Module 8 Exam 3 Flashcards by Hailey Fawson

What is a seizure

CHRONIC RECURRENT paroxysmal changes in neurologic function
altered funct
involuntary movement

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Do all seizures imply epilepsy

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what can seizures be related to

stress
sleep deprivation
alcohol or drug withdrawal
fever
decreased O2
trauma

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What is the dogs ability to detect

it is not understood, could be subtle change or scent

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What is the pathophysiology of epilepsy

excessive focal neuronal discharge

- altered Na channel, neuronal membrane, synaptic transmission, decreased electrical threshold

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What can epileptic seizures be evoked by?

flickering lights, monotonous sounds, music, loud noise

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what may be depressed in epilepsy

-hypothalmus may be depressed so person loses conciousness

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What are the phases of a grand mal seizure

Tonic/Clonic

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What procedes a grand mal seizure

aura

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what is an aura

unusual smell, visual disturbance, irratability

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*what is a sudden epileptic cry

-spasm of diaphragm

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What is the tonic phase of a grand mal seizure

gen muscle rigidity
pupil dilated
eyes roll up or to side
loss of conciousness

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What is the clonic phase of a grand mal seizure

-uncoordinated movements

rhythmic contractions, limbs, forced closure of mouth

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What are characteristics of a grand mal seizure

-doesnt last more than 90 sec
followed by headache, stupor, confusion
urinary incontinence

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Tonic:sudden_____
Clonic:rhythmic_____

stiffening and contraction

twitching or jerking

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What is a petit pal seizure

absence seizure

-slow electrical discharge, appears to be day dreaming

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What is status epilepticus

-repeated seizures in a short period of time without recovery

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what happens to a patient physically with status epilepticus

-pt can become hypoxic, acidic, and suffer permanent brain dysfunction

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Is there any alteration in a pt with seizures in dental treatment if they are well controlled

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What side effects of drugs should we be aware of in management of a pt with seizures

drowsiness, slow speech, dizziness

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What should you do in the dental offices if a seizure occurs

-clear area
turn pt to size to avoid aspiration
passively protect

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what should you do in the dental office after a seizure occurs

examine for traumatic injury

- discontinue tx

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What is a stroker (CVA) caused by

interruption of oxygenated blood to the brain

-decreased blood supply or ability of RBC to carry O2

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What is the neurologic deficit or disability is depentent on what of a patient who survives a stroke

duration, tissue death, location

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What deficits occur in a stroke

``` -unilateral paralysis numbness sensory impairment blindness dizziness dysphagia ```

What is a transient ischemic attack?

temporary disturbance in blood supply, numbness on one side, weakness, tingling, speech disturbances

How do you prevent a TIA

identify: HTN, diabetes, cholesterol, smoking anticoagulant corticosteroids to reduce edema

What are the dental managment considerations should we use in a patient post TIA

-only urgent care for the first 6 mo post attack -optimal OH medication

What medications should be evaluated in a patient who is post TIA?

- Inhibit platelets * clopidogrel (plavix) - Inhibit Vitamin K * warfarin (coumadin)

What is the most serious drug interaction with warfin

asprin

In a patient post TIA is L.A. ok? nitrous ok?

-cardiac recommendation -yes get a consult

WHat is Parkinsons Disease

- degenerative disease of the basal ganglia involving the dopamine secreting pathway - destructive leisons in the limbic, motor, and regulation of autonomic system

What is the etiology of parkinsons disease

unknown

What are the signs and symptoms of parkinsons disease

``` -muscle rigidity facial impassiveness tremors stooped posture pain-musculoskeletal burning bowel and bladder dysfunction ```

What is the medical tx for parkinsons

-no tx -increase in dopamine levels in CNS substantia nigra cells deteriorate

what is dopamine

-neurotransmitter

What medication should we know in the tx of parkinsons

levodopa (L-dopa), converted to dopamin in the brain Dopamine Agonists -roprinirole (requip) MAO-B Inhibitors* most commonly prescribed asagiline (azilect)

What should we know about dental tx in a pt with parkinsons

- manage excess saliva | - extensive OH instruction, power brush

what do parkinson drugs cause

-xerostomia, nausea, tardive dykinesia

What is alzheimers/dementia

- chronic progressive degenerative cognitive disorder, in people over 65, - degeneration of cholinergic neurons neurotranmitters acetylcholine/glutamine

what is the etiology of alzheimers/dementia

unknown, may be a genetic predisposition

What are the signs and symptoms of alzheimers

-loss of memory, personality change, inability to work or do daily activities, loss of motor skills, anxiety, loss of inhibitions

What do we do in the dental office in the management of alzheimer pts in the intial stage

- short words and sentences - repeat instructions - 3 mo recall - complete complex tx

what do we do in the dental office in the managments of alzheimer pts in the later stages

maintain dental status, minimize deterioration

What are oral complications of alzheimers

``` xeriostomia mucosal leisons candidiasis excessive plaque and calc deposits perio disease increased caries intraoral trauma from falls ```

What is multiple sclerosis

- most common autoimmune disease of the nervous system | - demylination of neurons

what is the etiology of multiple sclerosis

unknown, suspect its triggered by infectious agent

what are signs and symptoms of Multiple sclerosis

-dependent on area of brain, -visual, abnormal eye movement -vertigo- coordination- weakness -motor disturbances -bowel and bladder incontinence pain fatigue

How do we manage a MS pt in the dental office

-optimal OH -conticosterioids are immuno suppressive -dry or burning mouth -dysarthria parasthesia numbness of oral facial structures trigeminal neuralgia

What is amyotophic lateral sclerosis also known as

ALS, Lou Gehrigs disease

what is ALS

- chonic, progressive, fatal disease | - gradual degeneration of the nerve cells in the CNS that control voluntary muscle movement

What percentage of people with ALS die within 18 mo

50%

Is the mental awareness of an ALS patient altered

NO, they retain memories, personality, intellegence, sight, hearing

In ALS what does the brain lose the ability to do

-initate and control voluntary movement

What are signs and symptoms of ALS

-dysphagia dysarthria spasticity unable to: speak, swallow, walk, cant move unable to maintain bladder and bowel control

What is the etiology of ALS

unknown

What is treated in ALS

pain and depreession

what medication reduces the damage to neurons by decreasing the release of glutamate*

riluzole (Rilutek)

what is the most excitatory neurotransmitter in the nervous system

glutamate

what should we do in dental tx of a patient with ALS

- complete major tx ASAP - occlusal guard for grinding - optimal OH - oral rinses

Module 8 Exam 3 Flashcards

(60 cards)