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oral medicine and diagnosis > pulmonary dx pts/ vaping > Flashcards

pulmonary dx pts/ vaping Flashcards

1
Q

congential vs acquired pul dx

A
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2
Q

industrial acquired pul dx

A
  • Black Lung (coal miners)
  • Asbestosis (miners)
  • Bronchitis (Steel mills,smog)
  • COPD
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3
Q

recreational pul dx

A
  • Tobacco: Cigarettes, cigars, pipes
  • Vaping
  • Chew (Snus, chaw, dip, etc.)_
  • Cannabis (Marie Juana)
  • Cigarettes (joint)
  • Cannabidol
  • Topical (oils, creams)
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4
Q

Focal Problems aggravated by
Smoke and Smoking

A
  • Periodontal Disease
  • Asthma
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5
Q

relation of smoking to perio dx
cumulative/dependent?
result?

A

a

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6
Q

smoking increases tooth loss odds by?

A

70%

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7
Q

smoking effects on perio mechanism?

A
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8
Q

smoking effects on perio possible effects?
vascular?
pmn?
Ig?
lymphocytes?
pathogens?
fibroblasts?
difficulty with?
cytokines/GFs?

A
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9
Q

refactory periodontitis with smokers?

A
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10
Q

asthma

A

Chronic inflammatory airway disorder
* Airway hyper-responsiveness to stimuli
* Bronchial edema
* Narrowing of the airways i.e., obstruction

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11
Q

signs and symptoms of asthm,a

A

Recurrent, reversible episodes of:
*Dyspnea (shortness of breath)
*Wheezing
*Coughing
*Tightness of chest

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12
Q

Which of the following is a “true”
asthma symptom?
*Dyspnea (shortness of breath)
*Wheezing
*Coughing
*Tightness of chest

A

tightness of chest

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13
Q

Aggravating/Complicating Factors of asthma

A

● Smoking
● Air pollutants (quality)
- urban
- industrial

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14
Q

asthma stages

A
  1. Controlled
  2. Partially Controlled
  3. Uncontrolled
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15
Q

controlled asthma

A
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16
Q

partially controlled asthma

A
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17
Q

uncontrolled asthma

A
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18
Q

Types of Asthma

A
  1. Extrinsic (Allergic)
  2. Exercise Induced
  3. Intrinsic
  4. Drug Induced
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19
Q

Intrinsic (idiosyncratic, nonallergic, nonatopic)
* common?
* demo?
* Triggered by?
* Infrequently associated with?
* IgE levels?

A
  • Second most common
  • Middle-aged individuals
  • Triggered by respiratory irritants (tobacco, air pollution, emotional stress, gastroesophageal reflux
    disease (GERD)
  • Infrequently associated with family history
  • Normal IgE levels
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20
Q

intrinsic asthma pathway

A
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21
Q

patient considerations for asthma

A
22
Q

status asthmaticus

A

Severe prolonged asthma attack (more than 24 hours)
→ life threatening

23
Q

drugs to avoid with asthma

A

➢Aspirin, NSAIDs, Narcotics, Macrolide antibiotics
➢Sulfite containing local anesthetics may need to be avoided

24
Q

drug of choice for asthma attack

A

Short-acting Beta2-adrenergic agonist (inhaler) is the drug of choice for an acute attack

25
Q

sedation for asthma pts

A

➢Nitrous (better)
➢Short-acting benzodiazepine

26
Q

severe persistent asthma

A

med consult

27
Q

asthma emergency pt presentation
res. rate?
HR?
appearance?

