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OHCP III > Tx Planning > Flashcards

Tx Planning Flashcards

1
Q

What are the objectives of pretreatment evaluation of a patient?

A

Mnemonic: “DADDY”

Diagnosis
Assess medical conditions
Discover illnesses
Deal with emergencies
You establish rapport

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2
Q

What are the essential elements of a patient history?

A

Complaint
History of illness
Records of past medical history
Info on social life
System review
Tracked dental history

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3
Q

Define the chief complaint.

A

Mnemonic: “Your Words”

It’s the reason the patient seeks care in their own words.

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4
Q

What elements need to be included in the medical history?
Mnemonic: “

A

Health status
Medications
Past surgeries and hospitals
Allergies

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5
Q

What areas are routinely investigated in the social history?
Mnemonic:

A

Mnemonic: “SHOES”

Status (occupation, smoking, drugs)
Habits (alcohol, drugs)
Occupational hazards
Events in life (sexual history, marital)
Social environment (family)

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6
Q
A
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7
Q

Why is the family history of interest to the dentist?

A

Mnemonic: “Genetic Clues”

Family history helps identify genetic or family-related diseases (e.g., Diabetes, Heart Disease).

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8
Q

What techniques are used for physical examination of the patient?

A

Mnemonic: “IPPA”

Inspection (look)
Palpation (feel)
Percussion (tap)
Auscultation (listen)

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9
Q
A
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10
Q

What are the patient’s vital signs?

A

Blood pressure
Airway rate (Respiratory)
Rate (Pulse)
Temperature

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11
Q

What are the normal values for the vital signs?

A

Mnemonic: “BP 120/80, 16-20, 72, 98.6”
Blood Pressure: 120/80
Respirations: 16-20
Pulse: 72
Temperature: 98.6°F

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12
Q

What is a complete blood count (CBC)?

A

Mnemonic: “Red White Plate”
Red blood cells (Hemoglobin, Hematocrit)
White blood cells (counts)
Platelets

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13
Q

What are the normal ranges of a CBC?

A

Mnemonic: “Hemat 14-18, WBC 4000-10000”
Hemoglobin: 14-18g/dL
WBC: 4000-10000 cells

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14
Q

What is the most effective blood test to screen for diabetes mellitus?

A

Mnemonic: “Fasting Glucose or HbA1c”
Fasting glucose tests for instant levels, HbA1c checks over 90 days.

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15
Q

What is the technique of choice for the diagnosis of a soft tissue lesion in the mouth?

A

A biopsy is often the gold standard.

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16
Q

When is it appropriate to use microbiologic culturing in oral diagnosis?

A

Mnemonic: “Immuno Check”
For immunocompromised patients, or for infections not responding to antibiotics.

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17
Q

Which laboratory tests should be used to assess a patient who may be at risk for a deficiency in hemostasis?

A

Mnemonic: “Coag Check”
CBC (Platelets)
Prothrombin time (INR)
Partial thromboplastin time

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18
Q

What positive responses in the medical history should suggest to you that a patient may have a problem with hemostasis?

A

Mnemonic: “Bleed Clot Check”
Bleeding history (Hemophilia)
Chemotherapy (thrombocytopenia)
Cloth-related medications (aspirin, warfarin)
Clients with liver disease

