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xD3 Med Mgmt Ex3 > Emphasized Stuff > Flashcards

Emphasized Stuff Flashcards

1
Q

What type of partial seizure is associated with a loss of consciousness: simple or complex?

A

Complex (which may also include an underlying loss of consciousness)

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2
Q

The origin of all seizures is central or peripheral?

A

Central

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3
Q

What is the etiology of over 50% of primary seizures?

A

Idiopathic

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4
Q

Does the grand map seizure last more than a few minutes?

A

Not usually

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5
Q

Is the tonic phase long-lasting or transient?

A

Transient

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6
Q

What are the signs and symptoms in order for a grand mal seizure?

A
  1. Aura
  2. Epileptic cry
  3. Tonic phase
  4. Clonic phase
  5. Recovery
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7
Q

What management problems do well-controlled seizure disorders pose?

A

None

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8
Q

Why is pain management important in patients with a history of seizures?

A

Pain may cause stress which leads to seizure

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9
Q

What type of antibiotic prophylaxis should be given to a patient with a history of seizures?

A

None

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10
Q

What type of anesthesia is usually well-tolerated in a patient with a history of seizures?

A

No more than two carpules with 1:100,000 Epi

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11
Q

Why should anxiety-controlling measures be taken with a patient who has a history of seizures?

A

Much like pain, anxiety can trigger a seizure if not properly managed.

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12
Q

Why should you pay attention to skin changes (such as rash any erythema multiform in a patient with a history of seizures?

A

It may signify an allergic reaction to anti epileptic medication

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13
Q

What effect does valproic acid and carbemazepine (common medications for seizure control) have on hemostasis?

A

May adversely affect platelets, leading to a bleeding tendency.

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14
Q

Why is the monitoring of blood pressure critical with a patient who has a history of seizures?

A

A sudden increase or decrease in blood pressure may signal the onset of a seizure

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15
Q

A patient who is at risk for a seizure should be positioned how in the dental chair?

A

Supine

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16
Q

Is consultation with the physician of a seizure-prone patient indicated?

A

Yes

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17
Q

Other than gingival hyperplasia, what are some common adverse effects of anticonvulsant drugs?

A
  1. Drowsiness
  2. Slow mentation
  3. Dizziness
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18
Q

What are some ways to prepare for a grand map seizure?

A
  1. Use a ligated mouth prop at the beginning of the procedure
  2. The dental chair should be in a support supine position
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19
Q

What should you do during a seizure?

A
  1. Clear the area
  2. Turn the patient on the side (to avoid aspiration)
  3. Do NOT attempt to use a padded tongue blade
  4. Passively restrain
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20
Q

What should you do AFTER a seizure?

A
  1. Examine for traumatic injuries

2. Discontinue treatment; arrange for patient transport

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21
Q

What should you do if a seizing patient goes into cardiac arrest?

A

Call 9-1-1
Continue to monitor vitals
Administer CPR is necessary
Transport patient to emergency medical facilities

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22
Q

What should you do to follow-up after a patient has a seizure?

A

Call the patient (and the physician) to find out how the patient is doing

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23
Q

What are three medications that can cause gingival hyperplasia?

A
  1. Dilantin
  2. Cyclosporin
  3. Verapamil
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24
Q

What are 8 risk factors for cerebrovascular accidents? (he said he would do a question from this for sure)

A
  1. Hypertension
  2. CHF
  3. Diabetes Mellitus Type I and II
  4. History of TIAs or CVAs
  5. Over 75 years old
  6. Hypercholesterolemia
  7. Coronary atherosclerosis
  8. Smoking tobacco
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25
Q

What are four events associated with strokes?

A
  1. Transient ischemic attack (TIA)
  2. Reversible ischemic neurologic deficit (RIND)
  3. Stroke-in-evolution
  4. Completed Stroke
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26
Q

Which is “worse”: stroke-in-evolution or reversible ischemic neurologic deficit (RIND)?

A

SIE

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27
Q

Why does knowing the nature of the stroke matter with regards to giving Aspirin?

A

If it is a hemorrhagic stroke, aspirin will make it worse

If it is ischemic, aspirin will help

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28
Q

If a stroke patient is on coumarin, what should their pretreatment INR be?

A

Less than or equal to 3.5. Higher than that requires their physician to reduce the dose.

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29
Q

If a stroke patient is on IV heparin, what should you do?

