Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SCD > 3rd year key points > Flashcards

3rd year key points Flashcards

1
Q

sensory impairment

A

when one or more of a person’s senses are no longer normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

macular degeneration

A

wet - severe, quick

dry - gradual loss of central vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

glaucoma

A

rise in IO pressure

lose peripheral vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of cataracts

A

senile
traumatic
disease associated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

diabetic retinopathy

A

black spots and blurry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hemianopia

A

blindness in one half of the visual field

stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

causes of hearing impairment

A

build up of cerumen
ototoxic drugs
otosclerosis
perforated eardrums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

hearing loop

A

T
magnetic, wireless signal
cuts out unwanted background noise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

impairment

A

something doesn’t work

any loss or abnormality of psychological, physiological or anatomical structure or fct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

disability

A

functional performance
a restriction/lack (resulting from an impairment) of ability to perform an activity in a manner or within the range considered normal for a human being

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

handicap

A

disadvantage, resulting from impairment/disability that limits/prevents fulfilment of a role that is normal for that individual
- broader social and psychological consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

activity limitation

A

difficulty encountered by an individual in executing a task/action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

participation restriction

A

problem experienced by an individual in involvement in life situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

characteristics of service use

A 
fewer visits, longer intervals
limited access
difficulty communicating pain
financial
emergency care rather than planned
history of extractions
tx with GA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

important piece of legislation relating to capacity

A

AWI Act 2000 (2010) part 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what should you always assume with capacity?

A

that someone has it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is capacity?

A 
ability to:
 - act
 - make decision (reasoned)
 - communicate
 - understand
 - retain memory
action/decision specific
residual capacity
may fluctuate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

principles of AWI Act

A

benefit - without tx benefit not possible
minimum necessary intervention - least restrictive
take account of wishes of adult
consultation with relevant others
encourage adult to exercise residual capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2 types of PofA

A

continuing

welfare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how are PofA made?

A

granted by adult while they still have capacity
registered w Public Guardian
ceases on day they die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

continuing PofA

A

finances and property

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

welfare PofA

A

health and personal welfare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

WG orders

A

when adult can’t choose a PofA e.g. born with a severe LD
need 2 medical reports
continuous management of welfare and financial matters
usually 3yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how long do WG orders usually last?

