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CDM 3 Exam 1 > Lecture 4 - Oral Health & Infections > Flashcards

Lecture 4 - Oral Health & Infections Flashcards

(52 cards)

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1
Q

Recurrent aphthous stomatitis (RAS)

A

canker sores

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2
Q

Risk Factors canker sores

A

Stress
local injury
non-smoker
hormonal changes
genetics
certain diseases
Vit/mineral deficiencies
non-infectious

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3
Q

signs and symptoms of canker sores

A

ulcers form on moveable parts of mouth
painful
look like craters

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4
Q

minior canker sores

A

85% incidence
usually ~ 1 lesions
none to moderate pain
< 1 cm
duration 5-7days

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5
Q

Major canker sores

A

5% incidence
2-10 lesions
none-moderate pain
0.5- 2cm
duration 7-14 days

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6
Q

Herpetiform

A

~10% incidence
multiple crops
severe pain
1-4cm
Any intraoral area no self care
duration ~60 days

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7
Q

Self-treatment exclusions ulceres

A

present > 2 weeks
Frequent recurrent
Systemic illness or other Identifiable cause of ulcers
prior unsuccessful treatment

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8
Q

Major risk factors oral cancer

A

tobacco use
Heavy alcohol drinking

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9
Q

Other risk factors for oral cancer

A

HPV infection
male
> 55yrs old
Exposure to sunlight
Poor nutrition
Immunsuppresion

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10
Q

Non-pharm canker sore treatment

A

Apply ice for 10min
Rinse warm salt water or mouthwash
apply baking soda to ulcer
Avoid exacerbating factors

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11
Q

OTC oral debriding/wound cleaners

A

Carbide peroxide or Hydrogen peroxide (each has specific directions)

MOA: release O2 to mechanically cleanse the ulcer

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12
Q

Topical oral anesthetics

A

Benzocaine products

MOA: block conduction of nerve impulses to reduce pain

use ~4 times per day

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13
Q

Precaution/warnings of topical oral anesthetics

A

hypersensitivity reactions
Can be irritating
Methemoglobinemia = V rare

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14
Q

OTC topical oral protectants

A

MOA: provide protective barrier over canker to limit friction and irritation

place over sore for 10-20sec and stays on until dissolved

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15
Q

Prevention of canker sores

A

Avoid foods that can use it
stiff toothbrush
SLS toothpaste

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16
Q

Cold sore trigger of reactivation

A

Fatigue
Windburn
Stress
Fever
Immunosuppression
Common cold
injury
UV radiation

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17
Q

Self treat exclusions of cold sore

A

> 14 days present
increasing rate of recurrence
Infection
Immunosuppression

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18
Q

non-pharm cold sore treatment

A

wash hand frequently
clean lesson with gentle soap and water
keep lesions to prevent cracking
avoid identified triggers

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19
Q

OTC cold sore option

A

Docosanol 10% (Abreva)

