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HHD 2 > Respiratory and neuro systems and diseases > Flashcards

Respiratory and neuro systems and diseases Flashcards

1
Q

What are some asthma triggers?

A

Viral infections, bacterial infections, allergens, occupational exposure, food, aspirin and strong emotion.

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2
Q

How can asthma be classified?

A

Mild, intermittent to severe, persistent

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3
Q

What is the presentation of asthma?

A

Dyspnoea, cough and expiratory wheeze

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4
Q

What are the risk factors of asthma?

A

Family history, exposure to allergens, gastro-reflux, polyposis.

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5
Q

What is COPD?

A

Tissue damage and micro ciliary dysfunction which leads to inflammation

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6
Q

How to manage COPD?

A

Smoking cessation, immunisation, exercise, oxygen , lung volume reduction surgery.

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7
Q

What treatment can be done for COPD?

A

Bronchodilators, beta antagonists

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8
Q

Describe a pink puffer…

A

They work hard to maintain a normal pO2. They tend to have barrel shaped hyper inflated chest and breathe through pursed lips.

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9
Q

What is a blue bloater?

A

They are blue because of hypoxia and polycythemia. they are often obese and have an oedema.

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10
Q

What are some considerations to be made of someone with COPD?

A

At risk of infection, chronic lung disease, antibiotic resistance, emphysema, heart failure, sterio and oxygen dependence.

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11
Q

What are some outpatient considerations for COPD?

A

steroids, position of patients, halitosis, candida infection

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12
Q

Describe the pathophysiology of an embolus.

A

An embolus in the arterial tree will have a worse effect the bigger that it is. There is vascular resistance which increases as the artery tries to work harder. The cardiac output decreases and so does MAP.

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13
Q

Risk factors of pulmonary embolism.

A

Old age, obesity, bed rest, MH, drug history, family history and social history.

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14
Q

What are the causes of pneumonia?

A

Aspergillosis, community acquired, hospital, viral acute aspiration and legionella atypical bacteria.

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15
Q

What can be done to prevent community acquired pneumonia?

A

Smoking cessation, hygiene and vaccinations.

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16
Q

How does pneumonia present?

A

Productive cough, pyrexia, dyspnoea, pleuritic pain, abnormal Sculption, confusion, dull percussion and arthralgia.

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17
Q

What are the risk factors of pneumonia?

A

COPD, smoking, alcohol, poor OH, children, diabetes and chronic disease.

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18
Q

What is the management of pneumonia?

A

ABCD resus, antiobiotics and fluids.

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19
Q

What is TB?

A

An infectious disease caused by the mycobacterium tuberculosis.

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20
Q

What is the presentation of TB?

A

Cough, haemoptysis and night sweats.

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21
Q

What are the risk factors of TB?

A

Pyrexia, anorexia, weight loss, malaise and chest pain.

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22
Q

What is hyperfusion?

A

Shock leading to global perfusion of the brain.

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23
Q

What is the presentation of a stroke?

A

sudden, visual loss, weakness, aphasia and impaired co-ordination.

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24
Q

What are the risk factors of a stroke?

A

Old age, previous stroke, HTN, smoking, diabetes and arterial fibrillation.

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25
Q

How should an ischaemic stroke be managed?

A

CBT/MRI should use thrombolytic medication to dissolve the clot and endovascular intervention.

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26
Q

What is a transient ischaemic stroke?

A

Caused by ischaemia but without infarction.

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27
Q

How should a transient ischaemic stroke be managed?

A

Manage with antiplatelet therapy, lipid lowering agent and a carotid stent.

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28
Q

What is a haemorrhagic stroke?

A

The disruption of blood flow due to intra-parenchymal haemorrhage.

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29
Q

What are the causes of a haemorrhagic stroke?

A

Long standing hypotension and amyloid angiopathy causes a clot. The expanding clot tears arteries which causes further bleeding and clot expansion.

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30
Q

How to manage a haemorhagic stroke

A

Monitor intra-cranial pressure, protect airway, BP control and surgery.

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31
Q

What is a subarachnoid haemorrhage?

A

Where the circle of Willis is blown.

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32
Q

What are the symptoms of a subarachnoid haemorrhage?

A

A very bad headache or vasospasm

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33
Q

What is a vertebral/carotid dissection?

A

It mainly comes from a traumatic event where a haemorrhage in the tunica intima expands.

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34
Q

What is motor neuron disease?

A

A progressive condition catergerised with generations in upper and lower neurons

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35
Q

What does motor neuron disease look like on a macroscopic level?

A

It is the thinning of anterior roots of the spinal cord.

36
Q

What is motor neuron disease like on a microscopic level?

A

The loss of neurons in the motor cortex

37
Q

What is the aetiology of motor neuron disease?

A

It is unknown, may be genetic, virus or mineral deficiency.

38
Q

How would you diagnose motor neuron disease?

A

a nerve conduction study or MRI

39
Q

What are the symptoms when it affects the upper motor neuron?

A

Weakness, hypertonic and hyperreflexia.

40
Q

What are the symptoms when it affects the lower motor neuron?

A

Hypertonic, hyporeflexia and fasciculations.

41
Q

How would you manage motor neuron disease?

A

Symptom management, ventilation and physio.

42
Q

What are the dental considerations for someone with motor neuron disease?

A

OH, dysphasia, drooling may have botox in salivary glands to reduce saliva function.

43
Q

What is Parkinson’s disease?

A

It is the loss of pigmented cells in the substantia nigra which is part of the basal ganglia.

