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Dental Hygiene > Exam 2 Medical Emergencies > Flashcards

Exam 2 Medical Emergencies Flashcards

1
Q

What is the most common type of diabetes?

A

type 2

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2
Q

What causes type 2 diabetes?

A

obesity, high fat/ low fiber diets, sedentary lifestyle, heredity, and increased life span (old age).

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3
Q

What is a metabolic disorder characterized by hyperglycemia?

A

diabetes mellitus

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4
Q

What produces insulin in the pancreas?

A

beta cells

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5
Q

What diseases is characterized by the body being unable to produce sufficient insulin or the body is not able to use the insulin that is produced?

A

Type 2 diabetes mellitus

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6
Q

What causes an increase in type 2 diabetes?

A

old age, sedentary lifestyle, poor diet and exercise and obesity

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7
Q

Which disease is characterized by an absolute lack of insulin?

A

type 1 diabetes

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8
Q

In which type of diabetes are pancreatic beta cells within Islets of Langerhans destroyed due to immune dysfunction?

A

type 1 diabetes

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9
Q

Which type of diabetes requires supplemental insulin for survival?

A

type 1 diabetes

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10
Q

Glucose intolerance with initial onset during pregnancy is known as

A

gestational diabetes

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11
Q

What is the leading cause of blindness in ages 20-74?

A

diabetic retinopathy

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12
Q

What is diabetic retinopathy?

A

a complication of diabetes that affects the eyes

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13
Q

What is diabetic neuropathy?

A

A type of nerve damage that occurs with diabetes

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14
Q

What is diabetic nephropathy?

A

kidney damage that results from diabetes

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15
Q

What vascular changes are a result of diabetes?

A

gangrene, loss of limbs, fingers, toes, etc. and increased risk of CVA and MI

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16
Q

Name the types of diabetes tests

A

fasting plasma glucose test
oral glucose tolerance test
A1c
Self testing

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17
Q

How long do you have to fast when doing the fasting plasma glucose test and what are the numbered results?

A

12-14 hours; 100-125 pre diabetes, >125 diabetes

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18
Q

How does the oral glucose tolerance test work?

A

12-14 hour fast and then drink a glucose rich beverage…. two hours later have the reading 140-199 pre diabetes; >200 diabetes

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19
Q

How many diabetics are affected by neuropathy?

A

60-70%

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20
Q

What are the 3 types of diabetes?

A 
Type 1 (juvenile onset, insulin dependent)
Type 2 (adult onset, non insulin dependent)
Gestational
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21
Q

What is the normal reading on a self testing glucometer?

A

70-180

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22
Q

What does a reading of less than 70 on a self testing glucometer indicate?

A

hypoglycemia

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23
Q

What does an A1c reveal?

A

average blood glucose over the past 3 months

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24
Q

What should the glucose reading be 2 hours after eating a meal?

A

less than 180

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25
Q

What should the glucose reading be after 8 hours of fasting?

A

130

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26
Q

What is the normal reading for A1c?

A

5.7

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27
Q

What is the A1c reading for prediabetes?

A

5.7-6.4

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28
Q

What A1c reading indicates diabetes?

A

6.5 (2 tests to check)

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29
Q

The FPG (fasting plasma glucose test) requires no food or drink 8 hours before the test. What are the readings for normal, prediabetes, and diabetes?

A

Normal- less than 100
Pre- 100-125
Diabetes- 126+

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30
Q

The OGTT (oral glucose tolerance test) which requires no food or drink for 12 hours and then a glucose drink is given has what readings for normal, prediabetes and diabetes?

A

Normal-less than 140
Pre-140-199
Diabetes-200+

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31
Q

True or False: Insulin needs to be refrigerated to lengthen effectiveness

A

True

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32
Q

For which type of diabetes can exercise and diet control be an option instead of medicine?

A

Type 2

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33
Q

What is Diabetic Ketoacidosis?

A

Sugar too high, insufficient levels in blood

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34
Q

What is hypoglycemia?

A

Sugar too low

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35
Q

Who is at risk for Diabetic Ketoacidosis?

A

newly diagnosed type 1 diabetics, alcohol and drug users, poor diet

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36
Q

Fruity breath, altered mental state and increased thirst are all indicative of what?

A

Diabetic Ketoacidosis

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37
Q

How is DKA (diabetic ketoacidosis) treated?

A

check glucose level and lower w/ insulin, contact ems

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38
Q

What is another name for severe hypoglycemia?

A

insulin shock

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39
Q

How many diabetics are affected by severe hypoglycemia?

