Patient Management Flashcards
Autonomy :
is the right of a patient to their own choice of treatment performed in a manner based on personal preference.
Most common complication in a dental office?
Syncope
Syncope postion
Trendeleburg
The patient’s autonomy entails ___________, however good or bad the predicted outcome may be.
the right of a patient to proceed or refuse a treatment
In patients deemed mentally incapacitated, _______ chooses the best treatment that suits their case.
the physician
The use of informed consent and advance directives are based on the principle of _______.
autonomy
The recommended dose for pediatric prophylaxis is
oral amoxicillin 50 mg/kg of body weight
If the child is unable to take oral medication, ampicillin, ceftriaxone, or cefazolin can be given 50 mg/kg body weight intramuscularly (IM) or intravenously (IV).
For children who are allergic to penicillins and require prophylaxis the following may be administered [3]:
Cephalexin 50 mg/kg body weight
Clindamycin 20 mg/kg body weight
Azthromycin or clarithromycin 15 mg/kg body weight
______ ______ are a type of longitudinal study in which risk factors are analyzed for the group of people who do not have the disease and use correlations to determine the absolute risk of subject contraction.
Cohort studies
______ _______ pays the dentist before the treatment is provided.
Prospective reimbursement
- Exposure incident plan
- Hepatitis B vaccination
- Medical waste disposal
- Instrument sterilization and storage
OSHA
Children from ________________________are the most commonly abused or neglected group of children.
zero to three years of age
6mill+ currently suffering in the US. ~ 70% of children who die from abuse are under the age of four. Child abuse occurs at every socioeconomic level, across all ethnic and cultural lines, within all religions, and at all levels of education. ~ 30% will later abuse their own
The American Food and Drug Administration uses _________and _______ as the criteria for the evaluation of drugs and medical devices.
efficacy and safety
What valve type is used on handpieces and water spray hoses to prevent cross contamination to patients from dental operatories?
Anti-retraction
________ measure the significance of difference between two sets of data.
Chi-squared tests
The chi-squared value determines whether the null hypothesis should be accepted or rejected at a determined confidence level.
In ______ ____, a third party negotiates payments between providers and patients for services.
managed care
T/F. Esthetic Dentistry is a Specialty?
FALSE.
Neither is Implantology, Geriatric, Hospital
12 specialties: Anesthesia, Public Health, Endo, Path, Radio, OMFS, Oral med, OF Pain, Ortho, Pedo, Perio, Prostho
A researcher takes the number of diseased individuals in a population divided by the total population. Which of the following is this a calculation for?
Prevalence
Prophylactic antibiotics dose for macrolides (azith/Clarith):
(adults and child)
Azithromycin or clarithromycin:
Adults: 500 mg one hour before the procedure
Children: 15 mg/kg one hour before the procedure
The _________ states that there is no difference between the results of the control and experimental groups.
null hypothesis
The chi-squared value determines whether the null hypothesis should be accepted or rejected at a determined confidence level.
______ = maintains a continuous antimicrobial effect,
substantivity
ex: Chlorhexidine gluconate (Lasts 12hrs)
- Antiseptic works on Gram-positive and Gram-negative bacteria;
- Bactericidal and bacteriostatic- disrupts bacterial membrane.
- As an oral rinse, it helps prevent the formation of bacterial biofilm, preventing the formation of plaque.
____________ _____ examine two or more variables simultaneously .
Cross-sectional studies
for example, University of Iowa dental students were tested against University of Michigan dental students
_______ is the percentage of the population that has the disease or condition.
Prevalence
It gives a figure for a factor at a single point in time. Prevalence can tell only what is happening at a certain point.
In ______ ______, the dentist charges the patient the difference between what the insurance plan pays and the usual customary rates (UCR).
balanced billing
Prophylactic antibiotics dose for CLinda:
adults and child
Clindamycin:
Adults: 600 mg one hour before the procedure
Children: 20 mg/kg one hour before the procedure
epidemiology utilizes interventional studies to determine the effectiveness of the therapy or intervention in question.
