Physical Evaluation

Question 1

What are the components of physical evaluation?

Answer 1

1. medical history questionnaire
2. dialogue history
3. physical examination
4. risk assessment

Question 2

What seeks to determine the significance of any reported medical disorder to the proposed dental treatment plan?

Answer 2

dialogue history

• dentist review completed history with patient
• specific follow-up questioning for pertinent positives

Question 3

If a patient say “YES” to asthma or chest pain for example, what should you consider next?

Answer 3

1. follow-up questioning
2. additional information needed?
3. change in dental treatment based on this information

Question 4

Match the following symptoms as either allergy or side effect.

1. mild: itching, rash, hives
2. headache
3. N/V
4. serious: swelling of lips/tongue, difficulty breathing
5. palpitations

Answer 4

1 & 4 = allergy

2, 3, & 5 = side effect

Question 5

What should be considered when reviewing medications?

Answer 5

1. prescription medications, over-the-counter medications, supplements, vitamins, herbals
2. dose & frequency
3. recent changes to prescription medications
4. non-compliance with prescription medications
5. review for potential dental drug interactions (epocrates, lexicomp, etc.)

Question 6

What questions should you ask in the dialogue wrap-up?

Answer 6

“Do you have any other medical/dental problems that you think I should know about?

Is there anything that you wish to discuss with me in private?”

Question 7

What is included in vitals?

Answer 7

BP
Pulse (rate and rhythm)
Respiratory Rate

Question 8

This is an indicator of body mass composition used to assess risk for other health problems.

Answer 8

BMI (height & weight)

Question 9

What does a BMI>25 put one at risk for?

Answer 9

HTN
Dyslipidemia
Type II diabetes
coronary artery disease
stroke
gallbladder disease
osteoarthritis
OBSA
cancers

Question 10

T/F. Functional capacity is the ability to engage in normal physical activity without becoming SOB or fatigued.

Answer 10

True.

Question 11

What does METs stand for?

Answer 11

Metabolic equivalents of tasks

it quantifies the body’s use of oxygen

Question 12

If someone answers YES to “Are you able to climb a flight of stairs without getting chest discomfort or short of breath? What is their METs?

Answer 12

Yes = METs >4
No = METs

Question 13

What should be included in the patient summary?

Answer 13

age, race, gender
status of chronic medical conditions
contraindications to care/concerns with proceeding

Question 14

ASA I

Answer 14

Health patient:

1. major organ systems healthy
2. BP

Question 15

ASA II

Answer 15

Mild systemic disease:

1. Healthy patients with extreme anxiety
2. > 60 yo
3. BP 140-159/90-94
4. well-controlled DM II
5. smoker
6. Pregnancy

Question 16

ASA III

Answer 16

Severe systemic disease:

1. stable angina, >6 mo post-MI, exercise-induced asthma, controlled DM I
2. Signs of distress with activity
   - angina, SOB, fatigue

Question 17

ASA IV

Answer 17

• Unstable angina, uncontrolled seizures, pulmonary edema
due to uncompensated CHF
• Signs of distress at rest
• Angina, shortness of breath, fatigue
• Cannot tolerate any additional stress

Question 18

What are the indications for medical consultation?

Answer 18

‣ Concern for previously undiagnosed disease
‣ Poor historian
‣ Specific lab values or diagnostic tests that may influence
dental management
‣ Uncontrolled disease preventing elective care

Question 19

What is the point of medical consultation?

Answer 19

to gather relevant medical data to guide dental care

physician provides the info…the dentist make the treatment decisions!

Question 20

What do you ask the during medical consult?

Answer 20

• Brief description of how the medical concern
might influence the dental treatment
• Be specific in what assistance is requested
• Do not ask for “medical clearance”