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Patient Care Exam 2 > 10/26: Systemic Diseases > Flashcards

10/26: Systemic Diseases Flashcards

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1
Q

What is a general term for pulmonary disorders charactrized by chronic airflow limitation from the lungs?

A

Chronic obstructive pulmonary disease (COPD)

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2
Q

What is the 3rd leading cause of death in 2020?

A

COPD

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3
Q

Is COPD fully reversible?

A

No

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4
Q

COPD encompasses what 2 main diseases?

A
  1. Chronic bronchitis
  2. Emphysema
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5
Q

What is the recommended diagnosis of COPD?

A

Presence of septum production and dyspnea together with an abnormal measurement of lung function

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6
Q

This is chronic inflammation of the bronchi that produces excessive tracheobronchial mucus production and a persistent caught with sputum for at least 3 months in at least 2 consecutive years

A

Chronic bronchitis

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7
Q

This is permanent enlargement of the air spaces in the lungs that is accompanied by destruction of the air space walls without obvious fibrosis

A

Emphysema

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8
Q

The onset of COPD after what age?

A

40 years

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9
Q

What are patients with chronic bronchitis described as?

A

Sedentary, overweight, cyanotic, edematous and breathless

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10
Q

What are patients with COPD known as?

A

Blue bloaters

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11
Q

This is permanent enlargement of the air spaces in the lungs tha is accompanied by destruction of the air space walls without obvious fibrosis

A

Emphysema

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12
Q

What are patients diagnosed with emphysema known as?

A

Pink puffers because they demonstrated enlarged chest walls (barrel-chested appearance)

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13
Q

What does emphysema show as?

A

Weight loss with disease progression
Severe exertional dyspnea
Seldom coughing
lack of cyanosis
Pursing of lips with efforts to forcibly exhale air from the lungs

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14
Q

What are questions you should ask someone with emphysema or bronchitis?

A

How severe?
How long have you had it?
What medications are you
on?
Does it bother you to recline
completely?
Will the rubber dam be a problem?

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15
Q

What questions should you ask someone with shortness of breath?

A

how many blocks can you walk
before tiring?
can you walk two flights of stairs
without having to stop?

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16
Q

What is a condition in which the heart valves have been
permanently damaged by rheumatic fever

A

Rheumatic heart disease

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17
Q

When does heart valve damage start?

A

Shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever

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18
Q

What can result in on-going valve damage?

A

An immune response causes an inflammatory condition in
the body

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19
Q

What can happen to heart valves over time?

A

Become inflamed and scarred over

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20
Q

What is a disorder of cognition that
consequently interferes with the daily
functions and results in a loss of
independence?

A

Dementia

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21
Q

What are the most common causes of dementia?

A

Alzheimer’s disease, vascular dementia,
& dementia caused by Parkinson’s
disease

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22
Q

When does prevalenze of dementia and alzheimer’s increase?

A

With age: 65y/o-
7% by age 85, more than 40%

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23
Q

What gender is more at risk?

A

Women because they live longer

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24
Q

What are symptoms of alzheimer’s disease?

