hx of infective endocarditis
- cyonotic heart disease
- valve regurgitation w. heart thingys (even if has transplant or was repaired already)
[According to limited data, infective endocarditis appears to be more common in heart
transplant recipients than in the general population; the risk of infective endocarditis is
highest in the first 6 months after transplant because of endothelial disruption, high-intensity
immunosuppressive therapy, frequent central venous catheter access, and frequent
endomyocardial biopsies]
5 month old preggers with rheumatic fever and heart murmer: pre med?
a. yes
b. no
(remembered) - CORRECT ANSWER✔✔- b
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)?
(remembered) - CORRECT ANSWER✔✔- place her in trundelburg position.
- supine hypotension in 3rd trimester usually occurs (bc compression Inf vena cava) => must
prevent this in dental chair bc it can cause patient to pass out.
,- Best preventative treatment for supine hypotension is to turn the patient, prefera-bly 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?
(remembered) - CORRECT ANSWER✔✔- conservative debridement is what other person
answered.
- pregnancy gingivitis: It is SO important to do ScRP (and stress good oral hygeine) to
prevent plaque growth. The plaque can enter blood stream and stimuate patient's immune
system to produce prostaglandins, which can trigger uterine contraction leading to early
labor, 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?
(remembered) - CORRECT ANSWER✔✔- chronic perio
- 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 / small baby.
Permanent dentition with tetracycline staining, when did this happen?
(remembered) - CORRECT ANSWER✔✔- Patient ingested tetracycline when they were
between 0 and 5 years old
are what kind of drugs? - CORRECT ANSWER✔✔- barbiturates - Both pentobarbital
(Nembutal) and secobarbital (Seconal) are used primarily on the evening before the dental
appointment.
,Barbiturates - how should an allergic reaction be treated?
(remembered) - CORRECT ANSWER✔✔- Benadryl -> if its a mild-moderate allergy.
- When a patient experiences a milder form of anaphylactic reaction, the drug or prepara- tion
that caused a reaction is discontinued and the patient is given diphenhydramine (Benadryl),
25-50 mg/tablet PO q6h for 48-72 hr.
Steroids - whats most important information you need to get from your patient when you find
out they are on steroids.. before even thinking about treating them?
(remembered) - CORRECT ANSWER✔✔- duration and dosage.
- "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.
Patients _____ is the most important thing for calculating medication dosage for a child.
a. age
b. weight
c. gender
d. height
(remembered) - CORRECT ANSWER✔✔- b
, Biggest concern with down syndrome?
he thought Congenital Heart Defects.
- Trisomy 21 are at increased risk of cardiac defects, true.
- early onset periodontal disease IS MOST SIGNIFICANT ORAL HEALTH PROBLEM;
they have a lower prevalence of dental caries though.
Consider prescribing Chlorhexidine or other antimicrobial agents for daily use.
- When treating, consider patient's cardiac status and need for premedication (medical consult
may be indicated).
(remebered) - CORRECT ANSWER✔✔-
Patient just had a stroke. What do you need to worry about?
(remembered) - CORRECT ANSWER✔✔- if they are on anti-coagulants (blood thinners).
- 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.
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