A

3yrs usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
certificate of incapacity
only valid for your area of practice even if WG/WPofA still need CofI GMP/consultant, GDP if additional training detailed - exact - one for check ups for 3yrs where no capacity likely to be regained - individual tx course photocopy it in notes
26
schizophrenia
disorders of thought (delusions) and perception (hallucinations)
27
schizophrenia aetiological factors
cannabis - tachycardia neurotransmitter imbalance genetic predisposition triggers - stress
28
clozapine and schizophrenia
atypical antipsychotic neutropenia - monitor don't do smoking cessation - can lead to severe toxicity - clozapine levels in plasma changed
29
why is dentist-led sedation contraindicated in pts with active uncontrolled psychiatric disease?
may have unpredictable reactions and increased tolerance
30
russel sign
calluses on knuckles due to repeated self-induced vomiting
31
signs of SS
mirror sticks to mucosa food residues in oral cavity cracked tongue ocular symptoms
32
SS risks
oral infections malignant change altered taste
33
reasons for dry mouth
``` meds autonomic dysfct (endocrine) anxiety, stress dehydration starvation chemo and radio systemic conditions ```
34
cancer - pre-tx priorities
``` OH reduce tx complications - avoid chemo interruption - avoid mucositis exacerbation - remove potential sources of infection reduce post-tx complications - prevention - plan rehab ```
35
role of dentist for cancer pt
``` early detection pre-tx assessment - radiographs - necessary tx - pre-tx scaling dentate pts - imps for soft splints - start F therapy ```
36
during cancer tx role of dentist
ulceration infection emergency tx
37
pain relief for mucositis
opioid analgesia - severe pain
38
pathogenesis/stages of mucositis
inflammatory/vascular - cytokines released epithelial - atrophy ulceration/bacterial - full thickness erosion healing - epithelium renewal
39
grading of mucositis
0-4 WHO
40
mucositis grade 0
none
41
mucositis grade 1
mild | soreness and erythema
42
mucositis grade 2
mod erythema, ulcers solid diet tolerated
43
mucositis grade 3
severe oral ulcers liquid diet only
44
mucositis grade 4
oral feeding impossible | requires parenteral nutrition
45
management of mucositis
silk brushes CHX gel (in clean mouth as won't penetrate biofilm) avoid smoking, alcohol, tea and coffee, v hot/spicy topical lignocaine caphasol - artificial saliva conc CaPO4 tea tree MW - check not allergy to aloe vera ice during chemo
46
SEs of chemo
``` alopecia nausea and vomiting anorexia bone marrow suppression mucositis transient dry mouth coagulation defects reduced WBCs ```
47
how does chemo work?
cytotoxic - interact with cancer cell DNA/RNA and affect a phase of life cycle
48
what % of chemo pts get mucositis?
around 75-80%
49
when does mucositis usually appear with chemo?
7-14 days after initiation of chemo
50
describe the general trajectory of chemo SEs
systemic but more transient
51
describe the general trajectory of radio SEs
chronic, progressive and localised
52
why is radio fractionated?
only kills dividing cells
53
dental SEs of radio
``` hyposalivation hypogeuesia radiation caries fungal infections trismus ORN ```
54
why is trismus a SE of radio?
replacement fibrosis of MofM following progressive end arteritis of affected tissues with decrease in blood supply irreversible
55
ORN as a SE of radio?
dead bone shards avascular necrosis endarteritis obliterans - progressive fibrosis
56
what dose is the risk of SEs greater from radio?
>60Gy
57
cancer - IO reactivation of herpes simplex
``` so immunocompromised clinically atypical painful oral ulceration, sudden onset extensive, slow healing and aggressive ulceration on palate and tongue dorsum ```
58
xerostomia management
palliative water SF gum tooth mousse
59
cancer post-tx dentist roles
rehabilitation prevention monitoring
60
dentist pre-tx for cancer - getting pt dentally fit
if no time to restore - ext can't RCT - can't guarantee ask pt for GP and MDT team details at 1st appt if pt refuses ext - explain risks, note it down, contact oncologist
61
MRONJ
exposed bone (not healed) at 8wks
62
incidence of MRONJ
overall risk small <1%
63
what is Parkinsons?
progressive neurodegenerative | basal ganglia - degeneration of dopamine receptors
64
aetiology of Parkinsons
``` approx 5% genetic most idiopathic toxins? cerebrovascular disease head trauma drug induced ```
65
how is Parkinsons diagnosed?
clinical diagnosis
66
Parkinsons S+S
rest tremor - reduced by action - increased by emotion/stress
67
which type of dementia is Parkinsons associated with?
Lewy body dementia
68
tx of Parkinsons
drug therapy when fct disability Levidopa - non-ergot dopamine agonist Carbidopa - prolongs action late management - reduce motor fluctuation
69
outcome of Parkinsons
approx 10-15yrs death usually due to bronchopneumonia
70
Parkinsons dental risk
risk of postural hypotension
71
type of dementias
``` Alzheimers vascular dementia dementia with Lewy bodies frontotemporal dementia Korsakoff's syndrome early-onset dementia ```
72
Alzheimer's
lose connections between neurones - protein plaques and tangles less chemical messengers
73
vascular dementia
reduced blood supply to brain
74
dementia with Lewy bodies
protein deposits, links with Parkinsons
75
frontotemporal dementia
lose filter ability - sexual/inappropriate comments
76
Korsakoffs syndrome
alcohol
77
early onset dementia
U65s
78
signs of pain