A
  1. Only do palliative emergency care
  2. Discontinue heparin IV 6-12 hours before surgery, discontinue heparin and start another anticoagulant with the physician’s approval. Restart heparin after about 6 hours when the clot has formed.
  3. Use measures to minimize hemhorrage
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30
Q

What should you do if a stroke patient is on low molecular weight heparin?

A

No change from normal treatment is indicated

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31
Q

Should you monitor both blood pressure AND oxygen saturation if a stroke patient is on anticoagulation?

A

Yes

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32
Q

What care should you take with regards to epi with a stroke patient?

A
  1. Use a minimum of epi

2. Avoid epi-infused retraction cords

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33
Q

What drugs cause decreased warfarin metabolism?

A
  1. Metronidazole

2. Tetracyclines

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34
Q

What precautions should you take if a patient has had a stroke, TIA or RIND in the past six months?

A
  1. Short and stress-free appointments
  2. Good anesthesia
  3. Monitor BP and oxygen saturation
  4. Recognize signs and symptoms of a stroke
  5. Activate EMS system as needed
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35
Q

What type of plaques are visible on a panoramic radiograph and could predispose a patient to a stroke?

A

Carotid Calcified Atherosclerotic Plaques

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36
Q

Depletion of melanin pigmentation and a diffusion of the melanotic cells in the spinal cord is indicative of what disorder?

A

Parkinson’s Disease

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37
Q

What condition can cause parkinson’s-like symptoms?

A

Tardive Dyskinesia

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38
Q

What are some drug considerations for someone with Parkinson’s disease?

A

They may be on anticholinergic and dopamine agonist drugs, which may have adverse effects including sedation, drowsiness, slow mentation, fatigue, confusion and dizziness

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39
Q

How should you adjust your chair position to accommodate a patient with Parkinson’s disease?

A
  1. Supine position may not be tolerated
  2. Adequate support to reduce unnecessary movement
  3. Hypotension is possible so use caution when getting seated or arising
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40
Q

What two things may be given to a patient with parkinson’s to prevent facial movement?

A
  1. Benadryl

2. Botox injections

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41
Q

What are special considerations for anxiety control with alzheimer’s patients?

A

These patients may have difficulty understanding commands and cooperating and will therefore be more anxious. Use techniques to help put them at ease.

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42
Q

Is antibiotic prophylaxis necessary with CSF?

A

NOOOOOOOOOO
The only possible exception is if they need an incision and drainage at a different site or the replacement of an infected shunt

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43
Q

What is the term for an accumulation of CSF within the cerebral ventricles?

A

Hydrocephalus

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44
Q

What is placed within cerebral ventricles and peripheral cavities to reduce increased CSF pressure?

A

CSF shunt

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45
Q

What are 3 types of CSF shunts?

A
  1. Ventriculoperitoneal
  2. Ventriculoatrial
  3. Lumboperitoneal
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46
Q

In the system for classification of social health, which axis deals with personality disorders and mental retardation?

A

Axis II

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47
Q

In the system for classification of social health, which axis deals with global assessment of functioning?

A

Axis V

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48
Q

In the system for classification of social health, which axis deals with general medical conditions?

A

Axis III

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49
Q

In the system for classification of social health, which axis deals with psychosocial and environmental problems?

A

Axis IV

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50
Q

In the system for classification of social health, which axis deals with clinical disorders and other conditions that may be the focus of clinical attention?

A

Axis I

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51
Q

For Axis V, what does a higher score indicate?

A

Fewer symptoms or limits to functioning.

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52
Q

In a person with anxiety disorder, which neurotransmitter(s) will have increased activity?

A

Norepinephrine

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53
Q

In a person with anxiety disorder, which neurotransmitter(s) will have increased activity?

A

GABA and serotonin

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54
Q

What are 2 phobias that may affect medical or dental care?

A
  1. Needle Phobia

2. Claustrophobia (MRI or radiation therapy)

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55
Q

What is the definition of dental “phobia”?

A

A more extreme anxiety that the “usual” level of attending a visit to the dentist

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56
Q

What is cited as the major cause of dental phobia?

A

Previous frightening dental experiences

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57
Q

What are some specific sounds and sensations people who experience dental phobia are afraid of?

A
  1. Noise and vibration of the hand piece
  2. Sight of the injection needle
  3. The act of sitting in the dental chair
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58
Q

What are some signs that a person is experiencing dental phobia?

