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BDS3 past papers > summary > Flashcards

summary Flashcards

1
Q

What are reasons for non-surgical treatment before surgical?

A
  • To assess patient motivation
  • non-surgical therapy may reduce some deep pockets
  • stabilising condition will have better outcomes for surgery
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2
Q

Explain the pattern of distribution of decay in nursing bottle caries?

A

mandibular incisors are spared from decay as they are protected by the tongue

maxillary incisors are first to experience the cariogenic challenge and suffer the longest due to early eruption

teeth are affected in sequence of their eruption

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3
Q

What are causes of nursing bottle caries ?

A

bottles at night
prolonged breastfeeding
child holding milk in their mouth
sugar in bottles of milk
inappropriate use of bottles and feeding cups

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4
Q

what toothbrushing advice would you give for nursing bottle caries ?

A

1000ppm fluoride toothpaste
2x day - morning and night
small headed toothbrush with small bristles
brush for 2 minutes
wait at least 30 minutes after consumption of sugary foods

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5
Q

what special investigations are used for carious lower 6s?

A

bitewings

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6
Q

What indicates the suitable time for extracting 6s ?

A

bifurcation formation of unerupted 7s
8s present

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7
Q

What is treatment for upper non carious 6s

A

Fissure sealant

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8
Q

What are 2 advantages of extracting carious 6s at the right time?

A

gives a carious free permanent dentition
7s will erupt mesially and close the space

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9
Q

What are 2 disadvantages of extracting carious 6s ?

A

associated risk of GA
extraction of permanent molars can be demanding for a child and may affect future appointments

if extracting lower 6s need to extract caries free uppers to compensate

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10
Q

What is the origin and insertion of the masseter

A

origin - zygomatic arch
insertion - lateral surface and angle of the mandible

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11
Q

What is the function of the masseter ?

A

Elevates the mandible

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12
Q

What is the origin and insertion of the temporalis?

A

origin - floor of the temporal fossa
insertions - coronoid process and anterior border of the ramus

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13
Q

What is the function of the temporalis?

A

Elevates and retracts the mandible

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14
Q

What is the origin of the lateral pterygoid ?

A

from the lateral surface of the lateral pterygoid plate

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15
Q

What is the insertion for the anterior belly of the lateral pterygoid?

A

the anterior border of the condyle

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16
Q

What is the insertion for the superior belly of the lateral ptyergoid?

A

the anterior fibres of the intra-articular disc

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17
Q

What is the overall function of the lateral ptyerygoid?

A

protrudes and laterally deviates the mandible

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18
Q

What function does the inferior head of the lateral pterygoid have?

A

depresses the mandible

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19
Q

What is the insertion of the medial pterygoid?

A

medial surface of the angle of the mandible

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20
Q

What is the function of the medial pterygoid?

A

Elevates and assists in protrusion of the mandible

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21
Q

What is the origin of the deep head of the medial pterygoid?

A

medial surface of the lateral pterygoid plate

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22
Q

What is the origin of the superficial head of the medial pterygoid muscle?

A

the maxillary tuberosity

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23
Q

How can a dentist cause facial palsy during an IDB?

A

if the needle is advanced to far distally bone will not be contacted and LA is deposited into the parotid gland

The facial nerve runs through the parotid gland

dense fascia around the gland will because the LA to remain oft a long time causing paralysis of the facial muscles innervated by the facial nerve

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24
Q

How do you determine the difference between a facial palsy and a stroke?

A

Stroke - patient can wrinkle forehead and blink

facial palsy - face is affected on the same side where LA was given, cannot move upper or lower face

Stroke affects the opposite side of the body from the location in the brain that is affected

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25
Q

Explain neurologically the difference between stoke and facial palsy

A

The upper half of the face is supplied by both contralateral and ipsilateral innervation

The lower half of the face is only supplied by contralateral innervation

Lesions affecting the motor cortex (STROKE) result in contralateral weakens of lower face muscles but the upper muscles of the face are spared due to innervation from the opposite side

Lesions affecting the facial nerve in the brainstem (FACIAL PALSY) affect ipsilateral innervation for both upper and lower muscles

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26
Q

How would you manage a patient that has a facial palsy due to LA?

