Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 Past Papers > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

common perioperative complications

A

difficult access, fracture of crown/root/alveolar bone/jaw/tuberosity, broken instrument, damage to soft tissue/nerve/adjacent teeth, haemorrhage, abnormal resistance, involvement of maxillary antrum, loss of tooth, dislocation of TMJ, wrong tooth, extraction of permanent tooth germ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

part of root is missing when extracting 2nd premolar
what radiograph to assess

A

periapical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

anatomical structures supplied by mental nerve

A

lower lip, chin, mucosa of anterior teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

correct terminology of dry socket

A

alveolar osteitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

signs/symptoms of alveolar osteitis

A

dull, aching pain
pain radiating to ear
kept up at night
bad odour/taste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how to manage alveolar osteitis

A

reassure pt, give analgesia
give LA and irrigate socket to remove debris
curettage and debridement of socket to encourage bleeding and new clot formation
give antiseptic pack
alveogyl dressing
check socket to ensure no remaining debris/tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what type of drug is warfarin and what is the mechanism of action

A

vitamin k antagonist anticoagilant
inhibits vitamin k production which is responsible for production of clotting factors, therefore clotting synthesis does not occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what type of test must be carried out when pt on warfarin

A

INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what guidance to refer to for advice on dealing with pt on warfarin
what time frame should this be carried out prior to XLA

A

SDCEP
ideally no more than 24hrs, can be 72hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

below what INR level would it be safe to continue with extraction

A

less than 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

outline options to carry out clinically to deal with post-op bleeding

A

reassure and support pt
administer LA, debridement of socket, surgicel, bone wax, diathermy, pressure
suture wound closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if you could still not stop bleeding after management, what would you do

A

refer to specialist, vitamin k injection, surgical injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

removal of 48
what nerves must be anaesthetised

A

inferior alveolar, lingual, long buccal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to assess anaesthesia has been achieved

A

check for blanching, use a probe to poke around PDL, ask the pt if anything feels sharp or just pressure
ask pt if they feel numb [tongue/lip depending on where LA]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pins and needles feeling, or partial loss of sensation

A

paraesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

painful, unpleasant or neuralgic sensation that lasts for a fraction of a second

A

dysesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

total loss of sensation

A

anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

clinical reasons which account for neuro-sensory defecit such as loss of sensation, pins/needles feeling, painful sensation

A

damage to nerves due to crush injuries, stretching/cutting/shredding of nerves, transection, damage from surgery or LA administration
injection into parotid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how to achieve haemostasis after XLA

A

apply pressure by biting down on gauze/finger, sutures, LA with adrenaline, diathermy by cauterising/burning vessels to precipitate proteins to form plug in vessel, apply ligatures, bone wax, pack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

aims for raising a flap in minor oral surgery

A

better access to tooth/roots
protection of soft tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

things that influence flap design

A

procedure being done, surrounding nerves, how much access is required, personal preference, aim of procedure, minimal effect on gum recession, position of foramen, anatomical postion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

type of handpiece used for bone removal

A

straight handpiece saline cooled with carbide/tungsten bur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

why are highspeed handpieces not used for bone removal

A

push of air into soft tissues, creating surgical emphysema which can cause infection

24
Q

methods of debridement

A

physical = mitchells trimmer, victoria currette, remove sharp
aspiration = under flap to remove debris
irrigation = saline

25
Q

what is the drug family of apixaban

A

NOAC

26
Q

what does apixaban inhibit

A

factor 10a (Xa)

27
Q

what can apixaban be used to treat

A

DVT, atrial fibrillation, prevention of stroke

28
Q

what blood tests are needed before treatment

A

clotting assay, thrombin time

29
Q

what to advise pt for dosage when doing XLA when they take apixaban

A

miss morning dose

30
Q

pre-operative complications

A

location
inadequate access for elevators/luxators due to tooth position
medical history with bleeding tendency
ankylosis/infraoccluded radiographically
close to relevant tooth structures

31
Q

if pt INR is unstable, what further test can be done

A

blood sample to assess prothrombin time

32
Q

would you need to alter apixaban schedule for restoration

A

no

33
Q

predisposing factors for alveolar osteitis

A

mandibular molars, female, smoker, oral contraceptive pill, excessive trauma in XLA, excessive mouth rinsing after XLA

34
Q

neuropraxia

A

contusion of nerve/continuity of epineural sheath and axons maintained

35
Q

axonotmesis

A

continuity of axons but epineural sheath disrupted

36
Q

neurotmesis

A

complete loss of nerve continuity / nerve transected

37
Q

anaesthesia

A

total loss of sensation

38
Q

paraesthesia

A

tingling, pins and needles

39
Q

dysesthesia

A

painful, unpleasant or neuralgic sensation that only lasts a fraction of a second

40
Q

indications to extract tooth

A

unrestorable
traumatic position
orthodontic indications
interference with construction of denture
symptomatically partially erupted

41
Q

drugs which care must be taken with before XLA and why

A

anticoagulants [warfarin] - inhibits clotting factors
aspirin = antiplatelet, failure of clot forming
bisphosphantes = risk of osteonecrosis

42
Q

post extraction complications

A

pain/swelling/ecchymosis
trismus
haemorrhage
alveolar osteitis
prolonged effects of nerve damage
sequestrum
chronic OAF/root in antrum

43
Q

less common post extraction complications

A

osteomyelitis
osteoradionecrosis
medication induced osteonecrosis
actinomycosis
bacteraemia/infective endocarditis

44
Q

pt returns to surgery with persistent bleeding after XLA yesterday
explain txs

A

bite down on damp gauze
LA with vasoconstrictor adrenaline
suture socket
oxidised cellulose
debride and encourage new clot formation

45
Q

what is the most appropriate analgesic for a pt post-XLA

A

paracetamol

46
Q

how does the GP assess INR

A

blood sample to assess prothrombin time

47
Q

what is the mechanism of action of apixaban

A

factor XA inhibitor

48
Q

pt is taking apixaban
do you need to make any alterations to this when restoration of 16O

or XLA uncomplicated 22

A

no

no as low bleeding risk

49
Q

what group does chlorohexidine belong to

A

bisbiguanide

50
Q

mode of action of chlorohexidine

A

binds and disrupts cell membranes of microorganisms
causes leakage of cell contents, loss of integrity and cell death
disrupts microbial metabolism and function, inhibits enzymes in microbial growth and survival

51
Q

what is substantivity

A

ability of substance to bind to tissues and remain active on surface for extended periods after being washed away
peristence of action

52
Q

factors affecting chlorohexidine substantivity

A

absorption to oral surfaces
maintenance of antimicrobial activity
concentration of agent
structure
formulation
pH of environment
slow neutralisation of antimicrobial activty

53
Q

volume, concentration and frequency of chlorohexidine

A

20mg 2x day

54
Q

indications for use of chlorohexidine

A

post oral or periodontal surgery
immunucompromised
mentally/physical disability
adjunct to OH

55
Q
A

BDS3 Past Papers (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions