Patient Evaluation

Question 1

Risk Assessment 4 components

Answer 1

• The nature, severity, and stability of the patients medical condition
• The functional capacity of the patient
• The emotional status of the patient
• The type of magnitude of the planned procedure (invasive or noninvasive)

Question 2

The cornerstones of patient evaluation and risk assessment are

Answer 2

• Med hx
• Physical examination
• Lab tests as needed
• Medical consultation as needed

Question 3

Functional Capacity METS

Answer 3

• Metabolic Equivalent Levels
• MET is a unit of oxygen consumption
  
  • 1 MET equals 3.5 mL/kg/min at rest
  • Risk of perioperative event is increased in patients who are unable to meet a 4 MET demand during normal daily activity
• 4 METS include level walking at 4 miles/hr or climbing a flight of stairs

Question 4

Physical Examination

Answer 4

• Assessment of general apperance
• Measurement of vital signs
• examination of head and neck

Question 5

Vital Signs 6

Answer 5

• Blood pressure
• Pulse
• Respiratory rate
• Temp
• Height
• Weight

Question 6

HbA1c

Answer 6

• Glycolated hemoglobin levels in diabetes
• 4-6% with diabetes
• 5.7-6.4% increased risk for diabetes
• 6.5% and greater diabetes

Question 7

Lab tests

Answer 7

• Daily glucose level check
• ACTH stimulation test for primary adrenal failure
• INR- coagulation therapy
• Platelet count- 150,00-450,000/ uL
  
  • Less than 40,000 is an urgent situation

Question 8

INR Targets 5

Answer 8

• INR 1 - normal, healthy patient
• INR 2 - Atrial fibrillation target (2-3)
• INR 3 - Mechanical heart valve target
• INR 4 - Risk of uncontrolled bleeding
• INR 5 - Uncontrolled bleeding

Question 9

Medical Consultations 7

Dont ask 3

Answer 9

• Anticoagulation
• Cancer
• Cardiac disease
• Diabetes
• Dialysis
• Hypertension
• Multisystem disease
• Dont ask for
  
  • A medical clearance
  • Any contraindications to dental care
  • guidance in dental care

Question 10

Complete Blood Normal Count

WBC

RBC (MF)

Platelets

Hematocrit (MF)

Hb (MF)

Answer 10

• WBC 4400-11,000/mL
• RBC
  
  • Male 4.5-5.9 10^6/uL
  • Females 4.5-5.1 10^6/uL
• Platelets 150,000-450,000/uL
• Hematocrit
  
  • Male 41.5-50.4%
  • Females 35.9-44.6%
• Hb
  
  • Male 13.5-17.5 g/dL
  • Female 12.3-15.3 g/dL