A
  • Reassure the patient
  • explain the sensation and muscle control will return once the LA wears off
  • Give the patient an eyepatch or tape the eye closed to protect the eye until blinking function returns
  • give emergency contact number
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27
Q

What type of surgical flap should be used to remove retained roots of tooth 44 ?

A

2 sided flap

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28
Q

What are risk factors of stroke?

A
  • hypertension
  • smoking
  • alcohol
  • diabetes mellitus
  • age
  • DVT
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29
Q

What post op analgesic would you give to a patient on warfarin?

A

Paracetamol

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30
Q

What is the mechanism of apixaban ?

A

Apixiban is a factor 10a inhibitor

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31
Q

What are the protected characteristics from the Equality Act 2010?

A
  • Age
  • Disability
  • Gender
  • Marriage and Civil Partnership
  • Pregnancy and Maternity
  • Race
  • Religion
  • Sex
  • Sexual orientation
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32
Q

What is the definition on impairment?

A

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

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33
Q

What is the definition of disability ?

A

a physical or mental impairment that has substantial long term negative effect on ability to do normal daily activities

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34
Q

What is aim of the Equality Act 2010 ?

A

provide a legal framework to protect the rights of individuals and advance equality of opportunity for all

places a legal duty on organisations to make reasonable adjustments to remove barriers that affect people accessing care

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35
Q

What is the inverse care law

A

the people who need health care the most are least likely to receive it

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36
Q

What are the 5 domains to overcoming barriers to healthcare

A

Accessibility
Accommodation
Affordability
Acceptability
Availability

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37
Q

What is the function of the Adults with Incapacity Act 2000 (Scotland)

A

to protect welfare and manage finances of individuals (16 and over) who lack capacity due to mental illness, learning disabilities

aim to support their involvement in making decisions as far as they are able to do so

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38
Q

what are difficulties associated with treating a bariatric patient?

A
  • loss of anatomical landmarks
  • ID blocks may be difficult
  • may have to be treated semi-supine or sitting upright
  • access may be more difficult due to excess soft tissue
  • long procedures can cause acute leg oedema, cellulitis and pressure sores
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39
Q

How do you assess capacity ?

A

being incapable of:
- Acting
- Making a decision
- Communicating decision
- Understanding decision
- Retaining the memory of a decision

AMCUR

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40
Q

What are the principles of the AWI Act?

A

decisions made on behalf of another must be:
- benefit the patient
- minimum necessary intervention
- Take into account the wishes of the adult
- Consult with relevant others
- Encourage the adult to exercise residual capacity

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41
Q

What are the types of power of attorney

A
  • Continuing power of attorney - makes financial and property decisions
  • Welfare power of attorney - makes decisions on healthcare and dental treatment

Combined power of attorney - both financial and welfare decisions

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42
Q

What are the types of guardianship?

A
  • Welfare guardian- can consent to dental treatment
  • Financial guardian - cannot consent to dental treatment
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43
Q

Who can issue a AWI section 47 certificate ?

A

medical practitioner (GMP)
Consultant in charge of patients care
Dental practitioner *
Registered nurse *
Optometrist *

  • must have done additional training course
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44
Q

What is sensory impairment ?

A

When one or more of a person’s senses are no longer normal

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45
Q

What is cataract ?

A

Clouding of the lens of the eye which prevents clear vision

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46
Q

What are the two types of macular degeneration ?

A

wet - causes severe sight loss in a matter of months
dry - gradual loss of central vision

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47
Q

What causes wet macular degeneration ?

A

growth of new vessels under the retina which break and leak into the macula causing scarring

48
Q

What causes dry macular degeneration?

A

Layers of the macula become progressively thinner causing it to function less effectively

49
Q

What does macular degeneration look like visually?

A

loss of the central field of vision

patients may be sensitive to light

50
Q

What causes glaucoma?

A

fluid build up in the front part of the eye which increases pressure inside the eye

51
Q

what does glaucoma look like visually?

A

tunnel vision - dark black surrounding outside

52
Q

What causes diabetic retinopathy

A

vascular changes in the retinal circulation due to diabetes

53
Q

what does diabetic retinopathy look like visually ?

A

Black spots in the vision

54
Q

what is the most common because of hemianopia ?

A

stroke

55
Q

What does hemianopia look like visually?

A

vision from only half of the eye

56
Q

What are the impacts of hearing impairment ?

