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PC1 Exam 3 > Systemic Disease Cont. > Flashcards

Systemic Disease Cont. Flashcards

1
Q

Chronic Obstructive pulmonary disease (COPD)

A

Chronic airflow limitation/obstruction from lungs not fully reversible. Ex: Bronchitis and emphysema

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2
Q

Bronchitis

A

Excessive tracheobronchial mucus to cause productive cough w/ sputum production for at least 3 months in at least 2 consecutive years

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3
Q

Emphysema

A

Presence of permanent enlargement of the air spaces distal to terminal bronchioles with destruction of alveolar walls/septa without obvious fibrosis

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4
Q

Questions to ask pt w/ COPD

A

How severe? How long have u has it? when were you diagnosis? what meds? does it bother you to recline? will the rubber dam be a prob?

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5
Q

A pt with COPD needs

A

to monitor vitals, minor vital, low-flow O2 (depends on elevated arterial CO2 levels stimulate breathing)

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6
Q

Congestive heart failure (CHF)

A

Heart failure - cannot pump enough blood.

Usually >65 yr - complex of symptoms: no actual diagnosis, end stage of many CV diseases

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7
Q

Sign and symptoms of CHF

A

Fatigue, weakness, ankle swelling (edema), clubbing digits, syncope, angina, breathing difficulties, increased urination at night.

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8
Q

CHF respiratory

A

Dyspnea, orthopnea, sleep apnea.

“How many pillows slept on?” - Under head, 2 = caution bc cannot lay flat

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9
Q

Shortness of breath (SOB)

A

Look at respirations - how well chest is expanding, counting respirations, nice breathes, labored, wheezing?
Questions to ask - How many blocks can u walk before tiring? Can you walk 2 flights of stairs w/o having to stop?

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10
Q

Alzheimer’s disease

A

Memory loss, cognitive decline, behavioral and personality changes.

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11
Q

Dementia

A

Disorder of cognition that consequently interferes w/ daily functions & results in loss of independence.

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12
Q

Common causes and prevalence of Dementia

A

Alzheimer/s disease, vascular dementia, Parkinson’s disease.
Increases with age: 65 yo 7%, 85 yo >40%

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13
Q

Cause of Alzheimers

A

Unknown - most likely involve loss of cholinergic neurons, genetic profisposition contributes to <20% of all cases (not as big of a part of it now)

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14
Q

Ave lifespan after Dx of Alzheimers

A

8yr - long term care insurance if needed for assisted living

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15
Q

Dental Management of Alzheimers

A

Knowledge of stage of disease, meds, cognitive abilities of pt - do they have POA or spouse for decision making?
- Pt mild moderate maintain normal systemic organ function/can receive routine dental treatment: as progresses -antipsychotics, antidepressants, anxiolytics used to manage behavioral disturbances. May contribute to xerostomia w/increased risk for caries

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16
Q

Adrenal Glands

A

Small endocrine glands located bilaterally at superior pole of kidneys

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17
Q

Adrenal medulla and cortex

A

Functions as sympathetic ganglion & secretes catecholamines (mostly epinephrine)
Secretes secret steroid hormones

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18
Q

Primary adrenal insufficiency

A

Addison’s disease - caused by progressive destruction of adrenal cortex due to autoimmune disease and chronic infectious disease (TB, HIV, Cytomegalovirus infections, and fungal infections)

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19
Q

Secondary Adrenal insufficiency

A

Caused by pituitary disease or long-term critical illness

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20
Q

tertiary adrenal insufficiency

A

Caused by processes that impair function of hypothalamus, most common is chronic use of coticsoteriods

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21
Q

Secondary adrenocortical insufficiency

A

More common a problem and may be caused my mutual lesion of hypothalamus or pituitary gland, administration of exogenous corticosteroids, and ability to handle stress

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22
Q

Adrenal insufficiency

A

inability to increase cortisol production w/ stress
Tired, fatigue, weak, orthostatic hypotension, poor healing (increased infection), anxiety, inability to tolerate stress
Maybe from oral steroid use – How much? How often or long?

23
Q

Alcohol & drug abuse

A

Diagnosis of substance abuse requires
recurrent use of a substance over the past 12mon w/ subsequent adverse consequences – failure to fulfill major role @ work, school, home, legal problems, persistent interpersonal problems

24
Q

Alcohol abuse

A

Missed appointments, alcohol breath,
enlargement of parotid glands & spider angiomas are novices (due to increase in estrogen that is common, in alcoholics due to liver disease but also in
pregnancy due to increase in estrogen – not just liver sclerosis)
• Liver/bone marrow damage, cirrhosis, vit K deficiency, reduced effect of
local anesthetics & benzodiazepines, nutritional deficiencies, candida infections
• Binge drinking (>5 oz/4 hr)

25
Q

Drug abuse may cause issues/what you should look for

A

interactions w/ Rx, anesthetic, liver damage, infectious diseases if share needles

26
Q

Drinking + Smoking = Cancer risk:
▪ excessive drinking =
▪ combination

A
  • increased cancer of mouth, larynx, esophagus
  • greatly increases the chance of oral cancer; alcohol can act as irritant & damage cells which could alter DNA changes
27
Q

Oral complications and manifestations due too drug and alcohol abuse

A
  • Usually more plaque, calculus, caries, gingival inflammation (alcoholics too)
  • Cocaine-gingival recession & erosion of facial aspects, Meth mouth-xerostomia, rampant caries, bruxism & m. trismus
    (grinding)
  • Should not provide extensive care until homecare improves
28
Q

