Most Common... Flashcards
Neuromuscular Disease of Childhood
Pseudohypertrophic/Duchennes Muscular Dystrophy
Neurobehavioral disorder in children
ADHD
Co-morbid condition of people with developmental delay
Seizures
Type of Spina Bifida:
Occulta
Type of Cerebral Palsy
Spastic (with contractures)
Eating disorder in the US
Eating Disorder Not Otherwise Specified (EDNOS: Binge Eating)
Inherited Coagulation Disorder:
Von Willebrand Disease
Type of Hemophilia and deficiency associated:
A (Factor VIII deficiency) SIde note: Hemophilia B is factor 9 deficiency; hemophilia C is XI; Von willi is vW factor deficiency.
Genetic disorder of blood and inheritance link
Sickle cell disease, autosomal recessive
Cause of death by disease (age 1-14)
Cancer
Cause of death by leukemia
A.L.L (chemo needed, can have gingival overgrowth)
Developmental/odontogenic Cyst:
Dentigerous Cyst
Primary tumor/clinically significant odontogentic tumor of the jaws
Unicystic Ameloblastoma
Midface skeletal injury in children:
Nasal Fracture
Facial skeletal injury in hospitalized pedo patients:
Mandibular Fracture
Permanent tooth trauma:
Luxation (Mx [right] central incisors)
Surgically treatable cause of newborn Cholestasis
Biliary Atresia
Benign Salivary Gland Tumor:
Pleomorphic Adenoma
Malignant Salivary Gland Tumor:
Mucoepidermoid Carcinoma
Type of Osteogenesis Imperfecta:
Type I (associated with DI Type I)
Mass of the Soft Palate:
Squamous Papilloma (HPV 6 & 11)
Cause of Cancer Death age 1-5:
CNS and Brain tumors (especially in infants who have Ependymomas Primitive Neuruoectodermal Tumors (EPNET))
Syndrome Associated with Cleft Lip AND Palate and its inheritance linkage
Van der Woude Syndrome (median lip pits)
Autosomal Dominant
Chronic medical condition of childhood
Asthma
Syndrome associated with ONLY Cleft Palate:
Di George / VCFS (22q11.2)
Age Range for Childhood Leukemia or CNS Cancer:
1-4 years old
Cause of Hypothyroidism after age 8:
Acquired / Hashimoto’s
Cause of Acromegaly / Gigantism:
Benign Pituitary Adenoma
Syndrome with Cardiac Complications
William’s Syndrome (>70%)
“Tumor” of the Oral Cavity:
Traumatic/Irriatation Fibroma
Cause of Cancer Death ages <1 and >10 y/o
Leukemia
Oral Finding in Child with HIV
Candidiasis (Kaposi/malignt & linear gingival erythema/perio)
Most common fungal infection in children with HIV
Candida
Neural Tube Defects:
Spina Bifida / Anencephaly
Chronic Medical Condition of Childhood:
Asthma
Syndrome with an Eating Disorder
Prader Willi
Source of Sepsis in Cancer Patients:
the mouth
Common Site of Oral Lymphangioma:
tongue
Seizure type:
Tonic Clonic with convulsions
Syndrome with Taurodontism
Kleinfelter
Form of Hyperthyroid:
Graves Disease
Seizure without Convulsions:
Absence
Type of Diabetes in Children:
Type 2
Type of Ectodermal Dysplasia:
Hypohydrotic (X-Linked, Recessive)
Solid Organ Transplant in Children
Kidney and Liver (70%)
Thing associated with microglossia:
Cleft palate and congenitally missing lateral incisors
Cause for delayed eruption
Odontoma or dentigerous cyst
HPV strains causing cancer?
16 and 18
Cause of chronic periodontitis
P gingivalis
Cause of localized aggressive periodontitis?
Actinobacillus acetinomycetemcomitans
Cancer in pediatric patients 0-14 yr?
ALL, Brain and central nervous system, neuroblastoma
Cancer in adolescents (15-19)
Hodgkin lymphoma, thyroid carcinoma, brain and central nervous
Syndromes associated with periodontal disease?
Trisomy 21, Papillon levefere, chediak higashi
Trimester where women are more comfortable?
Second trimester
Medications to avoid in 1st and 3rd trimester?
Ibuprofen, naproxen (increased enterocolitis/hemorrhage)
Meds that cross placenta?
Codeine, Morphine
Cause of “ghost teeth”:
Regional odontodysplasia, caused by lack of apposition to dentin and enamel.
Bacteria that cause the most commonly seen green plaque?
Bacillus pyocaneus, aspergillus
Bacteria that cause orange plaque?
