HD Flashcards by Sophie Lynch

vital signs of shock

low BP <100

high HR >100

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what type of shock is sepsis and anaphylaxis

distributive shock

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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

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what medications may pt suffering from IBD take?

corticosteroids + cyclosporin

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3 factors increasing chance of aspiration in GA

non-fasted
history of hiatus hernia
pregnancy

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side effect of omeprazole

xerostomia

also CI with warfarin

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What causes yellow pigmentation in jaundice

raised bilirubin levels

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dental relevance of jaundice

bleeding - vit k clotting factors insufficient
drug metabolism - avoid miconazole, Abs, NSAIDs
cross infection control if hepatitis
limit LA cartridges

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how to exclude haemorrhage stroke

CT scan - Aspirin given once excluded

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dental relevance of parkinsons

hypersalivation

postural drop in BP

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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

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4 causes of tonic clonic seizures

epilepsy
hypoglycaemia
trauma
vasovagal syncope

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how much buccal midazolam to treat status epilepticus

> 10 yr 10mg
5-10 yr 7.5mg
1-5 yr 5mg
6m - 1yr = 2.5mg

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onset of extradural haemorrhage

acute
lens shape on scan
MMA

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onset of subdural haemorrhage

slow onset - venous bleed

crescent shape

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how to test if rhinorrhea is CSF

contains glucose

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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

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do BCC or SCC skin cancer have most metastatic potential?

SCC

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how to differentiate cherubim from hyperparathyroidism?

with blood test - increased calcium, phosphate and PTh in hyperparathyroidism

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why can’t IV sedation be used in myasthenia gravis pt?

BDZs contraindicated due to muscle relaxant properties

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how does sucking ice improve mucositis

reduces inflammation

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what can be used to reduce ulcers from chemotherapy

folic acid topical

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what measurement is classed as low granulocytes

<2x10^9/l

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why should you not do abdominal thrusts in infant?

may damage spleen or liver - should do chest thrusts instead

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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 1. before pt contact 2. after pt contact 3. before aseptic technique 4. before contact with pt surroundings 5. 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