A
  1. Muscle tension
  2. Tachycardia
  3. Tachypnea
  4. Sweating
  5. Stomach cramps
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59
Q

What are some anesthesia considerations for a patient with dental phobia?

A
  1. Oral sedation the night before with a fast-acting benzodiazepine can aide in the management of anxiety
  2. Inhalataion anxiolysis with nitrous oxide or intramuscular sedation or intravenous sedation can be used
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60
Q

What are some clinical signs of anorexia nervosa?

A
  1. The individual weights less than 85% of the minimally normal weight for a person their height and age
  2. Postmenarchal females with this disorder are amenorrheic
  3. May also have hypotension, hypothermia, and dryness of skin
  4. Bradycardia
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61
Q

What is the mortality of persons with anorexia nervosa?

A

5-20% (mostly from starvation, suicide or electrolyte imbalance)

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62
Q

What are some inappropriate compensatory behaviors prevalent in bulimia nervosa?

A
  1. Self-induced vomiting
  2. Misuse of laxatives, diuretics, enemas or other medications
  3. . Fasting
  4. Excessive weight gain
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63
Q

What is the long-term outcome of bulimia nervosa?

A

Not known but appears to have a more optimistic prognosis than for anorexia nervosa; the death rate from anorexia nervosa due to cardiac arrest and suicide is MUCH higher than the death rate for bulimia

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64
Q

What are some physical signs of bulimia nervosa?

A
  1. Erosion of lingual surfaces of maxillary teeth (or apparently the inicisal edges of mandibular teeth?)
  2. Bilateral parotid enlargement
  3. Ruessell’s sign
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65
Q

True or False; Early onset, recurrent course, and psychotic depression are heritable?

A

true

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66
Q

Do unipolar patients tend to have relatives with major depression and dysthymic disorder and fewer with bipolar disorder?

A

Yes

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67
Q

Do bipolar patients have more relatives with bipolar disorder, cyclothymia, unipolar depression and schizoaffective disorder?

A

Yes

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68
Q

What is the concordance rate in monozygotic twins for recurrent depression?

A

59%

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69
Q

What is the concordance rate in monozygotic twins for single episode depression?

A

33%

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70
Q

The concordance rate for depression in identical (monozygotic) twins is how many times greater than for fraternal (dizygotic) twins?

A

Four times

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71
Q

What is the bipolar concordance rate in identical (monozygotic) twins?

A

72%

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72
Q

What is the bipolar concordance rate in fraternal (dizygotic) twins?

A

19%

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73
Q

What is the very hard to remember mnemonic for symptoms of major depression?

A

“SIGECAPS”

  1. Sleep
  2. Interest
  3. Guilt
  4. Energy
  5. Concentration
  6. Appetite
  7. Psychomotor activity
  8. Suicidal ideation
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74
Q

What is the mnemonic for symptoms of mania?

A

“DIGFAST”

  1. Distractability
  2. Insomnia
  3. Grandiosity
  4. Flight of ideas
  5. Activity / agitation
  6. Speech (pressured)
  7. Thoughtlessness
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75
Q

Which bipolar type must have one episode of mania and one of depression within a month?

A

Type I

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76
Q

Which bipolar type must have a major depressive episode?

A

Type II

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77
Q

What is a side effect of SSRIs that can affect dental health (other than xerostomia)?

A

Bruxism

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78
Q

What can counteract the bruxism effects of SSRIs?

A

Low-dose TCA

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79
Q

What is the intentional production or feigning of physical or psychological signs when external reinforcers (e.g. avoidance of responsibility, financial gain) are not clearly present

A

Factitious disorder

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80
Q

Is factitious disorder more common in men or women?

A

Men

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81
Q

What professional group has a higher incidence of factitious disorder?

A

Health care workers

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82
Q

In factitious disorder, which are more common: skin lesions or oral lesions?

A

Skin lesions (oral lesions cannot be seen)

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83
Q

What are some symptoms of schizophrenia?

A
  1. Delusion
  2. Hallucination
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior
  5. Negative symptoms (such as flattened affect)
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84
Q

What are two side effects of antipsychotic drugs?

A
  1. Agranulocytosis

2. Tardive dyskinesia

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85
Q

What drugs can cause hyperprolactinemia?

A

Antidopaminergics

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86
Q

What does hyerprolactinemia cause in men?

A
  1. Gynecomastia
  2. impotence
  3. Loss of libido
  4. impaired spermatogenesis
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87
Q

What can cause extrapyramidal syndromes?

