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Oral surgery > 5. Examination of patients in the oral and maxillofacial surgery - a goal of clinical examination, medical history, examination of the general status. Paraclinical tests - reference values. > Flashcards

5. Examination of patients in the oral and maxillofacial surgery - a goal of clinical examination, medical history, examination of the general status. Paraclinical tests - reference values. Flashcards

1
Q

Steps in treating a patient in oral and maxillofacial surgery

A
  • Diagnostic sequence divided into five levels:
    1. History taking
    2. Clinical examination
    3. Radiological analysis
    4. Laboratory investigations
    5. Interpretation to arrive at a final diagnosis
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2
Q

Aims and objectives of preoperative assessment in oral and maxillofacial surgery

A
  • Decide the choice of anesthesia.
  • Determine if the patient can withstand general anesthesia
  • Assess if the patient can withstand the trauma of surgery
  • Identify any abnormalities in the patient’s general health that need to be addressed before surgery.
  • Choose appropriate premedication.
  • Develop a treatment plan that will benefit the patient the most.
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3
Q

Aims of history taking in oral and maxillofacial surgery

A
  • Obtain a correct account of the patient’s problems
  • Considering their symptoms
  • General condition, lifestyle, and socioeconomic background.
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4
Q

Steps involved in history taking

A
  1. Obtaining general information
  2. Recording the chief complaint(morbi)
  3. Gathering past and present medical history (vitae)
  4. Collecting personal and family history
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5
Q

General information obtained during history taking

A
  • Name
  • Age
  • Sex
  • Marital status
  • Address
  • Race and occupation
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6
Q

Details recorded for the chief complaint

A
  • All symptoms, chronologically, in the patient’s own words.
  • The onset, duration, and progress of each symptom.
  • Any previous treatment taken for the condition and the patient’s response.
  • A history of similar symptoms and treatments, along with outcomes.
  • Additional history regarding trauma, unconsciousness, vomiting, bleeding
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7
Q

Medical conditions covered in the past/present medical history

A

*Cardiovascular disorders, Respiratory diseases, Neurologic conditions
* Endocrine system disorders, Hematological disorders, Infectious diseases.
* Reproductive system,Gastric disorders, Renal pathologies.
* Liver disorders, Autoimmune disorders, Psychiatric ailments
* Digestive system issues, Drug allergies, Childhood illness/birth trauma
* Previous hospitalizations, blood transfusions, and surgeries
* Past/present radiation therapy
* Current/past medications

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8
Q

How medical conditions affect surgical management

A
  • Can alter the patient’s response to surgery
  • Influence anesthetic and surgical management
  • Affect postoperative recovery and wound healing
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9
Q

What is covered in the personal history of a patient

A
  • Habits like chewing tobacco
  • Alcohol consumption
  • Smoking, drug abuse, and exposure to commercial sex workers
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10
Q

Why family history important in patient examination

A
  • Highlights any hereditary conditions=>
  • Epilepsy, cardiac disorders, diabetes, bleeding disorders, Tuberculosis
  • Relevant to the patient’s diagnosis and treatment outcome
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11
Q

Purpose of routine haematological investigations in oral and maxillofacial surgery

A
  • Overall health status
  • Detect infections
  • Assess nutritional status
  • Identify bleeding disorders and evaluate the immune response to facilitate postoperative recovery
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12
Q

What haemoglobin (Hb) indicates in a blood test

A

Indicates the oxygen-carrying capacity of the blood

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13
Q

Normal haemoglobin values for males and females

A
  • Females: 12 to 16 g/dL
  • Males: 14 to 18 g/dL

g/dL- grams per decilitre

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14
Q

Decreased haemoglobin value suggests

A
  • Anaemia=>iron deficiency
  • Decreased absorption of vitamins and minerals
  • Bone marrow depression, increased blood loss
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15
Q

What should be done if a patient has low haemoglobin

A

Referred to specialists

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16
Q

What a complete blood count (CBC) includes

A
  • Red blood cell count
  • White blood cell count
  • Differential white blood cell count
  • Platelet number estimation, and a blood smear description
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17
Q

Benefits of performing a CBC

A
  • Helps to determine nutritional status
  • Detect infections
  • Identify bleeding disorders
  • Evaluate the patient’s immune response
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18
Q

