need to know;)

since drug administration can have a negative impact during postpartum breast feeding, when should the mother take her drugs

since drug administration can have a negative impact during postpartum breast feeding, when should the mother take her drugs

after she's done breast feeding

what trimester is the bets time to do elective treatments

2nd trimester

how much does blood volume increase when pregnant

40-50%

how much does cardiac output increase when pregnant

30-50%

how much does RBC volume increase when pregnant

15-20%

what are the signs that a pregnant patient is going into late pregnancy-supine hypotensive syndrome

abrupt fall in BP
bradycardia
sweating
air hunger
nausea in a supine position

what happens to WBC count when pregnant

increases

what happens to the pt diaphragm when they are pregnant

elevates which reduces lung volume

how much does total lung capacity decrease when pregnant

5%

how much does functional residual capacity decrease when pregnant

20%

what happens to respiratory rate when pregnant

increases

_____ and _____ worsen when the pt is in a supine position

Tachypnea
Dyspnea

what is Dyspnea

shortness of breath

t or f. pregnancy does not directly increase a pt risk for decay/periodontal disease

true

what does pregnancy increase the risk of in the OC

pyogenic granuloma

what is morning sickness also called

GERD

how long does GERD (morning sickness) last

4-8 weeks, usually done by week 16

t or f. the mom is predisposed to diabetes after giving birth

true

what increases the risk of endocrine infections from giving birth

large birth weight babies

t or f. Preventive dental care lowered the incidence of miscarriage

true

what two preventive procedures can be performed anytime during pregnancy

trophy and SRP

if a pregnant pt has a draining sinus tract should you take an x ray

yes

if a pt is pregnant, when can you take an FMX series

after giving birth

what are the anesthetics that can be used on pregnant pts

Lidocaine
Prilocaine

what antibiotics can be used when the pt is pregnant

penicillins
cephalosporins
clindamycin
macrolides
erythromycin
azithromycin

what analgesic is recommended for pregnant pt

acetaminophen

what analgesic should be avoided

ASA and NSAIDs

what NSAID can cause premature closing of ductus arteriosus if taken when the pt is pregnant

ibuprofen

t or f. It is okay for the mother to take benzodiazepine and barbiturates for anxiety when pregnant

false

t or f. it is safe to take tetracyclines, benzodiazepine, and barbiturates when pregnant

false

what oral complication is directly caused by pregnancy

pyogenic granuloma

what are the oral complications/manifestations that can be seen during pregnancy

pregnancy gingivitis
pyogenic granuloma
GDM
tooth loss
caries
tooth mobility
morning sickness
enamel erosion

what can cause the enamel erosion that is sometimes seen during pregnancy

morning sickness (GERDS)

during what trimester should the supine position be avoided

3rd trimester

IE is most common in what groups

men
middle aged
elderly people

what valve is the problem in iE

mitral valve

most common cause of native valve endocarditis

mitral valve prolapse

most common causative agent of IE

viridian streptococci

most common infective agent for IE in IV drug users

Staph aureus

what causes the damage to endothelial surfaces int eh cardiac valve from IE

high-velocity blood flow
flow from hight to low pressure chambers
flow across a narrowed office at high velocity

complications of IE

heart failure
stroke
MI
pulmonary emboli
renal dysfunction

most common complication of IE

heart failure

what is the mortality rate of IE

40%

sings and symptoms of IE

fever
new heart murmur
positive blood culture

what do studies say about IE in humans vs animals

bacteria from dental procedures is lower than the infective threshold in animals

what do studies say about IE in pts who have IE

they haven't had a dental procedure in the last two weeks

t or f. studies are starting tot distance dentistry as the causative agent of IE

true

t or f. IE is more likely to result from everyday activity vs dental treatment

true

antibiotic prophylaxis is recommend to prevent IE in patients with the following (will be a select all that apply)

prosthetic heart valve
previous IE
cardiac transplantation recipients with valve disorders
CHD
unprepared cyanotic CHD pt
completely repaired CHD with prosthetic within 6 months
repaired CHD with residual defects inhibiting reendothelialiation

what dental procedures do not need a prophy antibiotic for a pt that's at risk of IE

