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BDS3 Past Papers > Special Care > Flashcards

Special Care Flashcards

1
Q

reasonable adjustments

A

changing the way things are done, changing physical or adding aids/services to make more accessible

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2
Q

visually impaired pt
give modifications within dental practice

A

no obstacles, clearly lit, assistance in navigation, explain chair movements and procedures, braille, slow speaking and communication

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3
Q

wheelchair pt
accomodations in environment

A

ramps, lifts, ground floor surgery, wide corridors/doorway, accessible parking, low reception

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4
Q

hearing impaired pt
modifications

A

portable induction loop, BSL interpreter, visual aids, send information in text/email rather than over the phone, quiet tx environment

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5
Q

acquired causes of visual impairment

A

cataracts, diabetic retinopathy, glaucoma

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6
Q

techniques to support brushing in an older person

A

watch show do
modified bass technique
putty to mold around toothbrush - allowing easier holding/movements
brush with aspiration

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7
Q

priorities for oral health management in pt with dementia

A

elimination of infection, control of OH, education
IDENTIFY AND RETAIN KEY TEETH, HIGH QUALITY RESTORATIONS
PREVENTATIVE REGIME

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8
Q

mid stage dementia, management of cervical caries

A

GIC releasing fluoride, inhalation sedation

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9
Q

risks in older people with GA

A

mortality risk, CV and respiratory risk, cognitive impairment, functional decline

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10
Q

adults with incapacity principles

A

benefit, past and present wishes, consult relevant others, least restrictive, encourage residual capacity

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11
Q

who can provide capacity assessment in accordance to AwI Act 2000

A

general medical practioner, consultant under pt care, dentist with further training

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12
Q

common psychiatric conditions

A

BPD, bulimia, anorexia, anxiety, schizophrenia, depression

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13
Q

pt with psychiatric disorders often have poor OH, name contributory factors

A

lack of care in OH, side effects of medications such as xerostomia, lack of education, cannot access dentist

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14
Q

barriers to dental care for a schizophrenia pt

A

may be an inpatient, may be going through an acute episode, rely on carers/family to bring to practice, do not trust the dentist

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15
Q

legislation in the UK to ensure practices are built to allow all people equal access

A

Equality Act 2010, disability discrimination act 2004

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16
Q

what are the differences in definitions of disability in the medical and social model

A

medical - defines disability as something that needs fixed or cured medically
social - not just caused by impairment but by inequalities, access, barriers

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17
Q

how to communicate with a pt with cerebral palsy who cannot use sign language or pen/paper

A

visual aids, talking matt, simple yes/no questions, involve caregivers

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18
Q

how to safely position pt in wheelchair to allow safe dental examination

A

two person tansfer, hoist, turn table, transfer chair

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19
Q

aspects of cerebral palsy affecting access to mouth

A

involuntary movements, spasms, limited range of motion, dysphagia, sensory issues, muscle weakness

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20
Q

non-pharmacological aids to improve mouth access

A

bite blocks, mirror retaction, bedi shield, open wide mouth rest

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21
Q

characteristics of down syndrome

A

small nasal pasage, facial flattening, small ears, low muscle tone, upward slanting eyes, enlarged tongue

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22
Q

genetic change responsible for DS

A

extra copy of chromosome 21 [trisomy 21]

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23
Q

medical aspects of DS resulting in lack of capacity

A

difficulty making decisions, communicating decisions, understanding, retaining memory of decisions

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24
Q

what is the difference between welfare guardian and welfare power of attorney

A

WG is appointed by court, WPOA is appointed by adult before capacity lost
WG controls health, financial and WPOA only controls health

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25
Q

features associated with DS which contributes to periodontal disease

A

lack of dexterity leading to poor OH, lack of understanding importance of OH, delayed and atypical eruption, impaired migration of gingival fibroblasts, periodontal pathogens, impaired neutrophils chemotaxis, immune system dysregulation

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26
Q

what dose of antibiotic prophylaxis

A

amoxicillin 3g oral powder 1 hour before procedure

27
Q

risk factors for mouth cancer

A

genetics, smoking, excessive alcohol intake, poor nutrition, increased age, previous cancer history

28
Q

what information would you require about previous radiotherapy before tx

A

radiation dose and duration, radiation field and target, when was the radiation completed

29
Q

what dose of radiotherapy increases the risk of osteoradionecrosis

A

60 Gy

30
Q

pattern of caries unique to radiation

A

cervical and incisal caries

31
Q

management of unrestorable teeth when at risk of osteoradionecrosis

A

extract in conjunction with antibiotic prophylaxis
XLA at least 10 days prior to tx
extensive PMPR and clean mouth prior

