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SP18: Oral Surgery > Final > Flashcards

Final Flashcards

1
Q

T/F: Loss of natural teeth leads to progressive bone resorption.

A

True

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2
Q

What are some properties that can alter the amount of bone resorption?

A

Systemic: Nutrition, osteoporosis, endocrine dysfunction
Local: alveoloplasty, dentures, facial form

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3
Q

The ________ is the workhorse for removing sharp edges in bone.

A

rongeur

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4
Q

What is alveoloplasty?

A

Removing/recontouring bone abnormalities in preparation for prosthesis

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5
Q

T/F: Digital compression and interseptal alveoloplasty involve releasing a flap.

A

False

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6
Q

When should you do interseptal alveoloplasty?

A

When the interseptal bone seems loose after extraction

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7
Q

What type of flap should be raised for surgical alveoloplasty?

A

Full thickness

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8
Q

_______ is an overgrowth of bone on buccal surface of mandible or maxilla.

A

Exostosis

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9
Q

T/F: Exostosis are usually seen in maxillary molar areas.

A

True

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10
Q

T/F: Tori are found on the lingual aspect of the mandible.

A

True

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11
Q

T/F: Tori are more difficult to remove than exostosis.

A

True

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12
Q

What are the two major difficulties with maxillary tori removal?

A
  1. Torus may be pneumatized - communicate with nasal passage

2. Closure of wound is difficult - thin tissue

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13
Q

T/F: You will always remove bone when reducing a maxillary tuberosity.

A

False

Can be soft tissue, bone, or both

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14
Q

Patients not using proper care when wearing their denture can develop a fungal infections leading to ____________.

A

inflammatory papillary hyperplasia

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15
Q

What is inflammatory fibrous hyperplasia (epulis fissuratum)?

A

Inflammation for poor fitting denture

Need to cut it off

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16
Q

What is a special consideration when cutting off epulis fissuratum?

A

Must send for histological evaluation

Also patient may have an open wound

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17
Q

What could be some problems with an abnormal labial/lingual frenum?

A

Diastema, speech problems, in the way of a denture

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18
Q

T/F: Management and prevention of odontogenic infection is one of the biggest causes of morbidity/mortality and litigation.

A

True

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19
Q

T/F: The majority of odontogenic infections are from aerobic bacteria.

A

False

Mostly anaerobic but the majority of infections are a mixed group of bacteria

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20
Q

Most odontogenic infections are initiated by __________ bacteria that create an environment succeptible to _________ bacteria.

A

Aerobic; anaerobic

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21
Q

Which types of bacteria contain most of the toxins and antibiotic deactivating enzymes?

A

Anaerobic

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22
Q

What are the three stages in a natural course of infection?

A

Cellulitis -> abscess -> fistula

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23
Q

Cellulitis is primarily caused by what bacteria?

A

Streptococcus

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24
Q

T/F: Advanced cellulitis is diffuse and hard.

A

True

Life threatening

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25
Q

An abscess is primarily _________ bacteria.

A

Anaerobic

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26
Q

What are some factors for where an infection might spread?

A

Muscle attachment, bone thickness, root angulation

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27
Q

T/F: Maxillary infections are more likely to spread buccally than palatally.

A

True

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28
Q

T/F: An infection in the posterior maxilla is likely to stay within the buccinator muscle.

A

False

Anterior max: vestibular infection (inside muscle)

Post max: buccal space (outside muscle)

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29
Q

Where are infections of the 2nd/3rd molars in the mandible likely to spread?

A

Submandibular space

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30
Q

Where will infections of mandibular premolars likely spread?

A

Sublingual space

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31
Q

T/F: Submental infections are often directly from an anterior tooth.

A

False

Often some other pathology or spread from other areas

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32
Q

What is a Ludwig’s Angina?

A

Bilateral submandibular, sublingual, and submental space cellulitis - life threatening airway obstruction possible

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33
Q

What should you be worried about if a patient comes in and truly cannot open their mouth?

