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FINALS!!! > Special Care Dentistry > Flashcards

Special Care Dentistry Flashcards

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
Q

Welfare power of attorney

A

powers only come into effect when person incapable of making decisions
matters relating to health and personal
registered with office of public guardian

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26
Q

Continuing power of attorney

A

only covers finicial affairs and properties

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27
Q

Guardianship orders

A

court appointed
requires 2 medical reports
deals with property, finiance, martial affiars
appointed for 3 years

(person has no capacity)

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28
Q

Aim of adults with incapacity act 2000

A

to protct people who lack capcity to make decisons and support involvemtn in making decisions

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29
Q

Principles of AWI act

A

benefit
minimium intervention
take account wishes of adult
consultation with revelvant others
encourage adult to exercise resiudual capacity

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30
Q

Recognising substance abuse

A

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

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31
Q

Medical issues relating to substance abuse

A

increased infection risk
general health neglect and OH
IE
Venous thrombosis
chronic liver disease in alcohol abuse

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32
Q

Cannabis and LA

A

Prolonged acute tachycardia

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33
Q

Alcohol and LA

A

LA metabolised in liver - 2 cartridges max of articaine

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34
Q

What is a drug

A

med or other substance which has physiological effect when injected into the body

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35
Q

Why do you avoid IV sedation

A

as alcohol/opoids synergestic effect
collapse of veins

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36
Q

Dental implications of substance abuse

A

ramptant caries
perio disease
NCTSL
trauma
infection
poor OH and denture hyg
oral cancer
hyposalivation
masseteric hypertrophy - bruxism

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37
Q

Alcohol issues and dental

A

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

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38
Q

Why avoid metro with alcohol issues

A

inhibits breakdown of acid aldehyde causing vasodilation, nausea, headaches

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39
Q

Opiates

A

immediate effect of euphoria
analgesics may be ineffective

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40
Q

Methadone

A

high sugar so increased caries risk
prescribed by pharmacy

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41
Q

Cocaine

A

palatal and nasal septum perforation due to acidic nature of vasconstrictor
interaction with LA - delay tx 6-24hrs after adminstration

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42
Q

Signs of liver disease

A

jaudnice
ascites
clubbing
bleeding
spider naevi
oesophagela varices
palmer erythema

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43
Q

Casues of liver disease

A

infective - Hep A,B,C,D
non infective - alcohol related, drug induced, non alcoholic fatty liver disease, autoimmune, carcinoma

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44
Q

Stages of liver disease

A

Hepatitis - inflammation of liver which is reversible
Cirrhosis - irreversible liver necrosis and fibrosis
Failure - failure of normal function

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45
Q

Blood tests for liver disease

A

FBC
LFT
U&E’s
cogulation screening

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46
Q

What clotting factors is the liver responsible for

A

I, II, VII, IX, X, XI

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47
Q

Liver disease and thrmocytopenia

A

reduced roduction of thrombopoetin
anti cancer agents
bone marrow suppersion by hep C
antiviral tx with inteferon blind therapy

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48
Q

Why avoid IV sedation with liver disease

A

induces coma

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49
Q

What drugs to avoid with liver disease

A

avoid NSAIDs - as unable to metablosie, increase bleeding risk

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50
Q

What antibiotics do you avoid with liver disease

A

metro
erythromycin

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51
Q

Anticogulants for pt requiring renal analysis

A

heparin

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52
Q

Water leaves by osmosis at

A

loop of henle

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53
Q

Surplus of waste ion and molceues flow out as urine at

A

collecting tububles

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54
Q

Actively resorbs glucose, amino acids and salts

A

promximal convulated tubule

55
Q

Na is redeemed by active transport and water loss at

A

distal convulated tubulue

56
Q

Side effects of chemo

A

nasuea
vomiting
diarrhea
fatigue
loss of apeptite
fever
hair loss
mouth sores
dry mouth
tooth decay
infeciton
oral mucositis
reproduction function damaged

57
Q

Chemo blood tests

A

WBC
RBC
Platelets
leuopenia
neutropenia

58
Q

Side effects of radiotherapy

A

occurs only in area being irradiated
trismus
loss of taste (hypogeusia) - radiation of taste buds

59
Q

Mucisitis

A

inflammation and ulceration leading to pain
7-14 days after drug therapy

60
Q

Tx for mucosistis

A

morphine/ low laser light therapy
aloe vera, CHX
Honey
Na Bicarb
tea tree oil, topical ligno
gelclair
saline
cooling ice