Normal values for red blood cell count in males and females

A
  • Females: 4.5 to 5.5 million cells per cu mm
  • Males: 4.5 to 6.2 million cells per cu mm

cu= cubic millimetres (mm3)

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19
Q

Conditions are associated with decrease in red blood cell count

A
  • Anaemia, pellagra
  • Haemorrhage, and liver disease
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20
Q

Conditions associated with an increase in red blood cell count

A
  • Polycythaemia and extreme dehydration
21
Q

Normal values for white blood cell count in adults and children

A
  • Adults: 5000 to 10000 cells per cu mm
  • Children below 7 years: 6000 to 15000 cells per cu mm
22
Q

Conditions that cause an increased white blood cell count (leucocytosis)

A
  • Acute infections
  • Uraemia, leukaemia, and steroid therapy
23
Q

Conditions that cause a decreased white blood cell count (leukopenia)

A
  • Aplastic anaemia, radiation therapy
  • Infectious mononucleosis, malaria, AIDS
24
Q

Physiological factors can cause an increase in WBC count

A
  • Pregnancy, exposure to heat and cold
  • Muscular exercise, and emotional stress
25
Q

Normal distribution of polymorphonuclear leukocytes (neutrophils) in a differential white blood cell count

A

Neutrophils: 50 to 70 percent

26
Q

Conditions that cause an increase in neutrophils

A
  • Infections, granulocytic leukaemia
  • Post-surgery, severe exercise
27
Q

Conditions that cause a decrease in neutrophils

A

Aplastic anaemia, viral infections, and patients undergoing radiation

28
Q

Normal distribution of lymphocytes

A

25 to 40 percent

29
Q

Conditions that cause an increase in lymphocytes

A

Viral infections, tuberculosis, mononucleosis

30
Q

Conditions that cause a decrease in lymphocytes

A

Stress, uraemia, and steroid therapy

31
Q

Normal value for platelet count

A

150,000 to 400,000 cells per cu mm

32
Q

Conditions that cause an increased platelet count

A
  • Malignancy, post-surgery
  • Iron deficiency anaemia, trauma
33
Q

Conditions that cause a decreased platelet count

A

Viral infections, and infectious mononucleosis

34
Q

Normal ESR values for males and females using Wintrobe’s method

A
  • Females: 0-20 mm/hour
  • Males: 0-10 mm/hour
35
Q

What an elevated ESR indicates

A

Chronic infections, infarctions, trauma

36
Q

Normal bleeding time by Duke’s method

A

3 to 5 minutes

37
Q

Conditions that cause an increased bleeding time

A
  • Thrombocytopenia
  • Capillary wall abnormalities (vitamin C deficiency)
  • Platelet abnormalities (drug-induced, e.g., aspirin, warfarin)
38
Q

Normal clotting time by Lee-White method

A

4 to 10 minutes

39
Q

Conditions that cause prolonged clotting time

A

Thrombocytopenia, clotting factor deficiency, and use of anticoagulants.

40
Q

Normal prothrombin time

A

12-14 seconds

41
Q

Sites bacterial cultures can be obtained from

A

Throat, sputum, draining pus,

42
Q

How cultures from the oral cavity can be obtained

A
  • Gathering exudative material=>by aspiration with a needle and syringe
  • or by using a swab
43
Q

Biopsy and why is it important

A
  • Removal of tissue from a living subject for histological evaluation
44
Q

Punch biopsy and when it is used

A
  • Small part of the lesion is obtained using a punch
  • Useful for mucosal lesions in inaccessible regions
  • May cause crushing or distortion of the tissues
45
Q

When an incisional biopsy performedand how it is done

A
  • Large diffuse lesion
  • Section of the lesion, along with normal tissue, is incised using a scalpel
45
Q

Excisional biopsy and when it is appropriate

A
  • Removal of the entire lesion
  • Appropriate for extremely small lesions (less than 1 cm)
46
Q

Normal range for fasting blood glucose values

A

Between 65 and 110 mg/100 ml of blood

47
Q

Normal postprandial (after eating) blood glucose level

A

Between 120 and 160 mg/100 ml of blood.

48
Q

Conditions associated with increased blood glucose levels

A

Diabetes mellitus, Cushing’s syndrome, pancreatitis

Oral surgery (105 decks)

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