A

functional impact - affects ability to communicate with others and can affect academic perdormance of children

Social and emotional impact - isolation and exclusion from communication with others

financial impact - higher unemployment rate

57
Q

causes of hearing loss ?

A

congenital - low birth weight, infections during pregnancy, jaundice in neonatal period

acquired - infectious diseases (meningitis) , chronic ear infection, injury to head, recreational exposure to loud sounds

58
Q

Explain the social and medical model in regards to disbability

A

social model - disability is cased by the way society is organised rather than the persons impairments or differences

medical model - people are disabled by their impairments or differences and these should be fixed or treated

59
Q

What causes down’s syndrome?

A

extra copy of chromosome 21

60
Q

co morbidities associated with Down’s syndrome

A

congenital heart defects
alzheimers dementia
epilepsy
leukaemia
diabetes mellitus
coeliac disease
intellectual impairment

61
Q

what are dental implications of downs syndrome ?

A

reduced oral hygiene
increased risk of periodontal disease
immunocompromised
saliva quality is altered

62
Q

what are physical features of cerebral palsy

A
  • muscle stiffness
  • muscle weakness
  • random uncontrolled body movements
  • balance and co-ordination problems
63
Q

What are the different types of dementia

A

Alzheimers
Vascular dementia
Dementia with lewie bodies

64
Q

what causes Alzheimers?

A

abnormal protein fragments that build up in the spaces between nerve cells forming plaques and disrupting brain function

65
Q

What causes vascular dementia ?

A

reduced blood Flow to the brain which damages and kills brain cells

can be due to narrowing of vessels or stroke

66
Q

What causes dementia with lewy bodies?

A

Lewy body proteins accumulate inside the brain cells

67
Q

What is frontotemporal dementia?

A

a type of dementia that can affect younger peoplee and causes them to act out of character

it affects the frontal lobes of the brain which control emotion and personality

68
Q

What are risk factors for dementia ?

A

Age
Gender
Medical history - high blood pressure, diabetes and high cholesterol increase risk
smoking
lack of exercise

69
Q

What are early stage symptoms of dementia?

A

short term memory loss
confusion
anxiety and agitation
inability to manage everyday tasks

70
Q

what are middle stage symptoms of dementia ?

A

require support and reminders to eat, wash and dress
distress, aggression and anger common
risk of wandering
may behave inappropriately - go outside in pyjamas
may experience hallucinations

71
Q

What are late stage symptoms of dementia ?

A

inability to recognise familiar objects or people
Require assistance for all everyday tasks
Asphasia
Increased physical frailty
Difficulty eating and swallowing

72
Q

What are tests used for dementia diagnosis ?

A
  • Mini-Mental State Examination - Folstein!!
  • blessed dementia scale
  • Montreal cognitive assessment
  • Single neuropsychiological tests
73
Q

What drugs are used in dementia patients and why?

A

Anticholinesterases - may delay deterioration of cognition

74
Q

how to make care homes dementia friendly?

A
  • walls, flooring and skirting boards should be different colours to help way finding
  • labels and images on drawers to help find things

Bedroom WC should be visible from bed to remind patients to go to the bathroom

75
Q

How to make healthcare environments dementia friendly?

A

avoid non essential signs

walls and flooring used to help way finding

staff only areas should be the same colour as the walls to avoid attention

reception desk visible from the front door

76
Q

Why can losing weight affect a patients denture ?

A

fat in the cheeks are used to hold in the denture and aid retention

77
Q

what are questions to ask if you suspect a non verbal patient with dementia is in pain?

A
  • has their behaviour changes
  • has sleep been disturbed
  • has their eating behaviour changed
  • have they been holding or touching their face
78
Q

What are contraindications for fluconazole or metronidazole?

A

statins
patients taking warfarin

79
Q

What is an alternative to giveng fluconozol if the patient is taking statins?

A

nystatin

80
Q

Why can chemotherapy affect cells in the mouth?

A

chemotherapy affects cells with a high turnover.

Mucosa has a high turnover of cells and affects from chemo can lead to poor wound healing and oral mucositis

81
Q

How can you treat a fluoride overdose ?

A

activated charcoal

82
Q

what infections are more common during cancer treatment ?

