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Patient Care Exam 2 > 10/26: Systemic Diseases > Flashcards

10/26: Systemic Diseases Flashcards

1
Q

What is a general term for pulmonary disorders charactrized by chronic airflow limitation from the lungs?

A

Chronic obstructive pulmonary disease (COPD)

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2
Q

What is the 3rd leading cause of death in 2020?

A

COPD

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3
Q

Is COPD fully reversible?

A

No

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4
Q

COPD encompasses what 2 main diseases?

A
  1. Chronic bronchitis
  2. Emphysema
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5
Q

What is the recommended diagnosis of COPD?

A

Presence of septum production and dyspnea together with an abnormal measurement of lung function

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6
Q

This is chronic inflammation of the bronchi that produces excessive tracheobronchial mucus production and a persistent caught with sputum for at least 3 months in at least 2 consecutive years

A

Chronic bronchitis

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7
Q

This is permanent enlargement of the air spaces in the lungs that is accompanied by destruction of the air space walls without obvious fibrosis

A

Emphysema

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8
Q

The onset of COPD after what age?

A

40 years

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9
Q

What are patients with chronic bronchitis described as?

A

Sedentary, overweight, cyanotic, edematous and breathless

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10
Q

What are patients with COPD known as?

A

Blue bloaters

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11
Q

This is permanent enlargement of the air spaces in the lungs tha is accompanied by destruction of the air space walls without obvious fibrosis

A

Emphysema

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12
Q

What are patients diagnosed with emphysema known as?

A

Pink puffers because they demonstrated enlarged chest walls (barrel-chested appearance)

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13
Q

What does emphysema show as?

A

Weight loss with disease progression
Severe exertional dyspnea
Seldom coughing
lack of cyanosis
Pursing of lips with efforts to forcibly exhale air from the lungs

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14
Q

What are questions you should ask someone with emphysema or bronchitis?

A

How severe?
How long have you had it?
What medications are you
on?
Does it bother you to recline
completely?
Will the rubber dam be a problem?

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15
Q

What questions should you ask someone with shortness of breath?

A

how many blocks can you walk
before tiring?
can you walk two flights of stairs
without having to stop?

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16
Q

What is a condition in which the heart valves have been
permanently damaged by rheumatic fever

A

Rheumatic heart disease

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17
Q

When does heart valve damage start?

A

Shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever

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18
Q

What can result in on-going valve damage?

A

An immune response causes an inflammatory condition in
the body

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19
Q

What can happen to heart valves over time?

A

Become inflamed and scarred over

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20
Q

What is a disorder of cognition that
consequently interferes with the daily
functions and results in a loss of
independence?

A

Dementia

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21
Q

What are the most common causes of dementia?

A

Alzheimer’s disease, vascular dementia,
& dementia caused by Parkinson’s
disease

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22
Q

When does prevalenze of dementia and alzheimer’s increase?

A

With age: 65y/o-
7% by age 85, more than 40%

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23
Q

What gender is more at risk?

A

Women because they live longer

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24
Q

What are symptoms of alzheimer’s disease?

A

Memory loss
Cognitive decline
Behavioral and
personality changes

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25
Q

What is the cause of alzheimers?

A

Unknown but appears to involve loss of cholinergic neurons

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26
Q

How often does genetic predisposition contribute to?

A

Less than 20% of all cases

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27
Q

What is the average lifespan after dx?

A

8 years

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28
Q

What is dental management of alzheimer’s disease?

A

Knowledge of the
stage of the disease, medications taken,
and the cognitive abilities of the patient

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29
Q

What do medications such as antipsychotics, antidepressants,
and anxiolytics contribute to?

A

xerostomia with increased risk for dental caries

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30
Q

Where are small endocrine glands located?

A

Bilaterally at the superior pole of each kidney

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31
Q

What is progressive destruction of the Adrenal Cortex, Usually due to autoimmune disease?

A

Primary adrenal insufficiency (addison’s disease)

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32
Q

What are chronic infectious diseases?

A

TB, HIV, Cytomegalovirus and
some fungal infections

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33
Q

What does primary adrenal insufficiency decrease?

A

Cortisol (stress hormones) and aldosterone

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34
Q

What does cortisol do?

A

Decreases inflammation, regulates blood pressure, increases glucose

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35
Q

What does aldosterone do?

A

Stimulates Na+ absorption by the kidneys

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36
Q

This is caused by pituitary disease or critical illness

A

2nd adrenal insufficiency

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37
Q

This is caused by process that impair function of the hypothalamus

A

3rd adrenal insufficiency

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38
Q

What is the most common cause of tertiary adrenal insufficiency?

A

Chronic use of corticosteroids

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39
Q

What is adrenal insufficiency?

A

The inability to increase cortisol
production with stress

40
Q

What are symptoms of adrenal insufficiency?

A

Tired-fatigue
Weak
Orthostatic hypotension
Poor healing
Inability to tolerate stress
Increased infections
Areas of darkened skin
Salt Craving

41
Q

This refers to a condition caused by excessive cortisol in the body

A

Cushings syndrome

42
Q

What is the most common cause of cushings syndrome?

A

Steroid drugs

43
Q

Cushing disease can result in what?

A

Type 2 diabetes
Bone loss
High blood pressure

44
Q

When cushings syndrom is caused by a pathophysiologic process (like a tumor), it is called

A

Cushing’s disease

45
Q

What are some examples of when you have steroid use?

