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SP18: Oral Surgery > Final > Flashcards

Final Flashcards

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1
Q

T/F: Loss of natural teeth leads to progressive bone resorption.

A

True

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2
Q

What are some properties that can alter the amount of bone resorption?

A

Systemic: Nutrition, osteoporosis, endocrine dysfunction
Local: alveoloplasty, dentures, facial form

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3
Q

The ________ is the workhorse for removing sharp edges in bone.

A

rongeur

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4
Q

What is alveoloplasty?

A

Removing/recontouring bone abnormalities in preparation for prosthesis

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5
Q

T/F: Digital compression and interseptal alveoloplasty involve releasing a flap.

A

False

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6
Q

When should you do interseptal alveoloplasty?

A

When the interseptal bone seems loose after extraction

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7
Q

What type of flap should be raised for surgical alveoloplasty?

A

Full thickness

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8
Q

_______ is an overgrowth of bone on buccal surface of mandible or maxilla.

A

Exostosis

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9
Q

T/F: Exostosis are usually seen in maxillary molar areas.

A

True

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10
Q

T/F: Tori are found on the lingual aspect of the mandible.

A

True

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11
Q

T/F: Tori are more difficult to remove than exostosis.

A

True

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12
Q

What are the two major difficulties with maxillary tori removal?

A
  1. Torus may be pneumatized - communicate with nasal passage

2. Closure of wound is difficult - thin tissue

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13
Q

T/F: You will always remove bone when reducing a maxillary tuberosity.

A

False

Can be soft tissue, bone, or both

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14
Q

Patients not using proper care when wearing their denture can develop a fungal infections leading to ____________.

A

inflammatory papillary hyperplasia

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15
Q

What is inflammatory fibrous hyperplasia (epulis fissuratum)?

A

Inflammation for poor fitting denture

Need to cut it off

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16
Q

What is a special consideration when cutting off epulis fissuratum?

A

Must send for histological evaluation

Also patient may have an open wound

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17
Q

What could be some problems with an abnormal labial/lingual frenum?

A

Diastema, speech problems, in the way of a denture

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18
Q

T/F: Management and prevention of odontogenic infection is one of the biggest causes of morbidity/mortality and litigation.

A

True

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19
Q

T/F: The majority of odontogenic infections are from aerobic bacteria.

A

False

Mostly anaerobic but the majority of infections are a mixed group of bacteria

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20
Q

Most odontogenic infections are initiated by __________ bacteria that create an environment succeptible to _________ bacteria.

A

Aerobic; anaerobic

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21
Q

Which types of bacteria contain most of the toxins and antibiotic deactivating enzymes?

A

Anaerobic

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22
Q

What are the three stages in a natural course of infection?

A

Cellulitis -> abscess -> fistula

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23
Q

Cellulitis is primarily caused by what bacteria?

A

Streptococcus

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24
Q

T/F: Advanced cellulitis is diffuse and hard.

