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Patient Care I > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How many radiographs are in a full mouth survey?

A

20

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2
Q

How many PAs in a full mouth survey?

A

16

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3
Q

How many bitewings in a full mouth survey?

A

4

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4
Q

What does PA stand for?

A

periapical

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5
Q

What is a PA radiograph?

A

image that captures the outline of the entire crown and the entire root anatomy >2.0mm of alveolar

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6
Q

Where is the receptor placed during a PA?

A

-parallel to B and Li planes of lateral incisor
-receptors parallels long axis of lateral incisor
-incisor is within middle two 1/4s of mesiodistal width
-horizontal angle directed through mesial contact of lateral incisor

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7
Q

What do bitewing radiographs show?

A

-interproximal contact areas without overlapping
-detect interproximal caries
-crestal alveolar bone levels

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8
Q

What does Dx mean?

A

diagnosis

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9
Q

What does Hx mean?

A

history

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10
Q

What does N/A mean?

A

next appointment OR not applicable

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11
Q

What does FM mean?

A

full mouth

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12
Q

What does Bid mean?

A

twice a day

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13
Q

What does PRN mean?

A

as needed

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14
Q

What does Tid mean?

A

three times a day

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15
Q

What does Qid mean?

A

four times a day

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16
Q

What does pt mean?

A

patient

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17
Q

What does Rx mean?

A

prescription

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18
Q

What is asthma?

A

chronic inflammatory disease of the airway characterized by reversible episodes of increased airway hyper-responsiveness resulting in recurrent episodes of dyspnea, coughing, and wheezing

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19
Q

What type of onset is asthma?

A

sudden onset

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20
Q

How long does it take for peak symptoms of asthma to start?

A

10-15 minutes

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21
Q

How many patients having asthma attack go to the ER?

A

25%

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22
Q

How many people have asthma worldwide?

A

300 million

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23
Q

What is the death rate of asthma?

A

1 of every 250 deaths worldwide

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24
Q

since the 1960s, how much has the prevalence of asthma increased?

A

more than doubled
-from 2% to 7%

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25
Q

How many people in the US have asthma?

A

23 million

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26
Q

What is the second most common chronic disease in children?

A

asthma

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27
Q

percentage of children with asthma:

A

10%

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28
Q

What is the number one chronic disease in children?

A

caries

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29
Q

percentage of adults with asthma:

A

6%

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30
Q

What are some cause/triggers of asthma?

A

-emotional or physical stress
-allergy to food or drugs
-air pollution or irritating vapors
-upper respiratory infection
-exercised induced

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31
Q

What is extrinsic asthma?

A

allergic asthma
-more often in children
-triggered by specific allergens
-about 50% of children out grow extrinsic asthma

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32
Q

What is intrinsic asthma?

A

non-allergic
-develop in adults older than 35
-triggered by respiratory infections, physical exertion, environmental and air pollution
-psychological and physiological stress can induce an attack

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33
Q

What should you avoid in those with asthma?

A

aspirin and NSAIDs

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34
Q

What is the triad asthmaticus?

A

very sudden and very severe asthma attack
-wheezing, dyspnea, and hypoxia
-do not repsond to bronchodilators
-TRUE EMERGENCY
Asthma, nasal polyps, sensitivity to aspirin and NSAIDs

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35
Q

What are the symptoms of asthma?

A

chest congestion, wheezing/cough, dyspnea/tachypnea, increased blood pressure, anxiety, and cyanosis

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36
Q

What are some ways to prevent asthma attacks as a provider?

A

get a good medical history
-when do they have attacks
-when was their most recent
-how are the attacks managed
-have they needed emergency care

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37
Q

What are ways for patients to prevent asthma attacks?

A

vaccinations, know triggers, take medication, take puff of inhaler

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38
Q

How to manage asthma attacks:

A

-terminate procedure
-patient upright
-calm patient
-bronchodilators (up to three times)
-oxygen if unsuccessful
-get medical assistance
-epinephrine

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39
Q

What is mild asthma?

