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2nd Year > CMS > Flashcards

CMS Flashcards

1
Q

what types of disease can arthersclerosis cause?

A

ischaemic heart disease
peripheral vascular disease
cerebrovascular disease
renovascular disease

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2
Q

what are the biggest risks of heart disease?

A 
smoking
high cholesterol
high bp
diabetes
genes
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3
Q

what is primary hypertension?

A

caused by obesity, alcohol, high salt diet, genetics

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4
Q

what is secondary hypertension?

A

endocrine - excess hormones

renal - kidneys not working

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5
Q

what drugs are used in the tx of hypertension?

A 
B blockers
duiretics
ACE inhibitors
angiotensin 2 inhibitors
Ca channel blockers
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6
Q

what are the types of ischaemic heart disease?

A

angina
acute coronary syndromes
heart failure
arrhytmias

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7
Q

what are the types of peripheral vascular disease?

A

chronic - intermittent claudication

acute - ischaemic limb

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8
Q

what medications manage angina?

A

antiplatelets
statins
symptom relief - nitrates, calcium antagonists, B blockers

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9
Q

why can heart failure happen?

A

IHD
hypertension
valvular heart disease
alcohol excess

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10
Q

why should NSAIDs be avoided in heart failure?

A

fluid retention

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11
Q

what is regurgitation?

stenosis?

A
  • leaky valve

- narrow valve

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12
Q

what do patients with valvular disease at risk of?

what is it caused by?

A

infective endocarditis
strep viridans
staph aureus

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13
Q

what is AF associated with? what does it cause an increased chance of?

A

cerebrovascular disease

Stroke

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14
Q

what is SVT?

A

tachyarrhytmia - too fast and irregular

adenosine

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15
Q

what is bradyarrhytmia?>

A

too slow

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16
Q

what is Ventricular arrythmia?

A

tachycardia

med emergency

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17
Q

what oral side effects can statins cause?

A

Taste disturbance

lichenoid reaction

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18
Q

what oral side effects can beta blockers cause?

A

lichenoid reactions

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19
Q

what oral side effects can nifedipine cause?

A

hyperplasia

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20
Q

what oral side effects can ACE inhibitors cause?

A

taste disturbance

lichen planus

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21
Q

what oral side effects can nicorandil cause?

A

painful oral ulcers

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22
Q

what oral side effects can antihypertensives cause?

A

dry mouth

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23
Q

in what situations would you not treat a cardiac patient?

A

1 month post MI

unstable angina

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24
Q

why should you be cautious with adrenaline?

A

interacts with vasoconstrictors

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25
Q

what are the links of IE and dentistry?

A

no association with dental procedures
reg TB as much of a risk
prophylaxis not cost effective

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26
Q

what patients are at risk of IE?

A

valvular heart disease
valve replacement
structural congenital heart disease
prev IE

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27
Q

what oral side effects can anaemia cause?

A

recurrent apthous stomatitis - minor, major, herpetiform

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28
Q

what oral side effects can type 2 diabetes cause?

A

acute pseudomembranous candidosis

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29
Q

what is burning mouth syndrome and what can it be associated with?

A

idiopathic burning and oral discomfort

amitryptiline, gabapentin

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30
Q

if a lichen planus pt has an oral lesion what percent chance do they have a skin lesion?
if they have a skin lesion percent chance of an oral lesion?

A

25-30%

70-75%

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31
Q

opthalmic disease can be associated with what orally?

A

mucous membrane pemphigoid

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32
Q

what can GI disease be associated with orally?

A

recurrent oral ulceration

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33
Q

what can HIV/AIDS present with orally?

A

hairy leukoplakia
kaposi’s sarcoma
candidosis

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34
Q

what is the definition of MRONJ?

A

current or prev tx with bisphosphonates or anti angiogenic agents
exposed bone or bone that can be probed through an intra oral or extra oral fistula in the maxillofacial region that has persisted for 8 or more weeks
no history of radiation to the jaws or obvious metastatic jaw disease

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35
Q

what meds can cause MRONJ?

