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BDS4 > Human Diseases > Flashcards

Human Diseases Flashcards

1
Q

A 37 year old man attends your general practice requesting XLA of LR8 due to recurrent pericoronal infection. The pt weights 135kg and is 200cm tall and otherwise healthy. You wish to know the ASA classification for this pt to provide the proper management throughout the dental treatment. What is this pts ASA?
A - ASA I
B - ASA II
C - ASA III
D - ASA IV
E - ASA V

A

B - ASA II
mild disease - BMI ranging from 30-40kg/m2

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2
Q

Which of the following is a syndrome strongly associated with odontogenic keratocysts and basal cell carcinoma?
A - Eagle syndrome
B - Frey syndrome
C - Gardner syndrome
D - Gorlin-Goltz syndrome
E - Crouzon syndrome

A

D - Gorlin-Goltz syndrome

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3
Q

A 71 year old man is seen in the neurology clinic due to gradually progressive tremor, rigidity and recurrent falls. He is diagnosed with Parkinsons disease. Which is the best drug treatment for parkinsons disease?
A - Clonidine
B - Chlorpromazine
C - Dopamine
D - Levodopa
E - Vasopressin

A

D - Levodopa

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4
Q

Which of the following is the best chemical marker for determining whether a patient has had an MI?
A - Alkaline phosphatase (ALP)
B - Creatinine kinase
C - C-reactive protein (CRP)
D - D-dimer
E - Troponin

A

E - Troponin

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5
Q

Hypertensive patient attends for XLA with BP of 155/92. Can you do the extraction today?

A

Yes - modify for patient
- short and morning appointment
- limit adrenaline to 0.04mg per appointment
- limit adrenaline containing retraction cord

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6
Q

Which of the following is a disease typified by multiple osteomas, epithelial cysts and intestinal polyps?
A - eagle syndrome
B - frey syndrome
C- gardner syndrome
D - gorlin-goltz syndrome
E - crouzon syndrome

A

C - Gardner syndrome

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7
Q

How long is maternity exemption certificate valid for free dental care?

A

from 1 month prior to certificate issue until up to 1 year after babies birth.
If baby is still born after 24 weeks, woman is entitled to free dental care up to one year after.

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8
Q

Cardiovascular changes in pregnancy

A

40% increase in plasma volume
Reduced BP
Increased pulse
Fainting
Palpitations

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9
Q

Respiratory changes in pregnancy

A

Reduced total lung capacity
Tidal volume increases
Unchanged respiratory rate

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10
Q

What trimester is pregnancy induced gingivitis worse?

A

3rd

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11
Q

Name the benign oral lesion that can occur in 5% of pregnancies

A

Pregnancy epulus

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12
Q

What medications should be avoided in pregnancy (not including antibiotics)?

A

Teratogens: Valproate - epilepsy medication
Warfarin - associated with fetal warfarin syndrome

Alcohol
NSAIDS
Dihydrocodeine

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13
Q

Which drugs do not cross the placenta?

A

Low molecular weight heparin
Insulin

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14
Q

Which antibiotics are contrindicated in pregnancy?

A

Tetracycline
Ciprofloxacin
Gentamycin

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15
Q

When is a pregnant patient at lowest risk of radiographic effects?

A

Before 10 weeks
After 27 weeks

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16
Q

Name 5 intra oral risk factors for thrush

A

Poor oral hygiene
Salivary gland dysfunction
Oral mucosa damage
Intra oral prosthesis
Changes to commensal flora

17
Q

Name some extra oral risk factors for thrush

A

immunosuppression
endocrine
nutritional deficiences
antibiotics
steroids
smoking
high carb diet
female
extremes of age

18
Q

Topical treatment for thrush

A

Nystatin
Miconazole

19
Q

Systemic treatments for thrush

A

Fluconazole
targetted therapy

20
Q

Miconazole interactions

A

Statins
Calcium channel blockers
Warfarin
Sulphonyureas
Phenytoin
Midazolam
Carbamazepine

21
Q

What is oral mucositis?

A

Oral complication of some cancer therapies.
Inflammation caused by chemotherapy agents or ionisation.

22
Q

When does the onset of oral mucositis usually occur?

A

7-10 days after commencement of therapy (chemotherapy of radiotherapy)

23
Q

management of oral mucositis

A

Analgesia - systemic or topical
Mouth rinse
Mucosal protection
Systems therapies - folinic acid, palifermin

24
Q

What would a challacombe scale score of 9 visibly indicate?

A

Cervical caries (caused by dry mouth)
Need to exclude srjogens syndrome

25
Q

What does a ASA score of V indicate?

A

Moribund patient with poor survival prognosis (<24 hours)

26
Q

Name some IV anaesthetic agents

A

propofol, ketamine, thiopentone

27
Q

Name some gaseous anesthetic agents

A

Nitrous oxide,

28
Q

Name some conscious sedation agents

A

Benzodiazepenes
IV opiods
IV agents
Gaseous agents

29
Q

What are the risks of conscious sedation

A

oversedation
loss of airway
respiratory depression
vomitting and aspiration
idiosyncratic reactions
delayed recovery

30
Q

What is classified as an advanced technique anesthetic?

A

any sedation in patients under 12 other than NO
Benzodiazepine and any other IV agent
Propofol alone or with any other agent
Inhalation sedation using anything other than NO alone

31
Q

Reversal agent for IV midazolam overdose?

A

Flumazenil IV

32
Q

Which of the following can be used to identify and quantify xerostomia?
a. Miller’s scale
b. SPICT
c. Schirmer test
d. Challacombe scale

A

D - Challacombe scale

33
Q

Which of the following is a topical analgesic agent that can be prescribed to treat discomfort associated with oral mucositis?

a. Chlorhexidine mouthwash (0.2%)
b. Soluble paracetamol
c. Benzydamine mouthwash (0.15%)
d. Miconazole oromucosal gel (20mg/g)

A

C - Benzydamine mouthwash (0.15%_

34
Q

Considerations for pregnant patient at the dentist

A
  • inferior vena cava compression - lie on LHS, lateral tilt or manual displacement
  • radiographs
  • drugs: analgesics, antibiotics
  • vomitting
  • increased toilet need, may need longer appointments
  • emotional changes
  • anaemia
  • blood pressure falls at end of first trimester - faint risk
35
Q

what oral manifestations might you see in a pregnant patient?

A
  • pregnancy induced gingivitis
  • increased tooth mobility
  • pregnancy epulus
  • erosion/caries secondary to vomiting, reflux or increase in sugary foods
36
Q

Antibiotics contraindicated in pregnancy

A

tetracyclin
ciprofloxacin
gentamycin

37
Q

Which trimester is the most optimal to provide dental treatment?

A

Second trimester

38
Q

How to minimise risk when taking radiograph of a pregnant patient?

A
  • only take radiographs when necessary
  • use ALARP
  • lead apron
39
Q

Tx for a pregnancy epulus

A

OHI, reassess after delivery
If uncomfortable for pt due to large size consider referral to maxillofacial

BDS4 (13 decks)

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