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Paediatrics > Medical conditions > Flashcards

Medical conditions Flashcards

1
Q

Aetiology of cardiac conditions in children

A

Maternal rubella
Maternal diabetes
Maternal drugs – alcohol, phenytoin
Foetal chromosomal abnormality- Down syndrome
Foetal inborn errors of metabolism and connective tissue disorder-Williams syndrome

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2
Q

name examples of cardiac conditions (congenital heart defects)

A

tetralogy of fallot
ASD/VSD
transposition of great arteries
CoA

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3
Q

important aspects of dental treatment in cardio disease

A

OH
nice guidelines
consult cardiologist if issues
anticoagulants/antiplts

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4
Q

down’s syndrome -
clinical features
impact

A

congenital heart lesions
atlantoaxial instability
umbilical hernia/rib abscence
immunological defects - periodontal disease
increased chance of alzheimers/hypothyroidism
Acute lymphoblastic leukaemia (20x)
-social development, motor skills, memory skills, speech and language, learning disability.

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5
Q

down’s syndrome - oral manifestation

A 
high palate, CLP common
small mouth - open lip posture
macroglossia - fissured tongue
hypodontia - microdontia, delayed eruption, hypoplasia
bifid uvula
increased risk of periodontal disease - white cell chemotaxis deficiency
thick, dry fissured lips
AOB, class III, posterior crossbite
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6
Q

dental management of down syndrome

A

prevention - OHI (CHD importance), fluoride use, treat under LA if poss, CHX for perio disease

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7
Q

asthma - drugs

beta2 agonists

A

bronchodilators -
salbutamol (Blue) - short acting b2 agonist, quick onset (2-3min) last4-6hr
for acute bronchial constriction - oral/inh/iv

Salmeterol (green?) - long acting b2 agonist, slow onset (1-2hr), last 12-15hr
prevent acute bronchial constriction
ALWAYS with inh steroid

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8
Q

asthma drugs - anticholinergics

A

Ipratropium (grey)
inhibit muscarinic nerve transmissionin autonomic n
reduce mucous secretion and encourage bronchodiliation

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9
Q

asthma drugs - corticosteroids

-compound prep

A 
reduce inflammation of bronchilal walls
beclomethasone (brown)
budesonide (brown)
flutisocone (orange)
mometasone (pink)
-compound prep = inh steroid and long acting B2 agon
- seritide (fluticosone/salmeterol)
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10
Q

asthma treatment order

A 
1. occasional b2 agonist
2 low dose inh steroid
3 high dose inh steroid
4 long acting b2 agonist/antimuscarinic
5 oral steroid
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11
Q

cystic fibrosis

who

A

1 in 2500 births. Autosomal recessive
affects EXOCRINE system - thick mucous produced and lack of pancreatic lipase - malabsorption
diabetes and liver cirrhosis
recurrent chest infections

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12
Q

oral manifestations of cystic fibrosis

dental implications

A 
thickened saliva
reduced caries (high ammonia in saliva)
greater calculus levels
lower plaque and gingival disease
enamel defects and delayed eruption
-GA risk, resp failure, high sugar intake (large energy diet), diabetes and liver disease
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13
Q

chemotherapy side effects

-acute oral complications

A

bone marrow suppression - immunocompromised
anorexia
nausea and vomiting
alopecia
-gingival bleeding / halitosis / taste disturbance / dysphagia / trismus / tooth mobility / paraesthesia
-infection risk

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14
Q

what is mucocitis and how is it treated

A

oral ulceration of mucosa - painful (stomatitis to burning and ulceration)
mucocitis localised to oropharynx

treatment - sodium bicarbonate every 2hr
gelclair (2hr)
biotene mw - (2hr)
DIFFLAM (mw/spray) 2hr
lignocaine application
benzocaine flavoured gel
orabase with/out corticosteroid
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15
Q

biotene mw - how do they work

A

Moisturises oral mucosal cells
Antibacterial effect of proteins
Reinforces antibacterial activity of saliva
Contains Xylitol which inhibits bacteria
Triple enzyme formula: lysozyme;
lactoperoxidase; lactoferrin.
Contains fluoride, glucose oxidase, aloe vera

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16
Q

renal failure - oral findings

A 
Excessive plaque accumulation
Gingivitis & bleeding
Gingival overgrowth
Enamel hypoplasia
Some develop periodontitis
Osseous changes
Pulp obliteration
Pallour, petechiae, ecchymosis
Uraemic stomatitis
Reduced caries
17
Q

dental considerations for renal failure

A

Bleeding tendencies and haemostasis
Treatment: day after dialysis
Infections can be poorly controlled
Signs of inflammation can be masked
Increased risk blood borne viral infections
Osseous lesions may be seen jaws; lamina dura thinning, osteolytic lesions, giant cell lesions

  • antimicrobials - give lower doses of penicillin’s (except flucloxacillin & phenoxymethyl pen), metronidazole and cephaloridine to avoid toxicity CNS
18
Q

diabetes mellitus symps/signs

-undiagnosed features

A 
polyuria/polydipsia/tired/recent weight loss
weakness/fatigue/mental confusion/acetone breath
-
Vomiting, nausea, abdominal pain
Renal dysfunction
Hyperventilation – metabolic acidosis
Dehydration
Hypovolaemia
Pasasthesia(extremities)
Dysaesthesia
Gastrointestinal neuropathy
Muscle wasting
Shock
Coma
19
Q

oral manifestations of diabetes mellitus

A 
Reduced salivary flow
Xerostomia
Burning mouth/tongue
Candidal infection
Altered taste
Progressive periodontitis
Dental caries
Oral neuropathies
Parotid enlargement
Sialosis
Delayed wound healing
20
Q

diabetic hypo coma features

A 
Mood change, irritability
Strong bounding pulse
Nausea and stomach ache
Hunger
Shaking, tingling around mouth
Increased gastric motility
Hypothermia
•Disorientation
•blurred vision
•Lethargy
•slurred speech
•Sweaty skin
21
Q

diabetic hyper coma features

A 
Weak pulse
Rapid deep breathing (Kussmaul’s respiration)
Dry skin
Acetone breath
Increased frequency of micturition (to want to urinate)
Thirst
Severe hypotension
Abdominal pain and vomiting
Loss of consciousness (diabetic coma)
22
Q

Asthma intra-oral features

A
  • acidic inhalers: wear?
  • dry mouth: caries risk
  • gastric reflux: cough/laxity of lower oesophageal sphincter
23
Q

Renal Failure/disease intra-oral features

A
  • excessive plaque accumulation
  • gingivitis/bleeding
  • gingival hyperplasia
  • enamel hypoplasia
  • pulp obliteration
  • ecchymosis/pallour
  • reduced caries
24
Q

Dental considerations for Renal failure

-when to treat

A
  • bleeding tendency/haemostasis
  • poorly controlled inf
  • > risk of BBVs
  • Inh sedation is OK but IV sedation has a risk of thrombophlebitis
  • TREAT DAY AFTER DIALYSIS
25
Q

Renal failure & antibiotics: considerations

A
  • NEUROTOXICITY
  • lower doses of penicillin
  • contact renal consultant
26
Q

Renal transplant considerations

-CVS/GIT/Bone disease

A

LIFELONG IMMUNOSUPPRESSION!

  • anaema/platelet dysfunction
  • GIT: gastritis/peptic ulcer
  • CVS: hypertension/atherosclerosis/MI/heart failure
  • bone: low calcium/elevated PTH/high phospurus
27
Q

what can corticosteroids cause in Renal failure patients

A

-SCLEROTIC PULP CANALS

Paediatrics (8 decks)

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