human disease Flashcards
Which of the following statements regarding the resuscitation council’s recommendations of the ratio of compressions to breaths is correct?
a. 15:2 if there is 1 rescuer
b. 15:2 if there are 2 rescuers
c. 30:2 if there is 1 rescuer
d. 5:1 if there are 2 rescuers
e. aim is 200 compressions per min
C - 30:2
- aim for 100 compressions per minute
- the same regardless of the number of rescuers
A patient complains of severe chest pain whilst in the dental chair.
Which of the following is regarded as appropriate management?
a. administer glucose tablets only
b. lie the pt flat
c. lie the pt in the recovery position
d. administer IV GTN
e. give the pt oxygen
E - administer oxygen
Sublingual GTN would be the correct route of administration.
Which of the following statements regarding Down’s Syndrome is INCORRECT?
a. caused by trisomy 21
b. incidence increases with the age of the mother
c. pts suffer from microglossia
d. pts suffer from cardiac anomalies
e. pts have delayed eruption of their dentition
C - pts have microglossia
Down’s pts have MACROglossia.
A 35 year old pt has a productive cough with weight loss and drenching night sweats. A chest x-ray shows a right hilar mass with partial collapse of the upper lobe.
What is the likely diagnosis?
a. pulmonary embolus
b. pneumonia
c. TB
d. smoker’s cough
e. asthma
C - tuberculosis
A 45 year old alcoholic male is admitted with confusion, ataxia and opthalmoplegia. He is thin and wasted.
Which vitamin deficiency does he have?
a. vitamin A
b. vitamin B1 (thiamine)
c. vitamin B12
d. vitamin D
e. vitamin k
B - vitamin B1 deficiency
This pt has Wernicke’s encephalopathy (acute confusion, nystagmus, ataxia, variable opthalmoplegia) caused by thiamine deficiency.
If left untreated, will lead to irreversible neurological damage.
Which of the following statements regarding bacterial endocarditis is correct?
a. does not affect prosthetic heart valves
b. does not occur whilst using CPITN probe
c. in the uk, it is usually caused by strep viridans
d. usually responds well to a 2 week course of amoxicillin
C - usually caused by strep viridans
Which of the following statements regarding AF is correct?
a. uncommon in elderly people
b. treated with digoxin
c. does not cause fainting in elderly people
d. their is a p wave on an ECG
e. the thromboembolic risk is reduced by aspirin more than warfarin
B - treated by digoxin
- common in elderly people
- diagnosed on an ECG due to the LACK of p wave
- causes fainting in elderly people
- treated with digoxin
- warfarin is more efficacious than aspirin in reducing thromboembolic risk
Sudden onset of breath is not associated with which of the following:
a. asthma
b. emphysema
c. pulmonary embolism
d. pneumothorax
e. foreign body inhalation
B - emphysema
Emphysema is a chronic disease leading to a decrease in lung function over a period of time so therefore not presenting with acute shortness of breath.
Which of the following statements regarding jaundice is correct?
a. always accompanied by dark stools and dark urine
b. only caused by viral infections
c. associated with pain and weight gain in carcinoma of the pancreas
d. causes the alanine aminotransferase and alkaline phosphate levels to be reduced
e. can be acclaimed with post-XLA haemorrhage
E - acclaimed with post-xla haemorrhage
- can also be caused by bacterial as well as viral infections
Dysphasia is associated with which one of the following conditions?
a. lobular pneumonia
b. oesophageal carcinoma
c. hyperthyroidism
d. hypothyroidism
e. atrial fibrillation
B - oesophageal carcinoma
Oesophageal carcinoma causes progressive dysphagia and this can have a rapid onset.
(dysphagia = swallowing difficulty)
A pt with uncontrolled thyrotoxicosis is UNLIKELY to have:
a. increased sweating
b. heart block
c. resting tremor
d. lid retraction
e. diarrhoea
B - heart block
Thyrotoxicosis is likely to cause AF and increased chronotropic rate rather than heart block.
