CASES Flashcards
What are common contraindications for taking an NSAID?
allergy
GI ulceration
pregnancy
kidney disease
what space is an IANB inserted in to?
pterygomandibular space
following an IANB, why could facial palsy occur?
block given too far posteriorly, into parotid gland which contains facial nerve
how do you treat facial palsy, including eyes, after IANB?
eye lubrication and patch
what nerves must be anaesthetised for xLA of 47
IAN
Long buccal
Lingual
what nerves must be anaesthetised for xLA tooth 27?
greater palatine
posterior superior alveolar
what regulation does breach of pt confidentiality come under?
general data protection regulation
what SBAR stand for?
situation
background
assessment
recommendation
how would you go by treating a patient who is taking warfarin but their INR is below 4?
treat without interrupting medication
when should a pts INR be checked
no more than 24 hours before app
unless stable - 72 hours
how would you class a stable patient on warfarin?
one who does not require weekly monitoring and has had no INR above 4 in last 2 months
can you treat a pt with INR above 4?
no - inform their antigoaculant service
what forcep would be used to extract tooth 27?
upper left molar forceps
list the available local haemostatic materials
absorbent gauze - bite for 5-10 mins
haemostatic packing material (oxidised cellulose, collagen sponge)
suture kit
what haemostatic measure could be used for a pt on antithrombotic therapy? it can only be prescribed by a medical practitioner
tranexamic acid
list dental procedures that have the highest bleeding risk
complex xLA
more than 3 xLA
flap raising procedures
biopsies
gingival recontouring
list medical conditions that increase bleeding risk
renal failure
liver disease
haematological malignancy
chemo/radiotherapy
heart failure
coagulation disorders
platelet disorders
connective tissue disorders
list the dental procedures unlikely to cause bleeding
LA
BPE
supra PMPR
supra restorations
imps
ortho fitting
endo
what does a large fluctuant buccal swelling tell you about local anatomy of the tooth
the root lies above muscle attachment so it presents intra-orally
the apex lies closer to the buccal plate
4 stages of WSS
tell pt
apologise
document in notes
inform pt of complaints procedure
in what case would infection present extra orally and not intra orally?
the apex of the tooth lies below the muscle attachment
what term is used to describe swelling of the neck?
submandibular cellulitis
what is an abscess?
circumscribed collection of pus
why is submandibular cellulitis of concern?
progression to oedema of the laryngeal inlet, causing compromised breathing - ludwigs angina
what are IV drug users at risk of?
BBV - hep C or HIV
what is edoxaban and what is its mechanism of action?
NOAC
direct factor Xa inhibitor
what do you tell your pt taking edoxaban who needs xLA?
if they take it in the morning - omit it and take again 4 hours after tx
if they take it in the evening - no not need to change anything
