Oral and maxillofacial surgery and facial fractures: epinephrine in heart disease: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral and maxillofacial surgery and facial fractures: epinephrine in heart disease

Sample item

A patient with stable ischaemic heart disease needs a dental extraction under local anaesthetic with epinephrine. What is the commonly accepted limit of epinephrine per appointment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. About 0.04 mg, roughly two cartridges of 1 in 100,000

Epinephrine in small amounts improves anaesthesia and lowers the need for large doses, so it is limited rather than banned in stable cardiac disease. Aspiration before injection avoids intravascular delivery.

Option by option

  • A. None, as vasoconstrictors are absolutely contraindicated

    Vasoconstrictors are limited, not absolutely contraindicated, in stable disease.

  • B. 0.2 mg, as for a healthy adult

    0.2 mg is the ceiling for a healthy adult.

  • C. 0.5 mg

    0.5 mg would be far above any accepted cardiac limit.

  • D. About 0.04 mg, roughly two cartridges of 1 in 100,000 (correct)

    Correct. About 0.04 mg is the usual cap in cardiac patients.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is D, About 0.04 mg, roughly two cartridges of 1 in 100,000. Epinephrine in small amounts improves anaesthesia and lowers the need for large doses, so it is limited rather than banned in stable cardiac disease.

Why is "None, as vasoconstrictors are absolutely contraindicated" not the answer?

Vasoconstrictors are limited, not absolutely contraindicated, in stable disease.

Why is "0.2 mg, as for a healthy adult" not the answer?

0.2 mg is the ceiling for a healthy adult.

Why is "0.5 mg" not the answer?

0.5 mg would be far above any accepted cardiac limit.

What concept does this question test?

It tests Oral and maxillofacial surgery and facial fractures: epinephrine in heart disease in Dentistry. Aspiration before injection avoids intravascular delivery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral and maxillofacial surgery and facial fractures: epinephrine in heart disease?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.