Dr.BrenDr.PatExam1-Cardio Flashcards
What is the most common PRIMARY diagnosis in the US?
Hypertension
What % of patients have ‘white coat’ HTN?
15-20%
What % of HTN is idiopathic?
90%q
We would LOVE, to have all patients be under ___/___ for their BP, but it depends on age and comorbidities.
140/90
JNC 7 vs JNC 8: the GOAL is to have DBP be LESS THAN ____ and the SBP Depends on WHAT?
DBP: less than 90….SBP depends on AGE
JNC 7 vs JNC 8: greater than or equal to age 60 we a SBP less than WHAT is considered acceptable?
less than 150
JNC 7 vs JNC 8: less than 60 years of age the SBP should be less than WHAT to be considered not hypertensive?
less than 140
JNC 7 vs JNC 8: CKD or DM (and older than 18), the SBP should be less than _____ to consider the pt not hypertensive.
less than 140
What was the most common side effect with almost EVERY single anti-hypertensive drugs???
orthostatic hypotension
What was the only hypertension drug that has the side effect of gingival hyperplasia? What is a generic name example?
Ca channel blockers…nifedipine
BP and Dental Tx Guidelines: for a BP less than ___/___ and dental tx can be done and there is no need to refer to a physician
less than 120/80
BP and Dental Tx Guidelines: for a BP greater than or equal to ____/____ BUT less than ____/____, you can do any required tx, but encourage the patient to see physician
120/80 to 140/90……OR…..140/90 but less than 160/100
BP and Dental Tx Guidelines: What range is the patient in if we CAN DO ANY REQUIRED TX, but consider intraoperative monitoring of BP for upper level stage 2 HTN? ALSO, for this range you need to refer to a physician with in WHAT AMOUNT OF TIME???
160/100 to 180/110….WITHIN 1 MONTH
BP and Dental Tx Guidelines: what BP range do we defer ELECTIVE treatment and refer to a physician ASAP, or if symptomatic refer immediately?
GREATER THAN or EQUAL TO 180/110
BP and Dental Tx Guidelines: Is epinephrine contraindicated in Pts with HTN? What is the biggest concern with General Anesthesia?
Epi is not contraindicated, fluctuations in BP is biggest concern with GENERAL anesthesia (hypotension)
BP and Dental Tx Guidelines: What hypertension drug(s) MAY have an interaction with EPINEPHRINE?
EPI and NON-Selective beta-blockers (2nd half of alphabet!!) (cardioselective should be ok-1st half of alphabet)
“Although there are no clinical studies, it is generally recommended that non- emergent procedures be avoided in patients with a blood pressure of greater than ____/____mmHg.”
180/110mmHg
Dental Treatment for Post Acute Myocardial Infarction…
NO TX the first _____ after MI. If ABSOLUTELY necessary, Cardio medical consult
30 days
For patients with CAD & MI – WHAT is Important in pt management??
Stress Reduction (anti-anxiety meds, pain control)
Pts needing Prophy Abx All manipulation of gingival tissues, periapical region of teeth/perf oral mucosa….EXCEPT: routine anesthetic injections through _________ tissue
non-infected
Pts needing Prophy Abx All manipulation of gingival tissues, periapical region of teeth/perf oral mucosa….EXCEPT: taking of dental ________
radiographs
Pts needing Prophy Abx All manipulation of gingival tissues, periapical region of teeth/perf oral mucosa….EXCEPT: Placement of ________ prosthodontic or orthodontic appliances
removable
Pts needing Prophy Abx All manipulation of gingival tissues, periapical region of teeth/perf oral mucosa….EXCEPT: Adjustment of ________ appliances
orthodontic
Pts needing Prophy Abx All manipulation of gingival tissues, periapical region of teeth/perf oral mucosa….EXCEPT: Shedding of _______ teeth and bleeding from trauma to the ____ or oral mucosa
deciduous…lips
What are the ONLY 4 categories of patients in need of antibiotic prophylaxis before dental treatment?
1.Artificial heart valves 2.infective endocarditis 3.cardiac transplant c/o valve problem 4.congenital heart conditions (more to come)
What are the three types of congenital heart conditions that need antibiotic prophylaxis?
1.cyanotic congenital heart disease (palliative shunts/condiuts) 2.FIRST 6 months after prosthetic material placed to correct a congenital heart defect 3. any RESIDUAL defect after prosthetic placement
What is the drug of choice for antibiotic prophylaxis? Whats the dose?
Amoxicillin 2g
What drug SHOULD NOT BE USED in a person with a history of ANAPHYLAXIS, angioedema, or urticaria with penicillins or ampicillin?
CEPH-al-o-Sporins
What are the three choices for antibiotic prophylaxis if the patient is allergic to amoxicillin?
1.Cephalexin (BE CAREFUL) 2.Clindamycin (Dr. Spolarich’s choice) 3.Azithro or Clarithro-mycins
