ADC Practice Question — Techniques and complications

What is the pathophysiology behind Priya's symptoms?

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 pathophysiology behind Priya's symptoms?

A. Direct nerve trauma from injection
B. Metabisulfite preservative reaction
C. Glucose-6-phosphate dehydrogenase deficiency
D. Adrenaline causing cardiovascular stimulation
E. Plasma concentration of lidocaine causing systemic effects

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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: E

According to TG, systemic toxicity describes adverse systemic effects resulting from the plasma concentration of the anaesthetic.

Source: Ch 8: Systemic toxicity definition

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

Exam preparation FAQ

Should I memorise guidelines word-for-word for Techniques and complications?

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

How are Techniques and complications questions structured in the ADC written exam?

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

Every answer, traced to the source.

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What is the pathophysiology behind Priya's symptoms?

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