Final Sweep 1

Question 1

Aspirin—irreversible —— inhibitor

Answer 1

cyclooxygenase - can lead to excessive bleeding - antiplatelet drug

Question 2

ADP receptor inhibitors

Answer 2

(clopidogrel

Question 3

<20,000

Answer 3

spontaneous bleeding

Question 4

<50,000

Answer 4

bleed excessively with minor trauma

Question 5

Vitamin K antagonist -

Answer 5

coumadin/warfarin. Will work on liver to prevent synth of vitamin K clotting factors (yellow circles here)

Question 6

Von w. diseazse

Answer 6

Missing or defective von Willebrand factor, a clotting protein

Question 7

Most common bleeding disorder, 1% of US population

Answer 7

VW disease

Question 8

von Willebrand Factor—

Answer 8

Platelet Adhesion

Binds platelets to exposed collagen (adhesion) Binds platelets to platelets (aggregation)

Question 9

von Willebrand Factor—

Answer 9

Factor VIII Chaperone
Binds circulating factor VIII
Unbound factor VIII is destroyed

Question 10

Management of vWD

Answer 10

Desmopressin (DDAVP), replacement therapy with vWF- containing concentrates, and antifibrinolytic therapy

Question 11

Desmopression (DDAVP)

Answer 11

Stimulates the release of vWF from endothelial cells Increases plasma factor VIII and vWF levels

Question 12

Antifibrinolytic Therapy

Answer 12

Aminocaproic acid and tranexamic acid Prevent the dissolution of the hemostatic plug Oral and IV formulations

Question 13

vWD Type 1 and most type 2 can be treated as

Answer 13

outpatient Pre-op: desmopressin
Post-op: antifibrinolytic therapy
Local measures—primary closure if possible
Acetaminophen or acetaminophen-opioid combos for analgesia

Question 14

Hemophilia A

Inherited —— deficiency

Answer 14

factor VIII

Question 15

Normal homeostasis requires at least —- factor VIII activity

Answer 15

30%

Question 16

Anemia Causes:

Answer 16

1. decreased RBC production
2. blood loss
3. destruction of circulating RBCs

Question 17

Anemia tx Goal = hemoglobin

Answer 17

> 11 g/dL

Question 18

Sickle cell - ask

Answer 18

Have you had any surgery for sickle? Splenectomy should be a normal thing.

Question 19

Leukemia

Answer 19

Malignant proliferation of myeloid or lymphoid cells

Question 20

Acute leukemia -

Answer 20

rapid onset and prog

Question 21

Leukemia - 3 phases of chemotherapy
Induction & consolidation: ——
Maintenance: —-

Answer 21

hit hard, kill tumor cells

prevent expansion of remaining leukemic cells (patient is in remission at this point)

Question 22

Chronic Myelogenous:

Answer 22

possible to obtain complete remission

Question 23

Chronic Lymphocytic:

Answer 23

not curable, treatment has little effect on improving quality of life

Question 24

Lymphoma

Cancer of

Answer 24

lymphoid organs and tissues Higher grades are more aggressive Hodgkin, non-Hodgkin

Question 25

Medical Management of Lymphoma

—— to shrink volume —— to remaining mass

Answer 25

Induction chemo

Radiation

Question 26

Multiple Myeloma

Answer 26

Lymphoproliferative disorder

disorder
Overproduction of
•
malignant plasma cells
•
Multiple tumorous masses through the skeletal system

Question 27

WBC concerns

Answer 27

Concerns in Dentistry
Infection Delayed healing Bleeding
• • •

Question 28

Guidelines for Extraction Patients w/ WBC disorders

Answer 28

Be prepared to treat bleeding Obtain primary closure if possible
Minimum 10-14 days between surgery and start of chemo/radiation

Question 29

Status Asthmaticus associated with

Answer 29

respiratory infection

Question 30

Supraventricular Arrhythmias

Answer 30

Sinus nodal disturbances
Disturbances of atrial rhythm
Heart block

Question 31

Ventricular Arrhythmias

Answer 31

Premature ventricular complexes Ventricular tachycardia Ventricular fibrillation

Question 32

Ventricular Tachycardia

Answer 32

Rapid, regular ventricular contractions Inadequate ventricular filling/pumping to body

Question 33

Ejection fraction

Answer 33

35

Question 34

No nitro if SBC is less than

Answer 34

90

Question 35

Hypotension is the first sign of

Answer 35

acute adrenal crisis

Question 36

Anaphylaxis/angioedema - Depressed/absentee vital sign—

Answer 36

0.3-0.5ml 1:1000 epinephrine IM Q5min and CPR prn

Question 37

NSAIDS can prematurely

Answer 37

close patent ductus arteroisus

Question 38

Amount of drug excreted in milk ~—-% of maternal dose

Answer 38

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