A

-less than 3 attacks a week that last for less than 30 minutes
-only with allergen or exercise
-inhaler not always needed

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40
Q

What is moderate asthma?

A

-3-5 attacks a week
-last 30 minutes to several hours
-affect sleep
-ER visits
-inhaler more commonly used

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41
Q

What is severe asthma?

A

-daily attacks
-inhaler daily
-may use steroids
-frequent ER visit
-limit daily activity

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42
Q

What is diabetes?

A

group of metabolic diseases that result in low levels of insulin

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43
Q

What is Type I diabetes?

A

insulin dependent diabetes
-5% of diabetic patients
-more common in children
-beta cell destruction
-thought to be autoimmune
-abrupt onset

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44
Q

What is Type II Diabetes?

A

noninsulin dependent diabetes
-milder
-in adults
-overweight/obese
-blood sugar more stable

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45
Q

What is gestational diabetes?

A

abnormal glucose tolerance in pregnancy
5-7% of pregnant women

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46
Q

Symptoms of hyperglycemia:

A

-polyuria
-polydipsia
-polyphagia
-dry warm skin
-dry mouth
-fruity smelling breath
-Kussmauls breathing
-rapid weak pulse
-confusion and altered levels of consciousness

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47
Q

Symptoms of hypoglycemia:

A

-lethargy
-changes in mood, strange behavior
-nausea
-tachycardia
-hypertension
-anxiety
-full body sweating

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48
Q

Symptoms of severe hypoglycemia:

A

-loss of consciousness
-seizures
-coma

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49
Q

Management of hypoglycemia:

A

-position patient comfortably
-administer 100% oxygen
-oral carbs if conscious
-if unconscious cake icing on lips
-medical assistance

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50
Q

What is A1c?

A

average amount of sugar in blood over the past 2-3 months

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51
Q

Ideal A1c:

A

6.5% or below

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52
Q

What blood sugar levels should you defer elective treatment?

A

<70 or >200

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53
Q

What is normal fasting glucose level?

A

80-130

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54
Q

What is insulin shock?

A

excess insulin

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55
Q

What is the mild stage of insulin shock?

A

most common
-triggered by hunger, weakness, trembling, tachycardia, pallor, and sweating
-may occur before meals, during exercise, or when food is delayed

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56
Q

What is the moderate stage of insulin shock?

A

when blood sugar drops substantially
-patient becomes incoherent, uncooperative, and sometimes belligerent/resistant to reason
-patients may injure themselves

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57
Q

What is the severe stage of insulin shock?

A

-complete unconsciousness
-usually take place during sleep when the other two stages are ignored
-sweating, pallor, rapid and thready pulse

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58
Q

What are oral manifestations of diabetes?

A

-urinate when blood sugar is high
-xerostomia
-bacterial, viral, and fungal infections
-poor wound healing
-increase incidence and severity of caries

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59
Q

What are oral complications of diabetes?

A

-periodontal disease and abscess
-bidirectional hyperglycemia
-xerostomia and burning mouth syndrome
-increased infections
-gingival inflammation

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60
Q

What are allergies?

A

abnormal or hypersensitive response of immune system to a substance introduced into the body

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61
Q

What is the sensitizing dose?

A

the previous exposure to the allergen

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62
Q

What is the challenge dose?

A

subsequent exposure to the antigen

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63
Q

What is a type I hypersensitivity reaction?

A

related to humoral immune system
-occur soon after second exposure to the antigen

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64
Q

What is anaphylaxis?

A

acute reaction involving smooth muscle of the bronchi in which antigen-IgE antibodies form on surface of mast cells
-release of histamine

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65
Q

What is the most common cause of anaphylaxis?

A

antibiotics

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66
Q

What occurs in the cardiovascular system during anaphylaxis?

