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INBDE > Patient Management > Flashcards

Patient Management Flashcards

1
Q

Snowball effect

A

involved initial subject that recommends to another subject that meets the study criteria

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2
Q

width of a confidence interval will _____with increased sample size and decreased standard deviation.

A

decrease

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3
Q

AP required for CD 4 and neutrophil

A

CD4 less than 500
neutrophil les than 1000

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4
Q

_____is among the most resistant microorganisms to germicides and is used as a benchmark to measure how well a disinfectant can kill microorganisms.

A

tuberculosis
After that is MRSA whch is resistant to beta-lactam antibiotics but not very resistant to low-level disinfectants.

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5
Q

OSHA covers Hep B or Hep c vaccinations

A

Hep B

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6
Q

level 1 surgical mask filteration rate

A

95-97%

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7
Q

Independent variable is manipulated by researchers, dependent variable is outcome (t/f)

A

t

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8
Q

The recommendation for Post-Exposure Prophylaxis is to take it as soon as possible and preferably within____
with maximum of

A

24 hrs
1-3 days

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9
Q

_____ is used to treat status epilepticus, which is a state of continuous, repetitive seizures.

A

IV diazepam (Valium®)

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10
Q

if seizure, if the episode is less than 5 minutes, the most appropriate next step

A

reassess that the patient’s airway is open.

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11
Q

which study is retrospective

A

case control

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12
Q

true temporal study between exposure and disease is provided by

A

cohort study

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13
Q

calculate ODDS ratio

A

Odds ratio = diseases / not diseased
If odds ratio = 1: does not affect the odds of disease

OR > 1, the exposure is associated with higher odds of the disease

If OR < 1, the exposure is associated with lower odds of the disease

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14
Q

this virus does not survive long outside the body as it cannot replicate outside a human host. It lasts on surfaces for a matter of minutes to hours.

A

HIV

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15
Q

Hepatitis B can survive on surfaces for up t

A

7 days

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16
Q

_____ can survive on surfaces for months.

A

M. tuberculosis

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17
Q

if relative risk is :
<1
= 1
>1

A

<1 decrease risk
= 1 no risk
>1 increase risk

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18
Q

if surfaces are not properly disinfected following patient care, hep C virus can survive on a surface for up to

A

6 weeks

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19
Q

outliers have least / no effect on

A

mode and median

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20
Q

outliers have large effect on ?

A

mean and sd

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21
Q

the first sign of discomfort during a dental procedure is typically

A

eye twitching

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22
Q

what is attrition in research group

A

Attrition is the loss of subjects throughout a study due to lack of patient compliance, the decision to withdraw, or death and illness.

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23
Q

randomize control trials includes components like

A
  • it is superior group
  • two or more groups at random, given different treatments, and observed for the results. The control is a baseline or comparison group, allowing researchers to measure the effect of a treatment by comparing the outcomes of the other groups. Experimental groups will be subjected to an intervention and the outcome will be studied and compared to the other groups.
    -the trial is to be blinded, means subjects or researchers do not know whether they are in experimental or control group
  • no one is eliminated from the group
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24
Q

systemic review

A

combines resuts from 2 or more published studies to get a meta-analysis diamond

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25
Q

Non-randomized concurrent control group

A

2 groups, 2 different treatment

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26
Q

problems with single group “historical group”

A

spontaneous remission
“Hawthorne effect” : people in study behave differently
regression to the mean
“placebo effect”

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27
Q

single group “historical group”

A

non randomized patient w disease
all in one group
gets tx
result compare with historical control

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28
Q

response/ outcome variable

A

dependent/ predictor variable (y)

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29
Q

explanatory variable

A

independent/ predictor variable is manipulated by the researcher (x)

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30
Q

A paired data structure

A

by data that is being compared from the same individual in different time points.

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31
Q

An unpaired data structure

A

data that is being compared from different individuals. One group is usually the control group or gold standard, and the other groups are divided into different interventions.

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32
Q

there is an inherent ordering or ranking of the groups and fractions/decimals are possible.

A

ordinal

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33
Q

variables are numeric variables that are obtained by counting and taking a value based on a count from a set of distinct whole values.

A

discrete

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34
Q

variables are numeric variables that are obtained by measuring and can therefore take any value between a certain set of real numbers.

A

continuous

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35
Q

to disinfect digital sensors

A

spray and wipe with 70% isopropyl alchohol

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36
Q

In US medicare program, what’s part a, b, c, d

A

Part A: Inpatient or hospital-based coverage

Part B: Outpatient medical coverage

Part C: “Medicare Advantage” - similar to parts A, B, and D, but with additional coverage depending on the plan

Part D: Prescription medication

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37
Q

how often should an office spore test its autoclave for proper heat sterilization?

A

weekly

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38
Q

which disinfectant is best for smooth surfaces

A

phenol

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39
Q

platelet count

A

150,000 - 450,000

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40
Q

blood glucose

A

140 mg/dl

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41
Q

CD4 cound

A

500-1200 cells/m3

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42
Q

RBC count

A

4.7 - 6.7 million cells/uL

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43
Q

when to report abuse
child?
adult?
elderly
disabled

A

child - immediately social services
adult: ideally ask them alone first and then report to DHHS
elderly and disabled: report immediately

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44
Q

Abuse and neglect

A
  • recognize
  • report
  • record
  • render treatment
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45
Q

for how long can retired dentist name can be on the board

A

1 year

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46
Q

repor adverse reactions to fda

A

veracity

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47
Q

DO not remove amalgam bc its toxic is an example of what ada code os ethics

A

veracity

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48
Q

Veracity

A
  • truthfulness
  • do not mislead tx fees
  • do not waive copayment
  • no overbilling
  • submt correct fee (fee differential )
  • submit correct tx date and procedure
  • do not recommend or perform unnecessary tx
  • advertising
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49
Q

Justice

A
  • select patients fairly
    be available for emergencies
  • do not slander on other dentists
  • expert witness
  • no rebates or fee splitting
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50
Q

Beneficence

A
  • do good
  • volunteer
  • postpone elective treatment during public health emergency
  • join professional dental society
  • make research public
  • be familiar with signs of abuse and neglect
  • report suspected cases to proper authorities
  • do not engage in dusruptove behavior
  • provide respectful and collaborative work environment
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51
Q

patient abandonment

A

part of nonmaleficence
- do not stop treatment without giving adequate notice and opportunity to obtain dental service elsewhere

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52
Q

nonmaleficence

A
  • DO CE courses
  • refer when needed
  • well-trained staff
  • no drinking
  • post-exposure evaluation
  • no personal relationshp w patient
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53
Q

Autonomy

A

self-governance
must respect the patient;s rights to self-determination and confidentiality
- informed consent
- send patient’s chart to either patient or other dentist
- keep the health records private

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54
Q

ADA components

A
  1. Principle of ethics
  2. Code of professional conduct
  3. advisory opinion
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55
Q

FDA evaluates

A

efficacy and safety

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56
Q

Medicare
Medicaid
CHIP

A

medicare; elderly but does not cover dental
medicaid: for children under 21 and for poor
chip: children fam whose family income high for Medicaid but low for private insurance to afford

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57
Q

when to contact department of health and Human services

A

suspected elder abuse must be reported

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58
Q

HMO vs PPO based on premium and patients

A

HMO = less premium and less choice of providers
PPO = more premium and more choice of providers

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59
Q

PPO

A

Panel of providers agree to accept less than
usual fees in exchange for higher volume of
patients, since subscribers to this plan have a
financial incentive to use providers from this
panel

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60
Q

HMO pays ??