A

Infection to secondary spaces by muscles of mastication - superficial/deep temporal, infratemporal, pterygomandibular, masseteric

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34
Q

T/F: Pterygomandibular space infection could be caused by a needle tract infection.

A

True

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35
Q

Infections that spread to the ______________ can cause a variety of serious problems due to having access from the skull to the mediastinum.

A

Lateral pharyngeal space

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36
Q

T/F: High speed hand pieces should be used to section teeth for extractions.

A

False

Can cause infection

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37
Q

What can result from using a pneumatic hand piece to section a tooth for extraction?

A

Rapid fascial space infection

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38
Q

T/F: If you have a patient with severe trismus it is likely the infection has spread to a secondary space.

A

True

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39
Q

What is the first step in therapy of infection?

A

Determine severity

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40
Q

T/F: Patients with secondary or neck space infections should be referred immediately.

A

True

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41
Q

T/F: Temperatures over 101 indicate systemic involvement.

A

True

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42
Q

T/F: Oral temperatures are accurate for evaluating systemic involvement.

A

False

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43
Q

T/F: WBC count is a good measurement of the severity of an odontogenic infection.

A

False

Remains elevated throughout treatment

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44
Q

What is the most important surgical goal of treatment?

A

Remove source of infection!

Also, drain pus and relieve tension

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45
Q

T/F: Incisions should be made through healthy tissue to drain pus.

A

True

Heals better

46
Q

What is the empiric therapy with antibiotics?

A

No time for culture so you give antibiotics for what you think bacteria is

47
Q

If the patient is penicillin allergic what would you give them?

A

Clindomycin

48
Q

What is the first line of antibiotics for infection?

A

Amoxicillin

Possibly with metronidazole

49
Q

T/F: Most recurrent infections are do to poor antibiotic use.

A

False

Inadequate surgery: source remains, all spaces not explored, inadequate drainage

50
Q

What are some steps to take if the infection is not improving?

A
  1. Confirm pt is complying
  2. Look for additional source
  3. Get another CT scan
51
Q

What is a metastatic infection?

A

Occurs at a place other than the operation site

52
Q

What are the four criteria to get a metastatic infection?

A
  1. Surgical manipulation
  2. Transient bacteremia
  3. Distant susceptible site
  4. Infection
53
Q

What are the three conditions (post 2007) that require antibiotic prophylaxis?

A
  1. Prosthetic cardiac valve
  2. Previous infective endocarditis
  3. Cardiac transplant with valve defects
54
Q

T/F: The vast majority of SBE (subacute endocarditis) from dentistry is streptococcal and following extractions.

A

True

55
Q

T/F: Scaling and root planing requires prophylaxis.

A

True

56
Q

What is standard prophylaxis regimen?

A

Amoxicillin 2gm - 1 hour before operation

57
Q

T/F: Amoxicillin is better because it effects a broader spectrum of bacteria.

A

False

Better absorption, higher plasma level, slower excretion

58
Q

What will you give patients for prophylaxis who have penicillin allergy?

A

Clindamycin 600mg - 1 hour pre-op

59
Q

T/F: If a patient is already taking antibiotics they don’t need another one for prophylaxis.

A

False

60
Q

T/F: Ventricular shunts (in brain) need to be prophylaxed.

A

True

61
Q

T/F: A patient with an AV dialysis shunt needs prophylaxis.

A

True

62
Q

T/F: All patients with artificial joints should be prophylaxed.

A

False

2015 paper showed it is not necessary

63
Q

T/F: If the patient wishes to be prophylaxed with an artificial joint you should do it.

A

False

64
Q

What is the most important way to prevent infection?

A

Superb technical surgery

65
Q

When should the first dose of antibiotic be for wound prophylaxis?

A

Before surgery

66
Q

What is the correct dosage for prophylaxis of wound?

A

2x the therapeutic dose

67
Q

T/F: For wound prophylaxis, antibiotics should not be continued post-surgery.

A

True

68
Q

What are two key indicators for taking a biopsy?