A

capillary dilation and increases capillary permeability
-blushing and edema formation
-decreased venous return, decrease BP and cardiac output

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67
Q

What occurs in the respiratory system during anaphylaxis?

A

can lead to asphyxia due to increased secretions in the glands

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68
Q

What occurs on the skin during anaphylaxis?

A

itching and hives
-erythema rash
-angioedema

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69
Q

Progression of symptoms of anaphylaxis?

A

-skin
-eyes, nose, GI
-respiratory
-cardiovascular

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70
Q

How to manage rapid allergic reactions:

A

-position patient supine
-BCLS
-oxygen
-monitor vitals

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71
Q

doses of epinephrine for rapid allergic reactions

A

-1/10,000 3.0 cc IV
-1/10,000 0.3 cc IM/SC

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72
Q

doses of benadryl for rapid allergic reaction

A

50 mg IV or IM

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73
Q

What are the causes of delayed allergic reactions:

A

-greater than an hour
-non-life threatening
-antibiotics
-analgesics
-narcotics
-preservatives in anesthesia

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74
Q

What are the symptoms of delayed allergic reactions:

A

-rash
-pruritus (itching)
-urticaria (hives)
-edema
-rarely: hypotension, dyspnea, and coma

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75
Q

Management of delayed allergic reactions:

A

-terminate procedure
-position patient comfortably
-BSLC if indicated
-benadryl

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76
Q

Risk factors for cardiovascular disease: (can be changed)

A

-smoking
-excessive alcohol use
-stress
-obesity
-diabetes
-cholesterol
-hypertension
-sleep apnea

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77
Q

Signs and symptoms of cardiovascular disease:

A

-extreme fatigue
-chest pain
-difficulty breathing
-nausea
-edema

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78
Q

What is edema?

A

collection of fluid that can be due to venous insufficiency

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79
Q

What is stenosis?

A

narrowing or obstruction
-usually the aortic valve
-caused by: rheumatic fever, calcification of valve, or congenital anomalies

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80
Q

What is dyspnea?

A

difficult, labored, or uncomfortable breathing

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81
Q

What is orthopnea?

A

-difficulty breathing when lying down
-caused by: heart failure, COPD, panic disorder, or sleep apnea

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82
Q

What is coronary artery disease?

A

decreased or blocked blood flow to the heart due to plaque build up

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83
Q

What are the ABCs or cardiovascular disease and diabetes?

A

A- A1c done regularly
B- blood pressure WNR
C- cholesterol managed
s- stop smoking

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84
Q

What is the connection between diabetes and cardiovascular disease?

A

coronary artery disease is the leading cause of morbidity and mortality in patients with diabetes
-longer you have diabetes, the more likely you are to have heart disease

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85
Q

What is angina pectoris?

A

usually brief resulting from temporary ischemia of the myocardium
-tightness in midchest
-lasts 5-15 minutes

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86
Q

What are the three types of chest pain?

A

-angina pectoris
-hyperventilation
-acute MI

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87
Q

When can angina pectoralis be seen?

A

coronary obstruction-anemia, hypoxemia, and profound hypotension

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88
Q

What is stable angina?

A

pain is predictable, reproducible, unchanging, and consistent over time
-pain is usually associated with physical effort, eating, or stress
-pain relieved by stopping of physical exercise or use of nitroglycerin
-may have underlying coronary artery disease

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89
Q

What is unstable angina?

A

new-onset pain, increasing frequency and/or intensity
-occurs with less effort than acute angina
-not relieved by nitroglycerin
-key feature: changing character

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90
Q

What is nitroglycerin?

A

drug that is a powerful vasodilator
-can cause headache

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91
Q

How is nitroglycerin supposed to be taken?

A

placed under the tongue or in the vestibule and dissolved

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92
Q

how long does it take for nitroglycerin to work?

A

2-4 minutes

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93
Q

How long does nitroglycerin work?