A

capitation plan (based on how many patients they see not on what procedures)

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61
Q

quaternary ammonium compounds (quats)

A

disrups cell membrane and is lethal to many microbes (doesn’t kill spores, TB- or non-enveloped viruses)

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62
Q

overbilling

A

charging more than legally or ethically
acceptable

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63
Q

downcoding

A

code changed to a less complex or lower
cost procedure than was reported

64
Q

Upcoding

A

= reporting a more complex or higher cost
procedure than was actually performed

65
Q

Bundling=

A

the combining of distinct dental procedures

66
Q

unbundling

A

the separating of a dental procedure into
component parts

67
Q

Fee schedule=

A

list of fees the dentist has agreed upon
for dental services and the insurance will cover them in full

68
Q

Table of allowances=

A

lists maximum amount a plan
will pay for each procedure but allows dentists to
charge more if they want

69
Q

– Usual, customary, and reasonable (UCR)=

A

reasonable
fee based on geographic location

70
Q

Material Safety Data Sheet (MSDS)

  • Manual made
A

by the manufacturer
0-4 least to most dangerous
Blue: health hazard
Red: Fire
Yello: reactivity of chemical
white: required PPE

71
Q

EPA requires ____ CFU bacteria per ml of water

A

≤500 CFU of heterotopic bacteria

72
Q

hearing loss

A

≥90dB

73
Q

within how many feet from patient’s mouth is splatter

A

3 feet

74
Q

acute mercury toxicity

A

– Muscle weakness (hypotonia)
– Loss of hair (alopecia)
– Weight loss/GI disorders
– Exhaustion

75
Q

Spaulding Classification System
Critical, semi-critical and non critical

A
  1. Critical= contacts sterile tissue or vascular
    system
    – Requires sterilization
    – Examples are needles
  2. Semi-critical= contacts mucosa
    – Minimum of high-level disinfection but sterilization if
    material is heat stable
    – Examples are mouth mirror
  3. Noncritical= contacts skin
    – Requires disinfection
    – Examples include blood pressure cuffs
76
Q

Ethylene oxide

A

PSP plates
Ethylene oxide is a colorless gas used to sterilize heat and moisture-sensitive medical and dental equipment.

77
Q

Dry heat sterilization

A

– 160 ̊C for 60 min
– Only glass or metal objects can be sterilized by this method due to high temperatures
– Dry heat destroys bacteria by
COAGULATION of proteins
– Best preservation of cutting edges

78
Q

Pressure sterilization/Autoclave
–

A

-121 ̊C at 15psi for 30 min
– Moist heat destroys bacteria by DENATURATION of proteins
– Biologic monitors
– Process indicators

79
Q

Glutaraldehyde

A

– Cold solution used for heat-sensitive items
– Requires a long time

80
Q

Health care workers should have a tuberculin
skin test at least _________

A

once per year

81
Q

risk of trasmission

A

Hep B = 30 % (Vaccine availble)
Hep C = 1.8 % (no vaccine)
HIV = 0.3 % (no vaccine)

82
Q

Routes of Hep A, B, C, D, E

A

Hep A= fecal-oral
* Hep B= contaminated blood
* Hep C= contaminated blood
* Hep D= direct contact, prior infection with HBV
* Hep E= fecal-oral

Contaminated Blood fEcAl-oral

83
Q

How many seconds?
Hand wash
* Flush ultrasonic

A

= 15 seconds minimum
= 20-30 seconds minimum

84
Q

studies in descending order respectively

A

cohort study, case-control study, cross-sectional study, and case report.

85
Q

ANOVA (analysis of variance)

A

used to test differences between two or more means

86
Q

Z-test

A

= measures the statistical difference between two means, large sample size, variance is known

87
Q

T-test

A

= measures the statistical difference between two means, small sample size

88
Q

Chi-squared test (X2)=

A

measures the association between two categorical values

89
Q

Correlation coefficient (r)

A

= statistical measure that
represents the strength of relationship between two
quantitative variables
– Always between -1 and +1
– 0 means no linear relationship

90
Q

what is type 2 error (beta true)

A

false positive
when we accept the null hypothesis and H0 is false

91
Q

what is type 1 error (alpha error)

A

false positive when we reject the null hypothesis and H0 is true

92
Q

IIf p>.05

A

accept / fail to reject the null hypothesis = not significant

93
Q

If p<.05

A

reject the null hypothesis statistically significant

94
Q

Specificity (TN, FN)

A

increase in true negative and decrease false negative

95
Q

sensitivity and specificity calculation

A

sensitivity = TP/ (TP+FN)
Specificity = TN / (TN+FP)

96
Q

Sensitivity (TP and FP)

A

increase in true positive and decrease in false positive

97
Q

Sensitivity
Specificity

A
  • Sensitivity= to correctly identify the disease
  • Specificity= health, to correctly identifying people who DOnt have the disease (healthy)
98
Q

accuracy

A

how close the final results of an experiment are to the correct or accepted value.
(80% or 90%)

99
Q

what does reliability and validity mean in quality of diagnostic tests

A

reliability = precision are you getting consistent results from the tests?
validity = accuracy
how close to the truth are the results?