A
  1. Lesions that persist for two or more weeks with no known etiology
  2. Any inflammatory lesion that does not respond to local therapy within two weeks
69
Q

T/F: Lesions that interfere with function should be biopsied.

A

True

70
Q

A _______ is a raised fluid filled lesion in or under the epithelium.

A

Bulla

71
Q

________ is a superficial ulcer.

A

Erosion

72
Q

A __________ is a flat lesion typically brown or blue.

A

macule

73
Q

A _________ is a small elevated palpable mass.

A

Papule

74
Q

A __________ is a large elevated palpable mass.

A

nodule

75
Q

A __________ is a very slightly elevated confluence of papules often seen in smokers.

A

Plaque

76
Q

_________ are cloudy or white vesicles filled with pus.

A

Pustules

77
Q

A macroscopic accumulation of keratin is a ________.

A

Scale

78
Q

An __________ results in the loss of epithelium.

A

Ulcer

79
Q

A ___________ is a small loculation of fluid in or under the epithelium.

A

Vesicle

80
Q

What are some important factors in evaluating a lesion?

A
  1. Size and shape
  2. Single vs multiple
  3. Color
  4. Borders
81
Q

T/F: Red, Ulcerative, bleeding lesions are all red flags for malignancy.

A

True

82
Q

What are the four types of biopsies?

A
  1. Cytology
  2. Aspiration
  3. Incisional
  4. Excisional
83
Q

Why can aspiration be important to do before biopsies?

A

See if bony lesion is vascular or not

84
Q

T/F: Normal tissue should be included in a biopsy.

A

True

85
Q

T/F: Anything greater than 1 cm should be biopsied with an incisional technique.

A

True

86
Q

What biopsy technique should be used for suspected malignancies?

A

Incisional

87
Q

T/F: Incisional biopsies should be broad and shallow.

A

False

Deep and narrow

88
Q

T/F: Small (< 1cm) lesions can be biopsied with excisional technique.

A

True

89
Q

How large of a border should you leave around a malignant soft tissue biopsy?

A

5 mm

90
Q

T/F: High volume suction should be applied after biopsy.

A

False

Gauze to stop bleeding and suture

91
Q

T/F: Sometimes it is necessary to undermine the tissue prior to closure.

A

True

92
Q

T/F: A prescription is a written instruction for the preparation and administration of medication.

A

True

93
Q

T/F: The pharmacist has the responsibility to refuse prescriptions that are unsafe or inappropriate.

A

True

94
Q

What constitutes a patient-provider relationship?

A
  1. Chief complain and diagnostic studies
  2. History of illness and diagnosis
  3. Medical history
  4. Physical exam
95
Q

T/F: Anti-hypertensive and hypoglycemic drugs are appropriate to prescribe as a dentist.

A

False

96
Q

What are schedule 1 controlled substances?

A

High abuse with no medical use

Ex. Heroin, LSD, marijuana (in ohio)

97
Q

T/F: Schedule II drugs have an accepted medical use.

A

True

Highly addictive (oxycodone, adderall, percocet)

98
Q

T/F: Schedule V drugs have the lowest risk for abuse.

A

True

99
Q

T/F: The date issued on a prescription can be planned ahead.

A

False

100
Q

How must you write the quantity of drug for DEA controlled substances?

A

Write and spell number

Ex. Ten (10). Twenty (20).

101
Q

T/F: Schedule II drugs can be refilled.

A

False

102
Q

What does B.I.D stand for?

A

Twice daily

103
Q

What does a.c. Stand for?

A

Before meals

104
Q

What does H.S. Stand for?

A

At bedtime

105
Q

What does p.o. mean?

A

By mouth

106
Q

What does p.r.n. Mean?

A

As needed

107
Q

What does q.i.d. Mean?

A

four times a day

108
Q

What does q.4.h. Mean?

A

every 4 hours

109
Q

What does t.i.d. Mean?

A

Three times a day

110
Q

T/F: If a patient calls for a refill of narcotics they must be seen first.

A

True

SP18: Oral Surgery (2 decks)

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