DELANO Flashcards
Where is Bence Jones protein found?
Multiple myeloma in Urine
Where are mu receptors for Opiods found?
Brain stem
What is the mechanism of action of ACE inhibitors (prils)?
Inhibits conversion of angiotensin I to angiotensin II
What muscle protrudes the tongue?
Genioglossus
What is the ADA SCDI in charge of?
About Dental informatics (assists the dental profession, develops informatics standards and technical reports to assist the dental profession with hardware and software selection.
What is considered the values for Diabetes in regards to each of the following:
- Fasting glucose level
- HbA1C
- Glucose Tolerance Test
Fasting glucose level 126 or higher
HbA1C 6.5 or higher
Glucose tolerance test (GTT) 200 or higher
Hyperparathyroidism (Brown Tumor) looks like what?
CGCG
What does White Sponge Nevus look like? (White plaque that cannot be wiped)
Lichen Planus (wikham striae)
Discuss Cleft Palate in regards to each of the following:
- Develops in how many weeks in utero?
- Lack of fusion between ________.
- What skeletal classification does cleft palate tend to be?
Cleft Palate:
- 6-8 weeks in utero
- palatal shelves
- Class III skeletal
Note: Cleft lip = 4-6 weeks in utero
What are the 4 defects of Tetralogy of Fallot?
- Pulmonary valve stenosis (narrowing of the valve)
- Ventricular Septal Defect (VSD) [hole between bottom heart chambers)
- Shifting of the body’s main artery (shifting of the aorta to the right)
- Right Ventricular Hypertrophy
Supine hypotensive crisis: may occur during late pregnancy due to compression of vena cava. Need to lean patient to the left to relieve vena cava
Place pregnant bitch in Left Lateral Decubitus position NOT Trendelenburg
Differentials of stafne bone cyst:
OKC, traumatic bone cyst, residual cyst,
High Mandibular plane angle would present as what?
Anterior open bite
Review Angles Classification:
Review Antibiotic prophylaxis w/ dose and times:
Humira MOA:
Treats immunosuppression for RA. Tx crohn’s disease, RA ect.. (MOA: TNF blocker, reduces inflammation) Humira (Adalimumab) = antirheumatic drug
Muscles that attach to mandible:
● Mandibular body:
○ External (lateral) surface – mentalis, buccinator, platysma, depressor labii inferioris, depressor anguli oris.
○ Internal (medial) surface – genioglossus, geniohyoid, mylohyoid and digastric.
● Mandibular rami – masseter, temporalis, medial pterygoid and lateral pterygoid
○ External (lateral) surface – mentalis, buccinator, platysma, depressor labii inferioris, depressor anguli oris.
○ Internal (medial) surface – genioglossus, geniohyoid, mylohyoid and digastric.
What muscles elevate the tongue?
Palatoglossus = elevates back part of tongue
Mylohyoid = elevates hyoid and tongue
Geniohyoid = elevates hyoid and tongue during swallowing
Parasymphyseal fracture:
Symphyseal/parasymphyseal fracture was defined as fracture line in mandibular bone between the canine teeth.
Treatment of tmj dysfunction syndrome:
bite splint, heat compress, diet, exercise, icing, NSAIDs
(NEVER OCCLUSAL ADJUSTMENTS)
Force on denture compared to natural teeth:
Natural teeth each tooth individually affected. Denture teeth they all take force together. Dentures only use 1⁄4- the strength teeth can use
What does Sickle Cell look like radiographically?
STEP LADDER
Omeprazole MOA:
proton pump inhibitor. It inhibits the parietal cell H+ / K+ ATP pump, the final step of acid production. In turn, omeprazole suppresses gastric basal and stimulated acid secretion
Nitroglycerin MOA:
prevents angina, dilates coronary arteries , nitrate - conversion to nitric oxide - vasodilation of the coronary vessels
Sildenafil:
Sildenafil: enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum (same effects as nitroglycerin- not good to take together. Too much vasodilation)
Do NOT take Sildenafil and Nitroglycerine together
What CN’s are associated w/ dysphagia (difficulty swallowing)?
CN 7, 9, 10, 12
Signs of Parkinson diagnosis:
Signs of Parkinson dx (akinesia, bradykinesia (slow movement), tremor, vision loss, rigid muscles
How is Impetigo transmitted?
Touching
highly contagious skin infection that mainly affects infants and young children.
