Case Pres Flashcards
What is asthma?
Narrowing of the airways resulting in reversible airflow obstruction
Incidence of asthma?
5-10% all children
2-5% adults
How does asthma attack occur on cellular level?
Allergen inhalation followed by mast cell degranulaiton
- histamine and leukotrienes deposited into airway wall
Or allergen phagocytosed into antigen presenting cell
- presents antigen to CD4 T cell which interacts with B cell to produce inflammatory response
how mat airways narrow?
Bronchial smooth muscle constriction
Bronchial smooth muscle oedema
Excessive muscles secretions into the airway lumen
Symptoms of asthma?
Cough
Wheeze
- expiratory noise
Shortness of breath
Diurnal variation
- worse at times during day
Difficulty breathing out
What can trigger asthma?
Unknown
Allergens
Stress
Environmental stimul
- dust
- smoke
- chemicals
Cold air
what are the core asthma drugs?
Intermittent short acting beta adrenergic agonists
- relieve symptoms
Inhaled corticosteroids - low dose
- prevent issues
Inhaled corticosteroid - high dose
Regular long acting beta adrenergic agonist
How do beta adrenergic agonists work?
Engage with beta - 2 adrenergic receptors on walls of bronchial smooth muscle
- reducing bronchoconstriction
- reduce resting bronchial tone
Best tx for asthma?
Inhaled corticosteroid
- deal with all effects
- if SABA used more than 3 times per week, use a preventer inhaler daily
How might one give smoking cessation?
3 A’s
Ask - patient about their smoking habit and record this
Advise - on health risks and benefits of smoking
Act - on patients response, point them towards services that aid with quitting smoking
How would i treat an asthma medical emergency?
A - struggling to speak
B - increased rate with wheeze
C - increased
D - alert
E - tripods
Use of salbutamol inhaler - 100mcg/puff
- repeat until attack stops
Or 10 puffs into spacer device
- if pt cannot use inhaler
15L/oxygen/minute
Fx of marijuana on dental treatment?
Generally
- poor OH, higher risk caries and periodontal disease
Prolonged tachycardia, la with vasoconstrictor
High cariogenic diet due to the effect cannabis has on the desire to eat - commonly the munchies
Increased risk of oral cancer, oral candida and infection
What is asymptomatic apical periodontitis
Inflammation at the apex of the root of a tooth that is of pulpal origin, confirms pulp necrosis.
Why use MCC?
Not in aesthetic zone
Cheap
Excellent aesthetics
Benefits of using a MCC?
Alloy limits strain the ceramic experiences
Bonded via metal oxide on surface
- alloy is more ductile so it results in less strain on the porcelain
- porcelain is hard, rigid and has excellent aesthetics
