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FINALS!!! > Special Care Dentistry > Flashcards

Special Care Dentistry Flashcards

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1
Q

Diagnosis tools for dementia

A

Blessed dementia scale
Detailed cognitive testing
Mini mental state
Dementia screen to treat causes - FBC, U&E’s, kidney, thyroid, folate, calcium, protein, urainylis, serum

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2
Q

Early stages of dementia

A

short term mermory loss
confusion
poor judgement
unwilling to make decisions
communication issues
inability to manage everyday tasks

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3
Q

Middle stages of dementia

A

reminders to eat
fail to recognise people
increase forgetfulness
distress
aggression
anger
wandering
getting lost
hallicinations
throw backs
behave inappropraitely

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4
Q

Late stages of dementia

A

symptoms progressive and irreversible
unable to recognise objects, surrounding, people
incontinence and loss of speech
physical fraility
difficulty in eating, swallowing, weight loss

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5
Q

Treatment for dementia

A

counselling
NSAIDs
Aspirin and reducing cardiac risks
Vit E

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6
Q

Multi disciplinary team for dementia

A

Demntia nurses
GP
Consultant
Community nurses
Carers
Pharmacy
Nursing home staff

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7
Q

Care home dementia friendly places

A

walls, floors, skirting boards, different colours
lables on drawers
WC visible from bed
Radiator low temp
furnitiure traditional and domestic
personal pics and items

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8
Q

Healthcare dementia friendly places

A

natural light
reception desk visible
pictorial elements
avoid non essential signs
signage eye level
simple text and colour
colour and tone of walls distintive form flooring
locked rooms same colour as walls to avoid attention

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9
Q

What is dementia

A

deteriorination in cognitive function beyond whay is expected from normal ageing

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10
Q

What does dementia affect

A

memory
thinking
communication
learning
comprehension
language
calculation
orientation

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11
Q

Alzheimer’s

A

reduction in size of cortex, severe in hippocampus
Caused by protein fragments that build up in the spaces between nerve cells

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12
Q

Features of alzheimers

A

short term memory loss
loss of confidence
communication probs
withdrawn
mood swings
aphasia

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13
Q

Factors for alzheimer’s

A

age
women > men
head injury
lifestyle - smoking, hypertension, low folate

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14
Q

Vascualr dementia

A

reduced blood flow to the brain which damages and kills brian cells
Due to narrowing and blockage of small blood vessels in brain

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15
Q

Underlying conditions causing vascualr dementia

A

high blood pressure
smoking
overweight
diabetes

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16
Q

Features of vascular dementia

A

delusion
seizures
vispatial difficulties
anxiety
memory loss

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17
Q

Dementia with lewy bodies

A

desposits of abnormal proteins inside the brain cells, build up in areas responsible for memory and muscle movement

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18
Q

Features of dementia with lewy bodies

A

short term memory loss
sleep disorders
delusions
motor disorders
speech and swaollowing
cognitive issues

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19
Q

Frontotemporal

A

protein TDP-43 - abiqitin associated with clumps of protein
Younger age, changes in personaility, difficulties with language

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20
Q

Features of frontotemporal dementia

A

personality changes
mutism
reptition in words
decline in personal and social conduct

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21
Q

Incapable means

A

acting
making decisions
commnuicating decision
understanding decisions
retaining memory of decisions

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22
Q

Assessing capacity

A

capable of making and communicating choice
memory abilites
understand nature of what is being asked
asare of alterantives/risks/benefits
aware of personal revlance to them
not under influence from anyones

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23
Q

Who can you consultant with if erson has incapacity

A

nearest relative and primary care of adult
guardian, continuing attorney, welfare attorney
person sheriff decides
medical and dental practioners under 47 AWI act`

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24
Q

Who can supply certificates of incapity

A

medical practioner responsible for pt care
registered nurses
optometirsts
consultant in charge of pt care
dental practioners if specialised training

