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Clinical Applications II > Medical Management: Study Guide from Doc > Flashcards

Medical Management: Study Guide from Doc Flashcards

1
Q

condition associated w/ an area of damaged brain tissue

A

epilepsy

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2
Q

in epilepsy, type of seizure depends on which _______ is damaged.

A

area of the brain

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3
Q

majority of people with epilepsy develop which two types of seizures?

A

partial (focal, local), generalized (convulsive, non-convulsive)

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4
Q

how long do tonic-clonic seizures last? how long should you wait until you call EMS?

A

1-3 minutes, 10 minutes

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5
Q

what are common side effects of anticonvulsant medications?

A

gingival hyperplasia, not many other side effects

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6
Q

what is the most common anticonvulsant medication for epilepsy?

A

dilantin (phenytoin)

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7
Q

what is the cause of cerebral palsy (CP)?

A

brain damage (either prenatally, perinatally, or postnatally before CNS is fully developed)

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8
Q

characteristics of CP

A
  • paralysis
  • muscle weakness
  • lack of coordination
  • motor function disorders
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9
Q

what is the cause of multiple sclerosis (MS)?

A

unknown, most classify it as an autoimmune disease

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10
Q

possible oral findings associated with MS

A

salivary gland enlargement, poor oral hygiene

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11
Q

risk factors for caries/PD for a patient with MS?

A

high; spasticity causes issues with home care

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12
Q

what is the cause of Parkinson’s disease?

A

unknown

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13
Q

Parkinson’s disease most identifiable characteristics

A

Rhythmic tremors of extremities, slurred speech, staring, excess saliva

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14
Q

cause of rheumatoid arthritis

A

unknown, considered to be an autoimmune disease

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15
Q

clinical signs of rheumatoid arthritis

A

swollen and painful small joints of feet/hands with the overlying skin appearing shiny, red, and smooth

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16
Q

how does rheumatoid arthritis impact oral hygiene

A

Difficulty with manual dexterity

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17
Q

what is the following condition?

A

inflammation of the liver with viral/toxic origin

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18
Q

how is hepatitis B or C transmitted?

A

absorption of infective blood or saliva

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19
Q

Should local anesthetics/topical anesthetics be limited when a patient has hepatitis?

A

Yes – patients may have impaired liver function which could result in prolonged bleeding or the inability to efficiently metabolize certain drugs, including local anesthetics, topical anesthetics, and analgesics.

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20
Q

what is the difference between herpes simplex virus type 1 and type 2?

A

type 1 = oral

type 2 = genital

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21
Q

Should a dental hygienist treat a patient with a herpes simplex virus 1 outbreak?

A

No

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22
Q

Due to hormonal changes what oral implications may be present in a pregnant woman?

A

Hormonal changes create an exaggerated inflammatory response

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23
Q

One myth associated with oral health and pregnancy

A

They will develop caries and periodontitis

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24
Q

safety of dental radiographs on pregnant women is _____

A

well-documented

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25
Q

Can local anesthetics be used on pregnant women?

A

yes

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26
Q

Can Nitrous Oxide be used on pregnant women?

A

not in the first trimester; limit use in the 2nd and 3rd trimesters

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27
Q

when is the best time for providing elective dental care in pregnant women?

A

The 2nd and the first part of the 3rd are best for providing elective dental care; other than plaque control, dental care during the 1st is generally avoided unless emergency care is required. The 2nd is the safest and the first part of the 3rd the patient can still be comfortable.

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28
Q

direct cause of diabetes

A

failure of the beta cells of the pancreas to secrete an adequate amount of insulin

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29
Q

diabetes is characterized by…

A
  • hyperglycemia
  • chronic, premature macrovascular disease
  • serious microvascular disease
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30
Q

condition in which a deficient secretion of thyroid hormones resulting in a low basal metabolism.

A

hypothyroidism

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31
Q

hypothyroidism symptoms

A

mental/physical slowness, weight gain, slow pulse, dilation of the heart, weakness of muscles, dry skin and hair, and edema

32
Q

2 most common clinical signs of Grave’s disease

A
  • enlarged, highly vascular thyroid gland

- protrusion of the eyeballs (exophthalmos)

33
Q

what do you do if you have a patient with COPD?

A

place patient in an upright position in the dental chair

34
Q

what is COPD characterized by?

A

chronic labored respiration and evidence of obstructed expiratory flow

35
Q

what else can be characterized by COPD?

A

chronic bronchitis, emphysema, asthma

36
Q

what is the cause of a myocardial infarction?

A

inadequate coronary blood supply d/t occlusion of the coronary arteries by emboli or thrombi.

37
Q

symptoms of heart attack

A

sudden onset of severe substernal pain which may persist for hours. The pain may radiate to the neck and arms. Profuse sweating, pallor, rapid pulse, and low blood pressure in conjunction with severe pain

38
Q

After 4 to 6 weeks most patients with ______ myocardial infarction can receive elective dental care

A

uncomplicated

39
Q

how does angina pectoris manifest

A

brief pain in the chest

40
Q

most common drug to treat angina?

A

nitroglycerin

41
Q

what is another common name for CVA?

A

stroke

42
Q

what is the cause of a CVA?

A

a shortage of blood is supplied to the brain as a result of arteriosclerosis, hypertension, aneurysm, cerebral thrombosis, hemorrhage, embolism, or diabetes.

43
Q

If a patient had a CVA how long should elective dental treatment be postponed?

A

4-6 weeks

44
Q

is hypertension asymptomatic or symptomatic

A

asymptomatic

45
Q

uncontrolled hypertension may result in what conditions?

