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medicine Flashcards

1
Q

treatment of anaphylactic shock

A
  1. Patient is flat with his legs raised
  2. Adrenaline injection SC or IM (0.5-1mg)
  3. Hydrocortisone
  4. Oxygen administration
  5. Call ambulance
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2
Q

Treatment of angioedema.

A
  1. Remove the cause
  2. Adrenaline (0.5-1mg) or tracheotomy
  3. Less severe attacks: antihistamines
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3
Q

treatment of hay fever

A
  1. Antihistamines

2. steroids in refractory cases

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4
Q

clinical manifestations of hay fever

A
  1. Itching of nose and watery nasal discharge
  2. Parpxysms of sneezing and coughing
  3. Conjunctival irritation and lacrimation
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5
Q

clinical manifestations of angioedema

A
  1. edema may begin in less than 30 mins and last up to several days (face, lips, circuoral, around the eyes, chin, tongue, nasopharynx)
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6
Q

treatment of asthma

A
  1. stop the dental procedure
  2. loosen tight clothes
  3. enure airy and cool
  4. self-medication
  5. patient is upright
  6. adrenaline
    (leukotriene)
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7
Q
  • Effect of Histamine Release:
A
  1. Increased secretions from gastric, bronchial and nasal mucosa.
  2. Vasodilatation &increased vascular permeability and edema
  3. Contraction of smooth muscle fibers (bronchi and GIT).
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8
Q

placental transfer of maternal gig or IgA from breast milk is considered what type of immunity

A

passive natural

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9
Q

killed or attenuated organisms is considered what type of immunity

A

active artificial

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10
Q

infection by living organism is considered what type of immunity

A

active natural

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11
Q

acquired immunity with rapid and immediate protection

A

passive artificial

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12
Q

transfer by injection of serum antibodies from immunized animal or human is considered what type of immunity

A

passive artificial

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13
Q

in anaphylactic shock First signs appear

A

on skin

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14
Q

Free Ag binds to IgE on mast cells and cause release of histamine and other molecules

A

Type I

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15
Q
  1. Serum sickness
  2. Rheumatoid arthritis
  3. Lupus Erythematosus
  4. Stomatitis medicamatosa
A

Type III

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16
Q
  1. Anaphylactic shock
  2. Urticaria,
  3. Asthma
  4. Hay fever
  5. Angioedema
A

Type I

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17
Q

IgM, IgG, complement, neutrophils

A

Type III

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18
Q

IgE and Mast cells

A

Type I

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19
Q
  1. Contact dermatitis
  2. Contact stomatitis
  3. Lichenoid reaction
A

Type IV

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20
Q

Free IgG or IgM Ab binds to Ag on cell membranes to cause complement activation, cell damage or phagocytosis

A

Type II

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21
Q

Ag-Ab complexes may lead to activation of complement and phagocytosis attraction leading to tissue damage as vasculitis and arthritis

A

Type III

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22
Q

IgE and Mast cells

A

Type I

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23
Q

Ag activates sensitized T-cell to release factors (lymphokines) that stimulate other leucocytes

A

Type IV

24
Q
  1. Hemolytic anemia
  2. Idiopathic thrombocytopenia
  3. Agranulocytosis
  4. Erythroblastosis Fetalis
A

Type II

25
Q

Actiated T-Helper cells, activated macrophages

A

Type IV

26
Q

IgG, IgM and complement

A

Type II

27
Q
  • Oral Manifestations of Type II Allergic Reaction
A
  1. Oral infection
  2. Hemorrhage
  3. Petechiae
  4. Pallor
  5. Atrophy of the lingual mucosa
  6. Oral ulceration
28
Q

Oral Manifestations of Type II Allergic Reaction varies depending on

A

type of the affected blood forming element:

29
Q

Oral mucosa is less liable to sensitization compared to skin due to:
Brief contact as:

A
  1. Saliva dilutes, digests & washes away allergen.

2. High vascularity of submucosa which leads to rapid absorption & dispersion of allergens.

30
Q

IL- 4,5, 6).

A
  • T-helper activates B-lymphocytes to produce antibodies
31
Q

IL-2

A
  • T-helper is required to activate cytotoxic
32
Q

etiology of lupus

A
  1. Immunologic factors: auto-antibody formation is due to hyperactive B-cells and impaired function of suppressor T-cells
  2. Infectious and environmental factors: Epstein-Barr virus, cytomegalovirus and varicella-zoster and other virus particles
  3. Endocrine factors: high incidence in women in their child-bearing years with remission during pregnancy.
  4. Genetic factors: (specifically HLA-DR2 and HLA-DR3).
33
Q

drugs with high risk to form drug induced lupus

A

proainamide

hydralazine

34
Q

ASA IV management

A

a. Elective dental care should be postponed.
b. Emergency dental care only done only to control pain and infection
c. Other treatment in the hospital e.g extraction
d. Sedation

35
Q
  1. ASA III management
A

a. Elective dental treatment is not contraindicated (with precautions or modifications)
b. Reduce stress.
c. Sedation.
d. Short early appointments

36
Q
  1. ASA II management
A

a. Routine dental treatment with minor modification.
b. Short early appointments.
c. Antibiotic prophylaxis.
d. Sedation.