A
  • Respiratory rate >25 breaths/min, labored breathing
  • Tachycardia >110 beats/min
  • Flushed appearance
28
Q

what to do at school with asthma attack

A
  • Stop treatment, inform supervising faculty, administer O2, and call 4444
    ➢ Remove all items from patient’s mouth
    ➢ Record the time attack began
    ➢ Raise the dental chair
    ➢ Give short-acting β2-adrenergic agonist inhaler
    ➢ Administer oxygen
    o Administer 0.3-0.5 ml of 1:1000 epinephrine –small doses are SM dilators
    o Call an ambulance
    o Re-administer short-acting β2-adrenergic agonist inhaler every 20
    minutes until EMS arrive
    o The emergency team will continue treating the patient with bronchodilators and oral systemic corticosteroids
29
Q

Focal Problems from Smoke and Smoking

A
  • COPD
  • Bronchitis
  • Emphysema
  • CAD (coronary artery disease)
30
Q

types of COPD

A

bronchcitis and emphysema

31
Q

Bronchiolitis

A

(chronic obstruction - small airways)
* Excessive tracheobronchial mucus production to cause coughing and sputum production for >3 months for >2 consecutive years in the absence of infection or other causes of chronic cough

32
Q

emphysema

A
  • Longterm Chronic obstructive bronchiolitis leads to destruction of lung parenchyma and alveolar walls
  • Decreased elastic recoil
  • Difficulty in maintaining airway opening during expiration
33
Q

progression COPD

A

Type II (emphysema) is a progression of Type I leading many to just use these as descriptive terms for COPD.

34
Q

3rd leading cause of death in USA

A

COPD

35
Q

Chronic Obstructive Pulmonary Disease (COPD) Aggravating/Complicating Factors

A

● Smoking
● Air pollutants (quality)
- urban
- industrial
● CVD
- comorbidity

36
Q

Chronic Obstructive Pulmonary Disease (COPD)
Signs and Symptom

A
  • Dyspnea
  • Cough
  • Sputum
37
Q

COPD tx

A
  • Inhaled long-acting bronchodilators
  • Corticosteroids if asthma also present and/or more reversible obstruction
  • Smoking cessation is only intervention that actually lessens disease progression
38
Q

important COPD meds

A
39
Q

COPD oral manifestations

A
  • Dry mouth
  • Steven-Johnson syndrome with theophylline
40
Q

COPD can exacerbate the smoking effects of?
* breath?
* Tooth?
nicotine ?
* Periodontal?
* malignancies?
* plaques?
* what cancer?

A
  • Halitosis
  • Tooth staining
  • Nicotine stomatitis
  • Periodontal disease
  • Oral potentially malignant disorders
  • Leukoplakia
  • Erythroplakia
  • Oral squamous cell carcinoma
41
Q

Chronic Obstructive Pulmonary Disease (COPD) dental tx considerations
Determine?
➢ Medical consultation for?
➢ If COPD Stage III or higher?

A

Determine stage and severity of COPD
➢ Medical consultation for mild to moderate COPD to determine the presence of respiratory failure right-sided heart failure
➢ If COPD Stage III or higher or who have respiratory and heart failure
o Consider dental treatment in a hospital setting

42
Q

tx if <stage 3 copd:
➢ Place the patient in what position?
➢ Avoid using a?
➢ Avoid treating if?
➢ Local anesthetic with epi?
o May need to limit epi if?

A

➢ Place the patient in a semi-supine position to avoid respiratory distress
➢ Avoid using a rubber dam
➢ Avoid treating if upper respiratory infection is present
➢ Local anesthetic with epi is acceptable
o May need to limit epi if concomitant CVD

43
Q

what meds should be avoided in copd?
when should macrolides and ciprofloxacin be avoided?

A
  • Avoid medications that cause respiratory depression
    ➢Barbiturates
    ➢Narcotics
    ➢Nitrous oxide is contraindicated
    ➢Benzodiazepines (low dose may be acceptable in certain situations)
    o Consult physician
  • macrolide antibiotics and ciprofloxacin should not be prescribed to COPD patients already taking theophylline
44
Q

vaping

A
45
Q

vaping components

A
46
Q

e liquid ingredients

A
47
Q

are e liquids safe?

A
48
Q

vaping aerosol

A
49
Q

why is vaping popular

A
50
Q

EVALI

A
51
Q

other health concerns of vaping
hr?
bp?
bronchitis?
lung dx?
blood sugar?

A
52
Q

vaping effects on oral health?

A

oral medicine and diagnosis (6 decks)

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