A

bisphosphonates
Rank ligand inhibitor - denosumab
antiangiogenics

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36
Q

what is the action of bisphosphonates?

used orally to tx? IV to tx?

A 
deposit in bone and persist
inhibit formation, recruitment and function of osteoclasts
increase apoptosis
orally - osteoporosis
iv - cancer
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37
Q

what is the action of denosumab?

A

ab against RANK ligand
inhibits osteoclast function
inhibits bone resorption

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38
Q

what happens during MRONJ?

A 
reduced bone turnover
reduced vascularity
inflammation and infection
adverse effects on soft tissues
immune dysfunction
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39
Q

what risks increase the chance of MRONj?

A

potency of drug
route of administration
antiangiogenic and bisphosphonate
systemic corticosteroids, immunosuppressants, chemo and radio

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40
Q

what is stage 0 MRONJ?

A

no clinical evidence

non specific symptoms or clinical radiographic findings

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41
Q

what is stage 1 MRONJ?

A

exposed necrotic bone or fistulas that probe to bone

asymptomatic

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42
Q

what is stage 2 MRONJ?

A

exposed bone that is nectrotic or fistulas that probe to bone
associated with infections
pain/erythema

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43
Q

what is stage 3 MRONJ?

A 
same as stage 2 with
necrosis extending past alveolar bone
pathological fracture
extra oral fistula
oral antral or nasal communication
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44
Q

what is the tx of the stages of MRONJ?

A

0 - nil
1- antimicrobial rinses
2- antimicrobial rinses with systemic antibiotics and analgesics and debridement

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45
Q

in pregnancy avoid high doses of what antibiotic?

A

metronidazole

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46
Q

caution with what local anaesthetic in early pregnancy?

A

mepivicaine

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47
Q

oral manifestations during pregnancy are secondary to?

A

increased vascular permeability
reduced immunocompetence
increased infection susceptibility

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48
Q

why is gingivitis likely to happen during pregnancy?

A

progesterone

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49
Q

when is a pregnancy epulis likely to happen?

A

1st trimester

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50
Q

what is pytalism?

A

linked to nausea

settles in 12-14 weeks

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51
Q

why is there an increased erosion risk during pregnancy?

A

secondary to vomitting

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52
Q

what is the link with gestational diabetes and perio?

A

9x more likely to suffer from perio disease

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53
Q

perio is associated with what in terms of pregnancy?

A

pre term birth weight
pre eclampsia
low birth weight

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54
Q

what is asthma?

A

reversible small airway obstruction

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55
Q

what drugs are used to tx asthma?

A

inhaled beta agonists - sabutamol
inhaled corticosteroids
combo inhalers
anti leukotrienes

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56
Q

avoid prescribing what drug with asthma?

A

NSAIDs

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57
Q

what side effects can asthmatic drugs cause?

A

oral candidiosis
altered taste
dry mouth

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58
Q

what is COPD?

A

airway obstruction that is not fully reversible

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59
Q

what is pneumonia?

A

lung infection

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60
Q

what is a pneumothorax?

A

leak of air into the pleural space

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61
Q

what is sleep apnoea?

A

failure of upper airways during sleep

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62
Q

what is intersitial lung disease?

A

inflammation of lung tissue
restrictive lung defect
avoid sedation

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63
Q

what is CF?

A

gene defect = abnormal cl channels

highly viscous mucous - lungs, pancreas, gonads

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64
Q

avoid what in dentistry with CF patients?

A

immunosuppressants

sedation

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65
Q 
what are too big cells?
too small?
increased white blood cells?
reduced white blood cells?
increased platelets?
reduced platelets?
A 
macrocytic
microcytic
leukocytosis
leukopenia
thrombocythaemia
thrombocytopenia
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66
Q

what are the causes of anaemia?

A

lack of raw materials - vit b12, iron, folate
production problems - erythropoietin lack, bone marrow failure
longevity problem - haemolysis

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67
Q

what is neutropenia?

A

white cell deficiency
BM failure, autoimmune
candida, herpes simplex

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68
Q

what is leukeamia?

A

proliferation of immature cells in blood and bone marrow

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69
Q

what is lymphoma?

