Patient Care exam 2 Flashcards
Is asthma reversible or irreversible?
Reversible
What kind of onset isthma
Sudden onset
Which are these an example of
emotional stress
allergy to food
air pollution
upper respiratory infection
exercise induce
Asthma triggers
What is allergic asthma associated with
extrinsic asthma
With what population of people is extrinsic asthma most common in
children
Non allergic asthma is associated with what kind of asthma
Intrinsic asthma
What population of people is intrinsic asthma
adults older than 35
What should you avoid with asthma
aspirin and NSAIDS because they are vascoconstrictors
Asthma, nasal polyps and sensitivity to asprin and NSAIDS are assocaited with?
triad asthma
What kind of asthma is considered a true emergency
triad asthmaticus
People with triad asthmaticus have no containdication with what?
NO, Valium, O2
What is the goal of prevention of asthma?
to prevent an acute attack
With a good medical history with asthma the goal is to determine?
severity and stability of the disease
Terminate procedure
position patient up right
calm patient
adminster ventolin
administor O2
what do these associate with?
Asthma managment
What does this characterize
attacks <3 week
<30 min
only with exercise
mild asthma
What does this characterize as
3-5 attacks a week
last 30 min
affects sleep
Moderate asthma
What does this characterize
daily attacks
use steroids
er visits
Severe asthma attacks
What is a chronic and growing illness
Diabetes
What is the third leading cause of death
diabetes
What disease is a group of metabolic syndromes resulting in low levels of insulin
diabetes
What disease is more ommon in kids and is because of beta destruction and is an abupt onset
Type 1 diabetes
What disease is seen in adults and the onset is slow?
Type II diabetes
What kind of diabetes involves abnomrla glucose tolerance during pregnancy?
Gestational
When are glucose levels controlled?
in the morning
body produces high level of blood acid called ketons is what
diabetic ketoacidosis
When does diabetic ketoacidosis occur
when your body cant produce enough insulin
Polyuria
polydipsia
polyphagia
dry skin
dry mouth
fruity smelling breath
these are examples of what
hyperglycemia
pale
weakness
shallow weakness
onset very sudden
blood glucose values <50
hypoglycemia symptoms
when should you schedule an appointment for hypoglycemia
after a meal
postion patient comfortable
administer 100% oxygen
oral carbs
unconscious, cake icing
Managment of hypoglycemia
what does A1C measure
sugar in blood over the past 2-3 months
what does HbA1c measure
glucose over the last 30-90 days
if you have diabetes an ideal level is 6.5% or below
What happens when <70mg/dl
and >200mg/dl
at 70 defer treatment and give cards. at 200 defer treatement and refer to physician
what happens with insulin shock
if you fail to eat in accrodance with diet and continue to take insulin then you will experience hypoglycemic reaction
characterized by hunger, weakness, trembling, tachycardia, pallor, sweating are signs of what
mild insulin shock stage
because blood glucose drops the patient becomes incoherent and uncooperative and can sometimes judgement is defective and can hurt themselves or others
this is moderate insulin shock
What kind of insulin shock is determined by unconsciousness with or without tonic. Most of these reactions take place during sleep
Severe insulin shock
The reaction to excessive insulin can be corrected by giving the patient sweetend fruit juice
Insulin shock
poorly controlled urinate
xerosteomia
bacterial, viral and fungal infections
poor wound healing
These are examples of….
oral manifestations of diabetes
periodontal dsiease
bidirectional hyperglycemia affects oral health
xerostomia and burning mouth syndrome
increased infection and poor wound healing
increased incidence
These are examples……
diabetes of oral complications
What is an abnormal response of the immune system to a substance
Allergy
Rapid onsent
type 1- igE mediated anaphylaxis
antibiotics
analgesics
narcotics
anesthetics
These are examples….
rapid allergic reaction
What is an acute reaction involving smooth muscle of the bronchi in with antigen IgE antibody complexes
Anaphylaxis
Skin
respiratory
cardiovascular
eyes, nose, GI
respiratory
These are examples of….
anaphylactic reactions
position patient supine
BCLS
oxygen
monitor vital
These are examples of
allergic reaction management
onset is greater than an hour
non life threatening
antibiotics
analgesics
narcotics
These are examples of
Delayed Allergic reaction
rash
itching
hives
edema
These symptoms are examples of
Delayed allergic reactions
These management techniques are for ______?
terminate procedure
positition patient
BCLs
Benadryl 50 mg
Continue benadryl
delayed management for allergic reaction
What are these risk factors for___?
heredity
sex
race
age of 65 or older
heart disease
These are risk factors for ___?
smoking
alcohol use
stress
obesity
diabetes
cholestrol
hypertension
sleep apnea
heart disease
Extreme fatigue
dizzy
fast heart rate
irregular heart rate
chest pain
difficulty breathing
nausea
edema
These are signs for
Heart disease
What is edema related to
Heart disease
What is narrowing of the aortic valve
stenosis
what is is called when breathing id difficult or labored
dyspnea
What is it called when its difficult to breath lying down
orthopnea
_____ decreases or blocked blood flow to the heart is due to cholestrol
Coronary artery disease
How can someone prevent cardiovascular disease and diabetes
manage ABCs
a1c
blood pressure
cholestrol
stop smoking
____ is elevation in serum lipid leves is a major risk factor and increased blood pressure
atherosclerosis
systolic blood pressure is related to _____
atherosclerosis
_____ most common, brief resulting from temporary ischemia of myocardium
angina pectoris
____ least common, pain is prolonged
acute M. I.
