MED HISTORY Flashcards
Which trimester of pregnancy is the best for treatment due to reduced physiological changes in the mother and development of the baby?
second trimester
Which medical condition is the following?
- is a condition in which a patient has a low platelet count reducing their ability to clot
- it may be necessary to consult with haemotologist for a full blood count if trt plan involves anything that may cause bleeding
- should not recommend NSAIDs
- may need a secondary care referral
thrombocytopaenia
Which medical condition is the following?
- avoid ID blocks if possible
- consult with haemotologist for a full blood count if trt plan involves anything that may cause bleeding
- may need secondary care referral
- haemophilia A and B
- von willebrands disease
What is the threshold for an INR when treating a patient on warfarin?
if ≤ 4 - ok for treatment
if > 4 - refer back to haematology for adjustment
What is the dental adaptions for a treatment who has had a myocardial infarction?
no dental treatment for 3 months
What are dental adaptions for a patient with hypertension?
- knowledge of side effects of meds (e.g. gingival hyperplasia)
- limiting epinephrine to 0.04mg
What are 3 dental adaptions for patients with liver disease?
- potential for bleeding problems
- infection risk
- if liver function is impaired, LA should be used with caution
Which 4 medications may cause gingival hyperplasia?
- nifedipine
- phenytoin
- ciclosporin
- amlodipine
What are dental adaptions for patients with COPD?
- patients with COPD can suffer infectious lung diseases secondary to the aspiration of microorganisms in the presence of periodontal conditions
- macrolide abx are to be avoided
- RA sedation is contraindicated in patients with COPD
What are 2 dental adaptions for patients with asthma?
- xerostomia, oropharyngeal candidiasis and an increased presence of caries are associated with inhalers for treatment of asthma
- elective treatment should only be carried out in patients whos condition is controlled
What are 4 potential gastrointestinal dental considerations?
- dysphagia (difficulty swallowing): increased risk when using water generating equipment
- odynophagia (pain on swallowing): potentially make dental treatment uncomfortable
- indigestion, nausea or vomiting: increased risk of erosion and acid reflux
- haematemesis (vomiting blood)
What are 5 potential manifestations of neurological problems?
- any history of fits, blackouts or faints
- headache or facial pain
- disturbance in motor function or sensation
- muscle wasting, weakness
- disorders of co-ordination
What are dental considerations for patients with epilepsy?
- ensure buccal midazolam is available
- IV sedation is suggested to have anticonvulsant effects
- consider meds for possible side effects
What are dental considerations for patients with musculoskeletal conditions?
- reduced dexterity
- consider meds for possible side effects
- management considerations if taking methotrexate
What are dental considerations for patients with kidney disorders?
- renal dialysis patients are best treated the day after dialysis as renal function optimal and herparin effect has worn off
- renal transplant patients may be immune suppressed
What is the following defining?
- a recognised complication of bisphosphonate treatment, it presents as exposed bone for longer than 8 weeks in the abscence of radiotherapy treatment
osteonecrosis
What are 5 risk factors for osteonecrosis?
- local infection
- steroid use
- trauma
- chemotherapy
- periodontal disease
must be referred to rule out malignancy
Which recreational drug may exacerbate the systemic effects of adrenaline in LA?
cannabis
Which 3 recreational drugs may induce thrombocytopenia?
- amphetamines
- ectasy
- heroin
Which recreational drug increases the incidence of bruxism and TMJ dysfunction?
LSD
Which recreational drug may increase the intake of carbs?
anabolic steroids and performance enhancers
Which recreational drug increases the risk of ischaemia leading to loss of tissue and the rubbing on the gum leads to loss of gingivae and alveolar bone?
cocaine
What is a dental consideration for those who abuse solvents?
a reduction in the dose of adrenaline in LA
What are 5 contraindications for the use of NSAIDs?
- allergic reactions
- pregnancy: planning or already pregnant
- GI issues: stomach ulcers, bleeding or perforations
- heart, liver or kidney disease
- age: people over 65 have increased risk of stomach ulcers
What are 6 side effects of benzodiazepines and anti-depressants?
- xerostomia
- dry throat and lips
- soreness or burning mouth
- dysgeusia
- halitosis
- bruxism
Which medication is contraindicated in sedation patients?
benzodiazepines