A

proliferation of cells in nodes/spleen, liver, bone marrow

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70
Q

what can haematological conditions cause orally?

A

atypical infections
bleeding
lymphadenopathy
gum infiltraion

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71
Q

what is the coagulation cascade?

A

vessel injury - vasoconstriction, platelet aggregation, coagulation cascade = clot formation

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72
Q

what can interfere with coagulation cascade?

A

protein deficiency - liver disease/malnutrition

congenital - haemophilia, von wilebrands

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73
Q

what is haemophilia?

A

absent or low factor VIII, IX

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74
Q

what is von willebrands?

A

function problem of factor VIII

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75
Q

what are types of coagulopathy?

A

acquired - alcoholics, thrombocytopenia, drugs

congenital - haemophilia A/B, von willebrands, antiphsopholipid

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76
Q

what drugs should be avoided with idiopathic thrombocytopenic purpura?

A

NSAIDS

aspirin

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77
Q

what can anaemia cause orally?

A

angular chelitis
candidiasis
minor apthous ulcers

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78
Q

how does warfarin work?

A

antagonises Vit K
48-72 hours to develop
reversed by vit K

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79
Q

what happens if INR is over 1?

A

longer clotting time

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80
Q

what should be established about the INR prior to tx?

A

assessed within 72 hours
stable
<4

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81
Q

what is INR controlled by warfarin influenced by?

A

irregular tablet taking
high vit K
alcohol indigestion
cranberry juice

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82
Q

what are types of antiplatelets?

A

aspirin

clopidogrel

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83
Q

what are NOAC’s and what are they used for?

A

rivaroxaban

prophylaxis of venous thromboembolism`

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84
Q

dentally, what should we be aware of with upper GI problems?

A

NCTSL - acid reflux
osoephagus/stomach - caution with NSAIDs
oral ulceration/chronic blood loss anaemia

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85
Q

what is coeliac?

A

multi system autoimmune problem not an allergy

Small intenstinal venous atrophy

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86
Q

what are oral feautres of malabsorption?

A

iron, folate deficiency

oral ulceration

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87
Q

caution with what drug an coeliac pts?

A

bisphosphonates

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88
Q

what is IBD?

A

crohns - entire GI tract, non continuous lesions

UC - large intestine - continuous

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89
Q

oral features of crohns disease?

A 
ulcers
facial labial swelling
mucosal tags
cobblestone mucosa
angular chelitis
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90
Q

what are the stages of swallowing?

A 
pre swallow
oral prep
oral stage
pharyngeal stage
oseophageal stage
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91
Q

with aging how is swallowing affected?

A

delayed pharyngeal elicitation
loss of muscle reserve
increased laryngeal penetration

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92
Q

what are causes of dysphagia?

A 
dementia
CVA
poor oh
thrush
parkinsons
head injruy
degenerative neurological disorders
burns
facial trauma
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93
Q

what is trismus?

A

persistent contracture of masticatory muscles

hypervascularity, neural damage

94
Q

what can cause dry mouth?

A

thrush
sjogrens
meds
radiotherapy

95
Q

what is osteoarthritis and what is the tx?

A

affects weight bearing joints and hands

steroid injections

96
Q

what is rheumatoid arthritis?

A

autoimmune

synovial inflammation

97
Q

what other body systems can rheumatoid arthritis?

A 
nervous system
lungs
heart disease
kidney failure
eyes - inflammed
sjogrens
systemic inflammation
98
Q

what medications treat rheumatoid arthritis?

A

DMARDS

corticosteroids

99
Q

how is rheumatoid arthritis dentally relevant?

A

TMJ disease
sjogrens
hands - dexterity

100
Q

what kind of disease is systemic sclerosis? what are some signs?

A

autoimmune
sclerodactyly, telangiectasia, calcinosis, beaked nose, fixed expression, radial furrowing of lip, limited mouth movements

101
Q

what is systemic lupus erythematous?

A

autoimmuni multi system disease

102
Q

what does SLE effect?

A 
photosensitive butterfly rash 
small joint arthritis 
raynouds
fits and paralysis
valvular disease and endocarditis
lungs effusions
kidney failure
103
Q

what is gout?