44
Q

How does Parkinson’s present?

A

A tremor which begins unilaterally and then spreads across all 4 limbs.

45
Q

How do you manage Parkinson’s?

A

Dopamine antagonists

46
Q

What are some dental considerations for Parkinson’s?

A

Anxiety increases the tremor, raise patients carefully, some medications may affect BP and be careful when using adrenaline.

47
Q

What is multiple Sclerosis?

A

It is a common demyelination disease characterised by focal disturbance of function and a relapsing remitting course.

48
Q

How does multiple sclerosis present?

A

Earache, depression, limb weakness, disturbed vision, vertigo and sphincter disturbance.

49
Q

What is the clinical course for multiple sclerosis?

A

Relapsing and remitting is common but these phases may exist for years at a time.

50
Q

How do you diagnose MS?

A

Requires two or more episodes of symptoms which are attributed to demyelination at least 30 days apart.

51
Q

How do you manage MS?

A

Manage symptoms, antispasmodics, pain, depression and tremor.

52
Q

What are some dental considerations to be made with MS?

A

Poor OH, do not recline, steroid use ( dry mouth)

53
Q

What is huntington’s chorea?

A

Involuntary irregular movement affecting limbs and axial muscle groups. Progressive, localised neural cell death.

54
Q

Describe the pathophysiology of huntington’s chorea.

A

Loss of neurons in the striatum leading to a reduction in neuronal projections to other basal ganglia.

55
Q

How does huntington’s chorea present?

A

Chorea may be the initial symptom but can spread to mean that walking and eating become impossible.

56
Q

What is the treatment for Huntington’s chorea?

A

Calm muscle activity with risperidone or dopamine inhibitors. They may get Parkinson’s due to this medication.

57
Q

What is dementia?

A

It is the progressive deterioration of intellect, behaviour and personality because of the disease.

58
Q

In what ways can dementia be classified?

A

Alzheimer’s, degenerative, cerebrovascular, metabolic and trauma.

59
Q

How does dementia present?

A

Unsure of self, can’t cope with routine, loss of insight and behavioural changes.

60
Q

How is dementia diagnosed?

A

CT/MRI, biopsy, genetic, nutritional state and metabolic status.

61
Q

What are some dental considerations to make with those with dementia?

A

Comms skills, poor OH, forgotten appointments, denture loss, behavioural problems and avoid long/complex procedures.

62
Q

Hoe does a TBI present?

A

Headaches, vomiting, decreased consciousness, fixed pupils and neurological deficit.

63
Q

What is intracranial pressure?

A

No where for the pressure to go due to it being an enclosed space.
The brain will shift these can be a midline shift or a central descent.
Herniation leads to compression of CNIII
Tonsillar herniation leads to Cushing’s response.

64
Q

How can TBI’s be classified?

A

Acute, Chronic, diffuse, local, blunt, penetrating, severity and lesion type.

65
Q

What is concussion?

A

It is a mild and common TBI, there is no structural injury but may have post concussive syndrome.

66
Q

What is a skull vault fracture?

A

It comes from a high impact injury and there may be CSF fluid leaks, Battle’s sign and racoon eyees.

67
Q

What is a penetrating TBI?

A

Can be from a knife or gun, manage with ICP.

68
Q

What is a extramural haematoma?

A

A biconvex haematoma in the arteries, talk and die presentation to manage with neurological monitoring as they may need surgical evacuation.

69
Q

What is an Acute subdural haematoma?

A

An innocuous bump on the head but the veins in the subdural space are easily torn and the bleeding is continuous.

70
Q

What is a contusion?

A

Intraparenchymal bleeding which may cause generalised swelling.

71
Q

What are some investigations for TBI’s?

A

CT/MRI, coagulation studies and ICP measurements.

72
Q

How do you manage TBI’s?

A

Reduce damage caused by secondary injury, CSF diversion, craniectomy or burr-hole

73
Q

What is the prognosis for TBI’s?

A

A poor prognosis is indicated from grey and white matter found on a CT and brain stem involvement.

74
Q

What are some complications of a TBI?

A

Infections, residual disability, vitamin D synthesis, post traumatic seizures and post concussive syndromes.

75
Q

What are some dental considerations to be made post TBI?

A

Acute events may come with loose teeth, long term poor OH and polypharmacy.

76
Q

What are the stages of epilepsy?

A

Aura, ictal period, post ictal period.

77
Q

Describe the pathogenesis of epilepsy.

A

Glutamate is a stimulant and in epilepsy it has an overriding impact on its inhibiting enzyme GABA.

78
Q

What is a partial seizure?

A

Where consciousness is preserved and there is a cortical origin these start from an electrical storm coming from the cortex.

79
Q

Where does epilepsy start in the brain?

A

It is dependent on where the electrical impulses are coming from, it can move around the brain.

80
Q

What is Todd’s paralysis?

A

After a seizure limbs may be weak or paralysed but the symptoms should go.

81
Q

What are adverse seizures?

A

Where the head or the eyes move away from the point of origin.

82
Q

What is a tonic Clonic attack?

A

Tonic lasts around 10 seconds, locked eyes, elbows, legs and usually very clenched. Clonic is where there is shaking.

83
Q

What are some investigations for epilepsy?

A

CT/MRI, EEG, telemetry and ECG serum glucose.

84
Q

How do you manage epilepsy?

A

ABCDE and medication

85
Q

What are some dental considerations to be made with those with epilepsy?

A

No treatment with frequent seizures.

HHD 2 (5 decks)

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