Experimental
__________ is a payment method in which an entity pays the dentist a fixed amount irrespective of the services provided by the dentist.
Capitation
A diagnostic test that correctly identifies 20% of screened patients as disease-free has low…
specificity
High-specificity diagnostic tests correctly classify a group of patients as free of disease based on their results.
On the other hand, high-sensitivity diagnostic tests show the group of patients that are suffering from a particular disease.
A _________ ______ is an observational correlational research study that involves repeated observations of the same variables over long periods of time.
longitudinal survey
______ is the variation in measurements taken by a single person or instrument on the same item and under the same conditions.
Repeatability
_______ describes the number of new cases that occur in an at-risk population during a specific period of time
Incidence
T/F. The occupational Safety and Health Administration’s Blood Borne Pathogens Standard does not include the regulation of nitrous oxide scavenging systems.
TRUE.
This standard was created and designed to protect healthcare workers and personnel from the risk of exposure to blood borne pathogens, like hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
The Blood Borne Pathogens Standard involves the following:
Management of sharps/ disposal of regulated wastes Communication of hazards to employees Training and hepatitis B vaccination of employees Exposure incident plan Sterilization and storage of instruments
Prophylactic antibiotics are indicated for patients with the following (4) - 3 hearts and an I
- Artificial heart valves and heart repaired with prosthetic devices
- Cardiac transplant patients with a heart valve problem
- Congenital heart conditions and those have been treated but still have a residual defect
- Infective endocarditis history
_______ epidemiology attempts to quantify the disease status in a community.
Descriptive
What describes an agreement between an insurance company and a group of dentists in which the dentists accept a discounted payment rate?
Preferred Provider Organization
Prophylactic antibiotics dose for Amox:
adults and child
Amoxicillin:
Adults: 2 g one hour before the procedure
Children: 50 mg/kg one hour before the procedure
Which of the following ethical principles requires clinicians to inform their patients about treatment risks and benefits and to protect their confidentiality?
Autonomy
In a ____ ____ practice, dental patients receive care at specified facilities by a limited group of clinicians on a prepayment basis. Dentists must accept any beneficiary of a closed panel as a patient.
closed panel
_______ ____ are instruments that do not penetrate soft tissues or bone but are used inside the mouth and contact the mucosa.
Semi-critical items
These instruments must be sterilized after every use or must undergo high-level disinfection if they are not heat stable.
Advantages of gas sterilization include
it being ecologically friendly and safe to use.
- Heat and moisture sensitive items can be sterilized.
- Ethylene oxide (ETO) is considered safe, with abatement technology that reduces the amount of ETO being released by 90–99.9%.
- Hydrogen peroxide gas plasma is ecologically safe to use and requires reduced processing time compared to ETO.
_____________ epidemiology helps to discern the etiology of a disease.
Analytical (observational)
Flash steam =
270 F /132 C @ 28lbs for 3 min in a gravity displacement steralizer
Heat resistant plastics
Polyethelene, Polystyrene
Heast resistant plastics = poly-proplyene/carbonate
Patient consent exists in two forms. What are these two forms?
Informed and Implied
Informed consent is based on the principle that every adult of sound mind has the right to decide what can or cannot be done to his or her body. As long as the practitioner explains the risks and benefits of a treatment plan option, an adult can make the decision of what to do. Implied consent involves the assumed responsibilities of either a dentist or patient once a patient has been accepted for treatment or once a treatment plan has been accepted.
Txp order/sequence is?
systemic, acute, disease control, definitive, and maintenance. This order ensures that the patient’s medical needs are not overlooked and that the acute dental problems are also met.
The risk of MI or heart failure is increased in patients who are unable to meet ___ .
