ALL Flashcards
1
Q
What condition is a consequence of liver Cirrhosis?
A
Oesophageal Varices
2
Q
Alpha cells in the pancreas secrete what substance?
A
Glucagon
3
Q
How many layers are in the cortex of the adrenal gland?
A
3 layers
4
Q
Visual acuity tests the function of which cranial nerve?
A
optic nerve
5
Q
What is a typical feature of hypothyroidism?
A
Depression
6
Q
What best describes Cushing’s response in raised intracranial pressure?
A
Hypertension and bradycardia
7
Q
In Barret’s oesophagus which metaplasia is taking place?
A
Squamous epithelium is replaced by columnar epithelium.
8
Q
A male smoker has chest tightness after walking up a hill. The pain disappears shortly after, what is the diagnosis?
A
Stable Angina.
9
Q
An elderly patient has a shuffling gait and a pill rolling tremor at rest, which part of the brain is abnormal?
A
The substantia Nigra.
10
Q
A 25 year old homeless patient presents with a chronic cough and haemoptysis, which is the most likely diagnosis?
A
Tuberculosis.
11
Q
Which feature of dementia would indicate a vascular aetiology?
A
Step-wise progression.
12
Q
A one ‘pack-year history’ is equivalent to what?
A
Smoking 20 cigarettes a day for a year.
13
Q
Which test, tests the motor function of the trigeminal nerve?
A
Jaw jerk reflex.
14
Q
Antidiuretic hormone has what effects?
A
Increases blood volume.
15
Q
Failure of what results in left ventricle dysfunctoin?
A
Frank-starling Law
16
Q
For an average male, what is the volume of distribution of a drug confined to the plasma?
A
3 litres
17
Q
What condition is treated with a muscarinic receptor antagonist?
A
COPD
18
Q
What is the treatment for gastric acid related disease that can cause blackening of the tongue?
A
Bismuth Chelate
19
Q
How does warfarin act as an anticoagulant?
A
It inhibits VKORC1 which reduces the activity of clotting factors 2, 7, 9 and 10.
20
Q
How is benzydamine administered?
A
Oral spray/Mouthwash
21
Q
ACE inhibitors are used for which clinical condition?
A
Hypertension
22
Q
What is a side effect of short acting beta antagonist thereapy?
A
Trembling
23
Q
How does aciclovir work?
A
It inhibits the herpes virus DNA polymerase.
24
Q
What is a none selective agonist of a dopamine receptor?
A
Apomorphine
25
What glutamate antagonist can be used to treat Alzheimer's disease?
Memantine
26
Gingival hyperplasia and excess hair growth are side effects of what?
Phenytoin
27
What is a side effect of gliptin?
Gastro-intestinal disturbances.
28
Excessive exposure o glucocorticoids can lead to what?
Cushings syndrome
29
What drug is a tricyclic antidepressant?
Vomipromine
30
What is an intravenous anaesthetic agent?
Propofol
31
What drug is used to treat a morphine overdose?
Naloxone.
32
What can the hormone antagonist tamoxifen cause?
Thrombosis
33
What is the purpose of a vasoconstrictor in La?
To increase the duration of action of the anaesthetic.
34
How is mumps spread?
Through infected droplets of saliva.
35
Koplick's spots are associated with which disease?
Measels.
36
What causes a burning sensation and is result of secondary activation of the herpes varicella zoster virus?
Post herpetic neuralgia
37
What is a benign jaw overgrowth of normal mature cells that can be compound or complex?
Odontmes
38
What is not a symptom of colorectal cancer?
Dysphagia.
39
What are the two causes of chronic kidney disease?
Diabetes and hypertension
40
What term is used to describe a drug that enters the blood plasma following administration?
Absorption
41
If a patient is FAST positive what condition do they have?
A stroke
42
What is likely to be associated with a previous XLA site of a lower molar?
A residual cyst
43
What is the most common cause of dementia?
Alzheimer's Disease
44
What is the concentration of a drug that produces half the maximal response denoted as?
ED50
45
Which histamine receptor antagonist is most likely to cause sedation?
Promethazine.
46
What lesion is a whitish plaque or patch with no clinical cause other than the use of tobacco?
