TUTORIALS Flashcards
risk factors for angina?
smoking
diabetes
lack of exercise
family history
obesity
what type of patients are at risk of infective endocarditis?
valve replacement
known cardiac conditions/ prosthetic valves
previous endocarditis
congenital defects
infective endocarditis prophylaxis regime
200mg amoxicillin
600mg clindamycin
1 hour before dental tx
names of skin lesions caused by septic emboli?
janeway lesions
what device can be used to monitor asthma?
peak flow meter
COPD symptoms
cough
shortness of breath
fatigue
mucous
how can COPD impact dental tx
sitting back is difficult
sedation considered very carefully
inhaled therapies can cause dry mouth and candida
cerebellar ataxia
broad-based stance with instability when walking
intention tremor
coarse, low frequency oscillation during a purposeful motor movement
resting tremor typical presentation? what disease does it present in?
“pill rolling” action of hand
Parkinsons
essential tremor
not associated with neurological disorder
occurs during voluntary movement
festination? presents in?
pt appears to hurry
Parkinsons
bradykinesia? presents in?
slowness of movement
Parkinsons
spasticity? presents in?
pt just recovered from stroke
caused by stiffness of muscles - presents as flexed limbs
automatism
automatic, repetitive involuntary behaviour - lip smacking, swallowing, skin rubbing
post-ictal
events after a seizure
drowsiness, confusion, unable to speak
3 types of inhlaers?
meter dosed
spinhaler
turbohaler
what is PEFR? and what does it indicate?
volume of air forcefully expelled from lungs in one exhalation.
it indicates ventilation adequacy and airflow obstruction
stages in taking a PEFR reading?
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
what is a normal PEFR reading?
400-600l/min
*will be reduced in pts with COPD and asthma
addisons disease mouth symptoms
brown pigmentation
addisons disease and blood pressure
low blood pressure
pt with Addison’s, taking a steroid - what considerations for dental tx?
minor procedures - take additional dose 1hr prior
major procedures - supplemental prior to procedure and for 24hrs after
xLA - refer to secondary care
dose of steroid that can lead to adrenal insufficiency?
7.5mg/day for 3 weeks
Acromegaly dental symptoms?
pain and clicking TMJ
enlarged lower jaw
teeth spacing
enlarged tongue
reverse overbite
acromegaly pathology
excess secretion of GH and subsequent elevation IGF-1
what are the risks associated with acromegaly?
DM type II - due to increase GH
CV disease - ischaemic heart disease and acromegalic cardiomyopathy
questions to ask pt you suspect of having undiagnosed hypothyroidism?
constipation
angina
hair loss
poor memory
signs you may see as a dentist of hypothyroidism?
goitre
puffed face
dry coarse skin
delayed reflexes
confusion
hypothyroidism test results
high TSH
low T4
what drug is used to treat hypothyroidism
lexothyroxine
what drug is used to treat hyperthyroidism?
carbimazole
risks of undiagnosed hypothyrodism?
CV issues due to high cholesterol
Infection
what is the risk to a diabetic pt who hasnt taken their regular insulin dose?
ketoacidosis and hypoglycaemia
explain ketoacidosis
body doesnt have enough insulin to use sugar as energy so liver breaks down fat instead - producing ketones
ketoacidosis main symptom?
pear scented breath
hyperglycaemia symtpoms?
need to pee more often
very thirsty
nausea
sweating
pear scented breath
hyperlgycaemia reading
> 11mmol
7mmol if fasting
what does low haemoglobin imply?
anaemia
signs and symptoms of anaemia?
pale, tachycardia, pale mucosa
tired and weak, dizzy, SOB, palpitations
anaemia management
replace haematinics - FeSO4, vitB, folic acid
transfusions
erythropoietin
what is erythropoeitin?
hormone that stimulated red blood cell production
what does INR stand for?
international normalised ratio
what does INR measure?
how long it takes for blood to clot
what risk category does RSD come under?
high
can you prescribe amoxicillin to a pt on warfarin?
no - increases risk of bleeding
what risk is a biopsy?
high
3 common medications prescribed to a pt with IHD
aspirin
atorvastatin
isosorbide mononitrate
what group of drugs are anti-anginals?
nitrates: isosorbide mononitrate, GTN
what drugs are anti-platelets?
aspirin/ clopidogrel
what group of drugs are lipid-lowering?
statins:
atorvastatin
simvastatin
what drugs are B blockers?
bisoprolol
propranolol
atenolol
beta blocker action
prevent increase in heart rate by reducing heart muscle excitability
what drugs are calcium channel blockers
amlodipine
nifedipine
verapamil
calcium channel blocker action
vasodilation and reduction in heart rate
depression symptoms
loss of appetite
poor sleep
early morning wakening
poor concentration
suicidal ideation
what type of pts in the UK are at risk of vitD def?
housebound, SPF use, dark skin
poor nutrition, GI disease
antiepileptic drug users
breastfeeding, elderly, liver disease, kidney disease
what gives paracetamol OD a poorer outcome?
staggered overdose
what is helpful in management of T2DM?
weight loss and exercise
what drugs must be avoided in pts with history of gastric ulceration?
ibuprofen
what type of DM is an autoimmune condition?
DM1
DM1 cause?
autoimmune condition that leads to insulin deficiency in the pancreas - attack of islet cells
DM2 cause?
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
type 1 DM presentation
thirst
polyuria
tired
weight loss
thrush
blurred vision
type 2 DM symtpoms
polyuria
thirst
tired
weight loss
thrush
blurred vision
diabetes complications
retinopathy
nephropathy
neuropathy
periodontitis
CV problems
liver disease presentation
jaundice
finger clubbing
white nails
hair loss
oedema
dark urine and pale stools
upper abdom pain
types of liver disease
hepatitis
cirrhosis
oral signs of GI disease?
cobblestone mucosa
ulcers
warfarin mechanism of action
vit K antagonist
apixaban mechanism of action
inhibits prothrombin, factor Xa
dabigatran mechanism of action
direct thrombin inhibitor