A

may result in heart attack, heart failure, stroke, or kidney failure.

46
Q

If BP is high, how long should you wait to take it again?

A

5 minutes

47
Q

why is it important to know that antihypertensive medications cause xerostomia?

A

Vasoconstrictors may potentially interact with some of these medications. Medications may also have an adverse effect on the patient’s gingival tissue (creating gingival hyperplasia) or their salivary flow (creating xerostomia). As a result, medications may need to be adjusted, or salivary substitutes may need to be recommended.

48
Q

Disorder where your blood doesn’t clot normally because it lacks sufficient blood clotting proteins.

A

hemophilia

49
Q

what do you do if a patient is having prolonged or hemorrhagic gingival bleeding?

A
  • Apply compression with gauze over bleeding area
  • For severe bleeding apply digital pressure on the pressure point of supplying vessel.
  • Sutures may be necessary
50
Q

a true allergic reaction includes what symptoms?

A
  • urticaria (rash) on face/neck/arms/hands

- pruritus (itching) of face/neck/arms/hands

51
Q

is urticaria a rash or itching?

A

rash

52
Q

is pruritus a rash or itching?

A

itching

53
Q

what drug should be administered if a patient is having an anaphylaxis reaction?

A

The dentist or emergency medical personnel should inject 0.5 ml of 1:1,000
epinephrine into the tongue, IM or SC

54
Q

what drug should be administered if a patient is having a mild allergic rxn?

A

Diphenhydramid Hydrochloride (Benadryl) 50 mg, orally every 6-8 hours for two days OR Chlortrimeton 4-8 mg, orally every 6-12 hours for two days.

55
Q

a chronic mental disorder characterized by thoughts and feelings that do not accurately interpret reality.

A

schizophrenia

56
Q

schizophrenic behaviors may be _________

A

hyperactive or flat

57
Q

an eating disorder characterized by self-starvation or an avoidance of eating

A

anorexia nervosa

58
Q

those with anorexia nervosa may exhibit…

A

thin hair, brittle nails, constipation, amenorrhea, extreme weight loss (self starvation), depression, hypotension, and/or low pulse rate

59
Q

condition in which patients alternate between binge eating and self-induced vomiting or purging.

A

bulimia

60
Q

oral signs of bulimia

A

a pattern of decalcification of the lingual, palatal, and posterior occlusal surfaces of the teeth; caries and dentinal hypersensitivity may also occur

61
Q

do you administer oxygen in a hyperventilation attack?

A

NO, the patient is taking in too much oxygen. breathing in a paper bag /headrest cover allows them to breathe more CO2 to balance

62
Q

in a hyperventilation attack, correct respiratory ______ by having the patient rebreathe _______ (contains increased concentration of ________)

A

alkalosis, exhaled air, carbon dioxide

63
Q

In the rare case that the above procedures fail to stop the hyperventilation attack, the dentist can administer _______

A

diazepam IV.

64
Q

if the patient and dental healthcare worker feel comfortable, can dental care be continued after hyperventilation attack?

A

yes, but if there is any question to the degree of recovery, send patient home w/ friend/relative

65
Q

what do you do in an airway obstruction?

A
  1. apply basic airway maneuvers (encourage coughing, rule out tongue obstruction)
  2. establish emergency airway using abdominal thrust (Heimlich maneuver)
66
Q

what do you do with a patient with an airway obstruction and the patient is conscious?

A

Heimlich (abdominal thrust)

67
Q

what do you do with a patient with an airway obstruction and the patient is unconscious

A
  • Pt in supine
  • open airway with head tilt-chin lift
  • place heel of 1 hand against midline of xiphoid process
  • place other hand directly on top of 1st
  • press into Pt’s abdomen with quick inward & upward thrust
  • perform 6-10 abdominal thrusts
  • open Pt’s mouth and perform a finger sweep
68
Q

did you look at the airway obstruction protocol on the study guide in the shared drive?

A

I hope so! there’s a lot of info!!

69
Q

what do you do in an asthmatic attack?

A
  • terminal dental procedure
  • place patient upright
  • perform BLS as indicated
  • administer bronchodilator. Use pt’s aerosol spray of bronchodilator medication. If attack clears, proceed w/ dental procedure or send patient home
70
Q

if several doses of aerosolized bronchodilator fail to terminate acute asthmatic episode…

A
  • administer oxygen
  • call for EMS
  • record BP, pulse, and RR
  • have dentist/emergency personnel administer parenteral bronchodilator (may required hospitalization)
71
Q

if severe asthmatic attack occurs…

A
  • do not administer sedative medications

- if parenteral bronchodilators have been administered, hospitalization may be required

72
Q

in syncope episode, place patient in _________

A

supine position with feet elevated

73
Q

providing definitive management of unconsciousness includes…

A
  • loosening tight clothes
  • administer ammonia by inhalation
  • administer atropine if bradycardia persists
  • place cold towel on forehead
  • place blankets if patient is cold
  • keep patient calm
74
Q

term for when BP falls after you stand up too fast and you feel dizzy or faint

A

orthostatic hypotension

75
Q

did you study the angina pectoris protocol?

A

I hope so! there’s about 3/4 page of information on the study guide!

76
Q

what do you do in the case of cardiac arrest?

A
  • place patient in supine position on a hard surface (floor or chair w/ board)
  • deliver single precordial thump (but only if cardiac arrest was witnessed)
  • if patient has no pulse, begin BLS

Clinical Applications II (12 decks)

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