Neurology Flashcards
what is the difficulties in treating someone with dementia
capacity to consent
co-operation for treatment
treatment planning
what are the types of dementia
alzheimers
vascular
dementia with lewy bodies
korsakoff’s syndrome
what is dementia
chronic organic brain disease which is progressive and causes loss of cognitive and motor functions
what is the first stage presentation of dementia
memory loss, disorientation in time and place, judgement impaired
what is the second stage presentation of dementia
loss of intellect, aphasia, inability to clothe or feed oneself, acquired defects of visual - spatial skill
what is the third stage presentation of dementia
apathy, inability to communicate, anxiety, depression, absolute dependence
how would you take a history and perform an exam on a dementia patient
ask patient if they can tell you why they are there or anything about their own history
ask whoever they are with/carer
do the exam however is most comfortable with the patient
what are some signs that someone might be in pain
holding face
pulling at face
eating normally
altered sleeping pattern
exhibiting abnormal/changes in behaviour
what are the possible causes of an ulcer
trauma
medications - Fe tablets, aspirin
oral cancer
viral
stress related
what would cracked labial commissures suggest
angular cheilitis
what is the cause of angular cheilitis
fungal/bacterial and role of OVD
how do you manage angular cheilitis
improve OVD and give topical antifungal
how do you manage dry mouth
hydration, saliva substitutes, saliva orthana, biotene
how do you manage erythematous candidosis
good denture and oral hygiene
disrupt biofilm by cleaning palate and denture
chlorhexidine
consider topical therapy - miconazole
systemic agent - last option
what programme is in place to help oral hygiene in the care homes
caring for smiles
are there any concerns to about preventative measures of oral hygiene when giving them to dementia patients
many cannot provide self care so care home has to do it
what are the barriers to care in residential homes
under trained staff
poorly paid
volume of work
own perceptions of oral health
how can I help with barriers to care in the care home
develop link with care home or create communication with PDS
what type of drug is alendronic acid
bisphosphonate
how do bisphosphonates work
reduce bone resorption by hindering formation, recruitment and function of osteoclasts
what type of conditions are managed by bisphosphonates
osteoporosis
pagets disease
cystic fibrosis
breast cancer
prostate cancer
what are the 3 characteristics for MRONJ to be present
current or previous treatment with antiresorptive agents
exposed bone or bone that can be probed through intraoral or extraoral fistula in maxillofacial region that has persisted for more than eight weeks
no history of radiation therapy to jaws or obvious metastatic disease to jaws
when would a patient be at low risk of MRONJ
before they have started bisphosphonates or are taking them for prevention or management of osteoporosis
when would a patient be at high risk of MRONJ
previous diagnosis
take bisphosphonate for malignant condition
non-malignant systemic condition affecting bone
under care of a specialist for rare medical condition
concurrent use of systemic corticosteroids or other immunosuppressants
coagulopathy, chemotherapy, radiotherapy