A

Memory loss
Cognitive decline
Behavioral and
personality changes

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25
What is the cause of alzheimers?
Unknown but appears to involve loss of cholinergic neurons
26
How often does genetic predisposition contribute to?
Less than 20% of all cases
27
What is the average lifespan after dx?
8 years
28
What is dental management of alzheimer's disease?
Knowledge of the stage of the disease, medications taken, and the cognitive abilities of the patient
29
What do medications such as antipsychotics, antidepressants, and anxiolytics contribute to?
xerostomia with increased risk for dental caries
30
Where are small endocrine glands located?
Bilaterally at the superior pole of each kidney
31
What is progressive destruction of the Adrenal Cortex, Usually due to autoimmune disease?
Primary adrenal insufficiency (addison's disease)
32
What are chronic infectious diseases?
TB, HIV, Cytomegalovirus and some fungal infections
33
What does primary adrenal insufficiency decrease?
Cortisol (stress hormones) and aldosterone
34
What does cortisol do?
Decreases inflammation, regulates blood pressure, increases glucose
35
What does aldosterone do?
Stimulates Na+ absorption by the kidneys
36
This is caused by pituitary disease or critical illness
2nd adrenal insufficiency
37
This is caused by process that impair function of the hypothalamus
3rd adrenal insufficiency
38
What is the most common cause of tertiary adrenal insufficiency?
Chronic use of corticosteroids
39
What is adrenal insufficiency?
The inability to increase cortisol production with stress
40
What are symptoms of adrenal insufficiency?
Tired-fatigue Weak Orthostatic hypotension Poor healing Inability to tolerate stress Increased infections Areas of darkened skin Salt Craving
41
This refers to a condition caused by excessive cortisol in the body
Cushings syndrome
42
What is the most common cause of cushings syndrome?
Steroid drugs
43
Cushing disease can result in what?
Type 2 diabetes Bone loss High blood pressure
44
When cushings syndrom is caused by a pathophysiologic process (like a tumor), it is called
Cushing's disease
45
What are some examples of when you have steroid use?
Lupus Rheumatoid arthritis Asthma Psoriasis
46
What are the clinical features of cushings syndrome/disease?
1. Weight gain in the midsection, face, shoulders Face = moon face Shoulders = buffalo hump 2. Thinning, fragile skin that bruises easily 3. abdominal striae 4. decreased healing 5. acne
47
What is a potentialy-life threatening complication resulting form adrenal insufficiency triggered by emotional and physical stress?
Adrenal crisis
48
What does adrenal crisis manifest as?
Hypotensive collapse, abdominal pain, myalgia, and fever
49
What does the diagnosis of substance abuse require?
Recurrent use of a substance over the past 12 months with subsequent adverse consequences
50
What are features of suggestive of alcohol abuse?
Missed appointments, alcohol on breath, enlargement of the parotid glands and spider angiomas
51
What does alcohol cause?
Liver and bone marrow damage Cirrhosis Vitamin K deficiency Reduced effect of local anesthetics and benzodiazepines Nutritional dificiencies Candidal infections
52
What is binge drinking?
>5 oz/ 4 hours
53
What does excessive drinking caused an increased cancer of?
Mouth Larynx Esophagus
54
What does the combination of smoking and alcohol increase the chance of?
Oral cancer
55
What can alcohol act as?
An irritant and damage cells which could lead to DNA changes
56
When can drug abuse occur?
Interactions w/ Rx, anesthetic Liver damage Infectious diseases if share needles
57
What are oral complications and manifestations of drug and alcohol abuse?
More plaque, calculus, caries, gingival inflammation
58
What are oral complications of cocaine?
Gingival recession and erosion of facial aspects
59
What are oral complications of meth mouth?
Xerostomia, rampant caries, bruxism, and muscle trismus
60
Should you provide extensive care to someone who has oral manifestations as a result of drug and alcohol abuse problems?
Not until homecare improves
61
Reduction in the oxygen carrying capacity of the blood is called
Anemia
62
What is the most common blood conditions in the USA?
Anemia
63
What is anemia usually associated with?
Decrease in RBC's Abnormality in Hb contained within RBCs Caused by underlying disease especially in men More than 3 million cases per year in the US
64
Anemia affect more female or male?
Female
65
Decrease number of circulating RBCs in what?
Anemia
66
A abnormality in the hemoglobin contained within the RBCs
Anemia
67
Anemia may be caused by an underlying disease especially in
Males
68
What are the types of anemia?
Iron deficiency Folate deficiency Hemolytic anemia Sickle cell anemia
69
What are the symptoms of anemia?
Pallor = pale Fatigue Low blood pressure SOB Rapid heart rate
70
Oral signs of anemia are?
Smooth, burning red tongue Bleeding gums
71
This is the craving and chewing ice associated with iron deficiency, with or without anemia
Pagophagia
72
This is severe restriction of food intake, leading to weight loss and the medical sequelae of starvation
Anorexia nervosa
73
This is restriction of food by binge eating followed by various methods of trying to rid the food (vomiting, laxatives, diuretics)
Bulimia nervosa
74
Anorexia is 90-95% in
Females
75
What is the age of onset for anorexia?
14-18 y/o, rare after age 40
76
What is the mortality rate of people with anorexia?
5-20% usually by starvation, suicide, electrolyte imbalance
77
What are some signs of anorexia?
Low BP Amenorrhea Osteoporosis Anemia (20-40%) due to nutritional deficiences Hair thin and brittle Neck/facial swelling Irritable Fainting
78
What is the average age of onset for bulimia?
20 y/o
79
What is bulimia most often seen in?
Females
80
What happen to amalgam restorations in bulimia nervosa?
Higher than surround enamel
81
What is loss of enamel and dentin on the lingual surfaces by chemical and mechanical effects?
Perimylolysis
82
Where does tooth issues occur with bulimia?
Lingual of ant teeth due to enamel erosion form acidic chemicals
83
What do you ask someone with abnormal bleeding?
When did it occur? After extraction? How long did it last? Have you been diagnosed by a physician?
84
This test is used to detect bleeding disorders or excessive clotting disorders
Prothrombin time
85
This measures how quickly your blood clots
Prothrombin time
86
What is a calculation based on results of a PT
INR
87
What 2 prothrombin time is presented?
Seconds for blood clot to form INR
88
What is the average time for blood to clot?
10-30 seconds
89
You use this ratio if you are on blood thinning medications
INR
90
What is the equation for INR?
Patient Pt/Control Pt x ISI
91
If the INR score is too low, patients can be at risk for
Blood clot
92
If the INR score is too high, patients can experience
Bleeding issues
93
Typical INR score range for patient on blood thinner is
2-3
94
Healthy people not on blood thinner INR score is
1.1 or below
95

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