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CDM 3 Exam 1 > Lecture 4 - Oral Health & Infections > Flashcards

Lecture 4 - Oral Health & Infections Flashcards

1
Q

Recurrent aphthous stomatitis (RAS)

A

canker sores

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2
Q

Risk Factors canker sores

A

Stress
local injury
non-smoker
hormonal changes
genetics
certain diseases
Vit/mineral deficiencies
non-infectious

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3
Q

signs and symptoms of canker sores

A

ulcers form on moveable parts of mouth
painful
look like craters

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4
Q

minior canker sores

A

85% incidence
usually ~ 1 lesions
none to moderate pain
< 1 cm
duration 5-7days

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5
Q

Major canker sores

A

5% incidence
2-10 lesions
none-moderate pain
0.5- 2cm
duration 7-14 days

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6
Q

Herpetiform

A

~10% incidence
multiple crops
severe pain
1-4cm
Any intraoral area no self care
duration ~60 days

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7
Q

Self-treatment exclusions ulceres

A

present > 2 weeks
Frequent recurrent
Systemic illness or other Identifiable cause of ulcers
prior unsuccessful treatment

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8
Q

Major risk factors oral cancer

A

tobacco use
Heavy alcohol drinking

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9
Q

Other risk factors for oral cancer

A

HPV infection
male
> 55yrs old
Exposure to sunlight
Poor nutrition
Immunsuppresion

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10
Q

Non-pharm canker sore treatment

A

Apply ice for 10min
Rinse warm salt water or mouthwash
apply baking soda to ulcer
Avoid exacerbating factors

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11
Q

OTC oral debriding/wound cleaners

A

Carbide peroxide or Hydrogen peroxide (each has specific directions)

MOA: release O2 to mechanically cleanse the ulcer

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12
Q

Topical oral anesthetics

A

Benzocaine products

MOA: block conduction of nerve impulses to reduce pain

use ~4 times per day

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13
Q

Precaution/warnings of topical oral anesthetics

A

hypersensitivity reactions
Can be irritating
Methemoglobinemia = V rare

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14
Q

OTC topical oral protectants

A

MOA: provide protective barrier over canker to limit friction and irritation

place over sore for 10-20sec and stays on until dissolved

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15
Q

Prevention of canker sores

A

Avoid foods that can use it
stiff toothbrush
SLS toothpaste

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16
Q

Cold sore trigger of reactivation

A

Fatigue
Windburn
Stress
Fever
Immunosuppression
Common cold
injury
UV radiation

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17
Q

Self treat exclusions of cold sore

A

> 14 days present
increasing rate of recurrence
Infection
Immunosuppression

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18
Q

non-pharm cold sore treatment

A

wash hand frequently
clean lesson with gentle soap and water
keep lesions to prevent cracking
avoid identified triggers

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19
Q

OTC cold sore option

A

Docosanol 10% (Abreva)

Only FDA approved OTC, 12yrs+
reduces severity and duration

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20
Q

Docosanol 10%

A

MOA: inhibit fusion between HSV and human cells

use 5 times per day

ADE: mild burning/stinging

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21
Q

Cold sore supplements

A

Lysine
Lemon balm
Tea tree oil = similar to acyclovir cream efficacy
Vitamin E

22
Q

Systemic antivirals

A

Acyclovir
Valacyclovir
Famciclovir

23
Q

Dosing for -clovirs

A

Initial treatment usually different than dosing for recurrence

24
Q

MOA & adjustments for -clovirs

A

MOA: inhibit viral DNA synthesis and replication

have to be renal dose adjusted

25
Q

counseling points

A

maintain hydration
start first sign of prodrone
Famciclovir contains lactose*

26
Q

Indications for chronic suppressive treatment of cold sores

A

frequent recurrence, no clear prodrome
recurrences affect quality of life
recurrences associated w/ serious systemic complication
can use episodically, such as triggeres

27
Q

Options for suppressive old sore treatment

A

Acyclovir 400mg BID
Valacyclovir 500-1000mg QD
Famciclovir 500mg BID

28
Q

Xerostomia

A

Dry mouth

29
Q

Risk factors for dry mouth

A

Medications***

anticholinergic**
TCA**
Anti-psych**
Anti-hist 1st gen**
Antihypertensive
Benzo
opioids
muscle relaxants

