Exam 2 Flashcards
1
Q
How many radiographs are in a full mouth survey?
A
20
2
Q
How many PAs in a full mouth survey?
A
16
3
Q
How many bitewings in a full mouth survey?
A
4
4
Q
What does PA stand for?
A
periapical
5
Q
What is a PA radiograph?
A
image that captures the outline of the entire crown and the entire root anatomy >2.0mm of alveolar
6
Q
Where is the receptor placed during a PA?
A
-parallel to B and Li planes of lateral incisor
-receptors parallels long axis of lateral incisor
-incisor is within middle two 1/4s of mesiodistal width
-horizontal angle directed through mesial contact of lateral incisor
7
Q
What do bitewing radiographs show?
A
-interproximal contact areas without overlapping
-detect interproximal caries
-crestal alveolar bone levels
8
Q
What does Dx mean?
A
diagnosis
9
Q
What does Hx mean?
A
history
10
Q
What does N/A mean?
A
next appointment OR not applicable
11
Q
What does FM mean?
A
full mouth
12
Q
What does Bid mean?
A
twice a day
13
Q
What does PRN mean?
A
as needed
14
Q
What does Tid mean?
A
three times a day
15
Q
What does Qid mean?
A
four times a day
16
Q
What does pt mean?
A
patient
17
Q
What does Rx mean?
A
prescription
18
Q
What is asthma?
A
chronic inflammatory disease of the airway characterized by reversible episodes of increased airway hyper-responsiveness resulting in recurrent episodes of dyspnea, coughing, and wheezing
19
Q
What type of onset is asthma?
A
sudden onset
20
Q
How long does it take for peak symptoms of asthma to start?
A
10-15 minutes
21
Q
How many patients having asthma attack go to the ER?
A
25%
22
Q
How many people have asthma worldwide?
A
300 million
23
Q
What is the death rate of asthma?
A
1 of every 250 deaths worldwide
24
Q
since the 1960s, how much has the prevalence of asthma increased?
A
more than doubled
-from 2% to 7%
25
How many people in the US have asthma?
23 million
26
What is the second most common chronic disease in children?
asthma
27
percentage of children with asthma:
10%
28
What is the number one chronic disease in children?
caries
29
percentage of adults with asthma:
6%
30
What are some cause/triggers of asthma?
-emotional or physical stress
-allergy to food or drugs
-air pollution or irritating vapors
-upper respiratory infection
-exercised induced
31
What is extrinsic asthma?
allergic asthma
-more often in children
-triggered by specific allergens
-about 50% of children out grow extrinsic asthma
32
What is intrinsic asthma?
non-allergic
-develop in adults older than 35
-triggered by respiratory infections, physical exertion, environmental and air pollution
-psychological and physiological stress can induce an attack
33
What should you avoid in those with asthma?
aspirin and NSAIDs
34
What is the triad asthmaticus?
very sudden and very severe asthma attack
-wheezing, dyspnea, and hypoxia
-do not repsond to bronchodilators
-TRUE EMERGENCY
Asthma, nasal polyps, sensitivity to aspirin and NSAIDs
35
What are the symptoms of asthma?
chest congestion, wheezing/cough, dyspnea/tachypnea, increased blood pressure, anxiety, and cyanosis
36
What are some ways to prevent asthma attacks as a provider?
get a good medical history
-when do they have attacks
-when was their most recent
-how are the attacks managed
-have they needed emergency care
37
What are ways for patients to prevent asthma attacks?
vaccinations, know triggers, take medication, take puff of inhaler
38
How to manage asthma attacks:
-terminate procedure
-patient upright
-calm patient
-bronchodilators (up to three times)
-oxygen if unsuccessful
-get medical assistance
-epinephrine
39
What is mild asthma?
-less than 3 attacks a week that last for less than 30 minutes
-only with allergen or exercise
-inhaler not always needed
40
What is moderate asthma?
-3-5 attacks a week
-last 30 minutes to several hours
-affect sleep
-ER visits
-inhaler more commonly used
41
What is severe asthma?
