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BDS Exam style questions > PMHP/Decon > Flashcards

PMHP/Decon Flashcards

1
Q

What is meant by D3?

A

Obvious decay into dentine (using visual methods only)

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2
Q

What are the fluoride delivery methods at population level?

A

Water fluoridation

F enhanced milk in school

Fluoridated salt

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3
Q

What are the pillars of clinical governance?

A

Education and training

Clinical audit

Clinical effectiveness

R and D

Openness- report issues, evaluate errors, transparency, duty of candour

Risk management

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4
Q

What are the parts of the audit cycle?

A

Identify problem/issue

Set criteria and standards

Observe practice/data collection

Compare performance with criteria and standards

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5
Q

What should be done after audit cycle?

A

Implement change

Repeat audit

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6
Q

What concerns would you raise with nurses wearing uniforms in public?

A

Infection control

Profession reputation

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7
Q

What would the intended learning outcomes be from a training session on PPE?

A

Wear PPE when carrying out procedures

Wear PPE when cleaning up

Change PPE between patients

Correctly dispose of PPE

Protect you and patients- eyes, hands and clothing

Wear PPE when carrying out decontamination

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8
Q

How would you ensure staff have followed instructions?

A

Clinical audit

Inspection by supervisor

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9
Q

What are the steps in PICO?

A

Population

Intervention

Comparison

Outcome

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10
Q

What makes results significant?

A

If confidence interval overlaps 0 = NULL hypothesis

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11
Q

What can you do to randomise a study?

A

Blinding

Computer generated assignment

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12
Q

What other attributes make a study reliable?

A

Larger size

Longer duration

Diverse population

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13
Q

Why is manual cleaning carried out?

A

To remove gross debris, restorative material, restore function, aid disinfection, remove prions

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14
Q

Why must AWD and steriliser be tested?

A

To ensure machines are functioning as intended, medico-legal requirement

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15
Q

What are the 5 stages of the washer-disinfector cycle

A

Flush- submerges instruments in water

Wash- uses detergent to clean

Rinse- removes detergent

Disinfection- uses high temperature steam energy to kill microbes

Dry- removes moisture from instruments

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16
Q

Why do we not dry instruments with a paper towel?

A

As this is not a non-linting towel

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17
Q

Why is Type B better?

A

Creates a vacuum- removes air allowing steam to flood chamber and maintain desired temperature
-> can process porous load, wrapped instruments, channelled and lumped instruments

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18
Q

What is clinical governance?

A

Systematic approach to maintaining and improving quality of patient care within health system

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19
Q

What are the dimensions of healthcare?

A

Pt centred, safe, effective, efficient, equitable, timely

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20
Q

What are 3 divisions of NHS Scotland dental services?

A

Primary- GP

Secondary- PDS

Hospital services

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21
Q

How many hours of CPD must be completed in each cycle?

A

100 hours verifiable CPD within 5-year cycle and at least 10 hours verifiable every 2 years

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22
Q

What are the core CPD topics and how many hours are advised each cycle?

A

Medical emergencies- 10 hours every cycle (2 each year)

Decon- 5 hours every cycle

Radiation protection- 5 hours every cycle

Legal and ethical issues

Complaints handling

Oral Cancer: Early detection

Safeguarding children and young people / safeguarding vulnerable adults

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23
Q

What are the 9 GDC standards?

A
  1. Put patient’s interests first
  2. Communicate effectively with patients
  3. Obtain valid consent
  4. Protect patient information
  5. Have a clear and easy complaints procedure
  6. Work with colleagues in patient’s best interests
  7. Maintain, develop and work within own skills
  8. Raise concerns if patients are at risk
  9. Behave professionally and maintain patient confidence in you and the profession
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24
Q

Who are 6 members of the dental team who are registered with GDC?

A

Dentist, dental nurse, hygienist, therapist, orthodontic therapist, technicians, clinical technicians.

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25
Q

What chemicals are used for blood spill?

A

Sodium hypochlorite or sodium dichloroisocyanurate -> 10000ppm

-> applied for 3-5 mins

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26
Q

What are the waste streams?

A

Black- domestic

Orange- low risk like PPE

Sharps box- sharp

Red- hazardous like amalgam

Yellow- hazardous- teeth

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27
Q

What are the steps in chain of infection?

