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Patient Care > Medical History > Flashcards

Medical History Flashcards

1
Q

dx

A

diagnosis

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2
Q

hx

A

history

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3
Q

n/a

A

next appointment or not applicable

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4
Q

fm

A

full mouth

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5
Q

hbv

A

hepatitis b virus

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6
Q

hiv

A

human immunodeficiency virus

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7
Q

prn

A

as needed

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8
Q

bid

A

twice a day

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9
Q

tid

A

three times a day

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10
Q

qid

A

four times a day

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11
Q

pt

A

patient

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12
Q

rx

A

prescription

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13
Q

tmj

A

temporomandible joint

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14
Q

tb

A

tuberculosis

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15
Q

all patients get a medical history, even if you

A

appear apparently healthy

patients often don’t realize or recall the significance of this

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16
Q

what do you look for first?

A

the most common diseases

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17
Q

what do patients sometimes forget or fudge? (4)

A

oral hygiene
alcohol
smoking
drugs

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18
Q

make sure patients can understand your questions by

A

speaking at the patients level of understanding, language barriers

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19
Q

asthma

A

Is a chronic inflammatory disease of the airways characterized by reversible episodes of increased airway hyperresponsiveness resulting in recurrent episodes of dyspnea, coughing, and wheezing.

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20
Q

onset of asthma

A

sudden onset, with symptoms occurring within 10-15 minutes

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21
Q

inadequate treatment of asthma results in ER visits for about —% of patients

A

25%

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22
Q

Asthma affects —million people worldwide and accounts for 1 of every — deaths worldwide(pre-COVID)

A

300

250

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23
Q

In the US, asthma’s prevalence has more than doubled sine the 1960’s from -% to -% or greater. Affecting – million people

A

2
7
23

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24
Q

asthma is a disease primarily of

A

children

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25
Q

–% of children affected with asthma

A

10%

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26
Q

what is the most common chronic disease of children?

A

asthma

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27
Q

how many cases develop before age 10?

A

1/2

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28
Q

asthma affects -% of adults

A

6

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29
Q

do females or males have a higher rate of asthma?

A

females

although the prevalence is higher during childhood in boys

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30
Q

asthma occurs within all races, with a slightly higher prevalence among — and a lower prevalence among — than among other races or ethnic groups

A

African americans

hispanics

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31
Q

causes/triggers of asthma (5)

A

Emotional or physical stress
Allergy to foods or drugs-ingestion of nuts, shellfish, aspirin, nonsteroidal anti-inflammatory drugs (NSAID’s)
Air pollution or irritating vapors
Upper respiratory infections
Exercise induced –breathing through the mouth & inhaling colder and drier air.

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32
Q

what should you avoid for patients with asthma? (2)

A

aspirin

NSAIDs

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33
Q

aspirin causes bronchoconstriction in about –% of patients with asthma and sensitivity to aspirin occurs in – to –% of people with asthma who have pansinusitis and nasal polyps

A

10
30
40

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34
Q

if patients have triad asthmaticus, they may have a

A

very sudden and very severe asthma attack

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35
Q

asthma- no contraindication to (2)

A

nitrous oxide

valium

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36
Q

symptoms of asthma (6)

A 
chest congestion
wheezing and cough
dyspnea and tachypnea 
increased blood pressure 
anxiety and agitation
cyanosis
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37
Q

the underlying primary goal in dental management of patients with asthma is to prevent

A

an acute attack

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38
Q

Through a good medical history, the dentist should be able to determine the (2)

A

severity and stability of the disease

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39
Q

Frequency and severity of attacks, time of day attacks occur, most occur at

A

night

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40
Q

Any current or past problem with the

A

asthma attacks

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41
Q

SKIPPED

How are attacks usually

A

managed

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42
Q

Has the patient ever received emergency care for

A

an acute attack?

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43
Q

asthma prevention (5)

A

Get vaccinated for influenza and pneumonia (age appropriate)
Know your asthma triggers—smoke, exercise, animals
Take medication as prescribed
Risk assessment-through a good medical history. Severity is based on age, frequency of symptoms, impairment of lung function, and risk of attacks.
May want patient to take a puff from their inhaler prior to starting treatment.

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44
Q

management of asthma (7)

A 
Terminate procedure
Position patient-upright
Calm patient
Administer bronchodilator-Ventolin
Administer oxygen
Summon medical assistance
Administer epinephrine-Bronchodilator and antispasmodic
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45
Q

chronic complications of diabetes (8)

A 
blindness 
kidney disease 
nerve damage
amputation
cardiovascular disease (stoke, heart attack, loss of circulation in arms and legs)
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46
Q

diabetes is a chronic, — illness and a growing epidemic in the United States

A

incurable

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47
Q

According to the CDC, more than — (9.4%) million Americans have diabetes

A

30.3

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48
Q

— million Americans (23.8%) are undiagnosed.

A

7.2

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49
Q

– million are prediabetic.

