study guide

migraines affect women or men more?

dental aspects?

women,

• tooth extraction

• amalgam removal

• occlusal splints

cranial arteritis:

• women or men?

• what mediated?

• Dental aspects?

• women

• immune

• pain on mastication (20%), limited mouth opening

multiple sclerosis: what subtype is most common?

relapsing-remitting most common

Epilepsies: What management?

• prophylatic anticonvulsants

  • teratogenicity

  • thrombocytopenia

  • gingival hyperplasia

nephrotic syndrome: dental aspects

• long term corticosteroid side effects

• consider antibiotic prophylaxis

acquired heart disease:

• hospital setting for tx

  • unstable angina

  • MI < 3 months prev

  • General anesthesia = essential

for hyper tension: when appointment? what other considerations?

• short, late morning appointments

• avoid EPi

Myocardial infarction:

• MI < 6 months

• MI 6-12 months:

• MI > 12 months

• All post

• MI < 6; defer tx

• MI 6-12: simple elective

  • anxiolytics

• MI: > 12: elective dental care, minimize pain + anxiety

• All post:

  • Risk proportional to procedure

  • minimize pain and anxeity

  • Appropriate monitoring

Arrhythmias: when? what is most aggresive

• late AM/ early PM

• tachycardia and ventricular fibrillation

pacemakers:

• what is contradindicated

• is prophylaxis necessary?

• MRI, electrosurgery, diathermy, TENS

• no

__ should be available at every appt with pt with heart disease

Nitroglycerin

3P model

predisposing → precipitating → perpuating

Measuring dental fear: physiological (3)

• importnat but hard to detect:

  • perspiration

  • Increased respiration rate

  • high HR or BP

Measuring dental fear: behavioral (4)

• leg swinging, bouncing

• facial expressions

• use of humor, speed of talking

• escape behavior

decreased control + increased uncertainty = ?

increased perceived control + decrease uncertainty?

• anxiety

• calmer

Biophyscosocial pain: acute pain is a __ of the disease while chronic pain is _

symptom, disease itself

What are the 5 behavioral strategies

• communication

• information based strategy

  • tell show do

• distraction

• relaxation excercises

• biofeedback

What are the factors that influence dental health care across communities? (5)

• motivation

• culture + community values

• education and socioeconomic factors

• societal norms

• tech, info, options available

cultural humility

mindset of lifelong learning, self eval, self critique to ensure flexibility and openness to diverse perspectives

cultural competence

development process in which individuals achieve increasing levels of awareness, knowlegde, + skills along cultural competence continuum

primary vs secondary dimensions

• primary: born into

  • like age, gender, race, sex

• secondary: change:

  • like income, geo location, family status

HIV/AIDS: what to classifiy? how transmitted?

• CD4 helper cells are under 200

• Intimate contact, contaminated blood, tissue, needles

• NOT air, water, saliva

Oral manifestations of HIV/AIDS (7)

• candidiasis

• chronic HHV-1 infection

• herpes

• cytomegalovirus infection

• hairy leukoplakia

• kaposi sarcoma

• non-hodgkin lymphoma

neutropenia

decreased PNL due to disease or drugs (nuetrophols, basophils, eosinophils = granuloctyes)

Humoral Immunity: IgA, IgD, IgE, IgG, IgM

• IgA: secretory and mucosal immunity (most common)

• IgD: unknown

• IgE; allergy and parasitic

• IgG: bacterial infections

• IgM: opsonization

cell mediated immunity: Antigen presenting cells

Macrophages and langerhans

ALL CN except ? checked on exam

I

CN VII: what features? stroke vs palsy

• sensory + motor, sensory:taste to anterior 2/3

• bells palsy: paralysis to one side of face: facial nerve out

• stroke: facial nerve intact

Normal breath sounds: tracheal, broncial, vesicular

• tracheal: over trachea

• Bronchial; over hilum, high pitched, exhal > inhale

  • vesicular: over most of lung, low pitched, inhale > exhale

reference lines of post thorax

scapular line and vertebral line

PMI

point of max impulse (where you hear HR most)

• feel for left ventricular impulse to find PMI

• Normall at mid-clavicular line, if not: lateral displacement indicates large left ventricle, sign of chronic heart failure

water fluoridation level

0.7 ppm

mercury: high levels are ?

what is most common? metallic?