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25
Welfare power of attorney
powers only come into effect when person incapable of making decisions matters relating to health and personal registered with office of public guardian
26
Continuing power of attorney
only covers finicial affairs and properties
27
Guardianship orders
court appointed requires 2 medical reports deals with property, finiance, martial affiars appointed for 3 years (person has no capacity)
28
Aim of adults with incapacity act 2000
to protct people who lack capcity to make decisons and support involvemtn in making decisions
29
Principles of AWI act
benefit minimium intervention take account wishes of adult consultation with revelvant others encourage adult to exercise resiudual capacity
30
Recognising substance abuse
tremors less reliable mood and behavioural changes puncture marks, scars over veins impacted ability to drive requesting specific drugs constricted or dilated pupils detoriation in appearance and hyg
31
Medical issues relating to substance abuse
increased infection risk general health neglect and OH IE Venous thrombosis chronic liver disease in alcohol abuse
32
Cannabis and LA
Prolonged acute tachycardia
33
Alcohol and LA
LA metabolised in liver - 2 cartridges max of articaine
34
What is a drug
med or other substance which has physiological effect when injected into the body
35
Why do you avoid IV sedation
as alcohol/opoids synergestic effect collapse of veins
36
Dental implications of substance abuse
ramptant caries perio disease NCTSL trauma infection poor OH and denture hyg oral cancer hyposalivation masseteric hypertrophy - bruxism
37
Alcohol issues and dental
early appts glossitis sialosis erosion dry mouth bone marrow suppresion impaired wound healing avoid NSAID and aspirin caries perio NCTSL Avoid GA as increases vomiting Rhirophygma - thickening of skin around nose
38
Why avoid metro with alcohol issues
inhibits breakdown of acid aldehyde causing vasodilation, nausea, headaches
39
Opiates
immediate effect of euphoria analgesics may be ineffective
40
Methadone
high sugar so increased caries risk prescribed by pharmacy
41
Cocaine
palatal and nasal septum perforation due to acidic nature of vasconstrictor interaction with LA - delay tx 6-24hrs after adminstration
42
Signs of liver disease
jaudnice ascites clubbing bleeding spider naevi oesophagela varices palmer erythema
43
Casues of liver disease
infective - Hep A,B,C,D non infective - alcohol related, drug induced, non alcoholic fatty liver disease, autoimmune, carcinoma
44
Stages of liver disease
Hepatitis - inflammation of liver which is reversible Cirrhosis - irreversible liver necrosis and fibrosis Failure - failure of normal function
45
Blood tests for liver disease
FBC LFT U&E's cogulation screening
46
What clotting factors is the liver responsible for
I, II, VII, IX, X, XI
47
Liver disease and thrmocytopenia
reduced roduction of thrombopoetin anti cancer agents bone marrow suppersion by hep C antiviral tx with inteferon blind therapy
48
Why avoid IV sedation with liver disease
induces coma
49
What drugs to avoid with liver disease
avoid NSAIDs - as unable to metablosie, increase bleeding risk
50
What antibiotics do you avoid with liver disease
metro erythromycin
51
Anticogulants for pt requiring renal analysis
heparin
52
Water leaves by osmosis at
loop of henle
53
Surplus of waste ion and molceues flow out as urine at
collecting tububles
54
Actively resorbs glucose, amino acids and salts
promximal convulated tubule
55
Na is redeemed by active transport and water loss at
distal convulated tubulue
56
Side effects of chemo
nasuea vomiting diarrhea fatigue loss of apeptite fever hair loss mouth sores dry mouth tooth decay infeciton oral mucositis reproduction function damaged
57
Chemo blood tests
WBC RBC Platelets leuopenia neutropenia
58
Side effects of radiotherapy
occurs only in area being irradiated trismus loss of taste (hypogeusia) - radiation of taste buds
59
Mucisitis
inflammation and ulceration leading to pain 7-14 days after drug therapy
60
Tx for mucosistis
morphine/ low laser light therapy aloe vera, CHX Honey Na Bicarb tea tree oil, topical ligno gelclair saline cooling ice
61
Grading scale for mucositits
0 = none 1= mild - oral soreness and erythema 2 = moderate - erythema, ulcers 3 = severe - oral ulcers, liquid diet 4 = life theratening
