🦇🕸️👻 aging final 💀🎃🕷️ (finished)

- Frontotemporal Dementia

- personality changes and language issues

What type of dementia does Bruce Willis have? What are symptoms?

d. Combunox (Combunox = ibuprofen + oxy... also Vicoprofen = ibuprofen + hydrocodone and Percodan = aspirin + oxy)

Which is NOT tylenol (acetaminophen) blend?

a. Loracet

b. Lortab

c. Norco

d. Combunox

e. Percocet

e. Preparing a meal

Which of the following is not an ADL?

a. Getting up

b. Dressing

c. Walking

d. Eating

e. Preparing a meal

f. Bathing

g. Toileting

basement membrane (basal cell layer... causes blood blisters)

What cell layer is affected in pemphigoiD?

d. None of the above ("Nikolsky's sign is positive but not confirmatory for diagnosis" - per Vesiculobullous Lesions ppt)

What is a positive Nikolosky a confirmatory diagnosis for?

a. Pemphgiugs vulgaris

b. Erythema multiforme

c. Cicatrical pemphigoid

d. None of the above

d. Pseudomembrane Candidosis

Which of the following is not an autoimmune disease?

a. Pemphgiugs vulgaris

b. Erythema multiforme

c. Cicatrical pemphigoid

d. Pseudomembrane Candidosis

b. Erythema multiforme (chronic = oral lichen planus, pemphigus vulgaris, mucous membrane pemphigoid

Which of the following is a cyclic oral vesicular erosive diseases?

a. Pemphgiugs vulgaris

b. Erythema multiforme

c. Mucous membrane pemphigoid

d. Pseudomembrane Candidosis

e. Lichen Planus

valacyclovir HCL

Ideal prescription for herpes Zoster?

b. Azithromycin (or Clindamycin)

Which of the following drugs should you prescribe to a penicillin allergic patient with a true IgE response?

a. Cephalosporin

b. Azithromycin

c. Amoxicillin

dyspnea

What is the cardinal effect of heart failure?

b. Hypotension

Which of the following is not assoc w/ type II diabetes?

a. obesity

b. Hypotension

c. Dyslipidemia

d. Cardiovascular disease

>= 200 mg

Refer patient to physician when the 2 hour post prandial blood glucose level is:

b. 2 cartridges (0.04 mg epi max)

How many cartridges of 2% lidocaine 1:100,00 epi is advised in a patient with CVD?

a. 1 cartridge

b. 2 cartridges

c. 4 cartridges

d. 11 cartrdiges

a. Diabetes mellitus

Most common cause of End Stage Renal Disease

a. Diabetes mellitus

b. Alcoholism

c. Cancer

d. Hypertension

b. 50%

Kidney function is normal until what percent of nephrons are destroyed?

a. 25%

b. 50%

c. 75%

d. 100%

b. Larger initial doses may be required if dehydration or severe debilitation.

For people with chronic kidney disease, drug frequency and dosage adjustments are all of the following except

a. Larger initial doses may be required in the presence of substantial edema

b. Larger initial doses may be required if dehydration or severe debilitation.

c. Low serum albumin values reduce the number of binding sites for circulating drugs, enhancing drug effects.

d. Uremia can modify hepatic metabolism of drugs, increasing or decreasing clearance.

Reduces cardiac preload

Effect of nitrates

osteoarthritis

What is the Bouchnard's node associated with?

d. Bleeding on probing

Which is not a predictor for root caries?

a. Caries history

b. Numbering of teeth

c. Plaque index

d. Bleeding on probing

Macrolides and azole antifungals may increase citalopram levels

Side effect of SSRI (Selective Serotonin Reuptake Inhibitor)

Most likely to raise blood pressure

Side effect with SNRI (Serotonin-norepinephrine reuptake inhibitors)

Increases sedative effects of opioid analgesic

Side effect of tricyclic antidepressants

Surgical excision prior to rebasing or relining the denture w/ reduced flanges (pt has epulis fissuratum)

When in correspondence to surgical removal do you reline/rebase?

