CDCA OSCE

bulging eyes (exophthalmos), weight loss, and Graves disease are all due to _____

hyperthyroidism

signs/symtoms of skinny, weight loss

Graves disease

weight gain, dry hair, lower voice, feels cold

hypothyroidism

Acute adrenal insufficnecy is also known as ____disease. A patient on steroids might have an attack if not supplmeneted by ___ the steroid dose before dental treatment due to thier inability to produce extra ___ in response to stress

addisons disease

doubling the dose of steroids

cortisol in response to stress

patient with reduced or missing teeth on a pan

ectodermal dysplasia

patient has supernumerary teeth (extra teeth) ... likely diagnosis?

cleiodcranial dysplasia

: can cause hypercementosis of the roots, generalized skull and jaw enlragment with COTTON WOOL appearance of bone

Pagets disease

hypercementosis will follow the ____ on a PAX

PDL

Cleft lip is defection fusion of the ____ and _____

medial nasal process

maxillary process

failure of the palatal shelves to fuse result in ____

BIFID UVULA

cleft palate, bifid uvula

patient with cleft palate, mandibular micrognathia, glosspotopis (airway obstruction)

Pierre robin syndrome

looks like white and brown spots on the teeth

hypocalcified teeth

___ cannot be reversed

but microabrainsion and aching can improve aesthetics, but cannot reverse the condition

fluorosis

flurosis can be caued by a patient living in a region wher the fluoride content in the water is ____ppm. Normal is ____ppm

4ppm

normal is 0.7ppm

patient has no enamel on the teeth on bitewing or panx

amelognesis imperfecta

can see OBLITERATED pulp chambers on radiogrpahs and teeth have a TRANSLUCENT or opalescent hue (greyish or blue)

also known as osteogenisis imperfect

associated with collagenn maturation problem, non systemic

dentogenisis imperfecta

mulberry molars, screwdriver shaped incisors , maxillary anteriors with central depression

syphillis

___ also known as twinning is due to incomplete formation of two teeth, common on incisors, seen in maxillary laterals

gemination

bull shaped crowns with shortened roots on PAN or fms

What can be a 2 contributing factors?

taurodontism

overweight, hypertension

Tzanck test is to diagnose ________ (small painful ulcers that recure every 5-6 months with fever) Treatment is ___ with ____ and analgesics

acute herpactic gingivostomatitis

pallative care with lidocaine rinses and analgesics

long standing and heal with a scar, can see on the lip and palate, pemphoid can also heal with a scar

major apthous ulcers

mucocele on the lower lip can be due to an ____ salivary gland, treat with _____. Inside the mucocel is ____ (mucus)

injured salivary gland

treat with excision

saliva,mucous

A standard cartridge as ___ml of 2% lidcaine at ___mg. the active ingredient , and 1:100,000 (____) of EPI vasoconstrictor

1.8ml

36mg

0.018mg of EP

t/f: according to cdc regulations, you are not required to wash hands before and after removing gloves ?

true

Sodium hypochlorite should be changed ___

daily

to test the autoclave to ensure that it is properly sterilizing by doing a ___ test using biological indicators ___

spore test

Tx for tetracycline staining?

best to leave alone

____ can cause rampant decay due to lack of saliva to buffer acidic PH

xerostomia

____: can cause rampant caries in todder/infant

baby bottle syndrome

a patient on steriods will need ___

supplemenation

a MI can produce ___ symptoms while ___ does not

GI

syncope does not induce GI symptoms

T/F use retraction cord that contains epi for patient with recent MI

false

correct sympotms of MI. The other two are more likely ____

chest pain

upset stomach

pounding heart beat

left arm

jaw jerk

pain

indigestion

all except indigestion and upset stomach

angina

patienttakes nitroglycerine tablet with no effect in 5 min, you give a second and third tablet and still nothing happens. Patient is most likley have a ____

Myocaridal infarction

angina perctoris symptoms .Usually precipitated by exertion of _____. commonly with see __ _and ___ occur

chest discomfort(not pain) epigrastrium area, usually preciptated by stress and exertion

nasua and vomitting

if a patient is sitting in dental chair with hands on heart, first thing you do is give the patient _____

0.4mg of nitroglycerine tablet

if patient is having a myocradial infarction/chest pain, andminster anti anginal drugs such as _____.

when to not give this to the patient as can cause severe drop in blood pressure

0.4mg nitroglycerine/vasodilation

viagra or cialis

What does MONA stand for and when is it used?

morphine, oxygen, nitroglycerine, asprin

angina treatment

Norpace/disopyramide

Antiarrhythmic/antianginal agent

Valium (diazepam) has metabolies for long duration and binds to ___ receptors to cause inhibtory effects . will have ___ channel opening

It is a ___ used for anxiety, siezures ,and insomina

GABA

Cl

benzodiazapine

Pottasium-sparing diuretics for hypertension and edema (2)

WHEN IS IT NOT USED

TRAMETERNE AND SPIRONLACTONE

NOT USED FOR IMPAIRED RENAL FUNCtion

Stent has been placed for patient undergoing kidney dialysis . Does patient require medicaiton?

