PMHP Flashcards

1
Q

Key characteristics of a systematic review (5)

A
  1. Well formulated question
  2. Comprehensive search
  3. Unbiased selection
  4. Assessment of papers
  5. Synthesis of data
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2
Q

PICO

A

Population
Intervention
Comparison
Outcome

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3
Q

Dichotomous data

A

Binary

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4
Q

Continuous data examples

A

Blood pressure
Weight

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5
Q

Summary statistics used for dichotomous data (5)

A

OR
RR
RRR (Relative risk reduction)
RD (absolute risk difference)
NNT (1/RD)

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6
Q

Summary statistics for continuous data (2)

A
  1. Weighted mean difference
  2. Standardised mean difference
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7
Q

Sensitivity analysis

A

Does the result change according to small variations in the data and methods?

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8
Q

4 ingredients of resilience

A

Awareness
Thinking
Reaching out
Fitness

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9
Q

Name a common model used for risk factors

A

Dahlgren-Whitehead Rainbow

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10
Q

Access aids to the mouth for special care patients (3)

A
  1. Bedi shield
  2. Open wide mouth rests
  3. Head support
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11
Q

Clinical Holding

A

Physical holds used to assist a pt in receiving dental care where the patients behaviour may present a safety risk to themselves or the dental team

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12
Q

Assessment of learning disability (7)

A
  1. Level of understanding
  2. Communication
  3. Physical and emotional access
  4. Co-operation
  5. Medical status
  6. Social status
  7. Dental status
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13
Q

Signs of pain from someone who cannot reliably communicate (4)

A
  1. Sleep interruption
  2. Changes in behaviour
  3. Rubbing of an area
  4. Pulling at an area
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14
Q

What should you document for examinations of people with learning/physical disabilities

A

What was examined and what was not - justification

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15
Q

Biopsychosocial Model

A

General acceptance that illness and health are the result of interaction between biological, psychological and social factors

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16
Q

Financial barriers for patients (3)

A
  1. Cost
  2. Travel
  3. Carers
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17
Q

Mental health barriers for older patients (3)

A
  1. Shame
  2. Confusion or lack of recall of conversations
  3. Public services perceived as inadequate
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18
Q

Oral Health Literacy

A

Degree to which individuals have the capacity to obtain, process and understand basic oral health information and services

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19
Q

Barriers to effective communication (5)

A
  1. Limited time
  2. Financial incentives promoting tx over prevention
  3. Lack of OHL training
  4. Limited plain language pt education materials
  5. Pts with low OHL
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20
Q

Individual level barriers for pts with learning disability (4)

A
  1. Lack of consent
  2. Complicated MH
  3. Inability to co-operate with tx
  4. Inability to communicate dental pain
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21
Q

Facilitators of oral health care (4)

A
  1. Financial support
  2. Dentists chair side manner
  3. Community support
  4. Interprofessional communication
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22
Q

Aim of the guideline for use of GA in SCD (2)

A
  1. When should GA be used in SCD
  2. How should tx be delivered in SCD with GA
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23
Q

Communication aids for those with learning difficulties (5)

A
  1. Makaton
  2. Picture boards
  3. Talking mats
  4. Social stories
  5. Technology
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24
Q

For what patients is drooling more common (5)