A

True

Life threatening

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25
An abscess is primarily _________ bacteria.
Anaerobic
26
What are some factors for where an infection might spread?
Muscle attachment, bone thickness, root angulation
27
T/F: Maxillary infections are more likely to spread buccally than palatally.
True
28
T/F: An infection in the posterior maxilla is likely to stay within the buccinator muscle.
False Anterior max: vestibular infection (inside muscle) Post max: buccal space (outside muscle)
29
Where are infections of the 2nd/3rd molars in the mandible likely to spread?
Submandibular space
30
Where will infections of mandibular premolars likely spread?
Sublingual space
31
T/F: Submental infections are often directly from an anterior tooth.
False Often some other pathology or spread from other areas
32
What is a Ludwig’s Angina?
Bilateral submandibular, sublingual, and submental space cellulitis - life threatening airway obstruction possible
33
What should you be worried about if a patient comes in and truly cannot open their mouth?
Infection to secondary spaces by muscles of mastication - superficial/deep temporal, infratemporal, pterygomandibular, masseteric
34
T/F: Pterygomandibular space infection could be caused by a needle tract infection.
True
35
Infections that spread to the ______________ can cause a variety of serious problems due to having access from the skull to the mediastinum.
Lateral pharyngeal space
36
T/F: High speed hand pieces should be used to section teeth for extractions.
False Can cause infection
37
What can result from using a pneumatic hand piece to section a tooth for extraction?
Rapid fascial space infection
38
T/F: If you have a patient with severe trismus it is likely the infection has spread to a secondary space.
True
39
What is the first step in therapy of infection?
Determine severity
40
T/F: Patients with secondary or neck space infections should be referred immediately.
True
41
T/F: Temperatures over 101 indicate systemic involvement.
True
42
T/F: Oral temperatures are accurate for evaluating systemic involvement.
False
43
T/F: WBC count is a good measurement of the severity of an odontogenic infection.
False Remains elevated throughout treatment
44
What is the most important surgical goal of treatment?
Remove source of infection! Also, drain pus and relieve tension
45
T/F: Incisions should be made through healthy tissue to drain pus.
True Heals better
46
What is the empiric therapy with antibiotics?
No time for culture so you give antibiotics for what you think bacteria is
47
If the patient is penicillin allergic what would you give them?
Clindomycin
48
What is the first line of antibiotics for infection?
Amoxicillin Possibly with metronidazole
49
T/F: Most recurrent infections are do to poor antibiotic use.
False Inadequate surgery: source remains, all spaces not explored, inadequate drainage
50
What are some steps to take if the infection is not improving?
1. Confirm pt is complying 2. Look for additional source 3. Get another CT scan
51
What is a metastatic infection?
Occurs at a place other than the operation site
52
What are the four criteria to get a metastatic infection?
1. Surgical manipulation 2. Transient bacteremia 3. Distant susceptible site 4. Infection
53
What are the three conditions (post 2007) that require antibiotic prophylaxis?
1. Prosthetic cardiac valve 2. Previous infective endocarditis 3. Cardiac transplant with valve defects
54
T/F: The vast majority of SBE (subacute endocarditis) from dentistry is streptococcal and following extractions.
True
55
T/F: Scaling and root planing requires prophylaxis.
True
56
What is standard prophylaxis regimen?
Amoxicillin 2gm - 1 hour before operation
57
T/F: Amoxicillin is better because it effects a broader spectrum of bacteria.
False Better absorption, higher plasma level, slower excretion
58
What will you give patients for prophylaxis who have penicillin allergy?
Clindamycin 600mg - 1 hour pre-op
59
T/F: If a patient is already taking antibiotics they don’t need another one for prophylaxis.
False
60
T/F: Ventricular shunts (in brain) need to be prophylaxed.
True
61
T/F: A patient with an AV dialysis shunt needs prophylaxis.
True
62
T/F: All patients with artificial joints should be prophylaxed.
False 2015 paper showed it is not necessary
63
T/F: If the patient wishes to be prophylaxed with an artificial joint you should do it.
False
64
What is the most important way to prevent infection?
Superb technical surgery
65
When should the first dose of antibiotic be for wound prophylaxis?
Before surgery
66
What is the correct dosage for prophylaxis of wound?
2x the therapeutic dose
67
T/F: For wound prophylaxis, antibiotics should not be continued post-surgery.
True
68
What are two key indicators for taking a biopsy?
1. Lesions that persist for two or more weeks with no known etiology 2. Any inflammatory lesion that does not respond to local therapy within two weeks
69
T/F: Lesions that interfere with function should be biopsied.
True
70
A _______ is a raised fluid filled lesion in or under the epithelium.
Bulla
71
________ is a superficial ulcer.
Erosion
72
A __________ is a flat lesion typically brown or blue.
macule
73
A _________ is a small elevated palpable mass.
Papule
74
A __________ is a large elevated palpable mass.
nodule
75
A __________ is a very slightly elevated confluence of papules often seen in smokers.
Plaque
76
_________ are cloudy or white vesicles filled with pus.
Pustules
77
A macroscopic accumulation of keratin is a ________.
Scale
78
An __________ results in the loss of epithelium.
Ulcer
79
A ___________ is a small loculation of fluid in or under the epithelium.
Vesicle
80
What are some important factors in evaluating a lesion?
1. Size and shape 2. Single vs multiple 3. Color 4. Borders
81
T/F: Red, Ulcerative, bleeding lesions are all red flags for malignancy.
True
82
What are the four types of biopsies?
1. Cytology 2. Aspiration 3. Incisional 4. Excisional
83
Why can aspiration be important to do before biopsies?
See if bony lesion is vascular or not
84
T/F: Normal tissue should be included in a biopsy.
True
85
T/F: Anything greater than 1 cm should be biopsied with an incisional technique.
True
86
What biopsy technique should be used for suspected malignancies?
Incisional
87
T/F: Incisional biopsies should be broad and shallow.
False Deep and narrow
88
T/F: Small (< 1cm) lesions can be biopsied with excisional technique.
True
89
How large of a border should you leave around a malignant soft tissue biopsy?
5 mm
90
T/F: High volume suction should be applied after biopsy.
False Gauze to stop bleeding and suture
91
T/F: Sometimes it is necessary to undermine the tissue prior to closure.
True
92
T/F: A prescription is a written instruction for the preparation and administration of medication.
True
93
T/F: The pharmacist has the responsibility to refuse prescriptions that are unsafe or inappropriate.
True
94
What constitutes a patient-provider relationship?
1. Chief complain and diagnostic studies 2. History of illness and diagnosis 3. Medical history 4. Physical exam
95
T/F: Anti-hypertensive and hypoglycemic drugs are appropriate to prescribe as a dentist.
False
96
What are schedule 1 controlled substances?
High abuse with no medical use Ex. Heroin, LSD, marijuana (in ohio)
97
T/F: Schedule II drugs have an accepted medical use.
True Highly addictive (oxycodone, adderall, percocet)
98
T/F: Schedule V drugs have the lowest risk for abuse.
True
99
T/F: The date issued on a prescription can be planned ahead.
False
100
How must you write the quantity of drug for DEA controlled substances?
Write and spell number Ex. Ten (10). Twenty (20).
101
T/F: Schedule II drugs can be refilled.
False
102
What does B.I.D stand for?
Twice daily
103
What does a.c. Stand for?
Before meals
104
What does H.S. Stand for?
At bedtime
105
What does p.o. mean?
By mouth
106
What does p.r.n. Mean?
As needed
107
What does q.i.d. Mean?
four times a day
108
What does q.4.h. Mean?
every 4 hours
109
What does t.i.d. Mean?
Three times a day
110
T/F: If a patient calls for a refill of narcotics they must be seen first.
True

SP18: Oral Surgery (2 decks)

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