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GMDC > Final Exam > Flashcards

Final Exam Flashcards

1
Q
  • Colonoscopy revealed multiple linear and irregular ulcers in the colon and terminal ileum
  • Diagnosis ?
A

Crohn’s Disease with aphthous stomatitis

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2
Q

histology of ulcerative colitis

A

confined to the mucosal layer

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3
Q

histology of chrohn’s disease

A
  • Granulomas with multi- nucleated giant cells can be the HALLMARK histological sign
    o If we see these – we say Crohn’s but if we don’t see them we cannot rule out this disease
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4
Q

crohn’s disease pattern

A

more segmental inflammation – patchy - think crohn’s

because it effecrs deeper layers - transmural - more severe signs and symptoms and bowel obstructions

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5
Q

major oral manifestation assoicated with crohn’s?

A

Aphthous stomatitis

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6
Q

affective mood disorders

A
  1. major depression

2. bi-polar

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7
Q

part of the CDC guidelines for infection control

A

standard barrier precautions to minimize formation of an exposure to aerosols. droplets, and splatters

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8
Q

which is used to predict the risk of progression to AIDS

A

absolute CD4 cell count measured in the number of cells / mm3

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9
Q

stuck with needle from patient what do you do next?

A

SOAP AND WATER and immediatley report to the ED for evaluation

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10
Q

strongest risk factor for sporadic (non-heraditary) colon cancer?

A

increasing age

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11
Q

major fact to know about gardners syndrom?

A

patients have a lifetime risk of developing colon cancer of 100% if untreated

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12
Q

most important factor in the pathogenesis of GERD?

A

frequent transient relaxations of the lower esophageal sphincter

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13
Q

the most common oral manifestation of GERD?

A

dental erosion involving the posterior teeth, lingual and occlusal surfaces

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14
Q

25 year old with multiple osteomas of jaw and multiple un-urupted teeth..likely diagnosis?

A

colon polyposis/ cancer

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15
Q

what about colorectal cancer should we know>

A

CRC is the seconf leading cause of death in the US

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16
Q

sjorgens syndrome can be a secondary manifestation of what disease most likely?

A

Osteoarthritis

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17
Q

bilateral knee swelling and pain is most associated with?

A

Rheumatoid Arthr.

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18
Q

first manifestation of lupus?

A

hypertension (doesnt come first but first notiecable one)

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19
Q

two antihyperglycemic agents that are most likely to cause hypoglycemia

A
  1. glyburide

2. glipizid

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20
Q

T/F you can do elective dental tx on diabetic patient if FBS is <200 g/dl

A

TRUE – cannot if it is above this

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21
Q

T/F managing a patient with anxiety should avoid prescribing post-operative pain medications

A

FALSE - you can

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22
Q

T/F shortness of breathe / dyspnea can be caused by deep vein thrombosis?

A

False

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23
Q

describe abuterol

A

inhaled beta-2 agonist

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24
Q

what vital sign is most diagnostic in differentiating syncope from other manifestations

A

pulse

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25
Q

healthy patient and give LA then starts freaking out and pulse increases what likely happened?

A

intravascular injection of vasoconstrictor

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26
Q

diabetic patient unconsciouss in you waiting room what do you give first?

A

glucose

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27
Q

T/F albuterol is a systemic corticosteroid?

A

false- inhaled

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28
Q

time for appointments for diabetic patients

A

morning

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29
Q

T/F GFR can be used to test for acute kidney failure?

A

FALSE - only accurate in a steady state

30
Q

GFR is under-estimated in?

A

ingestion of cooked meats increases plasma Cr and CC is
underestimated

so plasma levels higher – underestimattion

31
Q

GFR is over-estimated in?

A

low muscle ass decreases Cr production and over-estimates CR

32
Q

Stages of Chronic Kidney Disease

A 
-	Stage I
o	GFR is above 90
-	Stage II
o	GFR is between 60-90
-	Stage III
o	GFR is between 30-59 ml/min 
-	Stage IV
o	GFR is between 15-29
-	Stage V
o	GFR is below 15 and needs replacement if uremia also present
33
Q

creatine 2 implication?

A

lost about half their GFR

  • normal creatinine is 1 (GFR is 120)
34
Q

most common cause of renal failure in hospitilized patients?

A

acute – PRE-RENAL failure due to VOLUME DEPLETION

35
Q

Chronic renal failure is defined by?

A

GFR - or creatine clearance

  • small shrunken kidneys **
36
Q

drugs you should not give renal impaired patients? why?

A

NSAIDs

  • like ibprofen
  • inhibit prostaglandins but these patients need them for physiologic compensation
37
Q

*common cause of secondary hypertension

A

NASAL DECONGESTANTS

38
Q

*common cause of secondary hypertension

A

NASAL DECONGESTANTS

39
Q

proph abx tx with dialysis patient?

A

2 grams amoxicillin 2 hours before any dental procedure for PERIOTENAL DIALYSIS ONLY

40
Q

pattern of OA?