No, does not require medication

if a patient has kidney disease, what can you prescribe and NOT prescribe

Tylenol (acetaminophen)

NOT aspirin, advil or naproxen (nsaids are metabolzied in the kidney)

t/f: If a patient has a kidney transplant, the patient may require antibiotic(stress dose)

true- due to anti rejection medications

analgesic for mild to moderate pain: NOT USED IF PATIENT HAS KIDNEY FAULURE

PROPROXEPHINE

antihistmine to prevent motion sickness and as a sedative for insomina when benzodiapenines are contacindicated. Can be used to treat allergic reactions

common side effects are tardive dysinesia, xerostomia

promethazine

bronchiodilater inhaler that relaxes muscles. Used for asthma

albuterol

t/f: should administer nitrous oxide to an asthmatic

false

angioedema of the upper lip has been dianosed as an allergic reaction with no other signs of allergy. The most apporpriate treatment is ?

oral administration of antihistmine (benedryl)

a 60 year old female taking naproxene, one asprin dialy who is allergic to penicillin is most likely taking the naproxene for ___. Do not make a a precision attachment for her due to her lack of ___ as a result of the arthritis

arthritis

lack of dexterity

patient has malaise, lethargy, itching, may have an allergic reaction. Give ____

benedryl

the major difference between syncope and severe analphylatic shock is there can be ____ in anaphylatic shock

diffuculity in breathing

patient undergoing anaphylatic shock. TX includes (4)

place patient in supine position

administer oxygen manually

monitor vitals

give 0.3-0.5ml of EPI SC or IM

the first thing to do if a patient experiences syndrome (fainting or hypotension) in the dental chair is to place patient in _____ position

place patient in trendelenburg position (supine) with feet higher than head by 15-30 degrees to increase cerebral perfusion pressure

When is trendelenburg position contraindicated and instead would use just horizontal position?

hypovolumic shock (loss of blood volume)

medical history of patient taking penicillin and has an allegic reaction on the lower lip. Tx? (2)

apply topical steriods or swithc antibiotics

anaphylactic shock tx? (2)

Epi 1:1000, 0.5 ml SQ, repeat every 10-20 min PRN

or steroid

dentist has needlestick , have ht patient do an ____ test to detect _____

then do ___ to confirm ELISA

elisa test to convern HIV antibiodies

Western blot

AIDS patient treatment include ___ precautions, try to avoid invasive procedures and _____ treatment

univerisal precautions

try to avoid invasive procedures

no treatment

A patient taking Isonizid, Rifampin or Pyaziminade has ___

tuberculosis

if you patient is having a seizure , first acition is to protect ___ and __ _form injurying themselves ,clear the area and _____ against the dental chair

yourself and patient from injury

clear the are and hold hands against dental chair

____ or ____is the test to evaluate blood coagulation (clotting) time and to monitor response o oral anticoagualant therapy like COUMARIN and liver disease

Prothrobmin test (PT)

INR

Name this disease:

pale gums due to decrease RBC count. diagnose by complete blood count test. What is sign of anemia RBC?

Anemia

2 million RBC

normal RBC range ?

4.7-5million

name this disease :

patient have low platelet count (poor clotting).

Normal platelet count is ____-_____.

Below 50,000 per microliter is _____

thrmobocytopenia

150,000-450,000

thromboyctopenia

name this diseaes:

symtoms inlcude increased WBC above normal and ginival bleeding. Blood level example : RBC-2.2million, platelets-24,00, WBC-79,000

What is normal WBC count?

How to diagnose(2)

lekuemia

4000-10,000

complete blood count, bone marrow examination

Name this disease:

can be caused by calcium channel blockers even after a few months.

Treatment and last option?

gingival hyperplasia

reduce or switch their medication

gingivectomy

patient with acid reflux and had mild dental pian. What can you prescribe?

acetominophin, no NSAIDS

tetracycline and oral contraceptives _____ the antibiotics effectivness

WEAKEN

penicillin allergic patient pre medication: ___ or ____ with dosages for adults

clindamycin 600mg/20mg/kg

erythromycin 500mg/15mg/kg

non allergic penicillin patient premedication with dosage for adult and kid and time

amoxcillin 1 hour prior to treatment

adult: 2g

kid: 50mg

Hip joint replacent prohpylaix is only given the first ___ years after surgery only

2 years

t/f: No ab is need for patient with rheumatic heart disease

false

true/false: should give antibiotic prophylaxis for a patient wit ha history of bacterial endocardtitis?

true

true/false: antibiotic prophylaxis is premedication indicated for all dental procedures on indicated patients ?

false, only for those that will be invasive and cause gingival bleeding

Name of disease:

on a pan view looks like a bone under the angle of the mandible. It is elongation and clarification of the temporal ____ at the back of the throat that occurs after a tonsillectomy or trauma.

eagle syndome

temporal styloid process

name of disease :

elongatoin and minerlaized of the styloid process that impinges on the carotid arteries and nerves. Patient ocmplains of aunilateral neck pain when turning thier head, possible sore throat, dysphagia.

