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Human Diseases > Neurological and special senses dentally relevant questions > Flashcards

Neurological and special senses dentally relevant questions Flashcards

1
Q

What anti-thrombotic medication is used?

A

Antiplatelet –> aspirin, clopidogrel, dipyramidamole
Antocoagulation –> wafarin
DOACs –> dabigatran, apixaban, rivaroxaban

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2
Q

What is the scale used to diagnose a stroke?

A

Rosier scale

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3
Q

What are the dental aspects to be aware of with a stroke?

A 
OH
Denture fitting problems 
Reduced airway protection, gag reflex 
Medications being taken 
Avoid adrenaline in LAs - hypertension risk
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4
Q

What are the 3 D’s of speech?

A

Dysarthia –> difficult articulating speech (slurred)
Dysphonia –> loss of voice (hoarse)
Dysphasia –> loss of cerebral language skills

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5
Q

What is the difference and parts of the brain that cause 1.receptive and 2.expressive/motor dysphasia?

A
  1. Patient can not comprehend - Wernike’s

2. Patient can not form words/sentences - Broca’s

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6
Q

What is the neurological assessment of ACVPU?

A

Rapid assessment:

  • Alert
  • Confusion (new onset)
  • Voice (response)
  • Pain (response)
  • Unresponsive
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7
Q

What is the Glasgow Coma Scale used for? and whats its scale?

A

Assess neuro condition - response with eye, response to verbal and pain
Scale from 3-15 (3 dead –> 15 fully alert)

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8
Q

What is conductive and sensory neural deafness?

A

Conductive –> air not transported through war (due to wax?)

Sensory neural –> mediated by CN VIII

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9
Q

What is the rinne test used for?

A

Can test conductive deafness when bone conduction is greater than air conduction with a vibrating tuning fork

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10
Q

What is the weber test used for and how does it work?

A

Tuning fork in the middle of the back of the head
Conductive deafness = sound same side as problem
Sensory neural deafness = sound from opposite side

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11
Q

What is Otitis externa?

A

Painful ear infection with serous discharge, can have swelling which can block ear canal

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12
Q

What is the treatment for otitis externa?

A

Gentamicin and steroid ear drops

If not working, might be fungal, therefore use anti-fungal

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13
Q

What is another name for Glue ear?

A

Otitis media

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14
Q

What is otitis media?

A

When the eustachian tube blocks (between middle ear and oropharynx) cause pain/pyrexia/hearing loss, usually from an ascending URTI, can become chronic infection with effusion

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15
Q

Why do ear infections need to be managed quickly?

A

Can track up to the brain or back to the mastoid

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16
Q

What is acoustic neuroma? and what symptoms can present?

A

Rare tumour of vestibulocochlear N

Unilateral deafness, facial palsy due to proximity to facial N

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17
Q

What dental pain can arise from earache?

A

TMD

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18
Q

How can glaucoma lead to optic N damage?

A

Increased intraocular pressure

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19
Q

How can a dentist identify temporal arteritis?

A

Patient complaining of headache and visual problems
Temporal A enlarged (especially unilateral)
MEDICAL EMERGENCY

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20
Q

What are the triad symptoms of Bechet’s disease?

A

Oral ulceration
Genital ulceration
Uveitis

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21
Q

What is the treatment of Bechet’s disease? And who should you not give this certain treatment to?

A

Immunosuppression, IV methylprednisolone, oral steroids, azathioprine, cyclosporin
Never give steroids if diabetic, osteoporosis, undiagnosed red eye

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22
Q

If patient has orbital cellulitis, what dental disease could this be caused by?

A

Could be due to sub periosteal abscess formed due to tooth infection

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23
Q

What is Ramsay hunt? What causes it? What tx?

A

Herpes zoster on the geniculate ganglion
Associated with nerve palsy and can not close eye properly
Treatment IV aciclovir

24
Q

What 5 tests can be used to test CN II?

A

Optic nerve

Visual acuity, pupillary reflexes, visual fields, colour vision, fundoscopy

25
Q

What tests can be used to test CN V?

A

Sensory - sensation in all 3 divisions

Motor - open against resistance and jaw jerk

26
Q

What tests can be used to test CN VII?

A

Motor of each branch - raise eyebrows, close eyes, puff nose
Taste
Schimer test - lacrimal test

27
Q

What tests can be used to test CN IX and X?

