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Medical Emergencies: INBDE study notes and practice questions

These questions ask you to recognize an emergency and respond in the right order, or to adjust dental care for a systemic condition. Vital signs, medication lists and medical history are the key data.

863 practice questions · 46 patient cases

Practice Medical Emergencies

Where it fits in the official INBDE blueprint

Diagnosis and Treatment Planning (systemic disease and emergencies). Nearest foundation knowledge area: FK 6. See the content outline for the official weights. This mapping is approximate: real items combine a clinical area with a foundation area.

What this area tests

High-yield checklist

Common traps

These notes are original study aids, not official exam content. Confirm clinical details against current guidelines.

Sample questions

1. An asthmatic patient reports symptoms occurring twice per week or less, with nighttime awakenings no more than twice per month, and no interference with normal activity. How would you classify this patient's asthma?

  1. Intermittent (mild)
  2. Mild persistent
  3. Moderate persistent
  4. Severe persistent
Show answer and explanation

Correct answer: A. Intermittent (mild)

Intermittent asthma (formerly 'mild intermittent') is defined by: symptoms ≤2 days/week, nighttime awakenings ≤2/month, short-acting beta-agonist use for symptom control ≤2 days/week, no interference with normal activity, and normal FEV1 between exacerbations. Treatment for intermittent asthma consists of a short-acting beta-agonist (SABA) as needed (Step 1 therapy). No daily controller medication is needed at this level. Dental management of intermittent asthma patients involves confirming that the patient has their rescue inhaler available at all appointments.

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2. What should you do FIRST?

  1. Administer epinephrine (EpiPen)
  2. Administer the patient's own albuterol inhaler
  3. Call 911
  4. Lay patient flat
Show answer and explanation

Correct answer: B. Administer the patient's own albuterol inhaler

For mild-moderate bronchospasm in an asthmatic patient (wheezing after anesthetic injection), the FIRST step is to administer their bronchodilator (albuterol inhaler). Albuterol is a β2-agonist that causes bronchodilation. Epinephrine is reserved for anaphylaxis with systemic signs (urticaria, hypotension, severe airway compromise). Position patient upright.

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3. Which of the following is a recognized side effect of long-term corticosteroid (e.g., prednisone) therapy?

  1. Hypoglycemia
  2. Posterior subcapsular cataracts
  3. Hypotension
  4. Increased bone density
Show answer and explanation

Correct answer: B. Posterior subcapsular cataracts

Long-term corticosteroid use is associated with posterior subcapsular cataracts, along with hyperglycemia (not hypoglycemia), hypertension (not hypotension), osteoporosis/decreased bone density (not increased), adrenal suppression, and increased infection risk.

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4. Ketone bodies are produced primarily from the breakdown of which substrate when glucose is low or unavailable?

  1. Lipids
  2. Glucose itself
  3. Amino acids primarily
  4. Carbon dioxide
Show answer and explanation

Correct answer: A. Lipids

Ketone bodies are produced in the liver via beta-oxidation of fatty acids (lipids) when glucose availability is low (such as during starvation, prolonged fasting, or insulin deficiency in diabetic ketoacidosis), providing an alternative energy substrate when glucose-based metabolism is insufficient.

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5. When repositioning a dental chair to the upright position, the patient suddenly feels dizzy and lightheaded. What is the most appropriate IMMEDIATE action?

  1. Return the chair to the supine (tilted back) position
  2. Call emergency services (911)
  3. Administer oxygen
  4. Administer nitroglycerin sublingual
Show answer and explanation

Correct answer: A. Return the chair to the supine (tilted back) position

Dizziness/lightheadedness when moving to upright = orthostatic hypotension (blood pools in lower extremities). IMMEDIATE treatment: return to SUPINE position — redistributes blood, restores venous return and cerebral perfusion. Source confirms: 'Supine position.'
  • A. CORRECT. Return to supine position — redistributes blood, restores BP and cerebral perfusion. First treatment for orthostatic hypotension.
  • B. 911 if patient loses consciousness or doesn't recover — first step is positional management.
  • C. Oxygen may be given after positioning but is NOT the primary immediate action.
  • D. Nitroglycerin would LOWER blood pressure and WORSEN the hypotension — absolutely contraindicated.

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6. A patient has positive SSA antibodies, dry eyes, and xerostomia. Dentist applies pressure on the parotid gland with no saliva expressed. What is the diagnosis?

  1. Sjögren's Syndrome
  2. Rheumatoid Arthritis
  3. Systemic Lupus Erythematosus
  4. Sarcoidosis
Show answer and explanation

Correct answer: A. Sjögren's Syndrome

Sjögren's Syndrome (A). Classic diagnostic triad:
• Xerostomia (dry mouth) — parotid gland fibrosis → no saliva on palpation
• Xerophthalmia (dry eyes — keratoconjunctivitis sicca)
• Positive SSA (anti-Ro) antibodies — most specific serological marker

2016 ACR/EULAR Criteria for Primary SS:
• Lip biopsy: focal lymphocytic sialadenitis (score ≥1)
• Anti-SSA/Ro positive
• Schirmer's test <5mm/5min (dry eyes)
• Unstimulated whole saliva <0.1 mL/min
• Ocular staining score ≥5

• Dental management: xylitol products, saliva substitutes, fluoride varnish, pilocarpine (muscarinic agonist — stimulates residual secretion), cevimeline, treat xerostomia-related caries aggressively.

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7. What is the normal (optimal) systolic blood pressure threshold per current AHA/ACC guidelines?

  1. Less than 120 mmHg
  2. Less than 140 mmHg
  3. Less than 160 mmHg
  4. Less than 100 mmHg
Show answer and explanation

Correct answer: A. Less than 120 mmHg

Per the current AHA/ACC blood pressure classification, normal blood pressure is defined as systolic less than 120 mmHg AND diastolic less than 80 mmHg. Values at or above this threshold fall into the Elevated, Stage 1, or Stage 2 hypertension categories.

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8. Which of the following is TRUE about Type 2 Diabetes Mellitus?

  1. Type 2 DM only occurs in obese individuals
  2. Patients with Type 2 DM always require exogenous insulin
  3. Type 2 DM is characterized by insulin resistance
  4. It is insulin-dependent by definition
Show answer and explanation

Correct answer: C. Type 2 DM is characterized by insulin resistance

Type 2 DM is characterized by insulin resistance (peripheral tissues do not respond normally to insulin) combined with progressive beta-cell dysfunction. It is NOT insulin-dependent — while some Type 2 patients may eventually require insulin, it is managed primarily with lifestyle modification, oral hypoglycemics, and GLP-1 agonists. Type 1 DM is the insulin-dependent form.
  • A. Incorrect. While obesity is a major risk factor, Type 2 DM occurs in non-obese individuals as well.
  • B. Incorrect. Many Type 2 DM patients are managed without exogenous insulin — they use lifestyle modification, metformin, and other oral agents.
  • C. CORRECT. Type 2 DM is fundamentally characterized by insulin resistance — the peripheral tissues fail to respond appropriately to insulin. This is the key distinction from Type 1.
  • D. Incorrect. Type 2 DM is NOT insulin-dependent. Insulin-dependent diabetes refers to Type 1 DM. Type 2 DM is defined by insulin resistance and relative (not absolute) insulin deficiency.

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Patient cases

All Medical Emergencies questions (863)