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TxPlan/MedComplex/SpecNeeds > Dr.BrenDr.PatExam1-Neuro/Blood > Flashcards

Dr.BrenDr.PatExam1-Neuro/Blood Flashcards

1
Q

Parkinson’s Disease: Medications cause _______….increased caries/fungal infections

A

xerostomia

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2
Q

Parkinson’s Disease: Difficulty with __________ (breaking, swallowing or falling out)

A

removable appliances

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3
Q

Parkinson’s Disease: ______ changes impact oral hygiene, dental treatment ease, swallowing (increased risk of aspiration)

A

Motor

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4
Q

Parkinson’s Disease: _________ (levodopa) – affects jaw as well

A

Dyskinesias

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5
Q

Parkinson’s Disease: Cognitive impairment…Take meds _________ prior to appt (peak response period), brief visits

A

60-90 minutes

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6
Q

What condition is responsible for 15-20% of ALL STROKES??

A

Atrial Fibrillation

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7
Q

What is the biggest risk associated with Atrial Fibrillation?

A

ischemic stroke

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8
Q

What are the two main antithrombotic treatments for A-Fib?

A

1.ASA and 2.Warfarin

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9
Q

How long do we wait after a STROKE, TIA, or reversible near defect? HOWEVER: A NEW STUDY showed Tx can be safely administered within _______ of CVA “as long as pts are kept under optimal medical surveillance.”

A

6 months….a few weeks

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10
Q

What is the most common inherited clotting disorder?

A

hemophilia A

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11
Q

What is another name for hemophilia B? Which clotting factor is involved?

A

Christmas disease…factor IX

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12
Q

Interesting: inherited blood disorders lack ____ coagulation factors where as acquired disorders lack ____ coagulation factors…

A

inherited - just 1…aquired - multiple

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13
Q

KNOW THIS KOLD: What are the 4 vitamin K dependent clotting factors made in the liver?

A

1972….lol II, VII, IX, and X

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14
Q

So Vit K affects clotting factor VII, which system is this found in? (extrinsic, intrinsic, common)

A

VII is EXTRINSIC

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15
Q

So Vit K affects clotting factor IX, which system is this found in? (extrinsic, intrinsic, common)

A

IX is INTRINSIC

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16
Q

So Vit K affects clotting factor X, which system is this found in? (extrinsic, intrinsic, common)

A

common

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17
Q

So Vit K affects clotting factor II, which system is this found in? (extrinsic, intrinsic, common)

A

common

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18
Q

What is another name for clotting factor II?

A

thrombin

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19
Q

What is another name for clotting factor I?

A

fibrin

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20
Q

Which blood test assesses the intrinsic clotting system?

A

aPPT

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21
Q

Which blood test assesses the extrinsic clotting system?

A

PT (INR)

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22
Q

Here we go: what does aPPT stand for?

A

activated Partial ThromboPlastin Time

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23
Q

Which condition is an aPPT typically used for?

A

Hemophilias

24
Q

Which clotting factors are tested in an aPPT?

A

(intrinsic)…VIII, IX, XI, XII

25
Q

Which test is a great indicator for those Vit K dependent clotting factors?

A

PT

26
Q

What does PT stand for?

A

Prothrombin Time

27
Q

Which clotting system does the PT gauge?

A

Extrinsic

28
Q

Which factors are assessed with a PT?

A

VII, V, X, Prothrombin II, Fibrinogen I (notice no IX!!)

29
Q

Which test do you use to check the effectiveness of warfarin?

A

PT (INR)

30
Q

Which test do you use to assess the effectiveness of aspirin?

A

Platelet count

31
Q

What does a platelet count assess?

A

hemostasis

32
Q

What is a great question to assess if a patient has a bleeding disorder?

A

Do you bleed or bruise easily?

33
Q

Which two conditions warrant a risky level of warfarin?

A

prosthetic heart valves and DVT

34
Q

What are the MAGIC numbers for INR and PT?

A

INR LESS THAN 3.5 and PT LESS THAN 20 seconds

35
Q

What is the best medication for post op pain control with coumadin?

A

minimal does of acetominophen w. codeine

36
Q

What is the SELF LIFE for an INR for you to consider it valid?

A

24 hours!

37
Q

What are two substances that ENHANCE the anti-coagulation effects of warfarin?

A

EtOH and Cranberry juice

38
Q

What type of food can COMBAT the effects of warfarin?

A

Vit K rich foods-GREENS

39
Q

What is the effect of ACETAMINOPHEN on INR?

A

INCREASES INR MARKEDLY (causes thinner blood) (higher INR = thinner blood)

40
Q

WHY is ASA/NSAIDS contraindicated with Warfarin use?

A

GI Bleed…NO increase in INR!! VERY INTERESTING!!

41
Q

Which antibiotics are best for patients on Warfarin? (no effects on INR)

A

Pen V or Clindamycin

42
Q

INR values: at ASDOH we stay under _____. DUMB EXAM QUESTION: What is the range a patient with a Hx of DVT might be in?

A

3.5…..2.5-3.5

43
Q

FRAME THIS AND PUT IT ON YOUR WALL! “Clinician’s judgment, experience, _______, and accessibility to appropriate bleeding management strategies are all important components in any treatment decision.”

A

training

44
Q

ASA, TicLid, and Plavix…Primary prophylaxis of coronary _______….Secondary prevention of adverse thromboembolic events in patients with a history of coronary thrombosis, stroke and unstable _____

A

thrombosis… angina (an GIN Ah)

45
Q

With anti platelet therapy: Increased clinical risk of bleeding with ASA or NSAIDS, alcohol use, advanced ____,
liver disease and existing coagulopathies.

A

age

46
Q

With Anti-platelet therapy: Little or no indication to ______ antiplatelet drugs for dental procedures

A

interrupt

47
Q

Not necessary to interrupt low-dose ______ therapy (____mg/day or less) for SIMPLE dental extractions

A

ASPIRIN…100mg

48
Q

For patients with a DES (Drug Eluding Stint), Premature discontinuation of antiplatelet therapy greatly _______ the risk of stent thrombosis, MI & death

A

INCREASES

49
Q

HOW long is the COMBINATION of ASA and PLAVIX post stint placement?

A

12 months

50
Q

How long do we postpone Elective dental surgery after a Drug Eluding Stent placement? How about a Bare Metal Stint?

A

DES-1 year…Bare metal-1 month

51
Q

What are three of the NOA (New Oral Anticoagulants) brand names?

A

Pradaxa, Xeralto, Eliquis

52
Q

Which system and clotting factor does Pradaxa effect?

A

Direct thrombin inhibitor (common, factor II)

53
Q

Which system and clotting factor do Xeralto, Eliquis, and Savaysa act on?

A

Factor Xa..beginnnign of common pathway

54
Q

What is the biggest unknown with the NOA’s?

A

there is no REVERSAL AGENT!!

55
Q

It does not appear that it is necessary to discontinue the use of dabigatran (_______) in patients with normal renal function and without other risks for impaired hemostasis, especially if adjunctive local hemostatic measures† are used when indicated.”

A

PraDaxa

TxPlan/MedComplex/SpecNeeds (21 decks)

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