Flavobacterium, serratia marcescens
Cause of “rootless teeth”:
Dentin dysplasia type I
Thing to do after swallowing excess toothpaste? :
Administer calcium carbonate, milk, aluminum magnesium based antacids to slow down absorption.
Missing teeth:
3rds, then mand 2nd premolars, max lateral, max 2nd premolars
NPO status hours:
2 hrs: clear liquids (including fruit juices, soda, tea), 4hrs: breast milk, 6hrs (formula, light meal, milk), 8hrs fried fatty foods
Hemoglobin value:
10-20g/dL
Hematocrit percentage:
30-50%
RBC value
4-6million.mm
WBC value:
6000-10,000mm
Presentation or arnold chiari malformation:
Meninges through foramen magnum
Neutrophil absolute count and percentage:
3-5000 and 50-60%
Arch that has the most leeway space:
mandibular with 1.7-2.4 vs max 1mm space per quadrant
Test that will prolong when someone has hemophilia A,B,C, Von wilebrand:
PTT test.
INR value without anticoagulant therapy:
1
Platelet amount:
150,000-400,000 platelets per microliter
Reason why PT test would be prolonged:
liver disease, vitamin K deficiency, surgical trauma with blood loss
CHARGE syndrome:
coloboma, heart defects, atresia, retardation, growth defect, ear abnormalities
Percentage at which someone is obese:
above 95% side note: less than 5% underweight, 85-95% overweight
Things that pregnant woman may obtain orally:
perimylolysis (Erosion of lingual surfaces), and xerostomia
Splinting time for less than 60 min avulsed teeth:
2 weeks max,
SPlinting time for more than 60min avulsed:
(4-6 weeks)
Rules for a minor who is pregnant rules in regards to dental visits:
Some need consent from parent in some states prior to 18, other states allow to treat if deemed competent
immunoglobulin in saliva:
IgA (saliva)
Atopic (inflammation of skin) triad:
asthma, eczema, food allergy
Contraindications for nitrous:
MTFHR reductase mutation, 1st trimester pregnancy, bleomycin sulfate, ear infections, cobalamin b12 deficiency, Upper resp infections, cystic fibrosis, TB, sickle cell disease only absolute contraindication is lack of consent.
Reason why band and loop fail:
Cement, solder
C spine precaution
Down and arnold chiari malformation
Compressions for CPR with one person:
30:2; (with 2 ppl, 15:2)
Fatal trio:
Hypovolemia, hypoxia, hypercapnia (carbia)
Women’s pregnancy 2nd trimester
13-28 weeks
Bronchus to aspirate?:
Right, it’s straight.
Thing to do if airway obstructs?
Reposition airway first!
Way to pass on hemophilia?
X linked recessive trait
Function of monetkulast
Leuktrotriene receptor antagonist, help decrease stuffiness etc.
AD disorder that results from deficiency in functional C1 esterase inhibitor?
Hereditary angioedema
Primary immunodeficiency:
primary b cell (generally have fewer oral complications than other immunodeficiencies)
Most common syndrome associated with primary t cell immunodeficiency:
di george syndrome. 3/4th pharygeal arch maldevelopment, CP, heart issues, , more infections since thymus is hyoplasic/agenic.
Missing tooth with patients who have cleft palate/lip:
Lateral incisor on affected side most common
Most common gene linked reason for craniosynostosis syndromes?
Autosomal dominant
Explanation for acronym OMENS:
Orbital distortion, mandibular hypoplasia, ear anomalies, nerve involvement, soft tissue deficiency (craniofacial microsomia)
Side upon which microsomia defects usually seen?:
Right side
Deletion syndrome:
Velocardiofacial syndrome (occurs in 1/3 of pierre robin seq patients; tetralogy of fallot commonly seen)
Benign tumor of infancy:
Hemangioma (may need excision with skin graft, otherwise watch) (likely to regress with age, more complicated in females; PHACE syndrome, large hemangioma on face)
Leading cause of death for kids less than 1 year and between 10-19 years:
Leukemia.
Leading cause of death for kids 1-5 years old:
Especially for infants with….Primitive neuroectodermal tumors and ependymomas (PNET)
Cancer diagnosed in first year of life
neuroblastoma embryonal tumor (sympathetic nervous system malignancy)
Type of pediatric bone cancer:
Osteosarcoma (malignant) (rare under 5yr old)
Malignant bone cancer that has a 7.5x occurrence in white children
ewing sarcoma
Soft tissue sarcoma of childhood
Rhabdomyosarcoma (from CT and mesechymal cells; two types embryonal and alveolar)
Neutrophil count that causes avoidance of elective dental care
if pt has <1,000/mm3 ANC during cancer. (regular count is neutrophil count 50-60%; 3,000-5,800mm/3)
Platelet count where you should consult Dr. prior to doing dental work when pt has cancer:
<75,000mm/3
(regular platelet count 150-400,000mm/3)
Heart defect in children
Congenital heart disease
Cause of congestive heart failure:
congenital heart disease, rheumatic heart disease, cardiomyopathy, vascular malformations, severe anemia.