A

accumulation of urate crystals in joints

104
Q

what is psoriatic arthritis?

A

destructive arthritis and psoriasis

105
Q

what is hyperparathyroidism?

A

excess parathyroid hormone

adenoma in parathyroid gland

106
Q

what can hypercalcaemia and hyperparathyroidism cause dentally?

A

bone resporption
loss of LD
giant cell lesions

107
Q

what is pagets disease?

A

abnormal bone remodelling

108
Q

what is osteomalacia?

A

vit d deficiency
bony pains and muscle weakness
affects tooth development in children

109
Q

what is osteoporosis?

A

loss of bone mass

increased fracture risk

110
Q

what is the relations between osteoporosis and dentistry?

A

risk with bisphosphonate tx

111
Q

what are some causes of dry mouth?

A 
psychogenic 
drugs
radiotherapy
dehydration
sarcoidosis
HIV 
sjogrens syndrome
112
Q

what is sjogrens syndrome?

A

autoimmune disease
chronic inflammation of tear and saliva glands
primary and secondary forms

113
Q

what are the causes of secondary sjogrens syndrome?

A

rheumatoid arthritis
systemic lupus erythematous
primary billiary chirrocis
mixed connective tissue disease

114
Q

what is the drug tx of sjogrens syndrome?

A

5mg prilocaine 3 x daily

115
Q

what are some salivary drug tx’s for sjogrens?

A 
orthana spray 
bioextra
glandosene
salivix pastilles
sugar free gum
116
Q

what is orthana spray?

A

gastric mucin
xylitol
sodium fluoride

117
Q

what is bioextra?

A

lactoperoxidase
lactoferrin
xylitol

118
Q

how can you spot sjogrens orally?

A

erythema

lubrication of tongue

119
Q

what problems can arise from lack of saliva?

A

opportunistic oral infections
perio disease
caries - esp cervical margins

120
Q

how are fungal infections managed?

A

nystatin

amphotericin C

121
Q

what is diabetes mellitus?

A

group of metallic diseases characterized by hyperglycaemia resulting from defects in insulin secretion and action

122
Q

what is type 1 diabetes?

A

pancreatic beta cell destruction

insulin dependant

123
Q

what is type 2 diabetes?

A

insulin resistant bc beta cell dysfunction

124
Q

what is insulin resistance?

A

insulin receptor not as responsive to the insulin molecule and therefore less glucose enters the cell = build up of glucose in the blood

125
Q

what are complicatins of diabetes?

A 
IHD
stroke
neuropathy
nephropathy
retinopathy
erectile dysfunction
psychaitric
126
Q

what is diabetes the leading cause of?

A

blindness
dialysis
amputation

127
Q

what are signs of low blood glucose?

A

sweats shakes flushing palpitations

confusion, reduced conscious, collapse, seizures, coma

128
Q

what are types of hyperglycaemia>?

A

1 - diabetic ketoacidosis

2 - hyperosmolar non ketotic coma

129
Q

what should blood glucose pre meal?

after meal?

A

4-8mmol

<10

130
Q

what are causes of hyperthyroidism?

A

autoimmune - graves disease
goitre/toxic ademona
pituitary driven

131
Q

what are signs of hyperthyroidism?

A 
sweating
heat intolerance
irritable
poor sleep
anxiety
palpitations
excess apatite
weight loss
pretibial myxoedema
132
Q

what drugs tx hyperthyroidism?

A

beta blockers

antithyroid drusg

133
Q

what are causes of hypothyroidism?

A

autoimmune
iatrogenic
iodine deficiency
rarely pituaitary disease

134
Q

what are signs of hypothyroidism?

A

reduced metabolism, cold intolerance, weight gain, mental slowness, hair loss, slow pulse, goitre

135
Q

what is hypopthyroidism treated with?

A

thyroxine

levothyroxine

136
Q

what are the types of goitre?

A
  • not associated with disease - simple cysts/adenomas, iodine deficiency
  • associated with intrinsic disease - autoimmune, toxic adedoma
  • malignant
137
Q

what difficulties can goitres cause?