A

84

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50
Q

diabetes is the — leading cause of death in the US (pre covid)

A

third

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51
Q

diabetes and age

A

Increases with age-95% are over 45 years of age

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52
Q

diabetes is the leading cause of — in the US

A

blindness

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53
Q

diabetes mellitus

A

Is a group of metabolic syndromes resulting from low levels of the hormone insulin

54
Q

diabetes mellitus is characterized by a disordered metabolism of (4)

A

carbohydrates,
lipids,
proteins

an abnormally high blood sugar level (hyperglycemia)

55
Q

the incidence of type 2 diabetes vs type 1 diabetes since 1998

A

2- more than doubles

1- remained stable

56
Q

The long-term hyperglycemia that results from DM can lead to damage of carious organs, including the (6)

A 
heart
eyes
kidneys
nervous system
vascular system
periodontium
57
Q

type 1 diabetes accounts for -% of diabetic patients

A

5%

58
Q

type 1 diabetes is more common in

A

children than cults

59
Q

what is absent in type 1 diabetes?

A

circulating insulin

60
Q

what is type 1 diabetes?

A

autoimmune destruction of the beta cells of the pancreas

61
Q

what does type 1 diabetes cause?

A

total insulin deficiency

62
Q

onset of type 1 diabetes

A

abrupt onset

63
Q

Persistent elevated blood glucose levels put persons at risk for

A

diabetes

64
Q

About –% of people with prediabetes who were followed annually developed overt diabetes each year during the average 3 years of follow-up

A

11%

65
Q

gestational

A

Any degree of abnormal glucose tolerance during pregnancy

66
Q

how prevalent is diabetes mellitus during pregnancy

A

5-7%

67
Q

obesity during pregnancy is a known

A

risk factor

68
Q

After childbirth, the mother’s glycemic control usually returns to normal, but these women have an increased risk of developing diabetes within

A

5-10 years

69
Q

Body produces high levels of blood acids called

A

ketones

70
Q

diabetic ketoacidosis develops when

A

your body can’t produce enough insulin

71
Q

Kussmaul’s respirations

A

deep and labored breathing pattern

72
Q

diabetic ketoacidosis can be trigger by (2)

A

infection or other illness

73
Q

DIABETIC KETOACIDOSIS is rare in people with

A

type 2

74
Q

DIABETIC KETOACIDOSIS glucose levels will be above

A

300 mg/dL

75
Q

hyperglycemia symptoms (7)

A 
polyuria 
polyphagia 
dry, warm skin
kussmauls respirations
fruity breath odor 
rapid, weak pulse 
altered level of conciousness
76
Q

hypoglycemia symptoms (7)

A 
pale, moist skin
weakness, dizziness
shallow respirations
headache 
altered level of conciousness
onset very sudden 
blood glucose values <50 mg/ 100 mL
77
Q

when is an appointment recommended for a patient with hypoglycemia?

A

after a meal or snack

78
Q

many patients with diabetes are recommended to eat a meal or snack every

A

4-5 hours

79
Q

common symptoms of an alert level include (4)

A

shakiness
irritability
confusion
hunger

80
Q

symptoms of severe hypoglycemias include (3)

A

loss of consciousness
seizures
coma

81
Q

management of hypoglycemia (4)

A

position the patient comfortable (ABC)
administer 100% oxygen
oral carbohydrates in conscious
medical assistance

82
Q

management of hypoglycemia if unconscious (4)

A

cake icing
50% dextrose (20-50 mL) IV
glucagon 1 mg IM or IV
epinephrine 1/1000 0.5 mg IM

83
Q

self test of blood sugar

A

perform with a blood glucose meter

tells you what your blood sugar level is at that point in time

84
Q

a1c measures

A

the average amount of sugar in your blood over the past 2-3 months

85
Q

HbA1c(Hemoglobin A1c)-monitors long term glucose control over

A

30-90 days

86
Q

If you have diabetes an ideal HbA1c level is —% or below

A

6.5

87
Q

if you are at risk of developing type 2 diabetes, your target HbA1c should be -%

A

6%

88
Q

If patient doesn’t know their A1c, test the patient with a

A

glucometer

89
Q

—mg/dL-consider deferring elective treatment or
give carbohydrates. Wait 15 minutes and retest

–mg/dL-defer elective treatment and refer to
physician

A

70

200

90
Q

Fasting (8-12 hours) Glucose Level – to – mg/dL

A

80-130

91
Q

1-2 hours after a meal-< —mg/dL

A

180

92
Q

A major goal is to prevent — — (very low blood glucose). Patient skips a meal but takes their insulin

A

insulin shock

93
Q

Patients who are treated with insulin must closely adhere to their diet. If they fail to eat in accordance with their diabetic management plan but continue to take their regular insulin injections, they may experience a

A

hypo-glycemic reaction caused by an excess of insulin.

94
Q

Reaction or shock caused by excess insulin occurs in three well-defined stages, each more

A

severe and dangerous than the one preceding.

95
Q

most common stage of insulin shock

A

mild stage

96
Q

mild stage insulin shock is characterized by (6)

A 
hunger,
weakness, 
trembling, 
tachycardia, 
pallor, and sweating; 
paraesthesias may be noted on occasion
97
Q

when might mild stage insulin shock occur? (3)

A

before meals,
during exercise,
when food has been omitted or delayed

98
Q

Because blood glucose drops substantially, the patient becomes (4); judgement and orientation are defective

A

incoherent,
uncooperative,
and sometimes belligerent
or resistant to reason or efforts at restraint

99
Q

The chief danger during moderate stage is that patients may

A

injure themselves or someone else.

