clutching at straws😃 Flashcards
(178 cards)
1
Q
name characteristics of an anxious pt
A
- high neuroticism and trait anxiety
- low pain threshold
- co-morbid anxiety disorders
- co-morbid depression disorders
2
Q
how would you treat an anxious child?
A
- tell show do
- enhanced control
- positive reinforcement
- distraction
- magic
3
Q
how would you measure anxiety in a child?
A
MCDAS
modified child dental fear and anxiety scale form
4
Q
how can you tell a tooth is non-vital using a radiograph?
A
ankylosis
internal root resorption
external root resorption
peri-apical radiolucency
5
Q
what problems can arise from having an incompetent lip?
A
- face may not develop properly
- longer face
- impeded speech
- mouth-breathing leading to dry mouth
- lip trap
- strain of the mentalis muscle by trying to close lips
6
Q
strap lip + competent lips
A
retroclined upper teeth
7
Q
strap lip + incompetent lips
A
retroclined lower teeth
8
Q
strap lip + low active lower lip line that retracts excessively
A
- retruded mandibular alveolar process
- protruded chin
- retroclined lower incisors
9
Q
strap lip + low lip and firmly retracting
A
- production of class II div 1 malocclusion
10
Q
strap lip + high lip line and firmly reacting
A
may produce class II div 2 maloclussion
11
Q
what are the causes of congestive heart disease?
A
- heart attack
- diabetes
- MI
- alcohol abuse
- hypertension
12
Q
what are the symptoms of congestive heart disease?
A
- rapid irregular heart beat
- fatique and weakness
- nausea
- shortness of breath
- cough, wheeze
- chest pain when breathing
13
Q
how do you manage congestive heart disease?
A
- lifestyle change
- ACE inhibitors e.g. rampril
- beta blockers e.g. bisopolol
- pacemaker
- heart transplant
- heart valve surgery
14
Q
what microorganism is responsible for most cases of infective endocarditis?
A
streptococcus viridians
15
Q
how is a biofilm formed?
A
adhesion to surface via weak VDW forces- if not removed then anchor onto surface more permanently using cell adhesion structures such as pili
colonisation-biofilms grown via cell divison and recruitment
accumulation
complex community
dispersal- biofilms spread and colonise new surfaces
16
Q
what factors affect colonisation growth?
A
surface roughness
whether the surface is hydrophobic or hydrophillic
17
Q
what is a biofilm?
A
a matrix-enclosed bacterial or fungal population adherant to each other and/or surfaces or interfaces
18
Q
define “canophilic anaerobic”
A
thrive in high cone of CO2
19
Q
define micro aerophilic
A
requires oxygen but at a lower cone than is available in the atmosphere
20
Q
give 5 methods of identifying micro-organisms
A
gram staining
ziehl-neelsen staining
PCR
blood agar, selective agar (mannitol salt)
H&E staining
21
Q
give 4 examples of cariogenic bacteria
A
streptococcus mutans
lactobacillus acidophilis
acitnomyces viscosus
nocardia spp
22
Q
which microorganisms are found in the red section of Socransky’s model?
A
porphyromonas ginigivlalis
tannerella forsythia
treponema denticola
23
Q
what bacteria are responsible for periodontal disease?
A
porphyromonas ginigivlalis
tannerella forsythia
treponema denticola
prevotella intermedia
24
Q
what are relevant acts of law for impairment and disability to have equal access
A
the disability discrimination act (2005)
The equality act 2010
25
what are features of downs syndrome that are likely to contribute to periodontal disease
ability to self care
impaired oral function
impaired migration of gingival fibroblasts
altered tooth morphology
systemic immunodeficiency
impaired phagocytic and chemotactic responses
altered oxidative metabolism related to gene on chromosome 21
26
how do you manage teeth is a patient is at risk of osteoradionecrosis
provide primary orthograde endodontics and decoronate
27
what are oral complications associated with radiotherapy to the head anc neck
trismus
dry mouth
increased risk of oral infection
radiation mucositis
dysgeusia or ageusia
skin burns
28
what are preventative measures for patients who have had radiotherapy
increased fluoride toothpaste - 2800ppmF
tooth mousse
Fluoride trays
prescribe oral saliva substitutes
29
what are management strategies of osteoradionecrosis of the jaw
surgical debridement
hyperbaric oxygen therapy
30
why is it important to degass the ultrasonic
air will prevent ultrasonic bubbles from reaching all surfaces of the instruments
31
why is it important to use demineralised water in the steriliser
to prevent the deposits of minerals on the machine and instruments
32
what are key microbial stages of caries plaque formation
adhesion
collonisation
maturation
acid prodcution
33
what are virulence factors used by strep. mutans for enamel dissolution
glucans (glucosyltransferase - attach)
ATPAse (control pH)
34
what are virulence factors of enterococcus faecalis
gelatinase
superoxide
cytolysins
adhesins
collagenase
35
what is the limitation of next generation sequencing
limited to describing what is present rather than what communities are causing the problem
36
What process should you follow to ask about the possibility of domestic abuse
AVDR
Ask - ask about abuse in a private setting
Validate - show you are concerned about them
Document - be specific and detailed, use patients own words and describe injuries in as much detail as possible
Refer - signpost to appropriate services
37
What are physical signs you may see in domestic abuse ?
repeated injuries
Bruises at different stages if healing
dental/maxillofacial injuries
facial bruising, strangle marks around the neck or fingertip bruising
TMJ problems
-Orofacial pain
38
What are causes of liver cirrhosis
Alcohol
Hepatitis virus
fatty liver disease
autoimmune causes:primary billary cirrhosis
haemochromatosis
hepatocellular carcinoma
drug induced
39
what does dentally fit mean
no active pathology
consider removing teeth of poor long-term prognosis
establish preventative plan
40
why should a patient be dentally fit before a transplant
A
the patient will be immunosuppressed for the rest of their life so must reduce the risk of further dental intervention in the future
41
what causes thrombocytopenia to occur
splenic sequestration
impaired hepatic synthesis
increased degredation of thrombopoeitin by platelets sequestered in the congested spleen
drug related - alcohol, penecillin based drugs or heparin
42
why might patients with advanced alcoholic liver disease have increased risk of bleeding
thrombocytopenia
medication induced, patient may be taking heparin
liver disease may have been caused by hepatitis or HIV which both affect bleeding
clotting factors essential for coagulation are formed in the liver. If the liver is not functioning proerly these will not be present and affects coagulation ability
43
What are the types of dementia
Alzheimers
Vascular dementia
Dementia with lewy bodies
44
what are early stages of dementia?
A
Short term memory loss
confusion
Anxiety, agitation or distress
Communication issues - decline in ability to talk or write
45
what are end stages of dementia?
inability to recognise familiar objects, surroundings or people
Increased physical frailty - may shuffle when walk or become confined to a bed or wheelchair
difficulty eating and swallowing
asphagia
46
how do you refer to child services?
initially by telephone
follow up referral in writing
47
what would you look for clinically when monitoring this with enamel dentine fracture?
normal mobility
no TTP
discolouration
Infection
48
what causes nursing bottle caries
going to bed with a bottle of milk or juice
prolonged breastfeeding
baby using bottle as a comforter rather than a dummy
inappropriate use of feeding bottles and cups - should not contain sugar juice or milk
49
What are local causes of maloclussion
variation on tooth number
variation in tooth size or form
abnomralities of tooth position
Local abnormalities of soft tissue
Local pathology
50
what are the types of supernumary teeth
conical
tuberculate
supernumary
odontome
51
what are possible non-skeletal factors that can cause class 2 div 2 occlusion
lip trap
digit sucking
crowding
52
what appliance can be used to correct class II div 2 malocclusion
functional appliance - twin block
53
how does mandibular growth occur
growth occurs at condylar cartilage
growth occurs by surface remodelling ( resorption and deposition of bone)
results in increase in height of the ramus and increase in the length of the dental arch to accomodate teeth
growth is downwards and forwards
54
when does collimation errors occur
when the axis is not truly horizontal. The photo receptor is unlevel
55
what special tests are used to diagnose NUG/P
There are no special tests
would take radiographs to see if there is any bone loss as probing may be extremely painful for the patient and bleeding may make probing difficult
56
What are risk factors for NUG/P
Smoking
Stress
Immunocompormised
Malnutrition
Sleep deprivation
Poor oral hygiene
57
what is the treatment for necrotising gingivitis
Smoking cessation, diet advise, OHI
ultrasonic debridement
Prescribe 0.2% chlorhexidine mouthwash 2x daily as pain may prevent brushing
may prescribe antibiotics
58
State each stage and its number
1 - Intercuspal Position
2 - Edge to edge
3 - protrusion
4 - maximum opening
5 - retruded axis position
6 - redruded contact point
7 - mandibular rest position
between 1 and 7 - freeway space
59
what are border movements of the mandible
non functionl movements of the mandible
the maximum movement in each direction
60
what is the terminal hinge axis
when the condyles of the mandible are in their most superior and posterior position in the glenoid fossa
61
why is the retruded contact position important
it is the initial point of tooth contact during mandibular closure
It is used as a reference point for mouting casts on an ariculator
62
what is the value of bennet angle on an average value articulator
15 degrees
63
what are the principles of root canal shaping
1. develop a continuously tapering funnel from the canal orifice to the apex
2. maintain apical foramen in the original position
3. Keep the apical opening as small as possible
64
what measurement must canal obturation be from the apex
within 2 mm of radiographic apex
65
what are objectives of irritant in root canal treatment?
disinfection
flush out debris from canal
dissolve tissues in the canal
lubricates root canal instruments
removes the endodontic smear layer
66
how do you bond composite to porcelain
silane coupling agent
67
characteristics that make biofilm resistant
Gram negative
pili/fimbriae - allows bacteria to attach and overcome mechanical forces
capsule - virulence factor
- protects bacteria from immune cells and can mediate adhesion
endotoxins - part of outer cell wall and protects bacteria
exotoxins - gram positive, secreted by lysis to surrounding environment
68
what are systemic diseases associated with periodontal biofilms
periodontitis
Rheumatoid arthritits
69
what are the 5 stages of the washer-disinfector cycle
pre-wash
wash
rinse
thermal disinfection
drying
70
what is the purpose of the prewash cycle
saturates contamination and removes gross contamination
71
what is the purpose of the wash cycle
supplemented by detergent to effectively remove biological mater
72
what is the purpose of the rinse stage
removes remaining residue before disinfection
73
what is the purpose f the thermal disinfection stage
actively kills microorganisms whith the use of heated water
74
why is water removed between each stage of the WD
to remove the contamination within the machine
removes prions during wash stages as they cannot be deactivated by sterilisation
75
what is a PICO
P - patiet/population
I - intervention
C - comparison/control group
O - outcome
76
what are benefits of digital radiography over film radiography
doesn’t require chemical processing
easy storage
easy back up of images
easy transfer of images
images can be manipulated
Images can be integrated into patient records
77
what chemical property of lead makes it effective at absorbing photons
density and has a large number of electrons
78
what are the disadvantages of pocket elimination?
supporting bone may be removed
the exposed root surface may be un-aesthetic
the exposed root surface may be sensitive
79
what is the biological width?
the natural distance between the gingival sulcus and the height of the alveolar bone
80
how is ANUG treated?
debridement using an ultrasonic
oxidising mouthwash
chlorhexidine
oral hygine instruction
antibiotics;
amoxicillin 500mg for 3-5 days
metronidazole 200mg for 3-5 days
81
how is a periodontal abscess treated?
drainage- incision via pocket, dialte with instrument
gentle sub-gingival debridement
hot saline mouthwash
extraction of teeth with poor prognosis
antibiotics;
amoxicilin 500mg for 5 days
metronidazole 200mg for 5 days
follow up with HPT, surgery in indicated, maintenance
82
what is the rationale for using antiseptics and antibiotics for perio disease?
perio diseases have infectious aetiology
pathogenic bacteria associated with periodontitis are susceptible to antibiotics and antiseptics
83
what does substantivity depend on?
adsorption onto oral surfaces
maintenance of antimicrobial activity
slow neutralisation of antimicrobial activity
84
what are the advantages of local delivery, antibiotics and antiseptics?
high GCF concentration
low systemic uptake
high pt compliance
85
what is the periochip?
local delivary of chlorhexidine 2.5mg
biodegrades in 7-10 days
86
what are the 4 features of periodontitis?
bone loss
loss of attachment
transforamtion of junctional epithelium to pocket epithelium
apical migration of junctional epithelium
87
what are the effects of uncontrolled diabetes mellitus on the periodontium?
tendancy towrds enlarged gingivae, abscess formation, periodontitis, mobile teeth
reduction in defence mechanisms and increased susceptibility leads to destructive periodontal disease
severe ginigval inflammation, deep periodontal pockets and rapid bone loss appear in diabetic patients with poor oral hygiene
diabetes mellitus alters the response of periodontal tissues to local factors, delaying post surgical healing
88
give systemic factors which can cause hyperpigmentation of the gingivae
increased melanin e.g. addisons disease
increased billirubin e.g. jaundice
increased iron e.g. pregnancy/diabetes
89
what is papillon-Lefe’vre syndrome?
inherited- follows autosomal recessive pattern
hyperkeratotic skin lesions
severe destruction of periodontium
calcification of dura
signs usually appear together before age 4
skin lesions consist of hyperkeratosis and ichthyosis of localised areas on palms, soles, knees, elbows
periodontal involvement consists of early inflammatory changes that lead to bone loss and exfoliation of teeth
90
what are the characteristics of papillon-Lefe’vre syndrome?
primary teeth lost by age 5-6
permanent dentition erupts normally but are lost within a few years due to destructive periodontal disease
pt usually edentulous apart from third molars by age 15
third molars lost within a few years of eruption
91
name drugs which can cause gingival enlargment
anticonvulsants e.g. phenytoin
immunosuppressants
calcium channel blockers e.g. nifedipine
92
a 5 year old presents with diffuse redness of oral mucosa including gingiva proceeded by vesicles. what is the most likely diagnosis?
acute herpetic gingivostomatitis
93
what are the aims of periodontal surgery?
to arrest disease by gaining access to complete root surface debridement and to regenerate lost periodontal tissues
94
what treatment would you carry out at a follow up appointment for a patient who smokes and presents with ANUG?
debridement with LA
smoking cessation advice
OHI
95
How do you bond metal to the tooth
Tooth
DBA
Composite luting agent
Metal bonding agent
Metal
96
What is an example of a Self adhesive composite resin luting agent
Panavia
97
How does metal bonding agent bond metal to composite luting agent
C=C bonds in metal bonding agent react with similar groups in the composite luting agent
Acid end of metal bonding agent reacts with metal oxide
98
What is a self adhesive composite resin
composite luting material with metal bonding agent in it
99
What is important when using compoosite luting agent to bond to metal
must use a self cure composite as light cannot penetrate through metal
100
What are examples of metal bonding agents
MDP and 4-META
101
what are the 4 stages of free radical polymerisation?
activation
initiation
propagation
termination
102
what type of bonds are present in the molecules that undergo free radical polymerisation?
C=C
103
How does composite luting agent bond to indirect restorations
chemical bond forms between C=C
micro-mechanical bond forms between composite luting agent and the rough inside surface of indirect restoration
104
what is free radical polymerisation?
chemical union of 2 molecules to form a larger molecule without elimination of the smaller molecule
105
give 2 disadvantages of self cure PMMA
polymerisation is less efficiant, meaning there are more unreacted monomers
irritant/allergy issues
lower molecular weight= reduced transverse strength
106
how can self cure PMMA dentures become oversized?
they absorb water and expand
107
how does dentine bonding agent bond composite luting agent to the tooth
hydrophilic end bonds to tooth
hydrophobic end bonds to composite
108
give an advantage of self cure PMMA
polymerisation doesnt require heat- less thermal contraction means a better fitting denture
109
when can you not use RMGI as a cement
for porcelain - it swells cracking the crown
for posts - it will swell and split the root
110
What does dual cure material mean
cured by:
- light
- cures on its own by REDOX reaction
111
give a disadvantage of heat cure PMMA
gaseous porosity occurs if cured too fast
results in process taking far to long to avoid this
112
what are ideal properties of luting agents
low viscosity - increases as it sets
low film thickness - <25 um
easy to use
Radiopaque
Good marginal seal
Low solubility
Cariostatic
Non-toxic
High compressive strength
High hardness
113
Define cold working
Shaping a material below its recrystallisation temperature
114
define springiness
the ability to undergo large deflection WITHOUT deformation
115
Define slip
Defects in a grain move to grain boundaries this results in fewer defects in the lattice structure
116
whar are the constitutes of gutta percha?
20% cutta percha
65% zinc oxide
10% radiopacifiers
5% plasticisers
117
Explain GI interaction with dentine tubules and its significance
GI seals dentine tubules
this decreases micro-leakage and decreases sensitivity
118
list steps to help with diagnosis of unerupted central incisor
take detailed histroy- check for environmental/hereditary factors and history of trauma
intraoral exam- sequence of eruption, presence of contralateral tooth, rotation/displacement of other teeth in region
check for presence of labial/palatal swellings which may indicate presence of the tooth
take a radiograph
119
define class III incisor malocclusion
lower incisors occlude/would occlude anterior to cingulum of upper incisors
120
define class I incisor relationship
the lower incisor edges occlude with or lie immediately below the cingulum plateau of the upper central incisors
121
define class II incisor relationship
the lower incisor edges lie posterior to the cingulum plateau of the upper incisors
122
define class II division 1 incisor relationship
the upper incisors are proclined or of average inclination and there is an increase in overjet
123
define class II division 2 relationship
the upper central incisors are retroclined. The overjet is usually minimal or may be increased
124
what is xerostomia?
dry mouth caused by reduced salivary flow
clinically diagnosed if unstimulated salivary flow <0.3ml
125
list oral problems which are exacerbated by xerostomia
caries
periodontal disease
candida infection
mucositis
126
give causes of xerostomia
radiotherapy/ chemotherapy
sjrogren’s syndrome
HIV
epstein Barr virus
127
what are the predisposing factors of oral candidosis?
prolonged antibiotic use
poor oral hygiene
denture wearer
immunocompromised
diabetes
dialysis
burn unit patient
128
list functions of a provisional crown for an EDP# and exposed RCT
improve aesthetics and provide pt with realistic expectations
improve functions of mastication and speech
resolve gingival inflammation and provide adequate gingival health prior to fitting the definitive restoration
to act as a marker for the dentist for tooth prep
prevents sensitivity
preserves tooth vitality
used as isolation for RCT
129
name 3 types of prefabricated crowns
polycarbonate crowns
clear plastic
metal (aluminium/stainless steel)
130
give disadvantages of prefabricated crowns
inaccurate fit ervically, occlusally, interdentally
if a large bank of crowns is needed it is very expensive
131
what factors can result in tooth mobility?
traumatic occlusion (bruxism)
trauma
periodontal disease
dental abscess
132
What are the types of posts?
manufactured - pre-formed
material - cast metal, steel, zirconia, carbon, glass fibre
shape - parallel sided or tapered
133
How do you determine the difference between a facial palsy and a stroke?
Stroke - patient can wrinkle forehead and blink
facial palsy - face is affected on the same side where LA was given, cannot move upper or lower face
Stroke affects the opposite side of the body from the location in the brain that is affected
134
How would you manage a patient that has a facial palsy due to LA?
Reassure the patient
explain the sensation and muscle control will return once the LA wears off
Give the patient an eyepatch or tape the eye closed to protect the eye until blinking function returns
give emergency contact number
135
what features should be present on maxillary definitive impressions?
tuberosity
hamular notch
extension anterior to the vibrating line for post dam
functional depth and width of sulcus to create a food peripheral seal and ensure hard palate and residual ridge are functional for primary support
136
what features should be present on a mandibular definitive impression?
coverage of pear-shaped pad and buccal shelf
retro-molar pad and extension into the lingual pouch should occur
functional width and depth of the sulcus
ensure there is area of primary support of buccal shelf and retromolar pad
137
what general features should be present on definitive impressions?
ensure denture bearing areas are covered
ensure there is good functional sulcus present
ensure there is good surface detail with no air blows
138
what indicates the posterior border of the maxillary denture?
post dam- sits 1-2mm anterior of vibrating line
139
describe the use of impression compound for primary impressions
non-elastic material which records poorer surface detail
expensive and can be messy
good for primary due to high mucocompressive viscosity
140
describe the use of alginate for primary impressions
elastic material- will flow into undercuts
can record surface detail for primarys
141
describe the use of silicone for master impressions
dimensionally stable
can be made into a variety of consistencies which means it accurately records surface detail
142
describe the use of polyether/impregum for master impressions
dimensionally stable
can be made into a variety of consistencies which means it accurately records surface detail
143
what provides retention for dentures?
accurate fit - as little space as possible between denture base and mucosa
border seal- extending flanges to the depth of functional sulcus and incorporation of post dam
144
what is the primary support area for maxillary dentures
hard palate
145
what are two areas in a maxillary denture that may require relief
midline suture
incisive papilla
lingual frenum
146
what are the primary support areas in lower dentures
buccal shelf and pear shaped pad
147
label from left to right and explain
labial sulcus - overextension causes denture to look bulky
incisive papilla - may need to relieve here due to underlying nerves , indicates where teeth have been
buccal frenum - in premolar area, connects to cheek
palatine raphe - midline of denture, tissue tight
tuberosity - most distal extension of maxilla
vibrating line - junction of hard and soft palate
palatine foveae - dimples in soft palate behind vibrating line
hamular notch - junction of maxilla to hamular process, overextension causes ulceration
buccal sulcus - overextension loses muscle balance, under-extended loses peripheral seal and makes unretentive
palatine rugae - lumps in palate
labial frenum - muscle attachment to midline, may need relieved
148
label from left to right and explain
labial sulcus
lingual frenum - attachment to tongue
buccal sulcus - overextension loses muscle balance, under-extended loses peripheral seal and makes unretentive
retromolar pad - most distal extension of mandible, rest denture as far back as possible here
buccal shelf - primary support area, make sure denture extended as far back as this
lingual sulcus - mylohyoid ridge here and may cause discomfort
buccal frenum
labial frenum
149
what are records required for mounting casts on a semi adjustable or average value articulator
face bow
inter occlusal record on the retruded axis
150
what are the functions of a sealer during endodontic treatment?
lubricate the canal
seal space between dentinal wall and core
fill voids and irregularities within the canal and between GP cones during lateral compaction
151
give reasons for obturating
entomb remaining surviving microorganisms within the root canal system
prevent ingress of fluid into root canal space which will promote the growth of surviving microorganisms
prevent entry of microbes from the oral environment due to coronal leakage
152
name 5 general oral surgery principles that should be adhered to when carrying out flap surgery
create maximal access with minimal trauma- bigger flaps heal just as quickly as small ones
use the scalpel in one firm continuous stroke
minimise trauma to dental papilla
keep the tissues mosie
aim for healing by primary intention to minimise scarring
153
what handpiece and bur are used to cut bone?
straight electrical hand piece with saline cooled bur
round of fissure tungsten carbide burs
air drive handpieces may lead to surgical emphysema and embolisms to form
154
describe factors which influence flap design
the type of surgery being carried out
proximity of important structures such as nerves and muscles e.g. lingual nerve can be damaged during surgical removal of lower 3rd molars
depending on the area of the mouth e.g. to improve aesthetics
ability to access/visualise and ability to suture it back
155
give methods of debridement prior to suturing
mechanical
* bone file/ handpiece to remove any sharp bony edges
* mitchell’s trimmer/victoria currette for soft tissue debris
irrigation
* sterile saline/water put into socket under flap to wash out debris
suction
* aspirate under flap to remove debris
156
what are the aims of raising a flap?
allows better access to the tooth if finding any difficulty to extract e.g. abnormal resistance, ankylosis etc.
helps with closure of an OAF
157
state the aims of retracting a flap
protection of the soft tissue
better access and vision
158
draw flap of retained root of lower premolar
159
name 3 regulations for waste disposal
the controlled waste regulations 2012
the hazardous waste directive 2011
the environmental protection act 1990
160
name the SICPs
patient placement/assessment for infection risk
hand hygiene
respiratory and cough etiquette
PPE
safe management of care equipment
safe management of care environment
safe management of linen
safe management of blood and bodily fluid spillages
safe disposal of waste including sharps
occupational safety- prevention and exposure management
161
what is the sinner circle?
shows components essential for adequate cleaning
* chemicals
* temperature
* time
* energy (mechanical force)
162
what features of cerebral palsy would impair your access to the mouth?
muscle stiffness (hypotonia)
muscle weakness
random and uncontrolled body movements
163
give two ways you can aid a patient who struggles to open their mouth
mouth rests for opening
bedi shield
164
name 4 types of dementia
alzheimers
vascular
frontotemporal
dementia with lewy bodies
165
name 3 cognitive testing methods for dementia
MMSE
blessed dementia scale
the montreal cognitive assessment (MoCA)
166
what are the advantages of the mini mental state examination?
well known
easy to administer
167
what are the cons of of the mini-mental state examination?
not sensitive to mild impairment
not sensitive in testing frontal lobe
non-standardised time between registration and recall
168
How do you assess capacity ?
being incapable of:
- Acting
- Making a decision
- Communicating decision
- Understanding decision
- Retaining the memory of a decision
AMCUR
169
what clotting factors does the liver produce?
1, 2, 7, 9 ,10 and 11
170
Apart from clotting factors what other product essential for achieving haemostasis is produced in the liver?
Thrombopoietin
171
give features of parkinsons disease
bradykinesia- slow movement
rigidity- increase motor tone
mask like face
resting tremors
posture instability, impaired use of upper limbs
172
how does parkinsons differ from other cerebellular diseases?
resting tremors as apposed to intentional active tremors
173
how does parkinsons cause dry mouth?
anticolinergic effects of drugs e.g. benztropine
174
what drugs can cause xerostomia?
tricyclics
anticholinergic
benzodiazepines
diuretics
opioid
nicotine
175
what is the drug action of flucanazole?
interupts conversion of lanosterol to ergosterol by interacting with the enzyme which catalyses the conversion which stops formation of fungal membrane
176
what is the drug action of nystatin?
binds to sterols in plasma membrane of fungi, causing cells to leak
this causes fungal cell death
177
what is the mechanism of apixaban?
a selective inhibitor of FXa
does not require antithrombin III for antithrombic activity
inhibits free and clot-bound FXa and prothrombinase activity
has no direct affect on platelet aggregation, but indirectly inhibits platelet aggregation induced by thrombin
decreases thrombin generation and thrombus developmen
178
what are the uses of apixiban?
prevention of DVT
prevention of pulmonary embolism
can prevent stroke and reduce risk in pts with AF
