HD Flashcards
vital signs of shock
low BP <100
high HR >100
what type of shock is sepsis and anaphylaxis
distributive shock
extra-intestinal complications of IBD
aphthous stomatitis (directly from crohns or secondary to anaemia in UC) vasculitis arthritis crohns - OFG, cobblestone mucosa chronic disease - anaemia
what medications may pt suffering from IBD take?
corticosteroids + cyclosporin
3 factors increasing chance of aspiration in GA
- non-fasted
- history of hiatus hernia
- pregnancy
side effect of omeprazole
xerostomia
also CI with warfarin
What causes yellow pigmentation in jaundice
raised bilirubin levels
dental relevance of jaundice
bleeding - vit k clotting factors insufficient
drug metabolism - avoid miconazole, Abs, NSAIDs
cross infection control if hepatitis
limit LA cartridges
how to exclude haemorrhage stroke
CT scan - Aspirin given once excluded
dental relevance of parkinsons
hypersalivation
postural drop in BP
dental relevance of renal disorders
anaemia - failrure to produce erythroprotein
bleeding - marrow fibrosis = platelet dysfunction
may be taking steroids - immunosuppressed
drug excretion - no NSAIDs + tetracycline
dialysis - heparin = see day after
often hypertensive
don’t swallow blood
4 causes of tonic clonic seizures
epilepsy
hypoglycaemia
trauma
vasovagal syncope
how much buccal midazolam to treat status epilepticus
> 10 yr 10mg
5-10 yr 7.5mg
1-5 yr 5mg
6m - 1yr = 2.5mg
onset of extradural haemorrhage
acute
lens shape on scan
MMA
onset of subdural haemorrhage
slow onset - venous bleed
crescent shape
how to test if rhinorrhea is CSF
contains glucose
signs of liver disease in clothed pt
liver flap dupuytren contracture palmar erythema finger clubbing leukonychia gynaecomastia ascites ankle oedema sialosis jaundice spider naevi bruising
do BCC or SCC skin cancer have most metastatic potential?
SCC
how to differentiate cherubim from hyperparathyroidism?
with blood test - increased calcium, phosphate and PTh in hyperparathyroidism
why can’t IV sedation be used in myasthenia gravis pt?
BDZs contraindicated due to muscle relaxant properties
how does sucking ice improve mucositis
reduces inflammation
what can be used to reduce ulcers from chemotherapy
folic acid topical
what measurement is classed as low granulocytes
<2x10^9/l
why should you not do abdominal thrusts in infant?
may damage spleen or liver - should do chest thrusts instead
doses of adrenaline for anaphylaxis in different ages
> 12 years = 0.5ml
6-12 years = 0.25ml
6month-6year = 0.12ml
<6month = 0.05ml
dose of midazolam for epilepsy in different ages
>10ys = 10mg 5-10yrs = 7.5mg 1-5yrs = 5mg 6month-1yr = 2.5mg <6month = <2.5mg
what is clozapine + what are its dental side effects
antipsychotic drug
can cause neutropenia, oral ulceration + hyper salivation
management for TMD
reassurance + education rescue stress heat/cold pack exercises soft diet analgesia splint advanced - physiotherapy, CBT, pharmacotherapy
when may antibiotic prophylaxis be require
high risk for IE
osteoradionecrosis + MRONJ
chemotherapy if WBC <2x10^9
immunocompromised/diabetes not routine - liase
what is the ayliffe technique? when?
60 seconds hand wash
- before pt contact
- after pt contact
- before aseptic technique
- before contact with pt surroundings
- after contact with bodily fluid
which lung is inhaled foreign body likely to enter?
right
how to do chest compressions
30 compressions
rate 100-120bpm
5-6cm deep
how to cover Addisons pts for GA
hydrocortisone 100-200mg IV I hour prior or 100-200mg IV at induction + stay at double dose for 24hrs
how to cover Addisons pts for major procedures (not GA)
double dose up to 200mg hydrocortisone for 24hrs§
how to cover pts with secondary adrenal suppression
don’t normally need cover
monitor BP for >25% diastolic drop –> IV hydrocortisone 100mg
how to treat Addisons crisis
lie flat + raise legs maintain airway + O2 15ml/min ABCDE up to 200mg IV hydrocortisone sodium succinate call 999 fluid + electrolyte
heamophillia A + B factors affected
A = 8 B = 9
factors produced in liver?
2 7 9 10
what is given if life threatening INR
beriplex
how to monitor heparinised pts?
through APTT intrinsic pathway
reversal agent for heparin
protamine sulphate
how is Idiopathic thrombocytopenia treated?
high dose prednisolone to suppress autoantibody production
haemophilia cover for operation
mild = DDAVP (doesn't work for type B) mod/severe = 8/9 replacement
von willebrand disease cover for operation
DDAVP + platelet infusion
what is classed as being on long term steroids?
5mg prednisolone or equivalent for more than 3 weeks
emergency treatment for diabetic ketoacidosis
IV insulin + rehydration + electrolyte replacement
signs of acute severe asthma
inability to complete sentence in 1 breath
RR >25
tachycardia >110
signs of life threatening asthma
RR <8
cyanosis, confusion, exhaustion, decreased consciousness
what can carbamazepine cause
Steven johnson syndrome
monitor LFT, U&E, rash, sore throat, jaundice
ask about blood tests if pt taking carbamazepine
oral side effects of carbamazepine
xerostomia
glossitis
oral ulceration
cervical lymphadenopathy
oral importance of anti-muscarinic drugs used to treat Parkinson’s
xerostomia hyper salivation difficulty tolerating dentures dysphagia + chewing 'on time' 60-90mins after medication - mornings
toxic trio for child abuse
parental substance abuse
parental mental health
domestic abuse
2 genetic disorders that predispose to developing SCC
fanconi anaemia
dyskeratosis congenita
what margin needs to be removed around SCC
5mm
how does aspirin affect warfarin
displaces warfarin from protein-binding so increases concentration
how do antifungals affect warfarin
compete for metabolising enzyme, reduces clearance of warfarin so increases effect
how do NSAIDs effect methotrexate?
reduces excretion
difference between papillomas and adenomas
both are benign epithelial neoplasms
papilloma = surface epithelium neoplasm
adenoma = glandular epithelium neoplasm
cells causing neoplasms can be categorised into
epithelium
mesenchymal
both
name for malignant epithelium neoplasms
carcinomas
name for malignant mesenchymal neoplasms
sarcomas
how to name a benign mesenchymal neoplasm
with prefix
e. g. fibroma (fibrous tissue)
e. g. osteoma (bone)
syndrome associated with multiple osteomas
Gardners syndrome
medication used to treat rheumatoid arthritis
DMARDs
tell tale characteristic of TMD caused by rheumatoid arthritis compared to osteoarthritis
bilateral
how does TMD present in Ehlers danlos pt
hypermobility + luxations