Malignant melanoma (Most common form of skin cancer is BCC, most common oral & pharyngeal cancer is SCC)

Most severe form of skin cancer?

a. buccal mucosa (DOES occur on movable/non-keratinized & attached/keratinized mucosa)

What tissue does VZV (Varicella-Zoster Virus) not occur on?

a. buccal mucosa

b. mucosa over bone

c. attached mucosa

Parotid gland

What salivary gland would be affected to cause facial

paralysis?

c. Experiencing a decrease in life expectancy

What is false concerning old patients? (complaints of patients)

a. Not as keen to removable

b. Living longer life expectancies

c. Experiencing a decrease in life expectancy

b. Prednisone (this is a steroid... key word is POST so antiviral would do no good)

Best treatment for neuralgia for post-herpetic outbreak?

a. antivirals

b. prednisone

c. no tx

Acyclovir or antiviral

Best treatment for herpetic outbreak

topical antifungal therapy

Patient has candidal infection causing a hairy tongue. What's the ideal tx?

c. Nystatin of orabase (Nystatin is antifungal)

What is not an ideal tx for a recurrent aphthous ulcer? (pic of aphthous ulcer)

a. Topical steroids

b. Silver nitrate

c. Nystatin of orabase

d. Kenalog of orabase

e. Topical analgesics

f. Immunosuppressants

d. Composite and Glass Ionomer

What 2 materials do you use in sandwhich combo?

a. Calcium Hydroxide and Composite

b. Calcium Hydroxide and Glass Ionomer

c. Calcium Hydroxide and Zinc Oxide Eugenol

d. Composite and Glass Ionomer

e. Composite and Zinc Oxide Eugenol

f. Glass Ionomer and Zinc Oxide Eugenol

a. Gram positive​ (streptococci mutans & lactobacilli)

What species of bacteria causes caries?

a. Gram positive​

b. Gram negative

c. Gram positive and Gram negative

d. None of the above

c. varnish

What form of fluoride has the hightest % delivery of fluoride?

a. paste

b. gel

c. varnish

d. mouthwash

c. Eating a lot of xylitol pills

Which of the following would not cause caries?

a. Poor salivary flow

b. Diet high in fermentable sugars

c. Eating a lot of xylitol pills

d. Exposed roots/gingival recession

Excessive exposure to UV rays (UV exposure from acute sunlight/tanning bed)

What is the cause of basal cell carcinoma (BCC)?

f. all of the above are antifungals (pick out antifungal... will have antiviral/narcotic ans choices)

What is the treatment for candida? (primary tx for fungal infections such as candidosis or opportunistic infxns)

a. Nystatin

b. Fungilin

c. Diflucon

d. Ketoconazole

e. Mycelex Troche

f. all of the above are antifungals

a. Brown eyes

Risk factors of skin cancer include all except:

a. Brown eyes

b. Radiation exposure

c. Blue or green eyes

d. Lighter colored skin

e. Blond or red hair

d. Other option

Alzheimer's disease... all of the following true except:

a. Beta amyloid plaques

b. Neuroinflammation that results in neurofibrillary tangles

c. Loss of cortical neurons

d. Other option

biotene dry mouth wash

Mouth wash to help increase saliva

a. need help/assistance

Which of the following is not a symptom of early stage dementia?

a. need help/assistance

b. forgetfulness

c. losing track of time

d. becoming lost in familiar places

d. All the above true

Premalignant lesions of SCC:

a. Erosive lichen planus

b. Leukoplakia

c. Dysplasia

d. All the above true

- dry sticky mouth and tongue

- dry lips

- thick saliva that feels like glue

- altered taste

- mouth soreness

- sores at the corners of the lips

- burning mouth or tongue sensation

- difficulty speaking, eating, and swallowing

- halitosis

- difficulty wearing dentures

- lipstick my stick to front teeth

- need to drink water to be able to swallow

Symptoms of dry mouth

d. Weight gain or other

Systemic signs of lymphoma EXCEPT:

a. Fever

b. Night sweats

c. Weight loss

d. Weight gain or other

1. Heberden Nodes (painless bony growths on the medial and lateral aspects of the proximal interphalangeal joints)

2. Bouchard Nodes (when these enlargements occur on the distal interphalangeal joints)

What nodes are associated with osteoarthritis?

c. increased joint space

Radiograph change in osteoarthritis of TMJ EXCEPT:

a. sclerosis

b. remodeling

c. increased joint space

d. osteophytes

f. none of the above

All are conservative therapy for osteoarthritis EXCEPT:

a. acetaminophen, aspirin, or NSAID

b. muscle relaxants

c. limiting jaw function

d. physical therapy

e. occlusal splints

f. none of the above

maybe all of the above

Psychosocial something or another question??

heart? (idk where to find this)

Which organ changes with aging and improves mortality?

a. pemphigus vulgaris​ (asked which has + nikolsky sign & direct pressure... technically both Pemphigus and Pemphigoid)

Positive nikolsky is associated with

a. pemphigus vulgaris​

b. erythema multiforme

c. pseudomembrane candidosis

digoxin

Drug reaction in LA

can't be cured in 2-3 yrs

Which is not true of oral vesicular erosive dz?

left ventricle

Which part of the heart fails first?