Appearance: reddish sore on face (nose, mouth, hands and feet)
note: sores can burst and develop honey colored crust
Is Herpetic Whitlow more common among dentists
Most common in dental hygienist and resp.
Therapist
Normal value of HbA1C in diabetes =?
less than 7
Achondroplasia:
Achondroplasia: disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size (macrocephaly), small fingers, and normal intelligence.
Government agency ensuring equal distribution of health personnel:
health and human services (HHSA)
HRSA: healthcare for uninsured and dental for HIV+ (Ryan White)
Bulimia- which wouldn’t you prescribe?
APF - acidulated phosphate fluoride - separate question -
erosion of lingual max ant
Sedation and eating before procedure: (how long do you need to fast before sedation?)
6-8 hours
When should the first dental visit be for a child?
Upon first tooth eruption < 1yr old
Sertraline (SSRI) side effects:
nausea. Diarrhea. Constipation. Vomiting. difficulty falling asleep
or staying asleep. dry mouth xerostomia. Heartburn. loss of appetite
MOA = selectective serotonin reuptake inhibitor
Management of autism kid patient:
desensitization and sameness, voice control and compliment
parents, distraction
Sameness: tendency to do or think about the same things over and over
Problem in managing down syndrome patients:
they have macroglossia, delayed/missing teeth,
malocclusion, periodontitis, NO HIGH CARIES RISK, BUT HIGH PERIODONTAL RISK
Drug diversion:
Is a medical and legal concept involving the transfer of any legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use
Giving someone a drug that was prescribed to me
Emancipated minors and informed consent (my question was who are considered emancipated)
MMPP (married, military, parent or pregnant)
Adult Mesenchymal stem cell derivative:
(eg. bone,cartilage,muscles,fat cells, skeletal system) NOT mucosal tissue
Rate of extrusion of maxillary central:
50g force (4mm)
Disinfection of alginate -
Rinse with water, spray, rinse
Signs of cavernous sinus thrombosis:
Has a lot to do with the eyes
fever, pain and swelling but also with specific findings such
as proptosis, chemosis, periorbital swelling, and cranial nerve palsies.
Antibiotics and analgesics safe in liver cirrhosis patient:
NOT Tylenol, NOT tetracycline,
How to prevent candidiasis in asthma patients using inhaler:
rinse out mouth with water/brush teeth
after using inhaler. Also using a spacer to decrease the inhaler touching the oral cavity.
Factors influencing retention of post:
length, rigidity, antirotational features, ferrule. (active posts engage into dentin: more retentive but more fractures)
Corticoid (side effects):
Fluid retention, Swelling in legs, High blood pressure, upset stomach, weight gain, osteoporosis, increased risk of infections, high blood sugar, suppressed adrenal gland, immunosuppression, redistribution of fat (G.O. H.A.I.R.)
What medication is used for Benzodiazepines reversal?
Flumazenil
What malignancy is associated with Paget’s Disease?
Osteosarcoma
Dry socket treatment:
Control the pain with a dressing material (e.g., Alvogyl(eugenol)TM paste,
DRESSOL-XTM).
● Irrigate the site with chlorhexidine or saline.
Function of IgA in Saliva?
neutralizing toxins and removing pathogenic microorganisms (antibacterial)
Which microorganisms survive the longest on surfaces:
mycobacterium tuberculosis
Granuloma vs periapical cyst:
Granuloma has no epithelial lining <2mm,
Periapical cyst: epithelial lining, >2mm.
Both look the same radiographically (mine was a question about histology,
squamous epithelial lining = periapical cyst)
Whereas a periapical granuloma comrprises inflamed granulation tissue, a periapical cyst represents an epithelium-lined cavity with an inflamed fibrovascular connective tissue wall.
What do you clean alginate with after taking an impression?
Discide
Discide ingredients: ammonium chloride and isoproply alcohol
Who regulates dental equipment?
FDA
predominant microorganisms in failed root canal:
Enterococcus Faecalis
Discuss Pierre Robin Sequence:
Do you need antibiotic prophylaxis for deep vein thrombosis?
NO
What is the reversal drug for Opiods?
Naloxone
What is there a risk of when doing internal bleaching for a patient?
A. Internal resorption
B. External resorption
B. External resorption
Internal bleaching causes external resorption in 10%
of cases.
