Care of Med Complex Midterm

What is the definistion of anoxia

absence of O2 to the tissues

what is the main differenc between MI and angina

duration and severity of symptoms

on pts w/ stage 1 or 2 controlled hypertension you should NOT use

a. lidocaine w/ 1:100K epi

b. epinephrine impregnated cord

c. nitrous oxide

d. do not use any ot the above

epinephrine impregnated cord

Which drug used to relieve heart failure causes increased risk for arrythmia and should be avoided if possible

digitalis

stage 2 hypertension will most often need to be treated with

lifestyle mods and at least 2 drugs with different mechanisms of action

70 year old man w/ history of hypretension and heart failure suddenly expereinces tachpnea, extreme dyspnea w/ cyanosis and frothy pink sputum. What is he experiencing

acute pulmonary edema

What drug class is used to treat hypertension and cause gingival hyperplasia

calcium channel blockers (CCBs)

what condition is most likely to result from untreated hypertension

congestive heart failure

Which of following NOT a classification of drug used in tx of hypertension

a. inotropic agents

b. CCBs

c. ARBs

d. ACE inhibitors

inotropic agents

72 year old w/ heart failure has orthopnea what is the best chair postion for them

semi-upright

A pt with angina at a frequency of 2-3 times a week would be considered what ASA physcial status

ASA 3

What is most commonly sued and is effective in stopping pain of stable angina

nitroglycerin

All of the following true regarding angina pectoris except

a. it is a result of myocardial ischemia

b. can be treated with vasoconstrictors

c. stress reduction protocol is important

d. often result of atheroslcerosis

can be treated with vasoconstrictors only vasodilators (nitroglycerin)

Digoxin

narrow theraputic index can become toxic if given with erythromycin or clarithromycin

in ischemic heart disease atheroscelrosis refers to

fatty deposits narrowing arteries

Variant (prinzmetals) angina caused by

spasm of coronary arteries

Abnormal enlargment and failure of right side of heart due to disease of lungs or pulmonary blood vessels can be termed

cor pulmonale

What is it called when a pt clutches their fist to their chest

levine sign

24 year old with asthma develops wheezing and dyspnea during rubber cup polishing what would be first line of meds

albuterol

20 year old anxious pt develops rapid breathing perioral tingling and carpopedal spasm what is most likely diagnosis

hyperventilation

What is not a common cause of heart failure

a. hypertension

b. myocarditis

c. dementia

d. valvular heart disease

dementia

In hypertensive crisis emergency care required when bp exceeds

180/120 mmHg

myocardial infarction management which drug given to prevent blood clots from forming

asprin

which type of heart failure associated with fluid buildup in lungs

left sided heart failure

common sign of right sided heart failure is

swelling in legs and ankles

in pts with heart failure digoxin commonly used to

increase strength and force of heart contractign

which med should be avoided in pts with asthma and nasal polyps

asprin

Which is not a risk factor related to dental appt

a. increased number of older pts, higher risk of death related to visit

b. medical advances, allowing more medically compromised pts to be seen

c. increased drug use, increasing complication with possible side effects

d. shorter appts, reducing attention to pt and throughness of care

d

True or false for the follwing statements

1. high anxiety and fear of being at the dentist can lead to acute exacerbation of med problems like asthma, seizures, hyperventialation, and syncope

2. There are 3 methods to help dr or hygienist recognize anxiety they are med/dental history, anxiety questionaire, and observation

both statements are true

According to ASA med risk of pt can be separated int odiffrent categories, what category would a pt with severe systemic disease that limits activity but no incapactiating fall under

ASA 3

when a pt has completed a full medical history and all dialouge questions have been answered if that pt has NO complications the medical history needs to be reviewed

every appt

at our clinic students must obtain a med clearance/physicians consult for which of following before pt can be seen

a. pt with arthritis

b. pt w/ bp 119/75

c. pt taking carbamazepine (tegretol)

d. pt w/ AIDS

e. renal transplant pt

c,d,e

pts who are mildly medically compromised and fearful should be scheduled at what time of day

in early morning

pt is scheduled for cleaning and upon inital observation you notice pt has open herpetic lesion with tissue no intact what should you do

postpone elective tx

values over 100 bpm would be considered

tachycardia

nitroglycerin should be given to a pt that

compains of chest pain/angina

if med emergency occrus what is the first step

recognize there is a problem

Which vitals are within normal ranges for an adult

a. BP 152/80 resp 12 pulse 72

b. BP 129/89 resp 14 pulse 90

c. BP 115/75 resp 16 pulse 65

d. BP 119/70 resp 35 pulse 60

c

Which of the follwing drugs are critical injectables

a. albuterol

b. epinephrine

c. diphenahydramine

d. nitroglycerin

epi and diphenahydramine

In anaphylaxis, acute systemic allergy, the admin of _______ is critical to pts survival

epinephrine

albuterol is a ______

bronchodilator

pt with asthma exhibiting breathing problems would be treated with

albuterol/ventolin

while taking BP after inflating cuff to 160mmHg upon deflating the cuff after the intial systolic beats you are unable to hear anything fo rshort while, upon further deflating the cuff, the beat returns. What is the term for this stuation? this can sometimes result in falsely low BP being recorded

asculatory gap

antibiotic prophylaxis prior to dental tx when thers possibilty of creatign bacteremia is standard of care to prevent endocarditis in certain high risk pts. what can be performed if a high risk pt forgot to take their antibiotic and presented for dental tx

• radiographs

• intra and extra oral exam

• injections through non-infected tissue

True or False for follwing statements

1. more appts needed for care of pt premedicated with antibiotics the greater the pts risk for developing allergies and resistant bacteira

2. becauses of this it is important to complete pts tx w/ appts scheduled as closely as possible over sevral concurrent days to maximize pts antibiotic coverage

first statement true second false

Which device has shown evidence for supporting need for antibiotic prophylaxis prior to dental procedures with potential to cause bacteremia

heart valve implants

for a pt requiring antibiotic premed for cardiac condition who has severe anaphylacic allery to penicillin who can take meds orally, antibiotic which would be perscribed would be

doxycycline

In treating pts with weight bearing prosthetic joint replaccements

dr or hygienist should consult pt physcian if theres any comorbid conditions present to determine need for antibiotic premed

For non-allergic pt who is already taking penicillin or amoxicillin for acute infection (sinus infection) what is the best way to approach givign antibiotic prohpylaxis for non-emergent elective dental tx for pt who would usually need premed

wait 10 days after they complete their antibiotic therapy and premed with usual amoxicillin regime

abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing

cheyne stokes breathing