A

Antidopaminergic drugs

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88
Q

What are some examples of acute dystonias caused by antidopaminergic drugs?

A
  1. Parkinson’s
  2. Akathisia
  3. Tardive dyskinesia
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89
Q

What is neuroleptic malignant syndrome caused by?

A

A combination of receptors

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90
Q

What are symptoms of neuroleptic malignant syndrome?

A

Rigidity, fluctuating consciousness (delirium, stupod) and lability (hyperthermia, tachycardia, hypotension or hypertension, sweating, pallor, salivation, incontinence)

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91
Q

What drug can cause agranulocytosis?

A

Clozaril?

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92
Q

What emergency precaution should be taken with a patient who is depressed and have thoughts of suicide?

A

Contact a relative and the patient’s physician immediately in an emergency situation.

93
Q

What considerations should be taken for elective dental treatment with patients who have severe symptoms of mania, depression, or schizophrenia?

A

Delay elective treatment until the condition is better controlled.

94
Q

What is the colloquial term for delirium tremens?

A

“The Shakes” (or “DTs”)

95
Q

How soon do alcohol withdrawals begin?

A

6 to 24 hours

96
Q

How long do alcohol withdrawal symptoms last?

A

2 to 7 days

97
Q

What are MILD symptoms of alcohol withdrawal?

A

Irritability, tremo, insomnia

98
Q

What are MODERATE symptoms of alcohol withdrawal?

A

diaphoresis, fever, disorientation

99
Q

What are SEVERE symptoms of alcohol withdrawal?

A

grand mal seizures, DTs

100
Q

What sense do DT hallucinations primarily affect?

A

Vision

101
Q

What is formication?

A

The sensation of something crawling on you, an example of a tactile hallucination common to DTs

102
Q

What are some symptoms associated with DTs?

A

Confusion, diarrhea, insomnia, nightmares, disorientation, agitation, visual or tactile hallucinations, gross tremor, autonomic instability (fever, tachycardia, hypertension), and fluctuating levels of psychomotor activity

103
Q

What are some anesthesia considerations for abusers of cocaine and methamphetamines?

A

Don’t use epi for 24 hours after the last dose of drug

104
Q

What are some analgesic considerations with a patient who has an alcohol or drug dependance?

A

Avoid prescribing narcotic analgesics if possible. However, if needed, consult with PCP and possibly a third party (“12 step program”)

105
Q

What are some bleeding considerations with a patient with alcohol abuse?

A

Excessive bleeding secondary to liver disease is possible. Lab tests may be needed for confirmation.

106
Q

What are you legally obligated to do is a patient is an immediate danger to others?

A

Report to the proper authorities

107
Q

What are you legally obligated to do if a patient is suicidal?

A

May need to admit the patient, with or without the patient’s consent, and share information with the hospital staff

108
Q

What is a legal term that can only be decided by a judge?

A

Competence

109
Q

What is a clinical term that may be assessed by clinicians?

A

Capacity

110
Q

Why is it important to assess capacity on a treatment-specific basis?

A

Because decision capacity is task-specific and can fluctuate over time (a patient may have capacity to make on treatment decision while lacking capacity to make other).

111
Q

What are two terms that refer to a patient’s ability to make informed treatment decisions?

A

Competence and capacity

112
Q

A patient is considered to have decisional capacity if he or she meets what four criteria?

A
  1. Can communicate a choice or preference
  2. Understands the relevant info regarding treatment (and can explain it back to you)
  3. Appreciate the situation and its potential impact or consequences and the ramifications of refusing treatment
  4. Can logically manipulate information regarding the situation and reach rational conclusions
113
Q

What are two main categories of admission to a psychiatric hospital?

A
  1. Voluntary admission

2. Involuntary admission

114
Q

What is voluntary admission to a psychiatric hospital?

A

Patient requests or agrees to be admitted by psychiatric ward. Maybe examined by staff psychiatrist who determines whether he or she should be hospitalized.

115
Q

What is involuntary admission (also known as civil commitment)?

A

The patient is found by two staff physicians to be potentially harmful to self or others. Case must be reviewed after several days and the patient has his or her rights explained.

116
Q

Is neuroleptic malignant syndrome more common in men or women?

A

More common in men who have recently begun medication

117
Q

Is neuroleptic malignant syndroms considered a medical emergency?