Leucoplakia
47
What bacterial infection is associated with Mulberry molars?
Congenital syphilis
48
What is the most common cause of a mucous retention cyst?
Sialoth
49
If a patient is experiencing chest pain on minimal exertion, the angina is...
Unstable
50
What is the most common type of HPV associated oral cancers?
HPV16
51
How can HPV positive head and neck cancer be described?
At the tonsils.
Involves Basaloid SCC
Affects the younger generation
Males more
Socioeconomic status is higher
Associated with sexual behaviour
Survival rates are increasing
52
How can HPV negative head and neck cancer be described?
It is at all sites
Keratinised SCC
Older generation
affects males more
Risk factors are alcohol/tobacco/diet/hygiene
survival rates are decreasing
53
what are the risk factors for potentially malignant lesions?
HPV
Alcohol
Tobacco
OH
Diet
Family history
Age
Gender
Race
54
What was the first material that was used for air polishing?
Sodium Bicarbonate
55
What is biological width?
The distance from the Junctional Epithelium to the root of the tooth.
56
What is the liver supplied by?
The portal Vein
57
What is the function of the liver?
To synthesise plasma proteins.
Make clotting factors.
Store glycogen, vitamins and minerals.
Make bile.
Provide immunity through hepatic macrophages.
58
What is a liver function test (LFT)?
Looks for ALT and if it is elevated it indicates damage.
59
What can excessive alcohol intake do to a person's oral health?
More susceptible to erosion.
Oral cancer
Dental trauma
Poor OH
Halitosis
Reduced bone density
60
What are the causes of chronic liver disease?
Alcohol
Obesity
Viral hepatitis
61
How is alcohol metabolised?
Alcohol dehydrogenase.
cytochrome P450 system.
62
How does liver disease present?
Abdominal pain
weight loss/gain
Malnutrition
Anorexia
fatigue
Perineal fluid build up
63
How would you manage a stroke?
999 an O2, protect airway.
64
What are some dental considerations to be made for those who have had a previous stroke?
They may be on anticoagulants
Poor OH - may need modifications
Paralysis of the facial muscles
Reduced sensation
Communication
Carers
65
If a patient having a stroke has ataxia and is 'past pointing', where is the stroke?
Ischaemic stroke in the middle cerebral artery.
66
What is a xenobiotic?
A chemical or substance that is found in an organism but it is not produced naturally.
67
How does a pulmonary embolism present?
Pleuritic chest pain
Dyspnoea
Collapse
Hypotension
Tachycardia
Fever
68
What are the dental considerations to be made for a patient with a previous pulmonary embolism?
Anticoagulants (INR)
Delay none urgent procedures.
69
What are the role of lipids?
They help to control what goes in and out of the cell.
70
What is vitamin E?
A fat soluble nutrient that protects cells from damage by free radicals.
71
What are the kidneys supplied by?
The renal artery
72
What part of the loop of henle is impermeable to water?
The ascending
73
What is tubular resoption?
Where water and solutes pass between the tubule and surrounding vasa react to determine what should be excreted.
74
The surrounding tissue of the loop of henle has a high osmolarity but why is there a high interval content?
Due to high sodium chloride.
75
What is the collecting duct regulated by?
Anti diuretic hormones.
76
How does acute renal disease present?
Reduced urine output
Dizziness
Vomiting
Orthopnoea
Peripheral oedema
Tachycardia
77
What are the dental considerations for renal disease?
To treat the day after dialysis
They are predisposed to blood borne viruses
La is safe unless a bleeding tendency.
78
What is a class III malocclusion?
Where the mandible is protruded relative to he maxilla.
79
What is the class III incosor relationship?
The lower incisor edges lie anterior to the cingulum of the upper incisor and the overjet is reduced.
80
What are the general factors that affect the occlusion?
Skeletal pattern
CROWDING
Early loss of deciduous teeth
Gernalised spacing
80
What are the general factors that affect the occlusion?
Skeletal pattern
CROWDING
Early loss of deciduous teeth
Gernalised spacing
81
What are the local causes of malocclusion?
Abnormalities in the number of teeth
Abnormalities in the shape of the teeth
Abnormalities in the position of the teeth.
hibits
Pathology
82
If a patient had an asthma attack, how would you manage the symptoms?
