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Special Care Dentistry > Haematology > Flashcards

Haematology Flashcards

1
Q

if a patient presents with white cheesy looking spots in their mouth what could this be

A

pseudomembranous candidosis

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2
Q

what are the local risk factors for candidosis

A

antibiotic use
dentures
local corticosteroid use
xerostomia

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3
Q

what are the general risk factors for candidiosis

A

drugs
extremes of age
endocrine - cushings/diabetes
immunodeficiency
nutritional deficiencies
smoking

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4
Q

what is atrial fibrillation

A

electrical impulses in the atria of the heart fire chaotically when they should be steady and regular

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5
Q

what are the symptoms of AF

A

fast and irregular heartbeat or pulse

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6
Q

why is AF serious

A

could create blood clots in heart that may lead to stroke

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7
Q

what is diabetes

A

chronic disease that occurs when the pancreas is no longer able to make insulin or when the body cannot make good use of insulin it produces

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8
Q

what is hyperglycaemia

A

raised glucose levels in blood due to not being able to produce insulin or use it effectively

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9
Q

what are high glucose levels associated with long term

A

damage to body and failure of organs and tissues

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10
Q

what are the 3 types of diabetes

A

type 1
type 2
gestational

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11
Q

what is type 1 diabetes

A

body produces no or very little insulin

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12
Q

what is type 2 diabetes

A

body cannot make good use of insulin it produces

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13
Q

what are the complications of diabetes

A

risk of hypoglycaemic episode
periodontal disease
xerostomia
oral dysesthesia
impaired wound healing
increased risk of infections and severity
parotid gland enlargement

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14
Q

what is hypertension

A

high blood pressure

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15
Q

what are risk factors for hypertension

A

drinking too much alcohol
smoking
being overweight
not doing enough exercise
eating too much salt

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16
Q

what is the action of warfarin

A

antagonise effects of vitamin K

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17
Q

how long does it take for warfarin to work

A

48-72hours

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18
Q

how does dabigatran work

A

reversible inhibitor of free thrombin, fibrin-bound thrombin and thrombin induced platelet aggregation

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19
Q

how does apixaban, edoxaban and rivaroxaban work

A

reversible inhibitors of activated factor Xa preventing thrombin generation and thrombus development

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20
Q

what is simvastatin

A

HMG CoA reductase inhibitors

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21
Q

what is simvastatin used to treat

A

hypercholesterolaemia

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22
Q

what is furosemide

A

loop diuretic

23
Q

what is furosemide used for

A

in combination with other hypertensive medications to control resistant hypertension

24
Q

what is carvedilol

A

beta blocker

25
Q

as carvedilol is not a first line treatment for hypertension what would this make us consider

A

the relevance of patients hypertension to dental care delivery

26
Q

what is metformin

A

anti hyperglycaemic

27
Q

why is metformin a first choice for diabetics

A

positive effect on weight loss
reduced risk of hypoglycaemic events
long term CV benefits

28
Q

what is the disadvantage of metformin

A

reduce B12 levels so vit B12 anaemia

29
Q

what does dapagliflozin do

A

reversibly inhibits sodium glucose co transporter in renal proximal convoluted tubule to reduce glucose reabsorption and increase glucose excretion

30
Q

what are the main acts of sulfonylureas

A

augment insulin secretion

31
Q

if a patient is on metformin, dapagliflozin and sulfonylurea what would this suggest

A

triple therapy for diabetes suggests he has had challenges in controlling his condition

32
Q

if a patient is on warfarin, what do we need to know

A

INR

33
Q

what dental procedures are unlikely to cause bleeding

A

LA
BPE
supragingival scaling
restorations supragingivally
endodontics
impressions
orthodontics

34
Q

how should we manage a candida infection

A

mechanical disruption
encourage denture hygiene
toothbrush to clean palate
cleaning denture/new denture
medication

35
Q

what antifungal is contraindicated with patients taking warfarin and stains

A

miconazole

36
Q

why is miconazole contraindicated for patients on warfarin and statins

A

it potentiates the anticoagulant effect
increased risk of myopathy

37
Q

what antifungal is safe to use for patients on warfarin

A

nystatin

38
Q

what is the final option for management of candidiasis

A

systemic antifungals

39
Q

what is INR

A

prothrombin time of patient

40
Q

what is the healthy value of INR

A

1

41
Q

at what INR level can you treat without interrupting medication

A

less than 4

42
Q

when should we obtain an INR

A

at least 24 hours prior to providing care

43
Q

if a patients INR varies what would this mean

A

control of warfarin use is not as good as it could be therefore higher risk of complications

44
Q

if a patient gets an INR at 3 day intervals what would this tell us

A

its quite frequent so suggests that they are not stable in warfarin control

45
Q

if the patient is on an anticoagulant which is lifelong (warfarin) how would you plan for an extraction

A

plan early in day/early in week to allow for time management for any complications
atraumatic technique to dental extractions
establish haemostasis
limit initial area of surgery
advise paracetamol not NSAIDs
provide full written instructions and emergency contact

46
Q

what should you tell patients on apixaban or dabigatran to do with their medication on day of treatment

A

miss morning dose

47
Q

what should you tell a patient on rivaraoxaban to do with medication on day of treatment

A

delay morning dose

48
Q

what should you tell a patient on edoxaban to do with medication on day of treatment

A

do not need to change routine as they only take in evening

49
Q

what are the 2 types of haemophilia

A

A and B

50
Q

what is haemophilia A

A

deficiency in Factor VIII

51
Q

what is haemophilia B

A

deficiency in Factor IX

52
Q

what treatments are safe to deliver to a patient with haemophilia

A

do not require manipulation of mucosa

53
Q

what is tranexamic acid

A

antifibrinolytic agent

Special Care Dentistry (15 decks)

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