SCD - liver

Question 1

What can causes of liver disease be split into

Answer 1

infective

non infective

Question 2

`What are infections that cause liver disease

Answer 2

hepatitis A, B, C etc

Question 3

What are non infective causes of liver disease

Answer 3

Auto-immune (primary biliary cirrhosis)
Alcohol related
Non alcoholic fatty liver disease
Haemochromatosis
Drug induced
Hepatocellular carcinoma

Question 4

What issues can liver disease cause in regards to bleeding

Answer 4

issues in clotting factor production, thrombocytopenia and thrombocythemia

Question 5

If you cant achieve haemostasis, what are the emasures

Answer 5

Apply pressure to the socket with LA soaked gauze
o Pack the socket with haemostatic material e.g oxidized cellulose
o Suture
o Re-evaluate the medical history
o Tranexamic mouthwash if available
o Cautery using silver nitrate sticks
o Bone wax

Question 6

What tests are required to tx a liver disease patient safely

Answer 6

Full blood count 
Coagulation/clotting screen 
INR
Liver function test 
Urea and electrolytes

Question 7

What numbers are we looking for when looking at platelet tests

Answer 7

Patient should have platelets above 100 to receive dentistry in primary care, it should be above 50 to receive dentistry in secondary care safely

Question 8

What LA should we use for liver disease px

Answer 8

articaine

Question 9

What analgesia do we give liver disease px

Answer 9

Paracetamol safer than NSAIDs due to NSAIDs bleeding risk

NSAIDs avoided in liver disease px unless mild

Question 10

What antibiotics do we give liver disease px

Answer 10

Amoxycillin safe
Metronidazole requires dose adjustment
Erythromycin not prescribed to this group routinely