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xD3 Med Mgmt Ex1 > Cardiovascular (Liu) > Flashcards

Cardiovascular (Liu) Flashcards

0
Q

What blood pressure reading requires deferring
dental treatment and directing patient to their primary
care provider or the ER?

A

180/110

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1
Q

What is the cause of 90% of hypertension diagnoses?

A

Unknown causes, usually primary hypertension.

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2
Q

When get a high blood pressure reading, what should you ask the patient?

A

What are your symptoms? Are you in any pain?

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3
Q

What dental instruments are contraindicated in patient with a pacemaker?

A
  1. Electrosurgery
  2. Ultrasonic scalers
  3. Battery operated curing lights
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4
Q

If patient has atrial fibrillation, what does this mean is going on in the heart?

A

Atrium not pumping correctly. Some blood inside will

be static. Static blood clots

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5
Q

What is the expected treatment/medical prescription for atrial fibrillation?

A

MD will prescribe anticoagulant (Coumadin or Warfarin) to avoid clotting in atrium

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6
Q

If patient is taking an anticoagulant, what must their INR be for minor oral surgery (single tooth extraction)?

A 
Therapeutic range (2.0-3.5). Consider packing foam 
and suturing after EXT.
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7
Q

What is the ideal time span for an INR?

A

The day of surgery

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8
Q

What type of procedure can you perform if the INR is in the 2.0-3.5 range?

A

Simple EXT, e.g. perio involved tooth. NOT a boney

impacted #16

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9
Q

How many carpules of local anesthesia with 1:200,000 epi can be administered in a patient with hypertension?

A

2 carpules

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10
Q

What is the term for stenosis of the arteries that brings nutrients and oxygen to the heart itself so it can function?

A

Coronary artery disease

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11
Q

What is the term for and ultrasound of the heart to look at heart structure and check ejection fraction?

A

Echocardiogram

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12
Q

What is the term for an electrical picture of the heart?

A

Electrocardiogram (ECG/EKG)

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13
Q

What is the term for a balloon blown up in the vein to break up an
occlusion?

A

Angioplasty

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14
Q

What is the term for metal mesh holding a blood vessel open?

A

Stent

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15
Q

What is the term for the procedure whereby you bypass a part of a coronary artery that is blocked?

A

Bypass surgery

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16
Q

What are 3 questions to ask to assess patients risk for the

procedure you will perform?

A
  1. Severity of the patient’s disease
  2. Type of procedure planned
  3. How is patient right now
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17
Q

What risk level is basic dental operative considered?

A

Low cardio risk

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18
Q

Gauging a patient’s ability to perform normalphysical activity is gauging their what?

A

Functional capacity

19
Q

The Metabolic Equivalents of Tasks (METs), which isna method to determine a person’s functional capacity, quantifies what?

A

The body’s use of oxygen

20
Q

A MET is equivalent to what with respect to oxygen?

A

MET is a unit of oxygen consumption

1 MET = 3.5 mL of O2/kg of body wt/minute at rest

21
Q

A patient is at risk of a perioperative cardiovascular event if they do not meet what MET level?

A

4-MET

22
Q

What are some types of CV disease?

A 
HTN 
Arrhythmia 
Ischemic heart disease/coronary artery disease
Heart failure 
Infective endocarditis 
Cardiomyopathy 
Inflammatory heart disease
23
Q

What are the limits for stage 1 hypertension?

A

140-159 sys or 90-99 dias

24
Q

What are the limits of stage 2 hypertenion?

A

> 160 sys or >100 dias

25
Q

If the patient has had a balloon angioplasty, how many days after the angioplasty must you wait before you perform head and neck surgery with aspirin?

A

More than 14 days

26
Q

If the patient has a bare-metal stent placed, how many days after the placement should you wait before you perform head and neck surgery with aspirin?

A

More than 30-45 days

27
Q

If the patient has had a drug-eluting stent placed, how long should you wait after the placement before you perform a head and neck surgery on that patient with aspiring?

A

More than 365 days

28
Q

Can EPI be given to a pt with mild/stable angina or a past history or MI?

A

Yes, no more than 2 carpules (0.036 mg) at a time

29
Q

If a patient has unstable angina or a recent MI, can they be given EPI?

A

Yes, nor more than 2 carpules (0.036mg ) at a time.Consider prophylactic nitroglycerin before procedure

30
Q

What are some heart conditions that require prophylaxis prior to dental procedures?

A
  1. Prosthetic cardiac valve
  2. Previous infective endocarditis
  3. Congenital Heart Disease
    - unrepaired cyanotic
    - repaired cyanotic but w/in 6 months of repair -repaired cyanotic, but w/residual defects
  4. Transplant that develops valvulopathy
31
Q

If a patient requiring antibiotic prophylaxis for

cardiac reasons has bleeding from trauma to the lips or oral mucosa, is antibiotic prophylaxis indicated?

A

No

32
Q

When is antibiotic prophylaxis indicated for dentistry?

A

All dental procedures involving manipulation of gingival tissue or periapical region of teeth or perforation of the oral mucosa

33
Q

Does perforation of the oral mucosa include routine anesthetic injections through noninfected tissue?

A

No

34
Q

In patients where antibiotic prophylaxis is indicated, how long before the procedure should the antibiotics be given?

A

30-60 minutes before the procedure

35
Q

What is the prophylactic dosage for orally administered amoxicillin?

A

2 g adult

50 mg/kg child

36
Q

What is the prophylactic dosage for IV or IM Ampicillin (unable to take oral amoxicillin)?

A

2 g adult

50 mg/kg child

37
Q

What is the prophylactic dosage for IV or IM Cefazolin or Ceftriaxone (unable to takeoral amoxicillin)?

A

1 g adult

50 mg/kg child

38
Q

If the patient is allergic to penicillin or ampicillin, what are alternatives for prophylaxis?

A

Cephalexin
Clindamycin
Azithromycin
Clarithromycin

39
Q

What is the regimen for prophylaxis with cephalexin (penicillin or ampicillin allergy)?

A

2g adult

50mg/kg child

40
Q

What is the regimen for prophylaxis for clindamycin (penicillin or ampicillin allergy)?

A

600 mg adult

20 mg/kg child

41
Q

What is the prophylactic regimen for Azithromycin/Clarithromycin (penicillin orampicillin allergy)?

A

500 mg adult

15 mg/kg child

42
Q

If the patient is allergic to penicillin or ampicillin and unable totake Cephalexin, Clindamycine, Azithromycin,
Clarithromycin orally, what is the alternative for prophylaxis?

A

Cefazolin or Ceftriaxone IV/IM

Clindamycin phosphate IV/IM

43
Q

What is the prophylactic regimen for Cefazolin/Ceftriaxone IV or IM for prophylaxis (penicillin or ampicllin allergy and unable oral)?

A

1 g adult

50 mg/kg child

44
Q

What is the prophylactic regimen for Clindamycin phosphate IV or IM for prophylaxis (penicillin or ampicillin allergy and unable oral)?

A

600 mg adult 20mg/kg child

45
Q

What is an acronym for treating Acute Coronary Syndrome that incorporates IV?

A 
A-airway 
B-breathing 
C-circulation
O-oxygen 
M-monitor 
I- IV
46
Q

What is an acronymn for treating Acute Coronary Syndrome that incorporates aspirin and nitroglycerine?

A

M-Morphine
O-Oxygen
N-Nitroglycerin
A-aspirin

xD3 Med Mgmt Ex1 (6 decks)

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