Medically Compromised Patients

Question 1

ASA I

Answer 1

Patient without systemic disease

Question 2

ASA II

Answer 2

Patient with mild systemic disease

Question 3

ASA III

Answer 3

Patient with moderate systemic disease which is limiting but not incapacitating

Question 4

ASA IV

Answer 4

Patient with incapacitating systemic disease which is a constant threat to life

Question 5

ASA V

Answer 5

Moribund patient not expected to live 24hrs unless treated

Question 6

ASA VI

Answer 6

Brain dead patient whose organs are to be removed for donor purposes

Question 7

Cardiovascular disease

Answer 7

Disease affecting blood vessels:
- Ischaemic heart disease
- Cerebrovascular disease eg stroke

Diseases affecting the heart itself
- dysrhythmias eg AF
- Valve disease
- Inflammatory disease eg endocarditis
- Cardiomyopathy
- CHD

Question 8

Ischaemic heart disease

Answer 8

Large variations
Anxiety may provoke ischaemic episode
Aspirin
Plavix
NOAC

Question 9

Infective Endocarditis

Answer 9

Infection of the lining of the heart, particularly valves caused mainly by bacteria but occasionally by other infectious agents
Morbidity 20%
NICE guidelines state that antibiotic anaphylaxis for IE is not routinely recommended for people undergoing dental treatment
Europeans recommend 2g Amoxil for all patients
NICE - 3g Amoxil/Clindamycin

Question 10

Atrial fibrillation

Answer 10

Most common dysrthymia
uncoordinated and ineffectual contractions
main issues with oral surgery due to medication eg warfarin