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Chirurgie > Extractii 4-8 > Flashcards

Extractii 4-8 Flashcards

1
Q

Rx fetale peste 10rad pot sa dea

A
  1. Mutatii
  2. Anomalii oculare
  3. Retard mental
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2
Q

Analgezicele in sarcina risc dezvoltare:

A
  1. ADHD
  2. Autism ASD
  3. Astm
  4. Scadere coeficient intelectual
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3
Q

Efect A cu VC 1:200k in sarcina

A
  1. Ameliorare circulatie placentara
  2. Efect tocolitic - relaxare musculatura uterina
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4
Q

Cu cat este iradiat fatul in Rx retro?

A

0.01mrad

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5
Q

Efecte sdr de compresie VCI in sarcina

A
  1. Scadere DC
  2. Scadere V vascular cerebral
  3. HipoTA
  4. Tahicardie
  5. Ameteala
  6. Senzatie lipsa aer
  7. Soc
  8. Fenomene de hipoxie fetala
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6
Q

Situare jonctiune incizie orizontala si de descarcare lambou in L la alveolotomie pentru extractie

A

P dentat - dintele imediat M de RR
P edentat - 6-7mm M de RR

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7
Q

Instrumentar alveolotomie cu rezectie marginala partiala/totala

A

Rotativ
Initial sferice apoi cilindrice/Lindemann

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8
Q

Cu ce se face rezectia corticalei in alveolotomia inalta Wassmundt

A

Pensa ciupitoare de os
Instrumentar rotativ

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9
Q

Cu ce se face indepartarea RR in alveolotomia inalta Wassmundt

A

Pensa Pean
Chiureta

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10
Q

Etape post alveolotomie

A
  1. Chiuretaj alveola
  2. Regularizare margini osoase - pensa ciupitoare sau rotativ
  3. Palpare margini - sa nu fie ascutite
  4. Sutura lambou
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11
Q

Leziuni nervoase postextractie nerv alveolar inferior si lingual se remit in ce procentaj?

A

Alveolar inferior 96%
Lingual 87%

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12
Q

Denumiri comerciale acid tranexamic

A

Ugurol
Exacyl

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13
Q

Efecte etamsilat

A
  1. Hemostaza primara
  2. Creste adezivitatea Tr
  3. Creste rezistenta capilara
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14
Q

Situatii activitate fibrinolitica accentuata

A

Infectie acuta
Inflamare spatiu medular osos

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15
Q

Tip culturi in alveolita uscata

A

Flora bacteriana saprofita

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16
Q

Factori favorizanti vindecare intarziata postextractionala

A
  1. Dehiscenta plagii
  2. Varsta P
  3. Boli generale asociate
  4. Medicatie cronica
  5. Malnutritie
  6. Rterapie
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17
Q

Medicatie care intarzie vindecare

A
  1. Citostatice
  2. AIS
  3. ACO
  4. Glucocorticoizi
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18
Q

Efecte medicatie care intarzie vindecarea

A

stimuleaza proliferare tesut de granulatie
inhiba migrare macrofage, modelare colagen

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19
Q

Medicatie cronica care grabeste vindecarea

A
  1. Hormoni crestere
  2. Vitamina A
  3. Vitamina C
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20
Q

Modificari acute post Rterapie

A

Mucozita
Eritem
Xerostomie

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21
Q

Modificari cronice post Rterapie

A
  1. Fibroza
  2. Vasculita obliteranta
  3. Raspuns imun deficitar
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22
Q

ATBprofilaxie EI la P cu af CV

A
  1. proteza valvulara
  2. EI in antecedente
  3. af cardiaca congenitala cianogenica netratata
  4. af cardiaca congenitala corectata chirurgical cu sunt rezidual/regurgitare valvulara

! daca nu exista sunt - 6 luni ATBprofilaxie postoperator

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23
Q

Substituenti in hemofilia A - f VIII

A
  1. sange proaspat
  2. plasma proaspata/congelata
  3. factor VIII recombinat
  4. crioprecipitat congelat (fVIII)
24
Q

Amoxi, cefalosporine, cefazolina, ceftriaxona CI la

A

pacienti cu:
1. anafilaxie
2. angioedem
3. urticarie

dupa penicilina/ampicilina - sensibilitate incrucisata

25
Q

Substituenti in hemofilia B - f IX

A
  1. plasma proaspata/congelata
  2. factor IX recombinat
  3. concentrat factor IX
  4. concentrat de complex protrombinic
26
Q

