Dental Review lecture Flashcards
Hypertension
- What systolic bp (in mmHg) is considered hypertensive?
140 mmHg (diastolic is 90 mmHg)
Hypertension
- What diastolic bp (in mmHg) is considered hypertensive?
90 mmHg (systolic is 140 mmHg)
Hypertension
- What systolic and diastolic bp is considered pre-hypertensive?
120-139 / 80-90 mm Hg
- At late stages of hypertension, target organ damage to occur. What are four organ examples?
Kidney, brain, heart, and eye
- Hypertension
- what eye damage can occur?
Retinal vessel hemorrhage, exudate, papilledema -> Advanced malignant hypertension
- Hypertension
- What brain damage can occur?
Hypertensive encephalopathy: headache, irritability, alterations in consciousness, CNS dysfunction
- Hypertension
- What heart damage can occur?
Left ventricle enlargement, congestive heart failure
- Hypertension
- What kidney damage can occur?
Hematuria, proteinura, renal failure
- At patient BP of >140/90, but
- Yes, you provide any required dental treatment
2. No, but you do encourage patient to see physician
- At patient BP of >160/100, but
- You provide any required, but consider intraoperative monitoring of BP for upper level stage 2
- Prompt referral to physician (w/in one month)
- At patient BP of >180/110
- Do you provide required dental treatment?
- Do you refer to physician?
- You defer elective treatment
2. Refer to physician ASAP; if patient is symptomatic, refer immediately
- What are some examples of oral manifestations of antihypertensive drugs?
Dry mouth, orthostatic hypotension, angioedema, dysguesia, lichenoid reactions, gingival hypertension
Many studies and meta-analyses have shown that NSAIDS (increase/decrease) BP, most significantly in those who have ___
- Increase
2. Hypertension
Why should you avoid norepinephrine and levonordefrin in HTN patients?
They have an increased alpha-1 stimulation
- Can you treat someone immediately after MI?
No, you have to wait thirty days
Greatest risk: Lowest left ventricular ejection fraction
- What are short term consequences of hyperglycemia (diabetes)?
- Polydipsia, polyuria, polyphagia
2. Diabetic coma (ketoacidosis or hyperosmotic)
- What are three long term consequences of hyperglycemia?
- Microangiopathy
2. Deposition of by-products in tissue
- What are three relevant diagnostic labs for diabetes and the associated values?
- Fasting blood glucose (>126/100mL)
- 2hr Post-prandial Glucose (>200mg/100ml)
- HbA1c
(>7% in well-controlled diabetes)
Do patients with diabetes have problems with:
- Saliva
- Infections
- Healing
- Pathology
- Yes, xerostomia
- Yes, bacterial, viral, and fungal
- Yes, poor wound healing, candidiasis
- Yes, caries, gingivitis, perio, abscesses, burning mouth, and leukoplakia
- What are consequences of kidney disease?
- Increased susceptibility to __
- Decreased amount of RBC
- Abnormal b__
- Electrolyte and fluid __
- High blood pressure
- __ intolerance
- __ abnormalities
- Infection
- Anemia
- Bleeding
- Imbalance
- Hypertension
- Drug
- Skeletal
- What are important lab values for Kidney disease?
- Kidney function tests (GFR, BUN, Creatinine clearance)
- Platelet count
- Neutrophil count
- Hemoglobin
- Kidney - At what level of GFR should dosage modification be considered?
What kind of meds should be avoided?
- What kind of tests for liver disease?
INR
Platelet
ALT/AST etc
They are susceptible to infection
- What drugs to avoid if liver disease?
Is acetaminophen (tylenol) okay?
- Avoid NSAIDs and Aspirin
2. Yes, but only if limited to
- What antibiotics can you use safety? Which should be used with caution and increased dose intervals?
(Aminoglycosides, beta-lactam antibiotics, clindamycin, macrolines, metronidazole, minocycline, tetracycline)
- Beta-lactam ab
- Metronidazole (use with caution)
- Tetracycline, minocycline, and doxycycline should be used at reduced dosages and increased dose intervals
- Antibiotic prophylaxis for prosthetic cardiac valve, previous infective endocarditis, cardiac transplantation recipient who develop cardiac valvulophy, patient with congenital heart disease
test
- Anti-platelet
- what is normal INR?
- what’s normal range for PT?
- What is normal platelet?
- INR 50k
- New Oral Anticoagulants
- Dabigatran - direct and specific __ inhibitor
- Irreversible binding?
- Which factor of the extrinsic pathway does Dabigatran block?
Thrombin
Reversible binding
Factor 2
Oral Antiresorptive Medications - if systemic conditions permit, Discontinue use how many months prior and how many months post?
- 2 months prior
2. 3 months post