Anema

A

Reduction of O2 carrying capacity of blood. Most common blood condition in US

29
Q

Anema is usually associated with

A

decrease # of circulating RBCs, abnormality in Hb

30
Q

Anema affects sexes how

A

Affects F>M, maybe caused by underlying disease especially in M, > 3mil US cases per year

31
Q

Types of Anemias

A

Iron deficiency, Folate

deficiency, Hemolytic anemia, Sickle cell anemia

32
Q

Oral signs or symptoms of Anemia

A

Pale (pallor), fatigue, low BP, SOB, rapid heart rate
Oral signs: smooth, burning red tongue,
bleeding gums, delayed healing, increase infections

33
Q

Pagophagia

A

Craving & chewing ice associated ice associated with iron deficiency, w/ or w/o anemia

34
Q

Eating disorder

A

2 major types - F 90% of cases
Anorexia nervosa
Bilimia nervosa

35
Q

Anorexia nervosa

  • What is it?
  • Onset
  • Mortality rate
  • Signs/symptoms
A

Severe restriction of food intake & weight loss & medical sequelae of starvation
▪ Onset: 14-18yo, rare after 40
▪ Mortality rate: 5-20% by starvation, suicide, electrolyte imbalance
▪ Hair thin/brittle, neck/facial swelling, fainting, irritable, low BP, anemia, osteoporosis, amenorrhea

36
Q

Bulimia nervosa

  • What is it?
  • Onset
  • Mortality rate
  • Oral sign
A

restriction of food by binge eating à various methods of ridding food (vomit, laxatives, diuretics)
▪ Onset: 20yo
▪ >30% abuse alcohol & stimulants, 1⁄2 have personality disorders
▪ Amalgam restoration are higher than surrounding enamel

37
Q

Questions to ask when Abnormal bleeding happens?

A

When did it occur? After extraction? How long did it last? Have you been
diagnosed by a physician? – have appointments in the morning

38
Q

What is an INR?

A

international normalized ration – standard measure

39
Q

Levels/understand INR readings

A
  • 2.0 = takes ~2x as long to clot – On blood thinner (Coumadin, Heparin) = 2.0-3.0
  • Score too low= @ risk for blood clot
  • Score too high= can experience bleeding issues
  • Levels >4.9 considered critical values & increase risk of severe bleeding
40
Q

Prothrombin time test

A

measures how quickly your blood clots, if taking blood- thinning medication the PT test will be expressed as a ration (INR)

41
Q

Cancer causes

A

1/3 due to tobacco, 1/3 due to poor nutrition, obesity, physical inactivity

42
Q

What dentists must be aware of when it comes to pt w/ cancer?

A

type & extent of cancer & prepare for complications (adverse bleeding, side effects of drugs, and infection).
Dentist will treating patients while undergoing various phases of treatment bc increased survival rates

43
Q

What are the precautions if a pt has cancer?

A

chemo (immunocompromised), head & neck radiation therapy (xerostomia, mucosal irritation, cervical caries), med consult

44
Q

What is Epilepsy?

A

No specific diagnosis but rather term that refers to group of disorders, characterized by chronic & recurrent, paroxysmal changes in neurological function (seizures), altered consciousness, or involuntary movements caused by abnormal & spontaneous electrical activity in brain

45
Q

Symptoms of epilepsy?

A

aura (momentary sensory alteration,
unusual smell/vision), irritability, epileptic cry just before (diaphragm spasm), loss of consciousness, m. rigidity, organ transplant on lot of immunosuppressant drugs

46
Q

Treatment of epilepsy?

A

Long-term drug therapy (Dilantin, Tegretol), 60-80% achieve complete control, gingival hyperplasia (Dilantin)
• “uncontrolled”: >1-2 seizures/month, med consult, avoid triggers
• “well-controlled”: <1-2 seizures/month, cleared to drive

47
Q

Dental treatment of pt with epilepsy?

A
  • Complete health history (type, age of onset, cause if known, frequency,
    meds, date of last seizure)
  • Ask if they feel unusually tired? Ask to communicate if they sense seizure coming. Don’t shine light in eyes, may stimulate seizure.
48
Q

What to do if a pt experiences a seizure in the chair?

A

1’- protect pt & try to prevent injury, don’t move to the floor instead place chair in supine position, instruments removed, no attempt to restain/hold pt, O2 if necessary, Call 4444

49
Q

If pt is on medications ask

A
  • medical history= Rx, OTC, herbal, natural, alternative, have pt bring list or all their pill bottles
  • What prescribed meds are you currently taking? What self-prescribed (over the counter) meds are you taking? Are you allergic to any meds? Did you take your meds today? – How does the pt appear? Regular MD visits? Trauma?
50
Q

What are the meds that cause xerostomia?

A

Antidepressants, antihypertensives, decongestants, sedatives, antihistamines (Benadryl, Sudafed, Tylenol, PM)

51
Q

Ways to relieve xerostomia?

A

water, xylitol gum or mints, moisturizing gels, toothpaste, mouthwash, fluoride rinses (no alcohol)

52
Q

What are true allergies?

A

itching, hives, rash, swelling, & wheezing

53
Q

What is drug intolerance?

A

nausea, vomit, palpitations, not true allergy, & avoid using drug anyway

PC1 Exam 3 (9 decks)

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