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Medically Complex Patients > Quiz 1. Oral Med. Review > Flashcards

Quiz 1. Oral Med. Review Flashcards

1
Q

T/F Control of oral disease in pregnant women reduces transmission of oral bacteria to child

A

t

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2
Q

Is there evidence for early spontaneous abortion if the pregnant mom seeks dental care in the 1st trimester

A

no

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3
Q

Is preclampsia a contraindication for dental care? What is it

A

no it is a pregnanacy complication characterized by high BP

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4
Q

What is the effect of periodontal care on low birth weight

A

none

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5
Q

Should periodontal care be provided during pregnancy

A

yes

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6
Q

What are the strategies to reduce maternal cariogenic bacterial load

A
  • Brush 2x perday and fluoride toothpaste and fluoride mouthwash (esp. before bed)
  • Floss daily
  • Restore caries
  • Chlorhexidine mouth rinse and fluoride varnish as needed
  • 4-5x/day use of xylitol chewing gum or other xylitol products
  • Drink fluoridated water
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7
Q

Should LA with Epi be used in pregnant patients

A

yes

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8
Q

Can you take X-rays on pregnant patients

A

yes utilize the abdominal apron with thyroid collar

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9
Q

What analgesic is perfered when using in a pregnanat patient

A

acetaminophen

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10
Q

Should antibiotics be used in pregnant patients when needed?

A

yes including penicicllin, cephalosporins and erythromycin

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11
Q

Should dentists consult with the patients prenatal care provider for routine treatment of a healthy pregnanat pateint

A

no

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12
Q

When should the dentist consult with the perinatal provide

A
  • Deferring treatment because of pregnanacy
  • Co-morbid conditions that may lead to dental issues such as DM, pulmonary issues, heart or valvular disease, hypertension, bleeding disorders, or heparin-treated thrombophilia
  • Use of nitrous oxide as LA adjunct
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13
Q

Arterial blood pressure is directly proportional to what two variables

A
  • Cardiac output

- Peripheral vascular resistance

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14
Q

Cardiac output and peripheral resistance are controlled by what two mechanisms

A
  • Baroreflexes (mediated by the SNS)

- Renin-angiotensin-aldosterone system

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15
Q

Which of the two mechanisms are responsible for ra[id changes in BP

A

baroreflexes (renin-angiotensin-aldosterone system is for long term BP control)

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16
Q

Caroreceptors are located where in the body that help monitor BP

A

carotid sinuses and aortic arch

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17
Q

Angiotensinogen is converted to angiotensin I by

A

renin (peptidase)

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18
Q

Angiotensin I is converted to angiotensin II by

A

ACE (angiotensin converting enzyme)

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19
Q

What is the role of angiotensin II

A

body’s most potent vasoconstrictor

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20
Q

Decrease in BP leads to (increase/decrease) in renal blood flow…. which leads to the release of….

A

decrease….renin

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21
Q

Activation of the SNS in response to decreased BP results in the activation of what receptors located on what tissues

A

Beta 1 on heart –> increase CO

Alpha 1 on Smooth muscle –> increased peripheral resistance

22
Q

Describe the mechanism of thiazide diuretics

A

Decrease in Na and H2O retention –> decreased blood volume –> decrease Cardiac output and decreased peripheral resistance –> decreased BP

23
Q

Mechanism of Beta-blockers on decreasing BP

A

decrease CO
decrease SNS activation
decreases renin release from kidneys

24
Q

Propranolol blocks _ receptors while metoprolol and atenolol blocks _ receptors

A

B1 and B2… B1 selective

25
Q

Propranolo is contraindicated in _ patients and why

A

asthmatic patients due to B2 mediated bronchoconstriction

26
Q

ACE inhibitors are recommended to lower BP when

A

preferred first-line agents (diuretics and B-blockers) are contraindicated

27
Q

Do ACE inhibitors increase risk of other diseases

A

it is unclear

28
Q

Mechanism of ACE inhibitors

A

Lower BP by reducing vascular resistance without reflexly increasing CO, cardiac rate, or contractility preventing the production of Angiotensin II (potent vasoconstrictor)

29
Q

Decreased angiotensin release has what effects on the body

A
  • Decreased SNS output
  • Increased vasodilitation
  • Decreased aldosterone release –> decreased Na and H2O retention
  • Increased levels of bradykinin
30
Q

Mechanism of action of losartan

A

Angiotensin II receptor blocker (similar effects as ACE inhibitors

31
Q

Disadvantage of losartan

A

fetotoxic

32
Q

What Ca channel blocker leads to the least dilitation of coronary vessels

A

verapamil

33
Q

What Ca channel blocker causes the largest and smallest decrease in AV conduction

A

Largest= verapamil

Smallest=Nifedipine

34
Q

Which Ca channel blocker has the most and least number of adverse effects

A 
Most= Nifedipine 
Least= Diltiazem
35
Q

Well controlled diabetics (do/don’t) require special attention when recieving dental tx

A

don’t

36
Q

What are potential adverse effects of diabetic taking analgesics

A

-Avoid aspirin and other NSAIDs when taking sulfonylureas because they can worsen hypoglycemia

37
Q

What are potential adverse effects of diabetic taking antibiotics

A

-Phorylaxis not required (unless patient has brittle diabetes with poor oral health and fasting plasma glucose >200 mg/dL)

38
Q

What are potential adverse effects of diabetic taking anesthesia

A
  • No issue if well controlled
  • For diabetics with concurrent hypertension or hx of recent MI/cardiac arrythmia limit dose of epi to 2 carpules of 1:100,000
39
Q

What conditions present no issues to DM patients

A

anxiety, allergies, breathing, and chair position

40
Q

What are potential adverse effects of diabetic bleeding

A

thrombocytopenia is a rare adverse effect associated with taking sulfonylureas

41
Q

What are potential adverse effects of diabetic in terms of BP

A

diabetes is associated with hypertension

42
Q

What are potential adverse effects of diabetic in terms of CV issues

A

Confirm cardiovascular status

-B-blockers can exacerbate hypoglycemia in patients taking sulfonylureas

43
Q

Is AB prophylaxis needed for a diabetic on an insulin pump

A

no

44
Q

Should the patient alter their insulin dosage/meals on days they have dental appointments

A

no

45
Q

People with brittle diabetes (Type I) Require a (high/low) insulin dose

A

high

46
Q

T/F Insulin dose may need to be increased when undergoing an invasive procedure or when they have an oral infection

A

t

47
Q

Describe the change in post-op infection risk for the following fasting plasma glucose levels

  • < 206 mg/dL
  • 207-229 mg/dL
  • > 230mg/dL
A
  • No increased risk of infection
  • Increased risk by 20%
  • Increased risk by 80%
48
Q

Epi will have what effect on blood glucose

A

increase blood glucose (epi has the opposite effect as glucose)

49
Q

Oral complications associated with DM

A
  • Xerostomia
  • Bacteria/viral/fungal infection
  • caries
  • gingivitis/periodontitis
  • periapical abscesses
  • burning mouth syndrome
50
Q

Oral lesions common in diabetics

A
  • Candida
  • Traumatic ulcers
  • Lichen planus
  • Delayed healing (esp. type I diabetics)

Medically Complex Patients (1 decks)

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