pyogenic infection symposium

Question 1

what 4 special investigations may be done for a suspected acute apical abscess

Answer 1

pulp sensibility testing - 2 forms
TTP
mobility
radiographs

Question 2

how long after treatment should a acute dento alveolar abscess be reviewed

Answer 2

48-72 hours

Question 3

name 2 common bacteria found in dento alveolar abscesses

Answer 3

streptococcus anginosus (streptococci)
prevotella intermedia (anaerobe)

Question 4

name 2 antibiotics effective against streptococci

Answer 4

penicillin
metronidazole
erythromycin and clindamycin

Question 5

name 2 antibiotics effective against strict anaerobes e.g prevotella intermedia

Answer 5

penicillin
metronizadole

Question 6

what does penicillin target

Answer 6

bacterial cell walls

Question 7

what does erythromycin and clindamycin target

Answer 7

protein synthesis

Question 8

what does metronizadole target

Answer 8

DNA synthesis

Question 9

SIRS is diagnosed if 2 of what criteria are present

Answer 9

temperature <36 or >38
HR > 90 bpm
Respiratory rate > 20 breaths a minute
(WCC <4000 or >1200mm3)

Question 10

method of relaying patient situation to a senior colleage

Answer 10

SBAR
situation - patient, age, diagnosis etc
b - background, summarise significant points in history
a - assessment - what have you found today
r - recommendation - what does the senior think should happen

Question 11

For incision and drainage of a swelling what size should the incision be

Answer 11

around 1cm

Question 12

what instrument may be used to carry out the hilton technique

Answer 12

curved clip scissors

Question 13

name 2 symptoms of a sublingual spread of infection

Answer 13

raised tongue
sore tongue

Question 14

what is the normal respiratory rate

Answer 14

12-18 breaths a minute

Question 15

name 4 questions you would ask a patient who presented with a facial swelling

Answer 15

when did the swelling begin
is it increasing or decreasing in size
is there any reduced mouth opening
is there a bad taste present
any dysphagia (difficulty swallowing)
any systemic symptoms

Question 16

neutropenic sepsis

Answer 16

signs and symptoms of sepsis but neutrophil count less than 0.5
(neutrophil count should be above 1 for all dental treatment)

Question 17

minimum neutrophil count for dental treatment

Answer 17

1

Question 18

name 2 potential causes of neutropenia

Answer 18

chemotherapy
stem cell transplant
immunosuppressive drugs
severe nutritional deficiencies

Question 19

what signs may indicate requirement of antibiotics

Answer 19

fever
lymphadenopathy
swelling
pus drainage

Question 20

what swellings are safe for a GDP to incise and what should be referred

Answer 20

buccal and palatal fine for GDP - beware of local anatomy
submandibular and sublingual should be referred - ducts, nerves, arteries etc