Mock QE Study Guide Flashcards
(113 cards)
1
Q
what enzyme is deficient with lesch nyhan
A
hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency
2
Q
what builds up in the blood in a patient with lesch nyhan
A
uric acid
3
Q
lesch nyhan is associated with what clinical presentations
A
gout, poor muscle control, moderate developmental delay, kidney problems, involuntary and repetitive movements, and self mutilating behaviors
4
Q
HPRT deficiency is associated with what vitamin deficiency? what is the result of this?
A
B12 deficiency –> megaloblastic anemia
- large red blood cells with inner contents not completely developed
- less cells and die earlier = anemia
5
Q
williams syndrome is a result of what (genetically)?
A
deletions of 26-28 genes on chromosome 7
6
Q
what personality is associated with william’s syndrome?
A
cocktail personality (outgoing)
7
Q
what are the facial features associated with william’s syndrome?
A
broad forehead
puffiness around the eyes
flat bridge nose
full cheeks
small chin
8
Q
what dental problems are associated with william’s syndrome
A
small teeth
spacing
missing
9
Q
what heart problems are associated with williams syndrome
A
supravalvular aortic stenosis (SVAS)
coronary artery stenosis
*increased risk with general anesthesia –> cardiac arrest
10
Q
why are patients with william’s syndrome more at risk for arteriopathy
A
it is an elastin disorder where less elastic vascular walls lead to arteriopathy
11
Q
what is the mechanism of action of nitrous oxide
A
inhibition of the NMDA receptor to excitatory glutamate
stimulation of GABA receptor
12
Q
is nitrous oxide soluble or insoluble?
A
relatively insoluble
13
Q
what are the contraindications to nitrous oxide
A
current respiratory tract infection, recent middle ear surgery, pregnancy, methylenetetrahydrofolate reductase deficiency, vitamin B12 deficiency
14
Q
what is the rate of cancer
A
1 in 300 kids get cancer
80% 5 year survival rate
15
Q
which syndrome is a risk factor for cancer
A
down syndrome
16
Q
what is the most common cancer in kids
A
ALL
17
Q
what is the most common cancer in teens
A
hodgkin lymphoma
18
Q
leukemia has a higher incidence in what racial group
A
white children
19
Q
when is ALL typically diagnosed
A
2-4 years old
20
Q
what is the 5 year survival rate of ALL
A
90%
21
Q
how is ALL treated
A
4-6 week induction, months of chemo, 2-3 years of maintenance
transplant for high risk cases or recurrence after remission
22
Q
when is AML diagnosed
A
1 and teens
23
Q
what is the survival rate of AML
A
64%
24
Q
what is the treatment of AML
A
induction chemo, CNS prophylaxis, post-remission therapy
transplant for high risk cases
25
what dental issues do we see in pediatric patients with cancer
tooth agenesis, microdontia, enamel hypoplasia, irregular roots, reduced mandibular length
26
true or false: vaseline can help with dry lips in cancer patients
false: do not use a petroleum based product, use lanolin
27
at what ANC should you defer elective care and use prophylactic antibiotics
1000
28
at what platelet count should you defer elective care and consult the physician
60,000; may need platelet transfusion before and 24 hours after
29
when should antibiotic prophylaxis be considered for a cancer patient
immunocompromised, central line
30
is it appropriate to do a pulpotomy in a cancer patient?
