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the strange smell noticed by a pt before a seizure is called:
Gingiva hyperplasia associated with phenytoin medications is caused by:
Fibroblasts and osteoblasts depositing extracellular matrix
What determines the severity of pheytoin-induced gingival enlargement?
Amount of biofilm
A pt has an acetone, fruity smelling breath. This is a classic symptom of:
Name 3 symptoms of hypoglycemia:
What is contraindicated during emergency management of an epileptic seizure?
Placing a tongue depressor between teeth
Name 3 things that will trigger a seizure:
- Alcohol use or withdrawal
- lack of sleep
name 3 possible complications of diabetes:
- increased susceptibility to infection
- increased risk for cardiovascular disease
- increased risk for kidney dysfunction
Your pt with type 1 diabetes has gone into insulin shock. what is the first step in addressing this emergency?
give pt sucrose - juice or cake frosting
The most common type of cental emergency associated with a person having diabetes is what?
The type of asthma triggered by an increase in pollen and seasonal allergens is known as what?
What should be avoided when using local anesthetics on an asthma patient?
epinephrine and levonordefrin
What orally inhaled drug is used to treat acute asthma attacks?
Use of oral albuterol inhalers can cause what?
What is the first action taken when a person has a syncopal episode?
Place them in the supine position
Which of the following is not an early pre-syncopal sign?
D. heavy perspiration
(this multiple choice question has been scrambled)
Placing a pt in the supine position is the #1 most important action to take for a pt who has fainted. The possibilit of a second syncopal episode is greatest during the post syncopal phase
both statements are true
neurologic damage can occur in as little as ____________________ if a pt remains in the upright position after fainting.
Name 2 alterations and adaptions to pt treatment to prevent or limit syncope.
- determine primary precipitating factors
- eliminate factors
What is the most likely cause of a seizure in the dental office?
local anesthesia overdose
Name 3 actions involved in managing a seizure
- Lower the chair and place pt in supine
- time the seizure
- let the seizure run its course
It is important to use long acting anesthesia on pts with diabetes to keep them out of pain longer. A diabetic patient should eat breakfast prior to their appointment.
The first statement is false, and the second is true
Name 3 treatment contraindications in a know asthmatic
- Nitrous oxide (if person is claustrophoic)
- anesthetics containing bisulfites, epinephrine, or levonordefrin
giving local anesthesia with epinephrine to an asthmatic pt who also has diabetes or high blood pressure may lead to ___________
If your pt's asthma attack is not resolving itself after they have used their inhaler and you have administered O2 what is the next action?
have a team member call 911
What is the most common emergency in the dental office?
Name 3 actions to take for a hyperventilating pt.
- cease treatment
- place pt in upright position
- have them breathe deeply into their cupped hands
name 3 symptoms of hyperventilation
- Rapid deep breathing
- light headedness
- rapid pulse
Name 5 oral health problems associated with kidney pt on hemodialysis
- halitosis due to excess urea
- periodontal disease
- bone loss/tooth loss
Kidney disease patients are often take blood thinners which may cause more bleeding during dental treatment. Systemic fluids should be prescribed for pts with kidney disease.
The first statement is true, and the second statement is false
When giving a kidney disease pt local anesthesia, it is best to give them the (highest/lowest)______________dosage possible
congestive heart failure is a principle complication of virtually all forms of heart disease. Heart failure is more prevalent in women than men.
the first statement is true and the second statement is false
The purpose of the kidneys is to cleans the urine of toxins. A kidney hemodialysis patient should have dental treatment on the same day as their dialysis.
Both statements are false
During a medical emergency involving a cardiac pt, the patient should be placed in a supine position. The pt's vital signs should be monitored every 5 minutes
the first statement is false, and the second statement is true
name 3 treatment adaptions/considerations with a cardiac patient
- short appointments
- morning appointments
- ensure optimum vital signs
When using local anesthetics with a cardiac patient, ___________ should be avoided. The best anesthesia choice is ___________
- epinephrine (vasoconstrictor)
List and briefly define the ASA physical status classifications
- I - normal, pt can climb a flight of stairs without distress
- II - pt can climb a flight of stairs without distress, but must stop once they complete the task due to distress
- III - pt can climb one flight of stairs, but must stop and rest before completing the task
- IV - pt cannot negotiate a flight of stairs because of shortness of breath or undue fatigue at rest
- V - pt is moribund and not expected to survive
What is the most dangerous type of stroke?
it is imperative to always check the blood pressure of a patient with a heart condition because _______ is the cause of 75% of all cases of heart failure
If your pt exhibits a spike in systolic blood pressure, they are at risk for which type of stroke?