62
Sign and symptoms of oral cancer
unexplained lump >3wks persisitent pain in throat > 3wks persisiten hoarseness > 3wks red or mixed patches on oral mucosa > 3wks ulceration or unexplained swelling in mucosa >3wks deep ulcer rolled margins firm and hard erythema dysphagia and odynophagria > 3wks
63
Risk factors for oral cancer
smoking alcohol betel quid nutrition HPV sociecominic factors poor OH and dental health
64
Multi disciplnary team for cancer
Oncologist chemo nurse pathologist surgeon
65
High risk sites for oral cancer
FOM oropharynx palate labial and buccal mucosa lateral and venetral surface of tongue
66
Pre malginant conditions
leaukoplakia erythroplakia lichen planus submucous fibrosis palatal keratosis SCC arising in pre exisitng actininc keratosis
67
Post tx for oral cancer
diet OH High fluoride stop smoking trismus fluoride trays tooth mousse
68
Osteoradionecorsis
damage of bone and jaw >60 Gy
69
Prevention of osteoradionecrosis
remove teeth of doubtful prognosis liase with oncologist XLA's 10-14days prior to radio Saline irrigation antibiotics antimicrobials
70
Why might you have the inability to achieve heamostasis?
medications disease - heamophillia, von willebrand liver disease infections - HIV, hep C Chronic renal failure Chemo
71
Safe dental procedures for haemophillia
exams supra ging restorations crowns/bridges with inf LA use articaine infs and intraligamental to avoid IDBs
72
Procedures carried out in haemophillic centre
xlas surgicals subging scaling LA -idb or lingual inf
73
Mild or von willebrand treatment
DDAVP consdier antibiotics
74
Moderate or severe heamophillia treatment
factor replacement - tranexamic acid (inhibits the breakdown of fibrin in blood clots)
75
Haemophilia A
deficiency in factor 8
76
Haemophillia B
defiency in factor 9 - x linked recessive
77
Von willebrand
factor VIII levels reduced abnormal plasma proteins
78
Bloods tests for bleeding disorders
FBC LFT Thrmobophilli and haemophilli factor screen Cogualation screening - prothrmobin and activated partial thromboplastin time
79
The types of severity of haemophilia
mild - 6-40% factor present moderate = 2.5% factor present severe = <=1% factor present
80
Thromobocytopenia
low platelet count <80
81
Hemarthrosis
bleeding into the joint space and associated with haemophillia pts
82
Prothrombin time
measures factors VII, X, V, prothrombin and firbronogen I, II deranged in liver disease or warfarint therapy
83
Activated partial thrmoboplastin time
measures factors VII, IX, XI, XII, X, V, prothrmobin and fibrnogen deraanged in heamophillia
84
INR
prothrobin time/ reference PT plasma
85
What is warfarin
vit k anticogualant that inhibits Vit K function and decreases clotting factors inhibits vit K, protein C and S,, II, VII, X, IX
86
Apixiban
factor xa inhibitor which works by blocking the action of activated factor X which is needed for forming clot taken twice daily
87
Dabigatra
direct inhibitor of cugulation factor thrombin taken x2 daily
88
Rivaroxaban
taken once daily
89
Depression dental implications
chronic facial pain burning mouth/sore tongue TMD Dry mouth spots or lumps disturbed taste sensation
90
Eating disorders dental implications
NCTSL Xerostomia senstivity loss of vertical dimension quality of dentine for bonding hostile acidic environment
91
Tardive Dyskiensia
involuntary movements of tongue, lip. face, trunk happens in people who recieve antipsychiotics for years
92
Psychosis
lose contact with reality
93
Schizphernia
affects how you think, feel, behave
94
Bipolar
affects mood of person
95
Panic disorder
regular or frequent panic attacks without clear cause or trigger
96
Phobics
extreme fear or anxiety triggered by a particular situation or object
97
PTSD
develop anxiety problems after going through something trauamatic
98
Body dysmorphic disorders
experience obession and compulsions to physical appearance
99
Reasons people have hypersalivation
Parkinsons Cerbral palsy Stroke Acid reflux Pregnant Meds - alzehiemers
100
Diseases causing xerostomia
radio and chemo Parkinson's Cystic fibrosis RA Sjogren's syndrome Diabetes Hyperthyroidism
101
Why not use glandosane in people with teeth
very acidic
102
Drugs causing xerostomia
diuretics beta blockers anti -depressants anti psychiotics anti covulsants NSAIDs - diclofenac
103
Causes of pseudomebranous candidiosis