A

30 minutes

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94
Q

What are side effects of nitroglycerin?

A

-pounding in head
-flushing
-tachycardia
-possible hypotension

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95
Q

What do you do if you have a patient experiencing angina pectoris?

A

-stress reduction protocol
-avoid excess vasoconstrictors
-oxygen as needed
-nitroglycerine tabs
-4444 if it does not go away

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96
Q

What is the treatment of angina pectoralis?

A

-place patient sitting up with head elevated
-ensure open airway
-check vitals
-administer nitroglycerin (3 doses max)
-check BP between doses
-if pain does not go away, give baby aspirin (only give aspirin after you have decided against anymore nitroglycerin)

97
Q

What are the signs and symptoms of MI?

A

-chest pain greater than angina that is lasting more than 15 minutes
-not relieved by nitroglycerin
-cyanotic, pale, or ashen appearance
-weakness, cold sweat, nausea, vomiting, air hunger, irregular pulse

98
Q

If a patient has had a heartache less than 8 weeks ago, what is the protocol for dental treatment?

A

no elective dental treatment

99
Q

If a patient has had a heartache more than 8 weeks ago, what is the protocol for dental treatment?

A

maybe can do some elective treatment
-need a med consult tho

100
Q

What should not be prescribed for those that have a history of MI?

A

NSAIDs

101
Q

What is the INR for those that are on anticogaulants?

A

2-3

102
Q

If you are not on blood thinners, what should the INR be?

A

1.1 or below

103
Q

What is the stress reduction protocol?

A

-short appointments
-early morning appointments
-nitrous oxide
-limit vasoconstrictor
-profound anesthesia
-explain everything

104
Q

What is congestive heart failure?

A

-just called heart failure
-> 65 years of age
-result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood

105
Q

Is congestive heart failure an actual diagnosis?

A

no, it is a complex of symptoms
-end stage of many CV disease

106
Q

Signs and symptoms of congestive heart failure:

A

-fatigue and weakness
-ankle swelling (edema)
-clubbing of digits
-syncope
-angina
-breathing difficulties
-increased urination at night

107
Q

Why is there increased urination at night in those that have congestive heart failure?

A

-less blood is pumped to the kidney during the day
-laying down makes is easier for blood to get to the kidneys

108
Q

What is dyspnea?

A

difficult/ labored breathing

109
Q

What is orthopnea?

A

sensation of breathlessness in the recumbent position

110
Q

what is a general term for pulmonary disorders characterized by chronic airflow limitation from the lungs that is not fully reversible?

A

chronic obstructive pulmonary disease (COPD)

111
Q

what was the 3rd leading cause of death in 2020?

A

COPD

112
Q

what is the main risk factor for COPD?

A

smoking

113
Q

what two diseases does COPD encompass?

A

chronic bronchitis and emphysema

114
Q

what is the recommended diagnoses for COPD?

A

the presence of sputum production, and dyspnea together with an abnormal measurement of lung function

115
Q

what is chronic bronchitis?

A

chronic inflammation of the bronchi that produces excessive tracheobronchial mucus production and a persistent cough with sputum

116
Q

when does onset of COPD typically occur?

A

usually begins after age 40
-symptoms develop slowly & many patients are unaware of emerging disease

117
Q

how are patients with chronic bronchitis typically described?

A

-sedentary
-overweight
-cyanotic
-edematous (water-retaining)
-breathless
-“blue bloaters”

118
Q

what is emphysema?

A

permanent enlargement of the air spaces in the lungs that is accompanied by destruction of the air space (alveolar) walla without obvious fibrosis
-also a loss of elasticity
*repeated exposure of irritants

119
Q

what are “pink puffers”?

A

patients diagnosed with emphysema
-enlarged chest walls, weight loss, severe exertional dyspnea, seldom coughing, lack of cyanosis, and pursing of the lips with efforts to forcibly exhale air from the lungs

120
Q

should I add what questions you ask patients?