-daily attacks
-inhaler daily
-may use steroids
-frequent ER visit
-limit daily activity
42
What is diabetes?
group of metabolic diseases that result in low levels of insulin
43
What is Type I diabetes?
insulin dependent diabetes
-5% of diabetic patients
-more common in children
-beta cell destruction
-thought to be autoimmune
-abrupt onset
44
What is Type II Diabetes?
noninsulin dependent diabetes
-milder
-in adults
-overweight/obese
-blood sugar more stable
45
What is gestational diabetes?
abnormal glucose tolerance in pregnancy
5-7% of pregnant women
46
Symptoms of hyperglycemia:
-polyuria
-polydipsia
-polyphagia
-dry warm skin
-dry mouth
-fruity smelling breath
-Kussmauls breathing
-rapid weak pulse
-confusion and altered levels of consciousness
47
Symptoms of hypoglycemia:
-lethargy
-changes in mood, strange behavior
-nausea
-tachycardia
-hypertension
-anxiety
-full body sweating
48
Symptoms of severe hypoglycemia:
-loss of consciousness
-seizures
-coma
49
Management of hypoglycemia:
-position patient comfortably
-administer 100% oxygen
-oral carbs if conscious
-if unconscious cake icing on lips
-medical assistance
50
What is A1c?
average amount of sugar in blood over the past 2-3 months
51
Ideal A1c:
6.5% or below
52
What blood sugar levels should you defer elective treatment?
<70 or >200
53
What is normal fasting glucose level?
80-130
54
What is insulin shock?
excess insulin
55
What is the mild stage of insulin shock?
most common
-triggered by hunger, weakness, trembling, tachycardia, pallor, and sweating
-may occur before meals, during exercise, or when food is delayed
56
What is the moderate stage of insulin shock?
when blood sugar drops substantially
-patient becomes incoherent, uncooperative, and sometimes belligerent/resistant to reason
-patients may injure themselves
57
What is the severe stage of insulin shock?
-complete unconsciousness
-usually take place during sleep when the other two stages are ignored
-sweating, pallor, rapid and thready pulse
58
What are oral manifestations of diabetes?
-urinate when blood sugar is high
-xerostomia
-bacterial, viral, and fungal infections
-poor wound healing
-increase incidence and severity of caries
59
What are oral complications of diabetes?
-periodontal disease and abscess
-bidirectional hyperglycemia
-xerostomia and burning mouth syndrome
-increased infections
-gingival inflammation
60
What are allergies?
abnormal or hypersensitive response of immune system to a substance introduced into the body
61
What is the sensitizing dose?
the previous exposure to the allergen
62
What is the challenge dose?
subsequent exposure to the antigen
63
What is a type I hypersensitivity reaction?
related to humoral immune system
-occur soon after second exposure to the antigen
64
What is anaphylaxis?
acute reaction involving smooth muscle of the bronchi in which antigen-IgE antibodies form on surface of mast cells
-release of histamine
65
What is the most common cause of anaphylaxis?
antibiotics
66
What occurs in the cardiovascular system during anaphylaxis?
capillary dilation and increases capillary permeability
-blushing and edema formation
-decreased venous return, decrease BP and cardiac output
67
What occurs in the respiratory system during anaphylaxis?
can lead to asphyxia due to increased secretions in the glands
68
What occurs on the skin during anaphylaxis?
itching and hives
-erythema rash
-angioedema
69
Progression of symptoms of anaphylaxis?
-skin
-eyes, nose, GI
-respiratory
-cardiovascular
70
How to manage rapid allergic reactions:
-position patient supine
-BCLS
-oxygen
-monitor vitals
71
doses of epinephrine for rapid allergic reactions
-1/10,000 3.0 cc IV
-1/10,000 0.3 cc IM/SC
72
doses of benadryl for rapid allergic reaction
50 mg IV or IM
73
What are the causes of delayed allergic reactions:
-greater than an hour
-non-life threatening
-antibiotics
-analgesics
-narcotics
-preservatives in anesthesia
74
What are the symptoms of delayed allergic reactions:
-rash
-pruritus (itching)
-urticaria (hives)
-edema
-rarely: hypotension, dyspnea, and coma
75
Management of delayed allergic reactions:
-terminate procedure
-position patient comfortably
-BSLC if indicated
-benadryl
76
Risk factors for cardiovascular disease: (can be changed)
-smoking
-excessive alcohol use
-stress
-obesity
-diabetes
-cholesterol
-hypertension
-sleep apnea
77
Signs and symptoms of cardiovascular disease:
-extreme fatigue
-chest pain
-difficulty breathing
-nausea
-edema
78
What is edema?