Tx?

Mild cases:_____

severe cases:____

carotid artery syndrome

mild cases: none except reassurance or local corticosteroids to relieve pain

severe caess: surgical intraoral excision of the process

largest, least numerous arranged in inverted V shaped row at the back of the tongue?

does or does not have taste bud?

circumvillate papillae

does have taste buds

smokless tocacco pouch keratosis

is the development of a white mucosal lesion in the area of tobacco contact

Name the pathology:

ca nbe caused by cheeck biting, dentures, orthodontic appliances, uneven teeth, and aggressive oral hygiene (benign hardening of the check mucosa due to excess kertain)

Tx:

linea alba

tx: remove the irritants is the proper treatment

Name the pathology: viral infection causing oral ulcers and inflammtion. Mainly affects the children

TX: (3)

herpetic stomatitis

tx: acyclovir, liquid diet and numbing medication , lidocaine rinse if pain severe

Name the pathology: PALATAL AND MUCCOBUCCAL FOLD LESIONS ARE OFTEN ASSOICATED WITH THIS

TOBACCO, SNUFF

Name the pathology: picture of palate with numerous small raised areas with central red dots caused by pipe smoking

This is not premalignant and is caused by the ____ form the smoke. Not the chemicals

tx?

nicotonic stomatitis

heat from the smoke, not the chemicals

is reversible, need to stop smoking

Name the pathology: can be seen on the palate in a pipe smoker

nicotonic stomatitis

Name the pathology:

Hepatitis that ca be caused by inoculation(serum, vaccination) iv drug use and blood transfusions

hepatitis C

Name the pathology: occurs on the lower lip an lateral tongue borders. may have a crusted or cauliflower appearance

Squamous cell carcinoma

patient comes in with hard palate swelling hat has been there for about 2 years. The patient tells you they had a similiar lesion removed some years ago

tx?

surgical removal

You see a swelling under the tongue on the floor of the mouth (ranula). What do you do for treatment ?(2)

surgical removal or masupialize

Dense, firm ulcer with indurated borders is of 4 months duration. It has been gradually increasing in size and severely restricts tongue movement. What do you do?

perform incisional biopsy

You see a hard palate with a midline swelling present for several years. Pt is concerned about this swelling because there is a family history of carcinoma. What do you do?

treatment: leave along and reassure the patient

Name the pathology: occurs on the face (might see under eyes)

patient has RAISED lesion under the ye present for about 2 years.

TX?

basal cell carcinoma

biopsy and surgica lremoval

heptatis serum can be acute or chronic , prlonged incubaton 4-26 weeks?

hep b

hepatitis infectious required from raw steamed shellfish, contaiminated water or food

hep A

T/f: a patient who has Hepatitis A over a year ago is okay to treat?

When is Hepatitis A okay to treat: after _____ fro mthe onset of jaundice.

How is it transmitted?

true, it resolves within a couple of weeks usually on its own

after one 1

transmitted fecal oral route

Name the pathology: looks like little dialted blood vessels (telangiectasis) on the tongue

multiple telangiestasias

Median Rhomboid Glossitis (Central Papillary Atrophy) is type of ___ infection.

Tx

candida

nystatin

Hairy tongue : looks nasty. treat by taking the patient of thier medicaitons , use ___ and improve oral hygiene (brush tongue)

mouthrinses, medications , and improve OH

Oral hairy leukoplakia (AIDS)

presents as white plaque usually on the lateral border of the tongue that does not rub off. Associated with __ and ___

Presents as a white mucosal plaque that does not rub off, usually on the lateral border of the tongue; associated with EBV and AIDS

Name the pathology: oral manfestation in aids patients. a malginant cnacer of the lining of blood vesels on the ______. May present as purple lesionson the palte. TX: ?

kaposi sarcoma

hard palate

tx: provide normal dntal treatment but NO invasive treatment

Geographic tongue (migratory glossitis) caused by atrophy of the ___ papillae on tongue

tx: ?

Pattern of normal coating interspersed with bright red, shiny, circular bald areas caused by atrophy of the filiform papillae, with raised pearly borders. Pattern resembles a map and changes with time. Not significant, and its cause is not known.

tx: ressure patient and leave alone