A

Yes

118
Q

What is the mortality rate of neuroleptic malignant syndrome?

A

20%

119
Q

What should you do if a patient has a neuroleptic malignant syndrome?

A

Discontinue whatever medication they recently started

120
Q

Is a manic episode a psychiatric emergency?

A

Yes

121
Q

What makes a patient having a manic episode so dangerous?

A

They have severely impaired judgment

122
Q

What is the mortality rate for delirium tremens?

A

15 to 20%

123
Q

What percentage of delirium tremens are hospitalized for alcohol withdrawal?

A

5%

124
Q

What is the treatment for delirium tremens?

A

Benzodiazepines

125
Q

What are 5 symptoms of schizophrenia?

A
  1. Delusion
  2. Hallucination
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior
  5. Negative symptoms (such as flattened functional)
126
Q

What are the 5 A’s of schizophrenia (negative symptoms)?

A
  1. Anhedonia
  2. Affect (flat)
  3. Alogia (poverty of speech)
  4. Avolition (apathy)
  5. Attention (poor)
127
Q

Schizophrenia symptoms usually present in what three phases?

A
  1. Prodromal
  2. Psychotic
  3. Residual
128
Q

What is the dopamine hypothesis of Schizophrenia?

A

Symptoms of schizophrenia are caused in part by disturbance in dopamine-mediated neuronal pathways in the brain

129
Q

What supports the dopamine hypothesis of schizophrenia?

A

Most antipsychotic drugs block the postsynaptic dopamine receptors.

130
Q

What is the prevalence of psychiatric disorders among adult dental patients at VCU?

A

28%

131
Q

What is the most common disorder reported among dental patients at VCU?

A

Depression

132
Q

What is the etiology of depression?

A

Reduced brain concentrations of norepinephrine and serotonin

133
Q

What is the etiology of mania?

A

Increased levels of norepinephrine and serotonin

134
Q

What is the association between thyroid hormones and depression?

A

Thyrotropin release of thryoid-stimulating hormone and cortisol release by corticotropin-releasing factor and adrenocorticotropin over a long period may be associated with the development of depression

135
Q

What are two types of anorexia nervosa?

A
  1. Restrictive type

2. Binge-eating and purging type

136
Q

What are two types of bulimia nervosa?

A
  1. Purging type

2. Non-purging type

137
Q

What are three types of eating disorder?

A
  1. Anorexia
  2. Bulimia nervosa
  3. Binge-eating disorder
138
Q

What are the diagnostic criteria for panic disorder?

A
  1. Spontaneous recurrent panic attacks with no obvious precipitant
  2. At least one of the attacks has been followed by a minimum of 1 month of one of the following: persistent concern of additional attacks, worry about implications of attack, significant change in behavior related to the attacks
139
Q

What are discrete periods of heightened anxiety that classically occur in patients with panic disorder?

A

Panic attacks

140
Q

What are the symptoms of panic attacks?

A 
Palpitations
Abdominal distress
Numbness, nausea
Intense fear of death
Choking, chills, chest pain, sweating, shaking, shortness of breath
141
Q

What are the 5 diagnostic criteria for specific phobias?

A
  1. Persistent excessive fear brought on by a specific situation or object
  2. Exposure to the situation brings about an immediate anxiety response
  3. Patient recognizes that the fear is excessive
  4. The situation is avoided when possible or tolerated with intense anxiety
  5. If the person is under age 18, duration must be at least 6 months
142
Q

What is defined as the subjective experience of fear and its physical manifestations?

A

Anxiety

143
Q

True or False: No single theory fully explains all anxiety disorders

A

True

144
Q

True or False: No single biologic or psychological cause of anxiety has been identified.

A

True

145
Q

Psychosocial and biologic processes together may best explain anxiety

A

True

146
Q

Panic and anxiety may be correlated with what?

A

Disregulated firing of the locus coeruleus caused by input from multiple sources

147
Q

How many people live with HIV worldwide?

A

34 million people

148
Q

True or false: the numbers of people with HIV have increased by new infections are falling?

A

True

149
Q

Are there increased survival rates with HIV? Why?

A

Yes because of current anti-retroviral therapies

150
Q

What type of virus is HIV: DNA or RNA?

A

RNA

151
Q

What are three main modes of HIV transmission?

A
  1. Sexual
  2. Bodily fluids
  3. Materno-fluid
152
Q

What are some compounding factors for HIV transmission?