collection of fluid that can be due to venous insufficiency
79
What is stenosis?
narrowing or obstruction
-usually the aortic valve
-caused by: rheumatic fever, calcification of valve, or congenital anomalies
80
What is dyspnea?
difficult, labored, or uncomfortable breathing
81
What is orthopnea?
-difficulty breathing when lying down
-caused by: heart failure, COPD, panic disorder, or sleep apnea
82
What is coronary artery disease?
decreased or blocked blood flow to the heart due to plaque build up
83
What are the ABCs or cardiovascular disease and diabetes?
A- A1c done regularly
B- blood pressure WNR
C- cholesterol managed
s- stop smoking
84
What is the connection between diabetes and cardiovascular disease?
coronary artery disease is the leading cause of morbidity and mortality in patients with diabetes
-longer you have diabetes, the more likely you are to have heart disease
85
What is angina pectoris?
usually brief resulting from temporary ischemia of the myocardium
-tightness in midchest
-lasts 5-15 minutes
86
What are the three types of chest pain?
-angina pectoris
-hyperventilation
-acute MI
87
When can angina pectoralis be seen?
coronary obstruction-anemia, hypoxemia, and profound hypotension
88
What is stable angina?
pain is predictable, reproducible, unchanging, and consistent over time
-pain is usually associated with physical effort, eating, or stress
-pain relieved by stopping of physical exercise or use of nitroglycerin
-may have underlying coronary artery disease
89
What is unstable angina?
new-onset pain, increasing frequency and/or intensity
-occurs with less effort than acute angina
-not relieved by nitroglycerin
-key feature: changing character
90
What is nitroglycerin?
drug that is a powerful vasodilator
-can cause headache
91
How is nitroglycerin supposed to be taken?
placed under the tongue or in the vestibule and dissolved
92
how long does it take for nitroglycerin to work?
2-4 minutes
93
How long does nitroglycerin work?
30 minutes
94
What are side effects of nitroglycerin?
-pounding in head
-flushing
-tachycardia
-possible hypotension
95
What do you do if you have a patient experiencing angina pectoris?
-stress reduction protocol
-avoid excess vasoconstrictors
-oxygen as needed
-nitroglycerine tabs
-4444 if it does not go away
96
What is the treatment of angina pectoralis?
-place patient sitting up with head elevated
-ensure open airway
-check vitals
-administer nitroglycerin (3 doses max)
-check BP between doses
-if pain does not go away, give baby aspirin (only give aspirin after you have decided against anymore nitroglycerin)
97
What are the signs and symptoms of MI?
-chest pain greater than angina that is lasting more than 15 minutes
-not relieved by nitroglycerin
-cyanotic, pale, or ashen appearance
-weakness, cold sweat, nausea, vomiting, air hunger, irregular pulse
98
If a patient has had a heartache less than 8 weeks ago, what is the protocol for dental treatment?
no elective dental treatment
99
If a patient has had a heartache more than 8 weeks ago, what is the protocol for dental treatment?
maybe can do some elective treatment
-need a med consult tho
100
What should not be prescribed for those that have a history of MI?
NSAIDs
101
What is the INR for those that are on anticogaulants?
2-3
102
If you are not on blood thinners, what should the INR be?
1.1 or below
103
What is the stress reduction protocol?
-short appointments
-early morning appointments
-nitrous oxide
-limit vasoconstrictor
-profound anesthesia
-explain everything
104
What is congestive heart failure?