What medications can cause Orthostatic Hypotension:
diuretics, alpha blockers (prazosin, doxazosin) for prostatic hypertrophy, antihypertensive drugs, and calcium channel blockers
What anesthetic lasts the longest?
Bupivicaine HCL
What is the max Epi for an adult?
0.2mg
Why is Blue Nevus blue?
Tyndall effect
Tyndall effect, in which shorter wavelengths of incident light are scattered by the dermal melanocytes
cavernous sinus infection:
septic blood clot in cavernous sinuses due to an infections
Cavernous sinus thrombosis is a blood clot in the cavernous sinuses. It can be life-threatening. The cavernous sinuses are hollow spaces located under the brain, behind each eye socket. A major blood vessel called the jugular vein carries blood through the cavernous sinuses away from the brain.
histological findings of macroglossia? (3)
Vascular malformations, muscular enlargement, and tumors
What 2 pathologies are associated with a positive Nikolsky sign?
Pemphigus Vulgaris or Erythema Multiforme (stevens johnson)
What is the critical pH in which deminerization occurs?
- Enamel:
- Fluoroapetite:
- Dentin:
Enamel teeth demineralize.5.5; Fluorapatite is 4.5; Dentin: 6.5
What is the pH of the oral cavity normally?
6.7-7.3
- PH after drinking soda: had a question about how long the acid lasts?
below 5.5. ~ 4-4.7,
30-40min
denosumab and bisphosphonates:
treat osteoporosis , RANKL inhibitors
case with precision or semi precision attachment in removable partial denture ???
They are indicated for a patient w/ high esthetic demands
Precision is more accurate and milled from alloy
Semi-precision are more resilient, both are more esthetic than the
traditional clasps.
Patient with multiple myeloma, what blood test to get:
CBC (complete blood test),
What you’ll find in a CBC of a pt w/ multiple myeloma: beta 2 microglobin (elevated in cancers involving bone marrow), M-spike (cancer makes the M-spike proteins).
Bence jones in urine.
Ketoacidosis in diabetic patients:
Ketoacidosis- DM1 body breaks down fat for energy, ketosis, metabolic acidosis, hyperglycemia
Type I vs Type 2 diabetes:
Type 1: immune system is attacking and destroying the insulin-producing cells in your pancreas. (that’s why you need insulin)
Type 2: (insulin resistance) you make insulin but receptors can’t respond to it.
Clammy and sweating pt is diabetic and scared of needle after LA;
unconscious give IM(dextrose) [pt is having hypoglycemic attack]
If they are conscious give glucose tab or orange Joosh
What is most effective on a patient undergoing Cardiac arrest?
A. Chest compressions
B. AED
B. AED
Apical abscess in pregnant pt severe pain 3 rd trimester:
- A. begin pulpectomy
- B. give sedative
- C. filling
- D. delay tx after pregnancy
A. begin pulpectomy
. Implant distance from inferior alveolar nerve:
A. 1.5mm
B. 2mm
C. 3mm
D. 5mm
B. 2mm
Hypoglycemia in type 1 diabetic symptoms and complications:
Sweaty, dizzy, pale, disoriented, rapid heart rate, confusion
Hypoglycemic = TIRED
- Tachycardia
- Irritability
- Restless
- Excessive hunger
- Diaphoresis (sweaty)
Interventional study?
Purpose
Interventional studies are often prospective and are specifically tailored to evaluate direct impacts of treatment or preventive measures on disease. Each study design has specific outcome measures that rely on the type and quality of data utilized.
Interventional study (clinical trial) A type of clinical study in which participants are assigned to groups that receive one or more intervention/treatment (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.
Primordial cyst?
Cyst formed where a tooth should have been from the
enamel organ, common third molar area
Least likely complication of la injection:
A. trismus
B. infection
C. hematoma
D. ecchymosis
D. ecchymosis
- infection IS a complication of injection.
Gow gates technique: (what nerves does this technique anesthetize?)
inferior alveolar and its terminal branches (incisive and mental), lingual, mylohyoid, auriculotemporal, and the buccal nerve 75% of the time
What is the main nerve for TMJ innervation:
Auriculotemporal (branch of V3)
What is the radiopacity at the midline of the maxilla?