A
121
Q

what is rheumatic heart disease?

A

a condition in which the heart valves have been permanently damage by rheumatic fever
-may start shortly after untreated or under-treated streptococcal infection (strep throat or scarlet fever)
-can take years to develop

122
Q

how does rheumatic heart disease start?

A

an immune response causes an inflammatory condition in the body which can result in on-going valve damage
-heart valves become inflamed and scarred over time resulting in narrowing or leaking of heart valves

123
Q

what is dementia?

A

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

124
Q

what are the most common causes of dementia?

A

-Alzheimer’s disease
-vascular dementia
-dementia causes by Parkinson’s disease

125
Q

does prevalence of dementia increase or decrease with age?

A

increase
-women more at risk bc they live longer

126
Q

what are the symptoms of Alzheimer’s?

A

-memory loss
-cognitive decline
-behavioral and personality changes

127
Q

what is the cause of Alzheimer’s disease?

A

unknown- appears to involve the loss of cholinergic neurons

128
Q

what is the average lifespan of patient diagnosed with Alzheimers?

A

8 years post diagnosis

129
Q

how does genetic predisposition play a role in Alzheimers?

A

contributes to less than 20% of cases

130
Q

what is the dental management of Alzheimers?

A

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

131
Q

how does Alzheimers affect dental treatment?

A

-patients with mild to moderate disease can receive dental treatment (normal organ function)
-as disease progresses medications are used to manage symptoms that contribute to xerostomia with increased risk for caries

132
Q

what is Addisons disease?

A

primary adrenal insufficiency
-progressive destruction of the adrenal cortex, usually due to autoimmune disease or chronic infectious diseases (TB, HIV, cytomegalovirus**, and some funagl infections)

133
Q

what does Addisons disease do to cortisol levels?

A

decrease
cortisol is responsible for decreasing inflammation, regulating blood pressure, and increasing glucose

134
Q

what does Addions disease do to aldosterone levels?

A

decrease
aldosterone responsible for stimulating Na absorption in kidneys

135
Q

when do Addions disease symptoms occur?

A

progress slowly but a stress (injury or illness) makes the symptoms worse

136
Q

what is secondary adrenal insufficiency caused by?

A

pituitary disease or critical illness

137
Q

what is tertiary adrenal insufficiency caused by?

A

processes that impair function of the hypothalamus
-chronic use of corticosteroids***

138
Q

what are the symptoms of adrenal insufficiency?

A

-fatigue
-weak
-orthostatic hypotension
-poor healing
-inability to tolerate stress
-increased infections
-areas of darkened skin
-salt craving

139
Q

what is Cushing’s syndrome?

A

a condition caused by excessive cortisol in the body

140
Q

what is the most common cause of Cushing’s syndrome?

A

use of steroid drugs

141
Q

what can Cushings syndrome result in?

A

high BP, bone loss, and type 2 diabetes

142
Q

when is Cushings syndrome referred to as Cushings disease?

A

when it is caused by a pathophysiologic process (tumor of pituitary or adrenal glands)

143
Q

what are steroids used to treat?

A

-rheumatoid arthritis
-lupus
-asthma
-psoriasis
-etc

144
Q

what are the clinical features of Cushings syndrome and disease?

A

-weight gain & fatty tissue deposits particularly in face (moon face) and between shoulders (buffalo hump)
-thinning, fragile skin that bruises easily
-abdominal striae
-decreased healing (bc steroids decrease inflammation)
-acne

145
Q

what is an adrenal crisis?

A

potentially life-threatening complication resulting from adrenal insufficiency triggered by emotional and physical stress
-manifests as hypotensive collapse, abdominal pain, myalgia, and fever

146
Q

What is the definition of substance abuse?

A

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

147
Q

What are some signs of alcohol abuse?

