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FINALS - Special Care Dentistry > Liver and renal > Flashcards

Liver and renal Flashcards

1
Q

What is liver Cirrhosis?

A
  • Chronic liver disease in which normal liver tissue is replaced by scar tissue
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2
Q

Why is a person most likely to be on Heparin?

A
  • Dialysis
  • Inhibits formation of fibrin which is involved formation of blood clots
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3
Q

What are the Liver disease?

A
  • Alcoholic liver disease
  • Liver Cirrhosis
  • Hepatitis B or C infection
  • Primary biliary cirrhosis
  • Hepatocellular carcinoma
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4
Q

What clotting factors does impaired liver function have a impact on?

A
  • Vitamin K dependent coagulation proteins
  • II, VII, IX, X
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5
Q

What is Thrombocytopenia?

A
  • AKA thrombopenia
  • Abnormally low level of platelets
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6
Q

What is thrombocythaemia?

A
  • excess platelets resulting in abnormal clotting or bleeding
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7
Q

What is the UKELD score?

A
  • United Kingdom End stage Liver disease score
  • Need a score of 49 to be considered for liver transplant
  • May impact what dental treatment we are to give and how we give it
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8
Q

What are some features of advancing liver disease?

A
  • Jaundice
  • Leukonychia
  • Clubbing
  • Palmar erythema
  • Spider naevi
  • Ascites
  • Tremors or cognitive impairment if alcohol related
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9
Q

What are the stages of liver disease?

A
  • Hepatitis
  • Liver Cirrhosis
  • Liver failure
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10
Q

What is Hepatitis?

A
  • Inflammation of the liver which may or may not be reversible depending on disease
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11
Q

What is Liver cirrhosis>

A
  • Irreversible liver necrosis and fibrosis
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12
Q

What is liver failure?

A
  • Failure of normal liver function
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13
Q

What blood tests can you request for someone who has liver disease?

A
  • FBC
  • Coagulation/clotting screen
  • INR
  • LFTS
  • Us and Es
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14
Q

What is included in the coagulation/clotting screen?

A
  • PT + ration (Prothrombin)
  • APTT + ratio (Activated partial thrombin time)
  • Thrombin time
  • TCT ratio (Thrombin clotting time)
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15
Q

What local anaesthetic would you use for pt with liver impairment?

A
  • Articaine as only 5-10% metabolised in liver and majority is metabolised in plasma
  • Decreases metabolic demand on liver
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16
Q

Why should you not prescribe NSAID’s in pt with liver impairments?

A
  • Increase bleeding risk which can result in mucosal bleeding
  • Risk of hepatorenal syndrome syndrome due to inhibition of prostaglandins which lead to decrease in renal perfusion, reduced GFR and sodium retention
17
Q

Should paracetamol be prescribed to pt with impaired liver function?

A
  • Carries risk as can be hepatotoxic
  • Risks less than NSAIDs
  • Consult hepatology team
18
Q

What are some methods available to pt in hospital setting if any dental treatment is being done which may result in bleeding?

A
  • Vitamin K replacement
  • FFP transfusion
  • +/- platelets transfusion
19
Q

Where should a pt be treated if not suited to be treated in primary care environment?

A
  • Treated in hospital associated with hepatology unit
20
Q

What hepatic condition is Strongly associated with obesity and diabetes type II

A
  • Non-alcoholic steatohepatitis / non alcoholic fatty liver disease
21
Q

What hepatic condition has circular RNA?

A
  • Hep D
22
Q

What hepatic condition is halothane responsible for?

A
  • Drug induced hepatitis
23
Q

The dane particle is found in serum of pt infected with?

A
  • Hep B
24
Q

The faeco-oral route is the main route of transmission for what hepatic condition?

A
  • Hep A
25
Q

Sofosbuvir is a treatment given to clear what virus ?

A
  • Hep C
26
Q

What does the proximal convoluted tubule do?

A
  • Actively reabsorbs glucose, amino acids, uric acid and inorganic salts
27
Q

What dose the loop of henle do?

A
  • Water leaves by osmosis
28
Q

What does the distal convoluting tubule do?

A
  • Na+ is reclaimed by active transport, with water loss by osmosis
29
Q

What does the collecting tubule do?

A
  • Surplus or waste ions and molecules flow out as urine

FINALS - Special Care Dentistry (17 decks)

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