A

Lupus
Rheumatoid arthritis
Asthma
Psoriasis

46
Q

What are the clinical features of cushings syndrome/disease?

A
  1. Weight gain in the midsection, face, shoulders
    Face = moon face
    Shoulders = buffalo hump
  2. Thinning, fragile skin that bruises easily
  3. abdominal striae
  4. decreased healing
  5. acne
47
Q

What is a potentialy-life threatening complication resulting form adrenal insufficiency triggered by emotional and physical stress?

A

Adrenal crisis

48
Q

What does adrenal crisis manifest as?

A

Hypotensive collapse, abdominal pain, myalgia, and fever

49
Q

What does the diagnosis of substance abuse require?

A

Recurrent use of a substance over the past 12 months with subsequent adverse consequences

50
Q

What are features of suggestive of alcohol abuse?

A

Missed appointments, alcohol on breath, enlargement of the parotid glands and spider angiomas

51
Q

What does alcohol cause?

A

Liver and bone marrow damage
Cirrhosis
Vitamin K deficiency
Reduced effect of local anesthetics and benzodiazepines
Nutritional dificiencies
Candidal infections

52
Q

What is binge drinking?

A

> 5 oz/ 4 hours

53
Q

What does excessive drinking caused an increased cancer of?

A

Mouth
Larynx
Esophagus

54
Q

What does the combination of smoking and alcohol increase the chance of?

A

Oral cancer

55
Q

What can alcohol act as?

A

An irritant and damage cells which could lead to DNA changes

56
Q

When can drug abuse occur?

A

Interactions w/ Rx, anesthetic
Liver damage
Infectious diseases if share needles

57
Q

What are oral complications and manifestations of drug and alcohol abuse?

A

More plaque, calculus, caries, gingival inflammation

58
Q

What are oral complications of cocaine?

A

Gingival recession and erosion of facial aspects

59
Q

What are oral complications of meth mouth?

A

Xerostomia, rampant caries, bruxism, and muscle trismus

60
Q

Should you provide extensive care to someone who has oral manifestations as a result of drug and alcohol abuse problems?

A

Not until homecare improves

61
Q

Reduction in the oxygen carrying capacity of the blood is called

A

Anemia

62
Q

What is the most common blood conditions in the USA?

A

Anemia

63
Q

What is anemia usually associated with?

A

Decrease in RBC’s
Abnormality in Hb contained within RBCs
Caused by underlying disease especially in men
More than 3 million cases per year in the US

64
Q

Anemia affect more female or male?

A

Female

65
Q

Decrease number of circulating RBCs in what?

A

Anemia

66
Q

A abnormality in the hemoglobin contained within the RBCs

A

Anemia

67
Q

Anemia may be caused by an underlying disease especially in

A

Males

68
Q

What are the types of anemia?

A

Iron deficiency
Folate deficiency
Hemolytic anemia
Sickle cell anemia

69
Q

What are the symptoms of anemia?

A

Pallor = pale
Fatigue
Low blood pressure
SOB
Rapid heart rate

70
Q

Oral signs of anemia are?

A

Smooth, burning red tongue
Bleeding gums

71
Q

This is the craving and chewing ice associated with iron deficiency, with or without anemia

A

Pagophagia

72
Q

This is severe restriction of food intake, leading to weight loss and the medical sequelae of starvation

A

Anorexia nervosa

73
Q

This is restriction of food by binge eating followed by various methods of trying to rid the food (vomiting, laxatives, diuretics)

A

Bulimia nervosa

74
Q

Anorexia is 90-95% in

A

Females

75
Q

What is the age of onset for anorexia?

A

14-18 y/o, rare after age 40

76
Q

What is the mortality rate of people with anorexia?

A

5-20% usually by starvation, suicide, electrolyte imbalance

77
Q

What are some signs of anorexia?

A

Low BP
Amenorrhea
Osteoporosis
Anemia (20-40%) due to nutritional deficiences
Hair thin and brittle
Neck/facial swelling
Irritable
Fainting

78
Q

What is the average age of onset for bulimia?

A

20 y/o

79
Q

What is bulimia most often seen in?

A

Females

80
Q

What happen to amalgam restorations in bulimia nervosa?

A

Higher than surround enamel

81
Q

What is loss of enamel and dentin on the lingual surfaces by chemical and mechanical effects?

A

Perimylolysis

82
Q

Where does tooth issues occur with bulimia?

A

Lingual of ant teeth due to enamel erosion form acidic chemicals

83
Q

What do you ask someone with abnormal bleeding?

A

When did it occur?
After extraction?
How long did it last?
Have you been diagnosed by a physician?

84
Q

This test is used to detect bleeding disorders or excessive clotting disorders

A

Prothrombin time

85
Q

This measures how quickly your blood clots

A

Prothrombin time

86
Q

What is a calculation based on results of a PT

A

INR

87
Q

What 2 prothrombin time is presented?

A

Seconds for blood clot to form
INR

88
Q

What is the average time for blood to clot?

A

10-30 seconds

89
Q

You use this ratio if you are on blood thinning medications

A

INR

90
Q

What is the equation for INR?

A

Patient Pt/Control Pt x ISI

91
Q

If the INR score is too low, patients can be at risk for

A

Blood clot

92
Q

If the INR score is too high, patients can experience

A

Bleeding issues

93
Q

Typical INR score range for patient on blood thinner is

A

2-3

94
Q

Healthy people not on blood thinner INR score is

A

1.1 or below

95
Q
A

Patient Care Exam 2 (5 decks)

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