CASES

Question 1

What are common contraindications for taking an NSAID?

Answer 1

allergy
GI ulceration
pregnancy
kidney disease

Question 2

what space is an IANB inserted in to?

Answer 2

pterygomandibular space

Question 3

following an IANB, why could facial palsy occur?

Answer 3

block given too far posteriorly, into parotid gland which contains facial nerve

Question 4

how do you treat facial palsy, including eyes, after IANB?

Answer 4

eye lubrication and patch

Question 5

what nerves must be anaesthetised for xLA of 47

Answer 5

IAN
Long buccal
Lingual

Question 6

what nerves must be anaesthetised for xLA tooth 27?

Answer 6

greater palatine
posterior superior alveolar

Question 7

what regulation does breach of pt confidentiality come under?

Answer 7

general data protection regulation

Question 8

what SBAR stand for?

Answer 8

situation
background
assessment
recommendation

Question 9

how would you go by treating a patient who is taking warfarin but their INR is below 4?

Answer 9

treat without interrupting medication

Question 10

when should a pts INR be checked

Answer 10

no more than 24 hours before app
unless stable - 72 hours

Question 11

how would you class a stable patient on warfarin?

Answer 11

one who does not require weekly monitoring and has had no INR above 4 in last 2 months

Question 12

can you treat a pt with INR above 4?

Answer 12

no - inform their antigoaculant service

Question 13

what forcep would be used to extract tooth 27?

Answer 13

upper left molar forceps

Question 14

list the available local haemostatic materials

Answer 14

absorbent gauze - bite for 5-10 mins
haemostatic packing material (oxidised cellulose, collagen sponge)
suture kit

Question 15

what haemostatic measure could be used for a pt on antithrombotic therapy? it can only be prescribed by a medical practitioner

Answer 15

tranexamic acid

Question 16

list dental procedures that have the highest bleeding risk

Answer 16

complex xLA
more than 3 xLA
flap raising procedures
biopsies
gingival recontouring

Question 17

list medical conditions that increase bleeding risk

Answer 17

renal failure
liver disease
haematological malignancy
chemo/radiotherapy
heart failure
coagulation disorders
platelet disorders
connective tissue disorders

Question 18

list the dental procedures unlikely to cause bleeding

Answer 18

LA
BPE
supra PMPR
supra restorations
imps
ortho fitting
endo

Question 19

what does a large fluctuant buccal swelling tell you about local anatomy of the tooth

Answer 19

the root lies above muscle attachment so it presents intra-orally
the apex lies closer to the buccal plate

Question 20

4 stages of WSS

Answer 20

tell pt
apologise
document in notes
inform pt of complaints procedure

Question 21

in what case would infection present extra orally and not intra orally?

Answer 21

the apex of the tooth lies below the muscle attachment

Question 22

what term is used to describe swelling of the neck?

Answer 22

submandibular cellulitis

Question 23

what is an abscess?

Answer 23

circumscribed collection of pus

Question 24

why is submandibular cellulitis of concern?

Answer 24

progression to oedema of the laryngeal inlet, causing compromised breathing - ludwigs angina

Question 25

what are IV drug users at risk of?

Answer 25

BBV - hep C or HIV

Question 26

what is edoxaban and what is its mechanism of action?

Answer 26

NOAC
direct factor Xa inhibitor

Question 27

what do you tell your pt taking edoxaban who needs xLA?

Answer 27

if they take it in the morning - omit it and take again 4 hours after tx
if they take it in the evening - no not need to change anything