A

Infectious agent

Reservoir

Portal of exit

Mode of transmission

Portal of entry

Susceptible host

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28
Q

What are the points in sinner circle?

A

Time

Temperature

Chemical

Energy

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29
Q

What are the 10 SICPs?

A
  1. Cough ettiquete
  2. Hand hygiene
  3. Equipment management
  4. Waste disposal
  5. Body fluid management
  6. Linen management
  7. Environmental control
  8. Sharps exposure
  9. PPE
  10. Patient placement
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30
Q

What are the pillars of ethics?

A
  1. Non-maleficence
  2. Beneficence
  3. Justice
  4. Patient autonomy
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31
Q

What is negligence?

A

Omission to do something a reasonable practitioner would do or something a reasonable practitioner would not do

-> Dentist owed a duty of care, duty was breached, caused harm/damage, harm/damage reasonably foreseeable

32
Q

What are requirements for patient notes?

A

Confidential

Accurate

Legible

Complete

Retrievable

Current

Retained (11yrs/age25 for children)

33
Q

What is an audit?

A

A quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change

34
Q

What are the uses of audit?

A

Encourages learning

Indicates gaps in knowledge and skills

Modify attitudes

Reinforces agreed procedures

Opportunity for training

35
Q

What factors ours make up consent?

A

Informed

Valid

Capacity

Voluntary

Non-manipulated

Non-coerced

36
Q

What must be discussed for consent to be informed?

A

What the treatment/process is

Benefits

Risks- material

Alternatives

No treatment consequences

Success rates

Cost

Your recommendation

37
Q

What makes consent valid?

A

Recent

Specific

Remain appropriate

38
Q

What study provides the highest level of evidence?

A

Systematic review of randomised control trials

39
Q

What are 4 aspects of RCT?

A

Randomised

Inclusion/exclusion criterua

Control group

Blinding

40
Q

What is incidence?

A

Number of new cases offer a specific time

41
Q

What is prevalence?

A

Number of cases of particular disease at that point in time

42
Q

What is SIMD?

A

Scottis index of multiple deprivation

43
Q

What factors influence deprivation?

A

Unemployment

Income

Education

Housing

Access to healthcare

Environment

Crime

44
Q

What are the signs and symptoms of Alzheimers?

A

STML

Aphasia

Communication difficulty

Mood swings

Withdrawal

Loss of confidence

Difficulty with everyday activities

45
Q

What are the signs and symptoms of Parkinson’s?

A

Intention termor

Bradykinesia

Mask-like face

Rigidity

Impaired gait

46
Q

What are the issues when treating patients with Alzheimers and Parkinson’s?

A

Issues with consent/capacity

Poor OH

Tremor

Communication issues

Poor denture care

Pain goes unrecognised

47
Q

What are the principles of AWI?

A
  1. Benefit
  2. Minimum necessary intervention
  3. Account for patient’s past wishes
  4. Consult relevant others
  5. Encourage residual capacity
48
Q

What is capacity?

A
  • Understand in simple language what the treatment is, its purpose
    and nature and why it is being proposed
  • Understand its principle benefits, risks and alternatives
  • Understand consequences of not receiving the proposed treatment
  • Retain the memory of the decision
  • Can communicate decision
    -> always assume people have capacity
49
Q

Who can consent on AWI?

A

Welfare POA

Welfare guardian

Qualified medical professionals under section 47

50
Q

What is the equivalent of AWI in England?

A

Mental capacity act 2005

51
Q

What are the advantages and disadvantages of a split mouth study?

A

ADV:
Control and intervention are exposed to same environment

DIS:
Patient cannot be blinded

52
Q

What is a confidence interval?

A

Representation of study findings to real world population
-> worked out using the effect size and the sample size relative to the true population
-> 95% likelihood of repeat results

53
Q

Risk ratio and absolute risk difference CI meaning:

A

Risk ratio- overlaps 1 (no significance)

Absolute risk difference- overlaps 1 (no significance)

54
Q

What are the steps in the decontamination cycle?

A

(Acquisition)

Cleaning

Decontamination

Inspection (disposal)

Packaging

Sterilisation

Transport

Storage

Use

Transport

55
Q

What are 4 legislations for decontamination?