A

missed appointments, alcohol on breath, enlargement of the parotid glands and spider angioma

148
Q

what are some consequences of substance abuse?

A

failure to fulfill a major role at work, school, home, legal problems, persistent interpersonal problems

149
Q

What does alcohol cause?

A

-liver and bone marrow damage
-cirrhosis
-vitamin K deficiency
-reduced effect of local anesthetics and benzodiazepines
-nutritional deficiency
-candidal infections

150
Q

What is the definition of binge drinking?

A

> 5 oz / 4 hours

151
Q

What types of cancer can drinking lead to?

A

mouth, larynx, and esophagus

152
Q

How does alcohol cause oral cancer?

A

act as an irritant and damage cells which could lead to DNA changes

153
Q

What can drug abuse cause?

A

interactions with prescriptions and anesthetic
-liver damage
-infectious diseases if share needles

154
Q

What are the oral complications and manifestations of drug abuse?

A

-more plaque, calculus, caries, and gingival inflammation

155
Q

What can cocaine cause orally?

A

gingival recession and erosion of facial aspects

156
Q

What is meth mouth?

A

xerostomia, rampant caries, bruxism, and muscle trismus

157
Q

What is anemia?

A

reduction of oxygen carrying capacity of the blood

158
Q

What is the most common blood condition in the US?

A

anemia

159
Q

What is anemia usually associated with?

A

-decrease number of circulating RBC
-abnormality in hemoglobin
-affects females more than males
-may be caused by underlying diseases
-more than 3 million cases per year in the US

160
Q

What are the four major types of anemia?

A

-iron deficiency
-folate deficiency
-hemolytic anemia
-sickle cell anemia

161
Q

What are some symptoms of anemia?

A

pale
fatigue
low blood pressure
SOB
rapid heart rate

162
Q

What are oral signs of anemia?

A

-smooth, burning red tongue
-bleeding gums
-delayed healing
-increased infection

163
Q

What is pagophagia?

A

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

164
Q

What is anorexia nervosa?

A

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

165
Q

What is bulimia nervosa?

A

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

166
Q

When does anorexia normally start?

A

14-18 years

167
Q

What is the percentage of people with anorexia that are female?

A

90-95%

168
Q

What is the mortality rate of anorexia?

A

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

169
Q

What are the symptoms of anorexia nervosa?

A

-thin and brittle hair
-neck/facial swelling
-fainting
-irritable
-low BP
-anemia
-osteoporosis
-amenorrhea

170
Q

What age does bulimia usually start?

A

20 years old

171
Q

What happens to amalgam fillings when you have bulimia?

A

the restorations are higher than the surrounding enamel

172
Q

What happens to teeth with bulimia nervosa?

A

enamel erosion from acidic chemicals
-lingual of anterior teeth most affected

173
Q

What is perimylolysis?

A

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

174
Q

When are PT tests done?

A

to detect bleeding disorders or excessive clotting disorders

175
Q

What does PT do?

A

measure how quickly blood clots

176
Q

What type of results are PT tests?

A

in seconds
-average time is 10-30 seconds

177
Q

What is INR?

A

ratio used if you are on blood thinning medication

178
Q

What are some examples of autoimmune diseases?

A

rheumatoid arthritis
lupus
sjogrens syndrome
diabetes
graves disease

179
Q

What are rheumatic diseases?

A

large group of disorders/diseases that affect bones, joints, and muscles

180
Q

What are examples of rheumatic disease?

A

psoriatic arthritis, lupus, scleroderma, sjorgen, gout

181
Q

What is osteoarthritis?

A

affects joints such as hips, knees, feet, spine, and hands
-TMJ may also be affects

182
Q

Is osteoarthritis an autoimmune disease?

A

no

183
Q

What is the leading cause of disability in eldery population?

A

osteoarthritis

184
Q

What is rheumatoid arthritis?

A

symmetric inflammation of joints: hands, feet, and knees
-autoimmune disease of unknown origin

185
Q

When does rheumatoid arthritis normally start?

