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Oral surgery 2020 > Management of the cardiac patient > Flashcards

Management of the cardiac patient Flashcards

1
Q

In hypertension what stage usually has no contraindication to ambulatory oral surgery?

A

-Mild to moderate

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2
Q

What is the systolic and diastolic range in mild to moderate hypertension?

A
  • Systolic < 200

- Diastolic < 110

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3
Q

What is the systolic and diastolic range in severe hypertension?

A
  • Systolic > 200

- Diastolic > 110

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4
Q

What do you do if someone has severe hypertension

A

-Postpone until pressure is better controlled

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5
Q

If someone is in mild to moderate hypertension what should you do with treatment?

A

-You can do treatment

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6
Q

If someone has an acute hypertensive event with SYMPTOMS what is that known as?

A

-Hypertensive emergency

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7
Q

What are some symptoms with a hypertensive emergency?

A
  • Dizzy

- Faint

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8
Q

What are the key principles with Ischemic heart disease?

A
  • Mismatch in myocardial oxygen demand and oxygen supply

- Angina is a symptom of ischemic heart disease

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9
Q

Who does Ischemic heart disease occur in?

A
  • Men over 40

- Post menopausal women

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10
Q

What drug do you give if someone has angina?

A

-Nitroglycerin

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11
Q

What does nitroglycerin do?

A
  • Venodilation (more than vasodilation)
  • Vasodilation
  • Decreases the demand on the heart because it diminishes the preload
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12
Q

How many carpules can you give at most to a patient with angina?

A

-2 carps every 30 minutes

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13
Q

What is what Metabolic equivalent defined as?

A

-3.5 mL O2 uptake/kg per min

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14
Q

If a person answers yes to getting chest pain after walking one city block or a flight of stairs what does that mean?

A

-They have poor functional capacity

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15
Q

What is the line of MET’s for poor function capacity?

A

< 4 MET

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16
Q

What is a Myocardial infarction?

A

-Results when an oxygen supply-demand mismatch results in myocardial cell/death/ dysfunction

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17
Q

What is the difference between angina and myocardial infarction?

A

-Myocardial infarction is associated with cell death

18
Q

If a person has a myocardial infarction history how long should it be until dental treatment elective surgeries are performed?

A

6 months

19
Q

Dual antiplatelet therapy is recommended for how long following PCI (Percutaneous intervention) and stenting procedures?

A

-12 months

20
Q

What drugs are they one if doing DAPT?

A
  • Aspirin (platelets)
  • Plavix (platelets)
  • Coumadin (vitamin K dependent)
  • Xabans
21
Q

What is common in patients with history of ischemic heart disease?

A

-Cardiac Dysrhythmias

22
Q

What is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body’s needs known as?

A

-Heart Failure

23
Q

What are some of they symptoms of congestive heart failure?

A
  • Shortness of breath (due to fluid build up in the lungs)

- Coughing

24
Q

What should you do if someone has congestive heart failure?

A

-Defer treatment until heart function has been medically improved an the physician believes treatment is possible

25
Q

What are Cerebrovascular accidents?

A

-Strokes

26
Q

What are the two types of strokes?

A
  • Hemorrhagic

- Ischemic

27
Q

Which type of stroke deals with a clogged artery?

A

-Ischemic

28
Q

If a patient has had a Cerebrovascular accident (CVA) what are they at further risk for?

A

-More CVAs

29
Q

If a person has had a CVA and you take their blood pressure and it appears hypertensive what should you do?

A

-Defer treatment

30
Q

What is infective endocardititis?

A

-An infection of the heart chambers or valves

31
Q

What bacteria is a common cause of IE?

A

-Streptococcus viridans

32
Q

What are the four guidelines if someone has IE that need a prophylaxis treatment?

A
  • Prothetic cardiac valve
  • Previous IE
  • Congenital Heart Disease
  • Cardiac transplant
33
Q

What is the most common antibiotic for IE prophylaxis?

A

-Amoxicillin

34
Q

If a person is allergic to penicillin what antibiotic should you use for IE prophylaxis?

A

-Clindamycin

35
Q

What amount of amoxicillin should you provide to someone who has IE?

A
  • 2 g 30-60 minutes prior to procedure (adults)

- 50 mg/kg in children

36
Q

What amount of clindamycin should you provide to someone who has IE?

A
  • 600 mg (adults)

- 20 mg/kg

37
Q

If patients have a mechanical valve are they anti-coagulated? If so for how long?

A

-Yes and for life

38
Q

What are the four Vitamin K dependent factors?

A
  • II
  • VII
  • IX
  • X
39
Q

What is a normal INR (International normalized ratio)?

A

1

40
Q

What do you need to know if somebody is on coumadin?

A

-INR #

41
Q

What is another name for Coumadin?

A

-Warfarin

42
Q

MONA stands for what? Use this for someone who begins having severe chest pain

A
  • Morphine
  • Oxygen
  • Nitroglyercine (sublingual)
  • Aspirin

Oral surgery 2020 (14 decks)

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