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19
Q

```

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What are the causes of halitosis?

A

Mnemonic: “Mouth, Body, Smell”
Mouth issues (food, periodontal disease, infections)
Body causes (smoking, alcohol, diseases like diabetes)
Sinus

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20
Q

Which bacteria are associated with halitosis?

A

Mnemonic: “Anaerobes Stink”
Anaerobic bacteria, especially gram-negative ones.

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21
Q

Which gases are associated with halitosis?

A

Mnemonic: “Sulfur Smell”
Hydrogen sulfide
Methyl mercaptan
Dimethyl sulfide

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22
Q

What are the common causes of lymphadenopathy?
Mnemonic:

A

Mnemonic: “Infect, Immuno, Malign”
Infectious causes (oral infections, pericoronitis, herpes)
Immunologic diseases (RA, lupus)

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23
Q

How can one differentiate between lymphadenopathy associated with an inflammatory process and lymphadenopathy associated with tumor?

A

Mnemonic: “Inflammatory vs Cancer”
Inflammatory nodes are tender and moveable
Cancerous nodes are hard, fixed, and grow progressively

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24
Q

What is the most appropriate technique for lymph node diagnosis?

A

Mnemonic: “Biopsy Best”
The biopsy or needle aspiration is the most accurate.

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25
Q

What are the most frequent causes of intraoral swelling?

A

Mnemonic: “Infection or Tumor”
Infection
Tumor (benign or malignant)

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26
Q

Why do humans get parotitis?

A

Mnemonic: “Viral or Bacterial”
Most common causes are viral (mumps, coxsackie) or bacterial (staphylococcus, Actinomyces).

27
Q

What are common causes of xerostomia?

A

Mnemonic: “Aging, Meds, Radiation”
Advanced age
Medications
Radiation therapy
Sjögren syndrome

28
Q
A
29
Q

What is the presentation of a patient with a tumor of the parotid gland? How is the diagnosis made?

A

Mnemonic: “Firm, Fixed Mass”
A firm, fixed mass near the parotid area, often with facial palsy.
Biopsy or imaging like CT and MRI help confirm.

30
Q

What are the major risk factors for oral cancer?

A

Mnemonic: “Tobacco, Alcohol, HPV”
Tobacco
Alcohol
HPV (especially subtypes 16 and 18)

31
Q

What is the most common location of cancers of the tongue?
Mnemonic:

A

“Lateral, Ventral”
Most common on the lateral or ventral surfaces of the posterior tongue.

32
Q

Summarize the impact of early detection of mouth cancers on survival.

A

Mnemonic: “Early = Higher Survival”
Early detection increases the survival rate significantly (e.g., 65% for early-stage tongue cancers vs 20% for advanced).

33
Q

How is oral cancer staged?

A

Mnemonic: “TNM”
Tumor size
Node involvement
Metastasis (whether cancer has spread)

34
Q

What are the two most common clinical presentations of oral cancers?

A

Mnemonic: “Ulcer, Leukoplakia”
Most common signs are a non-healing ulcer or an area of leukoplakia, often with erythema.

35
Q

What percentage of keratotic white lesions in the mouth are dysplastic or cancerous?
Mnemonic:

A

Mnemonic: “5-15% Risk”
5% to 15% of keratotic white lesions may be dysplastic or cancerous, especially higher in smokers.

36
Q

What is a simple way to differentiate clinically between necrotic and keratotic white lesions of the oral mucosa?

A

Necrotic lesions (e.g., caused by burns or infections) scrape off, while keratotic lesions (e.g., leukoplakia) do not.

37
Q

What is the differential diagnosis of ulcers of the oral mucosa?

A

Mnemonic: “TRAC CAN”
Traumatic ulcer
Recurrent aphthous stomatitis
Also cancer, TB, HSV
Chancre (syphilis)
Also Noma, Necrotizing sialometaplasia
Necrotizing infections

38
Q

Why is it a good idea to aspirate a pigmented lesion before obtaining a biopsy?

A

Mnemonic: “Aspirate Before Biopsy”
Aspirate first to avoid bleeding before the biopsy, as pigmented lesions may be vascular.

