Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            uld be initiated promptly.
Oral Complications and Manifestations
www.drcube.org 
Clinically, patients may present with tenderness over the lateral pole of the condyle,
crepitus, and limited opening. Radiographic changes initially may show increased joint
space caused by inflammation in the joint. Later, these inflammatory changes progress
to erosive degenerative changes and changes in size and shape of the joint and can
involve both the condyles and the fossa.
Oral Complications and Manifestations
A potential dental complication is the development
of an anterior open bite, caused by destruction of
the condylar heads and loss of condylar height.
Although palliative treatment such as interocclusal
splints, physical therapy, and medication may prove
to be helpful, surgical intervention can become
necessary to decrease pain, improve appearance, or
restore function.
There is recent evidence that patients with RA have
a
higher
incidence
of
periodontal
disease.
Therefore, meticulous oral hygiene combined with
more frequent dental prophylaxis will be more
effective in reducing periodontal problems.
Oral Complications and Manifestations
www.drcube.org 
Oral Complications and Manifestations
An additional complication that may be seen in patients with RA is severe stomatitis
that occurs after the administration of drugs such as gold compounds, penicillamine,
or immunosuppressive agents. Stomatitis may be an indication of drug toxicity and
should be reported to the physician.
Treatment for this problem should include consideration for changing the offending
drug and palliative mouth rinses, diphenhydramine elixir, or a topical emollient such as
Orabase.
www.drcube.org 
www.drcube.org 
1. Patient Evaluation and Risk Assessment
A. Evaluate and determine whether rheumatoid or joint disorder exists.
B. Obtain medical consultation if disease is poorly controlled or undiagnosed or if
the diagnosis is uncertain.
Dental Management
www.drcube.org 
2. Drugs
A. Analgesics: If patient is taking aspirin or another NSAID or acetaminophen, be
aware of dosing and the possibility that pain may be refractory to some analgesics;
dosing and analgesic choices may need to be modified in consultation with the
physician.
B. Antibiotics: Provide antibiotic prophylaxis if needed in accordance with ADA (2015)
guidelines. (Patients who are taking gold salts, penicillamine, sulfasalazine, or
immunosuppressive agents are susceptible to bone marrow suppression, which
can result in anemia, agranulocytosis, and thrombocytopenia.)
C. Anesthesia: No issues
D. Allergy: Allergic reactions or lichenoid reactions are possible in patients taking
many medications.
Dental Management
www.drcube.org 
3. Bleeding: Excessive bleeding may occur if major surgery is performed on patients
who take aspirin or other NSAIDs. Bleeding usually is not clinically significant and
can be controlled with local hemostatic measures. (only patient who is taking both
aspirin and a corticosteroid may be at greater risk fo

            Quiz: