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BDS Exam style questions > PMHP/Decon > Flashcards

PMHP/Decon Flashcards

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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
What chemicals are used for blood spill?
Sodium hypochlorite or sodium dichloroisocyanurate -> 10000ppm -> applied for 3-5 mins
26
What are the waste streams?
Black- domestic Orange- low risk like PPE Sharps box- sharp Red- hazardous like amalgam Yellow- hazardous- teeth
27
What are the steps in chain of infection?
Infectious agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host
28
What are the points in sinner circle?
Time Temperature Chemical Energy
29
What are the 10 SICPs?
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
30
What are the pillars of ethics?
1. Non-maleficence 2. Beneficence 3. Justice 4. Patient autonomy
31
What is negligence?
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
What are requirements for patient notes?
Confidential Accurate Legible Complete Retrievable Current Retained (11yrs/age25 for children)
33
What is an audit?
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
What are the uses of audit?
Encourages learning Indicates gaps in knowledge and skills Modify attitudes Reinforces agreed procedures Opportunity for training
35
What factors ours make up consent?
Informed Valid Capacity Voluntary Non-manipulated Non-coerced
36
What must be discussed for consent to be informed?
What the treatment/process is Benefits Risks- material Alternatives No treatment consequences Success rates Cost Your recommendation
37
What makes consent valid?
Recent Specific Remain appropriate
38
What study provides the highest level of evidence?
Systematic review of randomised control trials
39
What are 4 aspects of RCT?
Randomised Inclusion/exclusion criterua Control group Blinding
40
What is incidence?
Number of new cases offer a specific time
41
What is prevalence?
Number of cases of particular disease at that point in time
42
What is SIMD?
Scottis index of multiple deprivation
43
What factors influence deprivation?
Unemployment Income Education Housing Access to healthcare Environment Crime
44
What are the signs and symptoms of Alzheimers?
STML Aphasia Communication difficulty Mood swings Withdrawal Loss of confidence Difficulty with everyday activities
45
What are the signs and symptoms of Parkinson's?
Intention termor Bradykinesia Mask-like face Rigidity Impaired gait
46
What are the issues when treating patients with Alzheimers and Parkinson's?
Issues with consent/capacity Poor OH Tremor Communication issues Poor denture care Pain goes unrecognised
47
What are the principles of AWI?
1. Benefit 2. Minimum necessary intervention 3. Account for patient's past wishes 4. Consult relevant others 5. Encourage residual capacity
48
What is capacity?
* 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
Who can consent on AWI?
Welfare POA Welfare guardian Qualified medical professionals under section 47
50
What is the equivalent of AWI in England?
Mental capacity act 2005
51
What are the advantages and disadvantages of a split mouth study?
ADV: Control and intervention are exposed to same environment DIS: Patient cannot be blinded
52
What is a confidence interval?
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
Risk ratio and absolute risk difference CI meaning:
Risk ratio- overlaps 1 (no significance) Absolute risk difference- overlaps 1 (no significance)
54
What are the steps in the decontamination cycle?
(Acquisition) Cleaning Decontamination Inspection (disposal) Packaging Sterilisation Transport Storage Use Transport
55
What are 4 legislations for decontamination?
COSHH 2002 Health and safety at work act Medical devices act 2021 BS EN SHTM 01-01
56
What are reasons for cleaning?
Remove organic matter Remove restorative material Restore function Aids disnfection and sterilisation Medico-legal requirement
57
What are 5 common handpiece faults?
58
How is manual washing carried out?
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
What does an ultrasonic bath do?
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
What daily tests are done for AWD?
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
What temperature pressure and time is sterilisation carried out at?
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
What are 3 types of sterilisers and their uses?
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
What water is used for rinse stage of AWD?
Reverse osmosis - does not leave residue
64
What are factors in the aetiology of DFA?
Preparation from parents and peers Expectation of pain Previous negative experience Media Uneducated on modern practice
65
How may a patient with DFA present?
66
What are the steps in cycle of behavioural change?
Precontemplation Contemplation Preparation Action Maintenance **Progress and relapse possible at each stage
67
What management techniques can be used for anxious patients?
Medication- benzos Sedation Desensitisation Acclimatisation CBT Relaxation- breathing Tell-show-do Distraction Stop signals- control
68
What is a primary appraisal in stress?
Initial assessment of stressor as: -> Irrelevant -> benign -> Harmful- threat -> Harmful- challenge
69
What is secondary appraisal?
Reaction to primary appraisal -> Harm -> resistance -> exhaustion
70
What are the respsones to stress?
Direct action Seek info Do nothing Coping strategies
71
What are coping mechanisms for stress?
Exercise Work life balance Mindfulness Hobbies Relationships/family Travel Art
72
What is burnout?
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
What are the symptoms of stress?
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
What is the screening test for alcohol?
CAGE: Cut down Annoyed at criticism Guilty Early morning drinking
75
How is brief intervention for alcohol given?
FRAMES: Feedback Responsibility Advice Menu of self directed change Empathy Self-efficacy
76
How is pack years calculated?
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
How is brief intervention for smoking given?
3As- ask, advise, act 5As- ask, advise, assist, assess, arrange follow up

BDS Exam style questions (15 decks)

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