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Human Diseases > Medical emergencies dentally relevant questions > Flashcards

Medical emergencies dentally relevant questions Flashcards

1
Q

What ASA system would a dentist be expected to treat?

A

ASA 1 (healthy) to ASA 3 (severe systemic disease)

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2
Q

What are geudal airways used for?

A

Enable easier ventilation when doing ABCDE

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3
Q

How long do you listen to breathing when doing ABCDE?

A

10 seconds

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4
Q

What increase in blood volume does lying patient flat and raising legs when unconscious?

A

40% increase

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5
Q

If patient is struggling to breathe what position are they put in? and anaphylaxis exception?

A

Sat upright

Anaphylaxis - flat

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6
Q

What position should a pregnant woman be placed in a medical emergency and why?

A

Left lateral position
On right, inferior vena cava, therefore venous return will be worse
If flat, minimal venous return and will cause supine hypotension syndrome

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7
Q

In emergency anaphylaxis what should occur in dental practice?
How do the doses differ in children?

A

ABCDE
0.5ml 1:1000 sol. IM adrenaline in anterolateral thigh/ deltoid for 10 seconds
(<6months = 0.05ml, 6months-6yrs = 0.12ml, 6-12yrs = 0.25ml)
Repeat after 5 minutes if no change
Lie flat, maintain airway and give oxygen

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8
Q

How must carpal spasm and hyperventilation be managed?

A

Rebreathing exhaled air (more carbon dioxide) - using paperbag

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9
Q

What are the actions that need to be taken if an asthma attack were to occur in the dental chair?

A

ABCDE
B2-adrenoreceptor stimulant (salbutamol) inhaler via spacer
Struggling to breathe sit up
Repeat inhaler every 10 minutes

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10
Q

What is given in a suspected angina attack? and then MI?

A

GTN spray sublingual

300mg aspirin for MI - improves prognosis

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11
Q

What are the actions that need to be taken if an epileptic seizure were to occur in the dental chair?
How do the doses differ in children?

A

10mg midazolam in buccal sulcus or floor of nose
ABCDE
(<6months = 2.5mg max, 6months-1yr = 2.5mg, 1-5yrs = 5mg, 5-10yrs = 7.5mg)

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12
Q

What is the 1.conscious and 2.unconscious management of a hypoglycaemic attack?

A
  1. Oral glucose: glucogel/ 2-4tsp of sugar

1. IM/SC 1mg glucagon

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13
Q

What treatment is provided in an adrenal crisis?

A

Dentist: Put pt flat and legs up, clear airway, oxygen 15L/min
Paramedics: 200mg IV hydrocortisone, IV fluids

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14
Q

How is a MI treatment in a child carried out?

A

5 rescue breaths, 15 compressions, 2 ventilations

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15
Q

How is meningitis detected?

A

Roll tumbler and doesn’t fade

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16
Q

What are 1.shockable and 2.non shockable arrhythmia’s with an AED?

A
  1. VF, pulseless VT

2. Asystole, pulseless electrical activity

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17
Q

What is the normal amount of oxygen to give a patient in a medical emergency?

A

15L/min

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18
Q

What is impetigo and how is it treated?

A

Staphylococcus skin infection with gold encrusted highly infectious lesions
Fuscidic ointment or penicillin-based antibiotic if systemic

19
Q

What are oral signs a patient has addisons disease?

A

Adrenal hypofunction

Pigmentation in buccal mucosa/ FOM

20
Q

What is the treatment for oral lichen planus?

A

Low dose steroids

21
Q

How is CN IX palsy tested for?

A

Patient says AHHH, uvula moves to RHS = LHS problem

22
Q

What is the oral side effect of CCBs?

A

Gingival overgrowth

23
Q

What is the steroid, brown inhaler called?

A

Beclomethasone

24
Q

What homeostatic measures should be taken in a person with a bleeding disorder?

A

Local measures - sutures, oxidised cellulose

Anti-fibrinolytic agents - tranexamic acid

25
Q

What drug is used in treatment of hypothyroidism?

A

Thyroxine

26
Q

What drug is used in treatment of hyperthyroidism?

A

Carbimazole, radioiodine 131, surgery

27
Q

Name 4 types of shock.

A

Hypovolaemic, distributive, obstructive, cardiogenic

28
Q

What causes hypovolaemic shock and what treatment can be used?

A

Loss of intravascular vol. by haemorrhage, burns, GI loss

Treatment: ABCDE, identify and control bleeding, replace fluids/bloods

29
Q

What causes distributive shock and what treatment can be used?

A

Failure of vasoregulation, caused by sepsis, anaphylaxis, neuro injury
Treatment: Sepsis 6, Anaphylaxis adrenaline tx

30
Q

What causes cardiogenic shock and what treatment can be used?

A

Pump dysfunction, caused by MI, cardiomyopathy, dysrhythmia

Treatment: Revascularise if MI, correct arrhythmia

31
Q

What causes obstructive shock?

A

Physical obstruction, caused by tension pneumothorax, cardiac tamponade, pulmonary embolism

32
Q

What is the sepsis 6?

A

GIVE: oxygen, IV antibiotics, IV fluids
TEST: bloods, lactate, urine output

33
Q

What type of interaction is caused between nystatin and miconazole?

A

Renal problems - horrendous interaction causing ICU condition

34
Q

What is the positive interaction between LA and adrenaline?

A

Prolonged effect and vasoconstriction

35
Q

What LA does not contain adrenaline?

A

Mepivacaine

36
Q

What is the difference between a pharmacokinetic and pharmacodynamic interaction?

A

Pharmacokinetics - modification of drug X by drug Y, as Y alters the concentration of X reaching action site
Pharmacodynamics - Y alters X without altering concentration

37
Q

How can pharmacokinetics affect distribution? Give example drugs.

A

If drugs are highly PPB, therefore competition and if not bound very active drug.
Examples: aspirin, warfarin, carbamezapine

38
Q

Where is articaine metabolised?

A

Plamsa

39
Q

Where is prilocaine metabolised ?

A

Partly metabolised in the lungs

40
Q

What is the drug interaction of warfarin and azoles?

A

They both compete for drug metabolising enzymes in the liver (isosymes - e.g. cytochrome P450 family).
Therefore decreased clearance of warfarin and increased concentration in the blood.
Prolonged effect and increased dose dependent toxicity.

41
Q

What drug interaction happens between SSRIs and triptan?

A

Serotonin syndrome

42
Q

Why do propanolol and salbutamol interaction with each other?

A

Propanolol is a beta blocker and salbutamol is a beta agonist

43
Q

What is the interaction between NSAIDs and corticosteroids?

A

Peptic ulceration

Human Diseases (17 decks)

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