Final Exam Flashcards
Plumber- vincent syndrome
oral cancer possible association
How would the mucosa of Crohn’s disease look on an x-ray?
cobblestone appearance of mucosa
- Ilium, genetic component, granulomatous, persistent diarrhea, Malabsorption, increased GI cancer risk, treat with corticosteroids, oral lesions
- Dental aspects
- Malabsorption complications
- Corticosteroid complications
- Avoid NSAIDs
- Avoid antibiotics that cause diarrhea
- Large, linear, ragged mucosal ulcers
- “cobblestone” appearance of mucosa
- Facial and labial swelling
Cardner’s syndrome
GI polyps, jaw exostoses, jaw osteomas
NO CYSTS
- : Everything in excess = excess polyps, excess bone
- colo-rectal polyps—autosomal dominant disorder.
What blood disease is the highest risk in dentistry?
Hepatitis B
What is the serological marker for successful vaccination of hepatitis B?
Anti - Hbs
-
HBsAg
- Acute infection – 20-120 days post-infection
- Chronic infection – 13 weeks post – jaundice
-
Anti-HBs
- Recovery and immunity
- Successful vaccination
- HBcAg – current or recent infection
-
Anti-HBc
- With anti-HBs – recovery and immunity
- Without anti-HBs – carrier/chronic hepatitis
- HBeAg: Ongoing infectivity
-
Anti-HBe
- Inactive state
- Complete recovery if HBeAg absent
- What lesion has sulfur granules? Actinomycosis
What lesion has sulfur granules?
actinomycosis
Where can we see the Koplik’s spots?
Measles
aka rubeola
What is the most common physical handicap in the US?
cerebral palsy
What is the fastest growing developmental disorder in the US
Autism
What is the safest trimester to give dental care to pregnant women?
2nd trimester
What is associated with osteogenesis imperfecta?
abnormal translucency
brown-purple color
abnormal wear
altered enamel-dentin interface
obliterated pulp chamber
NOT IMPACTED TEETH!!
- Clinical Features
- Usually autosomal dominant, Brittle bone -> fracture, Easy bruising, Joint Hypermobility, Cardiac complications, Blue sclera, Otosclerosis (deafness)
What do you see on an X-ray of fibrous dysplasia?
ground glass appearance
Normal calcium and phosphate levels, polysialic
What is associated with butterfly rash?
lupus
Name and describe the different types of tissue grafts
Autograft - same person
Allograft - closely matched individual (cadaver)
Isograft - from a genetically identical individual (twin)
- Hematopoietic stem cell transplant – autologous or allogenic
- Peripheral blood / umbilical blood stem cell transplant
How long should you wait to provide elective dentistry after a bone marrow transplant?
6 months
What is the most common malignancy in humans?
basal cell carcinoma
What is metabolic syndrome and its features?
Risk factors for ischemic heart disease, diabetes, stroke:
hypertension
insulin resistance
obesity
dyslipidemia
2x ischemic heart disease risk
5X diabetes risk
What is the most common durg abused?
alcohol
What would be the most affected activity in the elderly
walking
Which of the following is a risk factor in type II diabetes mellatis
Hypertension
physical inactivity
obesity
average age above 40
- What would you find in Type II diabetes MD:
- Fasting blood sugar > 126 on 2 separate occasions
- HbA1C > 6.5% (Want to see people under 7 to 6.5) – 4 to 6 is normal range
- Random sugar > 200
- GTT > 200
- Signs/sx’s – polyuria/polydipsia/blurry vision
What are the complications of poorly controlled diabetes?
neuropathy (peripheral)
nephropathy
retinopathy
CVD/PAD/Stroke
poor wound healing
periodontal disease - 6th complication
What is the normal number of RBC’s?
4 - 5 million
What is the normal number of platelets?
150,000 - 400,000
average = 200,000
What is the most common inherited blood disorder?
von Willebrand’s disease
is hemophilia autosomal dominant, recessive or X-linked?
X - linked
What do you see in hemophilia?
hemarthrosis
deep muscle pain
normal INR
normal PT
NOT NORMAL PTT = prolonged prothrombin time
What can you see in DIC?
Disseminated intravascular coagulation
malignancies
acute hemolysis
bacterial sepsis
severe burns
IT IS NOT A DISEASE
- Widespread activation of thrombin and plasmin mechanisms
- Overwhelmed control mechanisms
- Consumption of participants in hemostasis
- Platelets
- Coagulation proteins
- Fibrinogen, prothrombin, factor V, factor VIII
- Control proteins
- Antithrombin, protein C, protein S, Plasminogen
- May present as bleeding or thrombosis
- Introduction of extrinsic clot promoting material
- Malignancy, amniotic fluid, fat embolism, etc
- Intravascular elaboration of procoagulants
- Acute hemolytic process
- Heparin associated thrombocytopenia
- Vascular injury
- Bacterial viral sepsis, hypotension
- Uncertain mechanisms
- Anaphylaxis, hypothermia, hepatic failure
What are the characteristics of anticoagulants?
Warfarin = slow onset, food interactions, drug interactions, no predictable drug effects, yes antidote
What are the etiologies of anemia?
pregnancies
GI blood loss
Parasitic infection
menstrual blood loss
hemolysis
decrease RBC production
genetic disposition
How does altitude impact anemia?
high altitude makes anemia worse
What are the characteristics of sickle cell anemia?
Can see hemolysis mainly
microvascular infarction
splenic infarcts
sepsis
Hypoproliferative anemia characteristics
- not making enough RBC
- low reticulocyte count
- nutritional deficiencies: vit B12, folic acid, iron deficiency
- Impaired iron metabolism: anemia of chronic infection
- Impaired erythropoietin: anemia of chronic kidney function
- aplastic anemia
Most common form of anemia in the US
iron deficiency anemia
most abused drug by dentists other than nitrous oxide?
acetaminophen with hydrocodone
What number do you need to prescribe controlled substances?
DEA number
What number should be on all prescriptions?
NPI number
When do you need prophylactic antibiotics?
- If patient has a history of IE, you would need prophylactic antibiotics
- Medically compromised patient with prosthetic joints comes in for severe dental surgery, do you immediately give prophylactic antibiotics or do you need to consult? Need to consult
- Anything prosthetic inside the heart needs prophylactic antibiotics
- Cardiac transplant: would NOT need a prophylactic antibiotic