4 METS
A patient’s ability to perform common daily tasks can be expressed in metabolic equivalent levels (METs), which provide a way of quantifying a patient’s general physical status. Daily activities requiring 4 METs.
Nitrous Oxide Flow rate
5-6 L/min to get to 50% ; most ppl need 30-40%
BP categories ( all):
Normal: systolic <120, diastolic <80
Elevated: systolic 120–129, diastolic <80
Stage 1 hypertensive: systolic 130–139, diastolic 80–89
Stage 2 hypertensive: systolic >140, diastolic >90
Hypertensive crisis: systolic >180, diastolic >120
Factors for dentist shortage:
- Good economic times
- High expectations for oral health. Since people’s oral health has generally improved in the last decades, people are expecting to maintain their dentition and invest in it throughout their life
- Less edentulism
- Growing utilization
- Effects of the “baby boomers” in the population
- Decline in the dentist/population ratio
Factors for dentist SURPLUS:
- Falling disease levels
- Changes in utilization of the younger generation. Many people who have had low levels of caries as children are growing into adults and requiring much less dental treatment
- Effects of the “baby bust” generation
- Economic downturns
- Increasing role of auxiliary personnel
The National Fire Protection Association color diamond
Red = flammability or susceptibility to burning. Yellow = instability, reactivity/ posibl release of E. White = special notice, [ex: oxidizer / reacts w/ water] Blue = a health hazard/ possible injury.
percentage do workplace fires and burns comprise of all workplace deaths?
4%
The American Society for Healthcare Engineering has made recommendations regarding the use of alcohol-based hand rub in dental practice. The maximum volume of a container of such liquid in an operatory =
2.0 L.
1.2L = hallway
Anything less wld req too frequent refills
One type of simple partial seizure is the _____ seizure. In this type of seizure, consciousness is not impaired, and there is usually a specific or localized sensory or motor change
Jacksonian
How soon after administration of levodopa dose should a Parkinson’s patient be scheduled for dental treatment?
60 - 90 min
D/t admin or wearing off of med can cause dyskinseaias that would effect dental tx
manifest in facial movements that could cause inflammation, damage to oral structures, tongue thrusting, and anterior teeth protrusion, and difficulties in wearing dentures. Even swallowing, speech, and respiration can become severely disabled
If prophylactic antibiotics are inadvertently missed in a patient who needs prophylactic antibiotic treatment to prevent bacterial endocarditis before a procedure, there is a window of opportunity of___________to administer the necessary treatment.
2 hours after the procedure
T/F. Fluoride is excreted in the urine.
TRUE
It also crosses the placental barrier; and there is some debate about whether prenatal use of fluoride may prevent caries in the unborn child. This has not yet been proven.
The mechanism of action of all of the following antimicrobial agents is _________ _______ ______ ______ _____ _____:
glutaraldehyde, formaldehyde, beta-propiolactone, ethylene oxide, and propylene oxide.
chemical cross-linking of functional groups on proteins and nucleic acids
*Peracetic acid acts through the mechanism of oxidation.
negative predictive value
TN
————————- *100%
( TN + FN )
T/F. Fluoride gets deposited in teeth, bone, and nails.
TURE
It also crosses the placental barrier; and there is some debate about whether prenatal use of fluoride may prevent caries in the unborn child. This has not yet been proven.
predominant method of financing dental care in Health Maintenance Organizations is?
Capitation
Billing for a full-mouth series of radiographs as if they were a number of individual radiographs is an example of
Unbundling
Which of the following is NOT correct concerning informed consent?
A- It must be obtained in advance of treatment
B- It must be in writing
C- It must include risks, benefits, and complications
D- It must include treatment options
B - dnt have to be written
A dentist administered a survey to patients to determine their satisfaction with practice characteristics and services provided. The survey was administered to patients seen during 1 month. Which type of study design was used by the dentist?
A- Cross-sectional
B- Cohort
C- Case control
D- Clinical trial
A
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