A

35-50 years old

186
Q
  • Multiple symmetric joint involvement
  • Significant joint inflammation
  • Morning stiffness lasting longer than 1 hour
  • Systemic manifestations (fatigue, weakness, malaise)
    All of these symptoms are associated with:
A

rheumatoid arthritis

187
Q
  • Usually, 1-2 joints involved
  • Pain usually without inflammation
  • Morning stiffness lasting less than 15 mins.
  • No systemic involvement
    These symptoms are involved with:
A

osteoarthritis

188
Q

What is systemic lupus erythematous?

A

the most common and most serious type of lupus
-autoimmune disease with unknown etiology
-chronic inflammatory disorder that affects both internal and external systems of the body

189
Q

Does systemic lupus erythematous affect women or men more?

A

women at a 6:1 ratio

190
Q

What aged women are most affected with systemic lupus erythematous?

A

14-44 years of age when estrogen levels are at the highest

191
Q

What is the typical presentation of systemic lupus erythematous?

A

women with polyarthritis and a butterfly-shaped erythematous rash across the nose and cheeks

192
Q

What percentage of people have skin involved with systemic lupus erythematous?

A

85%

193
Q

What can trigger systemic lupus erythmatous?

A

stress, sunlight exposure, and pregnancy

194
Q

What are the oral manifestations of SLE?

A

ulceration, petechiae, and burning mouth syndrome

195
Q

What causes oral candidiasis and infection in patients with SLE?

A

used of cortiocosteroids for treatment

196
Q

What is Sjogren’s syndrome?

A

a chronic, autoimmune, and inflammatory disorder
-characterized by symptoms of oral and ocular dryness and a chronic, progressive loss of lacrimal and salivary function

197
Q

Parotid glands are enlarged in what fraction of people with Sjogren’s syndrome?

A

1/3-1/2

198
Q

What is the ratio of females to males that have Sjogren’s syndrome?

A

10:1

199
Q

What is primary Sjogrens?

A

SS-1
-dry eyes and dry mouth are seen in absence of a connective tissue disease
-not as common

200
Q

What is secondary Sjogrens?

A

SS-2
-more common
-dry eyes and dry mouth are seen together with other autoimmune diseases like RA, SLE, scleroderma

201
Q

Characteristics of Sjogren’s syndrome:

A

eye dryness, hypo salivation, and enlargement of the parotid gland

202
Q

What are secondary outcomes of persistent oral dryness seen in Sjogren’s syndrome?

A

angular cheilosis, dysgeusia (taste dysfunction), burning mouth syndrome, secondary infections, and increased caries rate

203
Q

What are some dental treatments done on those with Sjogren’s syndrome?

A

-topical fluoride daily
-increased productions of saliva-drugs such as pilocarpine
-increased prophylaxis

204
Q

What is epilepsy?

A

chronic and recurrent paroxysmal changes in neurological function (seizure), altered consciousness, or involuntary movements caused by abnormal and spontaneous electrical activity in the brain

205
Q

What percentage of people with epilepsy have complete control of their seizures within 5 years?

A

60-80%

206
Q

What are the three types of seizures?

A

grand mal
petit mal
status epilecticus

207
Q

What are grand mal seizures?

A

-tonic-clonic
most common
-triggered by CV accidents, photic stimulation, fatigue, and intoxication
-last 5-15 minutes
-make take up to 2 hours for normal cerebral function to return

208
Q

What are petit mal seizures?

A

-absent
-occur frequently, multiple daily episodes
-shortly after awakening or during periods of inactivity
-no aura
-duration <10 second

209
Q

What are status epilepticus seizures?

A

continuous seizure or repetitive recurrence of any type of seizure without recovery between attacks
-give benzodiazepines
-rapid onset
-well tolerated with high efficacy

210
Q

What are symptoms of epilepsy?

