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23 Oral Diagnosis > 2 - Patient Interview - Medical and Dental Histories > Flashcards

2 - Patient Interview - Medical and Dental Histories Flashcards

1
Q

can you ever treat a stranger

A

never

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2
Q

what are the stages of patient interview

A
  1. the opening
  2. established expectations
  3. information gathering
  4. closing
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3
Q

what are different patient interview personality types

A
  1. silent patient
  2. talkative patient
  3. seductive patient
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4
Q

since patients are generally incapable of judging the technical quality of the care that dentists provide, what must be built

A

rapport

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5
Q

what is the primary resource in determining the patient’s fitness for treatment and quantifying what risks might be involved

A

medical history

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6
Q

once patient med hx is complete, but BEFORE SIGNED, what must you ask patient

A

ask if there is any other recent medical history that they may have forgotten

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7
Q

what are the basic parts of medical history

A
  1. patient evaluation
  2. general medical information
  3. review of systems
  4. patient verification (Signature!)
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8
Q

be sure to question female patients of child bearing age about the use of birth control pills if they answer NO on medical history. why?

A

BC pills + antibiotics = wrongful birth lawsuit and child support

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9
Q

what is the swelling of ankles, difficulty braething when recumbent, sleeps with 2 or more pillows

A

congestive heart failure

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10
Q

what disease must defer electrive treatment for 4-6 weeks, non-elective treatment requires physician consult

A

myocardial infarction

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11
Q

what disease is okay to treat if stable but but have a MD consult if unstable

A

angina pectoris

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12
Q

angina pectoris patients should have what medicaiton on them

A

nitroglycerin

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13
Q

what is an atrial fibrillation characterized by swelling of ankles

A

arrythmias

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14
Q

what medication is prescribed to patients with arrythmias

A

Coumadin (warfarin) to prevent formaion of blood clots

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15
Q

patients with arrythmias should be asked when their last ___ was and how long ago it was taken. what is it

A

INR = international normalized ratio

it evaluates the extrinsic pathway of coagulation

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16
Q

normal systolic/diastolic

A

<120/<80

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17
Q

prehypertension

A

120-129/<80

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18
Q

hypertension stage 1

A

130-139/80-89

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19
Q

hypertension stage 2

A

> /= 140/>/= 90

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20
Q

hypertensive crisis

A

> 180 and/or >120

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21
Q

defer elective treatment if BP is what

A

> /= 174/104 and REFER

22
Q

defer emergency treatment if BP is what

A

> /=180/110 and REFER

23
Q

for patients presenting with BP >/= 210/120, what msut you do

A

immediate consult with MD of record and referral to emergency room ASAP

24
Q

examples of conditions that are high risk of infective endocarditis

A

artificial or porcine heart valves, cardiac transplantation, previous infective endocartitis, prosthetic material used for cardiac valve repaid, congenital heart disease

25
Q

___ is when procedures resulting in significant bactermia (significant hemorrhage) require premedicatation with antibiotics

A

management

26
Q

you premedicate for what type of treatments

A

bleeding o teeth is anticipated

27
Q

you don’t premedicate for what type of procedures

A

stuff that doesnt cause bleeding

28
Q

if patient fails to remember to take antibiotic dose prior to appointment, the antibiotic may be administered when?

A

at the start of appointment or up to 2 hours after

29
Q

amoxicillin dosage, dispense, and sig

A

dose: 500 mg
dispense: 4
sig: take 4 tabs 1 hour prior to dental appointment

if forgotten, may be administered up to t2 hours after procedure

30
Q

what to prescribe for penicillin/amoxicillin allergic patients

dosage, dispense, sig

A

Cephalexin 500 mg
Dispense; 4
Sig: 4 tabs 1 hour prior to dental appointments

31
Q

what is partial pressure of O2 in blood driving respiration for those with this sickness, therefore O2 therapy may suppress respiration

A

emphysema

32
Q

T/F: dermal and musculoskeletal artificial joints CURRENTLY require antibiotic prophylaxis

A

FALSE! used to require

33
Q

we will no longer prescribe antibiotics for patients with prosthetic joints unless what

A

unless patient or patient’s orthopedic surgeon requests that we do

34
Q

what has an increased risk of infection and delayed healing following dental procedures. make sure the patient has taken meds and have eaten prior to appointments. afternoon appointments may be best

A

diabetes (endocrine)

35
Q

what is ther ule of 2’s

A

consider supplemental steroid dosage for patients who have taken 20 mg of cortisone (or more) or an equivalent dose of anotehr steroid for two or more weeks in the last 2 years. this causes ADRENAL INSUFFICIENCY which may cause patient inability to tolerate stressful situations

36
Q

adrenal crisis may evolve into what

A

CVD collapse and death

37
Q

cortisone dose

A

25 mg

38
Q

hydrocortisone dose

A

20 mg

39
Q

prednisone dose

A

5 mg

40
Q

prednisolone dose

A

5 mg

41
Q

triamcinolone dose

A

4 mg

42
Q

methylprednisolone dose

A

4 mg

43
Q

dexamethaone dose

A

0.75 mg

44
Q

betamethasone dose

A

0.6-0.75 mg

45
Q

glucocorticoids from highest to lowest dose

A
46
Q

what is ASA 1

A

patient is normal and healthy

47
Q

what is ASA 2

A

patient with mild systemic disease (controlled hypertension or diabetes without systemic complications, or ASA 1 plus pregnancy, tobacco use, systemic medications, or extreme fear/apprehension)

48
Q

what is ASA 3

A

moderate to severe systemic disease does not limit patient physical activities (stable angina
or diabetes with systemic complications). May require
medical consult prior to extensive or invasive dental
treatment. (or ASA2 plus severe fear/apprehension)

49
Q

what is ASA 4

A

ASA4: Severe systemic disease that is a constant
threat to life. Dental treatment only in hospital setting.

50
Q

what is ASA 5

A

ASA5: Moribund patient not expected to survive
without immediate medical intervention.

51
Q

what is ASA6

A

organ donor

52
Q

what makes a patient “special needs”

A
  1. Medical: ASA 3 or 4
  2. physical: mobility challenged or physical disability
  3. Psychological: developmental or acquired disability
  4. social: non-english speaking and requires interpreter to communicate and give consent

23 Oral Diagnosis (13 decks)

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