behavioural changes body language mood changes
79
Huntington's (chorea)
``` often mid-life AD - 50% chance Chr4 mutation relentless progressive chorea and dementia cerebral atrophy ```
80
chorea
a movement disorder that causes involuntary, irregular, unpredictable muscle movements
81
S+S of Huntington's
involuntary jerky movements poor balance personality changes - moody
82
dental aspects of Huntingtons
communication movements swallowing
83
stroke S+S
``` interruption of brain blood supply one side weakness/numb dizziness LOC altered speech ```
84
dental aspects of stroke
retain prosthesis? defer tx for 6m post TIA/stroke protective reflexes? oropharyngeal dysphagia - swallow ability compromised. Risk of aspiration/pneumonia. Need good suction
85
SE of nicorandil
large ulcers
86
VAP
``` most freq HAI in intubated pts main risk factor - ETT - impairs natural defence mechanisms OH essential diagnosis - temp >38 - WCC >12000/mm3 - + tracheal cultures - resp distress - chest xrays ```
87
Berwick report
``` pt safety key principles - quality of pt care - engage patients and carers - growth and development of all staff - embrace transparency ```
88
barriers to change - OH in care homes
``` OH low priority assessed often by non-dentist carers limited knowledge of OH carers difficulty gaining access to teeth high turnover of care staff poorly paid ```
89
early stage dementia tx planning
``` oral assessment plan for future consider replica models identify and try to retain key teeth - 4 occluding pairs - L anteriors ```
90
mid stage dementia tx planning
maintenance and prevention
91
late stage dementia tx planning
comfort free of pain and infection non-invasive
92
txing pts with dementia
communication - approach from front break it down non-verbal right env
93
causes of LD
preconception - parental genotype pre-natal - maternal health, toxics perinatal - injury post-natal - infection, trauma, SSD
94
syndromes associated with LD
``` autism/Aspergers Down syndrome CP Fragile X syndrome Prader Willi PKU ```
95
CP
``` 1 in 400 neurological - affect movement and coordination muscle stiffness/floppiness (hypotonia) random and uncontrolled body movements balance problems ```
96
Down syndrome
``` trisomy 21 CHDs increased risk of haematological malignancy reduced IQ risk Alzheimers PDD dental anomalies ```
97
Prader Willi syndrome
``` 15 constantly hungry - obesity hypotonia learning difficulties behavioural problems ```
98
Autism prep before visit
``` my health passport social stories pre-visit timing specific language take straight to surgery ```
99
what can be used to aid keeping mouth open?
open wide mouth rests
100
LD RFs
poor motor control pouching mouth breathing meds
101
LD toothbrushing advice
sit up behind pt encourage pt to do as much as possible
102
clinical holding
consent no capacity and deemed of benefit - safety risk unplanned emergencies always record and justify
103
thickeners
dysphagia | prevent aspiration
104
self-injurious behaviour management
``` self-biting tx strategies - symptomatic relief - reassurance - distraction when SIB - pharmacological - behaviour psychology - positive reinforcement - extract specific anterior teeth - orthognathic surgery to create open bite ```
105
safeguarding
``` recognise respond record - non-urgent - contact SS within 24hrs - 999 immediate risk of harm ``` Removal (7days) Assessment Banning (up to 6m) - where adult at risk likely to be seriously harmed
106
dementia definition
syndrome - chronic/progressive deterioration in cognitive fct beyond what might be expected from normal ageing consciousness not affected depression and anxiety often precursors
107
most common type of dementia
Alzheimers 60%
108
dementia risk factors
``` age gender genetics MH lifestyle ```
109
dementia early stage symptoms
often misattributed STML confusion anxiety
110
dementia mid stage symptoms
``` need more support inc reminders distress, aggression wandering inappropriate behaviour hallucinations ```
111
dementia late stage symptoms
physical frailty - shuffle can't recognise people incontinence loss of speech
112
dementia testing
``` MMSE (not sensitive for frontal lobe) Blessed Dementia Scale MINICOG GPCOG dementia screen to eliminate treatable causes - diagnosis of exclusion ```
113
what drug may delay the progression of dementia?
anticholinesterases
114
risk of dementia in Down Syndrome
50%
115
severe haemophilia
<1% factor
116
non-selective B-blockers and LA
heightened sensitivity to effects of vasopressors in LA
117
hypertensive crisis
>180/110
118
what is metformin?
antihyperglycaemic
119
what is the leading cause of renal failure?
diabetes
120
when do neutrophils drop to their lowest point in chemo?
10-14 days after chemo delivery
121
how long should you allow for healing after ext prior to oncology tx?
10-14 days
122
dose which gives risk of ORN
50 or more Gy
123
how many WGs do you need consent from?
1
124
UKELD
UK model end stage liver disease
125
biotene oralbalance
lactoperoxidase
126
saliva orthana
porcine mucin
127
tooth mousse
recaldent CPP-ACP
128
glandosane
carboxymethylcellulose | artificial saliva spray
129
caphosol
supersaturated Ca and PO4
130
where can chemo induced mucositis affect?
the whole GIT
131
why are bisphosphonates used in cancer?
to reduce the risk of metastatic spread
132
where do radiation caries typically appear?
cervical/smooth surface
133
what can cannabis do to the CV system?
cause tachycardia
134
for end stage liver disease, before operative dental tx what should you request?