61
Q

Grading scale for mucositits

A

0 = none
1= mild - oral soreness and erythema
2 = moderate - erythema, ulcers
3 = severe - oral ulcers, liquid diet
4 = life theratening

62
Q

Sign and symptoms of oral cancer

A

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
Q

Risk factors for oral cancer

A

smoking
alcohol
betel quid
nutrition
HPV
sociecominic factors
poor OH and dental health

64
Q

Multi disciplnary team for cancer

A

Oncologist
chemo nurse
pathologist
surgeon

65
Q

High risk sites for oral cancer

A

FOM
oropharynx
palate
labial and buccal mucosa
lateral and venetral surface of tongue

66
Q

Pre malginant conditions

A

leaukoplakia
erythroplakia
lichen planus
submucous fibrosis
palatal keratosis
SCC arising in pre exisitng actininc keratosis

67
Q

Post tx for oral cancer

A

diet
OH
High fluoride
stop smoking
trismus
fluoride trays
tooth mousse

68
Q

Osteoradionecorsis

A

damage of bone and jaw
>60 Gy

69
Q

Prevention of osteoradionecrosis

A

remove teeth of doubtful prognosis
liase with oncologist
XLA’s 10-14days prior to radio

Saline irrigation
antibiotics
antimicrobials

70
Q

Why might you have the inability to achieve heamostasis?

A

medications
disease - heamophillia, von willebrand
liver disease
infections - HIV, hep C
Chronic renal failure
Chemo

71
Q

Safe dental procedures for haemophillia

A

exams
supra ging restorations
crowns/bridges with inf LA
use articaine infs and intraligamental to avoid IDBs

72
Q

Procedures carried out in haemophillic centre

A

xlas
surgicals
subging scaling
LA -idb or lingual inf

73
Q

Mild or von willebrand treatment

A

DDAVP
consdier antibiotics

74
Q

Moderate or severe heamophillia treatment

A

factor replacement - tranexamic acid (inhibits the breakdown of fibrin in blood clots)

75
Q

Haemophilia A

A

deficiency in factor 8

76
Q

Haemophillia B

A

defiency in factor 9 - x linked recessive

77
Q

Von willebrand

A

factor VIII levels reduced
abnormal plasma proteins

78
Q

Bloods tests for bleeding disorders

A

FBC
LFT
Thrmobophilli and haemophilli factor screen
Cogualation screening - prothrmobin and activated partial thromboplastin time

79
Q

The types of severity of haemophilia

A

mild - 6-40% factor present
moderate = 2.5% factor present
severe = <=1% factor present

80
Q

Thromobocytopenia

A

low platelet count <80

81
Q

Hemarthrosis

A

bleeding into the joint space and associated with haemophillia pts

82
Q

Prothrombin time

A

measures factors VII, X, V, prothrombin and firbronogen I, II
deranged in liver disease or warfarint therapy

83
Q

Activated partial thrmoboplastin time

A

measures factors VII, IX, XI, XII, X, V, prothrmobin and fibrnogen
deraanged in heamophillia

84
Q

INR

A

prothrobin time/ reference PT plasma

85
Q

What is warfarin

A

vit k anticogualant that inhibits Vit K function and decreases clotting factors
inhibits vit K, protein C and S,, II, VII, X, IX

86
Q

Apixiban

A

factor xa inhibitor which works by blocking the action of activated factor X which is needed for forming clot
taken twice daily

87
Q

Dabigatra

A

direct inhibitor of cugulation factor thrombin
taken x2 daily

88
Q

Rivaroxaban

A

taken once daily

89
Q

Depression dental implications

A

chronic facial pain
burning mouth/sore tongue
TMD
Dry mouth
spots or lumps
disturbed taste sensation

90
Q

Eating disorders dental implications

A

NCTSL
Xerostomia
senstivity
loss of vertical dimension
quality of dentine for bonding
hostile acidic environment

91
Q

Tardive Dyskiensia

A

involuntary movements of tongue, lip. face, trunk
happens in people who recieve antipsychiotics for years

92
Q

Psychosis

A

lose contact with reality

93
Q

Schizphernia

A

affects how you think, feel, behave

94
Q

Bipolar

A

affects mood of person

95
Q

Panic disorder

A

regular or frequent panic attacks without clear cause or trigger

96
Q

Phobics

A

extreme fear or anxiety triggered by a particular situation or object

97
Q

PTSD

A

develop anxiety problems after going through something trauamatic

98
Q

Body dysmorphic disorders

A

experience obession and compulsions to physical appearance

99
Q

Reasons people have hypersalivation

A

Parkinsons
Cerbral palsy
Stroke
Acid reflux
Pregnant
Meds - alzehiemers

100
Q

Diseases causing xerostomia

A

radio and chemo
Parkinson’s
Cystic fibrosis
RA
Sjogren’s syndrome
Diabetes
Hyperthyroidism