39
Q

What are the major causes of pigmented oral and perioral lesions?

A

Mnemonic: “Pigment Origins: Endo vs Exo”
Endogenous: Melanoma, Addison’s disease, Peutz-Jeghers syndrome
Exogenous: Lead poisoning, Amalgam tattoos, medications (e.g., tetracycline)

40
Q

Do any diseases of the oral cavity also present with lesions of the skin?

A

Mnemonic: “Skin & Mouth Diseases”
Diseases like Lichen Planus, Lupus, Pemphigus, and Erythema multiforme affect both the oral cavity and skin.

41
Q

What is the appearance of the skin lesion associated with erythema multiforme?

A

Mnemonic: “Target Lesion”
Bull’s-eye or Target lesion: Central erythema with a circular ring around it.

42
Q

A 25-year-old woman presents with a chief complaint of spontaneously bleeding gingiva. She also notes malaise. On oral examination, you find that her hygiene is excellent. Would you suspect a local or systemic basis for her symptoms? What tests might you order to make a diagnosis?

A

Mnemonic: “Systemic Bleeding = Leukemia”
Systemic origin is more likely. Acute leukemia is a strong possibility. Tests to order: CBC and platelet count.

43
Q

A 45-year-old, overweight man presents with suppurative periodontitis. As you review his history, he tells you that he is always hungry, drinks water almost every hour, and awakens four times each night to urinate. Which systemic disease is most likely a cofactor in his periodontal disease? What test(s) might you order to help you with a diagnosis?

A

A 45-year-old, overweight man presents with suppurative periodontitis. As you review his history, he tells you that he is always hungry, drinks water almost every hour, and awakens four times each night to urinate. Which systemic disease is most likely a cofactor in his periodontal disease? What test(s) might you order to help you with a diagnosis?
Mnemonic: “Polyuria, Polyphagia = Diabetes”
Diabetes mellitus is likely, considering his symptoms. Order fasting blood glucose

44
Q

A 60-year-old woman presents with a complaint of numbness of the left side of her mandible. Four years ago, she had a mastectomy for treatment of breast cancer. What is the likely diagnosis? What is the first step that you take to confirm it?
Mnemonic:

A

A 60-year-old woman presents with a complaint of numbness of the left side of her mandible. Four years ago, she had a mastectomy for treatment of breast cancer. What is the likely diagnosis? What is the first step that you take to confirm it?
Mnemonic: “Mandibular Numbness = Metastasis”
Likely metastatic breast cancer. First step: Radiograph of the jaw.

45
Q

Which endocrine disease may present with pigmented lesions of the oral mucosa?

A

Mnemonic: “Addison’s Disease”
Addison’s disease can cause pigmented lesions in the oral mucosa.

46
Q

What drugs cause gingival hyperplasia?

A

Mnemonic: “Phenytoin, Cyclosporine, Nifedipine”
Phenytoin
Cyclosporine
Nifedipine

47
Q

What is the most typical presentation of the oral lesions of tuberculosis? How do you make a diagnosis?

A

Mnemonic: “TB Ulcers = Non-healing”
Non-healing ulcers on the lateral tongue; often purulent in the center. Diagnosis: Histology with bacterial organisms.

48
Q

What are the typical oral manifestations of a patient with pernicious anemia?

A

Mnemonic: “B12 Deficiency = Smooth Tongue”
Smooth tongue (denuded of papillae), burning sensation, and angular cheilitis.

49
Q

What is angular cheilitis? What is its cause?

A

Mnemonic: “Cracked Corners = Infection”
Cracking at the corners of the mouth, often due to bacterial and fungal infections caused by excess saliva or systemic conditions like anemia.

50
Q

What is the classic oral manifestation of Crohn disease?

A

Mnemonic: “Crohn = Cobblestone”
Cobblestone appearance of mucosa with aphthous lesions, orofacial granulomatosis, and angular cheilitis.

51
Q

List the oral changes that may occur in a patient receiving radiation therapy for treatment of a tumor on the base of the tongue.

A

Mnemonic: “Xerostomia, Caries, Osteonecrosis”
