10/26: Systemic Diseases Flashcards
What is a general term for pulmonary disorders charactrized by chronic airflow limitation from the lungs?
Chronic obstructive pulmonary disease (COPD)
What is the 3rd leading cause of death in 2020?
COPD
Is COPD fully reversible?
No
COPD encompasses what 2 main diseases?
- Chronic bronchitis
- Emphysema
What is the recommended diagnosis of COPD?
Presence of septum production and dyspnea together with an abnormal measurement of lung function
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
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
The onset of COPD after what age?
40 years
What are patients with chronic bronchitis described as?
Sedentary, overweight, cyanotic, edematous and breathless
What are patients with COPD known as?
Blue bloaters
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
What are patients diagnosed with emphysema known as?
Pink puffers because they demonstrated enlarged chest walls (barrel-chested appearance)
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
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?
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?
What is a condition in which the heart valves have been
permanently damaged by rheumatic fever
Rheumatic heart disease
When does heart valve damage start?
Shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever
What can result in on-going valve damage?
An immune response causes an inflammatory condition in
the body
What can happen to heart valves over time?
Become inflamed and scarred over
What is a disorder of cognition that
consequently interferes with the daily
functions and results in a loss of
independence?
Dementia
What are the most common causes of dementia?
Alzheimer’s disease, vascular dementia,
& dementia caused by Parkinson’s
disease
When does prevalenze of dementia and alzheimer’s increase?
With age: 65y/o-
7% by age 85, more than 40%
What gender is more at risk?
Women because they live longer
What are symptoms of alzheimer’s disease?
Memory loss
Cognitive decline
Behavioral and
personality changes
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?
- Weight gain in the midsection, face, shoulders
Face = moon face
Shoulders = buffalo hump - Thinning, fragile skin that bruises easily
- abdominal striae
- decreased healing
- 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