A

-aura
-unusual smell or vision
-irritability
-epileptic cry
-loss of consciousness
-muscle rigidity

211
Q

What are long term treatments for seizures?

A

Dilantin and tegretol

212
Q

What can dilantin cause?

A

gingival hyperplasia

213
Q

What are the characteristics of uncontrolled epilepsy?

A

> 1-2 seizures a month

214
Q

What are the characteristics of well controlled epilepsy?

A

<1-2 seizures a month

215
Q

What do you do if someone have uncontrolled epilepsy?

A

get a med consult and avoid triggers

216
Q

What do you do if someone has well controlled seizures?

A

get a med consult

217
Q

What are the interview questions for those that have epilepsy?

A
  • How long have you had epilepsy?
  • What type of seizures do you have?
  • How frequently do your seizures occur?
    -What type of medication, if any, do you take to
    control the seizures?
  • How do your seizures begin?
  • Is there a warning at the beginning of the seizure?
  • Can you talk and respond appropriately during a
    seizure?
  • Do you get confused or tired after a seizure?
  • When was your last (or most recent) seizure?
218
Q

What is the management of a seizure in the clinic?

A

-protect patient and try to prevent injury
-do not move patient to the floor
-place chair in supine position
-remove instruments from the area
-do not attempt to restrain or hold the patient
-O2 if necessary
-call 4444

219
Q

What does GERD stand for?

A

gastroesophageal reflux disorder

220
Q

What happens with GERD?

A

stomach liquids regurgitate

221
Q

What can cause GERD?

A

pregnancy
bad sphincter
obesity
alcohol
smoking
can increase with age

222
Q

What are complications/ implications of GERD?

A

halitosis
enamel erosion

223
Q

What medicine should be avoided in those with GERD?

A

codeine
erythromycin

224
Q

What is trigeminal Neuroalgia?

A

tic douloureux
-sudden, severe, electric or stabbing pain
-side of jaw or cheek
-triggered by physical stimulus

225
Q

What are the signs of trigeminal neuraglia?

A

intermittent attacks
lasts several seconds
mostly women >50
may disappear sporadically

226
Q

What are some reasons that a med consult would be necessary?

A

-rheumatic fever
-MI in the last 6 months
-hypertension >160/>100
-unsure of diabetic control
-congenital heart defects
->5 significant meds
-chemo or radiation treatment
-open heart surgery
-solid organ transplant
-major joint replacement
-bone marrow transplant

227
Q

What does medication history need to include?

A

-prescriptions
-over the counters
-herbal, natural, and alternative medicines

228
Q

What do true allergies cause?

A

itching, hives, rash, swelling, and wheezing

229
Q

What does drug intolerance cause?

A

-nausea, vomiting, palpations,
-not a true allergy
-avoid using the drug anyway

230
Q

How are radiographs oriented?

A

with dot convexity facing the clinician
-there are aligned in the same orientation as when looking at the patient
-film mounts should be made out of a material that blocks high around the window that holds the film

231
Q

What are the perferred mounts for X-rays?

A

pocket mounts because they protect of a film survey and serve as an infection control barrier

232
Q

How does radiolucent appear on film ?

A

black

233
Q

What are radiolucent structures in the mouth?

A

cavities, depressions, or opening in bones (sinus, fossa, canal, or foramen)

234
Q

What color radiopaque objects look like on X-ray?

A

white

235
Q

What are radiopaque things?

A

bony in origin or stop the penetration of the X-rays, not allowing them to get to the receptor

236
Q

What is the incisive foramen?

A

a hole in the midline of the lingual aspect of the heard palate above the central incisor tooth crowns

237
Q
A
238
Q

Risk factors of cardiovascular disease: (can’t be changed)

A

-heredity (30% due to genetic factors)
-sex (men develop 10 years earlier than women)
-race (African americans at higher risk)
-age (65 or older)

Patient Care I (4 decks)

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