To diagnosis _____
chest pain
tightness in midchest
pain is brief, lasting 5-15 min
angina pectoris
the cause of _____
blood supply to cardiac muscle is insufficient for oxygen
angina pectoris
_____ is pain that is predictable and unchanging. Pain is precipated by physical effort such as walking stairs
stable angina
______ is defined as a new onset increasing frequency, precipated by less effort than before
Not readily relieved by nitroglycerin
KEY FEATURE is changing character
unstable angina
factory workers exposed to high levels of nitrogelycerin power coined the term
monday disease
What _____ exerts action in 2-4 min, lasts 30 min and the side effects are
pounding head
flushing
tachycardia
nitroglycerin
the stress reduction protocol for ______ is to avoid vasoconstrictors, oxygen, nitrogycerine tabs, 4444 if it doesnt go away
angina pectoris
the treatment for _____ is to semi sitting positino, check vitals, nitroglycerin, repeat 5 minutes up to 3 doses in 15 min times period. Check BP, if BP drops below 100mm/Hg STOPPPPPP!!!
angina pectoris
After you have administed nitroglycerin and the pain is not relieved you should _____
give one aspirin 325 mg or four 81 mg
signs of ______ are chest pain, angina lasting longer than 15 min, pale, weakness, cold sweat, sense of impededing death
myocardial infaction
myocardial infarction can progess to ____
cardiac arrest
with unresponsive patients from mycocardial infarction you should ____-
do CPR and use AED
if a patient has a mycardial infarction
when can you and can you not administer dental treatmetn
less than 8 weeks NO treatment
more than 8 weeks, must have permission from medical consult
what should you not prescribe for patients who have a history of MI
NSAIDS
what is the stress reduction protocol for myocardial infarction
short app
early app
NO
limit vasoconstrictors
profound anesthesia
____ most common >65 years of age, results from functional cardiac disorder and ability of the VENTRICLE to fill with blood
heart failure
these are signs for ____
fatigue
edema
clubbing of digits
syncope
angina
breathing difficulty
heart failure
_____ is characterized by chronic airflow limitation from lungs and is NOT REVERSIBLE
COPD
____ is the 3rd leading cause of death in 2020
COPD
what are the two disesases of COPD
chronic bronchitis and emphysema
_____ is chronic inflammation of the bronchi that produce excess tracheobronchial mucus
chronic bronchitis
_____ is a persistent cough with sputum for at least 3 months in at least 2 consecutive years in a patients
chronic bronchitis
___ typically begins at age 40
COPD
____ this term describes patients with chronic bronchits because they are descirbes as overweight, and breathless
blue bloaters
____ is permanent enlargment of air spaces inthe lungs accompanied by the destruction of air space
emphysema
patients with emphysema are known as _____ because they have barrel chest and have weight loss, dyspnea and pursing lips
pink puffers
_____ is a condition is which heart valves have been permanently damaged by rheumatic fever
rheumatic heart disease
what disease is caused by an untreated streptococcal infection like strep throat or scarlet fever
rheumatic heart disease
____ is a disorder that interferes with daily function and results in loss of independence
dementia
the most common causes of _____ are alzheimers, vascular dementia, and parkinsons
dementia
the signs of ____ are memory loss, cognitive decline, behaviorial change
alzheimers
what is the average lifespan of someone with alzeimers
8 years
patients with _____ diseases maintain normal organ function and recieve routine dental treatment
mild to moderate alzeimers
antipsychotics, antidepressants and anxiolytics are used with patients who have
severe alzheimers disease
(these medications contribute to xerostomia with increased dental caries)
what is the disease accompanied with primary adrenal insufficiency
addisons disease
autoimmune disease
decrease in cortisol
decrease in aldosterone
These are symptoms of…..
addisons disease
discoloration of lips and gums is a sign of…..