-just called heart failure
-> 65 years of age
-result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill or eject blood
105
Is congestive heart failure an actual diagnosis?
no, it is a complex of symptoms
-end stage of many CV disease
106
Signs and symptoms of congestive heart failure:
-fatigue and weakness
-ankle swelling (edema)
-clubbing of digits
-syncope
-angina
-breathing difficulties
-increased urination at night
107
Why is there increased urination at night in those that have congestive heart failure?
-less blood is pumped to the kidney during the day
-laying down makes is easier for blood to get to the kidneys
108
What is dyspnea?
difficult/ labored breathing
109
What is orthopnea?
sensation of breathlessness in the recumbent position
110
what is a general term for pulmonary disorders characterized by chronic airflow limitation from the lungs that is not fully reversible?
chronic obstructive pulmonary disease (COPD)
111
what was the 3rd leading cause of death in 2020?
COPD
112
what is the main risk factor for COPD?
smoking
113
what two diseases does COPD encompass?
chronic bronchitis and emphysema
114
what is the recommended diagnoses for COPD?
the presence of sputum production, and dyspnea together with an abnormal measurement of lung function
115
what is chronic bronchitis?
chronic inflammation of the bronchi that produces excessive tracheobronchial mucus production and a persistent cough with sputum
116
when does onset of COPD typically occur?
usually begins after age 40
-symptoms develop slowly & many patients are unaware of emerging disease
117
how are patients with chronic bronchitis typically described?
-sedentary
-overweight
-cyanotic
-edematous (water-retaining)
-breathless
-"blue bloaters"
118
what is emphysema?
permanent enlargement of the air spaces in the lungs that is accompanied by destruction of the air space (alveolar) walla without obvious fibrosis
-also a loss of elasticity
*repeated exposure of irritants
119
what are "pink puffers"?
patients diagnosed with emphysema
-enlarged chest walls, weight loss, severe exertional dyspnea, seldom coughing, lack of cyanosis, and pursing of the lips with efforts to forcibly exhale air from the lungs
120
should I add what questions you ask patients?
121
what is rheumatic heart disease?
a condition in which the heart valves have been permanently damage by rheumatic fever
-may start shortly after untreated or under-treated streptococcal infection (strep throat or scarlet fever)
-can take years to develop
122
how does rheumatic heart disease start?
an immune response causes an inflammatory condition in the body which can result in on-going valve damage
-heart valves become inflamed and scarred over time resulting in narrowing or leaking of heart valves
123
what is dementia?
a disorder of cognition that consequently interferes with the daily functions and results in a loss of independence
124
what are the most common causes of dementia?
-Alzheimer's disease
-vascular dementia
-dementia causes by Parkinson's disease
125
does prevalence of dementia increase or decrease with age?
increase
-women more at risk bc they live longer
126
what are the symptoms of Alzheimer's?
-memory loss
-cognitive decline
-behavioral and personality changes
127
what is the cause of Alzheimer's disease?
unknown- appears to involve the loss of cholinergic neurons
128
what is the average lifespan of patient diagnosed with Alzheimers?
8 years post diagnosis
129
how does genetic predisposition play a role in Alzheimers?
contributes to less than 20% of cases
130
what is the dental management of Alzheimers?
knowledge of the stage of disease, medications taken, and the cognitive abilities of the patient
131
how does Alzheimers affect dental treatment?
-patients with mild to moderate disease can receive dental treatment (normal organ function)
-as disease progresses medications are used to manage symptoms that contribute to xerostomia with increased risk for caries
132
what is Addisons disease?
primary adrenal insufficiency
-progressive destruction of the adrenal cortex, usually due to autoimmune disease or chronic infectious diseases (TB, HIV, cytomegalovirus**, and some funagl infections)
133
what does Addisons disease do to cortisol levels?
decrease
cortisol is responsible for decreasing inflammation, regulating blood pressure, and increasing glucose
134
what does Addions disease do to aldosterone levels?
decrease
aldosterone responsible for stimulating Na absorption in kidneys
135
when do Addions disease symptoms occur?
progress slowly but a stress (injury or illness) makes the symptoms worse
136
what is secondary adrenal insufficiency caused by?
pituitary disease or critical illness
137
what is tertiary adrenal insufficiency caused by?
processes that impair function of the hypothalamus
-chronic use of corticosteroids***
138
what are the symptoms of adrenal insufficiency?