Weight gain is a feature of:
a. over treatment with steroids
b. carcinoma of the stomach
c. inflammatory bowel disease
d. thyrotoxicosis
e. chemotherapy
A - over treatment with steroids
(pts are also at risk of osteoporosis, diabetes and immunosuppression)
Pts on dialysis treatment are at risk of:
a. infections
b. malnutrition
c. bleeding diathesis
d. all of the above
e. none of the above
D - all of the above
Which of the following conditions are transplant pts NOT at risk of?
a. opportunistic infections
b. cancer
c. lymphomas
d. peptic ulcers
e. osteoporosis
D - peptic ulcers
One of the physical signs of a left lower motor neurone lesion of the 7th cranial nerve is:
a. sparing of the muscles of the forehead on the same side
b. inability to close the right eye
c. loss of power in the left muscles of mastication
d. hyperacusis if the nerve to stapedius is involved
e. decreased sensation over the left maxilla and mandible
D - hypercausis if the nerve to stapedius is involved
Which of the following regarding trigeminal neuralgia is correct?
a. pain is continuous
b. pain involves more than 1 branch of trigeminal nerve
c. there is a precise trigger point
d. dental XLA may help
e. drug of choice is a steroid
C - there is a precise trigger point
Trigeminal neuralgia is characterised by an electric shock-like shooting pain which involves 1 branch of the trigeminal nerve.
There is a trigger point or movement which precipitates the pain (e.g: cold wind, shaving)
Which of the statements regarding warfarin is true?
a. warfarin treatment for a pulmonary embolus can be interrupted safely for 1 week when dental tx is required
b. warfarin causes reduction of clotting factors II, VII, IX and X
c. its effects can be revered by protamine sulphate
d. bleeding time is the monitoring test for warfarin
e. it has a short life
B - warfarin causes reduction of clotting factors II, VII, IX and X.
- has a long half life (48-72 hrs)
- metabolised in the liver and monitored using INR
- reversal agent is vitamin K
Which of the following is not used in the treatment of anaphylaxis?
a. intramuscular adrenaline injection
b. intramuscular chlorphenamine injection
c. hydrocortisone IV injection
d. IV diazepam
e. oxygen
D - IV diazepam
Which of the following would NOT raise suspicion of physical abuse in a child?
a. skull fracture in a 6 week old baby who allegedly rolled off the bed
b. torn lingual fraenum in a 2 year old child
c. bruises of various ages over the shins of a 6 year old
d. bruises of various ages over the back and buttocks of an 8 year old
e. report by an 8 year old sibling of an excessive beating
C - bruising on shins of a 6 year old
Which of the following regarding chickenpox is INCORRECT?
a. may be contracted by contact with fluid from vesicles
b. infectious for 7 days after all vesicles have crusted over
c. potentially life threatening in children receiving cancer chemotherapy
d. encephalitis is generally benign and in most cases resolves completely
e. recognised cause of congenital malformation when the mother is affected in the first 5 months of pregnancy
B - infectious for 7 days after all vesicles have crusted over
The virus is spread by respiratory tract droplets or by contact with fluid from the vesicles - not infectious once the vesicles have dried out.
Which of the following regarding HIV in children is FALSE?
a. due to the administration of contaminated blood products
b. may present with pneumocystis pneumoniae
c. may present with neurological signs in the absence of immunodeficiency
d. more likely to present with recurrent bacterial infections than in adults
e. may be acquired by breastfeeding from an infected mother
A - mainly occurs due to the administration of contaminated blood products
Most HIV in children occurs from vertical transmission from an infected mother.