X-rays
Injections through non-infected tissue
Placement of removable orthodontic or prosthetic appliances
adjustment of orthodontic appliances
shedding of primary teeth
minor oral trauma

Antibiotic regimen for IE prophylaxis

2g Amox 30-60 mins prior to apt
600 mg Clinda 30-60 min prior to apt (pen allergy)

your pt forgot to take their premed prior to the apt, how long after the apt can they take the premed to have protection

2 hours after

t or f. Englands dumb4sses stopped doing premeds for IE and the rates went up

true

what is considered normal BP

<120/80

what is considered elevated (prehypertensive) BP

120-9/<80

what is considered stage 1 HT BP

130-9/80-9

what is considered stage 2 HT BP

140+/90+

what % of the population is hypertensive

29%

patients receiving treatment for hypertension has increased form ___ to -___

31% to 76%

patients taking meds controlling HT at 140/90 or less has increased from ____ to ___

10% to 31%

what % of pt taking meds for HT aren't well controlled

48%

what % of the population does not know they have HT

18%

what % of the population has HT but are not receiving treatment

24%

what are the target organs for hypertension (select all that apply or odd one out)

Kidney
Heart
Brain
Retina

what are the heart disease that HT can lead to

LVH
Anginal/MI
prior MI
Coronary insufficiency/ prior coronary revascularizaiton
heart failure
CVA or TIA
PAD

what do 50% of untreated HT patients die from

coronary heart disease or CHF

what are the early signs of HT (odd one out q)

elevated BP
narrowing and sclerossing of retinal arterioles
headaches
dizziness
tinnitus

what are the advanced stages of HT symptoms

rupture/hemorrhage of renal arterioles
left ventricular enlargement proteinuria
CHF
angina
renal failure
dementia

what are the risk factors for HT

lifestyle choices
dyslipidemia
genetics
renal problems
over 60 years old
men
POSTmenopausal women
family history

systemic causes of HT

sleep apnea
drug induced
chronic kidney disease
primary aldosteronism
renovascular disease

at what BP do we defer elective treatment

180/120

what are the symptoms that a pt can have if they have a BP of 180/120

headaches
dyspnea
nosebleeds

what are the side effects that should be expected if a PT is taking beta-blockers to treat HT

tastes changes (bad taste)

what are the side effects that should be expected if a PT is taking calcium channel blockers to treat HT

gingival hyeprplasia

what is the BP reading for "uncontrolled" HT

180/110

if the pt has HT, what is the max carps of anesthesia we should use to be safe

2 carps

what should you do when you are finished treating an HT pt

raise the chair up slowly

at what BP readings should the PT be wearing BP monitor for the entire apt

>160/100

what are the risk factors for IHD

males
older
family history
hyperlipidemia
HT
smokes camel crushes
physical inactivity
obese
diabetes

symptoms of IHD

aching, squeezing pressure or tightness int he mid chest region that can radiate the left/right arm or mandible

what is used to treat/shorten angina episodes

nitroglycerin

what should be administered early if a pt is having MI

aspirin
oxygen

what has a major risk for MI stable or unstable angina

unstable angina

difference between stable and unstable angina

Stable angina: pain happens with certain activities but then goes away with rest.
Unstable angina: chest pain can occur at rest, becomes more sever or frequent, or lasts longer

what can we do as dentist for a pt that has a high risk of MI

prophylactic nitroglycerin
place an IV line
sedation
pulse oximeter
monitor vitals frequently
cautious use of epi

most common type of cardiac arrhythmias

atrial fibrillation

what are the symptoms of cardiac arrhythmias

palpations
syncope
fatigue
symptoms associated with CHF

what anesthetic should pts taking non-selective B-blockers, pt at low and moderate risk for complication from arrhythmias receive

2 carps of lido with epi