-fatigue
-weak
-orthostatic hypotension
-poor healing
-inability to tolerate stress
-increased infections
-areas of darkened skin
-salt craving
139
what is Cushing's syndrome?
a condition caused by excessive cortisol in the body
140
what is the most common cause of Cushing's syndrome?
use of steroid drugs
141
what can Cushings syndrome result in?
high BP, bone loss, and type 2 diabetes
142
when is Cushings syndrome referred to as Cushings disease?
when it is caused by a pathophysiologic process (tumor of pituitary or adrenal glands)
143
what are steroids used to treat?
-rheumatoid arthritis
-lupus
-asthma
-psoriasis
-etc
144
what are the clinical features of Cushings syndrome and disease?
-weight gain & fatty tissue deposits particularly in face (moon face) and between shoulders (buffalo hump)
-thinning, fragile skin that bruises easily
-abdominal striae
-decreased healing (bc steroids decrease inflammation)
-acne
145
what is an adrenal crisis?
potentially life-threatening complication resulting from adrenal insufficiency triggered by emotional and physical stress
-manifests as hypotensive collapse, abdominal pain, myalgia, and fever
146
What is the definition of substance abuse?
recurrent use of a substance over the past 12 months with subsequent adverse consequences
147
What are some signs of alcohol abuse?
missed appointments, alcohol on breath, enlargement of the parotid glands and spider angioma
148
what are some consequences of substance abuse?
failure to fulfill a major role at work, school, home, legal problems, persistent interpersonal problems
149
What does alcohol cause?
-liver and bone marrow damage
-cirrhosis
-vitamin K deficiency
-reduced effect of local anesthetics and benzodiazepines
-nutritional deficiency
-candidal infections
150
What is the definition of binge drinking?
>5 oz / 4 hours
151
What types of cancer can drinking lead to?
mouth, larynx, and esophagus
152
How does alcohol cause oral cancer?
act as an irritant and damage cells which could lead to DNA changes
153
What can drug abuse cause?
interactions with prescriptions and anesthetic
-liver damage
-infectious diseases if share needles
154
What are the oral complications and manifestations of drug abuse?
-more plaque, calculus, caries, and gingival inflammation
155
What can cocaine cause orally?
gingival recession and erosion of facial aspects
156
What is meth mouth?
xerostomia, rampant caries, bruxism, and muscle trismus
157
What is anemia?
reduction of oxygen carrying capacity of the blood
158
What is the most common blood condition in the US?
anemia
159
What is anemia usually associated with?
-decrease number of circulating RBC
-abnormality in hemoglobin
-affects females more than males
-may be caused by underlying diseases
-more than 3 million cases per year in the US
160
What are the four major types of anemia?
-iron deficiency
-folate deficiency
-hemolytic anemia
-sickle cell anemia
161
What are some symptoms of anemia?
pale
fatigue
low blood pressure
SOB
rapid heart rate
162
What are oral signs of anemia?
-smooth, burning red tongue
-bleeding gums
-delayed healing
-increased infection
163
What is pagophagia?
craving and chewing ice associated with iron deficiency, with or without anemia
164
What is anorexia nervosa?
severe restriction of food intake, leading to weight loss and the medical sequelae of starvation
165
What is bulimia nervosa?
restriction of food by binge eating followed by various methods of trying to rid the food
(vomiting, laxatives, diuretics)
166
When does anorexia normally start?
14-18 years
167
What is the percentage of people with anorexia that are female?
90-95%
168
What is the mortality rate of anorexia?
5-20% usually by starvation, suicide, electrolyte imbalance
169
What are the symptoms of anorexia nervosa?
-thin and brittle hair
-neck/facial swelling
-fainting
-irritable
-low BP
-anemia
-osteoporosis
-amenorrhea
170
What age does bulimia usually start?