Salbutamol inhaler
O2
Assess pulse and BP
Pupil size
Blood glucose
Temperature
Remove allergens
999 if unstable
83
What are the main complications of diabetes?
Microangiopathy
Nephropathy
Neuropathy
Macro vascular disease
Delayed wound healing
Periodontitis
84
What are the differences in the immune response with patients that have diabetes?
There is altered function of neutrophils (adherence/chemotaxis)
Immune inflammatory responses are upregulated which increases host tissue destruction
85
AGEs alter functions of the extracellular matrix, how do they affect collagen formation?
Increase cross linkage between collagen molecules.
reduce solubility
Decrease turnover rate.
86
How can periodontitis have a negative impact on glycaemic control?
Diabetes exacerbates the elevated production of pro-inflammatory cytokines.
Increases insulin resistance
Poor wound healing leads to attachment and bone loss.
87
What is azole antifungal used to treat?
Oral thrush and cadidiasis
88
How do you manage a patient on warfarin?
INR checked 72 hours before in a stable patient.
INR below 4
NO NSAIDs
Delay any non-urgent procedures
See at the beginning of the day
Multiple surgery visits
Antibiotics can increase INR
Refer to primary care if liver impairment
LA with vasoconstrictor
Haemostatic agent
89
What are the factors affecting nerve damage in and extraction?
Clinicians expertise
tooth sectioning
Time
Surgical technique
Formed roots
Roots close to the nerve bundle
Age
Distal bone removal
Visualisation of mandibular canal.
90
What is the role of vitamin D?
To help the body absorb and retain calcium and phosphorus.
91
Who signs the patient group direction?
Dentist/doctor/pharmacist
92
What antibiotics should be avoided in a patient on warfarin?
Metro/ammox
93
Antibiotics with the worst resistance are...
Penicillin
94
What are the responsibilities when prescribing drugs?
To avoid creating dependence
Ensure that the patient can't increase the dose
Avoid being an unwitting source for addicts.
95
What are the most common side effects with antibiotics?
Allergic reaction
Anti-biotic associated colitis
Diarrhoea
Nausea
96
What advice would you give to a diabetic patient with periodontitis?
OHI
Eat before appointment
Short recall
Morning appointments
Topical
Prophylactic antibiotics
Diet advice
Good glycaemic control
PMPR
Fluoride
97
What is a radicular cyst?
Associated with non-vital teeth. Treat with enucleation during RCT or XLA.
98
What is a residual cyst?
Inflammatory odontogenic cysts that are asymptomatic and present on post XLA sites.
99
With what conditions will a patient be put of warfarin?
Stroke
Heart attack
Deep vein thrombosis
Pulmonary embolism
Atrial fibrillation
Clotting disorders
100
What type of analgesic is paracetamol?
Antipyretic analgesic
101
What does cocodamol contain.
codeine and paracetamol
102
What are the 6 keys to an ideal occlusion?
Correct molar relationship
Correct crown angulation
correct crown inclination
Teeth in contact
No rotations
Flat occlusal plane
103
What is a class I incisor relationship?
The lower incisor edges occlude with or lie immediately below the cingulum plateau of the upper centrals.
104
Describe a class II incisor relationship?
The lower incisor edges lie posterior to the cingulum plateau of the upper incisors with an increased overjet and proclined uppers.
105
What is a class III incisor relationship?
The lower edges lie anterior to the cingulum plateau of the upper incisors. The over jet is reduced or reversed.
106
What are the risk factors of root caries in the elderly?
Diet
OH habits
fluoride exposure
Past dental history
Overall health
Dentures
Dexterity
Xerostomia
Gingival recession
107
What advice and treatment would you give for root caries?
GIC restoration
Fluoride
OHI
Diet advice
Check medications for dry mouth
Atraumatic restorative technique
establish risk
consider risk factors
108
What are the treatment targets for a referral?
a 2 week rule that the patient must have a diagnosis in 31 days and treatment to start within 62.
109
What are the short term complications of head and neck cancer?
Mucositis
Infection
Xerostomia
Pain
dysgeusia
110
When may a patient need an urgent referral?
when there are red and white patches present that are painful, swollen or bleeding.
111
Where would you make an urgent referral to?