ANS (Anterior Nasal Spine)
Rhinolith is the calcification in the nasal cavity. The question wasn’t asking about the Rhinolith… It stated at Midline of maxilla
What’s the order of removing PPE?
gloves, eye protection, gown, mask. None of the other answer choices start w/ gloves so just remember gloves first.
Gloves –> Goggles –> Gown –> Mask
Deficiency of _____ is associated w/ cleft palate.
Vitamin B & Folic acid
Function of clopidogrel(Plavix)/aspirin?
(blocks platelet aggregation) (enhances effect)
MOA of statin drugs?
decreases amount of cholesterol made by liver
inhibition of HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase, the rate-limiting enzyme in the cholesterol biosynthesis pathway
What HbA1c should be for dental treatment:
below 7
Which of the following is associated with a NON-Vital tooth?
A. Condensing Osteitis
B. Osteosclerosis
A. Condensing Osteitis
- Osteosclerosis: unknown cause, 90% in MD, mostly 1st molar region; radiopaque with NO radiolucent rim, uniform, apex of VITAL tooth (most common) or inter-radicular
- Condensing Osteitis: teeth with inflamm/pulpal necrosis, mostly MD premolar-molar region, well defined + no border/rim, often NONVITAL or infected tooth, widened PDL
What p (stats) measures:
probability that two variables are unrelated (P.05 accept the null hypothesis -> not significant)
Which of the following is a False Positive (FP)?
A. Type 1 error
B. Type 2 error
A. Type 1 error
Type 1 error = FP
Type 2 error = FN
Primary stress bearing site for maxillary denture?
Palate, Alveolar ridge
Fentanyl is ______ times more potent than morphine
Fentanyl is 100x more potent than morphine
A ground glass radiographic presentation is associated with ______.
Fibrous Dysplasia
What is the main cause of ankylosis in primary teeth?
Trauma
What are the contraindications for a Hawley Retainer?
Which teeth are most likely to have additional canals/ only one canal?
Mx central/lateral/canine= 1 canal always
Mx 1st PM: most have 2 canals instead of one
Mx 2nd pm: most have 1 canal but can have 2
Md incisors/canine: most have 1 but can have 2
Md 1st PM: most have 1 canal but can have 2
Guided tissue regeneration best for what type of defect?
3 and 4 wall boney defects
Which 1⁄3 is most likely to be under reduced for a veneer prep?
Not sure answer but incisal third is the guess
How long do you etch enamel and dentin?
Dentin = 15 seconds (20 seconds max)
Enamel = 20-30 seconds
What are mesenchymal cells and what do they give rise to?
Undifferentiated cells that give rise to blood vessels, lymph vessels, bone and muscle
What are the acronyms to remember each of the following:
- Hypoglycemia
- Hyperglycemia
Hypoglycemia = TIRED
Hyperglycemia = SINFUL
What content causes Myeloneuropathy in denture adhesive?
Excess ZINC
Pts who use excess denture adhesive are at risk for over ingestion of Zinc.
Myeloneuropathy is caused by Copper deficiency
What type of test is done to detect Bence Jones protein?
Urinalysis
Bence Jones protein = Multiple Myeloma
What is Adalimumab (Humira) used to tx and what’s it’s MOA:
Rheumatoid Arthitis (and other autoimmune inflammatory disorders like Crohns)
neutralization of TNF-alpha bioactivity and the induction of apoptosis of TNF-expressing mononuclear cells.
A drug commonly used to treat rheumatoid arthritis (RA), adalimumab (also known as Humira), has long been thought to exert its anti-inflammatory effects through specific binding to Tumor Necrosis Factor-α (TNF α), preventing it from interacting with TNF receptors.
Structures coming from infraorbital foramen:
V2 (maxillary), infraorbital vein/artery
(T/F)
High BMI is linked to higher prevalence of cancer.
True
Discuss Fetal Alcohol Syndrome:
Factors that can affect contrast of an x-ray:
Kvp and FIltration
Vertical angulation of PID (x-ray tube) can lead to what on x-ray:
Elongation (vertical angulation to small)
Foreshortening (vertical angulation to large)
What causes “reverse smile line” on pano:
chin too high
Butterfly rash over bridge of nose is characteristic of:
Systemic lupus erythematosus
Review Periapical cemento-osseous dysplasia (PCOD):
Presents in middle aged African women in the mandibular anteriors:
- VITAL teeth
Trigeminal neuralgia presentation:
almost always unilateral, brief sharp pain, trigger zones