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Dental management of the Medically Complex Patient > DM Midterm > Flashcards

DM Midterm Flashcards

1
Q

Pick efferent arteriole:

A
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2
Q

Ang II mediated vasoconstriction is a regulatory mechanism that acts on the:

A

efferent arteriole

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3
Q

Vasoreactive (myogenic) reflex acts on the:

A

afferent arterial

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4
Q

B/L pelvoureteral obstruction is an example of what type of renal failure?

A

Post-renal failure

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5
Q

Hypovolemia, decreased cardiac output, decreased effective circulating volume (CHF, liver failure), impaired renal autoregulation (NSAIDs, ACE-I/ARB, Cyclosporine) would all cause what type of renal failure?

A

Pre-renal failure

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6
Q

What is NOT a risk factor for chronic kidney disease?

A

Dementia

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7
Q

Causes of chronic kidney disease:

A
  1. chronic glomerulonephritis
  2. systemic lupus erythematosus
  3. neoplasms
  4. polycystic kidney disease
  5. AIDs nephropathy
  6. diabetic nephropathy
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8
Q

Risk factors for chronic kidney disease include:

A

-age of greater than 60
-smoking
-obesity
-HTN (poorly controlled)
-diabetes
-nephrotoxins/drugs
-infections
-low birth weight
-chronic inflammation

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9
Q

Results of RIGHT-sided heart failure:

A
  1. pulmonary edema
  2. coughing
  3. peripheral edema (arms & legs mostly)
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10
Q

Results of LEFT-sided heart failure:

A
  1. affects all organ systems
  2. decreased kidney function (leads to fluid retention)
  3. pulmonary edema
  4. coughing
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11
Q

Which ventricle typically fails first in heart failure?

A

Left

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12
Q

What does the EF fraction measure?

A

amount of blood pumped out / amount of blood in chamber

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13
Q

What is a normal EF?

A

55-70%

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14
Q

What is considered severely below normal in regard to EF?

A

Less than 35%

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15
Q

Reduced left ventricular EF:

A

systolic failure

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16
Q

Heart failure with normal left ventricular EF:

A

diastolic failure

17
Q

Signs of heart failure:

A
  1. rapid, shallow breathing
  2. inspiratory rales (crackles)
  3. increased HR
  4. distended jugular veins
  5. peripheral edema
  6. ascites
  7. cyanosis
  8. weight gain
  9. clubbing of fingers
18
Q

Symptoms of heart failure:

A
  1. fatigue & weakness
  2. orthopnea- SOB in recumbent position
  3. exercise intolerance
  4. muscle fatigue
  5. weight gain
  6. GI distress (nausea, vomiting, constipation)
19
Q

Therapy for stage A heart failure:

A

ACE inhibitors for ARBs

20
Q

Therapy for stage B heart failure:

A

ACE inhibitors, ARBs, Beta-blocker

21
Q

Therapy for stage C heart failure:

A

ACE inhibitors, Beta-blockers, Diuretics for fluid retention

22
Q

LVAD is considered:

A

intermediate therapy

23
Q

Signs of valvular heart disease include:

A
  1. murmurs
  2. syncope
  3. HF
  4. SOB
24
Q

Symptoms of valvular heart disease include:

A
  1. HF
  2. exercise intolerance
  3. SOB
25
Q

Procedures that do NOT require antibiotic prophylaxis in patient IE:

A
  1. anesthetic injection
  2. radiographic imaging
  3. placement of removable prosthodontics prosthesis
  4. placement of removable ortho appliances & brackets
  5. exfoliation of primary dentition
  6. bleeding of lip or oral mucosal trauma
  7. simple impressions
  8. optical scans
26
Q

What is the antibiotic of choice for infective Endocarditis if a patient is allergic to PCN:

A

Azithromycin (or clindamycin)

27
Q

What is NOT approved by the AHA for antibiotic prophylaxis:

A

Cephalexin

28
Q

What do you give patient allergic to penicillin to take orally?

A

Azithromycin (or clindamycin)

29
Q

Example of a true allergy:

A

Rash
Itching
Angioedema

30
Q

Chest pain at rest:

A

unstable angina

31
Q

The role of the macula densa:

A

glomerular BP

32
Q

What organ system is responsible for finger clubbing?

A

Cardiovascular

33
Q

Which of the following shoes immunity for hep B?

A

Anti-Hbs

34
Q

Endocrine etiology of secondary HTN:

A

Increased catecholamines

35
Q

What is produced in the adrenal cortex?

A

Cortisol, androgen, aldosterone

36
Q

Norepinephrine is produced in the:

A

adrenal medualla (catecholamines are produced in adrenal medulla)

37
Q

Hepatic encephalopathy is associated with:

A

Asterixis

38
Q

What causes the poor wound healing seen in diabetics?

A

Impaired angiogenesis & cytokines

39
Q
A

Dental management of the Medically Complex Patient (5 decks)

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