A

dysphagia

breathing difficulties

138
Q

what can anti thyroid drugs cause orally?

A

neutropenia

taste disturbances

139
Q

what disease has excess corticosteroids?

A

cushings syndrome

excess ACTH, bc pituitary ademona, ecptopic production by cancers

140
Q

what risks do cushings pts suffer from?

A

high bp
diabetes
prone to infection

141
Q

what is a deficiency of corticosteroid production called?

A

addisons
iatrogenic
hypopituitarism
adrenal destruction

142
Q

what can be seen orally with addissons disease?

A

hyperpigmentation

buccal mucosa, scars, pressure points, skin creases

143
Q

what can be seen orally with cushings disease?

A

oral infections

144
Q

what is acromegaly?

A

excess growth hormone

prognathism, ID seperation, large tongue, diabetes

145
Q

how common is type 1 diabetes?
insulin dependent or independent?
affects who
what type of disease is it?

A

10% of diabetics
dependent
autoimmune disease in younger people

146
Q

how common is type 2 diabetes?
dependent or independent?
what type of disease?
affects who?

A

90%
non insulin dependent
insulin resistant and deficiency
more likely if obese

147
Q

what is a risk for diabetic patients?

A

increased infection risk

148
Q

what drugs can cause xerostomia?

A

antidepressants
antihypertensives
anxiolytics

149
Q

what can fungal infections be caused by?

A

fungal infections

150
Q

why can angular chelitis be caused?

A

staph infection

iron deficiency anaemia

151
Q

how can angular chelitis be treated?

A

miconazole

152
Q

where are oral carcinomas commonly found and what type are they commonly?

A

lips and tongue

squamous cell

153
Q

tumours found where in the mouth metabolise the fastest?

A

tongue and floor of mouth

154
Q

what is the at risk dose of paracetamol?

normal toxic dose?

A
  • 7g in 24 hours

- 10g in 24 hours

155
Q

what are some signs of an apsirin overdose?

A 
increased resp rate
ringing in ears
parasthesia
vomitting, nausea
drowsiness
156
Q

what are some signs of an NSAID overdose?

A

antiplatelet effects - bleeding and bruising
metabolic effects - dizzy, tired, parasthesia
GI irritation - epigastric pain, nausea, vomitting

157
Q

what are the eventual effects of an NSAID OD?

A

renal impairment
cerebral oedema
cardiac arrest

158
Q

what are some signs of an opiate OD?

A

pupils constrict
drowsiness - confusion and agitiation
reduced GCS

159
Q

what is a seizure?

A

excess electrical activity

160
Q

what is a focal/partial seizure?

what is a generalised seizure?

A

part of brain affected

whole brain affected

161
Q

what are types of generalised seizures?

A

grand mal

tonic clonic

162
Q

what are some causes of seizures?

A 
hereditary
structural problems
electrolyte disturbance
alcohol withdrawl
hypoglycaemia
163
Q

what drugs are used to tx epilepsy?

A

phenytoin
carbamazepine
sodium valporate

164
Q

what is used to treat tension headaches?

A

tricyclic antidepressants

conventional analgesics

165
Q

what are migraines treated with?

A

conventional analgesia

metoclopramide, serotonin antagonists

166
Q

what is trigeminal neuralgia and what is it treated with?

A

intense stabbing 10/10 pain
touch shaving and waxing make it worse
paroxsymal
carbamazepine

167
Q

what is raised intracranial pressure caused by?

A

tumours
bleeding
drainage problems
abscess

168
Q

what are signs of bacterial meningitis?

A 
impaired conscious 
meningism
\+/- rash
drowsy
photophobia
169
Q

what is encephalitis?

A 
inflammation of brain parenchyma
viral
impaired conscious 
personality changes
meningism/seizures
170
Q

what is giant cell arteritis?

A

scalp tenderness and jaw claudication with vision loss
risk of blindness, stroke and death
high doses of prednisolone to tx

171
Q

what is glaucoma?

A

constant aching around the eye
reduced vision
nausea and vomitting
red congested and dilated non reactive pupil

172
Q

what is a stroke and what is it caused by?