32
Q

preventative measures implemented to reduce risks of future dental disease in pt who have recieved radiotherapy

A

OHI, fluoride application/tooth paste, tooth mouse, chlorohexidine

33
Q

oral complications associated with radiation therapy

A

xerostomia, oral mucositis, traumatic ulceration, candida infections, reactivation of herpes simplex

34
Q

management of osteoradionecrosis of the jaw

A

antibiotics, surgical bone grafts

35
Q

causes of liver cirrhosis

A

alcohol, haemochromatosis, cystic fibrosis, hepatitis,

36
Q

priorities for a pt to render them dentally fit

A

sufficient OH, no active decay, free from infection or risk of infection

37
Q

why is it important to establish oral health prior to recieving transplant

A

eliminate risk of infection, infective endocarditis

38
Q

why would thromobocytopenia occur in pt with liver disease

A

reduced platelet production, increased platelet destruction, enlarged spleen

39
Q

level of thrombocytopenia where it is safe to XLA in GDP

A

above 50,000 ul/L

40
Q

why would a pt with advanced liver disease be at increased bleeding risk

A

clotting factors are synthesised in the liver, therefore any damage will decrease this production

41
Q

types of dementia

A

alzheimers, lewy body, frontotemporal, vascular

42
Q

signs/symptoms in late stage dementia

A

lack of familiarity of people/places, aggressive, incontinence, loss of ability to communicate/speech, frailty, weight loss, difficulty eating

43
Q

features of parkinsons

A

tremours, bradykinesia, rigidity, mask like face, postural instability

44
Q

how does parkinsons differ from other cerebellar disease

A

affects dopamine production
resting tumour in parkinsons, cerebral is intention

45
Q

reason for dry mouth in pt with parkinsons

A

medications like antipsychotics/anticholinergics/benzatropine causing xerostomia, polypharmacy

46
Q

tests used to establish progression of dementia

A

mini mental state exam, blessed dementia scale, montreal cognitive assesment, combined single test

47
Q

4 types of inherited bleeding disorders

A

von willebrand, haemophilia A/B, faxtor XIII/X deficiency

48
Q

modifications in GDP to be dementia friendly

A

reception desk visible from entrance, signage at eye level [clear, colour, pictorial], colour and tone of walls distinct from flooring furniture [staff/locked rooms colour of walls to avoid attention]

49
Q

define mutlidisciplinary team

A

team of individuals from a wide variety of disciplines who work alongside each other to provide best care for pt

50
Q

examples of members of MDT for cancer pt

A

oral maxfax surgeon, radiologist, chemotherapist, ENT, cancer nurse

51
Q

why is enhanced prevention needed in pt with radiotherapy

A

xerostomia, leads to increased caries, less salivary buffering and clearance ability
OHI, fluoride

52
Q

complication of extraction in pt with radiotherapy

A

irradiation of bone can cause osteoradionecrosis, impair healing of sockets, infections

53
Q

effect of chemotherapy on blood count

A

bone marrow suppression, decreased white blood cells and platelets

54
Q

pt is suspected of bleeding disorder
what tests to investigate?

A

APPT, FBC, prothrombin time

55
Q

what one type of disorder of platelet numbers

A

thrombocytopaenia

56
Q

what clotting factors are affected by warfarin

A

2, 7, 9, 10

57
Q

xerostomia exacerbates which oral health problems

A

caries, candida, periodontitis, sialadenitis

58
Q

names of drugs which cause xerostomia

A

benzodiazepines, antidepressants, anticholinergics, antihypertensives

59
Q

non drug related causes of xerostomia

A

sjogrens syndrome, diabetes

60
Q

link of radiotherapy to formation of ulcers

A

moderate to high dose levels are given to overlying tissue
can result in oral mucositis

61
Q

why is enhanced prevention needed for those who have had radiotherapy

A

will suffer xerostomia due to impact of radiotherapy on salivary glands
leads to increased caries, higher viscosity and high acidic pH
reduces buffering clearing ability
OHI and fluoride

62
Q

complications of XLA in pt who has had radiotherapy

A

risk of osteoradionecrosis due to radiation o the bone
impairment of socket healing

63
Q

effects of chemotherapy on blood count

A

impact rapidly dividing cells - such as bone marrow
bone marrow suppression which is where blood cells are produced
number of white blood cells and platelets are reduced
reduction in red blood cells can cause anaemia
reduction in platelets is known as thrombocytopenia

64
Q
A

BDS3 Past Papers (13 decks)

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