diseases of human systems Flashcards
- Other than schizophrenia name THREE examples of common psychiatric conditions. (3 marks)
major depressive disorder
generalised anxiety disorder
bipolar disorder
- Patients with a psychiatric diagnosis often have poor oral health.
Name THREE contributory factors. (3 marks)
medication side effects = antipsychotics, antidepressants and mood stabilisers can cause dry mouth
poor oh = difficulty with routine, apathy and cognitive impairment
lifestyle factors = poor diet, smoking, substance abuse, limited dental care due to socioeconomic factors or barriers
- Give FOUR potential barriers to receiving adequate, ongoing dental care that exist for a patient who has schizophrenia. (4 marks)
cognitive impairments = impaired memory, attention and problem solving skills
difficult to remember appointments, follow oh instructions, or understand importance of dental care
financial constraints = limited income, unemployment or reliance on government assistance
transportation difficulties
stigma and discrimination
Dentist causes a facial palsy as a result of a right IAN block. The patient’s has a
sore right TMJ.
a) How is the facial palsy caused? (2 marks)
If the clinician doesn’t hit bone and inserts needle too far back, LA is
deposited in parotid gland. The facial nerve runs through it, and due to the
dense fascia around the gland the LA will remain for a long time and cause
paralysis of the facial muscles that the nerve innervates
b) Describe 3 differences between stroke and facial palsy (3 marks)
Facial palsy occurs as a result of LA administered into the parotid gland and
affects the side injected.
Stroke causes loss of movement of facial muscles on opposite side
If it is a stroke, the patient can still wrinkle their forehead on the affected
side.
c) Explain the neural anatomy which accounts for this difference (3 marks)
In a stroke there is interruption of supra nuclear fibres from the motor areas
of cerebral cortex, before they reach the facial motor nucleus
The upper part of the facial motor nucleus receives crossed and uncrossed
fibres and the frontalis and orbicularis oculi still have the ability to function as
a result.
d) Name 4 ways in which you could initially manage this patient (2 marks)
Reassure them
Tell them that sensation will return in a few hours
Cover the eye with an eye patch to prevent the cornea drying out
Give a contact number
- 3 common features of Parkinson’s disease
Resting Tremor
Rigidity
Bradykinesia
Mask-like facial expression
Postural Instability
- difference between movement to other cerebral disease (1 mark)
Parkinsons is a resting tremor
Cerebellar tremor is an intention tremor
c) most likely reason for dry mouth (1 mark)
Antimuscarininc/cholinergic effect of drugs
d) how would you help prevent patient loosing dentures (2 marks)
Mark initials on the denture during processing
If already constructed then can mark using sandpaper, or use a sealant
e) most important reason for not extracting existing teeth for Parkinson’s
patient (2 marks)
Tremor could make extraction difficult
Poor mouth opening
Will require new prostheses to replace missing teeth.
Will they be able to manage this?
f) 2 key principle affecting future oral health for this patient (1 mark)
Poor motor function therefore the ability to maintain sufficient oral hygiene is
compromised
- Bleeding Disorders
a. Pt suspected of B.D. 3x blood tests to investigate
b. 1 inherited coagulation disorder
Haemophilia A - factor 8
Haemophilia B - factor 9
Von Willebrand Disease - von Willebrand factor,
