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Special Care Dentistry > Neurology > Flashcards

Neurology Flashcards

1
Q

what is the difficulties in treating someone with dementia

A

capacity to consent
co-operation for treatment
treatment planning

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2
Q

what are the types of dementia

A

alzheimers
vascular
dementia with lewy bodies
korsakoff’s syndrome

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3
Q

what is dementia

A

chronic organic brain disease which is progressive and causes loss of cognitive and motor functions

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4
Q

what is the first stage presentation of dementia

A

memory loss, disorientation in time and place, judgement impaired

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5
Q

what is the second stage presentation of dementia

A

loss of intellect, aphasia, inability to clothe or feed oneself, acquired defects of visual - spatial skill

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6
Q

what is the third stage presentation of dementia

A

apathy, inability to communicate, anxiety, depression, absolute dependence

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7
Q

how would you take a history and perform an exam on a dementia patient

A

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

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8
Q

what are some signs that someone might be in pain

A

holding face
pulling at face
eating normally
altered sleeping pattern
exhibiting abnormal/changes in behaviour

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9
Q

what are the possible causes of an ulcer

A

trauma
medications - Fe tablets, aspirin
oral cancer
viral
stress related

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10
Q

what would cracked labial commissures suggest

A

angular cheilitis

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11
Q

what is the cause of angular cheilitis

A

fungal/bacterial and role of OVD

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12
Q

how do you manage angular cheilitis

A

improve OVD and give topical antifungal

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13
Q

how do you manage dry mouth

A

hydration, saliva substitutes, saliva orthana, biotene

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14
Q

how do you manage erythematous candidosis

A

good denture and oral hygiene
disrupt biofilm by cleaning palate and denture
chlorhexidine
consider topical therapy - miconazole
systemic agent - last option

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15
Q

what programme is in place to help oral hygiene in the care homes

A

caring for smiles

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16
Q

are there any concerns to about preventative measures of oral hygiene when giving them to dementia patients

A

many cannot provide self care so care home has to do it

17
Q

what are the barriers to care in residential homes

A

under trained staff
poorly paid
volume of work
own perceptions of oral health

18
Q

how can I help with barriers to care in the care home

A

develop link with care home or create communication with PDS

19
Q

what type of drug is alendronic acid

A

bisphosphonate

20
Q

how do bisphosphonates work

A

reduce bone resorption by hindering formation, recruitment and function of osteoclasts

21
Q

what type of conditions are managed by bisphosphonates

A

osteoporosis
pagets disease
cystic fibrosis
breast cancer
prostate cancer

22
Q

what are the 3 characteristics for MRONJ to be present

A

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

23
Q

when would a patient be at low risk of MRONJ

A

before they have started bisphosphonates or are taking them for prevention or management of osteoporosis

24
Q

when would a patient be at high risk of MRONJ

A

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

25
Q

how do you manage patients at low risk of MRONJ

A

extract as atraumatically as possible
review healing at 4 weeks

26
Q

how do you manage patients at high risk of MRONJ

A

contact OMFS to determine whether they should be treated in primary care, do so by letter and include full details of PMH and DH

27
Q

how do you assess capacity

A

understand in simple language what treatment is
understand its principle benefits, risks and alternatives
understand in broad terms what consequences will be of not receiving it
retain information long enough to use it

28
Q

what does incapable mean

A

incapable of:
- acting
- making decisions
- communicating decisions
- understanding decisions
- retain memory of decisions

29
Q

when is it best to proceed with emergency treatment without AWI certificate

A

where it will prevent serious deterioration

30
Q

what are the 5 principles to treatment when it is non-urgent treatment

A

benefit
minimum necessary intervention
take account of wishes of adult
consult with relevant others
encourage residual capacity

Special Care Dentistry (15 decks)

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