30
Q

Risk factors for dry mouth

A

Depression
DM
Crohns
Soren’s = most common
HIV

substance use
Hx of radiation

31
Q

prevention of caries

A

thorough brushing/flossing
use fluoride-enriched products
toothpaste w/o SLS
avoid high sugar/acid food+drink
regular dental care

32
Q

self treatment exclusions for dry mouth

A

periodontal disease
damage,decay,etc
Signs of infection
Evidence of mouth trauma
Gums bleeding w/o identifiable cause
Use dentures dont fit right

33
Q

dry mouth therapeutic lifestyle changes

A

Avoid alc, caffeine, tobacco, hard to chew food
sip water throughtday + while eating
chew sugar free gum
take suspected meds before eating

34
Q

risk factors tooth hypersensitivity

A

Erosion of enamel = brush to hard/stiff bristles
Acidic food/drink
Gum disease
Gridning teeth
whitening products

35
Q

signs & symptoms of tooth hypersensitivity

A

Sharp pain caused by temp or sugary food/drink
Varies in severity

36
Q

How does tooth hypersensitivity vary from toothache

A

toothache is not self treatable

hypersensitivity occurs in response to stimuli

37
Q

self treatment exclusions for tooth hypersensitivity

A

constant dull pain = indicative of toothache
damage or loosening of teeth
signs of infection
evidence of mouth trauma
gums bleeding w/o identifiable cause
use of dentures that dont fit correctly

38
Q

Therapeutic lifestyle changes for tooth hypersensitivity

A

avoid acid food/bev
avoid whitening toothpastes/products
Proper toothbrushing

39
Q

Desensitizing toothpaste info

A

MOA: decrease excitability of neurons in dentin (Potassium nitrate 5% active ingredient)

age 12+

takes 2-4 weeks, use instead of regular toothpaste

40
Q

viral pharyngitis

A

conjunctivitis
Rhinorrhea+cough
Oral ulcer
Hoarseness
Diarrhea
Rash

41
Q

bacterial pharyngitis

A

abrupt onset of sore throat
fever
HA
GI upset
Patch exudates
Palatal petichiae
Scarlatiniform rash
Anterior cervical adenitis
Exposure to GAS pharyngitis

42
Q

Screening Culture

A

Advantages: 90-95% sensitivity/sepcigicity

Disadvantages: 18-24hrs incubation

43
Q

Screening Rapid Antigen Detection Test

A

Advantage: immediate results

Disadvantage: 70-90% sensitivity

44
Q

Drugs to avoid for bacterial pharyngitis

A

Tetracyclines: prevalent resistance in GAS
Sulfonamides: not effective elim GAS
Fluoroquinolone: more adverse effects

45
Q

Symptoms management pharyngitis

A

Tylenol= 10-15mg/kg q4/6hrs,max 5doses/24hrs
ibuprofen = 10mg/kg (400max) q4/6hrs, max 40mg/kg or 2400mg/day

46
Q

Symptoms management pharyngitis

A

Tylenol= 10-15mg/kg q4/6hrs,max 5doses/24hrs

ibuprofen = 10mg/kg (400max) q4/6hrs, max 40mg/kg or 2400mg/day

phenol 1.4% spray = topical

Avoid aspirin

47
Q

1st line penicillin ADE

A

common: stomach discomfort, N, V
Serious: C.diff, Hypersensitivity

48
Q

1st line penicillin pt counseling

A

take w/ or w/o food
shake suspension before using
store in fridge, throw away after 14 days

49
Q

1st line amoxicillin ADE

A

Common: N/V/D, HA, rash
Serious: hypersensitivity, SJS, TEN, eryhtema multiforme

50
Q

1st line amoxicillin Pt counseling

A

Take w/ or w.o food
shake suspension before using
store in fridge, throw away after 14 days

51
Q

non-anaphylactic PCN allergy Cephalexin + cefadroxil

A

Cephalexin: common = D, serious - SJS,TEN, Hypersensitivity

Cefadroxil: Common = N/D, Serious = SJS, multiform, C.diff, hypersensitivity, thrombocytopenia

52
Q

anaphylactic PCN allergy Clinda,Clarith,Azith- thromycin

A

Clinda/Clarith = dont refridge

Azith = store room temp or fridge, discard 10 days

CDM 3 Exam 1 (10 decks)

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