Xerostomia (dry mouth)
Cervical and incisal edge caries
Osteoradionecrosis
Mucositis

52
Q

A patient presents for extraction of a carious tooth. In taking the history, you learn that the patient is undergoing chemotherapy for treatment of a breast carcinoma. What information is critical before proceeding with the extraction?

A

Mnemonic: “Chemotherapy Risks = WBC, Platelets”
You need to check the patient’s WBC and platelet count before proceeding, as chemotherapy can cause myelosuppression. Also consider risks for osteonecrosis if bisphosphonates are used.

53
Q

What oral findings have been associated with use of the diuretic hydrochlorothiazide?

A

Mnemonic: “Lichen Planus = Hydrochlorothiazide”
Lichen planus has been associated with the use of hydrochlorothiazide.

54
Q

Some patients believe that topical application of an aspirin to the mucosa next to a tooth will help odontogenic pain. How may you detect this form of therapy by looking in the patient’s mouth?

A

Mnemonic: “Aspirin = Chemical Burn”
Chemical burns caused by aspirin often appear as white necrotic lesions where aspirin was applied.

55
Q

What are the possible causes of burning mouth symptoms?

A

Mnemonic: “Burning = Dry, Deficiencies, Meds”
Causes include:
Dry mouth
Nutritional deficiencies
Diabetes
Psychogenic factors
Medications
Acid reflux
Hormonal imbalances
Allergy
Chronic infections (fungal)
Blood disorders (e.g., anemia)
Iatrogenic factors
Inflammatory conditions (e.g., lichen planus)

56
Q

What is the most important goal in the evaluation of a taste disorder?

A

Mnemonic: “Neurologic or Systemic?”
The primary goal is to eliminate any neurologic or systemic disorder as the cause of the taste disorder.

57
Q

What drugs often prescribed by dentists may affect taste or smell?

A

Mnemonic: “MATS Code”
Metronidazole
Ampicillin
Tetracycline
Sodium lauryl sulfate (toothpaste)
Codeine

58
Q

What systemic conditions may affect smell and/or taste?
Mnemonic: “Bell’s MS, Cancer & More”

A

What systemic conditions may affect smell and/or taste?
Mnemonic: “Bell’s MS, Cancer & More”
Conditions include:
Bell’s palsy
Multiple sclerosis
Head trauma
Cancer
Chronic renal failure
Cirrhosis
Niacin deficiency
Adrenal insufficiency
Cushing syndrome
Diabetes mellitus
Sjögren syndrome
Radiation therapy to head and neck
Viral infections
Hypertension

59
Q

What is burning mouth syndrome?

A

Mnemonic: “Burning = No Visible Lesion”
Burning mouth syndrome involves unprovoked oral burning, often in the tongue, lips, and hard palate. The mucosa appears normal, and no underlying disease is identified.

60
Q

hat questions should a clinician consider before ordering a diagnostic test to supplement a clinical examination?

A

Mnemonic: “Likelihood, Severity, Test Quality”
Questions to ask:
Likelihood of disease based on clinical findings and risk factors
Seriousness of condition and consequences of delay
Test availability, accuracy, and sensitivity
Cost, risks, and practicality of the test

61
Q

Which systemic diseases have been associated with alterations in salivary gland function?

A

Mnemonic: “C-H-D-RAST-SO”
Cystic fibrosis
HIV
Diabetes
Renal disease
Affective disorders
Sjögren syndrome
Thyroid disease
Sarcoidosis
Other autoimmune diseases (e.g., Alzheimer’s, cancer)

62
Q

What is PCR? Why may it become an important technique in oral diagnosis?

A

What is PCR? Why may it become an important technique in oral diagnosis?
Mnemonic: “PCR = DNA Amplification”
PCR (Polymerase Chain Reaction) is a DNA amplification technique that helps diagnose viral infections due to its high sensitivity.

63
Q

What conditions and diseases may cause blistering (vesiculobullous lesions) in the mouth?

A

Mnemonic: “Viral, Autoimmune, Multiforme”
Causes include:
Viral infections (e.g., HSV)
Lichen planus
Pemphigoid
Pemphigus vulgaris

64
Q

What are the most common sites of intraoral cancer?

A

posterior lateral and ventral surfaces of the tongue.

OHCP III (18 decks)

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