ADC Practice Question — Techniques and complications

What is the most appropriate immediate management for Priya?

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.

Priya Sharma, a 33-year-old software engineer, presents for extraction of her lower right wisdom tooth. She mentions she might be pregnant but hasn't confirmed it yet. During the procedure, you administer 3.6 mL of 2% lidocaine with adrenaline via inferior alveolar nerve block. Five minutes after injection, Priya becomes restless and anxious, complaining of ringing in her ears and dizziness. Her speech becomes slightly slurred and she appears drowsy. What is the most appropriate immediate management for Priya?

A. Administer antihistamines for allergic reaction
B. Stop local anaesthetic administration and provide appropriate management
C. Give additional local anaesthetic to ensure adequate anaesthesia
D. Reassure patient and continue with observation only
E. Continue the procedure quickly to minimize total anaesthetic time

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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: B

According to TG, if signs of systemic toxicity occur, stop administration of the local anaesthetic and provide appropriate management.

Source: Ch 8: Management of systemic toxicity

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 should I prepare for Pharmacology & Therapeutics in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar Techniques and complications vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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