Actual case pres

Question 1

What is depression

Answer 1

Mental health disorder

Depression is a constant feeling of sadness and loss of interest, which stops you doing your normal activities

Question 2

What is angina

Answer 2

Angina is chest pain caused by reduced blood flow to the heart muscles

Question 3

What is COPD and its symptoms

Answer 3

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties

-emphysema – damage to the air sacs in the lungs

-chronic bronchitis – long-term inflammation of the airways

The main symptoms of COPD are:

-shortness of breath particularly when active
-Persistent chesty cough with phlegm
-frequent chest infections
-persistent wheezing

Question 4

What is collapsed lung

Answer 4

occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath

Question 5

What is aspirin and its MOA

Answer 5

Antiplatelet prevents platelets from clumping together to form a clot
- in platelets, leading to the inhibition of thromboxane A2

Also used as a painkiller
-inhibit the activity COX which leads to the formation of prostaglandins

Question 6

What is atorvastin and side fx

Answer 6

Statin

HMG coA Reductase inhibitor

Inhibit cholesterol synthesis in the liver
-Reduce total cholesterol and LDL-cholesterol (low-density lipoprotein)

Watch with antifungals possible myositis

Question 7

What is ramipril and side fx

Answer 7

ACE inhibitor

Inhibit conversion of angiotensin I to angiotensin II, a substance that narrows blood vessels

relax the veins and arteries to lower blood pressure

side effects–cough, hypotension, may give a lichenoid reaction or angio oedema

Question 8

What is bisoprolol

Answer 8

Beta-adrenergic blockers (β-blockers)

Selective to beta receptor 1

Stop arrhythmias leading to cardiac arrest and Reduces heart muscle excitability

Blocks the effects of the hormone epinephrine, also known as adrenaline

Side fx
-Cause postural hypotension
-Make heart failure worse
-Block beta receptors in the lungs, asthma worse or difficult to treat

Question 9

What is sertaline

Answer 9

selective serotonin reuptake inhibitor

increasing the levels of a mood-enhancing chemical called serotonin in your brain

Question 10

What is symbicort

Answer 10

fixed-dose combination medication used in the management of asthma or chronic obstructive pulmonary disease. It contains budesonide, a steroid and formoterol, a long-acting β2-agonist

Question 11

What is gtn spray and side fx and why administered subL

Answer 11

Glyceryl Trinitrate (GTN)
Emergency management of angina

Antihypertensive and for Heart Failure

Dilate VEINS
-Reducing preload to the heart

Dilate resistance arteries
-Reducing cardiac workload
-Reducing cardiac oxygen consumption

Dilates colateral coronary artery supply
-Reducing anginal pain

Side fx= Headache and hypotension

Aminstered SubL cause Inactivated by first pass metabolism

Question 12

Effects of not smoking

Answer 12

Co returns to normal within 48hrs

Nicotine leaves body within 72hrs

Breathing improves between 2wks-3months

AFter 1yr CVHD risk down by half

10yrs lung cancer chance by half

(40% of chronic perio due to smoking)

Question 13

What are the mobilty grades

Answer 13

0= No mobility

1= <1mm of mobility

2= >1mm of mobility

3= rotation and vertical movement and >2mm

Question 14

What is attrition and erosion

Answer 14

Att= Physiological wearing away of tooth structure due to tooth to tooth contact

Eorison= Loss of tooth substance due to chem. process not bacterial

Question 15

What are the BEWE scores

Answer 15

1 = initial loss of enamel surface

2 = distinct defect of hard tissue loss less than 50% of the surface area

3 = distinct defect of hard tissue loss more than 50% of the surface area

Question 16

How does the periodontium heal

Answer 16

Following root surface debridement bacterial remnants will wash out of the pocket by blood and gingival fluid & within a few hours an acute inflammatory reaction occurs in the soft tissue pocket wall

Remnants of pocket epithelium proliferate and the pocket wall is fully epithelialised within 2 days

Involution of the pocket epithelium occurs giving rise to new junctional epithelium

After 5 days, epithelial reattachment commences at the apical extremity of the pocket and progresses coronally until, under conditions of ideal plaque control epithelial reattachment is
complete in 14 days and a new gingival sulcus is formed near to the crest of the gingivae

Some shrinkage of the gingiva will occur due to loss of oedema

The formation of functionally orientated collagen to replace granulation tissue at 3 weeks

Pocket charting at the re-assessment stage often reveals decreased pocket
depth due to a combination of factors:
* Decreased oedema leading to gingival recession
* An increase in clinical attachment resulting from:
-the formation of a long junctional epithelium
-an increase in “tissue tone” which produces resistance to probing

Most of the healing response leading to reduction in probing depth and gain in
clinical attachment has taken place within 8 weeks

For this reason re-evaluation is usually carried out at least 8 weeks after the last PMPR However, there will be continued gradual improvement seen even 9-12 months after the completion of active treatment provided that good plaque control is maintained

Question 17

What is normal blood pressure and hypertension

Answer 17

between 90/60 mmHg and 120/80 mmHg normal

> 140mm Hg/>90mm Hg