Dental Therapeutics-Baker test 1

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  1. Name the organism targeted by antibiotic premedication regimens
    Strep Viridans group (Alpha hemolytic strep>>>dextran allows this organism to stick well to prosthetic devices)
  2. List the patient conditions that require premedication according to the AHA 2007 guidelines.
    Prosthetic cardiac valves

    Previous infective endocarditis

    • Congenital heart disease
    • unrepaired cyanotic CHD
    • completely repaired CHD w/in 6 mos
    • repaired CHD with residual effects

    cardiac transplant recipients who develop valvulopathy
  3. Characteristic of subacute or acute...staph aureus infection usually
  4. Characteristic of subactute or acute...40% mortality rate
  5. Characteristic of subacute or acute...IV drug use is usually a factor
  6. Characteristic of subacute or acute...often secondary to sepsis
  7. Characteristic of subacute or acute...Viridans group strep is common
  8. Characteristic of subacute or acute...associated with <10% mortality rate
  9. Characteristic of subacute or acute...80% of patients usually have some sort of heart problem
  10. Characteristic of subacute or acute....bacterial endocarditis usually shows up in less than 14 days from initial exposure
  11. What are the three questions to ask a patient with a prosthetic joint
    • 1. How long have you had the joint?
    • 2. Have you had any post-op complications
    • 3. Is your immune system suppressed by any disease or drug therapy
  12. How long of a window do patients with a large weight bearing joint need to be given an antibiotic premed?
    Cover all patients in the first two years with a large weight bearing joint...exceptions do exist
  13. What are three times where it might be necessary to have a patient take antibiotic premedication for a large weight bearing joint outside the normal window?
    • 1. Immune system suppression
    • 2. Radiation therapy
    • 3. Chronic infection
  14. What drugs suppress the immune system?
    • 1. methotrexate
    • 2. corticosteroids
    • 3.others exist as well these were just the ones listed
  15. What diseases suppress the immune system?
    SLE, HIV, IDDM (type I diabetes), rheumatoid arthritis, malignancies
  16. What chronic infections necessitate antibiotic premed coverage for pts with large weight bearing joints?
    UTI, periodontitis, alcoholics, hemophiliacs
  17. What are the 4 things you need to do at each appointment with patients with prosthetic joints?
    • 1. Update health history with each visit
    • 2. reinforce home-care procedures and use chemotherapeutic measures to reduce bleeding
    • 3. immediate and aggressive treatment of acute and newly recognized chronic infections
    • 4. avoidance of regular bacteremia
  18. Which joints are considered large weight bearing joints?
    • 1. ankles
    • 2. knees
    • 3. hips
    • 4. shoulders
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Dental Therapeutics-Baker test 1

Dental Therapeutics- Baker test 1
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