101
Q

Why not use glandosane in people with teeth

A

very acidic

102
Q

Drugs causing xerostomia

A

diuretics
beta blockers
anti -depressants
anti psychiotics
anti covulsants
NSAIDs - diclofenac

103
Q

Causes of pseudomebranous candidiosis

A

antiobiotcis
dentures
xerostomia
cortocsteirod use
drugs
smoking
iron diefiency
diabetes

104
Q

Xerosotmia

A

reduced or absent saliva flow <0.3ml/min of unstimualted saliva flow
viscosity increased, ph decreased

105
Q

Risks associated with xerostomia

A

caries
perio
candidosis
dental erosion
sialadentitis (infection of salivary gland)

106
Q

Management of xerostomia

A

oral balance
chew on sugar free gum
ice cubes
tooth mousse
water

107
Q

Causes of ulcers

A

trauma
meds
oral cancer
viral infection
recurrent apthous stomatitis

108
Q

Equality act 2010

A

protects people from discrimniation in workplace and wider society
age, sex, relgion, disability, sexual orientation

109
Q

Disability discrimination act 2004

A

rights in employment, access to goods, facilities,
buying or renting land/ property

110
Q

Adaptation to dental practices for people with disabilites

A

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
Q

How to help people with physical disbaility brush

A

electric toothbrush
putty handles
foam handles
ball handles
collis curve toothbrush

112
Q

What to do if someone has hearing impairment

A

face pt
finger spelling
write things down
allow extra time
no echo
speak slowly and clearly

113
Q

Social model

A

disbaility casued by how society is organsied rather than a persons impairment

114
Q

Medical model

A

disability casued by a persons impairment and differences should be fixed/ changed by medical treatment

115
Q

Impairment

A

any loss of abnormality of psychological, physiological or anatomical structure or function

116
Q

Disability

A

restriction or lack of ability resulting in impairment to perform an activity in a manner or within the range considered normal

117
Q

Handicap

A

disadvantage for a given individual resulting from an impairment or a disability that limits or prevents fulfiment of a role

118
Q

Drooling

A

abnormalities in swallowing rather than absence of swallowing
poor mouth closure, tongue thrusting, jaw instability

119
Q

Tx for bruxism/ NCTSL

A

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
Q

Dentally fit

A

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
Q

Multi disciplenary team

A

incldues professionals from different areas in healthcare who come together to plan, assess and provide care for someone

122
Q

ways to gain acess to the mouth

A

bedi shield
toothbrush
mirror
good light
open wide mouth rests
clincial holding

123
Q

Opitions to aid trasnfr to chair

A

hoist
stand aid
wheelchair recliner
turn table
wheelchair tipper
banana board

124
Q

Signs pt in pain but can’t communicate

A

crying/groaning
refusing to eat
rubbing area
depressions
withdrawn
sleep disturbance
aggressive behaviour
biting
grimacing

125
Q

Causes of learning disability

A

infection
injury
nutrition
prematurity
genetics
injury
toxic agents
chromosmoal
materal health

126
Q

Risk factors for people with learning disability

A

poor moisutre control
imbrication of teeth
lack of cleansing
pouching and limted food clearnace
meds
rewarding
mouth breathing (reduced salvia)

127
Q

Down syndrome

A

a neurodevelopmental disorders of gentic origin affecting chromosome 21
fally trismoy of 21 = extra copy of 21

128
Q

Down syndrome signs

A

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
Q

Prader willi

A

chromsome 15 does not function/ not present

130
Q

Prader willi symptoms

A

constant desire to eat food
restricted growth
reduced muscle tone
lack of sexual development
learning difiiculties
behavioural issues

131
Q

Cerebral Palsy

A

neuroloigcal condition affecting movement ad co-ordination

132
Q

3 types of cerebral palsy

A

sapastic = muscles appear tight and stiff
dyskinetic = involuntary movements
ataxic = sharky movements - affects balanace
mixed

133
Q

Cerebral palsy and dentistry

A

impaired access to mouth
store food in mouth
can’t hold toothbrush
meds - high in sugar

FINALS!!! (20 decks)

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