antiobiotcis dentures xerostomia cortocsteirod use drugs smoking iron diefiency diabetes
104
Xerosotmia
reduced or absent saliva flow <0.3ml/min of unstimualted saliva flow viscosity increased, ph decreased
105
Risks associated with xerostomia
caries perio candidosis dental erosion sialadentitis (infection of salivary gland)
106
Management of xerostomia
oral balance chew on sugar free gum ice cubes tooth mousse water
107
Causes of ulcers
trauma meds oral cancer viral infection recurrent apthous stomatitis
108
Equality act 2010
protects people from discrimniation in workplace and wider society age, sex, relgion, disability, sexual orientation
109
Disability discrimination act 2004
rights in employment, access to goods, facilities, buying or renting land/ property
110
Adaptation to dental practices for people with disabilites
designated parking signposting for people with sensory impairment ground level access ramps for wheelchairs wheelchair turing circle unisex disabled toilets hearing loops handrails for support wide doors and corridors
111
How to help people with physical disbaility brush
electric toothbrush putty handles foam handles ball handles collis curve toothbrush
112
What to do if someone has hearing impairment
face pt finger spelling write things down allow extra time no echo speak slowly and clearly
113
Social model
disbaility casued by how society is organsied rather than a persons impairment
114
Medical model
disability casued by a persons impairment and differences should be fixed/ changed by medical treatment
115
Impairment
any loss of abnormality of psychological, physiological or anatomical structure or function
116
Disability
restriction or lack of ability resulting in impairment to perform an activity in a manner or within the range considered normal
117
Handicap
disadvantage for a given individual resulting from an impairment or a disability that limits or prevents fulfiment of a role
118
Drooling
abnormalities in swallowing rather than absence of swallowing poor mouth closure, tongue thrusting, jaw instability
119
Tx for bruxism/ NCTSL
flurodie mw's toothpastes - low abrasion, low acidity, high flurodie, anti-hypersenstitivty flurodie varnish dentine bonding agents chew sugar free gum reduce carbonated drinks, acidic fruits
120
Dentally fit
means the patient is free from all dental disease before they have their tx carried out which makes them immunocompromised and increase infection risk
121
Multi disciplenary team
incldues professionals from different areas in healthcare who come together to plan, assess and provide care for someone
122
ways to gain acess to the mouth
bedi shield toothbrush mirror good light open wide mouth rests clincial holding
123
Opitions to aid trasnfr to chair
hoist stand aid wheelchair recliner turn table wheelchair tipper banana board
124
Signs pt in pain but can't communicate
crying/groaning refusing to eat rubbing area depressions withdrawn sleep disturbance aggressive behaviour biting grimacing
125
Causes of learning disability
infection injury nutrition prematurity genetics injury toxic agents chromosmoal materal health
126
Risk factors for people with learning disability
poor moisutre control imbrication of teeth lack of cleansing pouching and limted food clearnace meds rewarding mouth breathing (reduced salvia)
127
Down syndrome
a neurodevelopmental disorders of gentic origin affecting chromosome 21 fally trismoy of 21 = extra copy of 21
128
Down syndrome signs
short neck and flat back of head growth failure diminsted muscle tone abnormal ears big toes widley spread cogential heart disease umblical hernia small and arched palate short broad hands enlarged colon thryoird disease hearing impairment
129
Prader willi
chromsome 15 does not function/ not present
130
Prader willi symptoms
constant desire to eat food restricted growth reduced muscle tone lack of sexual development learning difiiculties behavioural issues
131
Cerebral Palsy
neuroloigcal condition affecting movement ad co-ordination
132
3 types of cerebral palsy
sapastic = muscles appear tight and stiff dyskinetic = involuntary movements ataxic = sharky movements - affects balanace mixed
133
Cerebral palsy and dentistry
impaired access to mouth store food in mouth can't hold toothbrush meds - high in sugar

FINALS!!! (20 decks)

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