Medical History Info and Questions to ask (UDC) Flashcards
What are questions to ask if your patient has asthma?
any medications, any steroids, well controlled or not, is it worse in stressful situations, do they have their inhalers
What are patients with asthma at an increase risk of and what are the reasons for this?
oropharyngeal candidiasis and caries due to use of inhaled corticosteroids; gingivitis as oral breathers; xerostomia
What medications should be avoided for patients with asthma?
aspirin, NSAIDs, opiates
What are some common respiratory diseases?
COPD, asthma, TB, obstructive sleep apnea, cough
What are things to keep in mind if patient has COPD?
may worsen during treatment, try and treat patient in a more vertical position
What should you do if your patient has TB?
postpone all non urgent care until no longer infective, use rubber dam in urgent situations
What is obstructive sleep apnea?
critical narrowing and occlusion of airways during sleep
What questions should you ask if your patient has a cough?
how long they have had the cough, is the cough productive, do they cough up any blood
What questions should you ask your patient if they have diabetes?
have they taken their medications that morning, have they had breakfast, well controlled or not, have they eaten normally in the last 2-3 days
What should you ensure your diabetic patients have before treatment?
a sugary drink or something to eat
What questions should you ask your patient if they have epilepsy?
well controlled or not, when was their last fit, what type of fit do they have, can they tell before they fit, do their fits happen at certain times of day, what caused their last three fits, any recent changes in medication
What drug should be available in case of a medical emergency for epileptic patients?
buccal midazolam
What questions should you ask your patient if they have hypertension?
what is their blood pressure, well controlled or not, what medication are they on
What should you do if your patient’s hypertension is over 160/100mmHg?
consider postponing treatment until better controlled
What should you do if your patient has had an MI within the last 3 months?
no treatment
What should you do if your patient has had an MI within the last 6 months?
no general anaesthetic
What questions should you ask if your patient has angina?
how often are the attacks, what starts them, how effective GTN is, do they have GTN with them
What questions should you ask if your patient has had a stroke?
does it affect their mobility, does it affect their ability to swallow, does it affect their ability to carry out good oral hygiene
What should you do if your patient has hepatitis/jaundice?
coagulation screen and full blood count, liver function test
What should you be aware of if your patient has hepatitis/jaundice?
potential for bleeding problems, increased infection risk, use LA with caution if liver function is impaired
When should you try and treat patients that undergo dialysis? Why?
the day after treatment as renal function is optimal and heparin effect has worn off
What should you be aware of in patients that have undergone a kidney transplant?
may be immunosuppressed, increased risk of oral infection, increased risk of skin cancer
Which injections can you not give if patient has Haemophilia A or B? why?
IDB or lingual infiltration as risk of bleeding into muscles
What can be indications of haemorrhagic diseases or blood abnormalities?
bruises, haematomas, multiple skin purpura, petechiae, swollen joints
What can be an indicator of leukaemia?
impaired liver function and spontaneous gingival bleeding
At what stage of pregnancy is the optimal time for treatment?
second trimester
What gastro intestinal diseases can manifest as glossitis?
anaemias, vitamin B deficiency, infections
What gastro intestinal diseases can manifest with oral ulceration, mucosal swelling, cobblestone mucosa, mucogingivitis?
IBS, Crohn’s, Ulcerative Colitis
What conditions can be indicated with irreversible dental erosion?
gastric reflux, bulimia, anorexia
What effect can cannabis have on the whole body?
exacerbation of the systemic effects of adrenaline
Which recreational drugs can cause thrombocytopenia?
heroin, cocaine, amphetamines, ecstasy
Do heroin addicts have a higher or lower pain threshold?
lower
What is there an increased risk of for a patient that has taken cocaine?
risk of cardiac arrest if LA is used during treatment due to sympathomimetic effect
What is there an increased incidence of for patients that have taken LSD?
bruxism, panic attacks in stressful situations
What is there an increased risk of for patients that abuse solvents?
convulsions and status epilepticus
What should you do for patients that abuse solvents regarding LA?
reduce adrenaline dose
What is an issue that can occur for patients that use anabolic steroids?
poor blood clotting
What is a common drug that interacts with metronidazole?
warfarin
What are some common antibiotics that interact with warfarin?
penicilins, fluconazole, miconazole, cephalosporins, tetracyclines