In the tx of asthma:
a. most children over 6 can use a metered dose aerosol effectively without a spacer
b. use of a regular inhaled steroid is limited by a high incidence of side effects
c. advice should be given to restrict the child’s participation in sports
d. oral corticosteroids should be reserved only for children who require hospital admission
e. regular anti-inflammatory treatment should be recommended for a child who requires a bronchodilator most days
E - regular anti-inflammatory treatment should be recommended for a child who requires a bronchodilator most days.
Frequent bronchodilator use suggests chronic asthma for which anti-inflammatory treatment would be appropriate.
A 46 year old woman presents with spider naevi, bruising, confusion and jaundice.
What would be the most appropriate diagnosis?
a. alcoholic liver disease
b. congestive heart failure
c. haemochromatosis
d. hepatitis B
e. metastatic liver disease
A - alcoholic liver disease
A 27 year old IV drug user presents with fever and abdominal pain.
What would be the most appropriate diagnosis?
a. alcoholic liver disease
b. congestive heart failure
c. haemochromatosis
d. hepatitis B
e. metastatic liver disease
D - hepatitis B
A 50 year old woman presents with pigmented skin, type 1 diabetes and raised transaminases.
What would be the most appropriate diagnosis?
a. alcoholic liver disease
b. congestive heart failure
c. haemochromatosis
d. hepatitis B
e. metastatic liver disease
C - haemochromatosis
A 50 year old woman presents with jaundice 3 years after chemotherapy for breast cancer.
What would be the most appropriate diagnosis?
a. alcoholic liver disease
b. congestive heart failure
c. haemochromatosis
d. hepatitis B
e. metastatic liver disease
E - metastatic liver disease
(cancer starting in one part of the body and spreads to the liver)
A 75 year old man presents with shortness of breath, raised jugular venous pressure and swollen legs.
What would be the most appropriate diagnosis?
a. alcoholic liver disease
b. congestive heart failure
c. haemochromatosis
d. hepatitis B
e. metastatic liver disease
B - congestive heart failure
Following oral administration of a 3g sachet of amoxicillin, a 20 year idk woman reports shortness of breath and the development of a red rash on her body.
What would the most appropriate management option be for this scenario?
a. adrenaline 1:1000 (1mg/ml)
b. adrenaline 1:10000 (1mg/10ml)
A
A 20 year old man in the waiting room is shaking involuntarily, frothing at the mouth and showing signs of incontinence.
What would the most appropriate management option be for this scenario?
Diazepam
A 57 year old woman with type 1 diabetes collapses in the dental chair and a dipstick shows low blood glucose.
What would the most appropriate management option be for this scenario?
Glucagon
(counteracts the actions of insulin top increase blood sugar levels)
Whilst being treated, a 60 year old man complains of severe central crushing chest pains which radiate down the left arm. The pain does not respond to GTN spray or oxygen.
What would the most appropriate management option be for this scenario?
Aspirin
Which of the following might make a pt more susceptible to infective endocarditis following dental tx?
a. previous history of rheumatic fever
b. presence of a pacemaker
c. congenital cardiac lesion
d. diagnosis of AF
e. heart murmur
A, C and E - history of rheumatic fever, congenital cardiac lesion and heart murmur
A pt tells you they have had hepatitis. Which of the following may be of concern when providing dental tx for them?
a. the pt will need AB cover for invasive procedures
b. increased bleeding following invasive procedures due to impaired synthesis of clotting factors
c. high risk of infective endocarditis after XLA
d. possible cross infection risk
e. impaired drug metabolism
B, D and E - increased bleeding following invasive procedures, cross infection risk and impaired drug metabolism.
(pts with liver disease are likely to have impaired clotting and drug metabolism)
Which of the following about Down’s Syndrome are true?
a. caused by trisomy 20
b. caused by trisomy 21
c. incidence increases with increasing age of the mother
d. often causes delayed teeth eruption
e. pts often have microglossia
f. pts often have congenital cardiac defects
B, C, D and F - trisomy 21, increase incidence with age, delayed tooth eruption, congenital cardiac defects.
(causes MACROglossia)