100
Q

severe stage of insulin shock

A

Complete unconsciousness with or without tonic or clonic muscular movements

101
Q

Most of these reactions take place during sleep, after

A

the first two stages have gone unrecognized

102
Q

May also occur after exercise or alcohol ingestion if the earlier signs have been

A

ignored

103
Q

what may be present during serve stage insulin shock? (6)

A 
Sweating, 
pallor, 
rapid and thready pulse, 
hypotension, 
hypothermia
104
Q

how can insulin shock be corrected?

A

giving the patient sweetened fruit juice or anything with sugar in it (cake icing)

105
Q

Patients in the severe stage (unconsciousness) are best treated with an — solution; — or — may be used for transient relief.

A

Iv-glucose

glucagon or epinephrine

106
Q

treatment of diabetes mellitus (5)

A

treat uncontrolled patient only with consultation with physician
decrease insulin on day of treatment if patient will be eating less
consider chronic complications - infection
early morning appointments
good medical history

107
Q

— — is commonly seen in people with diabetes and is considered a complication of diabetes.

A

Periodontal disease

108
Q

Bidirectional — affects oral health while — affects glycemic control (increased HbA1c)

A

hyperglycemia

periodontitis

109
Q

oral complications of diabetes (7)

A

Periodontal disease is commonly seen in people with diabetes and is considered a complication of diabetes
Bidirectional-hyperglycemia affects oral health while periodontitis affects glycemic control( increased HbA1c)
Xerostomia
Increased infections and poor wound healing
Burning mouth syndrome
Increased incidence and severity of gingival inflammation
Periodontal abscess.

110
Q

allergy

A

an abnormal or hypersensitive response of the immune system to a substance introduced into the body

111
Q

it is estimated that more than –% of all Americans demonstrate an allergy to some substance

A

25%

112
Q

rapid allergy reaction (7)

A 
Rapid onset-less than one hour
Type I-true IgEmediated anaphylaxis
Antibiotics
Analgesics
Narcotics
Preservatives in anesthetics-Articaine
Venom of stinging insects
113
Q

type 1 hypersensitivity reactions are related to the humoral immune system (antibody-mediated immunity) and usually occur soon after

A

second contact with an antigen; however, many people have repeated contacts with a specific drug or material before they become allergic to it

114
Q

acute reaction involving smooth muscle of the bronchi in which antigen-IgE antibody complexes form in the surface of mast cells which causes sudden histamine release from these cells. The potential end resultis acute respiratory compromise and cardiovascular collapse.

A

Anaphylaxis

115
Q

Most anaphylaxis occur within one — of taking a medication

A

hour

116
Q

Antibiotics are the most common cause but most recently, — — have also been shown to induce

A

chemotherapy drugs

117
Q

SKIPPED

signs and symptoms of rapid allergic reaction (14)

A 
pallor
rash
itching
hives
angio-edema
hypotension
dyspnea 
GI upset
bronchospasm 
laryngeal edema
rhinorrhea
circulatory collapse
dysrhythmias 
cardiac arrest
118
Q

management of rapid allergic reaction (7)

A

position patient supine
BCLS
oxygen
minor vital
epinephrine (1/10,000) 3.0cc IV or epinephrine (1/1,000) 0.3 cc IM/SC
Benadryl: 50 mg IV or IM
obtain medical assistance and transport to hospital

119
Q

where does epinephrine get inserted

A

outer thigh

120
Q

Cost of epi pens: Mylan purchased the rights to EpiPen in 2007 and gradually raised the list price from $50.00 for a pen to — for a 2-pack

A

$800

121
Q

Shelf life of epi pens was 16 months BUT the FDA is allowing an additional - months

A

4

122
Q

The outer thigh should be used as opposed to the front of the thigh. It provides a skin area with (2)

A

thinner tissue and less fat

123
Q

Hold the auto-injector in place for - seconds

A

3

124
Q

delayed allergic reaction (6)

A 
onset greater than one hour
usually non-life threatening 
antibiotics 
analgesics
narcotics
preservatives in anesthetics
125
Q

signs and symptoms of delayed allergic reaction (5)

A 
rash
pruritus (itching)
urticaria (hives)
edema
rarely -hypotension, dyspnea, coma
126
Q

management of delayed allergic reaction (5)

A

terminate procedure
position patient based upon comfort
BCLS if indicated (usually not)
Benadryl 50 mg PO or IM q 4 h depending upon severity of symptoms
continue Benadryl for 24 hours after symptoms disappear

127
Q

about – to – % of self-reports of allergy are not true allergies

A

5-10%

128
Q

syncope after injection of a

A

local anesthetic

129
Q

nausea or vomiting (N/V), after ingestion of

A

codeine

130
Q

a family history of a reaction to a specific drug typically does not increase your chance of

A

reacting to the same drug

Patient Care (15 decks)

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