Bacteria that causes infective endocarditis?
Staph Aureus
IE out of subacute and acute that a pediatric pt may obtain?
Subacute (slower onset)
Reason why abx prophylaxis indicated:
Prosthetic heart valves, previous IE, congenital heart disease (unrepaired cyanotic congenital heart disease , defect repaired with device or material during first 6 months after procedure, repair with residual defects at site, cardiac transplant patients who get cardiac valvulopathy)
Reason indicated for abx SBE prior to dental procedures:
manipulation of gingival tissue, manipulation of periapical region of teeth, perforation of oral mucosa.
Way to stimulate formation of alternate form of Hb for a RBC so it doesn’t sickle?
Hydroxyurea
Reason why prothrombin time may be elevated:
Due to warfarin, liver disease, vitamin K deficiency
eason why partial thromboplastin time is elevated:
heparin, hemophilia vW disease, liver disease
Medication to manage prolonged bleeding:
DDAVP Demospressin to release more clotting factor
(One of most) Childhood infections:
Lice
Bacterial causes of orbital cellulitis:
Staph aureus or strep pneumonia
Complication after shingles VZV reactivation/chickpox is:
Postheraputic neuralgia,
Second most common sti in US:
Gonoccocal stomatitis (gonorrhoeae)
Deep throat infection in children and adolescents:
peritonsillar abscess.
Cause of death in renal disease is
cardiovascular complications (left ventricular hypertrophy, cardiac dysfunction, vascular calcification) Followed by infection and malignancy.
Inherited cause of intellectual disability is:
Frágil x syndrome
Neurobehavioral disability in kids
ADHD
Site of origin of partial seizure:
frontal/temporal lobes.
Birth defects internationally:
Ancencephaly and spina bifida
Type of spinal form of neural tube defect:
spina bifida oculta
Severe form of spinal neural tube defect :
myelomeningocele (meninges protrude as a sac through cleft in vertebrae like Arnold chiari II malformation)
Motor disability in childhood
Cerebral palsy (more common in boy African A kids).
highest mortality risk of any mental illness
eating disorders
Psychiatric disorder of childhood:.
anxiety
Thing found with hemifacial hyperplasia:
right side affected most often, abdominal tumors also seen (wilms,hepatoblastoma, adrenal cortical carcinoma)
Systemic diseases associated with apthous ulcers:
bechets disease, celiac, crohn(apthous ulcer and calcifications of the lip)
Causes of herpangina and hand foot mouth disease?
Enterovirus (coxsackie)
Inheritance pattern of lesch nyhan
(x linked condition, self mutilating behavior, absence of hypoxanthine (guanine)
Form of epidermolysis bullosa?
EB simplex, Autosomal dominant
Disease(s) with polyps:
Peutz jeghers (benign polyps intestinally, generalized pigmentation orally), gardener syndrome (MALIGNANT intestinal polyps ( AD, osteomas, supernumerary teeth).
dosages for demerol, hydroxyzine, midazolam, diazepam , chloral hydrate
1-2mg/kg max 50mg, 0.5-1mg/kg; 0.3mg-1mg/kg max 15 then 20 above 8 yr; 0.25mg/kg-0.3 max10mg; 10-50mg/kg max 1g)
dosages for reversals
REVERSAL: Flumazenil 0.01mg/kg for IV, Triple the dose for IM (0.03mg/kg), ONLY IV OR IM
o Comes in 5mL bottle (.1mg/1mL)
o Max dose: IV: 0.2mg, IM: 0.6mg (=6mL: 3mL in each deltoid/vastus lateralis);
REVERSAL: Naloxone 0.1 mg/kg (IV, IM, SM: maxillary buccal vestibule)
o Comes in 1 mL (.4mg/1mL) vials
o Max dose: 2mg which would be 5 vials, 5mL
Cause of single tooth permanent anterior crossbite
over retained primary tooth
Requirements for regendo
traumatized tooth MUST be non vital, apex 1.1mm, patient age 7-16 good health
Vital pulp therapy options
protective liner, apexogenesis (indirect pulp cap, direct pulp cap, partial pulpotomy)
Non vital pulp therapy options
Pulpectomy (endo), apexification (root end closure with paste, or MTA), apical barrier techniques, revascularization
Timeline prior to immunosuppression at which a permanent tooth should have a RCT if symptomatic?
1 week
Swelling that extends to the orbit? Beneath the mandible?
Cavernous sinus thrombosis, airway compromise/ludwig angina.
Restoration not to survive well in primary teeth?