A

candida - treat with fluconazole (systemic), miconazole (topical) or nystatin

herpes simplex virus - treat with acyclovir

83
Q

What is schizophrenia ?

A

psychological condition affecting neurotransmitters in the brain which affects the way people interpret reality

84
Q

What are the 2 types of symptoms in schizophrenia?

A

positive symptoms - things something is there that isn’t (e.g. hallucinations)

Negative symptoms - affects emotions and communication

85
Q

what level of neutrophils would because concern?

A

<1 means have greater risk of infection

86
Q

what LA is used in patients with advanced liver disease?

A

Articaine as it is not metabolism in the liver

87
Q

what clotting factors does the liver produce?

A

1, 2, 7, 9 ,10 and 11

88
Q

Apart from clotting factors what other product essential for achieving haemostasis is produced in the liver?

A

Thrombopoietin

89
Q

What causes thrombocytopenia?

A

portal hypertension - leads t congestive splenomegaly and sequestration of platelets in the spleen

impaired hepatic synthesis

bone marrow suppression by hepatitis C

90
Q

What anticoagulant is commonly used in patients requiring renal dialysis?

A

Heparin

91
Q

What does low white blood cells indicate?

A

immunosuppression or autoimmune disease

92
Q

what is the normal range for WBC?

A

4.5 - 10 x10^9/L

93
Q

what does a high white blood cell count indicate?

A

current infection

94
Q

what is a normal range for neutrophils in the blood?

A

> 1

if <1 give antibiotics before treatment

95
Q

What can low haemoglobin indicate?

A

Thalassaemia

96
Q

What is the range of platelets for a patient to be treated in general practice?

A

> 100

97
Q

What does low red blood cell and low haemoglobin mean?

A

anaemia

98
Q

what does low haemoglobin with reduced MCV indicate?

A

microcytic anaemia

caused by iron deficiency or Thalassemia

99
Q

what does low haemoglobin with increased MCV indicate?

A

Macrocytic anaemia

caused by liver damage and b12 and folate deficiency

100
Q

What does low haemoglobin with normal MCV indicate>

A

Normocytic anaemia

101
Q

What questions would you ask a patient who smokes?

A

what do they smoke?
How often do they smoke?
How long have they smoked for?
Have they ever tried to quit before?

102
Q

What advice would you give to patients about vaping?

A

Explain there is not enough research to determine long term effects of vaping however they are considered safer than normal cigarettes

recommend research backed methods to quitting smoking (e.g. nicotine patches)

don’t use as an alternative to smoking - use as a method of quoting

try not to use in public or infront of children

103
Q

What are the 5 A’s in smoking sessation?

A

Ask - about smoking

Advise

Assess

Assist

arrange follow up for patients

104
Q

What is the shortened approach to smoking cessation ?

A

Ask - establish smoking status and record
Advise
Act - offer referal to local stop smoking services

105
Q

What are risk factors of oral cancer?

A

smoking
alcohol
sunlight
HPV

106
Q

What are services to refer to for smoking cessation

A

local stop smoking services
Local pharmacy

107
Q

What are services to refer to for smoking cessation

A

local stop smoking services
Local pharmacy

108
Q

What periodontal issue might occur when patients stop smoking?

A

increased bleeding when brushing due to gingival blood flow increasing

109
Q

Explain a randomised control trial

A

Gold Standard

used for determining effectivemness of treatment

uses blinding, randomisations and control groups

110
Q

Explain a cohort study

A

a prospective study

establish risk factors, follows a group over time and identifies which individuals develop the disease

used for estimating incidence and causes of disease

111
Q

Explain a case cohort study

A

retrospective study that looks back at exposure to particular risk factors and potential causes of disease

disadvantage: human error, and individuals cannot remember past events

112
Q

What is the value that means data is not statistically valid?

A

if CI overlaps 0

113
Q

What does SIMD mean?

A

Scottish index of multiple deprivation - ranks data zones from most to least deprived

114
Q

What are roles of epidemiology?

A

To assess peoples risk of disease

To study the causes of disease

To develop preventative programmes

115
Q

Define incidence

A

The amount of new cases in the population in a specific time period

116
Q

Define prevalance

A

proportion of the population affected by the disease at a single point in time

117
Q

What are factors of deprivation

A

housing
crowding
crime
education
health access
income
empoymeny

BDS3 past papers (8 decks)

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