addisons disease
_____ is caused by the pituitary disease
secondary adrenal insufficiency
_____ is caused by a impair function of the hypothalmus
tertiary adreanl insufficiency
____ is the inability to increase cortisol production with sress
adrenal insufficiency
symptoms of ____
tired
weak
orthostatic hypotension
poor healing increase infection
darkened skin
SALT CRAVING
addisons disesase (adrenal insufficiency)
____ refers to a condition by excessive cortisol in the body and is caused by steroid drugs
cushing disease
____ can be caused by steroid drugs and pathophysiolic process
cushing disease
these are examples of _____
rheumatoid arthritis
lupus
asthma
psoriasis
steroid uses
These are symptoms of_____
weight gain
moon face
buffalo hump
fragile skin
abdominal striae
decreased healing
cushing syndrome
____ manifest as hypotensive collapse, abdominal pain, myalgia and fever
adrenal crisis
failure to fulfill major role, and causes personal problems can be diagnoses as ____
alcohol or drug abuse
enlarged parotid glands and spider angiomas are signs of ___
alcohol abuse
liver and bone damage
cirrhosis
vit k def
reduced effect of anesthetics
nutritional def
These are effects of ____
alcohol
> 5 oz/ 4 hrs is ___
binge drinking
drinking and smoking can result in _____
oral cancer
the effect of ____ are
ineraction with anesthetic
liver damge
infections diseases if share needles
drug
_____ is characterized by gingivial recession and erosion of facial aspects
cocaine
____ is characterized by xerostomia, caries, bruxism and muscle trismus
meth
What should you do with someone who is on drugs and has bad oral manifestations
dont provide extensive care till home care improves
____ is the reduction in oxygen carrying capacity of the blood
anemia
___ is associated with decrease in RBC, affects females more, abnormality in hb
anemia
iron
folate
hemolytic
sickle cell
These are types of what?
anemia
symptoms of ___ pale, fatigue, low bp, rapid heart rate
anemia
oral signs of ___ are burning red tongue, bleeding gums, delayed healing
anemia
____ is craving and chewing ice and is assocaited with ____
pagophagia and is assocaited with iron def
___ is a severe restriction of food intake, leading to weight loss
anorexia nervosa
____ is restriction of food by binge eating followed by methods to get rid of food
bulimia nervosa
these define what disease?
age onset: 14-18
females 90-95%
anorexia
these are symptoms of ____?
hair thin
neck swelling
fainting
low bp
osteoporosis
Anorexia nervosa
these are characteristics of what disease ____?
average onset: 20 yrs old
females 90-95%
1/2 have peronsality disorders
bulimia
amalgam restorations are higher than enamel is a sign of _____
bulimia
this is a characteristic of ____
enamel erosion on the lingual of ant teeth
bulimia
____ is the loss of enamel and dentine on lingual surfaces by chemical effects
perimylolysis
to determine ______
ask: when did it occur?
how long did it last?
have you been diagnososed?
abnormal bleeding
____ is used to detect bleeding disorders or excessive clotting disorders
PT test
if you take a blood thinning medication then your PT test will be expressed as ____
INR
____ is calculated from a PT test result
INR
PT test can be represented either in ____ or _____
seconds (10-30 seconds) or INR
typcial INR score for people on blood thinner is
2-3
a healthy INR range is
1.1
These are examples of ____
rheumatoid arthritis
Systemic Lupus
Sjogren syndrome
diabetes
graves disease
autoimmune disease
____ is a disroder that affect bones joints and muscles
rheumatic disease
what disease is not an autoimmune disease
osteoarthristis
most everyone over the age of 60 has some degree of ____
osteoarthritis
____ is a autoimmune disaese of unknown orgin
rheumatoid
symptoms of ____
inflammation of joints, hands feet and knees
rhumtoid
_____ characteristics
joint involvement
joint inflammation
morning stiffness
systemic manifestations
rheumatoid
_____ characteristscs
1-2 joints
no inflammation
heberden nodes of DIP
no systemic involvement
osteoarthritis
___ is chronic inflammatory disorder that affects interal and external sytems of body
systemic lupus
____ is present in a women with polyarthritis and a butterfly shaped erythematous rash across nose and cheeks
systemic lupus
____ oral manifestations
ulcerations, burning mouth, infection are common because of corticosteroids
systemic lupus
____ characterized by symptoms of oral and ocular dryness and progressive loss of salivary function
sjogrens syndrome
____ is dry eyes and dry mouth seen in absence of CT disease, not common
primary sjogren
___ is more common and dry eyes and dry moth are seen together with other autoimmune disease
secondary sjogren
___ is characterized by chronic and recurrent paroxysmal changes in neurological function, altered consciousness or involunary movements by spontantous electrical activity in brain
epilepsy
___ symptoms are
aura
irritability
epilpetic cry
loss of consciousness
muscle rigidity
epilepsy symptoms
____ treatment is
long term drug therapy of dilantine and tegretol
epilepsy
epilepsy uncontrolled occurs between ____ seizures a moth
and well controlled is ___ a month
> 1-2 and <1-2
a patient with ____ ask them if they feel tired?
ask them to communcate if they sense a seizure coming
Dont shine light in pt eyes
epilepsy
____ management
protect patient
dont move pt to floor, place chair in SUPINE position
Remove instruments
O2 if necessary
4444
epilepsy
____ is when stomach liquids regurgitate
GERD
dental implications of ____
halitosis
enamel erosion
GERD
____ is sudden or electric pain
trigeminal neuraliga
____ is intermittent attacks, women >50
trigeminal neuraliga
Reasons for med consults are
rheumatic fever
MI in last 6 mos
hypertension 160/100
unsure how well diabetes is controlled
heart defects
> 5 meds
chemo or radiation
what does medication history include
Rx, OTC, herba natural or alt
have patients bring a list of all meds
these are examples of ____
itching
hives
rash
swelling
wheezing
true allergies
these are examples of ____
nausea
vomiting
palpations
not true allergy
drug intolerance