A

30%

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40
Q

What are things that can lead to severe hypoglycemia?

A

missed meal, alcohol, increased exercise without adjusting insulin dosage

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41
Q

What is the first step in treating severe hypoglycemia?

A

Give sugar

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42
Q

What is the 15-15 rule and when should it be applied?

A

Give 15 grams of sugar, check in 15 minutes. If it’s still below 70, repeat.

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43
Q

If a patient suffering severe hypoglycemia becomes unconscious, what is the first step taken?

A

contact EMS

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44
Q

The risk of hypoglycemia can be reduced 58% if body fat is reduced by

A

7%

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45
Q

When should a diabetic patient be scheduled?

A

early to mid morning, short and frequent appointments

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46
Q

What should diabetic patients remember to do before appointments?

A

eat

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47
Q

Where is the butterfly shaped thyroid gland located?

A

anterior to the trachea

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48
Q

The thyroid gland produces hormones that determine

A

metabolic rate and growth rate

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49
Q

Hypothyroidism is when not enough____is produced.

A

thyroid hormone

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50
Q

What is another name for hypothyroidism?

A

Myxedema

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51
Q

True or False: Myxedema causes facial swelling

A

True

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52
Q

What is another word for Thyrotoxicosis?

A

Hyperthyroidism

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53
Q

What happens when a patient has thyrotoxicosis?

A

Too much thyroid hormone is produced

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54
Q

True or False: When a patient has thyrotoxicosis, the eyes are very small.

A

False, the eyes are big and have a fixed staring expression

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55
Q

What swells on a patient with thyrotoxicosis?

A

neck

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56
Q

How is hypothyroidism treated?

A

synthetic thyroid hormone, must be taken for life

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57
Q

What is Levothyroxine?

A

Synthetic thyroid hormone

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58
Q

How is hyperthyrodism treated?

A

anti thyroid medications, ablation therapy, or surgery for removal of thyroid.

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59
Q

What is a myxedema coma?

A

Severe hypothyroidism leading to decreased mental status, hypothermia and slowing of function in multiple organs

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60
Q

What is a thyroid storm?

A

thyroid too high and heart rate, blood pressure and body temperature soar dangerously high-

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61
Q

What occurs when the body is unable to compensate for thyroid hormone deficiency due to some precipiating event and what time of year does this normally occur?

A

Myxedema Coma, winter

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62
Q

Hypothermia patients usually have a temperature reading of less than

A

95 degrees

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63
Q

For Myxedema and thyroid storm, what is the first step to take?

A

Contact EMS

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64
Q

What is Epistaxis?

A

nosebleed

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65
Q

85% of nose bleeds are: anterior or posterior

A

anterior

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66
Q

For whom are posterior bleeds normally found in the case of Epistaxis?

A

Geriatric (occurs at Woodruffs Plexus)

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67
Q

People with what condition are more likely (3 times more) to have Epistaxis?

A

hypertension

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68
Q

What color is posterior Epistaxis?

A

dark red

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69
Q

What color is anterior Epistaxis?

A

bright red

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70
Q

When treating Epistaxis, the patient should be seated upright with the head tilted____.

A

forward

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71
Q

All of the following statements are true for the treatment of Epistaxis except one. Which one is the exception?
Pinch the lower part of the nose for 10-20 minutes
Have patient breath through mouth
Apply an ice pack over the bridge of the nose
Have patient blow the nose to get rid of the blood

A

Have patient blow the nose-this should NEVER occur

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72
Q

Hemophilia is excessive_____

A

bleeding

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73
Q

How many types of hemophilia are there?

A

3 types: A, B, and C

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74
Q

True or False: Patients with hemophilia clott excessively

A

False

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75
Q

What do anticoagulants reduce?

A

clotting

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76
Q

What is a hematoma?

A

Collection of blood trapped beneath the skin

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77
Q

What is the usual casue of a hematoma?

A

trauma

78
Q

Individuals are 2 to 4 times more likely to have____and 5 times more likely to have_____

A

heart disease, stroke

79
Q

A normal blood glucose reading is between ___and ___mg/dL

A

50 and 150

80
Q

A glucose reading below___indicates the patient is hypoglycemic

A

50

81
Q

A glucose reading above___indicates that a patient is hyperglycemic

A

150

82
Q

The HbA1c test reveals a patients average blood sugar level over the past_______

A

2-3 months

83
Q

The drugs Humalog or Novolog are types of___

A

insulin

84
Q

What type diabetes does Humalog and Novolog treat?

