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Systemic Diseases Flashcards

1
Q

Chronic obstructive pulmonary disease is a general term for

A

pulmonary disorders

characterized by chronic airflow limitation from the lungs that is not fully reversible

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2
Q

COPD encompasses two main diseases:

A

Chronic bronchitis and

emphysema

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3
Q

Chronic inflammation of the bronchi that
produces excessive tracheobronchial
mucus production and a persistent cough
with sputum for at least 3 months in at
least 2 consecutive years in a patient in
whom other causes of productive chronic
cough have been excluded.

A

chronic bronchitis

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4
Q

Permanent enlargement of the air
spaces in the lungs that is accompanied
by destruction of the air space (alveolar)
walls without obvious fibrosis

A

emphysema

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5
Q

These 2 conditions are related, and often represent

A

the progression of disease and may have overlapping symptoms, making differentiation difficult

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6
Q

The recommended use of COPD is used and is diagnosed on the presence of, (2) together with an abnormal measurement of — function

A

sputum production, and dyspnea

lung

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7
Q

The onset of COPD takes many years in
most patients and usually begins after
age

A

40

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8
Q

Symptoms develop —, and many
patients are unaware of the emerging
condition

A

slowly

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9
Q

“Blue Bloaters”

A

Traditionally, patients with chronic bronchitis have been described as

sedentary, 
overweight,
cyanotic, 
edematous 
and breathless
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10
Q

Patients diagnosed with emphysema

were traditionally know as “Pink Puffers” because they demonstrated (6)

A

enlarged chest walls (barrel-chested appearance),
weight loss with disease progression,
severe exertional dyspnea,
seldom coughing,
lack of cyanosis,
pursing of the lips with efforts to forcibly exhale air from the lungs

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11
Q

with patients with COPD, monitor

A

vitals

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12
Q

what kind of oxygen do patients with COPD get?

A

low flow oxygen only

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13
Q

why low flow oxygen only?

A

they depend on
elevated arterial CO2
levels to stimulate
breathing

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14
Q

questions with Emphysema,

bronchitis (5)

A 
How severe?
How long have you had it? 
What medications are you 
on?
“Does it bother you to recline 
completely?” 
“Will the rubber dam be a problem?”
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15
Q

how many attacks a week with mild asthma?

A

<3 /week

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16
Q

duration of mild asthma attack

A

<30 min duration

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17
Q

when do you have a mild asthma attack?

A

only w exercise or allergen

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18
Q

do those with mild asmtha use an inhaler?

