High Yield - OMFS Flashcards by Kevan Green

What test is needed for a patient on Warfarin/Coumadin?

INR (prothrombin time)

Should be under 3

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What is the mode of action for Warfarin/Coumadin?

Decrease K+. Needed to synthesize factors II, VII, IX, X

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T/F: The effects of Warfarin are seen immediately, and they go away abruptly upon stopping the med.

False

A few days for effect to occur. Can last up to 5 days after stopping

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What is the mode of action of heparin?

Binds to and activates antithrombin III. Leads to inactivation of thrombin, factor Xa. This interrupts fibrinogen -> fibrin.

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What is a normal INR?

1.
2-3 is desirable in Coumadin patients.
Higher equals more bleeding

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What can reverse Coumadin?

Vitamin K supplement

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T/F: An INR should be ordered for a severe alcoholic.

True

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Which test will asses platelet function?

Bleeding time.

Aspirin affects this.

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What will be the effect of inhibiting prostaglandins?

Increase gastric acid. Decrease gastric mucous

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What is a normal hematocrit (RBC) level?

Men = 45%
Women = 40%

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T/F: The INR/PT asses the extrinsic clotting pathway.

True

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T/F: PTT assesses the intrinsic clotting pathway.

True

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Pts with hemophilia A are missing what clotting factor?

Factor VIII

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T/F: Glucocorticoids are indicated for diabetic patients.

False

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Why would Sulfonylurea not be effective in Type I diabetes pts?

Sulfonylurea stimulates beta cells in pancreas to release more insulin.
Type I diabetics lack beta cells

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What type of channels do Sulfonylurea drugs bind to?

ATP-dependent K+ channels

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What is the MOA of metformin?

Decreases glucose production in liver

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Which molecule (insulin/glucagon) would cause a decrease in glycogenolysis in the liver?

Insulin.
Blood glucose high -> insulin released -> increase in glycogenesis and lipogenesis; decrease in glycogenolysis and lipogenolysis

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T/F: There is more bacteria found in gingiva of diabetic patients.

False

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What is the HbA1c for controlled diabetes?

Normal: 4-6
Increased: 7-8
Uncontrolled: >8

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T/F: Epinephrine is contraindicated in hyperthyroidism patients.

True

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What is given to an unconscious patient in hypoglycemic shock?

50% dextrose IV

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What are common symptoms of CHF?

Orthopnea (SOB when laying flat) and dyspnea (SOB when exercising)

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What is the most common reason for heart problems in kids?

Respiratory failure

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What is Digitalis and how does in work?

Cardiac glycoside. Increase CO (treat CHF). Blocks Na/K/ATPase allowing more Ca influx

What med should be avoided in patient on Ginsing?

Aspirin

What are some side effects of nitroglycerin?

Orthostatic hypotension and headaches

T/F: Patients should take nitroglycerin during a TIA.

False Angina

_____ patients have trouble inhaling, while _____ patients have trouble exhaling.

Asthma; COPD

What can occur after air is blown into the sulcus?

Soft tissue emphysema

What does a crowing sound or Stridor sound indicate?

Laryngospasm. Blockage of upper resp tract

Which pain relievers are contraindicated in asthmatics?

NSAIDs

T/F: Patient starts wheezing, it is important to give O2 as quickly as possible.

False No O2 for asthma patients

T/F: Pregnant patients should lay on left side.

True | Takes pressure off of Vena cava preventing syncope

What is the trendelenburg position?

Supine with feet slightly elevated. Used for syncope

T/F: Syncope can be treated with 100% O2.

True Except hyperventilation syndrome

What is the most common dental complication in chair?

Syncope

What medication should be given to a patient experiencing grand mal seizure?

Dilantin (phenytoin)

What drug is indicated for status epilepticus (long seizure)?

Diazepam (valium)

Pregnancy, myasthenia gravis, and acute narrow glaucoma are all contraindications for _______.

Diazepam

________ can cause seizures.

Hyponatremia

_______ has a very low risk of resp depression in regards to benzos.

diazepam

Serious drug interaction between MAO inhibitor and which opioid?

Meperidine

What are some symptoms of opioid overdose?

Hypothermia, Hypotension, miosis, respiratory depression

What is the role of an antagonist?

High affinity, no intrinsic activity

Which opiate is given as a transdermal patch?

Fentanyl

What is the reversal agent for opioids?

Naloxone

What drug is used for recovering opioid addicts?

Methadone

T/F: Mu receptors are found in the medulla.

True

What pain relievers can you give a patient with a codeine allergy?

NSAIDs, Naproxen, Meperidine, tramadol,

Why do 2nd generation antihistamines not cause drowsiness?

They do not cross the BBB. Most end in -tidine

T/F: Benedryl (diphenhydramine) causes xerostomia.

True Anticholinergic effect

T/F: H1 blockers are used for gastric ulcers.

False H1: nasal H2: gastric

T/F: Tylenol can cause liver toxicity.

True

T/F: Plavix and aspirin inhibit platelet aggregation.

True

How long after stopping will aspirins anti-coag effects continue?

7 days

T/F: Saw Palmetto enhances anti-coagulants.

True

T/F: The ceiling analgesia of Ibuprofen is reached at 400mg.

True 600mg best for anti-inflammation

T/F: Celebrex is a COX2 inhibitor that does not cause coagulation.

True

Which pain reliever is preferred in patients with kidney problems? Liver problems?

Acetaminophen is best for kidney failure. | NSAIDs better for liver failure.

Best pain med for pregnant patient?

Tylenol

T/F: Codeine is indicated in a breastfeeding mother.

False

Drugs are scheduled based on potential for _____.

abuse

Morphine, cocaine, methadone, hydrocodone, and fentanyl are all schedule ___ drugs.

Schedule 2

Codeine products with Tylenol or aspirin are schedule __ drugs.

Schedule 3

Most benzodiazepines are schedule ___ drugs.

Schedule 4

T/F: Vicodin is a schedule 2 narcotic.

False Schedule 3 Since it has less than 15mg hydrocodone

What NSAID lasts for 8 hrs?

Naproxen

What is the most difficult impaction to remove?

Mandibular distoangular

When is distraction osteogenesis preferred over normal osteotomy?

When a large advancement is needed

T/F: Arthrocentesis is considered a surgical treatment.

False

T/F: Local anesthetics have the direct effect of vasoconstriction.

False Epinephrine causes vasoconstriction. LA itself causes dilation

T/F: Lidocaine can be packaged with and without epinephrine.

True

What is the pKa of lidocaine?

7.9

What is the proper position for LA injection?

Supine. Helps prevent syncope

What is considered slow delivery of LA?

1 carp over 1 minute

What is the proper depth of insertion for PSA?

16mm. Half length of long needle.

What is the adequate amount of anesthesia for an ASA block?

1/2 carp

T/F: Lower pKA results in faster onset.

True

What are the most important factors for duration of action for LA?

Lipid solubility and protein binding. Bupivicaine is longest acting LA

T/F: Articaine has a relatively short half-life.

True

What is the first step in taking a biopsy on a soft tissue lesion deep to mucosa?

Aspirational biopsy