A

Type 1

85
Q

Oral agents such as metformin, tolbutamide and glyburide (glucophage, orinase, glyburide, micronase) are prescribed to treat____

A

Type 2 diabetes

86
Q

If a patient has an insulin pump, do they still need to measure glucose levels?

A

yes

87
Q

What type of insulin medication is more rapidly absorbed than the injectible type?

A

insulin via inhalation device

88
Q

What is happening in the body when it begins to exhale excess carbon dioxide, which results in tachypnea accompanied by an increased depth in respiration known as Kussmaul respirations or air hunger?

A

Diabetic ketoacidosis

89
Q

What is a common complication in children with diabetic ketoacidosis?

A

cerebral edema (fluid builds around the brain)

90
Q

True or False: The first step in treating a pt. with DKA is to determine an accurate blood glucose level.

A

True

91
Q

In what diabetic emergency are pt.’s hyperglycemic and dehydrated?

A

hyperosmolar hyperglycemic state

92
Q

Graves disease results in an enlarged___

A

thyroid gland

93
Q

Where there are multiple nodules on an enlarged thyroid gland, what is the condition called?

A

nodular goiter

94
Q

What two illnesses can thyroid medications cause?

A

aranulocytosis and hepatitis

95
Q

Why is aspririn not recommended in patients experiencing a thyroid storm?

A

Because it can increase serum levels of T3 and T4.

96
Q

Warfarin, aspirin, heparin, clopidogrel and prasugrel are all types of_____

A

anticoagulants

97
Q

What should patients be advised to do after extractions?

A

No exercise for 12-24 hours
lie down with head elevated for several hours
Place gauze over the tooth socket and apply pressure for at least two hours.

98
Q

What is the most effective way to control bleeding?

A

Apply pressure

99
Q

Wrapping a tea bag with guaze and placing it on the extracted socket with pressure is recommended because it contains____

A

tannic acid

100
Q

It is normal for blood to ooze out of the extraction site for ____hours.

A

12

101
Q

What is the most common inherited bleeding disorder?

A

Von Williebrands disease (VWD)

102
Q

What is the most common dental office emergency?

A

syncope

103
Q

How can medical emergencies be prevented in the dental office?

A

Taking a complete and accurate medical history

104
Q

What type of patient falls under ASA PS I?

A

Normal healthy patient

105
Q

What type of patient falls under ASA PS II?

A 
Mild systemic disease such as:
controlled type 2 diabetes
controlled epilepsy
controlled stage 1 hypertension
allergies
fearful dental patient
pregnancy
106
Q

What type of patient falls under ASA PS III?

A

Severe systemic disease that limits activity but is not incapacitating such as:
stable angina
myocardial infarction longer than 6 months ago
controlled type 1 diabetes
renal failure
controlled heart failure
poorly controlled hypertension with BP >160/100 (stage 2)
morbid obesity

107
Q

What type of patient falls under ASA PS IV?

A 
Incapacitating systemic disease that is a constant threat to life such as:
MI or CVA within the past 6 months
unstable angina
heart failure
uncontrolled diabetes
uncontrolled epilepsy
hypertension with blood pressure >180/110
uncontrolled thyroid conditions
108
Q

What patient falls under ASA PS V?

A

Moribound patient not expected to survive 24 hours with or without operation:
multiorgan failure
poorly controlled coagulopathy
Sepsis with hemodynamic istability

109
Q

What patient falls under ASA PS VI

A

A declared brain dead patient who’s organs are being harvested for donation

110
Q

What is a normal pulse rate?

A

60-100

111
Q

What is the normal respiration rate?

A

12-20

112
Q

What is the normal blood pressure?

A

120/80

113
Q

What is the normal temperature?

A

98.6

114
Q

What is considered stage 1 hypertension?

A

130-139/80-89

115
Q

What is considered stage 2 hypertension?

A

140+/90+

116
Q

What blood pressure is considered critical?

A

Any systolic over 180 and diastolic over 120

117
Q

What treatment is recommended for a severe allergic reaction?

A

Epinepherine

118
Q

What size oxygen tank is recommended for use in the dental office?

A

Size E

119
Q

What things should oxygen NOT be administered for?

A

hyperventilation, ischemic heart disease, or severe hypertension

120
Q

What is nitroglycerin indicated for?

A

acute angina, myocardial infarction, heart failure

121
Q

What does the reducing valve do an oxygen tank?

A

allows for the safe release of oxygen

122
Q

What does the flow meter do on an oxygen tank?

