ADC Practice Question — Maximum doses and calculations

the procedure, you notice the patient developing…

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Dimitrios Papadopoulos, a 61-year-old Greek-Australian man, presents to your dental practice for multiple posterior restorations. He has a history of unstable angina (recent chest pain episodes), type 2 diabetes mellitus, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. His medications include metformin, aspirin, and sublingual GTN. He weighs 75kg. You plan extensive treatment requiring significant local anaesthesia. His cardiologist has advised avoiding adrenaline-containing preparations due to his cardiac condition. During the procedure, you notice the patient developing slate-grey lips and nail beds, along with mild confusion. What is your immediate management?

A. Stop procedure immediately and arrange emergency hospital referral
B. Switch to lidocaine and continue procedure
C. Administer supplemental oxygen and continue with reduced dose
D. Continue procedure but monitor vital signs closely
E. Give sublingual GTN and reassess in 5 minutes

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: A

According to TG, methaemoglobinaemia is a rare but potentially life-threatening condition that requires emergency referral to hospital if diagnosis is suspected. Slate-grey or blue skin, lips and nail beds with confusion are distinctive clinical features.

Source: Ch 8: Methaemoglobinaemia emergency management

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

How are Maximum doses and calculations questions structured in the ADC written exam?

ADC Maximum doses and calculations questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Should I memorise guidelines word-for-word for Maximum doses and calculations?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

Every answer, traced to the source.

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the procedure, you notice the patient developing…

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