100
Q

bell curve and numbers of standard deviation

A

Normal distribution= bell-shaped
– 68% is within 1σ
– 95% is within 2σ
– 99.7% is within 3σ

101
Q

range, variance, standard deviation

A
  • Range= max minus min
  • Variance= how spread out individual values
    are from the mean
  • Standard deviation= square root of variance
102
Q

mean, median, mode

A

Mean= average value
* Median= middle value
* Mode= most frequent measurement in a set
of data

103
Q

higher the standard deviation

A

more spread the numbers are

104
Q

Retrospective cohort study=

A

Look back after following
the cohort and decide what disease you want to look
for, incidence & relative risk
INCIDENCE AND RELATIVE RISK

105
Q

Prospective cohort study=

A

cohort followed through
time to see who develops a disease, incidence &
relative risk
INCIDENCE AND RELATIVE RISK

106
Q

Case-control study=

A

people with a condition (cases) are
compared to people without it (controls) in the past,
odds ratio
ODDS RATIO

107
Q

Cross-sectional study=

A

survey or measurement taken to
represent a snapshot in time, prevalence
PREVALANCE

108
Q

Analytical/Observational Studies

A

To determine the etiology of a disease

109
Q

Descriptive/Epidemiological Studies

A

To quantify disease status in a community

110
Q

Rule of 5s for fluoride toxicity

A

TOXIC DOSE IS
5MG/KG

LETHAL DOSE IS
5G FOR AN ADULT

111
Q

rule of 6

A

Rule of 6’s states that no supplemental systemic
fluoride if:
– Fluoride level in drinking water is >0.6ppm
– Patient is <6 months old OR
– Patient is >16 years old

112
Q

explain fluoride supplements

A

≤3 years old = fluoride drops, because children this young have difficulty chewing and swallowing
tablets
* >3 years old = fluoride tablets and lozenges
* >6 years old = fluoride mouth rinse
– 0.2% NaF solution weekly
– 0.05% NaF solution daily

113
Q

What US population lives in fluoridated
communities

A

210 million

114
Q

what is the optimal amount of fluoride in community water fluoride

A

1 ppm
0.7 mg/L

115
Q

what is the most cost effective adn most practical way to prevent tooth decay

A

communty water flouride

116
Q

define Early childhood caries
and when does it occur

A

Defined as 1 or more dmfs between birth and
71 months of age
– Mostly occurs in ages 3 to 5
– Mostly involves maxillary incisors and molars

117
Q

Simplified Oral Hygiene Index (OHI-S)

A

Quantifies the amount of debris (DI-S) and
calculus (CI-S)
* Oral hygiene
– Good
– Fair
– Poor

118
Q

periodontal index

A

– 0= healthy
– 1= bleeding
– 2= calculus
– 3= shallow pockets
– 4= deep pockets

119
Q

Why does AAP doesn’t like periodontal index?

A

AAP doesn’t like it because it doesn’t account for
recession so attachment loss is inaccurate

120
Q

Gingival Index

A

Uses four surfaces on six indicator teeth
* 0= normal gingiva
* 1= mild inflammation
* 2= moderate inflammation
* 3= severe inflammation, ulcerated tissue with tendency
toward spontaneous bleeding

121
Q

In epidemiologic measures, what is irreversible

A

DMFT (caries): decayed, missing, and filled permanent teeth

122
Q

what med to give:
mild, moderate, and sever pain.