A

allows the operator to determine how much oxygen the patient is receiving

123
Q

What type of patient would a nasal cannula be recommended for and what should the setting be?

A

A conscious patient suffering from MI or CVA. Set between 1 and 6/L per minute

124
Q

What type of patient should the non rebreathing face mask used on?

A

asthma or angina pectoris; can deliver 6-12 L per minute

125
Q

When is the bag mask device used and what should the regulator be set at?

A

when the patient is in respiratiory arrest and requires complete oxygen delivery. Regulator should be set at 8-12 L/minute

126
Q

What is noncardiac syncope?

A

involves situations that do not affect the heart such as seizures, orthostatic hypotension, hyperventilation and metabolic diseases

127
Q

What is orthostatic hypotension?

A

At least a 20mmHG drop in BP after assuming an upright position after prolong suppine position

128
Q

Which type of syncope is the most common form?

A

neurocardiac syncope– commonly associated with pain, fear, exhaustion or illness

129
Q

What causes cardiac syncope?

A

inadequate cardaic output as a result of an underlying heart disease

130
Q

What is tachyarrhythmia?

A

rapid, irrelgular heart beat

131
Q

What is bradyarrhythmia?

A

slow irregular heart beat

132
Q

How is syncope treated?

A

If possible, pt. should be in suppine position, open the airway and assess breathing, loosen tight clothing, deliver oxygen at 4-6L/minute

133
Q

What is the condition produced when the cardiovascular-pulmonary system fails to deliver enough oxygenated blood to body tissues to support the metabolic needs of those tissues and leads to abnormal cellular and tissue function?

A

shock

134
Q

How many types of shock are there? Describe each

A

4 types of shock:
hypovolemic shock-MOST COMMON caused by inadequate venous return to the heart or dehydration
cardiogenic shock-destruction in tissue perforation caused by a decrease in cardiac output
distribtive- also called vasogenic shock. caused by loss of sypathetic nerve activity from the brains vasomotor center. 3 types: anaphylactic, septic, and neurogenic
obstructive-indirect heart pump failure, leading to decreased cardiac function and reduced circulation

135
Q

What part of the eye covers the iris?

A

The cornea

136
Q

What is the white part of the eye called?

A

sclera

137
Q

What is the thin layer of the eye that covers the sclera and inside of eyelids?

A

conjunctiva

138
Q

What types of foreign body are inorganic?

A

metallic and nonmetallic

139
Q

What types of foreign body are organic?

A

dirt, wood, or vegetation

140
Q

What types of foreign body are metallic?

A

steel, iron, lead, aluminum

141
Q

What types of foreign body are nonmetallic?

A

plastic, stone, glass and other minerals

142
Q

Which type of foreign body creates a higher chance of infections if it enters the eye?

A

organic

143
Q

When a high velocity object enters the globe or orbit of the eye, what is likely?

A

loss of vision

144
Q

What should the patient be instructed NOT TO DO when a foreign object enters the eye?

A

DO NOT RUB

145
Q

Is loss of vision likely when a low velocity object is on the cornea?

A

no

146
Q

What should be done if a foreign body becomes embedded in the eye?

A

do not attempt to remove, cover both eyes to limit eye movement, seek immediate care for a specialist to remove

147
Q

What is a perioretriever?

A

magnetized instrument used to retrieve broken instrument tips

148
Q

What are amphetamines?

A

central nervous system stimulants

dexadrine, ritalin, adderalll, meth,

149
Q

What are the side effects of adderall?

A

excessive excitability, restlessness, dizziness, headache and blurred vision/ improves focus in pt.’s with ADHD

150
Q

What are the side effects of ritalin?

A

rapid heartbeat, psychosis, heart failure

151
Q

True or False: Amphetamines activate the sympathetic nervous system and result in increased heart rate, pupil dialation, bronchodilation, increased blood flow to the brain and skeletal muscles.

A

True

152
Q

What type of drug users have bruxism and tooth wear due to an overall increase in energy and neuromuscaular function?

A

methamphetamine users

153
Q

What type of drug users have rampant caries developing from dehydration and xerstomia and also have an increased intake of carbohydrates and high-calorie carbonated beverages?

A

methamphetamine users

154
Q

What type of anesthetic should methamphetamine users NOT receive?

A

anesthetic agent with a vasoconstrictor

155
Q

What will happen if a methamphetimine user recieves anesthetic with a vasoconstrictor?

A

myocardial ischemia and cardiac dysrhythmias

156
Q

What are some signs and symptoms of amphetamine toxicity?

