10/26: Systemic Diseases Flashcards by Anita Maxwynn

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

Chronic obstructive pulmonary disease (COPD)

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

COPD

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Is COPD fully reversible?

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COPD encompasses what 2 main diseases?

Chronic bronchitis
Emphysema

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What is the recommended diagnosis of COPD?

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

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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

Chronic bronchitis

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

Emphysema

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The onset of COPD after what age?

40 years

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What are patients with chronic bronchitis described as?

Sedentary, overweight, cyanotic, edematous and breathless

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What are patients with COPD known as?

Blue bloaters

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

Emphysema

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What are patients diagnosed with emphysema known as?

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

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What does emphysema show as?

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

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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What questions should you ask someone with shortness of breath?

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

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

Rheumatic heart disease

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When does heart valve damage start?

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

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What can result in on-going valve damage?

An immune response causes an inflammatory condition in
the body

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What can happen to heart valves over time?

Become inflamed and scarred over

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

Dementia

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What are the most common causes of dementia?

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

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When does prevalenze of dementia and alzheimer’s increase?

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

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What gender is more at risk?

Women because they live longer

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What are symptoms of alzheimer’s disease?

Memory loss
Cognitive decline
Behavioral and
personality changes

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What is the cause of alzheimers?

Unknown but appears to involve loss of cholinergic neurons

How often does genetic predisposition contribute to?

Less than 20% of all cases

What is the average lifespan after dx?

8 years

What is dental management of alzheimer's disease?

Knowledge of the stage of the disease, medications taken, and the cognitive abilities of the patient

What do medications such as antipsychotics, antidepressants, and anxiolytics contribute to?

xerostomia with increased risk for dental caries

Where are small endocrine glands located?

Bilaterally at the superior pole of each kidney

What is progressive destruction of the Adrenal Cortex, Usually due to autoimmune disease?

Primary adrenal insufficiency (addison's disease)

What are chronic infectious diseases?

TB, HIV, Cytomegalovirus and some fungal infections

What does primary adrenal insufficiency decrease?

Cortisol (stress hormones) and aldosterone

What does cortisol do?

Decreases inflammation, regulates blood pressure, increases glucose

What does aldosterone do?

Stimulates Na+ absorption by the kidneys

This is caused by pituitary disease or critical illness

2nd adrenal insufficiency

This is caused by process that impair function of the hypothalamus

3rd adrenal insufficiency

What is the most common cause of tertiary adrenal insufficiency?

Chronic use of corticosteroids

What is adrenal insufficiency?

The inability to increase cortisol production with stress

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

This refers to a condition caused by excessive cortisol in the body

Cushings syndrome

What is the most common cause of cushings syndrome?

Steroid drugs

Cushing disease can result in what?

Type 2 diabetes Bone loss High blood pressure

When cushings syndrom is caused by a pathophysiologic process (like a tumor), it is called

Cushing's disease

What are some examples of when you have steroid use?

Lupus Rheumatoid arthritis Asthma Psoriasis

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

What is a potentialy-life threatening complication resulting form adrenal insufficiency triggered by emotional and physical stress?

Adrenal crisis

What does adrenal crisis manifest as?

Hypotensive collapse, abdominal pain, myalgia, and fever

What does the diagnosis of substance abuse require?

Recurrent use of a substance over the past 12 months with subsequent adverse consequences

What are features of suggestive of alcohol abuse?

Missed appointments, alcohol on breath, enlargement of the parotid glands and spider angiomas

What does alcohol cause?

Liver and bone marrow damage Cirrhosis Vitamin K deficiency Reduced effect of local anesthetics and benzodiazepines Nutritional dificiencies Candidal infections

What is binge drinking?

>5 oz/ 4 hours

What does excessive drinking caused an increased cancer of?

Mouth Larynx Esophagus

What does the combination of smoking and alcohol increase the chance of?

Oral cancer

What can alcohol act as?

An irritant and damage cells which could lead to DNA changes

When can drug abuse occur?

Interactions w/ Rx, anesthetic Liver damage Infectious diseases if share needles

What are oral complications and manifestations of drug and alcohol abuse?

More plaque, calculus, caries, gingival inflammation

What are oral complications of cocaine?

Gingival recession and erosion of facial aspects

What are oral complications of meth mouth?

Xerostomia, rampant caries, bruxism, and muscle trismus

Should you provide extensive care to someone who has oral manifestations as a result of drug and alcohol abuse problems?

Not until homecare improves

Reduction in the oxygen carrying capacity of the blood is called

Anemia

What is the most common blood conditions in the USA?

Anemia

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

Anemia affect more female or male?

Female

Decrease number of circulating RBCs in what?

Anemia

A abnormality in the hemoglobin contained within the RBCs

Anemia

Anemia may be caused by an underlying disease especially in

Males

What are the types of anemia?

Iron deficiency Folate deficiency Hemolytic anemia Sickle cell anemia

What are the symptoms of anemia?

Pallor = pale Fatigue Low blood pressure SOB Rapid heart rate

Oral signs of anemia are?

Smooth, burning red tongue Bleeding gums

This is the craving and chewing ice associated with iron deficiency, with or without anemia

Pagophagia

This is severe restriction of food intake, leading to weight loss and the medical sequelae of starvation

Anorexia nervosa

This is restriction of food by binge eating followed by various methods of trying to rid the food (vomiting, laxatives, diuretics)

Bulimia nervosa

Anorexia is 90-95% in

Females

What is the age of onset for anorexia?

14-18 y/o, rare after age 40

What is the mortality rate of people with anorexia?

5-20% usually by starvation, suicide, electrolyte imbalance

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

What is the average age of onset for bulimia?

20 y/o

What is bulimia most often seen in?

Females

What happen to amalgam restorations in bulimia nervosa?

Higher than surround enamel

What is loss of enamel and dentin on the lingual surfaces by chemical and mechanical effects?

Perimylolysis

Where does tooth issues occur with bulimia?

Lingual of ant teeth due to enamel erosion form acidic chemicals

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?

This test is used to detect bleeding disorders or excessive clotting disorders

Prothrombin time

This measures how quickly your blood clots

Prothrombin time

What is a calculation based on results of a PT

INR

What 2 prothrombin time is presented?

Seconds for blood clot to form INR

What is the average time for blood to clot?

10-30 seconds

You use this ratio if you are on blood thinning medications

INR

What is the equation for INR?

Patient Pt/Control Pt x ISI

If the INR score is too low, patients can be at risk for

Blood clot

If the INR score is too high, patients can experience

Bleeding issues

Typical INR score range for patient on blood thinner is

2-3

Healthy people not on blood thinner INR score is

1.1 or below