Quiz 1. Oral Med. Review

Question 1

T/F Control of oral disease in pregnant women reduces transmission of oral bacteria to child

Answer 1

t

Question 2

Is there evidence for early spontaneous abortion if the pregnant mom seeks dental care in the 1st trimester

Answer 2

no

Question 3

Is preclampsia a contraindication for dental care? What is it

Answer 3

no it is a pregnanacy complication characterized by high BP

Question 4

What is the effect of periodontal care on low birth weight

Answer 4

none

Question 5

Should periodontal care be provided during pregnancy

Answer 5

yes

Question 6

What are the strategies to reduce maternal cariogenic bacterial load

Answer 6

• Brush 2x perday and fluoride toothpaste and fluoride mouthwash (esp. before bed)
• Floss daily
• Restore caries
• Chlorhexidine mouth rinse and fluoride varnish as needed
• 4-5x/day use of xylitol chewing gum or other xylitol products
• Drink fluoridated water

Question 7

Should LA with Epi be used in pregnant patients

Answer 7

yes

Question 8

Can you take X-rays on pregnant patients

Answer 8

yes utilize the abdominal apron with thyroid collar

Question 9

What analgesic is perfered when using in a pregnanat patient

Answer 9

acetaminophen

Question 10

Should antibiotics be used in pregnant patients when needed?

Answer 10

yes including penicicllin, cephalosporins and erythromycin

Question 11

Should dentists consult with the patients prenatal care provider for routine treatment of a healthy pregnanat pateint

Answer 11

no

Question 12

When should the dentist consult with the perinatal provide

Answer 12

• Deferring treatment because of pregnanacy
• Co-morbid conditions that may lead to dental issues such as DM, pulmonary issues, heart or valvular disease, hypertension, bleeding disorders, or heparin-treated thrombophilia
• Use of nitrous oxide as LA adjunct

Question 13

Arterial blood pressure is directly proportional to what two variables

Answer 13

• Cardiac output

- Peripheral vascular resistance

Question 14

Cardiac output and peripheral resistance are controlled by what two mechanisms

Answer 14

• Baroreflexes (mediated by the SNS)

- Renin-angiotensin-aldosterone system

Question 15

Which of the two mechanisms are responsible for ra[id changes in BP

Answer 15

baroreflexes (renin-angiotensin-aldosterone system is for long term BP control)

Question 16

Caroreceptors are located where in the body that help monitor BP

Answer 16

carotid sinuses and aortic arch

Question 17

Angiotensinogen is converted to angiotensin I by

Answer 17

renin (peptidase)

Question 18

Angiotensin I is converted to angiotensin II by

Answer 18

ACE (angiotensin converting enzyme)

Question 19

What is the role of angiotensin II

Answer 19

body’s most potent vasoconstrictor

Question 20

Decrease in BP leads to (increase/decrease) in renal blood flow…. which leads to the release of….

Answer 20

decrease….renin

Question 21

Activation of the SNS in response to decreased BP results in the activation of what receptors located on what tissues

Answer 21

Beta 1 on heart –> increase CO

Alpha 1 on Smooth muscle –> increased peripheral resistance

Question 22

Describe the mechanism of thiazide diuretics

Answer 22

Decrease in Na and H2O retention –> decreased blood volume –> decrease Cardiac output and decreased peripheral resistance –> decreased BP

Question 23

Mechanism of Beta-blockers on decreasing BP

Answer 23

decrease CO
decrease SNS activation
decreases renin release from kidneys

Question 24

Propranolol blocks _ receptors while metoprolol and atenolol blocks _ receptors

Answer 24

B1 and B2… B1 selective

Question 25

Propranolo is contraindicated in _ patients and why

Answer 25

asthmatic patients due to B2 mediated bronchoconstriction

Question 26

ACE inhibitors are recommended to lower BP when

Answer 26

preferred first-line agents (diuretics and B-blockers) are contraindicated

Question 27

Do ACE inhibitors increase risk of other diseases

Answer 27

it is unclear

Question 28

Mechanism of ACE inhibitors

Answer 28

Lower BP by reducing vascular resistance without reflexly increasing CO, cardiac rate, or contractility preventing the production of Angiotensin II (potent vasoconstrictor)

Question 29

Decreased angiotensin release has what effects on the body

Answer 29

- Decreased SNS output - Increased vasodilitation - Decreased aldosterone release --> decreased Na and H2O retention - Increased levels of bradykinin

Question 30

Mechanism of action of losartan

Answer 30

Angiotensin II receptor blocker (similar effects as ACE inhibitors

Question 31

Disadvantage of losartan

Answer 31

fetotoxic

Question 32

What Ca channel blocker leads to the least dilitation of coronary vessels

Answer 32

verapamil

Question 33

What Ca channel blocker causes the largest and smallest decrease in AV conduction

Answer 33

Largest= verapamil | Smallest=Nifedipine

Question 34

Which Ca channel blocker has the most and least number of adverse effects

Answer 34

``` Most= Nifedipine Least= Diltiazem ```

Question 35

Well controlled diabetics (do/don't) require special attention when recieving dental tx

Answer 35

don't

Question 36

What are potential adverse effects of diabetic taking analgesics

Answer 36

-Avoid aspirin and other NSAIDs when taking sulfonylureas because they can worsen hypoglycemia

Question 37

What are potential adverse effects of diabetic taking antibiotics

Answer 37

-Phorylaxis not required (unless patient has brittle diabetes with poor oral health and fasting plasma glucose >200 mg/dL)

Question 38

What are potential adverse effects of diabetic taking anesthesia

Answer 38

- No issue if well controlled - For diabetics with concurrent hypertension or hx of recent MI/cardiac arrythmia limit dose of epi to 2 carpules of 1:100,000

Question 39

What conditions present no issues to DM patients

Answer 39

anxiety, allergies, breathing, and chair position

Question 40

What are potential adverse effects of diabetic bleeding

Answer 40

thrombocytopenia is a rare adverse effect associated with taking sulfonylureas

Question 41

What are potential adverse effects of diabetic in terms of BP

Answer 41

diabetes is associated with hypertension

Question 42

What are potential adverse effects of diabetic in terms of CV issues

Answer 42

Confirm cardiovascular status | -B-blockers can exacerbate hypoglycemia in patients taking sulfonylureas

Question 43

Is AB prophylaxis needed for a diabetic on an insulin pump

Answer 43

no

Question 44

Should the patient alter their insulin dosage/meals on days they have dental appointments

Answer 44

no

Question 45

People with brittle diabetes (Type I) Require a (high/low) insulin dose

Answer 45

high

Question 46

T/F Insulin dose may need to be increased when undergoing an invasive procedure or when they have an oral infection

Answer 46

t

Question 47

Describe the change in post-op infection risk for the following fasting plasma glucose levels - < 206 mg/dL - 207-229 mg/dL - >230mg/dL

Answer 47

- No increased risk of infection - Increased risk by 20% - Increased risk by 80%

Question 48

Epi will have what effect on blood glucose

Answer 48

increase blood glucose (epi has the opposite effect as glucose)

Question 49

Oral complications associated with DM

Answer 49

- Xerostomia - Bacteria/viral/fungal infection - caries - gingivitis/periodontitis - periapical abscesses - burning mouth syndrome

Question 50

Oral lesions common in diabetics

Answer 50

- Candida - Traumatic ulcers - Lichen planus - Delayed healing (esp. type I diabetics)