A

disorder of vascular supply to the brain
infarction - atherosclerosis
cardiac emboli
haemorrhage - hypertension

173
Q

what can brain infarctions cause?

A

transient ischaemic attacks

completed strokes

174
Q

what is the tx of strokes caused by infarctions?

A

anti platelets
warfarin if AF
NOACs

175
Q

what is parkinons disease and how can it be spotted?

A

degeneration of dopaminergic neurones in the basal ganglia
bradykinesia, rigidity, tremor
tx with dopaminergics

176
Q

what is essential tremor? what is it treated with?

A

hereditary
unilateral
improves with alcohol
tx with beta blocker and primidone

177
Q

what is MS?

A

autoimmune destruction of the central nervous system
loss of myelin - demylination
- relapsing and remitting
- chronic progressive

178
Q

what do you tx MS with?

A

acute episodes tx with prednisolone

reduce relapse rate with beta interferron

179
Q

where does peripheral neuropathy?

A

generalised and specific nerves

180
Q

what is bells palsy?

A

viral
palsy of lower motor neurone of facial nerve
oral steroids in 72 hours improve outcome

181
Q

what is motor neurone disease?

A

obstruction of motor neurones
limb weakness
swallowing problems

182
Q

what problems can liver disease cause?

A

impaired wound healing
impaired clotting - deficient clotting factors, reduced platelets
risk of blood borne virus

183
Q

what are primary infections of HSV1?

A

gingivostomatitis

pharyngitis

184
Q

what is a recurrent infection involving HSV1?

A

herpes labialis

185
Q

how long do orolabial herpes last for?

A

self limiting in 7-10 days

186
Q

how many strains does HPV have?
what can they cause?
what strains are oncogenic?
what does HPV hold links with orally?

A

> 70
can cause orolabial warts
oncogenic
links to oral cancers

187
Q

what causes syphillus?

A

treponema pallidium

invades skin and mucous membranes

188
Q

what is the function or the kidney?

A

excretory function
acid base balance
endocrine function - erythropoietin and activates vit D

189
Q

what are some consequences of renal failure?

A

excretion failure - oedema, high K
acid base balance - acidosis
endocrine - no erythropoietin, no vit D, high bp

190
Q

what are some causes of renal failure?

A 
atherosclerosis
diabetes
high bp
hypovolaemia
NSAIDs
angiotensin 2 
diuretics
tetracyclines
infections
obstructions
191
Q

what are the two types of dialysis?

A

peritoneal

haemolysis

192
Q

what are issues with organ transplanting?

A

rejection
immunosuppression
high cardiovascular mortality

193
Q

what are some oral considerations with renal failure?

A

care with prescribing NSAIDs
secondary anaemia effects - slow tooth eruption
oral opportunistic infections and stomatitis
dry mouth/taste disturbances
post op infections and bleeding
renal osteodystrophy - loss of lamina dura, radiolucencies, problems with bone healing and XLA
complications with immunosuppressants

194
Q

when should you treat a patient on dialysis?

A

day after dialysis, heparin

195
Q

what patients have bleeding tendancies?

A

abnormal platelet production
diminished factor 3
von willebrands

196
Q

what are oral side effects of chronic renal failure?

A 
dry mouth
halitosis
metallic taste
insidiuous oral bleeding and purpura 
salivary gland swelling
anaemia - oral ulceration and changes
197
Q

what is acne treated by?

A

topical abrasives and antibiotics, vitamin A, analgesics, isotretinoin

198
Q

what is rosacea treated by?

A

isotretinoin

antibiotics

199
Q

what is impetigo? what might it cause?

A

staph and strep

may cause glomerulonephritis

200
Q

what is folliculitis caused by?

A

Staph aureus

infection of hair follicle

201
Q

what is erysipelas?

A

form of cellulitis
strep infection
systemic antibiotics to tx

202
Q

what is erythema multiforme caused by?

A

herpes viral infection

mucosal involvement

203
Q

what is steven johnsons syndrome?

A

caused by infection or reaction to medications

acute onset and severe mucosal involvement, systemic disturbance

204
Q

what is actinic keratoses?

A

hyperkeratotic areas on sun exposed skin

can progress to SCC but uncommon

205
Q

what is bowens disease?

A

intra epidermal SCC

commonly on lower legs in elderly females

206
Q

how can you spot a basal cell cancer?

A 
sun exposed sites
slow growing
raised pearly edge
telangiectasia, central ulceration
locally invasive dont metastasise
207
Q

where are melanomas common?

A

moles
history of sun exposure
sunbed use
skin type

208
Q

what is ABCD of mole severity?

A

a - asymmetry
b - border - irregular
c - colour - multiple
d – diameter - >6mm

209
Q

what drugs induce anaesthesia?

A

propofol
thiopental
etomidate

210
Q

what inhalation drugs can induce and maintain anaesthesia?

A

nitrous oxide

o2 and air

211
Q

what are benzodiazepines used for in anaesthesia?

A

pre med for anaesthetic - reduces amount of anaesthetic required

212
Q

what are the 4 stages of anaesthetic?

A

1 - loss of conscious
2- excitement and delirium, coughing and vomitting
3- stage of surgical anaesthesia
4- cessation of respiration to death

213
Q

what is a short and long acting muscle relaxant?

A

short - sumexathonium

long - attracurium

214
Q

what is malignant hyperthermia?

A

abnormal accumulation of calcium in muscle cells = hypermetabolism, muscle rigidity, muscle breakdown

  • increased expired CO2
  • unexplained tachycardia
  • increased O2 need
  • increased temp
  • tx with dantrolene and cooling
215
Q

what is nociceptive pain?

neuropathic pain?

A
  • appropriate physiological response to painful stimuli

- inappropriate response to pain bc dysfunction in the NS

216
Q

what is chronic pain managed by?

A 
non opiod analgesics
opiods
antidepressants
anticonvulsants
topical analgesics
217
Q

how can chemotherapy affect the mouth?

A

chemo affects rapidly dividing cells - oral mucosa included

218
Q

what are short time effects of radiotherapy orally? long term?

A

short - oral mucositis

long - osteoradionecrosis, xerostomia

219
Q

what can oral mucotaneous ulcers be associations of?

A 
SJ syndrome
pemphigoid
herpes simplex
varicella zoster
SLE
crohns
220
Q

what are some organic psychiatric disorders?

A

dementia and delirium

protected by adults with incapacity act 2000

221
Q

what is a consideration with schizophrenic patients and oral health?

A

hypersalivation drugs caused by anticholinergic drugs

222
Q

what is dentally relevant about bullimia?

A 
acid erosion
caries
cheilosis
parotid gland enlarges
palate reddening
lymphadenopathy
223
Q

what acts protect those with mental health issues?

A

mental health care and tx act 2005

adults with incapacity act 2000

224
Q

what can cancer tx cause orally?

A 
ulceration and mucositis
salivargy gland dysfunction and xerostomia
radiation caries and perio disease
infections - candidiasis 
loss of taste
dysphagia
osteoradionecrosis
225
Q

what is mucositis and how is it treated?

A

inflammed mucosa - slough, ulceration, bleeding, heals 2-3 weeks post tx
soft TB, H peroxide MW, chx MW, topical analgesics, soft bland non carious diet and at low temp, avoid alcohol and tobacco

226
Q

what risks present to a patient with decreased salivary production?

A

increased infection risk
increased demineralisation risk
mastication or swallowing impaired

227
Q

how is decreased saliva treated?

A

prilocarpine
salivary substitutes - water atomiser, ice chips
F
sugar free gum

228
Q

how should radiation caries be treated?

A

daily F application - 2800ppmF
Salivary substitute
caution with diet

229
Q

what is osteoradionecrosis?

A

damage to blood vessels and bone cells
change in endothelial cells = sclerosis of vessels
= pain, trismus, exposed bone, suppuration, halitosis

230
Q

what is dysgensia?

A

altered or loss of taste
regained after 2-4 months of tx
= dietary supplements plus zinc

231
Q

if using chx and nystatin do what?

A

stagger use by one hour

2nd Year (4 decks)

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