A
  1. Developmental disability
  2. Cerebral palsy
  3. Progressive neurological conditions
  4. Parkinsons disease
  5. Motor neuron disease
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25
What can oxygen therapy cause
Xerostomia
26
Open wide
Training resource and manual for the delivery of oral care for people with additional care needs
27
Empowerment for those with disabilities (4)
1. Prompt 2. Encourage 3. Support 4. Maximise the skills and ability of the person
28
Positioning for brushing teeth in patients with ASN (3)
1. Support for body 2. Head support 3. Forward and down to prevent gagging
29
Behavioural strategies for those with disabilities (5)
1. Bridging 2. Chaining 3. Hand over hand 4. Distraction 5. Rescuing
30
Bridging
Demonstrate a behaviour yourself and give the pt what they need to mirror the behaviour
31
Chaining
Bringing the persons hand to their mouth while describing the activity
32
Hand over hand
Place your hand over their hand and gently brush their teeth
33
Where to start with toothbrushing in pt with ASN (4)
1. Small head 2. Soft brush 3. Flavourless toothpaste 4. Start at back and move forward
34
How to make oral care a positive habit (3)
1. Cue 2. Repetition 3. Reward
35
Facilitating behaviour change (5)
1. Supportive and stable environments 2. Piggyback it onto an already positive experience 3. Make it easy/achievable 4. Unique and personalised queues 5. Practice and repeat
36
DisDAT
Disability Distress Assessment Tool
37
ART
Atraumatic Restorative Treatment
38
What is addiction
Chronic, primary, neurobiological condition influenced by genetic, psychosocial and environmental factors
39
3 different ways drugs can be classified
Behavioural Pharmacodynamic Legal
40
Complications of injecting drugs (3)
1. Cellulitis 2. Abscess 3. Thrombophlebitis
41
DCR
Drug consumption room
42
HAT
Heroin assisted treatment
43
Alcohol misuse
Excess of 5 units per day
44
Alcohol amount guidance
14 units per week with 2 alcohol free days
45
Signs of substance misuse (5)
1. Requesting specific drugs 2. Loss of reliability 3. Tremors 4. Altered pupils 5. Puncture marks
46
Barriers to dental care for drug users (4)
1. Chaotic lifestyles 2. Fear or prejudice 3. Poor attendance and compliance 4. Cost
47
Consent for drug dependent users
Capacity unlikely if pt currently under the influence - postpone tx
48
LA in opioid users
Can have LA resistance
49
LA in cannabis users
LA with adrenaline can prolong tachycardia
50
LA in alcohol misusers (3)
Care with LA that is metabolised in the liver Keep doses to minimum Avoid IDB in coagulation defects
51
Scheduling appointments for alcoholics
Morning appointments as they're less likely to be under the influence
52
Dental advice for methadone users (4)
1. Straw 2. Drink water after consumption 3. Don't brush immediately after 4. Engage with dental services
53
LA in patients who use cocaine, ecstasy, methamphetamines
Avoid adrenaline containing LA
54
Populations at risk of ineffective endocarditis (4)
1. Previous IE 2. Prosthetic valves 3. Congenital heart disease 4. Ventricular assist devices
55
Dental anxiety (2)
Emotional response to unknown danger General and anticipatory
56
Dental fear
Intense biological response to immediate danger which is specific
57
Dental phobia
Overwhelming and debilitating fear
58
MDAS (2)
Modified Dental Anxiety Scale Scores between 5-25
59
What age can the MDAS be used
16+
60
Severe dental anxiety on MDAS
>19 or 5/5 on LA question
61
MCDASf (2)
Modified child dental anxiety scale faces version Scores 9-45
62
What ages can the MCDASf be used on
8-15
63
Severe dental anxiety on MCDASf
>27
64
General approaches to anxiety (2)
Pharmacological Psychological
65
Building blocks of fear and anxiety (5)
1. Situation 2. Thoughts 3. Physical sensations 4. Emotions 5. Behaviours
66
Feared hierarchy (2)
1. Create a fear ladder 2. Expose pt to small things and gradually work your way up
67
DFA
Dental fear and anxiety
68
Dimensions of healthcare quality (6)
Person centred Safe Effective Efficient Equitable Timely
69
Factors contributing to adverse events (3)
Human factors Structural factors Clinical factors
70
Components of clinical governance (6)
Education & training Risk Management Research & development Clinical effectiveness Clinical audit Openness
71
Quality standards - process (3)
Setting Delivering Monitoring
72
GDC CPD highly recommended topics (3)
1. Medical emergencies (10+/cycle and 2+/year) 2. Decon (5+/cycle) 3. Radiography and radiation protection (5+/cycle)
73
SDRS
Scottish Dental Reference Service Review a sample of patients each year
74
Audit Cycle (5)
1. Identify problem 2. Set standards 3. Observe practice/collect data 4. Compare performance with standard 5. Implement change
75
Timeline for complaints (3)
Acknowledged within 3 days Quick resolution - 5 days Respond asap - no more than 20 days
76
Time limit for Dental Complaints Service
12 months
77
Main 3 questions for complaints (3)
1. What specifically 2. Expected outcome 3. Is it realistic
78
Complaints should be
Investigated
79
If pt unsatisfied with complaint handling (2)
Ombudsman for Health Service Complaints Dental Complaints Service
80
If a complaints can't be resolved quickly
Give them regular updates (at least every 10 days)
81
Key teeth to retain for QoL (3)
1. Occluding pairs 2. Number 3. Anteriors
82
GA in elderly - complications
Complications increase with age
83
Domiciliary care patients (4)
1. Bedbound 2. O2 therapy 3. Hospitalised 4. Agoraphobia
84
Frailty phenotype (5)
1. Exhaustion 2. Reduced grip strength 3. Weight loss 4. Low activity 5. Slow gait
85
Clinical Frailty Scale
1 - 9 From very fit to terminally ill
86
Geriatric Giants now known as
Frailty Syndromes
87
Frailty Syndromes (5)
1. Falls 2. Immobility 3. Delirium 4. Incontinence 5. Susceptibility to side effects (poly pharmacy)
88
CGA
Comprehensive Geriatric Assessment