Haematology

Question 1

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

Answer 1

pseudomembranous candidosis

Question 2

what are the local risk factors for candidosis

Answer 2

antibiotic use
dentures
local corticosteroid use
xerostomia

Question 3

what are the general risk factors for candidiosis

Answer 3

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

Question 4

what is atrial fibrillation

Answer 4

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

Question 5

what are the symptoms of AF

Answer 5

fast and irregular heartbeat or pulse

Question 6

why is AF serious

Answer 6

could create blood clots in heart that may lead to stroke

Question 7

what is diabetes

Answer 7

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

Question 8

what is hyperglycaemia

Answer 8

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

Question 9

what are high glucose levels associated with long term

Answer 9

damage to body and failure of organs and tissues

Question 10

what are the 3 types of diabetes

Answer 10

type 1
type 2
gestational

Question 11

what is type 1 diabetes

Answer 11

body produces no or very little insulin

Question 12

what is type 2 diabetes

Answer 12

body cannot make good use of insulin it produces

Question 13

what are the complications of diabetes

Answer 13

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

Question 14

what is hypertension

Answer 14

high blood pressure

Question 15

what are risk factors for hypertension

Answer 15

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

Question 16

what is the action of warfarin

Answer 16

antagonise effects of vitamin K

Question 17

how long does it take for warfarin to work

Answer 17

48-72hours

Question 18

how does dabigatran work

Answer 18

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

Question 19

how does apixaban, edoxaban and rivaroxaban work

Answer 19

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

Question 20

what is simvastatin

Answer 20

HMG CoA reductase inhibitors

Question 21

what is simvastatin used to treat

Answer 21

hypercholesterolaemia

Question 22

what is furosemide

Answer 22

loop diuretic

Question 23

what is furosemide used for

Answer 23

in combination with other hypertensive medications to control resistant hypertension

Question 24

what is carvedilol

Answer 24

beta blocker

Question 25

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

Answer 25

the relevance of patients hypertension to dental care delivery

Question 26

what is metformin

Answer 26

anti hyperglycaemic

Question 27

why is metformin a first choice for diabetics

Answer 27

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

Question 28

what is the disadvantage of metformin

Answer 28

reduce B12 levels so vit B12 anaemia

Question 29

what does dapagliflozin do

Answer 29

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

Question 30

what are the main acts of sulfonylureas

Answer 30

augment insulin secretion

Question 31

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

Answer 31

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

Question 32

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

Answer 32

INR

Question 33

what dental procedures are unlikely to cause bleeding

Answer 33

LA BPE supragingival scaling restorations supragingivally endodontics impressions orthodontics

Question 34

how should we manage a candida infection

Answer 34

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

Question 35

what antifungal is contraindicated with patients taking warfarin and stains

Answer 35

miconazole

Question 36

why is miconazole contraindicated for patients on warfarin and statins

Answer 36

it potentiates the anticoagulant effect increased risk of myopathy

Question 37

what antifungal is safe to use for patients on warfarin

Answer 37

nystatin

Question 38

what is the final option for management of candidiasis

Answer 38

systemic antifungals

Question 39

what is INR

Answer 39

prothrombin time of patient

Question 40

what is the healthy value of INR

Answer 40

1

Question 41

at what INR level can you treat without interrupting medication

Answer 41

less than 4

Question 42

when should we obtain an INR

Answer 42

at least 24 hours prior to providing care

Question 43

if a patients INR varies what would this mean

Answer 43

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

Question 44

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

Answer 44

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

Question 45

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

Answer 45

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

Question 46

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

Answer 46

miss morning dose

Question 47

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

Answer 47

delay morning dose

Question 48

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

Answer 48

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

Question 49

what are the 2 types of haemophilia

Answer 49

A and B

Question 50

what is haemophilia A

Answer 50

deficiency in Factor VIII

Question 51

what is haemophilia B

Answer 51

deficiency in Factor IX

Question 52

what treatments are safe to deliver to a patient with haemophilia

Answer 52

do not require manipulation of mucosa

Question 53

what is tranexamic acid

Answer 53

antifibrinolytic agent