A
  1. IV drug use
  2. Lower socio-economic strata
  3. Presence of other chronic illnesses (especially STDs)
153
Q

How long does the acute infections stage last following an HIV infection?

A

2-4 weeks

154
Q

What are the symptoms of the acute infectious stage of HIV infection?

A

Range from asymptomatic to mild flu-like symptoms

155
Q

How long may the clinically latent stage of HIV infection last?

A

A few months to 20 years

156
Q

What are some late-stage HIV infection symptoms?

A
  1. Lymph node enlargement
  2. Fever
  3. Night sweats
  4. GI and musculoskeletal pain
  5. Detectable antibodies
157
Q

What is a normal CD4 count?

A

600 to 1200

158
Q

A person has full-fledged AIDS if their CD4 count drops below what number?

A

200

159
Q

What does HAART stand for?

A

Highly active antiretroviral therapy

160
Q

What drug classes are presently in HAART?

A
  1. Nucleoside reverse transcriptase inhibitors
  2. Non-nucleoside reverse transcriptase inhibitors
  3. Integrase inhibitors
  4. Protease inhibitors
  5. Fusion and entry inhibitors
161
Q

Why do you want to know an HIV patient’s CD4 count?

A

It helps to know about their state of immunosuppression

162
Q

What are some lab values you want to know for HIV patients?

A
  1. CD4
  2. Total WBC
  3. Absolute neutrophils
  4. Platelets
163
Q

What is the normal range for total WBC count?

A

4,000 to 10,000 cells per mm3

164
Q

What CD4 count raises a concern for infection susceptibility?

A

Below 2,000

165
Q

What CD4 count may warrant post-operative antibiotic coverage?

A

Below 1,000

166
Q

What is the normal range for platelets?

A

150,000 to 450,000

167
Q

What platelet number raises a concern for prolonged bleeding in an HIV patient?

A

Below 60,000

168
Q

What may an MD do for an HIV patient with less than 60,000 platelets?

A
  1. Infuse platelets

2. Administer prednisone

169
Q

You might consider infusion if RBCs are below what number?

A

Under 1 million / mm3

170
Q

You might consider infusion if hemoglobin is below what number?

A

10

171
Q

You might consider infusion if the hematocrit is below what percent?

A

10%

172
Q

What is the normal range for CD4 helper T-lymphocytes?

A

590 to 1120 cells / mm3

173
Q

AIDS is indicated when the helper T-lymphocyte CD4 count drops before what number?

A

200

174
Q

What is the ideal number for plasma HIV-RNA?

A

0

175
Q

Does viral load of HIV impact provision of dental treatment?

A

Nope

176
Q

How frequently should you obtain labs if the HIV patient has a CD4 count over 200?

A

At least every 6 months or per MD recommendation

177
Q

How frequently should you obtain labs if the HIV patient has a CD4 count below 200?

A

At least every 3 months or per MD suggestion

178
Q

Are extra precautions necessary for HIV patients (those beyond standard precautions)?

A

No

179
Q

What diseases may be spread by needlestick injuries?

A
  1. HIV
  2. Hep B
  3. Hep C
  4. Hep D
180
Q

What is the management for an HIV patient with pseudomembranous candidiasis?

A

Antifungals

181
Q

What is the management for an HIV patient with erythematous candidiasis?

A

Antifungals

182
Q

Other than AIDS, what are three things that can manifest with oral hairy leukoplakia?

A
  1. EBV
  2. Burkitt’s Lymphoma
  3. Infection mononucleosis
183
Q

What is the management for an exophytic growth, condyloma acumenatum?

A

A topical cream (tenofovir or some other drug that ends in -ovir)

184
Q

What is unilateral and painful and follows the path of the trigeminal nerve?

A

Herpes Zoster Infection

185
Q

How do you manage a Herpes Zoster infection?

A

High dose antivirals (-cyclovirs)

186
Q

How do you treat a herpes simplex virus?

A

Valtrex

187
Q

What is it called when herpes vesicles fuse together (often associated with HIV)?

A

Vesiculobullous

188
Q

what looks like a large red lesion on the lip and is associated with HSV?

A

Cytomegalovirus

189
Q

What is a low-grade bacterial infection manifest as a reddish line along the gingival margin?

A

Linear erythematous gingivitis

190
Q

How do you manage necrotizing ulcerative periodontitis?