Class IV restoration.
Scale used to assess dental trauma?
Modified glasgow coma scale (lower numbers indicated more significant injury)
Most common ‘sign’ of posterior cranial fracture and anterior cranial bone fracture?
Posterior battles sign (mastoid hematoma), anterior racoon sign (orbital hematoma)
Reason for failure of further tooth development in dental trauma?
Damage to hertwigs root sheath.
Dental trauma followup period:
1mo, 2mo, 6mo, 12 mo. (common timeline for all trauma except luxation/extrustion where followup is 2wk, 2mo, 6mo, and annually for 5 years)
Crown fracture splint time and then followup
splint permanent for 4 months; follow up in primary 1wk, 2mo; permanent 4weeks.
Med to avoid a patient with duchenne muscular dystrophy?
Succinylcholine (can cause rhabdomyolysis; also MH is a big consideration if under GA)
Principal growth cartilage of the cranial base and only one remaining active during childhood growth?
Spheno occipital
Spacing in primary teeth:
Generalized spacing (baume type 1 in 66%)
Primary terminal molar plane
Flush
Reason for premature loss of primary canine:
ectopic eruption of permanent lateral.
Associations with bilateral posterior crossbite
dolicofacial skeletal vertical growth/openbite/mouthbreathing
Protocol for dolicofacial open bite:
extraction therapy (expansion arch development for brachyfacial/deepbite)
Most commonly affected ankylosed teeth
primary first molars (lower), then upper first primary molars
Supernumerary tooth location and gender:
mesiodens, maxilla, boys 2x as often as girls.
Full Class II, End on Class II, Class III ANB angles
> 6 degrees, <6, negative ANB
Time to stop NNSH
5 years( physiologic rewards 4-6years; mechano therapy 6-10years)
Maxillary canine impaction affects:
Females 3x more than male (1%) of population
General guidelines for retention of records:
Kids 28 yrs from birth, adults 10 years.
Self reported intensity scale for kids older than 6
Visual Analogue Scale VAS
Self reported pain intensity scale for kids older than 3:
Wong baker scale.
Amide anesthetic with longest duration for pulpal and soft tissue anesthesia:
0.5% bupivicaine 1:200,000 epinephrine 340min!
Preservative in lidocaine
Bisulfate
Reaction to lidocaine overdose:
Initial excitatory reaction (inhibatory neurons depressed), then depressive reaction where you seizure, lose consciousness, heart collapse.
Opioids catalyze by cytochrome p450 cyp3a4, cyp2d6
codeine hydrocodone, oxycodone.
Ultra rapid metabolizers of codeine have a polymorphism in
liver cytochrome enzyme CYP2D6
IV rate calculation
4:2:1 rule (1st 10kg x4, 2nd 10kgx 2ml, rest of the kg x 1ml (so 25kg = 65ml/hr flow)
Recovery score chart for anesthesia
modified aldrete post anesthesia recovery score (2,1,0; 0 being the worst; need total greater than 9 for discharge)
meds use for nausea
phenegran (promethazine) max 25mg zofran (odansetron) max 4mg
doses for epi pen and epipen jr
greater than 30kg epipen (0.3mg), epipen jr (less than 30kg) .15mg
albuterol brand meds
proventil, ventolin
what med is commonly used for myocardial infarction?
aspirin (81mg per tab) for MI use 325mg immediately 4pills*
med commonly used for angina pectoris (chest pain)
nitroglycerin ,4mg sublingual tab or spray
complications when having SLE
renal complications
CLP findings in males? Females?
Males: Cleft Lip, Females: Cleft palate
Incidence of CLP in
American indiansm alaska natives, latinos, asians
Surgical management timeline for CLP
0-3months presurgical orthopedics used to narrow cleft (NAM), 3-6 mo Cheiloplasty, 10-18mo palatoplasty, 2-5 years possible lip or nose revision or second palate surgery, 6-11 years possible alveolar graft surgery, 12-18 lip revision or jaw septorhinoplasty surgeries, Adult final surgeries
embryonal tumors
dx before age 5; neuroblastoma (most common cancer dx in first year of life, wilms kidney tumor, retinoblastoma)
thing that reticuloendothelial system is responsible for
removing old or defective RBC (RES spleen liver bone marrow)
disorders of connective tissue matrix of blood vessels
marfan syndrome, ehler danlos, scurvy
meds used to prevent strokes and clots (due to abnormal clotting)
plavix (clopidrogel); coumadin warfarin (antagonized vitamin K), low molecular weight heparin levonox (binds to antithrombin and doesn’t let thrombin turn fibrinogen to fibrin), new med factor Xa inhibitor
laryngeal lesion in children
recurrent respiratory papillomatosis; can cause airway obstruction