no pulpotomies in primary
endo 1 week before chemo in permanent
31
what considerations should be made when pursuing orthodontics in a pediatric cancer patient
remove braces if patient has poor oral hygiene or is at risk for mucositis
resume after 2 years disease free survival
32
when should extractions be done in a patient undergoing chemo
7-10 days before chemo
if tooth was infected, then also give antibiotics for 1 week after the extraction
33
what medication can be used for prevention and treatment of mucositis
palifermin
oral cryotherapy for mucositis
34
how long should dental treatment be deferred following a stem cell transplant
100 days
35
is intervention necessary for loose primary teeth in children with cancer
loos primary teeth should be allowed to exfoliate naturally
extract teeth with perio pockets
36
when do blood counts fall and rise again following chemo
fall 5-7 days after starting chemo
rise after 14-21 days before starting next cycle
37
what is the normal range for ANC
1500-8000
38
what is the normal range for lymphocytes
1500-3000
*high numbers in leukemia
*low numbers of functional lymphocytes
39
what is the normal range for platelets
150k-400k
40
what is the normal range for hematocrit
32-52%
41
what is the normal range of RBCs
4-6 million/mm^3
42
what is the normal range of WBCs
4000-12,000 mm^3
43
if there is radiographic lesion in a cancer patient, what steps should be taken
refer to PCP for lab values or order CBC yourself
44
what percentage of hemophilia A patients develop inhibitors
10%
45
true or false: hemophiliacs can have aspirin
false: no aspirin for hemophiliacs
46
what is avitene
absorbable topical hemostatic agent = bovine dermal collagen
promotes aggregation of platelets and formation of fibrin
47
what is the purpose of amicar
promotes clotting; can be used in bleeding disorders, cancer, liver diagnosis
48
what needs to be done for a patient with hemophilia that is having a block or an extraction
40% factor replacement
49
what is stimate
- used to help stop bleeding in patients with von Willebrand's disease or mild hemophilia
- causes the release of von Willebrand's antigen from the platelets and the cells that line the blood vessels where it is stored
50
what are examples of acyanotic congenital heart disease
ventricular septal defect
atrial septal defect
aortic stenosis
coarctation of the aorta
51
an acyanotic congenital heart disease defect causes what direction of shunting of blood?
left to right shunting of blood
52
a cyanotic congenital heart disease defect causes what direction of shunting of blood?
right to left shunting of blood
53
what are examples of cyanotic congenital heart disease
tetralogy of fallot
transposition of the great vessels
truncus arteriosis
tricuspid atresia
total anomalous pulmonary venous return
54
what congenital heart defect is associated with CHARGE syndrome
ventricular septal defect
atrioventricular septal defect
atrial septal defect
55
what congenital heart defect is associated with DiGeorge syndrome
aortic arch anomalies
tetralogy of fallot
56
what congenital heart defect is associated with down syndrome
atrioventricular septal defects
ventricular septal defects
57
what congenital heart defect is associated with marfan syndrome
aortic root dissection
mitral valve prolapse
58
what congenital heart defect is associated with noonan syndrome
pulmonic stenosis
atrial septal defect
59
what congenital heart defect is associated with turner syndrome
coarctation of the aorta
bicuspid aortic valve
60
what congenital heart defect is associated with Williams syndrome
supravalvular aortic stenosis
61
what are the cardiac conditions requiring SBE prophylaxis
- Prosthetic cardiac valve, or prosthetic material used for cardiac valve repair
- Previous history of infective endocarditis
- Unrepaired cyanotic congenital heart disease; including palliative shunts/conduits
- Completely repaired congenital heart defect during first 6 months following procedure (if repaired with prosthetic material/device)
- Repaired congenital heart disease with residual defects at the site or adjacent to the site of prosthetic patch/device
- Cardiac transplant recipients who develop cardiac valvulopathy
62
what are the components of tetralogy of fallot
pulmonary valve stenosis
ventricular septal defect
shifting of the aorta (overriding aorta)
right ventricular hypertrophy
63
is it appropriate to do a pulpotomy in a cardiac patient?
- pulp therapy is not indicated in primary teeth because of high incidence of associated chronic infection; extraction is preferred
- endo therapy in permanent teeth can usually be accomplished successfully
64
what are the levels of sedation
I - anxiolysis
II - interactive
III - non-interactive, arousable with mild/moderate stimuli
IV - non-interactive, arousable with intense stimuli
V - GA
65
GA clearance time
clear liquids - 2 hours
breast milk - 4 hours
infant formula - 6 hours
nonhuman milk - 6 hours
solids - 6 hours
66
what is the concentration of oral versed
2 mg/mL
67
what is the dosage of oral versed
0.5-1.0 mg/kg
68
what is the maximum dose of oral versed (and for riley)
general: 20 mg or 10 mL
Riley: 15 mg or 7.5 mL
69
what is the concentration of nasal versed
5 mg/mL
70
what is the dosage of nasal versed
0.3 mg/kg
71
what is the maximum dosage of nasal versed
10 mg or 2 mL
72
how is flumazenil used
concentration = 0.1 mg/mL
dose: 0.01 mg/kg
administer over 15 seconds
repeat every 60 seconds PRN up to 5 doses
max dose is 0.2 mg or 2 mL
73
what is the concentration of hydroxyzine
10 mg/5 mL
74
what is the dose of hydroxyzine
1.0-2.0 mg/kg
75
what is the maximum dosage of hydroxyzine
25 mg or 12.5 mL
76
what is the dosage for diazepam
0.7 mg/kg
or 1 mg for every year of age
77
how are amides metabolized
by p450 enzymes in the liver
78
how are esters metabolized
in plasma by pseudocholinesterase
79
what are the symptoms of local anesthetic overdose
- generalized tonic-clonic seizure or CNS depression
- hypotension
- bradycardia
- respiratory depression
80
what is done at an ortho record appointment
exam (facial analysis, intraoral exam, functional analysis)
panoramic radiograph
cephalometric radiograph
extraoral and intraoral pictures
diagnostic records/impression/scan
81
when is mixed dentition
6-13 years old
82
what is the most frequently missing permanent tooth
mandibular second premolar > maxillary lateral incisor
83
what percentage of ectopic eruptions self correct by 9
70%
84
why correct anterior crossbites
- improve esthetics
- redirect skeletal growth
- reduce attrition
85
what are the ways to correct anterior crossbites
- tongue blade/popsicle stick
- resin/acrylic ramp
- lower inclined plane
- hawley with palatal spring
- fixed palatal wire with palatal spring
- fixed transpalatal wire with springs
- bracket and archwire
86
what are ways to do maxillary expansion
- fixed palatal wire (W wire or quad helix)
- fixed jackscrew expander (rapid palatal expander)
- removable split-acrylic plate expander
87
selective equilibrium
- reduction/slanting
- lingual of upper primary canines
- labial of lower primary canines
88
how to correct posterior crossbite
RPE
Hyrax
89
for a patient with true class III occlusion, what headgear should be done
- reverse pull headgear/facemask to encourage maxillary growth
- chin-cup to restrict mandibular growth
90
how does treatment of true class III differ from pseudo class II
tx for true class III: directed at dentofacial orthopedic changes to correct skeletal malocclusion
tx for pseudo class III: directed at advancement of maxillary incisor segment to eliminate interference
91
what percentage of primary dentition posterior crossbites have a functional shift?
90%
92
what is the cause of functional posterior crossbites
typically due to bilateral maxillary constriction
93
what habits are usually associated with functional posterior crossbites
thumb sucking or mouth breathing habits
94
what appliances are used to correct functional posterior crossbites
rapid palatal expanders
hyrax
fixed archwire expanders
95
bilateral crossbites make up what percentage of crossbites in children
2-3%
96
bilateral posterior crossbites are associated with what
- dolichofacial skeletal vertical growth
- open bite malocclusion
- compromised airways
- mouth breathing
97
definition of bilateral posterior crossbite
true maxillary skeletal constriction with bilateral buccal segment crossbite, midline symmetry, and no notable shift of mandible
98
what is the basic treatment for a bilateral posterior crossbite
emphasis on sutural separation for significant transverse discrepancy
- fixed palatal expanders
- requires multi-phased comprehensive treatment plan
99
what is the incidence of ectopic eruption of first permanent molars
2-3% in maxillary arch, rare in lower arch
100
when is irreversible ectopic eruption diagnosed
no self correction by age of 7
101
when is intervention with ectopic eruption of first permanent molars indicated
- potential space loss with blocked first molars
- loss of second primary molars
- asymmetric arch development
102
what treatment is necessary if ectopic eruption of first permanent molars is not necessary if not self-corrected by age 7
- interceptive therapy with appliances to guide molar into place
- brass ligature wire or elastic separators
- careful disliking of second primary molar distal ledge that the molar is "caught" on
- humphrey appliances or halterman appliance
103
what is the transition of wires
0.012 NiTi
0.014 NiTi
0.016 NiTi
0.016 SS
0.016 x 0.016 SS - square
16 x 22 SS for power chains
104
a flush terminal plane will lead to what occlusion
end to end
class I
class II
105
a mesial step will lead to what occlusion
usually class I but sometimes class III
106
a distal step will lead to what occlusion
usually class II
107
what is the most frequent dental signs of hypophosphatasia in children
- premature loss of primary teeth
- decrease in height of alveolar bone
- malocclusions
108
what condition can have oral apthous ulcers and genital ulcers
Bechet disease
109
mouth ulcers and butterfly rash on face
systemic lupus erythematosus
110
crohn's disease can cause what
oral ulcers
111
facial asymmetry, can be missing condyle and/or parotid gland
goldenhaar
112
what is the dosage of amoxicillin for an infection
20-40 mg/kg/day divided into 3 doses
113
