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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
How should an ischaemic stroke be managed?
CBT/MRI should use thrombolytic medication to dissolve the clot and endovascular intervention.
26
What is a transient ischaemic stroke?
Caused by ischaemia but without infarction.
27
How should a transient ischaemic stroke be managed?
Manage with antiplatelet therapy, lipid lowering agent and a carotid stent.
28
What is a haemorrhagic stroke?
The disruption of blood flow due to intra-parenchymal haemorrhage.
29
What are the causes of a haemorrhagic stroke?
Long standing hypotension and amyloid angiopathy causes a clot. The expanding clot tears arteries which causes further bleeding and clot expansion.
30
How to manage a haemorhagic stroke
Monitor intra-cranial pressure, protect airway, BP control and surgery.
31
What is a subarachnoid haemorrhage?
Where the circle of Willis is blown.
32
What are the symptoms of a subarachnoid haemorrhage?
A very bad headache or vasospasm
33
What is a vertebral/carotid dissection?
It mainly comes from a traumatic event where a haemorrhage in the tunica intima expands.
34
What is motor neuron disease?
A progressive condition catergerised with generations in upper and lower neurons
35
What does motor neuron disease look like on a macroscopic level?
It is the thinning of anterior roots of the spinal cord.
36
What is motor neuron disease like on a microscopic level?
The loss of neurons in the motor cortex
37
What is the aetiology of motor neuron disease?
It is unknown, may be genetic, virus or mineral deficiency.
38
How would you diagnose motor neuron disease?
a nerve conduction study or MRI
39
What are the symptoms when it affects the upper motor neuron?
Weakness, hypertonic and hyperreflexia.
40
What are the symptoms when it affects the lower motor neuron?
Hypertonic, hyporeflexia and fasciculations.
41
How would you manage motor neuron disease?
Symptom management, ventilation and physio.
42
What are the dental considerations for someone with motor neuron disease?
OH, dysphasia, drooling may have botox in salivary glands to reduce saliva function.
43
What is Parkinson's disease?
It is the loss of pigmented cells in the substantia nigra which is part of the basal ganglia.
44
How does Parkinson's present?
A tremor which begins unilaterally and then spreads across all 4 limbs.
45
How do you manage Parkinson's?
Dopamine antagonists
46
What are some dental considerations for Parkinson's?
Anxiety increases the tremor, raise patients carefully, some medications may affect BP and be careful when using adrenaline.
47
What is multiple Sclerosis?
It is a common demyelination disease characterised by focal disturbance of function and a relapsing remitting course.
48
How does multiple sclerosis present?
Earache, depression, limb weakness, disturbed vision, vertigo and sphincter disturbance.
49
What is the clinical course for multiple sclerosis?
Relapsing and remitting is common but these phases may exist for years at a time.
50
How do you diagnose MS?
Requires two or more episodes of symptoms which are attributed to demyelination at least 30 days apart.
51
How do you manage MS?
Manage symptoms, antispasmodics, pain, depression and tremor.
52
What are some dental considerations to be made with MS?
Poor OH, do not recline, steroid use ( dry mouth)
53
What is huntington's chorea?
Involuntary irregular movement affecting limbs and axial muscle groups. Progressive, localised neural cell death.
54
Describe the pathophysiology of huntington's chorea.
Loss of neurons in the striatum leading to a reduction in neuronal projections to other basal ganglia.
55
How does huntington's chorea present?
Chorea may be the initial symptom but can spread to mean that walking and eating become impossible.
56
What is the treatment for Huntington's chorea?
Calm muscle activity with risperidone or dopamine inhibitors. They may get Parkinson's due to this medication.
57
What is dementia?
It is the progressive deterioration of intellect, behaviour and personality because of the disease.
58
In what ways can dementia be classified?
Alzheimer's, degenerative, cerebrovascular, metabolic and trauma.
59
How does dementia present?
Unsure of self, can't cope with routine, loss of insight and behavioural changes.
60
How is dementia diagnosed?
CT/MRI, biopsy, genetic, nutritional state and metabolic status.
61
What are some dental considerations to make with those with dementia?
Comms skills, poor OH, forgotten appointments, denture loss, behavioural problems and avoid long/complex procedures.
62
Hoe does a TBI present?
Headaches, vomiting, decreased consciousness, fixed pupils and neurological deficit.
63
What is intracranial pressure?
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
How can TBI's be classified?
Acute, Chronic, diffuse, local, blunt, penetrating, severity and lesion type.
65
What is concussion?
It is a mild and common TBI, there is no structural injury but may have post concussive syndrome.
66
What is a skull vault fracture?
It comes from a high impact injury and there may be CSF fluid leaks, Battle's sign and racoon eyees.
67
What is a penetrating TBI?
Can be from a knife or gun, manage with ICP.
68
What is a extramural haematoma?
A biconvex haematoma in the arteries, talk and die presentation to manage with neurological monitoring as they may need surgical evacuation.
69
What is an Acute subdural haematoma?
An innocuous bump on the head but the veins in the subdural space are easily torn and the bleeding is continuous.
70
What is a contusion?
Intraparenchymal bleeding which may cause generalised swelling.
71
What are some investigations for TBI's?
CT/MRI, coagulation studies and ICP measurements.
72
How do you manage TBI's?
Reduce damage caused by secondary injury, CSF diversion, craniectomy or burr-hole
73
What is the prognosis for TBI's?
A poor prognosis is indicated from grey and white matter found on a CT and brain stem involvement.
74
What are some complications of a TBI?
Infections, residual disability, vitamin D synthesis, post traumatic seizures and post concussive syndromes.
75
What are some dental considerations to be made post TBI?
Acute events may come with loose teeth, long term poor OH and polypharmacy.
76
What are the stages of epilepsy?
Aura, ictal period, post ictal period.
77
Describe the pathogenesis of epilepsy.
Glutamate is a stimulant and in epilepsy it has an overriding impact on its inhibiting enzyme GABA.
78
What is a partial seizure?
Where consciousness is preserved and there is a cortical origin these start from an electrical storm coming from the cortex.
79
Where does epilepsy start in the brain?
It is dependent on where the electrical impulses are coming from, it can move around the brain.
80
What is Todd's paralysis?
After a seizure limbs may be weak or paralysed but the symptoms should go.
81
What are adverse seizures?
Where the head or the eyes move away from the point of origin.
82
What is a tonic Clonic attack?
Tonic lasts around 10 seconds, locked eyes, elbows, legs and usually very clenched. Clonic is where there is shaking.
83
What are some investigations for epilepsy?
CT/MRI, EEG, telemetry and ECG serum glucose.
84
How do you manage epilepsy?
ABCDE and medication
85
What are some dental considerations to be made with those with epilepsy?
No treatment with frequent seizures.

HHD 2 (5 decks)

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