Maxillo-facial/oral med unit
112
How is peri-implantitis diagnosed?
Plaque and calculus accumulations
Inflammation of the peri-implant tissue
Increase in peri-implant probing depth
BoP
Suppuration
Mobility
Radiographic changes
113
What is peri-implantitis?
An inflammatory process around osseo-integrated implants involving the loss of bone. Peri-implant disease and periodontal diseases have similar signs and symptoms.
114
What are the microbes that are commonly involved in peri-implantitis?
Spirochetes
Gram negative anaerobes
115
What are three illnesses that are associated with the elderly?
Dementia
Stroke
Parkinson's
116
What is the warfarin action in relation to vitamin K?
Warfarin is a vit K antagonist.
It inhibits VKORC1 which reduces clotting factors 2,7, 9, 10.
117
What is a full mouth disinfection?
Used to treat periodontal disease where half the mouth is treated at each visit under LA to remove plaque and calculus where bacteria are killed with chlorohexidine mouthwash.
118
What type of tooth whitening causes root resorption?
Intracoronal bleaching
119
What is the definition of institutional abuse?
The mistreatment of people through inadequate care to ensure the smooth running of an organisation.
120
What is the definition of descrimination?
Prejudicial treatment of people based on their race, ethnicity, gender, sex, disability or age.
121
What are the protected characteristics in the equality act?
Age
Sex
Gender Reassignment
Disability
Marriage
Pregnancy
Race
Religion
Sexual orientation
122
How does heart failure present?
Tachycardia
Can't lie down
Fatigue
Palpitations
Confusion
Chest pain
123
What are the risk factors of heart failure?
Diabetes
Hypertension
Age
Male
MI
Dyslidaemia
124
What does the failure of the Frank-Starling law mean?
That there is increased CO2 and fluid retention.
125
How is heart failure managed by the patient?
Beta blockers
Aldosterone antagonists
Lifestyle changes
Implantable cardiac defibrilator
Heart transplant
Pacemaker
125
What are some dental considerations to be made for a patient with heart failure?
Polypharmacy
Dry mouth
Poor healing
Increased infection risk
O2 requirement
Don't lie flat
126
What is the pathophysiology of asthma?
A trigger leads to the inflammatory response.
CD4 leukocytes, Chemokines and mast cells release histamine.
The white cells are inflamed and pour into the airway.
This leads to vasoconstriction and a high level of mucous.
127
How does asthma present?
Expiratory wheeze
Cough
dyspnoea
128
What are the triggers of asthma?
Viral infections
Bacterial infections
Allergens
Occupational exposures
Food additives
Aspirin
Strong emotion
129
A patient begins to have an asthma attack whilst in the midst of treatment, What do you do?
Remove all instruments and stop treatment.
Airway - Is the patient breathing? Are they awake, can they talk to you?
130
In the peripheral airways of patients with COPD, why is there airflow limitation?
Loss of alveolar attachments
Inflammatory obstruction of the airway
Luminal obstruction with mucus
131
How do inhaled corticosteroids help those with COPD?
LCS’s decrease the rate of exacerbation and improve the response to bronchodilators and decrease dyspnea in stable COPD
132
How is COPD diagnosed?
A diagnosis is made from one or more of the symptoms: -
- Exertional breathlessness
Chronic cough
Irregular sputum production
Winter bronchitis
Wheeze
133
Describe the pathophysiology of COPD.
Noxious particles cause microdamage which leads to inflammation.
CD8+, cytokines and macrophages are released to combat inflammation.
Production of proteases which causes destruction of the alveolar wall and mucous hypersecretion.
134
What are the pharmacological properties of Atropines?
Non-selective muscarinic antagonists.
Long duration of action.
Lipid soluble and well absorbed.
135
What are the pharmacological properties of Atropines?
Non-selective muscarinic antagonists.
Long duration of action.
Lipid soluble and well absorbed.
136
What are the adverse effects of Atropine?
urinary retention
Blurred vision
Dry mouth
137
What is glaucoma characterised by?
Elevation of intraocular pressure.
Atrophy of the optic nerve.
Gradual loss of vision
138
What is Ipratropium?
A non-selective muscarinic antagonist that acts as a broncho-dilator.
139
What are the adverse effects of Ipratropium?
Dry mouth
Altered taste
Throat irritation
140
In the body, where is histamine mainly found?
Mast cells
Leukocytes
Neurons
141
What is histamine?
An amine that modulates the local immune responses and regulates physiological function.
142
What are H1 receptor antagonists used for?
To treat inflammatory and allergic conditions.
143
What do H2 receptor antagonists do?
To treat peptic ulcers and inhibit gastric acid secretion.
144
What are the adverse effects of H1 receptor antagonists?
Dry mouth
Blurred vision
Urinary retention
If they cross the blood-brain barrier than it can cause sedation.
145
What histamine receptor antagonist is structually reltaed totricyclic antidepressants?
Loratadine
146
What are the adverse effects of muscarinic histamine antagonists that are related to dentistry?
Burning sensation in the mouth
Poor OH
Increase in dental caries
Increase risk of perio
Intolerance to dentures
Oral infections
147
What protects the mucous cells from acidic lumen in the stomach?
Mucous layer with HCO3
148
Which prostaglandin has cytoprotective effects?
PGE2
149
How do peptic ulcers develop?
failure of luminal defences.
Failure to inhibit gastric acid secretion.
Increased pepsin secretion
Increased gastric acid emptying into the duodenum.
150
What condition is charactrised by discomfort, bloating and a feeling of fullness.
Dyspepsia
151
What are complication of peptic ulcer disease?
bleeding
Perforation
Peritonitis
Septicaemia
Scarring
152
What molecules stimulate gastric acid secretion?
Acetylcholine
Histamine
Gastrin
153
What inhibits gastric acid secretion?
Somastatin
154
What is an example of a proton pump inhibitor that inhibits gastric acid secretion?
Omeprazole
155
Wat is an example of a histamine receptor antagonist that inhibits gastric acid secretion?
Cimetidine
156
What is sucrulfate?
A cytoprotective drug.
157
Why should misoprostol beavoided in pregnancy?
Causes uterine contractions.
158
What is the triple therapy to eradicate a H pylori infection?
Proton pump inhibitor
Anti-bacterial
Bismuth subsalicylate
159
What are the four movements of a fixed orthodontic appliance?
Tipping
Intrusion
Extrusion
Bodily tipping
160
How do you know if a removable appliance has not been worn?
No movement
No pt lisp
No wear and tear
Trouble inserting appliance
No imprints on the soft tissue
Springs are active
161
What are the active components in a removable prosthesis?
Springs
Screws
Balls
Elastics
162
What is the mechanism of action of Azole anti fungal?
There is cell membrane synthesis
It inhibits Ergesterol synthesis
It is bacteria static against S.Aureus
163
What do azole anti fungals interact with?
Warfarin
Simvastatin
164
What are some antibiotics to avoid in warfarin?
Metronidazole
Erythromycin
Clindamycin
165
What information would you put on a referral letter for an oral lesion?
Patient details
Consultant
Relevant department
Address appropriately
Mark the letter as urgent under two week rule
Clinical description of the lesion
Attach images
Any related lesions
X-rays
Differential diagnosis
Sign with name and qualification
166
How would you appropriately probe around an implant?
A calibrated probe
0.25N
BPE at every visit
6PPC once a year
Fixed reference point
167
What is the role of carbohydrates?
To support the body with energy and maintain blood glucose levels.
168
What is the role of fats?
To insulate the body from cold
To cushion the organs
169
Which drug legislation includes:-
Authorisation of medicinal products for human use.
Manufacture, import, distribute, sale and supply.
Levelling and advertising.
Human medicines regulations 2019
170
What is in the misuse of drugs act 1971?
Controls the use of drugs linked to addiction and other social problems.
171
What is contained in the misuse of drugs act 2001?
Defines who is allowed to supply, prescribe and possess controlled substances.
Lays down the conditions for their use.
172
What is a dentigenerous cyst?
Associated with an unerupted tooth.
173
A neoplasm with more than one germ layer is known as what?
Teratoma
174
What are common musculoskeletal disease related to the elderly?
Osteoporosis
Osteoarthritis
Rheumatoid arthritis
175
What is excessive bleeding from warfarin treated with?
Vitamin K