A

COSHH 2002

Health and safety at work act

Medical devices act 2021

BS EN

SHTM 01-01

56
Q

What are reasons for cleaning?

A

Remove organic matter

Remove restorative material

Restore function

Aids disnfection and sterilisation

Medico-legal requirement

57
Q

What are 5 common handpiece faults?

A
58
Q

How is manual washing carried out?

A

PPE- face shield, mask, gown, nitrile gloves and marigolds on top

Water <35 degrees

Detergent- pH neutral

Immersion and non-immersion as required

Use long handled non-metallic brush

Rinse afterwards

59
Q

What does an ultrasonic bath do?

A

Uses ultrasound to create micro bubbles which cause cavitation when they implode having scouring effect on instruments

Done at 20-30 degrees

pH neutral detergent

Degas to remove air prior

60
Q

What daily tests are done for AWD?

A

Checking the spray arms rotate and spray jets are not blocked

Checking the door seal for damage or contamination

Verifying the condition of the load carrier

Checking there are no instruments (parts) from previous cycles

Making sure the strainer/filter is clear

Making sure there is a sufficient amount of chemical

Carrying out a protein detection test and soil test

Noting disinfection temperatures on daily cycles

Carrying out a full ACT

61
Q

What temperature pressure and time is sterilisation carried out at?

A

134-137 degrees

Pressure equivalent gauge (from atmospheric) 2.05 – 2.35 bar
-> required to reach temperature

Pressure equivalent absolute (from absolute zero) 3.05 – 3.35 bar

Minimum hold time of 3 mins

62
Q

What are 3 types of sterilisers and their uses?

A

Type B- active air removal, processes instruments wrapped and lumped

Type S- used for handpieces

Type N- passive air removal, solid steel instruments, not wrapped or lumened

63
Q

What water is used for rinse stage of AWD?

A

Reverse osmosis - does not leave residue

64
Q

What are factors in the aetiology of DFA?

A

Preparation from parents and peers

Expectation of pain

Previous negative experience

Media

Uneducated on modern practice

65
Q

How may a patient with DFA present?

A
66
Q

What are the steps in cycle of behavioural change?

A

Precontemplation

Contemplation

Preparation

Action

Maintenance

**Progress and relapse possible at each stage

67
Q

What management techniques can be used for anxious patients?

A

Medication- benzos

Sedation

Desensitisation

Acclimatisation

CBT

Relaxation- breathing

Tell-show-do

Distraction

Stop signals- control

68
Q

What is a primary appraisal in stress?

A

Initial assessment of stressor as:
-> Irrelevant
-> benign
-> Harmful- threat
-> Harmful- challenge

69
Q

What is secondary appraisal?

A

Reaction to primary appraisal
-> Harm
-> resistance
-> exhaustion

70
Q

What are the respsones to stress?

A

Direct action

Seek info

Do nothing

Coping strategies

71
Q

What are coping mechanisms for stress?

A

Exercise

Work life balance

Mindfulness

Hobbies

Relationships/family

Travel

Art

72
Q

What is burnout?

A

A process whereby a previously committed professional disengages from his or her work in response to stress and strain experienced in the job
-> physical and mental exhaustion
-> negative cynical, dissatisfied

73
Q

What are the symptoms of stress?

A

Physical:
Exhaustion
GI problems
Headaches
Shortness of breath
Skin complaints
Sleeplessness
Aches/pains

Psychological:
Touchy and irritable
General lethargy
screaming/shouting,
Outbursts of anger

74
Q

What is the screening test for alcohol?

A

CAGE:
Cut down
Annoyed at criticism
Guilty
Early morning drinking

75
Q

How is brief intervention for alcohol given?

A

FRAMES:
Feedback
Responsibility
Advice
Menu of self directed change
Empathy
Self-efficacy

76
Q

How is pack years calculated?

A

20 cigs per day for a year is one pack year
-> 20/day for 20 years in 20 pack years
-> 10/day for 5 years- 2.5 pack years

77
Q

How is brief intervention for smoking given?

A

3As- ask, advise, act

5As- ask, advise, assist, assess, arrange follow up

BDS Exam style questions (15 decks)

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