A
  1. Systemic antibiotics

2. Chlorhexadine

191
Q

Other than HIV, what are four things that can cause parotid enlargement?

A
  1. Mumps
  2. Bulemia
  3. Liver disease
  4. Sarcoidosis
192
Q

What is a differential for a Kaposi’s sarcoma on the tongue?

A

Granular cell tumor

193
Q

Do Kaposi’s sarcomas normally affect healthy individuals?

A

No

194
Q

What virus is associated with Kaposi’s sarcomas

A

HHV-8

195
Q

What HIV drug can cause pigmentation of the buccal mucosa?

A

Zidovudine (AZT)

196
Q

What is the management for an aphthous ulcer?

A

Orabase cream or Steroids (the cause is not viral, bacterial or fungal)

197
Q

What are some possible causes for aphthous ulcers?

A

Changes in immunity, nutrition, hematologic changes

198
Q

What is the management for Kaposi’s sarcoma?

A

Incisional biopsy

199
Q

What is the management of angular cheilitis?

A

Ketoconazole

200
Q

Does every HIV exposure require antibiotic prophylaxis?

A

No. In some cases if the viral load is low enough, it may not be necessary. This is one of the few times the viral load comes into play.

201
Q

What is the most common population for deep fungal infections?

A

cancer patients or other immunocompromised patients

202
Q

Does molluscum contagiosum occur only in adults?

A

No. It can also occur in children.

203
Q

What percentage of Hep C cases have spontaneous remission?

A

40%

204
Q

Is there currently a vaccine for Hep C?

A

Nope

205
Q

What is the protocol for an Hep C exposure?

A

Inject with Hep A and Hep B vaccine as well as an injection with interferon Alpha 2B

206
Q

When is PEP most likely to be effective?

A

When initiated as soon as possible

207
Q

What is the gold standard for HIV PEP?

A

An hour (but certainly within 48-72 hours of infection and continued for at least 28 days

208
Q

What is important in HIV PEP?

A

Adequate doses of antiretroviral treatment given for long enough

209
Q

What body fluid carries the highest risk of infection in an exposure?

A

Blood

210
Q

What type of skin exposure carries the highest risk of infection?

A

Percutaneous (mores than the mucous membrane or the skin)

If the skin is intact then no PEP is needed

211
Q

What should you do if an exposure report is delayed for more than 72 hours?

A

Seek expert consultation for HIV PEP

212
Q

What should you do if an exposure has an unknown source?

A

Seek expert consultation for HIV PEP

213
Q

What should you do if there is a known or suspected pregnancy in an exposed person?

A

Seek expert consultation for HIV PEP

214
Q

What should you do if the exposed person is breast-feeding?

A

Seek expert consultation for HIV PEP

215
Q

What should you do if there is known or suspected resistance of the source virus to antiretroviral agents?

A

Seek expert consultation for HIV PEP

216
Q

What should you do if there is toxicity in the initial PEP regimen?

A

Seek expert consultation for HIV PEP

217
Q

What should you do if there is a serious medical illness in the exposed person?

A

Seek expert consultation for HIV PEP

218
Q

HIV usually connects with what virus?

A

Hep C

219
Q

Why are platelet counts reduced in a patient who is Hep C+?

A

Thrombopoetin production is impaired

220
Q

What lesions are causes by a dsDNA pox virus transmitted via skin to skin contact and by auto-inoculation?

A

Molluscum contagiosum

221
Q

Where does molluscum normally manifest itself in HIV patients?

A

Face, neck and genital tract

222
Q

How is molluscum contagiosum managed?

A
  1. Manage the patient’s immune status by initiating potent antiretroviral therapy
223
Q

Does a lack of respiratory symptoms mean aspiration has not taken place?

A

Not necessarily

224
Q

What are three ways to manage a foreign body aspiration?

A
  1. Retrieve, if possible
  2. Heilmich
  3. Cricothyroidotomy
225
Q

What is the new order of ABCD?

A

DCAB

226
Q

What are 3 drugs to use for the management of allergy anaphylaxis?

A
  1. Epinephrine
  2. Benadryl
  3. Steroids
227
Q

What is more dangerous in the acute stage: hypo or hyperglycemia?

A

Hypoglycemia

228
Q

A patient is nauseous, sweating, has tachycardia: what is their problem?

A

Hypoglycemia (if they have fruity breath it is possibly hyperglycemia)

xD3 Med Mgmt Ex3 (5 decks)

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