Only FDA approved OTC, 12yrs+
reduces severity and duration

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20
Q

Docosanol 10%

A

MOA: inhibit fusion between HSV and human cells

use 5 times per day

ADE: mild burning/stinging

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21
Q

Cold sore supplements

Study These Flashcards
A

Lysine
Lemon balm
Tea tree oil = similar to acyclovir cream efficacy
Vitamin E

22
Q

Systemic antivirals

Study These Flashcards
A

Acyclovir
Valacyclovir
Famciclovir

23
Q

Dosing for -clovirs

Study These Flashcards
A

Initial treatment usually different than dosing for recurrence

24
Q

MOA & adjustments for -clovirs

Study These Flashcards
A

MOA: inhibit viral DNA synthesis and replication

have to be renal dose adjusted

25
counseling points
maintain hydration start first sign of prodrone ***Famciclovir contains lactose****
26
Indications for chronic suppressive treatment of cold sores
frequent recurrence, no clear prodrome recurrences affect quality of life recurrences associated w/ serious systemic complication can use episodically, such as triggeres
27
Options for suppressive old sore treatment
Acyclovir 400mg BID Valacyclovir 500-1000mg QD Famciclovir 500mg BID
28
Xerostomia
Dry mouth
29
Risk factors for dry mouth
Medications*** anticholinergic** TCA** Anti-psych** Anti-hist 1st gen** Antihypertensive Benzo opioids muscle relaxants
30
Risk factors for dry mouth
Depression DM Crohns Soren's = most common HIV substance use Hx of radiation
31
prevention of caries
thorough brushing/flossing use fluoride-enriched products toothpaste w/o SLS avoid high sugar/acid food+drink regular dental care
32
self treatment exclusions for dry mouth
periodontal disease damage,decay,etc Signs of infection Evidence of mouth trauma Gums bleeding w/o identifiable cause Use dentures dont fit right
33
dry mouth therapeutic lifestyle changes
Avoid alc, caffeine, tobacco, hard to chew food sip water throughtday + while eating chew sugar free gum take suspected meds before eating
34
risk factors tooth hypersensitivity
Erosion of enamel = brush to hard/stiff bristles Acidic food/drink Gum disease Gridning teeth whitening products
35
signs & symptoms of tooth hypersensitivity
Sharp pain caused by temp or sugary food/drink Varies in severity
36
How does tooth hypersensitivity vary from toothache
toothache is not self treatable hypersensitivity occurs in response to stimuli
37
self treatment exclusions for tooth hypersensitivity
constant dull pain = indicative of toothache damage or loosening of teeth signs of infection evidence of mouth trauma gums bleeding w/o identifiable cause use of dentures that dont fit correctly
38
Therapeutic lifestyle changes for tooth hypersensitivity
avoid acid food/bev avoid whitening toothpastes/products Proper toothbrushing
39
Desensitizing toothpaste info
MOA: decrease excitability of neurons in dentin (Potassium nitrate 5% active ingredient) age 12+ takes 2-4 weeks, use instead of regular toothpaste
40
viral pharyngitis
conjunctivitis Rhinorrhea+cough Oral ulcer Hoarseness Diarrhea Rash
41
bacterial pharyngitis
abrupt onset of sore throat fever HA GI upset Patch exudates Palatal petichiae Scarlatiniform rash Anterior cervical adenitis Exposure to GAS pharyngitis
42
Screening Culture
Advantages: 90-95% sensitivity/sepcigicity Disadvantages: 18-24hrs incubation
43
Screening Rapid Antigen Detection Test
Advantage: immediate results Disadvantage: 70-90% sensitivity
44
Drugs to avoid for bacterial pharyngitis
Tetracyclines: prevalent resistance in GAS Sulfonamides: not effective elim GAS Fluoroquinolone: more adverse effects
45
Symptoms management pharyngitis
Tylenol= 10-15mg/kg q4/6hrs,max 5doses/24hrs ibuprofen = 10mg/kg (400max) q4/6hrs, max 40mg/kg or 2400mg/day
46
Symptoms management pharyngitis
Tylenol= 10-15mg/kg q4/6hrs,max 5doses/24hrs ibuprofen = 10mg/kg (400max) q4/6hrs, max 40mg/kg or 2400mg/day phenol 1.4% spray = topical Avoid aspirin
47
1st line penicillin ADE
common: stomach discomfort, N, V Serious: C.diff, Hypersensitivity
48
1st line penicillin pt counseling
take w/ or w/o food shake suspension before using store in fridge, throw away after 14 days
49
1st line amoxicillin ADE
Common: N/V/D, HA, rash Serious: hypersensitivity, SJS, TEN, eryhtema multiforme
50
1st line amoxicillin Pt counseling
Take w/ or w.o food shake suspension before using store in fridge, throw away after 14 days
51
non-anaphylactic PCN allergy Cephalexin + cefadroxil
Cephalexin: common = D, serious - SJS,TEN, Hypersensitivity Cefadroxil: Common = N/D, Serious = SJS, multiform, C.diff, hypersensitivity, thrombocytopenia
52
anaphylactic PCN allergy Clinda,Clarith,Azith- thromycin
Clinda/Clarith = dont refridge Azith = store room temp or fridge, discard 10 days

CDM 3 Exam 1 (10 decks)

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