In a pt with a history of stroke, for every 10 mm Hg over 160 that blood pressure increases, chances for hemorrhagic stroke go up __________
If your patient reports that they have recently had a stroke, dental treatment must be delayed __________ from the date of the reported stroke
Name 3 ethnic groups that show a higher risk for stroke
- African American
- Native Americans
Using low dosage of nitrous oxide is accpetable for a pt with a history of stroke. Epinephrine and certain anti-anxiety agents should be avoided when treating a pt with a history of stroke
both statements are true
In an emergency, a conscious stroke pt should be placed in the ______ position. An unconscious stroke victim should be placed in the _______ position
name a common dental allergen
Name 4 progressive symptoms of an allergic reaction
- flushing of skin
- loss of consciousness/anaphylactic shock
What are the two most important therapeutic agents used in the treatment of anaphylaxis?
If your hypertensive pt has an allergic reaction, what therapeutic agent is contraindicated? What is an alternative treatment for this patient?
- antihistamine or corticosteroids prior to appointment
Which type of angina emergency would you most likely see in the dental office?
Symptoms of an angina attack may last from _______ to ______ minutes
1 - 15
If your pt is known to have a pacemaker, ultrasonic scaling is contraindicated. A magnetically-attached headrest should be removed when working with a cardiac pt with a pacemaker
the first statement is false and the second statement is true
What is the common medication used with angina pectoris patients?
In the SLCC dental hygiene clinic, where is the AED located?
In the 6-pack on the north wall
cardiac arrest may be mistaken for what?
All are steps in the chain of survival except what?
A. begin CPR
B. call 911
C. give O2
d. transport to hospital ASAP
C. give O2
(this multiple choice question has been scrambled)
The organism that causes tuberculosis is called what?
The type of tb where the organism lays dormant within the body and shows no symptoms is called what?
How do health care workers determine if latent tb is present?
positive tuberculin skin test (TST)
Name 4 modes of transmission of active tb.
What are the 3 major symptoms of active tb?
- cough that lasts more than 3-4 weeks
- cough produces blood/sputum
- chest pain with breathing/coughing
A myocardial infarction (MI) is commonly know as a what?
Name 4 risks factors for MI
name 3 emergencies in which you would place your pt in the supine position
- syncope (fainting)
How are the symptoms of a heart attack different in women from men?
Women tend to have chest pain along with shortness of breath, nausea, vomiting, neck, back, and jaw pain
In the event of a heart attack, what will help reduce the patients pain?
nitroglycerin or aspirin
Dental treatment should be avoided at least _______ months following a heart attack
name 3 things that will minimize the risk of a heart attack during dental treatment
- nitrous oxide
- supplemental oxygen
- pain control
- stress reduction
Name 4 controllable risk factors of hypertension
- activity level
name 4 possible consequences of a hypertensive crisis
- heart attack
- kidney damage
- memory loss
- loss of consciousness
- eye damage
- blood vessel damage
- fluid in lungs
What type of local anesthesia is indicated for patients with hypertension?
Name 4 contraindications to treatment with a hypertensive patient
- vasoconstrictors in local anesthesia
- salt water rinses
- jet polisher
- sodium bicarbonate rinses or brushing
What is the most common inherited bleeding disorder?
Von willebrand's disease
Which common over-the-counter medication can cause thinning of the blood?
Before treating a patient with hemophilia, what should you do?
have a doctors note confirming treatment can go forward
What does COPD stand for?
Chronic Obstructive Pulmonary Disease
What are the 2 primary diseases which cause COPD?
- chronic bronchitis
If your pt with COPD is having trouble breathing, what can you do to help them?
- seat them in a comfortable position (usually upright)
- have them breathe through pursed lips
- give them low level oxygen
- have them lean their elbows on their knees while they breathe
Name 2 environmental causes of COPD
- Smoking (1st or 2nd hand)
- air pollution
In which chair position should you treat your pt with COPD?
name 3 contraindications when treating the pt with COPD
- rubber dam use
- nitrous oxide
- bilateral mandibular or palatal anesthetics
- high levels of O2
Labored breathing is alson know as what?
What is contraindicated for a hyperventilating patient?