Past Stations Flashcards
What are the 5 A’s of Stop Smoking.
Ask
Advise
Assess
Assist
Refer
What is involved in an E/O exam of a face fracture?
Palpation of zygoma- bilateral palpation
Examination of eye
Examination of sensation of infra-orbital region
Limitation of mandibular movement
What is involved in an I/O exam of a facial fracture?
Tenderness of the buttress root of zygoma
Bruising/swelling/haematoma
Occlusal derangement
How do you manage fractured cheek bone?
Radiographs- CBCT, CT or occipitomental views
Urgent phone referral to OMFS (or A&E)
ORIF- open reduction, internal fixation
What are the steps of handpiece safety?
Back cap check
Bur security check
Tension applied to handpiece when fitted to coupling
Bur rotated laterally
Attempts to move bur laterally
Handpiece sound tested when running
When should INR be taken if the patient is stable? what defines INR stability?
72 hours
Stable INR= <4 for the last 3 months
When should INR be taken if the patient is not stable?
Within 24 hours
INR is not stable if it has been >4 for last 3 months
What is involved in a pain history?
Ask about presenting complaint
S- site
O-onset of pain, when did it start
C-what kind of pain is it, worse with hot/cold
R-does the pain travel anywhere
A-is the pt well within themselves?
T- how long pain lasts? anything that makes it worse?
E-is pt taking anything for the pain?
S-rate pain 1-10
Ask if pt is kept awake.
Provide provisional diagnosis
When is fluoride varnish contra-indicated?
Severe uncontrolled asthma (hospitalised in last 12 months) or allergy to colophony (plasters)
What are the instructions to provide a parent after fluoride varnish?
Don’t eat/drink for 1 hour
Soft diet for the rest of the day
Avoid any fluoride supplements for rest of the day
Explain why fluoride varnish is used for children.
Promotes remineralisation (hardening of the tooth) and prevents remineralisation (softening of teeth).
Prevents acid production
What is the fluoride toxicity recommendations?
ingested
5mg/kg- give child milk
10mg/kg- milk and possible referral
>15mg/kg- hospital referral
How do you diagnose oro-antral communication?
Radiographic position of roots in relation to antrum
Bone at trifurcation of roots
Bubbling of blood
Good light & suction
What may chronic OAF patients complain of?
Fluids from nose
Speech and singing of nasal quality
Problems playing wind instruments
Problems smoking or using a straw
Bad taste/odour, halitosis or pus discharge
Pain/sinusitis type symptoms
What is the management of oro-antral communication?
Inform patient
If small or sinus intact- encourage clot, suture margins, post-op instructions
If large or lining torn- close with buccal advancement flap
What are the post-op instructions for OAC?
Refrain from blowing nose or stifling a sneeze by pinching nose
Steam or menthol inhalations
Avoid using a straw
Refrain from smoking
What are the treatment planning stages?
Immediate
Initial
Re-evaluation
Re-constructive
Maintenance
What is the SPIKES protocol for breaking bad news?
Setting - sitting at same level
Perceptions - are you awake of what might be wrong etc
Information - inform what you would like to discuss
Knowledge - give knowledge of what you know
Empathy - Understand it must be hard
Summary -Summarise what you’ve told them and plan for going forward
What are the safe levels of INR?
<4
Patient is regarded as stable if INR has been below 4 for last 3 months
When should you check pt’s INR before XLA?
Within 24hrs or 72hrs if pt is stable
You overhear a nurse badmouthing a patient to a colleague in a public place in the surgery. They refer to them in a derogatory manner and joke about potentially posting this on social media. The patient and the family are easily identifiable from the information discussed.
Discuss this issue with your nurse.
Ask nurse for their own version of events
Highlight the risks of career when posting inappropriate things on social media
Emphasise patient confidentiality
Emphasise unprofessional conduct of discussing this in this manner and in a public setting