A

joint pain gets WORSE with use (NOT associated with prolonged morning stiffness)

Hips, knees, 1st metatarsal-phalangeal joints, distal interphalangeal joints, proximal interphalangeal joints, 1st carpo-metacarpal joints, and lumbar spine

(ankle, wrist, and elbow are rarely involved)

41
Q

pattern of Rheumaoid arthritis

A

SYMETTRICAL and typically affecting the peripheral joints

Proximal interphalangeal, metacarpophalangeal, and wrists in 90% of cases

involves, elbows, ankles, knees, and cervical spine

rarely distal interphalangeal and

42
Q

antibody production in systemic lupus

A

ANA – positive in 99% of time

Anti-dsDNA - very specific but only found in 40%

anti-Ro/SSA- found in 15% of SLE, but found in ALL ANA negative SLE and seen in Sjorgen’s syndrome

43
Q

will ANA test help for positive of negative lupus?

A

positive is non-specific so more helpful if this is negatives

44
Q

major malignant risk with sjorgen’s syndrome

A

development of Lymphoma - increases 44% - compared to others and more likely to die if do

45
Q

antibodies for Sjorgens

A

anti-Ro/SSA

46
Q

RA vs sjorgens

A

RA – targeting joints more

47
Q

treatment for RA?

A

initial - glucocorticoids

mild disease - hydroxyxhloroquine

48
Q

use of hydroxyxhloroquine? implication for dental treatment>

A
  1. Non- immunosuppressive  so if need to do surgery  not at increased risk for wound infections
  2. Check blood count with this (white count)
    but DO NOT NEED to discontinue
49
Q

methotrexate use? implication with dental treatment>

A

RA - should stop if CBC count is low

  • usually are not immunosuppressive but good to get a white blood cell count
50
Q

describe syncope

type?

A

neurogenic shock

vaso/vagal problem

1.

51
Q

very important treatment intervention with emergencies

A

OXYGEN

52
Q

patient presents as
- Pulse and BP not too abnormal now
- Color is pink, pupils are normal
- Receptionist says patient came in and seemed nervous, was breathing rapidly,
complained that her fingers and toes were cramping and collapsed onto the floor

what could be diagnosis?

A

hyperventilation syndrome leading to respiratory alkalosis

o H+ CO3-  H2CO3 H2O + CO2
- With high pH, calcium metabolism in muscles is affected  muscle spasms

53
Q

treat hyperventilation syndrome?

A

rebreathe in bag or mask with low flow O2

54
Q

TREATMENT OF ANGINA

A

nitroglycerin - repeat 3 x if necessary - if does not come down - assume MI and treat with MONA

55
Q

syncope that is not responsive to oxygen may respond to? which?

A

atropine – which blocks parasymathetic slowing of the heart

56
Q

management of seizure

A

protect patient from self-inflicted injury

57
Q

suffering from hyperventilation syndrome and may develop muscle spasms caused by?

A

respiratory alkalosis

58
Q

T/F lupus and RA are both inflammatory and OA is not

A

TRUE!

59
Q

presentation of celiac’s disease

A
  • Painful cracks at corner of mouth
  • Burning tongue
  • Frequent loose, grey, foul stool
  • Abnormal fat in stool, anemic, deficient in iron and folic acid, serologic testing shows elevated levels of anti- tissue transglutaminase (TTG) antibodies  how you diagnose
60
Q

histologic sign of celiacs

A

small bowel biopsy –> LOSS OF VILLI - intra-epithelial lymphocytes, crpt hyperplasia, villous atrophy

61
Q

major findings with alcoholic

A

alcoholic cirrhosis with periodontal disease and sialadenosis –> major swelling of the parotid gland

62
Q

generalized anxiety disorder characterized as

A

persistant feeligns of anxiety , most of the day, for over 6 months

  • restlessness, easy fatigue, difficulty concentratin, irritable, muscel tensionn, insomnia
63
Q

major discriminating feature between type I and type II diabetes

A

autoimmune destruction of beta cells in type I

64
Q

sulfonylureas, repaglinide and nateglinide can all?

A

INCREASE INSULIN SECRETION

65
Q

BIGUANIDE - METFORMIN is effective when?

A

nocturnally as well

66
Q

obstructive renal disease is most commonly caused by?

A

enlarged prostate

67
Q

characteristics of nephrotic syndrome?

A

a lot of protein in urine (proteinuria)

hypoalbuminemia with resulting edema

hyperlipidemia

NOT macroscopic hematuria (red blood cells in urine)

68
Q

bleeding complications in acute or chronic renal failure due to?

A

FUNCTIONALLY ABNORMAL platalets (NOT that they are not there)

bleeding time is only thing different

69
Q

most common cause of chronic liver failure

A

diabetic nephropathy

70
Q

most common way to assess GFR?

A

Creatinine clearance

GMDC (15 decks)

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