20 years old
171
What happens to amalgam fillings when you have bulimia?
the restorations are higher than the surrounding enamel
172
What happens to teeth with bulimia nervosa?
enamel erosion from acidic chemicals
-lingual of anterior teeth most affected
173
What is perimylolysis?
loss of enamel and dentin on the lingual surfaces by chemical and mechanical effects
174
When are PT tests done?
to detect bleeding disorders or excessive clotting disorders
175
What does PT do?
measure how quickly blood clots
176
What type of results are PT tests?
in seconds
-average time is 10-30 seconds
177
What is INR?
ratio used if you are on blood thinning medication
178
What are some examples of autoimmune diseases?
rheumatoid arthritis
lupus
sjogrens syndrome
diabetes
graves disease
179
What are rheumatic diseases?
large group of disorders/diseases that affect bones, joints, and muscles
180
What are examples of rheumatic disease?
psoriatic arthritis, lupus, scleroderma, sjorgen, gout
181
What is osteoarthritis?
affects joints such as hips, knees, feet, spine, and hands
-TMJ may also be affects
182
Is osteoarthritis an autoimmune disease?
no
183
What is the leading cause of disability in eldery population?
osteoarthritis
184
What is rheumatoid arthritis?
symmetric inflammation of joints: hands, feet, and knees
-autoimmune disease of unknown origin
185
When does rheumatoid arthritis normally start?
35-50 years old
186
- Multiple symmetric joint involvement
- Significant joint inflammation
- Morning stiffness lasting longer than 1 hour
- Systemic manifestations (fatigue, weakness, malaise)
All of these symptoms are associated with:
rheumatoid arthritis
187
- Usually, 1-2 joints involved
- Pain usually without inflammation
- Morning stiffness lasting less than 15 mins.
- No systemic involvement
These symptoms are involved with:
osteoarthritis
188
What is systemic lupus erythematous?
the most common and most serious type of lupus
-autoimmune disease with unknown etiology
-chronic inflammatory disorder that affects both internal and external systems of the body
189
Does systemic lupus erythematous affect women or men more?
women at a 6:1 ratio
190
What aged women are most affected with systemic lupus erythematous?
14-44 years of age when estrogen levels are at the highest
191
What is the typical presentation of systemic lupus erythematous?
women with polyarthritis and a butterfly-shaped erythematous rash across the nose and cheeks
192
What percentage of people have skin involved with systemic lupus erythematous?
85%
193
What can trigger systemic lupus erythmatous?
stress, sunlight exposure, and pregnancy
194
What are the oral manifestations of SLE?
ulceration, petechiae, and burning mouth syndrome
195
What causes oral candidiasis and infection in patients with SLE?
used of cortiocosteroids for treatment
196
What is Sjogren's syndrome?
a chronic, autoimmune, and inflammatory disorder
-characterized by symptoms of oral and ocular dryness and a chronic, progressive loss of lacrimal and salivary function
197
Parotid glands are enlarged in what fraction of people with Sjogren's syndrome?
1/3-1/2
198
What is the ratio of females to males that have Sjogren's syndrome?
10:1
199
What is primary Sjogrens?
SS-1
-dry eyes and dry mouth are seen in absence of a connective tissue disease
-not as common
200
What is secondary Sjogrens?
SS-2
-more common
-dry eyes and dry mouth are seen together with other autoimmune diseases like RA, SLE, scleroderma
201
Characteristics of Sjogren's syndrome:
eye dryness, hypo salivation, and enlargement of the parotid gland
202
What are secondary outcomes of persistent oral dryness seen in Sjogren's syndrome?
angular cheilosis, dysgeusia (taste dysfunction), burning mouth syndrome, secondary infections, and increased caries rate
203
What are some dental treatments done on those with Sjogren's syndrome?
-topical fluoride daily
-increased productions of saliva-drugs such as pilocarpine
-increased prophylaxis
204
What is epilepsy?
chronic and recurrent paroxysmal changes in neurological function (seizure), altered consciousness, or involuntary movements caused by abnormal and spontaneous electrical activity in the brain
205
What percentage of people with epilepsy have complete control of their seizures within 5 years?
