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Dental Management of the Medically Complex Patient > Midterm > Flashcards

Midterm Flashcards

1
Q

Label the efferent arteriole

A
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2
Q

Ang II mediated vasoconstriction is a regulatory mechanism that acts on:

A

efferent arteriole

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3
Q

Vasoreactive (myogenic) reflex acts on the:

A

afferent arteriole

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4
Q

Bilateral Pelvoureteral obstruction is an example of what type of renal failure?

A

Post- renal

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5
Q

Hypovolemia, decreased cardiac output, decreased effective circulating volume (CHF, Liver failure), impaired renal autoregulation, (NSAIDS, ACE1-ARB, & Cyclosporine) would all cause what type of renal failure?

A

pre-renal failure

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6
Q

What is NOT a risk factor for chronic kidney disease?

A

Dementia

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7
Q

Causes of chronic kidney diseases include:

A
  1. chronic glomerulonerphritis
  2. Systemic lupus erythmatosus
  3. Neoplasms
  4. Polycystic kidney disease
  5. AIDS nephropathy
  6. Diabetic nephropathy
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8
Q

Risk factors for chronic kidney disease include:

A
  1. Age (greater than or equal to 60)
  2. Smoking
  3. Obesity
  4. HTN (poorly controlled)
  5. DM
  6. Nephrotoxins/drugs
  7. Infections
  8. Low birth weight
  9. chronic inflammation
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9
Q

Results of RIGHT sided heart failure include:

A
  1. pulmonary edema
  2. coughing
  3. peripheral edema (arms + legs)
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10
Q

Results of LEFT sided heart failure:

A
  1. effects all organ systems
  2. decrease kidney function (leads to fluid retention)
  3. pulmonary edema
  4. coughing
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11
Q

Which ventricle typically fails first in heart failure?

A

left

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12
Q

What does the ejection fraction measure?

A

amount of blood pumped out / amount of blood in chamber

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13
Q

What is a normal ejection fraction?

A

55-70%

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14
Q

What is considered severely below normal in regards to EF?

A

Less than 35%

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15
Q

Reduced left ventricular EF:

A

systolic heart failure

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16
Q

Heart failure with NORMAL left ventricular EF:

A

diastolic heart failure

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17
Q

Signs of heart failure include:

A
  1. rapid, shallow breathing
  2. inspiratory rales (crackles)
  3. increased HR
  4. distended jugular veins
  5. peripheral edema
  6. ascites
  7. cyanosis
  8. weight gain
  9. clubbing of fingers
18
Q

Symptoms of heart failure include:

A
  1. fatigue and weakness
  2. orthropnea (SOB in recumbent position)
  3. exercise intolerance
  4. muscle fatigue
  5. weight gain
  6. GI distress (nausea, constipation, vomiting)
19
Q

Therapy for STAGE A heart failure:

A

ACE inhibitor or ARB

20
Q

Therapy for STAGE B heart failure:

A

ACE inhibitors, ARBs, and Beta Blockers

21
Q

Therapy for STAGE C heart failure:

A

ACE inhibitors, Beta blocker, Diuretics for fluid retention

22
Q

LVAD is considered:

A

intermediate therapy

23
Q

Signs of valvular heart disease include:

A
  1. murmurs
  2. syncope
  3. HF
  4. SOB
24
Q

Symptoms of valvular heart disease include:

A
  1. HF
  2. exercise intolerance
  3. SOB
25
Q

Procedures that do NOT require antibiotic prophylaxis with IE:

A
  1. anesthetic injection
  2. radiographic imaging
  3. placement of removable prosthodontic prosthesis
  4. placement of removable ortho appliances & brackets
  5. exfoliation of primary dentition
  6. bleeding of lip or oral mucosa trauma
  7. simple impressions
  8. optical scans
26
Q

What is the antibiotic of choice for infective endocarditis if a patient is allergic to PCN?

A

Azithromycin (or clindamycin)

27
Q

What is NOT approved by the AHA for antibiotic prophylaxis?

A

Cephalexin

28
Q

What do you give patient allergic to PCN to take orally?

A

Azithromycin (clindamycin)

29
Q

Example of a reaction with a true allergy:

A

rash
itching
angioedema

30
Q

Chest pain at rest:

A

unstable angina

31
Q

Role of the macula densa:

A

glomerular BP

32
Q

What organ system is responsible for finger clubbing?

A

cardiovascular

33
Q

Which of the following shows immunity for hep B?

A

anti-Hbs

34
Q

Endocrine etiology of secondary hypertension?

A

increased catecholamines

35
Q

What is produced in the adrenal cortex?

A

cortisol, androgens, aldosterone

36
Q

Norepinephrine is produced in the:

A

medulla (catecholamines produced in the adrenal medulla)

37
Q

Hepatic encephalopathy is associated with:

A

asterixis

38
Q

What causes the poor wound healing seen in diabetics/

A

impaired angiogenesis & cytokines

39
Q

Microvascular changes:

A

blindness & bladder probs

40
Q
A

Dental Management of the Medically Complex Patient (5 decks)

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