A

rarely

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19
Q

age of mild asthma

A

usually childhood, usually outgrow

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20
Q

how many attacks with moderate asthma

A

3-5 attacks/week

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21
Q

how long does a moderate asthma attack last

A

30 min-several hours

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22
Q

moderate asthma affects

A

sleep

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23
Q

inhaler use with moderate asthma

A

more common

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24
Q

amount of attacks with severe asthma

A

daily attacks

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25
inhaler use with severe asthma
daily
26
severe asthma may require (2)
frequent ER visits, hospitalized | steroids
27
severe asthma limits
daily activity
28
Shortness of Breath (S.O.B.) questions (2)
``` “how many blocks can you walk before tiring?” “can you walk two flights of stairs without having to stop?” ```
29
sleep apnea (2)
Paroxysmal nocturnal dyspnea waking suddenly in middle of night short of breath
30
symptoms of sleep apnea (4)
Snoring with occasional apneas Tired (difficulty concentrating during day) Sore throat in morning Increased gastric reflux
31
behavioral treatment of sleep apnea (2)
weight loss | cessation of alcohol use
32
surgery as treatment for sleep apnea (4)
``` Uvulopalatopharyngoplasty genial advancement hyoid suspension maxillomandibular advancement (MMA) ```
33
sleep apnea treatment option includes
Constant Positive Air Pressure (CPAP) machine
34
Constant Positive Air Pressure (CPAP) machine
+ pressure during | sleep
35
rhematic fever (2)
Usually from Strep throat as a child (5-15 yrs. old) | Autoimmune condition
36
Strep symptoms (5)
``` Sore throat Fever Headache swollen tonsils White patches on tonsils ```
37
rheumatic fever group
Group A, β-hemolytic | Strep
38
what can rheumatic fever involve? (4)
Heart valves= rheumatic heart disease Inflamed joints Brain (chorea =uncontrolled movements) Broad pink patches on skin
39
rheumatic heart disease is used to premeditate for
invasive dental procedures
40
rheumatic heart disease is not included in
latest recommendations
41
what should you do if concerned?
med consult
42
coronary bypass graft surgery (2)
Single, double, triple, quadruple. | Redirects blood around a partially blocked or blocked artery in your heart
43
what type of graft? (2) Synthetic? Allograft?
* Synthetic?-Dacron | * Allograft?-autologous vein, human umbilical vein
44
for coronary bypass graft surgery, no elective treatment for at least
2 months
45
after that,
med consult
46
symptoms of Alzheimers disease (3)
Memory loss Cognitive decline Behavioral and personality changes
47
Dementia is a disorder of cognition that consequently interferes with
the daily functions and results in a loss of independence
48
Most common causes of dementia are | 3
Alzheimer’s disease, vascular dementia, dementia caused by Parkinson’s disease
49
Prevalence of Alzheimer's increases with age:
age 65 7% | by age 85, more than 40%
50
Women are at greater risk primarily | because they
live longer
51
Cause of Alzheimer’s disease is unknown | but appears to involve the loss of
cholinergic neurons
52
Genetic predisposition contributes to | less than --% of all cases
20%
53
Average lifespan after diagnosis
8 years
54
Dental Management (3)
Knowledge of the stage of the disease, medications taken, cognitive abilities of the patient
55
Patients with mild to moderate disease generally (2)
maintain normal systemic organ function and can receive routine dental treatment
56
As disease progresses, (3) are frequently are used to manage behavioral disturbances
antipsychotics antidepressants anxiolytics
57
these medications contribute to --- with increased risk for dental caries
xerostomia
58
adrenal glands
small endocrine glands located bilaterally at the superior pole of each kidney
59
adrenal medulla functions as a
sympathetic ganglion
60
adrenal medulla secretes
catecholamines, primarily epinephrine
61
adrenal cortex secretes
several steroid hormones
62
etiology of Addisons disease
primary adrenal insufficiency
63
adddisons disease is caused by
progressive destruction of the adrenal cortex
64
progressive destruction of the adrenal cortex is usually due to (2)
autoimmune disease | chronic infectious disease
65
chronic infectious disease examples (4)
TB hIV cytomegalovirus infections fungal infections
66
secondary adrenal insufficiency is caused by (2)
pituitary disease or critical illness