Risc extractii la P cu leucemii cronice

A
  1. suprainfectare frecventa
  2. complicatii:
    1) GUN
    2) alveolite
    3) necroza osoasa
    4) osteomielita
27
Q

Afectare hemostaza in af hepatice prin perturbarea sintezei:

A

factori care intervin in coagulare
1. protrombina
2. fibrinogen
3. vitamina K

28
Q

Risc complicatii trombembolice la pacientii cu antiagregante plachetare si

A

FiA
* istoric de HTA
* DZ
* vartsa <75ani
* fractia de ejectie VS <35%
* ICC
* istoric de accidente trombembolice

proteze valvulare mecanice in pozitie mitrala
sindrom coronarian acut
angioplastie coronariana percutana/stent recente <1an

29
Q

Riscuri extractii P cu HIV/SIDA

A

asociate infectiei si terapiei
1. osteonecroza postextractionala
2. Ritonavir - inhiba osteoclastele
3. corticosteroizi - risc osteonecroza

30
Q

Indicatii MED antiresorbtive osoase si antiangiogenice

A
  1. mielom multiplu
  2. metastaze osoase
  3. osteoporoza
  4. osteopatii
    - b Paget
    - osteogeneza imperfecta
31
Q

Riscuri complicatii in sarcina in functie de perioada

A

perioada embriogeneza - sapt 3-8 - anomalii structurale la nivelul tesuturilor si organelor
perioada organogeneza - sapt 9-nastere
1. intarziere crestere
2. anomalii SNC
3. deces
4. risc nastere prematura

32
Q

Suma efecte catecolamine ENDOGENE + EXOGENE

A
  1. scadere marcata a circulatiei feto-placentare
  2. hipoxie
  3. tahicardie reflexa a fatului
  4. declansarea precoce a travaliului
33
Q

Caracteristici sarcina care influenteaza medicatia si anestezia in stoma

A
  1. V crescut distributie medicamente
  2. scade concentratia plasmatica maxima
  3. scade timpul de injumatatire plasmatica
  4. creste solubilitatea lipidica
  5. creste viteza de eliminare

acces mai facil al medicatiei prin placenta

34
Q

Risc paracetamol in sarcina

A
  1. ADHD
  2. tulburari spectru autism
  3. astm bronsic
  4. scaderea coeficientului intelectual
35
Q

I extractie cu separatie

A

D pluriradicualri cand:
1. radacini divergente
2. radacini curbe, foarte divergente
3. hipercementoza
4. D cu distructii coronare care nu permit pozitionarea clestelui si extractia cu elevatorul nu e posibila
5. D cu distructii coronare masive la care radacinile sunt unite inca la nivelul podelei CP
6. MT fara rizaliza semnificativa
7. fractri coronare/corono-radiculare in timpul extractiei
8. solidarizare interradiculara

36
Q

I extractie prin alveolotomie

A
  1. radacini situate profund intraalveolar
  2. radacini foarte divergente
  3. radacini cu Hcementoza
  4. Hcementoza
  5. odontoame satelite
  6. RR ramase profund mult timp
  7. radacini convergente ce cuprind sept gros interradicular - dinte barat
  8. dinte cu LP conjuncta - cand doreste sa fie pastrata
  9. anchiloza
  10. cand tehnicile uzuale nu au dat rezultate
37
Q

Tipuri lambouri si alveolotomii in extractii

A

LAMBOURI:
1. in plic
2. trunghiular/in L
3. trapezoidal

ALVEOLOTOMII:
1. cu rezectie marginala limitata a tabliei osoase V
2. cu rezectie marginala partiala/totala a tabliei osoase v
3. cu crearea unei ferestre in corticala V
4. Wassmundt - cale alveolara inalta

38
Q

I alveolotomie cu rezectie marginala partiala/totala

A
  1. RR mici, profunde
  2. Hcementoza - radacini deformate apical
  3. anchiloza pe toata lungimea radacinii
39
Q

manopere post alveolotomie

A
  1. chiuretaj alveola
  2. regularizare margini - rotativ/ciupitoare de os
  3. Pa margini - sa nu fie ascutite
  4. sutura lambou
40
Q

Factori de risc fractura radiculara D de extras

A
  1. radacini subtiri, gracile
  2. radacini curbe/cudate, in baioneta
  3. radacini divergente - mai ales M1max
  4. anchiloza
  5. Hcementoza
  6. sept interradicular gros
  7. os alveolar dens
  8. x examen Rx/interpretare superficiala
41
Q