??

bumps on the hard palate

mobility

Get up and go assessment assesses what?

extranodal sites

- swelling associated with a lymph node

- composed of ectopic lymphoid tissue

Lymphoma is seen as oral lesions in what location?

Augmentin

What prescription would you write to inhibit beta lactamase?

Stage 1: Mild >80% lung function

Stage 2: Moderate; 50-80% lung function; shortness of breath during exertion

Stage 3: Severe; 30-50% lung function; worsening of airflow limitation and exacerbations that impact a patient's quality of life

Stage 4: Very Severe; chronic respiratory failure that may be life threatening **DO NOT DO DENTAL TX ON STAGE **

COPD: staging & management

b. False (avoid in patients with Stage III or IV beacuse it may accumulate in air spaces of the diseased lungs)

(T/F): it is safe to give nitrous oxide to patients with COPD.

a. True

b. False

- vascular dementia

~10-20% of people

What type of dementia may be associated mini TI stroke?

- hallucinations

- muscle stiffness

- shuffled walk

- stooped procedure

Lewy Body dementia is present in ~5% of the patients. What are the symptoms?

1. creativity

2. flexibility

3. being patient

What are 3 skills most essential for dealing with patients with dementia?

Sam Bennett

What is the name of the Texas A&M golfer whose dad was diagnosed with early onset Alzheimers and passed away 8 years later?

Vetter

What is Dr. Fast's dog's middle name?

a. bacteriocidal - disrupts the cell wall biosynthesis (completely kills the cell)

Penicillin is [bacteriocidal/bacteriostatic] which means it [disrupts the cell wall biosynthesis/inhibits the initiaion of peptide chain synthesis].

a. bacteriocidal - disrupts the cell wall biosynthesis

b. bacteriostatic - disrupts the cell wall biosynthesis

c. bacteriocidal - inhibits the initiation of peptide chain synthesis

d. bacteriostatic - inhibits the initiation of peptide chain synthesis

d. bacteriostatic - inhibits the initiation of peptide chain synthesis (stops replication)

Clindamycin is [bacteriocidal/bacteriostatic] which means it [disrupts the cell wall biosynthesis/inhibits the initiaion of peptide chain synthesis].

a. bacteriocidal - disrupts the cell wall biosynthesis

b. bacteriostatic - disrupts the cell wall biosynthesis

c. bacteriocidal - inhibits the initiation of peptide chain synthesis

d. bacteriostatic - inhibits the initiation of peptide chain synthesis

pain

Strongest motivator in patient's seeking dental care?

mini cog assesment

Which do you use if patient is having trouble remembering?

opthamologist

What kind of doctor would you refer a patient with

pemphigoid?

dermatologist

What kind of doctor would you refer a patient with pemphigus?

desmosomes (Pemphigus vulgaris disrupts...)

Blistering in this disease is due to antibodies directed against component of ​___? (picture showing histo slide with intraepithelial split)

prickle cell layer (clear fluid blisters)

What cell layer is affected in pemphgUs (PICTURE ON DRIVE)?

hemidesmosomes

Blistering in this disease is due to antibodies directed against component of ​___? (picture showing histo slide with basement layer split)

a. Dilaudid

Which of the following is a class 2 drug?

a. Dilaudid

b. Tylenol 3

c. Tramadol

d. Cephalexin

Pen VK 500 mg

Drug of choice for bacterial infxns? (such as Dental abscess or Cellulitis)

Patient was asked 3 subjects and asked to remember them. Then they made the patient draw a clock. After this activity, they were made asked to remember the 3 words mentioned earlier If the person can repeat the words, the person is probably not suffering from dementia. If the person can't repeat any of the words, the person might be considered mildly cognitively impaired. If the Pt draws the clock abnormally, they would fall into the category of mild cognitively impairment

Question where the half the clock is drawn, and asked what happened to the patient?

Amoxicillin & clavulanic acid

What are the components of augmentin?

Hydrocodone 7.5 mg + ibuprofen 200 mg

What drugs are in vicoprofen?

chronic TMJ pain

What does selective NSAIDs best treat?