60-80%
206
What are the three types of seizures?
grand mal
petit mal
status epilecticus
207
What are grand mal seizures?
-tonic-clonic
most common
-triggered by CV accidents, photic stimulation, fatigue, and intoxication
-last 5-15 minutes
-make take up to 2 hours for normal cerebral function to return
208
What are petit mal seizures?
-absent
-occur frequently, multiple daily episodes
-shortly after awakening or during periods of inactivity
-no aura
-duration <10 second
209
What are status epilepticus seizures?
continuous seizure or repetitive recurrence of any type of seizure without recovery between attacks
-give benzodiazepines
-rapid onset
-well tolerated with high efficacy
210
What are symptoms of epilepsy?
-aura
-unusual smell or vision
-irritability
-epileptic cry
-loss of consciousness
-muscle rigidity
211
What are long term treatments for seizures?
Dilantin and tegretol
212
What can dilantin cause?
gingival hyperplasia
213
What are the characteristics of uncontrolled epilepsy?
>1-2 seizures a month
214
What are the characteristics of well controlled epilepsy?
<1-2 seizures a month
215
What do you do if someone have uncontrolled epilepsy?
get a med consult and avoid triggers
216
What do you do if someone has well controlled seizures?
get a med consult
217
What are the interview questions for those that have epilepsy?
- How long have you had epilepsy?
- What type of seizures do you have?
- How frequently do your seizures occur?
-What type of medication, if any, do you take to
control the seizures?
- How do your seizures begin?
- Is there a warning at the beginning of the seizure?
- Can you talk and respond appropriately during a
seizure?
- Do you get confused or tired after a seizure?
- When was your last (or most recent) seizure?
218
What is the management of a seizure in the clinic?
-protect patient and try to prevent injury
-do not move patient to the floor
-place chair in supine position
-remove instruments from the area
-do not attempt to restrain or hold the patient
-O2 if necessary
-call 4444
219
What does GERD stand for?
gastroesophageal reflux disorder
220
What happens with GERD?
stomach liquids regurgitate
221
What can cause GERD?
pregnancy
bad sphincter
obesity
alcohol
smoking
can increase with age
222
What are complications/ implications of GERD?
halitosis
enamel erosion
223
What medicine should be avoided in those with GERD?
codeine
erythromycin
224
What is trigeminal Neuroalgia?
tic douloureux
-sudden, severe, electric or stabbing pain
-side of jaw or cheek
-triggered by physical stimulus
225
What are the signs of trigeminal neuraglia?
intermittent attacks
lasts several seconds
mostly women >50
may disappear sporadically
226
What are some reasons that a med consult would be necessary?
-rheumatic fever
-MI in the last 6 months
-hypertension >160/>100
-unsure of diabetic control
-congenital heart defects
->5 significant meds
-chemo or radiation treatment
-open heart surgery
-solid organ transplant
-major joint replacement
-bone marrow transplant
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What does medication history need to include?
-prescriptions
-over the counters
-herbal, natural, and alternative medicines
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What do true allergies cause?
itching, hives, rash, swelling, and wheezing
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What does drug intolerance cause?
-nausea, vomiting, palpations,
-not a true allergy
-avoid using the drug anyway
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How are radiographs oriented?
with dot convexity facing the clinician
-there are aligned in the same orientation as when looking at the patient
-film mounts should be made out of a material that blocks high around the window that holds the film
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What are the perferred mounts for X-rays?
pocket mounts because they protect of a film survey and serve as an infection control barrier
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How does radiolucent appear on film ?
black
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What are radiolucent structures in the mouth?
cavities, depressions, or opening in bones (sinus, fossa, canal, or foramen)
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What color radiopaque objects look like on X-ray?
white
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What are radiopaque things?
bony in origin or stop the penetration of the X-rays, not allowing them to get to the receptor
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What is the incisive foramen?
a hole in the midline of the lingual aspect of the heard palate above the central incisor tooth crowns
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Risk factors of cardiovascular disease: (can't be changed)
-heredity (30% due to genetic factors)
-sex (men develop 10 years earlier than women)
-race (African americans at higher risk)
-age (65 or older)