67
tertiary adrenal insufficiency is caused by
processes that impair function of the hypothalamus
68
most common cause of tertiary adrenal insufficiency
use of corticosteroids
69
adrenal insufficiency symptoms (6)
```  TIRED-FATIGUE  WEAK  ORTHOSTATIC HYPOTENSION  POOR HEALING  INABILITY TO TOLERATE STRESS  INCREASED INFECTIONS ```
70
adrenal insufficiency healing
poor
71
increased --- with adrenal insufficiency
infections
72
adrenal insufficiency has inability to tolerate
stress
73
adrenal insufficiency may be from
oral steroid use
74
SECONDARY ADRENOCORTICAL INSUFFICIENCY IS FAR | MORE COMMON A PROBLEM AND MAY BE CAUSED BY (2)
 SUCTURAL LESIONS OF THE HYPOTHALAMUS OR PITUITARY GLAND  ADMINISTRATION ON EXOGENOUS CORTICOSTEROIDS
75
A DIAGNOSIS OF SUBSTANCE ABUSE REQUIRES THE | 2
RECURRENT USE OF A SUBSTANCE OVER THE PAST 12 | MONTHS WITH SUBSEQUENT ADVERSE CONSEQUENCES
76
alcohol and drug abuse results in
FAILURE TO FULFILL A MAJOR ROLE AT WORK, SCHOOL, HOME; LEGAL PROBLEMS;PERSISTENT INTERPERSONAL PROBLEMS
77
FEATURES SUGGESTIVE OF ALCOHOL ABUSE INCLULDE (4)
MISSED APPOINTMENTS ALCOHOL ON BREATH ENLARGEMENT OF THE PAROTID GLANDS SPIDER ANGIOMAS
78
alcohol use can result in (6)
```  LIVER AND BONE MARROW DAMAGE  CIRRHOSIS  VITAMIN K DEFICIENCY  REDUCED EFFECT OF LOCAL ANESTHETICS AND BENZODIAZEPINES  NUTRITIONAL DIFICIENCIES  CANDIDAL INFECTIONS ```
79
binge drinking
>5 oz /4 hours
80
Excessive drinking = Increased cancer of: (3)
Mouth Larynx Esophagus
81
combo of smoking and alcohol greatly increases the chance of
oral cancer
82
alcohol can act as an irritant and damage cells which could lead to
DNA changes
83
drug abuse interacts with
Rx, anesthetic
84
drug abuse leads to --- damage
liver
85
infectious diseases if shared
needles
86
oral complications with drugs alcohol: tends to have more (4)
plaques calculus caries gingival inflammation
87
cocaine leads to (2)
gingival recession and erosion of facial aspects
88
meth mouth (4)
xerostomia rampant caries bruxism muscle trimus
89
should not provide extensive care until --- improves
homecare
90
anemia
reduction in the oxygen carrying capacity of the blood
91
most common blood condition in the US
anemia
92
anemia is usually associated with (2)
decrease number of circulating RBC | an abnormality in the Hb contained within RBC
93
who does anemia affect mostly
females>males
94
anemia may be caused by
an underlying disease especially in men
95
more than - million US cases of anemia per year
3
96
types of anemia (4)
 IRON DEFCIENCY  FOLATE DEFCIENCY  HEMOLYTIC ANEMIA  SICKLE CELL ANEMIA
97
symptoms of anemia (5)
``` Pale (= pallor) Fatigue Low blood pressure SOB Rapid heart rate ```
98
oral signs of anemia (2)
Smooth, burning red tongue | Bleeding gums
99
anemia results in delayed --- and increased ---
healing | infections
100
pagophagia
Craving and chewing ice associated with | iron deficiency, with or without anemia
101
2 major eating disorders
anorexia nervosa | bulimia nervosa
102
ANOREXIA NERVOSA
SEVERE RESTRICTION OF FOOD INTAKE, LEADING TO WEIGHT LOSS AND THE MEDICAL SEQUELAE OF STARVATION
103
BULIMIA NERVOSA
RESTRICTION OF FOOD BY BINGE EATING FOLLOWEED BY VARIOUS METHODS OF TRYING TO RID THE FOOD.(VOMITING,LAXATIVES,DIURETICS)
104
age onset of anorexia
14-18
105
anorexia is rare after
age 40
106
who does anorexia affect
females (90-95)
107
mortality rate of anorexia
5-20% usually by starvation, suicide, electrolyte imbalance
108
anorexia nervosa symptoms (8)
``` Hair thin and brittle Neck / facial swelling Fainting Irritable Low b.p. Anemia Osteoporosis Amenorrhea ```
109
with bulimia nervosa, --- --- are higher than surrounding enamel
amalgam restorations
110
age onset of bulimia
20 years
111
who does bulimia affect
females, 90-95% of cases
112
more than --% abuse alcohol and stimulants
30%
113
how many of bulimics have personality disorders
1/2
114
bulimia nervosa results in enamel erosion from
acidic chemicals
115
where does enamel erosion occur
Lingual of ant teeth
116
perimylolysis
LOSS OF ENAMEL AND DENTIN ON THE LINGUAL SURFACES BY CHEMICAL AND MECHANICAL EFFECTS
117
PT measures
how quickly your blood clots
118
if you take blood thinning medication, your PT test will be expressed as
a ratio, INR
119
IF THE INR SCORE IS TOO LOW- PATIENT CAN BE AT RISK FOR
A BLOOD CLOT
120
IF THE INR SCORE IS TOO HIGH, PATIENT CAN EXPERIENCE
BLEEDING ISSUES
121
TYPICAL INR SCORE RANGE FOR PATIENT ON BLOOD | THINNER IS
2-3
122
HEALTHY PEOPLE NOT ON BLOOD THINNER __ OR | BELOW
1.1

Patient Care (15 decks)

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