Final Practice Flashcards
First part is the same as midterm
if patient shoes up with sores, what must you do
report to clinic supervisor and dismiss patient
what are findings determined from examination
signs
what is a precise term used to describe a deviation from normal, derived from examination findings thru deductive reasoning
diagnosis
information gathering/patient interview must be what? why?
systematic and consistent. do it the same way every time so you won’t miss anything
what is the best way to avoid medical emergencies
patient history
trasillumination is best for what caries
class III
what diagnosis has high certainty
definitive
T/F: when doing clinical exam, you should tell the patient what you are doing before you do it and have assistant present
TRUE
T/F: the dentist owes the patient that degree of skill, care, and judgement possesed by a resonable dentist
true
are patients POOR judges of clinical excellence
yes
should you ever give patient original charts
never! give them copies
what is the failure to do what a reasonable persona would do
negligence
what is the right of competent adults to make decision
consents
age of consent in NE
19
what are exceptions to not getting consent
life threatening emergeny and treatment that patent has previously consented to
what is the primary resource for determining the patient fitness for tx
medical history
why should you ask if patient if theyre on birth control
because antibiotics decreaseses its effectiveness
swollen ankles on patient means what
congestive heart failure and arrythmias
do not treat patient with systemic disease if BP is what
> 159/95
defer elective tx if bp is what
> /= 170/104
defer emergency tx if bp is what
> /= 180/110
what BP should get immediate MD consult
> 210/120
do you need to premedicate for suture removal
no
if patient is allergic to penicillin (amoxicillin) what do dyou give them
erhythromycin
how much amox? when
500 mg, ammox, 4 tabs, 1 hour before ppt
how much clinda? when
150 mg clindamycin, 4 tabs, 1 hour before appt
question about IV
do same amounts as antibiotic questions?
what is the rule of twos
supplemental steroid dosage for patients who have taken 20 mg cortisone or more or equibalent dose another steroid for 2 or more weeks in the last two years. may cause adrenal insufficiency which may cause patient inability to tolerate stressful situations
what is ADA 2 and 4
2 = pregnant
4 = severe systemic disease constant threat to life
___% of sqamous cell carcinoma found where
80% on lateral boder of tongue
T/F: decision to order radiographs based on pt hx, clinical exam, past/current path
true
order radiographs when
ater clinical exam
what are considerations in prescribing radioraphs
risk of exposure, cost, yield
if patient swallows and swelling moves, what is wrong
tyroid
use ___ with radiographas
clinical judgement
what is most indicative of ordering radiographs
caries experience
what provides more detailed image and less anatomical coverage
FMX
what xray for interproximal caries
BW
if an xray is shown without the apex of tooth for PA can you use it for diagnose?
no, PA must capture apex of tooth
if xray is shown of BW with lots of overlap, can you use it to diagnose
no
occlusal radiographs are indicated for what
- supernumerary teeth
- salivary stones
- dental development pre-eruption
- boney expansion
what is most important funciton of fluoride
precipitation of calcium and phosphate
is quality or frequency of sugar intake most important
frequency
is remineralization faster or slower than demin
SLOWER
all carioues lesions start as what spot
white spot
if there is a dark spot with a halo around it, what do you have to do?
there is caries in dentin so need to restore with restoration
know the radiograph classifications
E0-2, D1-3
white spot lesion on dry tooth is __ way thru enamel
<1/2
white spot lesion on wet tooth is __ way thru enamel
> 1/2
if patient has multiple severe caries that can’t be treated in one visit, what can you use
SDF
is SDF single use?
no! reapplied 2x a year
one month follow-up to check for lesion hardness. if soft, reapply following protocol.
in six month, reapply if lesion remains asymptomatic
how often does insurance pay for different xrays
BW - 1x year
Pano/FMX - 1x every 5 years
PA - any time
how often to take BW of patients with risk of caries (both child/adolescent and adults)
child - 6-12 months
adolescent - 6-12 months
adult - 6-18 months
how often to take BW of patients with no caries or not at risk (child, adolescent, and adult)
child - 12-24 months
adolescent - 18-36 months
adult - 24-36 months
Sign and symptoms are noted in order to arrive at diagnosis. You must be ___ and ___ at gathering that information
systemic and consistent
best way to avoid emergencies is thru taking/reviewing is how
thorough health history
what are the classifications of diagnoses
- definitive - high certainty
- differential - various possibilities
- tentative - uncertain, but treatment may still be immediately necessary
you accept the patient when you accept what
their healthy history
informed consent does not apply to what
- life threatening conditions
- routine procedures the patient has accepted in the past
what phase is RCT in
phase 3 - disease control
what are phases of tx plan
- systemic
- acute
- disease control
- definitive
- maintenance
what are indications for prophylaxis (MUST KNOW ALL)
- Prosthetic cardiac valve or prosthetic material for valve repair
- Previous Infective Endocarditis (IE)
- Congenital Heart Disease (CHD)
- Unrepaired cyanotic CHD, including palliative shunts and conduits
- Completely repaired congenital heart defect with prosthetic material or device (For first 6 months after procedure)
- Cardiac transplantation recipients who develop cardiac valvulopathy
- Mitral valve prolapse without regurgitation?
- Innocent heart murmur? No
- Rheumatoid infection?
when is prophylaxis not needed
- Restorative dentistry with or without retraction cord
- Local anesthetic injections
- Intracanal endodontic treatment, posts, and build-ups
- Rubber dam placement
- Suture removal
- Placement of removable prosthetic/orthodontic appliances
- Impressions
- Fluoride treatments
- Radiographs
- Orthodontic appliance adjustment
what do prescribe if patient allergic to penicillin/amox
clindamycin 150 mg, 4 tabs 1 hour prior to appt so 600 mg total dose
what ASA:
patient normal and healthy
ASA 1
what ASA
Patient with mild systemic disease (controlled hypertension or diabetes without systemic
complications, or ASA 1 plus pregnancy, tobacco use, systemic medications, or extreme
fear/apprehension)
ASA 2
what ASA
Moderate to severe systemic disease that does not limit patient physical activities (stable angina or
diabetes with systemic complications). May require medical consult prior to extensive or invasive
dental treatment. (or ASA 2 plus severe fear/apprehension)
ASA 3
what ASA
Severe systemic disease that is a constant threat to life. Dental treatment only in hospital setting.
ASA 4
what ASA
Moribund patient not expected to survive without immediate medical intervention.
ASA 5
what ASA
organ donor
ASA 6
what ASA is special need patient
3 or 4
primary cause of oral cancer
tobacco
you should never biopsy what type of lesion? then you should do what
never biosy red - refer it out
how many Gys in chemotherapy
5500 Gys
prognoses are based on what staging
TNM - tumor, nodes, metasatsis
what are the tumor classifications
T1S = Carcinoma in Situ
T1 = 2 cm or less diameter
T2 = 2-4 cm
T3 = greater than 4 cm
what are the nodular classification
NO = no nodes
N1 = ipsilateral palpable node
N2 = contralateral/bilateral palpable node
N3 = Palpable, large, fixed nodes
what is the acute care exam
SOAP
Subjective: chief complaint
Objective: clinical assessment
Assessment diagnoses
Procedure: the plan
what are the metastatic classifications
MO = no metastasis
M1 = clinical or radiographic metastasis present
can you use regular mouth wash to manage high caries risk?
NO it won’t work - use CHX
what are methods to manage high caries risk
xylitol gum and more fluoride, CHX
what type of diagnoses if patient left a voicemail message
tentative diagnoses