- Pharmacological effect that is opposite of insulin

- Causes rise in blood glucose levels

2% Lidocaine 1:100,000 epi has an

e. A and C

What are the characteristics of stable angina?

a. Pain: precipitated by exertion such as walking or climbing stairs but also may occur with eating or stress.

b. Pain: increasing in frequency, increasing in intensity, precipitated by less effort than before, or occurring at

rest.

c. Pain: relieved by cessation of the precipitating activity, by rest, or with the use of nitroglycerin.

d. Pain: not readily relieved by nitroglycerin.

e. A and C

f. B and D

- ddx: SCC, traumatic fibroma

- tx: Surgical excision prior to rebasing or relining the denture with reduced flanges (Any ulceration that does not heal once the etiology has been resolved should be biopsied to rule out SSC)

What are ddx for epulis fissuratum? (wasn't this exact image, but similar) What is the tx?

- ddx: rad induced mucositis, chemo induced mucositis

- tx: Clotrimazole Trorches 10 mg; topical or systemic antifungal tx (rinses less effective than other topical forms b/c duration of tissue contact is suboptimal)

Patient has a wipeable white lesion. What's the ddx?What's the ideal treatment? (pic of pseudomembranous candidiasis aka Thrush)

high in sugar so be cautious in pts with diabetic

What is a concern when using pastilles or troches to treat candida?

- Involves large & small airways

- Involved in expiration and inspiration

What are the characteristics of chronic bronchitis?

- involves the lung parenchyma

- ONLY involved in expiration

What are the characteristics of emphysema?

get up and go gait (walk 10 feet... 10 sec is normal, if 15 sec is exceeded, pt may be a fall risk)

Which assessment to you use to test how well patient can walk?

f. all of the above

Picture of inflammatory papillary hyperplasia. What are possible causes?

a. bad OH

b. negative pressure by form fitting denture

c. candida

d. A and B only

e. B and C only

f. all of the above

i. Discontinue using denture for a period of time

ii. Improved oral hygiene

iii. Topical antifungal therapy (may be helpful)

iv. Tissue conditioner may reduce problem (mild cases)

v. Surgical removal of hyperplastic tissue (severe cases)

1. Scalpel/Cautery/Laser

vi. May need new denture fabricated

Inflammatory papillary hyperplasia was asymptomatic, scenario: pt is using half a thing of denture glue to hold it in place. What is tx?

gum disease (OR CARIES ??? idk)

Most common cause for tooth loss in elderly pts

3

What would be the best score for Alert and oriented test?

- exophytic, ulcerated soft tissue lesions with poorly demarcated margins in mandible, maxilla, or palate

- mobile and rubbery pharyngeal and posterior tongue lymph nodes

Describe the appearance of lymphoma.

- unexplained fevers

- drenching night sweats

- weight loss

What are the systemic (Beta) symptoms of lymphoma?

- SCC

- verrucous carcinoma

- traumatic ulcer

- erosive lichen planus

What are some ddx for lymphoma?

- histologic diagnosis with biopsy

- refer to oncologoist for removal

- may require radiotherapy

What are the tx for lymphoma?

a. Experiencing an INCREASE in life expectancy

Dental needs of today's aging population:

a. Experiencing an INCREASE in life expectancy

b. Experiencing continued tooth loss & need for biologically sound dentition.

c. Greater numbers of elderly seeking quality dental care.

d. Traditional removable prostheses provide less patient satisfaction.

e. Traditional removable prostheses contribute to long-term bone loss.

b. Edentulous patients have less weight loss. (they have MORE weight loss)

Which of the following is false?

a. Edentulous patients eat fewer fresh fruits and vegetables.

b. Edentulous patients have less weight loss.

c. Overall health of patient improves with improved masticatory ability.

d. A full complement of teeth provides the elderly patient with the ability to masticate a variety of foods and will help improve the quality of their diet. With a varied and balanced diet, the overall health of the patient is improved.

a. No tx (unless symptomatic → topical steroids)

What is the best treatment for geographic tongue?

a. No tx

b. topical anesthetic

c. topical steroid

d. topical steroid + anesthetic

- Usually no tx

- If symptomatic:

1. Topical anesthetics

2. Topical antifungal agents (clotrimazole, nystatin)

What is the treatment for Median rhomboid glossitis? Not sure if symptomatic or not...

Assesses: dental, medical, functional, ethical, fiscal

Stands for: Oral, Systemic, Capability, Autonomy, Reality

What is OSCAR about, and what does it assess?