NBDHE Practice Test 8
10 free NBDHE practice questions in the real exam format, covering the official content areas, with an explanation for every answer.
Question 1 of 10
Case Based ItemsPatient Case
| Field | Details |
|---|---|
| Patient | Male, 32 years |
| Chief Complaint | Caregiver: "We brush his teeth every night, but his gums keep getting bigger and they bleed." |
| Background and/or Patient History | Cerebral palsy (spastic quadriplegia); uses a power wheelchair. Mild intellectual disability. Seizure disorder; last seizure 8 months ago. Constipation. Medications: phenytoin 100 mg three times daily; baclofen 10 mg three times daily; polyethylene glycol daily; senna at bedtime; trihexyphenidyl 2 mg twice daily. Received dental care under general anesthesia at age 25; last cleaning 18 months ago. Lives in a group home; his sister is his court-appointed legal guardian. A group home caregiver accompanies him. |
| Allergies | Latex (skin rash) |
| Social History | Never smoked. Attends a day program 4 days a week. |
| Current Findings | BP 118/74 mm Hg; pulse 84 bpm. Speaks in short phrases and follows simple directions. Exaggerated startle response to sudden noises; involuntary head and arm movements. Unable to rinse and expectorate on request. Oral hygiene: heavy plaque along the gingival margins. |
| Tooth | Facial PD (D-F-M) | Lingual PD (D-L-M) | Recession F / L | BOP | Mobility | Furcation |
|---|---|---|---|---|---|---|
| 6 | 5-4-5 | 4-4-5 | −2 / −1 | D-F-M | 0 | — |
| 7 | 5-4-6 | 5-4-5 | −2 / −2 | D-F-M, D-L | 0 | — |
| 8 | 5-4-5 | 4-3-5 | −2 / −1 | D-F-M | 0 | — |
| 9 | 5-4-5 | 5-3-4 | −2 / −1 | D-M | 0 | — |
| 23 | 4-4-5 | 4-3-4 | −2 / −1 | D-F | 0 | — |
| 24 | 5-4-5 | 4-3-4 | −2 / −1 | D-F-M | 0 | — |
| 25 | 5-4-5 | 4-3-4 | −2 / −1 | D-F-M, M | 0 | — |
| 30 | 4-3-4 | 4-3-4 | −1 / 0 | D-F | 0 | — |
| Tooth | Condition |
|---|---|
| 1, 16, 17, 32 | Missing |
| 8 | Mesial incisal corner chipped |
| 19, 30 | Occlusal composites |
Radiograph description (bitewings and anterior periapicals): Mandibular anterior periapical — all structures (teeth, crestal bone and trabeculae) show a doubled, blurred outline across the whole image. Bitewings — bone crests 1–2 mm apical to the CEJ; no proximal radiolucencies.
Clinical photograph description: Firm, pink, lobulated enlargement of the interdental papillae covering the cervical third to half of the crowns of teeth 6–11 and 22–27; little stippling; heavy plaque along the margins; drooling at the corners of the mouth.
Which medication in the history is most likely associated with the gingival enlargement?