Human Diseases L5: CVD 5 - valvular heart disease, congenital heart disease and infective endocarditis

Question 1

Q44 what is the purpose of doing multiple blood cultures for a patient suffering from infective endocarditis?

Answer 1

Multiple blood cultures will determine the causative agent responsible to help direct antimicrobial therapy.

Question 2

Q48 what antibiotic is to be used if prophylaxis is required with penicillin allergy?

Answer 2

Clindamycin capsules 300 mg

Question 3

Q6 which people require special consideration for antibiotic prophylaxis prior to invasive dental procedures?

Answer 3

Any patients with prosthetic valves.

Question 4

Q30 atrial septal defect,

ventricular septal defect,

patent ductus arteriosus,

coaction of the aorta

and tetralogy of fallout are all examples of kind of heart disease?

Answer 4

Congenital heart disease.

Question 5

Q27 what is the INR therapeutic range for people taking warfarin for disorders such as atrial fibrillation or blood clot in the leg or lungs?

Answer 5

2.0 to 3.0

Question 6

Q11 the disordered physiological processes associated with disease or injury is best defined as?

Answer 6

Pathophysiology

Question 7

Q28 what is the desired INR for patients with metal valves?

Answer 7

Usually >3

Question 8

Q42 bacterial vegetation of the heart valves results in which condition?

Answer 8

Infective endocarditis

Question 9

Q3 what is INR for a person with a mechanical valve replacement?

Answer 9

3 - 4

Question 10

Q36 patent ductus arteriosus is an abnormal connection between which arteries?

Answer 10

Aorta and the pulmonary artery.

Question 11

Q8. Which valves are most commonly affected in valvular heart disease?

Answer 11

Left sided valves, the aortic and mitral valves

Question 12

Q25 if the INR is too low, does that increase or decrease the formation of blood clots?

Answer 12

Increases

Question 13

Q21 what lifelong medication is required with a TAVI?

Answer 13

Antiplatelet therapy

Question 14

Q35 which artery undergoes increased pressure in ventricular septal defect?

Answer 14

Pulmonary artery

Question 15

Q41 The circulation of deoxygenated blood around the body is a result of which heart condition?

Answer 15

Cyanotic heart disease (cyanosis refers to a bluish colour of the skin and mucous membranes)

Question 16

Q33 patients suffering from atrial septal defect are NOT at increased risk of endocarditis why?

Answer 16

Due to the slow velocity of shunt flow.

Question 17

Q2 everyone with a valve replacement needs lifelong anticoagulation – true or false?

Answer 17

False

Question 18

Q10 the aetiology of valvular heart disease is very broad, however what is the most common cause of valvular heart disease?

Answer 18

Age -related

Question 19

Q47 what antibiotic is to be used if prophylaxis is required with no penicillin allergy?

Answer 19

Amoxicillin 3g oral powder sachet (1 sachet) 60 minutes before procedure.

Question 20

Q15 what two valve replacement options are available for surgery?

Answer 20

Biological and mechanical

Question 21

Q16 which valve replacement requires the need to take lifelong anticoagulation with warfarin?

Answer 21

Mechanical

Question 22

Q26 if the INR is too high what does that increase?

Answer 22

Increase risk of bleeding

Question 23

Q22 what risk is imposed on patients who are on warfarin and other anticoagulation drugs in dentistry?

Answer 23

Warfarin and anticoagulants impair clotting and consequently patients have an increased risk of bleeding during surgical procedures and postoperatively.

Question 24

Q5 which people are at increased risk for infectious endocarditis?

Answer 24

Anybody with an acquired valvular disease

Question 25

Q43 prolonged febrile (having or showing symptoms of a fever) illness is a symptom of which heart disease?

Answer 25

Infective endocarditis

Question 26

Q32 atrial septal defect is better known as hole in the heart. The hole is present between the right and left atrium. The hole causes a shunt of blood from which side?

Answer 26

The left atrium is under higher pressure which causes shunt of blood from left side of heart to the right.

Question 27

Q18 why do mechanical heart valves cause blood clots?

Answer 27

The mechanical heart valve is recognised as foreign, which increases adhesion of blood to the foreign material. The pieces of the valve are also hard, unlike the soft tissue of a natural valve. These pieces can tear blood cells are they pass through the valve.

Question 28

Q4 a person with an atrial septal defect should get antibiotic prophylaxis prior to dental treatment – true or false?

Answer 28

False

Question 29

Q17 having a mechanical valve increases the risk of developing what?

Answer 29

Mechanical heart valves increase the development of blood clots, which can go on to cause heart attacks and strokes.

Question 30

Q20 what is the name of the valve replacement procedure that does not require open heart surgery?

Answer 30

Transcatheter aortic valve implantation (TAVI).

Question 31

Q23 If patients on warfarin who require dental surgery have an International Normalised Ratio (INR) of below 4.0, can they receive their dental treatment without needing to stop their warfarin or adjust their dose?

Answer 31

Yes, they can

Question 32

Q45 prolonged course of intravenous antibiotics for 4 weeks or more is done to treat which valvular heart disease?

Answer 32

Infective endocarditis

Question 33

Q38 failure of closure of the patent ductus arteriosus increases the risk of what?

Answer 33

Endocarditis

Question 34

Q12 one of the pathophysiology of valvular heart disease is regurgitation, describe regurgitation?

Answer 34

Regurgitation is the name given for leaking heart valves as a result of valve integrity. This results in blood flowing backwards back into the chamber.

Question 36

Q13 one of the pathophysiology of valvular heart disease is stenosis, describe stenosis:

Answer 36

stenosis is when the vales do not open properly, causing narrowing of the valve leading to obstruction of flow. Leading to inadequate output and heart failure

Question 37

Q7. Valvular heart disease most commonly affects which side of the heart?

Answer 37

Left

Question 38

Q1 what is the most common cause of valvular heart disease?

Answer 38

Ageing

Question 39

Q9. What are the names of the valves in the right side of the heart?

Answer 39

Pulmonary valve and tricuspid valve

Question 40

Q46 special consideration of prophylaxis before a treatment should be considered when a patient has any?

Answer 40

Patients with any prosthetic valves

Question 41

Q37 which septal defect is part of foetal circulation and closes at birth?

Answer 41

patent ductus arteriosus

Question 42

Q40 in cyanotic heart disease which way is the shunt favoured?

Answer 42

Right to left

Question 43

Q14 medication is a method used to treat valvular heart disease, however it isn’t the most durable. What would be another option in treating valvular heart disease?

Answer 43

Open heart surgery valve replacement.

Question 44

Q19 do patients with biological valve replacement require lifelong anticoagulation?

Answer 44

No, may need short post op anticoagulation.

Question 45

Q31 what is a septum?

Answer 45

A partition separating two chambers, such as that between the nostrils or the chambers of the heart.

Question 46

Q29 endocarditis can occur spontaneously thus enforcing the importance in dentist monitoring which two oral conditions?

Answer 46

Dental caries and gingivitis

Question 47

Q24 The risk of thromboembolism after temporary withdrawal of warfarin therapy outweighs the risk of oral bleeding following dental surgery true or false?

Answer 47

True

Question 48

Q39 which congenital defect has a narrowing of the aorta at the embryonic ductus arteriosus?

Answer 48

Co-arctation of the aorta