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Medical Managemnet > Cardiovascular Systme > Flashcards

Cardiovascular Systme Flashcards

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USMLE® Step 1 flashcards
1
Q

Acute Rheumatic fever is a disease of – or –

A

childhood or adolescence

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2
Q

Prevention of recurrent rheumatic fever depends upon the continuous low-dose of –

A

prophylactic antibiotics

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3
Q

Patients with rheumatic heart disease are not at risk to – and dont need a –

A

dental treatment bacteremia

premed

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4
Q

Patients with Rheumatic heart disease are at risk for – caused by physiologic bacteremia but the risk is minimized in patients with good oral hygiene.

A

endocarditis

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5
Q

If endocarditis is suspected patients should be referred for –

A

medical eval and treatment

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6
Q

what are the signs and symptoms for endocarditis?

A

fever, murmur, chills, sweats, nausea, vomiting, weight loss, septic emboli, confusion.

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7
Q

A myocardial infarction is another word for –

A

heart attack

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8
Q

What results from inadequate coronary blood supply due to the occlusion of the coronary arteries by an emboli or thrombi?

A

heart attack

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9
Q

What are the sympotoms of a sudden heart attack?

A

sudden onset of substernal pain that might radiate to neck and arms. Also rapid pulse and low blood pressue

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10
Q

No elective dental care should be given on patients who had a heart attack within a — time frame

A

4-6 week

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11
Q

A medical consult is suggested for all patients with a history of heart attack to –

A

confirm meds and the patients status

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12
Q

The use of – should be minimized in patients who have heart attacks.

A

vasoconstrictors

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13
Q

What anticoagulant is a concern because of its effect on clotting?

A

warfarin

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14
Q

What is the normal prothrombin time?

A

11-15 seconds

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15
Q

what is a normal INR?

A

1

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16
Q

what is the cut off INR for treatment??

A

3.5 and below

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17
Q

what INR are patients on warfarin at?

A

2.5-3.5 to prevent heart attack

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18
Q

What if a patient has a INR of greater than 3.5?

A

send them to the doc to get dosage reduced and wait 3-5 days

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19
Q

What occurs when the heart is no longer able to circulate an adequate amount of blood to the body tissues?

A

congestive heart failure

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20
Q

What are the symptoms of congestive heart failure?

A

shortness of breath, fatigue, chest pain, blood lips/tongue/mucosa.

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21
Q

Patients with poorly controlled symptoms of congestive heart failure should not receive routine dental care until…

A

medication has been provided for treatment

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22
Q

Patients with congestive heart failure are usually unable to tolerate a – or – chair position.

A

supine or semisupine

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23
Q

Use of – should be limited with patients with congestive heart failure.

A

vasoconstrictors

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24
Q

What is a sign of coronary artery disease?

A

angina

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25
Q

what is angina?

A

brief chest pain

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26
Q

Angina is a lack of – to the myocardium

A

oxygen

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27
Q

What is a common drug for angina?

A

nitroglycerin or other vasodilators.

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28
Q

What causes angina pain?

A

exercise, emotion, or heavy meal

29
Q

Patients with severe or progressive angina should have minimized use of – and –

A

local anesthetics containing vasoconstrictors.

30
Q

What occurs when there is a shortage of blood to the brain?

A

stroke

31
Q

what efforts should be made for patients with a history of stroke?

A

minimize stress, and get them to breathe normally.

32
Q

— should be minimized in stroke patients

A

vasoconstrictors

33
Q

What is caused by a turbulence of blood flow producing vibratory sounds during the beating heart?

A

heart murmur

34
Q

What kind of heart murmur occurs in the absence of any pathologic change in the structure of the heart or valvues?

A

functional heart murmur

35
Q

What type of murmur occurs when there is a structural change or damage to the heart or valves?

A

organic or pathologic murmur

36
Q

The presence of a organic heart murmur may predispose patients to –

A

bacterial endocarditis infection

37
Q

Patients with murmurs of unknown origin should be referred to –

A

evaluate need for meds or treatment

38
Q

What are the group of genetically determined malformations of the heart frequently associated with other systemic diseases called?

A

congenital heart disease

39
Q

The AHA feels that most patients with congenital heart disease are not at risk for – from dental treatment bacteremia.

A

endocarditis

40
Q

What severe lesions of the heart recommend a premed to prevent endocarditis?

A

valvular dysfunction, congestive heart failure, need for valve replacement, multiple embolic events.

41
Q

what severe heart condition REQUIRES a premed?

A

unrepaired cyanotic lesions with palliative shunts and repaired lesions with a prosthetic devices for the first 6 months, and repaired lesions with defects.

42
Q

What is the congenital heart defect created by a thickening of the connective tissue of the mitral valve?

A

mitral valve proplase

43
Q

What is caused by a microbial infection of the heart valves or lining of the heart?

A

infective endocarditis

44
Q

What is caused by a microbial infection of the endothelium of the arteries?

A

infective endarteritis

45
Q

What occurs when the heart tissues fail to conduct normal impulses from the atrium to the ventricles of the heart?

A

arrhythmias

46
Q

Poorly insulated, older pacemakers are subject to malfunction when exposed to –

A

ultrasonic scalers, pulp testers

47
Q

Patients with prosthetic heart valves often take — which may have dental implications.

A

anticoagulants

48
Q

Patients with – grafts should have a premed for first 6mo after repair

A

dacron

49
Q

Patients with pros heart valves who require — for oral infection should take a premed

A

incision and drainage

50
Q

What is the recommended BP?

A

less than 140/90

51
Q

Uncontrolled hypertension may result in —

A

heart attack, heart failure, stoke or kidney failure

52
Q

Patients with a BP reading of — should be referred immediately for medical eval.

A

180/110

53
Q

Hypertensive medications can effect the patients – and –

A

gingiva and salivary flow

54
Q

What dental modifications are needed with angina patients?

A

shorter appointments not after lunch.

55
Q

No treatment for – after a stroke

A

6 months

56
Q

Treat patients who had a heart attack with caution for – following attack

A

6 mo

57
Q

Evaluate IRN prior to – for patients with heart attack, angina or stoke

A

extractions, perio therapy and surgery

58
Q

A a patient with heart attack, angina or stroke is taking – or – , minimize use of local ane with vasoconstrictors

A

aldomet or fifitalis

59
Q

Do heart attack, angina or stroke patients need a premed?

A

no

60
Q

What potential emergency situation can arise in patients with heart attack, angina and stroke?

A

heart attack, cadiac arrest, CVA

61
Q

Is a premed needed for a heart murmur?

A

no

62
Q

What conditions of infective endocarditis indicate a premed?

A

history or IE

presence of p heart valve

63
Q

Do patients with a pacemaker need a premed?

A

no

64
Q

When is a premed needed in patients with p heart valves?

A

within 6 months following surgery or if leakage is present

65
Q

If a patient is taking anticoagulants, test patients –

A

INR

66
Q

When do you need a premed for open heart surgery?

A

6months or beyond, heart transplants

67
Q

What condition of hypertension indicates a medical consult?

A

uncontrolled, undiagnosed high BP

68
Q

What drugs are to be avoided in patients with high BP?

A

vasoconstrictors in large doses (3 or more cartridge’s)

69
Q

What dental mods should be made for high BP patients?

A

shorter appointments, reduced stress and anxiety

Medical Managemnet (13 decks)

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