neurotoxic and nephrotoxic

• organic mercury most common

• metallic: no consistent evidence of adverse effects

most drug allergies/hypersenstivities are __ mediated

IgE

Pencillin allergy: type ?

latex allergy:: type?

type I

type IV (contact)

hypogeusia vs dysgeusia

• hypo: loss of taste acuity

• dys: distortion of tase function

most common cancer and lethal cancer in women adn men

• women:

  • common: breast, lethal: lung

• Men

  • common: prostate, lethal: lung

microbial carcinogenesis: 4

• parasitic: bile and bladder

• oncogenic DNA: HPV, EBV, HBV

• oncogenic RNA: human t cell luekemia, hep C

• H pylori: gastric adenocarcinoma

systole vs diastole

systele: vent contraction, dysole: relaxed

causes of iron deficiency anemia

blood loss, diet, absorption issues, menstrual, pregnancy

osteogenesis imperfecta

abnormal formation of bone

• can be associated with dentinogenesis imperfecta (abnormal formation of dentin)

• translucent teeth, obliterated pulp chambers

Fibrous dysplasia: where/who common, what lesions

• more common in maxilla > mandible, more F > M

• cafe au lait skin lesions

butterfly rash on mid face?

lupus erythematous

Sjorgens primary and secondary

• primary: dry mouth and dry eyes

• secondary: dry mouth and dry eyes, rheumatoid arthritis, increased risk of parotid lymphoma

scleroderma

hard skin, mask like face, restricted movements, limited tongue movement

Crohn’s syndrome apparence

cobblestone intenstinal lining

MEasles presents with

kolpik spots

kaposi sarcoma

HIV/AIDS patients, hole in palate, aggressive cancer of mouth

actinomycosis

sulfure granules most charateristic feature

Cocaine/drug use in mouth

1. Hyperstimulation and mimics adrenaline effects

2. Ischemic necrosis (perforated septum and hard palate)!!!

   1. CIMDL - cocaine induce midline destroctive lesions

3. Dental Aspects

• Dental erosion

• Blood-borne infections

• Bruxism

• Xerostomia

• Avoid epinephrine for 2 hours after use

• Best to treat 6 hours after last

BCC

• where often?

• appears?

• does it metastaize?

• most common type of skin, head, neck

• Pink, pearly papule rolled edge

• rarley

Actinic keratosis

• where occur?

• appearance?

• what can progress to?

• sun damaged areas (scalp, face, tops of ears)

• rough or gritty pink to red macule or papule with anglular border

• invasive SCC

SCC

• how appear?

• How common?

• appearance>

• metastasis?

• Second most common, most in AA

• most often on head, neck

• pink to red scaly or ulcerated enlarging papule

• Metastases higher in these groups

  • high risk: lip ear

  • immunosuppresion

  • arising in scars or sites of chronic inflammation

Malignant melanoma

• risk factors (6)

• family history of MM

• personal history of MM

• presence of atypical nevi

• numbers of banal nevi

• history of excessive UV and sunburns

• fair skin type

Seborrehic dermatitis (dandruff)

• what?

• where?

• appearance?

• sebum production and commensal yeast malassezia

• sebum rich areas

• sharply demaracated, greasy, pink-yellow to red-brown patches

• chronic

lichen planus

• inflammatory disease of skin, hair,, nails,

• flat topped, polygonal

• Flexural lower legs, ankles, wrists, genitalia

Stevens-Johnson Syndrome

• what?

• what implicated?

• Characterized by?

• mortality rate

• risk factor?

• rare, potentiall fatal acute rxn

• meds implicated in majority

• illness and meds in children

• Characterized by mucosal and skin lesions due to extensive keratinocyte death

• 1-5%

• immunsuppression (lymphoma!) risk factor

Ectodermal dysplasia

• what kind of disorder? affects?

• depening on mutation…

• inherited disorders

• affects hair, teeth, nails, sweat glands

• Depending on mutation

  • X-linked, AD, or AR

  • immunodeficiecy, digit abnormalities

Basal cell nevus syndrome

• what kind?

• affects?

• gorlin syndrome

• autosomal dominant inheritance

• affects PTCH gene (checkpoint to stop growth)

  • transmembrane protin

cancer cell movement

seedin in cavity, blood, lymph, neuron

Bells palsy vs facial

• eyebrows wont move but it could it stroke pts

impacted teeth = ?

gardners syndrome

isograft

identical twins give each other perfect mouth transplant

CN testing: whats tested together

3,4,6 together, 9+10