Systemic Diseases Related to Oral Surgery Flashcards
a substernal thoracic pain precipitated by exercise, heavy emotions, or a heavy meal
Angina Pectoris
How to relieve Angina Pectoris
relieved by vasodilators and/ or a few minutes rest
Cause of Angina Pectoris
Atherosclerosis (narrowing of arteries)
discrepancy between O2 demand and supply
Angina Pectoris
causes a squeezing or pressing feeling in
the substernal area
Ischemia
Sudden referred pain to the left arm, left chest area, and mandible
ischemic attack
thumping of chest (sign that the px is having anginal attack)
Levine’s sign
DIFFERENCE OF ISCHEMIA AND INFARCT
ISCHEMIA - lacks (kulang)
INFARCT - cellular death
Condition where portion of the heart muscle that has become necrotic
Myocardial infarct
absence of heart beating
ASYSTOLE
heart beats irregularly w/ One side contracting, one side relaxing
FIBRILLATION
Defer elective surgery until ______ after last infarct/episode
6 months
cut-off for hypertension
120/80
Hypertension signs and symptoms
○ occipital headache
○ altered vision
○ flushed face
○ dizziness
○ weakness tinnitus
tips for patients with hypertension
anxiety control
pain control is probably the most important
aspect
short appointments or break it up if it’s long
morning appointments
Two types of stroke
- Emboli
- Thrombi
blockage of the artery at the site of injury
Emboli
particle that is detached and travels elsewhere to cause blockage
Thrombi
occurs when an artery in the brain leaks blood or ruptures
hemorrhagic stroke
The artery that supplies oxygen-rich blood to the brain becomes
blocked.
ischemic stroke
can result to CVA or cerebrovascular accident or stroke
untreated hypertension
Symptoms of cerebrovascular accident or stroke
slurred speech, motor control difficulty
can also be a consequence of untreated hypertension, heart condition, IHD
Congestive Heart Failure
Manifestations of left side failure in CHF
dyspnea due to pulmonary fluid accumulation
Manifestations of right side failure in CHF
venous congestion and peripheral edema
Signs and symptoms of CHF
- Gallop rhythm (increased/rapid heart rate)
- Enlarged heart (checked by doing an x-ray)
- Tender liver (pain in palpation)
- Cyanosis (ashy gray patient)
- Ascites (fluid accumulation in the abdomen)
- Orthopnea (difficulty in breathing with change of position)
- Paroxysmal nocturnal dyspnea
- Pulsus allerans (alternate strong and weak pulse)
- Distended neck vessels (even at rest)
- Edema (when pressure is applied, remains distended for 2-3 secs because you displace the fluid)
- Weight gain (due to fluid retention, you can test by pressing and if it takes a while to come back, then there is fluid retention)
- Dyspnea
- Fatigue
Blood test results of patient with CHF shows:
high RBC and low WBC & platelet count
you cannot prescribe beta blockers to patients with ______
COPD or Asthma
Possible medications for CVS Disorders
Beta Blockers
Calcium Channel Blockers
Anticoagulants
Ace Inhibitors
Diuretics
Anti-hyperlipidemias
Vasodilators
Damage to mitral or aortic valves
Rheumatic Heart Disease
Short acting bronchodilator
Salbutamol
Long-acting Bronchodilator
Procaterol
Tests indicated for patients with hepatic disorders
Bleeding time, Prothrombin Time (PT), and Partial thromboplastin time (PTT)
Insulin Dependent type of Diabetes Mellitus
Type 1
Type of Diabetes Mellitus seen in adults
Type 2
Medications of Diabetes
Chlorpropamide: Diabenese
Glibenclamide: Daonil, Euglucon
Gliclazide: Diamicron, Glucophage
Metformin: Glucophage / Fornidd
Acarbose: Glucobay, Gluconase
Inability of adrenal glands to produce and secrete adrenal hormone & corticosteroid
Adrenal Insufficiency
Signs and symptoms of Adrenal Insufficiency
● Weight loss / decreased appetite
● Hypotension / syncopal episodes
● Fatigue & muscle weakness
● Hyperpigmentation
● Nausea / Vomiting / Diarrhea = GI upset
Medication protocol if patient is currently taking steroids for adrenal insufficiency
○ Double dose: day before, of, after surgery
○ Second post-op day: back to normal dose
Medication protocol if patient has not taken medication for adrenal insufficiency within one year
Give Hydrocortisone = total 7 days
- 60 mg - day before & of
- 40 mg - 2 days post-op
- 20 mg - 3 days post-op
state of having normal thyroid gland function
Euthyroid
What is more dangerous, Hyperthyroidism or Hypothyroidism
Hyperthyroidism
Abnormal increase in WBC count
Leukemia
Main Problem in Leukemia
Prone to infection - immature cells
Disorder of cerebral function characterized by an attack involving changes in the state of consciousness, motor activity, and sensory phenomenon
Seizures
Most common trigger of seizures
Anxiety
Best time for treatment in pregnant patients
2nd Trimester
Dental surgery protocol for patients taking anticoagulants
Need to stop the medications prior to surgery at least 5-7 days prior to surgery
How does bisphosphonate intake affect oral surgery
Tendency for surgery site to have non / poor healing