A 
Gag reflex 
Voice 
Cough 
Puff checks 
Swallow
28
Q

What tests can be used to test CN XI?

A

Shoulder shrug - trapezius

Head turn - SCM

29
Q

What can anti-convulsant medication treat?

A

Epilepsy
Neuralgia
Neuropathic pain

30
Q

What is the difference between generalised 1.motor and 2.non-motor epilespy?

A
  1. Body moves in own way with no control, tonic-clonic seizures (LOC, m. contract, jerk)
  2. Stop and stare or repetitive movements (e.g. lip smacking)
31
Q

What is the difference between generalised and focal epilepsy?

A

Generalised - affects both sides of the brain

Focal - develops in 1 side of the brain

32
Q

What is focal epilepsy?

A

Aware of seizure, confused, emotional changes

33
Q

What are some first line anti-convulsant drugs?

A

Phenytoin/carbamazepine –> block na and ca channels
Na valporate
Gabapetin and pregablin
BZDs

34
Q

What is status epilepticus? What is its best treatment?

A

Fits always happen, rapid firing of nerves, rapid movements

Best treatment = BZDs

35
Q

What is MoA of anti-convulsants?

A

Inhibit rapid repetitive firing that characterises seizures by inhibiting ion channels or enhancing GABA mediated neurones
Decrease neuro inflammation for pain
Decrease central trigeminal activation

36
Q

What drug is used to treat trigeminal neuralgia? and what doses are given

A

Carbamazepine
100-200mg 1/day
Then can slowly increase to TDS, max 1600mg

37
Q

What body interactions can occur with carbamazepine?

A

Steven-johnsons - rashes/ulcers
Blood dyscrasis - decreased WBC therefore decreased immunity
Liver disorder - bruising/ yellow skin

38
Q

What is the general impact of anti-convulsant drugs on dental treatment?

A

Have haematological effects: anaemia, decreased WBCs, decreased platelets
Therefore need to know if patient has normal blood tests

39
Q

What is seen in patient on phenytoin, dentally?

A

Gingival overgrowth
Root shortening/resorption
Hypercementosis
Can have teratogenic effect cleft lip and palate

40
Q

What is seen in patient on carbamezapine, dentally?

A

Xerostomia
Glossitis
Oral ulceration
Can have teratogenic effect cleft lip and palate

41
Q

What is the pathology of parkinsons disease?

A

Loss of dopaminergic neurones of substania nigra
Presence of Lewy bodies and neurites within neurones
Therefore decreased dopamine and increased ACh

42
Q

What are the effects of dopaminergic drugs on mouth and perioral structures?

A 
Dry mouth 
Taste disturbance 
Stomatitis
Oral ulceration 
Head ache 
Dyskinesias
43
Q

When to treat a patient on dopaminergic medication?

A

When patient is in ON time: medications working (treatment within 60-90 mins of meds), therefore good for dental treatment
Morning often better and shorter appointments
Not good in OFF time: medications not working, more tremor and decreased movement

44
Q

What is the dental side effect of anti-muscarinic drugs?

A

Dry mouth

45
Q

What is the function of fluoxetine?

A

Blocks serotonin reuptake, increases availability, increases mood

46
Q

What types of antipsychotic drugs are there?

A

1st and 2nd generation

47
Q

What is the drug interaction of alcohol and BZDs?

A

Increased sedation

48
Q

What is the drug interaction of erythromycin and antipsychotics?

A

Ventricular arrhythmias –> asystole –> cardiac arrest

49
Q

What is the drug interaction of SSRIs and TCAs?

A

Ventricular arrhythmias

50
Q

What is the dental relevance of patients of antipsychotics?

A

Xerostomia

Postural hypotension

51
Q

What is the MoA of antidepressants?

A

To increase monoamine

52
Q

What types of antidepressants are there?

A

SSRIs, SNRIs (selective noradrenaline), TCAs, MAOIs (monoamine oxidase inhibitors)

53
Q

What interaction occurs between SSRI and SNRI?

A

Serotonin syndrome

54
Q

What dental use can be used for SSRI?

A

Burning mouth syndrome

55
Q

What dental side effects do most antidepressants cause?

A

Postural hypotension and xerostomia

Human Diseases (17 decks)

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