A

Rx
– Mild ibuprofen or acetaminophen
– Moderate ibuprofen and acetaminophen
– Severe ibuprofen and/or acetaminophen and opioid

123
Q

Anxious patients are more likely to report pain
and discomfort (T?F)

A

true

124
Q

what scale is used to assess pain experience in children

A

Wong-Baker Faces Pain Rating Scale

125
Q

what is:
controllability
familiarity
predictability
imminence

A
  • Controllability—how controllable the situation
    seems to be
  • Familiarity—how familiar the situation is
  • Predictability—how predictable the situation is
  • Imminence—if the situation seems to be
    approaching near
126
Q

which coping method is very effective in peds

A

tell-show-do

127
Q

which coping strategy is least effective for a hypervigilant anxious patient

A

distraction

128
Q

Systematic desensitization/graded exposure—

A

exposing patient to items from an agreed upon hierarchy of
slowly increasing feared stimuli allowing them to pair a
relaxation response with a feared stimuli

129
Q

3 steps of stress management

A
  1. trust
  2. comfort
  3. coping
130
Q

Motivational Interviewing (OARS)

A
  • Person-centered counseling style to assist in the resolution from ambivalence to change
  • OARS= open questions, affirmations, reflective
    listening, summarizing
131
Q

Premack Principle

A

making a behavior that has a
higher probability of being performed contingent on a
behavior that has a lower probability of being
performed

132
Q

3 typeso of behavior learning

A
  1. classical conditioning (pavlov’s dogs)
  2. operant conditioning
  3. observational learning
133
Q

Health belief model

A
  1. Perceived susceptibility= to given disease or
    problem
  2. Perceived costs and benefits= severity of
    consequences
  3. Cues to action= prompts to engage or not
    engage in certain behavior
134
Q

Social cognitive theory

A
  1. Self-efficacy= cognitive perception that you
    can execute behaviors necessary for a given
    situation
  2. Behavioral modeling= learn proper behavior
    from models around you
  3. Social reinforcement= positive social
    consequences
135
Q

The stages of change

A
  1. precontemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
136
Q

Behavior Change (ABC)

A
  1. Antecedent= factor that facilitates behavior
  2. Behavior= the behavior itself
  3. Consequences= consequences of the behavior
137
Q

Present treatment alternatives in what order

A

descending order of desirability

138
Q

Laundry list à

A

ask patient to respond from a list
of choices

139
Q

Probing

A

à gather additional information

140
Q

Leading questions

A

à direct the patient to
respond a certain way, DO NOT USE

141
Q

Closed questions à

A

elicit more specific
information

142
Q

Open-ended questions

A

allow patient to explain
what is important to them

143
Q

veracity

A

Be honest and trustworthy in dealings with
the public
* Respect the position of trust inherent in the
dentist-patient relationship
* Must not represent care being rendered, fees
being charged, or any form of advertising in a
false or misleading manner

144
Q

justice

A

Be fair in dealings with patients, colleagues,
and society
* Deal with people justly and deliver dental care
without prejudice
* Never slander another dental professional

145
Q

beneficence

A

Professionals have a duty to act for the benefit
of others
* Provide service to the patient and the public
at large
* Promote patient’s welfare
* The same ethical standard exists no matter
the financial arrangement

146
Q

Nonmaleficence

A

Primum non nocere= first do no harm
* Keep skills and knowledge up-to-date through
continuing education
* Know your limitations and refer difficult cases
to a specialist

147
Q

what is the most essential component for risk management

A

documentation

148
Q

how long to keep all the documents for?

A

Keep all documents for as long as possible

149
Q

what is the exception for a minor to sign the consent form

A

Exception if they are emancipated (freed from care and
control of parents) or in an emergency situation
– Married
– Parent
– Pregnant
– Military

150
Q

what if not inform about informed consent

A

assault and battery

151
Q

what is not included in informed consent

A

Fee (cost of treatment )
Must inform patient about nature of procedure, benefits, risks, and alternative treatment options including no treatment—
not cost of treatment

152
Q

informed consent

A

Based on ethical principle of autonomy

153
Q

Name all ada principles of ethics

A
  1. autonomy = self-governance
  2. nonmaleficence = do no harm
  3. beneficence = do goof
  4. justice = fairness
  5. veracity = truthfulness
154
Q

how many ADA principles of ethics

A

5

155
Q

which sample has lowest errors and reduced bias

A

stratified random sampling

156
Q
A

INBDE (10 decks)

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