37
Q

angina management

A
  1. Short morning appointments, before patient is fatigued by exertion of the day.
  2. Avoid pain and long tiring procedures. If patient complained of chest pain, procedure should be discontinued at once, and a tablet of 0.5 mg nitroglycerine is applied under the tongue, loosen restrictive garments. Assure patient and administer O2, with patient lying down.
  3. Fear reactions can be prevented by premedication e.g., diazepam (valium) 5-10 mg tablet (One hour before appointment).
  4. Local anesthesia is preferable than general anesthesia, patient with ischemic heart may not tolerate any deprivation of oxygen. It should contain a vasoconstrictor to ensure adequate anesthesia. If without V.C pain may be experienced by patient causing him to be secrete endogenous adrenaline in much larger quantities than that supplied in ampule of local anesthetic.
  5. The patient’s medication should be readily accessible on dental tray.
  6. The surgical procedure should be atraumatic as possible.
  7. Patients who are on vasodilators are frequently subjected to postural hypotension. Sudden rising from supine position → syncope. (nerfa3 el dental chair bl tadreg)
38
Q
  1. Coronary arterial bypass (CABG) management
A
  1. Avoid performing any elective therapy until 6 months post bypass
  2. Prophylactic antibiotics under physician consultation should be given for arterial bypass patients.
39
Q

Causes of heart failure:

A
  1. Hypertensive heart disease (chronic increase in work load )
  2. Hypertrophic cardiomyopathy (direct damage to myocardium )
  3. Increase body’s oxygen requirement e.g *Thyrotoxicosis (hyperthyroidism) *Anemia
40
Q

Dental management of chronic heart failure:

A
  1. Consult patient’s physician
  2. Reduce stress through premedication
  3. Short procedure
  4. Presence of thrombocytopenia (bleeding tendency) or leukopenia
  5. Prophylactic antibiotic if the patient with low white blood cell count (to avoid infection)
41
Q

Signs & Symptoms of MI

A
  1. Pain is not relieved by rest or vasodilators
  2. Nausea, vomiting and tachycardia
  3. Irregular pulse
  4. Symptoms of shock with pallor and diaphoresis (sweating)
  5. Pulmonary edema with difficulty in breathing
42
Q

Patients that are usually on anti-coagulant treatment

A

MI

43
Q

some hypertensive drugs cause

A
  1. Xerostomia
  2. Loss of taste
  3. Gingival hyperplasia
  4. Orthostatic hypotension
  5. Lichenoid drug reaction
44
Q

Dental management of RHD:

A
  1. Medical consultation
  2. Prophylactic antibiotics.
  3. Mild tranquilizers (2-5 diazepam).
  4. Short morning dental appointment.
45
Q

Risk Factors for infective endocarditis:

A
  1. Artificial heart valves
  2. A history of infective endocarditis
  3. Congenital heart valve abnormalities
  4. Congenital heart surgery in the last 6M
  5. Chronic rheumatic heart disease
  6. Poor oral hygiene
  7. Coexisting condition especially ones that suppress immunity e. g diabetes mellitus, chronic liver disease or HIV
  8. Unrepaired congenital heart defect
46
Q

Post-traumatic Neuropathic Pain Clinical features

A
  1. Anesthesia (loss in sensation)
  2. Paresthesia (a feeling of “pins and needles”)
  3. Allodynia (pain caused by a stimulus that is normally not painful)
  4. Hyperalgesia (exaggerated response to a mildly painful stimulus)
47
Q
  • Patients have a throbbing headache accompanied by generalized symptoms, including fever, malaise, and loss of appetite.
  • A serious complication in untreated patients is ischemia of the eye, which may lead to blindness.
A

Cranial arteritis

48
Q

rx Cranial arteritis

A

Systemic corticosteroids

49
Q

prodromal aura (visual flashing lights or a localized area of depressed vision (scotoma) followed by unilateral headache and nausea and vomiting

A

Classic migraine

50
Q

not preceded by an aura

A

b. Common migraine

51
Q

most common in young women, accompanied temporary blindness, vertigo and confusion

A

c. Basilar migraine

52
Q

Facial migraine type of pain

A

throbbing pain in the neck or jaws

53
Q
  • Episodes of severe unilateral stabbing head pain (patient may cry or hit objects) occurring chiefly around the eye, defect originate in hypothalamus that stimulate trigeminal and vascular system.
A

Cluster Headache

54
Q

Glossopharyngeal Neuralgia trigger zones

A

the pharynx, posterior tongue, ear. Mainly intraoral

55
Q

TMJ disorders clinical features

A
  1. Myofacial pain (pain of muscle origin on palpation including ms of mastications, shoulders, post and antro auricular)
  2. Myofacial pain with limited opening
  3. Disc displacement with clicking sound
  4. Arthalgia (pain and tenderness of joint capsule)
56
Q

Classification of TMJ disorders

A
  1. Muscle and facial disorders: Myalgia, myositis(bruxism), and muscle hypertrophy.
  2. TMJ disorders: Disc condyle incoordination, polyarthritis, open dislocation and arthralgia
  3. Disorder of mandibular mobility: Ankylosis, intracapsular adhesion, fibrosis of muscular tissue
  4. Disorders of maxilomandibular growth: Masticatory muscle hypertrophy or atrophy, and condylar hypo or hyperplasia
57
Q

Etiology of tmj disorders

A
  1. Parafunctional habits (eg, nocturnal bruxing, tooth clenching, lip or cheek biting)
  2. Emotional distress that release unreleased nervous energy in form of parafunctional habits. 3
  3. Acute trauma to the jaw
  4. Trauma from hyperextension (eg, dental procedures, oral intubations for general anesthesia, yawning)
  5. Rheumatic or musculoskeletal Disorders
  6. Unhealthy lifestyle as chewing gum or occupational tasks (such as holding the telephone between the head and shoulder)

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