FBC, coagulation screen, LFTs, U and Es
135
when should you tx a pt on haemodialysis?
day after haemodialysis
136
do you need an AWI certificate to tx a spreading dental infection?
no
137
max AWI
3yrs
138
WG
a person who is legally appointed by the courts to make the decision on behalf of a person who lacks capacity
139
PofA
person who is nominated whilst an individual still has capacity who is subsequently legally appt by a court to make decisions on behalf of that individual when they lose capacity
140
who should you contact to confirm welfare PofA?
Office of Public Guardian
141
purpose of AWI
provides a framework for safeguarding the welfare and managing the finances of adults who lack capacity due to mental disorder or inability to communicate
142
residual capacity
ensure everything possible is done to provide the individual with the opportunity to decide about the medical tx they receive
143
least restrictive option
any action/decision taken should be the min to achieve the purpose should be the option that restricts freedom as little as possible
144
benefit
any action or decision must benefit the pt and only be taken when that benefit cannot reasonably be achieved without it
145
consultation with relevant others
take account of the views of others with an interest in the person's welfare Act lists who should be consulted whenever practicable and reasonable
146
which part of the AWI Act is relevant to dentistry?
part 5
147
if a pt needs ABP for invasive procedures, what does this cover?
"manipulation of mucosa and mucoperiosteum" | - not LA
148
Down Syndrome and immune system
neutrophil chemotaxis impaired
149
Dalteparin (fragmin)
low molecular weight heparin
150
where is thrombopoietin made?
liver
151
where are platelets made?
bone marrow
152
if platelets <100 what should you do before ext?
speak to someone
153
causes of inability to achieve haemostasis
``` inherited/congenital bleeding disorders medication induced other drugs e.g. chemo SE haematological disease infections liver disease ```
154
platelet level for a single uncomplicated tooth extraction
>50 x10 ^9/L should be a safe level to achieve haemostasis
155
S+S of liver disease
``` jaundice palmar erythema, spider naevi bleeding and oesophageal varices ascites encephalopathy if alcohol related: tremors, cognitive impairment ```
156
causes of liver disease
``` infective - hepatitis virus autoimmune - primary biliary cirrhosis alcohol related non-alcoholic fatty liver disease hemochromatosis drug induced hepatocellular carcinoma ```
157
stages of liver disease
hepatitis: inflammation of liver, may/may not be reversible depending on the disease liver cirrhosis: irreversible liver necrosis and fibrosis liver failure: failure of normal liver fct
158
UKELD score
UK model for end stage liver disease predicts a person's prognosis in chronic liver disease, used as a guide to determine the need for a liver transplant 49 minimum for pt to be assessed for a liver transplant - >9% mortality within 12m
159
liver disease and LAs
lignocaine fully metabolised in liver only 5-10% of articaine processed in liver, most is metabolised in plasma - decreases metabolic demand on liver could use articaine infiltrations to avoid IAN blocks? - reduces risk of haematoma formation
160
liver disease and post-op analgesia
``` NSAIDs - bleeding risk - hepatorenal syndrome - inhibition of prostaglandins leads to reduction in renal perfusion, reduction in GFR and sodium retention paracetamol - risk of hepatotoxicity - safer than NSAIDs ```
161
liver disease and antibiotics
may need to alter dose amoxicillin safe may need to alter dose of metronidazole erythromycin can affect liver
162
liver disease and IV sedation
dentist led IV sedation with midazolam not appropriate | if need sedation - anaesthetist led propofol sedation or GA
163
if pt needs medical transfusion product for tx
do as much tx as possible as transfusion comes with associated risks
164
is diazepam dialysable?
no
165
cannabis and dentistry
``` attend less regularly associated with schizophrenia increased caries rare - xerostomia - hunger - acts on hormone leptin - more PDD and gingival enlargement - oral leukoplakia and cancer acts on CV system - tachycardia with widespread vasodilation - can become acute medical issue if LA containing adrenaline given during tachycardia period ```
166
bulimia presentations
palatal NCTSL erosion dry mouth nutritional deficiency related - ulceration and infections increased keratin in oral STs in response to trauma from purging/acidic vomit sialadenosis damage to nails or fingers if used to purge
167
post-vom methods of increasing pH
chew gum, rinse mouth with water/milk rinse with antacid prep avoid abrasive toothpastes gentle brushing with desensitising toothpaste and a soft brush may be ok
168
cancer GDP pre-tx
``` radiographs and assessment any necessary tx pre-tx scaling imps for soft splints if dentate F therapy if dentate ```
169
cardinal features of Parkinsons
``` bradykinesia rigidity resting tremor postural instability gradual symptom progression sustained response to therapy with levodopa (precursor to dopamine) ```
170
features of Parkinsons
``` head forward micrographia mask like face drooling rigidity resting tremor akinesia ```
171
vascular dementia
reduced blood flow to brain
172
mod haemophilia
2-5% factor
173
mild haemophilia
6-40% factor

SCD (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions