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1 - BDS4 finals - big topics > diseases + special care > Flashcards

diseases + special care Flashcards

(115 cards)

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1
Q

What are the 5 barriers to care

A

availability
accessibility
accomodation
affordability
acceptability

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2
Q

how can access to the dental setting be improved?

A

ground floor access
suitable car parking
elevators
hand rails
wide corridors
disabled toilets

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3
Q

How can mouth access be improved?

A

head support
open wide mouth rests
mirror
bedi shield
good light

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4
Q

where can special care dentistry be provided?

A

GDP
community/public dental services
hospital
hospice
care home
patient’s own home

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5
Q

What is an advocate?

A

a person who offers support and helps a person to express their wishes and views

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6
Q

what are the types of power of attorney?

A

continuing
welfare
joint

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7
Q

What is a bariatric person?

A

any person of any age who has limitations in health and social care due to their physical size, health mobility and environmental access

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8
Q

contributing factors to obesity

A

genetics
SES
hypothyroidism
steroid medications
physical limitations
lifestyle factors

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9
Q

medical conditions associated with bariatric patients

A

hypertension
diabetes
sleep apnea
GORD
osteoarthritis
depression
liver disease
cellulitis

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10
Q

dental considerations for bariatric patients

A

loss of anatomical landmarks
ID blocks more difficult
OPT may not accommodate to their size
long appointments
coagulation abnormalities - potentially
excess fat may affect drug absorption

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11
Q

bariatric patients - dental implications

A

periodontitis
caries
poor wound healing
tooth erosion

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12
Q

why are bariatric patients contraindicated for IV sedation?

A

risk of sleep apnea
difficulty placing cannula
compromised airway

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13
Q

features of a dementia friendly practice

A

reception desk visible from front door
ceilings, floors and floor coverings should be acoustically absorbent for audible communication
colour and tone of walls distinctive from flooring
avoid non-essential signs to avoid confusion
signage placed at eye level with simple use of text and colour
ensure good levels of natural light to minimise artificial light

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14
Q

how can a dentist communicate in a dementia-friendly way?

A

engage attention and eliminate distraction
eye contact
hold hand
verbal cues
- short simple sentences
yes/no questions
provide reassurance
use humour for rapport
call by first name
- (they may forget surname)

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15
Q

what is Parkinson’s disease

A

chronic and progressive neurological disorder
caused by degeneration of dopaminergic neurones in basal ganglia

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16
Q

parkisnons signs and symptoms

A

dyskinesia
- involuntary movement
bradykinesia
- slow movement
muscular rigidity
resting tremor
mask like face

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17
Q

What is drug is used to treat Parkinson’s?

A

levodopa
- increases dopamine that reaches the brain

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18
Q

Parkinson’s dental implications

A

dry mouth
- root caries
poor OH
movement, drooling and tremor increase his of harm when using sharp/rotating instruments
dysphagia
limited muscular control
may require toothbrush handle modification

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19
Q

dementia is characterised by…

A

amnesia
inability to concentrate
disorientation in time, place, person
deterioration in emotional control
social behaviour and motivation

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20
Q

Alzheimer’s distinctive features

A

short term memory loss
aphasia
communication difficulties
muddled one every day activities
mood swings
withdrawn behaviour
loss of confidence

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21
Q

vascular dementia risk factors

A

smoking
diabetes
atria fibrillation
hypertension
age

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22
Q

vascular dementia distinctive features

A

memory problem of sudden onset
anxiety
delusions
seizures
visuospatial difficulties

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23
Q

dementia dental implications

A

lost’ broken dentures
halitosis
xerostomia
- periodontal disease
- caries
dysphagia
loss of taste - high sugar diet

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24
Q

What is downs syndrome?

A

a neurodevelopmental disorder of genetic origin affecting chromosome 21

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25
Down syndrome physical features
cranial anomalies - flat back of head growth failure increased BMI short hands reduced muscle tone stubby fingers atlanto-axial instability
26
medical conditions associated with downs syndrome
congenital heart defects alzheimer's epilepsy leukaemia diabetes melitus intellectual impairment coeliac disease GORD hypothyroidism
27
Down's syndrome dental implications
hypodontia delayed and out of sequence eruption severe early onset periodontal disease Microdontia increased incidence of gag reflex high arched palate macroglossia
28
how may an individual with intellectual impairment communicate pain?
aggression towards themselves or others altered facial expressions change in behavhoir confusion changes to apetite or vocalisation restlessness/sleep pattern changes
29
what communication adjuncts are available?
makaton picture boards letter boards talking mats drawing writing
30
who is involved in the MDT for head and neck cancer?
surgeons radiologists clinical oncologists SALT dieticians restorative dentists clinical support nurses pathologist
31
what is the role of the GDP in head and neck cancer?
early detection through soft tissue examination take clinical photographs onward referral pre-treatment assessment
32
prevention and management of oral mucositis
caphosol gelclair muguard soluble aspirin benzydamine aloe vera cryotherapy Manuka honey
33
What is osteoradionecrosis?
an area of exposed bone for at least 3 months duration in an irradiated site and not due to tumour resistance
34
ORN prevention
Remove teeth of doubtful prognosis in pre-assessment phase OHI extractions completed at least 10 days prior to radiotherapy lease with oncologist
35
What can be used in ORN patients to encourage blood vessel growth and healing of the area?
vitamin E Pentxyfyline
36
radiographic features of head and neck cancer?
moth eaten bone pathological fractures non healing sockets spiking root resorption floating teeth unusual periodontal loss generalised widening of PDL space and loss of lamina dura loss of bony outlines for anatomical features
37
What is tardive dyskinesia?
involuntary movements of the tongue, lips, face, trunk and extremities associated with antipsychotics
38
what is psychosis?
when an individual loses contact with reality
39
common causes of psychosis?
schizophrenia bipolar disorder severe depression traumatic experience stress drug or alcohol misuse side effects of prescribed medication physical condition e.g. brain tumour
40
features of bipolar disorder
mania - happy, energetic - impulsive depression - sadness - little energy - trouble concentrating
41
common casuses of depression
stress events personality traits family history giving birth alcohol and drugs illness
42
what is Schizophrenia?
a disorder of the mind that affects how you think, feel and behave
43
anorexia nervosa features
self starvation and weight loss - results in a low weight for height and age
44
types of anorexia nervosa
restrictive eating binge eating/purging
45
anorexia nervosa signs and symptoms
dizziness no period/irregular periods brittle hair and nails cold intolerance GORD muscle wasting constipation osteoporosis depression/anxiety poor concentration
46
anorexia nervosa complications
hypokalaemia hypotension arrythmia cardiac atrophy sudden cardiac death hypothermia
47
what is bulimia nervosa?
alternative diet with binging on forbidden foods binges occur at least weekly for 3 months followed by compensatory behaviours each as - fasting - laxative misuse - exercise - vomitting
48
bulimia nervosa signs and symptoms
frequent bathroom trips after meals large amounts of food disappearing chronic sore throat sialosis caries/erosion GORD dizziness recurrent and unexplained diarrhoea mouth ulcers mallory-weiss Syndrome
49
dental implications of eating disorders
dental erosion - dental sensitivity angular chelitis candidiasis oral ulceration glossitis sialosis xerostomia - dehydration/antidepressants poor OH caries - periodontal disease consider weight in LA dosage
50
What is Rheumatoid arthritis?
an autoimmune inflammatory disease where the immune system attacks the joints
51
Rheumatoid arthritis typically affects...
hands, wrists and knees
52
Rheumatoid arthritis risk factors
age sex - females > male genetics - HLA class II history of live births - never giving birth early life exposures - smoking obesity
53
Rheumatoid arthritis signs and symptoms
pain or aching in more than one joint stiffness in more than one joint tenderness and swelling in more than one joint weight loss fever fatigue weakness
54
Rheumatoid arthritis treatment
disease modifying anti-rheumatic drugs (DMARDs) biologics self management techniques to reduce pain and disability
55
Rheumatoid arthritis complications
premature heart disease increased diabetes risk obesity unemployment
56
What is osteoporosis?
a bone disease that develops when bone mineral density and bone mass decreases results to a decrease in bone strength
57
how can osteoporosis be prevented?
staying physically active participating in weight bearing exercises such as walking drinking in moderation no smoking medication nutritious diet high in calcium and vitamin D
58
osteoporosis risk factors
gender - females > males race - non-hispanic white - asian age - increases with age body size - more slender hormonal changes - menopause - low testosterone in men low level of physical activity
59
osteoporosis treatment
proper nutrition - calcium and vitamin D lifestyle changes - no smoking - low alcohol - exercise medication - bisphosphonates - osterogen agonist - osterogen and hormone therapy - parathyroid hormone - RANKL inhibitors
60
Options of aids that can be used to transfer a patient into a dental chair?
sling and hoist banana board reclining wheelchair turn table wheelchair recliner stand aid
61
advantages of a hoist
can be used for non weight bearing individuals safest allows transfer to dental chair
62
disadvantages of a hoist
requires additional training
63
advantage of a banana board
allows for self transfer
64
disadvantages of a banana board
requires a leg break chair
65
what is atrial fibrillation
when the electrical impulses of the atria fire irregular and chaotically, leading to fibrillation/quivering
66
atrial fibrillation presents with...
an irregular and fast heart rate
67
hypertension risk factors
high alcohol intake smoking overweight/obesity high sodium intake lack of exercise
68
causes of secondary hypertension
kidney disease diabetes medications - oral contraceptives
69
hypertension complications
heart attack stroke kidney failure heart failure sight problems vascular dementia
70
types of stroke
ischaemic haemorrhagic carotid artery dissection cerebral venous thrombosis
71
stroke risk factors
medical - hypertension - diabetes - atrial fibrelation - high cholesterol - sickle cell disease gender - male>female age genetics lifestyle factors - smoking - alcohol - lack of exercise - poor diet
72
signs and symptoms of a stroke
facial weakness arm weakness slurred speech gait disturbance urinary incontinece loss of taste impaired pain headache confusion loss of consciousness facial/neck pain Horner's syndrome
73
Stroke - dental considerations
communication patients may have aphasia short mid-morning appointments take care with adrenaline avoid benzodiazepines - respiratory depression denture wearing issues - muscular control loss poor OH root caries - xerostomia
74
Dental advice to stroke survivors with dysphagia
brush teeth upright with suction or aspirating toothpaste low foaming toothpaste remove excess water on toothbrush rub toothpaste into toothbrush before placing in mouth
75
what is haemophilia A ?
Factor VIII deficiency
76
What is haemophilia B?
factor IX deficiency
77
what can be given to patients with mild haemophilia or von willebrands prior to dental treatments with an increased bleeding risk?
DDAVP
78
What can be given to patients with moderate or severe haemophilia before dental treatments that carry and increased bleeding risk?
factor replacement
79
What is warfarin?
an oral anticoagulant which antagonises vitamin K antagonists
80
Dabigatran mechanism of action
reversibly inhibit thrombin-induced platelet aggregation
81
how do Apixaban, Edoxaban and rivaroxaban work?
reversibly inhibit activated factor Xa which prevents thrombin generation
82
What is simvastatin?
A HMG CoA reductase inhibitor used to treat hyperchloesterolaemia
83
What is furosemide?
a loop diuretic used to treat resistance hypertension
84
diabetes dental and medical implications
risk of hypoglycaemic episode increased prevalence, progression and severity of periodontal disease xerostomia increased risk of infections poor wound healing oral dyseastheisa parotid gland enlargement
85
What is metformin
an anti hyperglycaemic medication
86
metformin side effects
can reduce B12 levels associated with B12 deficient anaemia
87
Where is lidocaine metabolised?
in the liver
88
where is articaine metabolised?
5-10% liver rest = plasma
89
What additional procedures can be carried out under GA?
investigation by other medical specialties blood sampling eye examination ECG nail cutting hair cuts
90
alcohol abuse dental implications
advanced caries periodontal disease NCTSL increased oral cancer risk glossitis angular stomatitis tooth erosin nocturnal bruxism dry mouth - secondary to dehydration and vomiting
91
dental advice for methadone users
use a straw drink water after consumption don't brush teeth immediacy after engage with dental services prevention sugar free available
92
dental implications of opioids
suboptimal oral hygiene and self care xerostomia taste impairment rampant decay and periodontitis
93
Patient you are treating is an alcoholic - what considerations should you make?
LA - take care with LA metabolised in the liver - consider articaine - metabolised in plasma avoid aspirin and NSAID's avoid metronidazole
94
Give an example of an ACE inhibitor
Ramipril Lisonipril Enalapril
95
What do ACE inhibitors do?
inhibit conversion of angiotensin I to angiotensin II reduce blood pressure reduce excess salt and water retention
96
What is thrombocytopenia?
a reduced number of platelets
97
Dental care can proceed safely in primary care if the platelet count is greater than...
100x10 ⁹/L
98
Dental care can be safely provided in a hospital setting if the platelet count is greater than....
50 x 10 ⁹/L
99
What is diabetes insidipidus?
abnormality of renal function
100
what is diabetes mellitus?
abnormality of glucose regulation
101
What tests can be done for diabetes?
HbA1C Glucose tolerance test Random plasma glucose
102
what HbA1C score would indicate diabetes?
>48mmol/mol (6.5%)
103
HbA1C that would indicate controlled diabetes?
<53mmol/mol (7%)
104
What Gi conditions can cause microcytic aenamia
Crohns coeliac ulcerative colitis gastric carcinoma
105
Give 3 oral conditions associated with microcytic anemia
poor wound healing RAS candida atrophic glossitis burning sensation of oral mucosa
106
What is frailty?
a state of increased vulnerability to adverse health outcomes, often associated with aging
107
How would you treat a patient with HbA1c levels above 9%
only emergency treatments should be carried out surgical procedures should be done in hospital setting
108
What is an iscahemic stroke?
cerebral infarction - occluded artery and affects central circulation
109
what is a haemorrhage stroke?
cerebral - blood vessel rupture subarachnoid - between surface of brain and arachnoid tissue
110
signs and symptoms of a stroke
facial weakness arm weakness slurred speech gait disturbance urinary incontinence headache impaired pain confusion loss of consciousness face/neck pain hornets syndrom - partial ptosis -- drooping of upper eyelid loss of voluntary movement of opposite side of the body to cerebral lesion
111
stroke risk factors
hypertension diabetes mellitus atrial fibrillation high cholesterol infective endocarditis carotid artery disease congestive heart failure congenital heart disease >55 years = risk doubled genetic s sickle cell smoking alcohol poor diet physical inactivity
112
Parkinson's non-motor symptoms
sleep disturbances urinary urgency psychoses depression
113
key teeth to retain for patients quality of life?
occluding pairs number of teeth anteriors
114
treatment planning for late stage dementia
focus on comfort moist, clean and healthy mouth free from pain and infection non-invasive emergency management - limited options
115
head and neck cancers - when to refer
stridor - emergency referral persistent unexplained head and neck lump >3 weeks ulceration or unexplained oral mucosal swelling persisting > 3 weeks all red or mixed red and white patches of oral mucosa > weeks persistent horseless >3 weeks - chest x ray dysphagia >3 weeks persistent throat pain >3 weeks

1 - BDS4 finals - big topics (17 decks)

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