Factori de risc fractura coronara D vecin in extractie

A
  1. D cu procese carioase/obturatii mari
  2. cleste inadecvat - falci prea late
  3. punct de sprijin D vecin - aplicare defectuoasa elevator
  4. aplicare incorecta cleste - in afara apexului
  5. aplicare incorecta cleste - neadaptat la conturul D
  6. derapare instrumentar
42
Q

Factori de risc smulgere/lezare muguri DP

A

extractia cu clestele a MT
- DT cu radacini insuficient resorbite care inconjoara mugurele MP
- aplicare prea profunda a falcilor clestelui

extractia cu elevatorul
- aplicare prea profunda
- lezare sac folicular/mugure DP

43
Q

C plagi gingivale liniare

A
  1. derapare elevator
  2. pozitionare cleste peste mucoasa
44
Q
A
45
Q

Zone cu corticala subtire - risc fractura la extractii

A
  1. V - Csuperior
  2. V - M superior
  3. V - grup F inferior
  4. L - M inferior
  5. TM
  6. podea sinus maxilar
46
Q

Factori risc fractura mandibulara in extractie

A
  1. M3 mand inclus profund
  2. atrofie crescuta mandibula
  3. procese patologice mandibulare - chist folicular, osteomielita

! CI folosire elevator Lecluse in odontectomie M3 cu radacini drepte –> favorizeaza fractura in unghi mandibular

47
Q

Complicatii posibile post impingere D in spatii perimaxilare

A

complicatii septice severe
1. abces spatiu infratemporal
2. flegmonul hemifacial

48
Q

Preventie lezare nerv lingual in extractii

A
  1. evitare rezectie corticala L/chiuretaj intempestiv/decolare brutala a sacului folicular de pe versantul L
  2. trepanarea osoasa cat mai mult V
  3. D poate fi sectionat - facilitare extractie
  4. evitare perforare corticala L cu instrumentar rotativ
  5. suturi plasate superficial in lamboul L
    - evitare incarcare si lezare n lingual
49
Q

Factori favorizanti locali hemoragie postextractionala

A
  1. VD secundara
  2. persistenta tesut de granulatie
  3. RR/eschile osoase/proeminente osoase - iritatie
  4. lezare vase sanguine
  5. fractura PA
  6. nerespectare P indicatii - in special clatiri orale
  7. plagi mucoase intinse + delabari ale gingivomucoasei
50
Q

Factori generali care determina tulburari hemostaza

A
  1. vasculopatii - fragilitate si permeabilitate capilara
  2. carente vitaminice
  3. insuficienta hepatica
  4. afectiuni endocrine
  5. infectii acute
  6. infectii cronice
  7. Trpatii si coagulopatii
  8. afectiuni elemente figurate
  9. afectiuni Tr cantitative si calitative
  10. menstruatie
  11. T ACO, antiagregante
  12. deficiente factori plasmatici
  13. T citostatic
  14. stari alergice
  15. HTA
51
Q

Grupul celor 5 A

A

medicatie care influenteaza hemostaza
1. Aspirina
2. ACO
3. ATB
4. Alcool
5. Antitumorale - citostatice

51
Q

Factori favorizanti complicatii infectioase

A
  1. nerespectare asepsie si antisepsie
  2. extractie traumatica cu delabari ggvomucoasa, eschile osoase
  3. utilizare instrumente rotative intempestiva, fara racire
  4. chiuretaj alveolar incomplet
  5. extractie in plin proces infectios, la cald
52
Q

Factori favorizanti alveolita

A
  1. extractii laborioase
  2. persistenta eschile osoase/fragmente D
  3. infectii preexistente acute/cronice
  4. aplicare intraalveolara subst antiseptice/hemostatice care interfereaza cu formarea cheagului
  5. pansament compresiv intraalveolar prelungit
  6. tulburari vaso-motorii regionale datorate traumatismului operator si actiunii VC
  7. activitate fibrinolitica crescuta - infectie acuta, inflamare spatiu medular osos
53
Q

Cauze dehiscenta plagi postextractionale

A
  1. spine iritative osoase
  2. lambou repozitionat si suturat fara suport osos subiacent
  3. noduri prea stranse/prea apropiate
  4. sutura in tensiune
54
Q
A

Chirurgie (8 decks)

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