A 
euphoria
restlessness
anxiety
agitation
confusion
seizures, possible coma or MI
157
Q

Is it safe to give a pt. with amphetamine toxicity an emetic agent to induce vomiting? Why or why not?

A

No because vomiting can induce seizures

158
Q

What are pt.’s with amphetamine toxicity given charcoal for in the hospital?

A

to prevent systemic absorption of the drugs

159
Q

What was cocaine used as a local anesthetic for?

A

mucous membranes

160
Q

What are the ways cocaine can be taken as a street drug?

A

snorted, smoked, IV or oral

161
Q

Does cocaine have a slow onset?

A

No it is rapid and powerful

162
Q

How long does it take cocaine to reach it’s peak affect? How long does it last?

A

10-30 minutes; 1 hour (intranasal effects in 3-5 minutes after snorting)

163
Q

What does cocaine do to the mind and body of it’s users?

A

produces a feeling of euphoria and well being, increases cardiac bp and body temperature,

164
Q

Palatal necrosis and perforation is common with usage of what drug?

A

cocaine

165
Q

Which drug decreases the sense of smell?

A

cocaine

166
Q

What are some complications of using cocaine?

A

Chronic sinusitis, decreased sense of smell, vasoconstriction can lead to necrosis sand ischemia of nasal septum and perforation, bruxism, increased caries due to carb intake, gingival lesions if repeatedly applied to tissues

167
Q

Name the CNS depressants

A

opiods (poppies)-heroine, oxycodone, fentanyl, tramadol
barbiturates- phenobarb, sleep
benzodiaepines- diazepam (valium), versed, xanax, klonapin

168
Q

Why are heroin users sometimes given opiods?

A

to counteract heroin

169
Q

True or False, Opiate and Opioids inhibit gastrointestinal motility which lead to constipation

A

True

170
Q

What drugs are uppers?

A

Uppers include amphetamines, methamphetamine, cocaine and khat. Pharmaceutical examples include Adderall, Ritalin and Concerta.

171
Q

What drugs are downers?

A

Downers include benzodiazepines, barbiturates, GHB and flunitrazepam.

172
Q

What drug relieves anxiety, causes CNS depression and acts as a sedative?

A

Barbituates

173
Q

What RX replaced barbituates?

A

benzodiazepines

174
Q

What are benzodiazepines used in the place of barbituates for?

A

reduction of anxiety, anticonvulsant properties, and muscle relaxant properties (versed, zanax, klonopin, ataivan, halciaon, valuim, etc.) Produces sedation, hypnosis and antianxiety

175
Q

What are the signs and symptoms of benzodiazepine toxicity?

A

lethargy, slurred speech, mental confusion, coma and respiratiory arrest, usually in combination with other CNS depressants

176
Q

What are the mild signs of barbituate toxicity? What are the severe signs of barbituate toxicity?

A

Mild signs: lethargy, slurred speech and rapid eyeball movement
Severe signs: hypothermia, hypotension, pulmonary edema, coma, and respiratory arrest

177
Q

Why would Flumazenil be administered in the hospital to a patient experiencing Benzodiazepine toxicity?

A

act as an antidote as it counteracts the sedative effect

178
Q

What are the 2 Options for treatment of a superficial foreiogn in the eye?

A

Option 1: Instruct the pt. not to rub, operator wash hands and re glove, gently pull down lower lid and have pt. look up, then direct object away using a moist cotton tip (better to let pt. remove)

Option 2:Irrigate the eye with saline or water, use the emergency eyewash station or eye cup, irrigate from medial to lateral portion of eye.

179
Q

If an foreign body becomes embedded in the eye, is okay to try to remove it?

A

No, never

180
Q

What condition often mimics CVA?

A

hypoglycemia

181
Q

Left ventricular heart failure results in?

A

respiratory distress

182
Q

When does RV heart failure occur?

A

after LV

183
Q

Is Cyanosis a symptom of late stage heart failure?

A

yes

184
Q

LV heart failure occurs before___?

A

RV

185
Q

Which ventricle pumps blood out to the body?

A

LV

186
Q

Which ventricle pumps blood to the lungs?

A

right

187
Q

Which heart failure fills the lungs up with blood?

A

LV

188
Q

What is dyspnea?

A

difficulty breathing

189
Q

Is nitroglycerin recommended for patients with a stystolic pressure lower than 100mmHg?

A

no

190
Q

Prominent jugular veins while seated in an upright position is indicative of?

A

pulmonary embolism

191
Q

What is the most frequent etiology of heart failure?

A

myocardial infarction

Dental Hygiene (5 decks)

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