TUTORIALS

Question 1

risk factors for angina?

Answer 1

smoking
diabetes
lack of exercise
family history
obesity

Question 2

what type of patients are at risk of infective endocarditis?

Answer 2

valve replacement
known cardiac conditions/ prosthetic valves
previous endocarditis
congenital defects

Question 3

infective endocarditis prophylaxis regime

Answer 3

200mg amoxicillin
600mg clindamycin

1 hour before dental tx

Question 4

names of skin lesions caused by septic emboli?

Answer 4

janeway lesions

Question 5

what device can be used to monitor asthma?

Answer 5

peak flow meter

Question 6

COPD symptoms

Answer 6

cough
shortness of breath
fatigue
mucous

Question 7

how can COPD impact dental tx

Answer 7

sitting back is difficult
sedation considered very carefully
inhaled therapies can cause dry mouth and candida

Question 8

cerebellar ataxia

Answer 8

broad-based stance with instability when walking

Question 9

intention tremor

Answer 9

coarse, low frequency oscillation during a purposeful motor movement

Question 10

resting tremor typical presentation? what disease does it present in?

Answer 10

“pill rolling” action of hand
Parkinsons

Question 11

essential tremor

Answer 11

not associated with neurological disorder
occurs during voluntary movement

Question 12

festination? presents in?

Answer 12

pt appears to hurry
Parkinsons

Question 13

bradykinesia? presents in?

Answer 13

slowness of movement
Parkinsons

Question 14

spasticity? presents in?

Answer 14

pt just recovered from stroke
caused by stiffness of muscles - presents as flexed limbs

Question 15

automatism

Answer 15

automatic, repetitive involuntary behaviour - lip smacking, swallowing, skin rubbing

Question 16

post-ictal

Answer 16

events after a seizure
drowsiness, confusion, unable to speak

Question 17

3 types of inhlaers?

Answer 17

meter dosed
spinhaler
turbohaler

Question 18

what is PEFR? and what does it indicate?

Answer 18

volume of air forcefully expelled from lungs in one exhalation.
it indicates ventilation adequacy and airflow obstruction

Question 19

stages in taking a PEFR reading?

Answer 19

ensure PFM is set to 0
position pt upright
pt takes deep breath
hold meter parallel to floor and position mouth around mouthpiece, creating tight seal
exhale as forcefully as you can
note reading
repeat 3 times and use highest

Question 20

what is a normal PEFR reading?

Answer 20

400-600l/min
*will be reduced in pts with COPD and asthma

Question 21

addisons disease mouth symptoms

Answer 21

brown pigmentation

Question 22

addisons disease and blood pressure

Answer 22

low blood pressure

Question 23

pt with Addison’s, taking a steroid - what considerations for dental tx?

Answer 23

minor procedures - take additional dose 1hr prior
major procedures - supplemental prior to procedure and for 24hrs after
xLA - refer to secondary care

Question 24

dose of steroid that can lead to adrenal insufficiency?

Answer 24

7.5mg/day for 3 weeks

Question 25

Acromegaly dental symptoms?

Answer 25

pain and clicking TMJ enlarged lower jaw teeth spacing enlarged tongue reverse overbite

Question 26

acromegaly pathology

Answer 26

excess secretion of GH and subsequent elevation IGF-1

Question 27

what are the risks associated with acromegaly?

Answer 27

DM type II - due to increase GH CV disease - ischaemic heart disease and acromegalic cardiomyopathy

Question 28

questions to ask pt you suspect of having undiagnosed hypothyroidism?

Answer 28

constipation angina hair loss poor memory

Question 29

signs you may see as a dentist of hypothyroidism?

Answer 29

goitre puffed face dry coarse skin delayed reflexes confusion

Question 30

hypothyroidism test results

Answer 30

high TSH low T4

Question 31

what drug is used to treat hypothyroidism

Answer 31

lexothyroxine

Question 32

what drug is used to treat hyperthyroidism?

Answer 32

carbimazole

Question 33

risks of undiagnosed hypothyrodism?

Answer 33

CV issues due to high cholesterol Infection

Question 34

what is the risk to a diabetic pt who hasnt taken their regular insulin dose?

Answer 34

ketoacidosis and hypoglycaemia

Question 35

explain ketoacidosis

Answer 35

body doesnt have enough insulin to use sugar as energy so liver breaks down fat instead - producing ketones

Question 36

ketoacidosis main symptom?

Answer 36

pear scented breath

Question 37

hyperglycaemia symtpoms?

Answer 37

need to pee more often very thirsty nausea sweating pear scented breath

Question 38

hyperlgycaemia reading

Answer 38

> 11mmol >7mmol if fasting

Question 39

what does low haemoglobin imply?

Answer 39

anaemia

Question 40

signs and symptoms of anaemia?

Answer 40

pale, tachycardia, pale mucosa tired and weak, dizzy, SOB, palpitations

Question 41

anaemia management

Answer 41

replace haematinics - FeSO4, vitB, folic acid transfusions erythropoietin

Question 42

what is erythropoeitin?

Answer 42

hormone that stimulated red blood cell production

Question 43

what does INR stand for?

Answer 43

international normalised ratio

Question 44

what does INR measure?

Answer 44

how long it takes for blood to clot

Question 45

what risk category does RSD come under?

Answer 45

high

Question 46

can you prescribe amoxicillin to a pt on warfarin?

Answer 46

no - increases risk of bleeding

Question 47

what risk is a biopsy?

Answer 47

high

Question 48

3 common medications prescribed to a pt with IHD

Answer 48

aspirin atorvastatin isosorbide mononitrate

Question 49

what group of drugs are anti-anginals?

Answer 49

nitrates: isosorbide mononitrate, GTN

Question 50

what drugs are anti-platelets?

Answer 50

aspirin/ clopidogrel

Question 51

what group of drugs are lipid-lowering?

Answer 51

statins: atorvastatin simvastatin

Question 52

what drugs are B blockers?

Answer 52

bisoprolol propranolol atenolol

Question 53

beta blocker action

Answer 53

prevent increase in heart rate by reducing heart muscle excitability

Question 54

what drugs are calcium channel blockers

Answer 54

amlodipine nifedipine verapamil

Question 55

calcium channel blocker action

Answer 55

vasodilation and reduction in heart rate

Question 56

depression symptoms

Answer 56

loss of appetite poor sleep early morning wakening poor concentration suicidal ideation

Question 57

what type of pts in the UK are at risk of vitD def?

Answer 57

housebound, SPF use, dark skin poor nutrition, GI disease antiepileptic drug users breastfeeding, elderly, liver disease, kidney disease

Question 58

what gives paracetamol OD a poorer outcome?

Answer 58

staggered overdose

Question 59

what is helpful in management of T2DM?

Answer 59

weight loss and exercise

Question 60

what drugs must be avoided in pts with history of gastric ulceration?

Answer 60

ibuprofen

Question 61

what type of DM is an autoimmune condition?

Answer 61

DM1

Question 62

DM1 cause?

Answer 62

autoimmune condition that leads to insulin deficiency in the pancreas - attack of islet cells

Question 63

DM2 cause?

Answer 63

insulin resistance - overtime cells stop responding to insulin so pancreas keeps trying to make more for cells to respond, overtime it then stops producing any

Question 64

type 1 DM presentation

Answer 64

thirst polyuria tired weight loss thrush blurred vision

Question 65

type 2 DM symtpoms

Answer 65

polyuria thirst tired weight loss thrush blurred vision

Question 66

diabetes complications

Answer 66

retinopathy nephropathy neuropathy periodontitis CV problems

Question 67

liver disease presentation

Answer 67

jaundice finger clubbing white nails hair loss oedema dark urine and pale stools upper abdom pain

Question 68

types of liver disease

Answer 68

hepatitis cirrhosis

Question 69

oral signs of GI disease?

Answer 69

cobblestone mucosa ulcers

Question 70

warfarin mechanism of action

Answer 70

vit K antagonist

Question 71

apixaban mechanism of action

Answer 71

inhibits prothrombin, factor Xa

Question 72

dabigatran mechanism of action

Answer 72

direct thrombin inhibitor