Student RDH Trivia Night December 2nd, 2025 - Topic: AFIB

  1. What is the natural pacemaker of the heart?

    1. Sinoatrial (SA) node

      1. in the right atrium

      2. released electrical signal that spreads through the right and left atrium

      3. depolarizes heart cells

      4. atria contract

      5. depolarization = contraction

      6. electrical signal sequence: SA - AV - Bundle of His - Bundle branches - Purkinje fibers (causes ventricular contraction)

    2. What occurs during depolarization of the heart

      1. sodium channels open

    3. what is atrial fibrillation

      1. an irregular and often rapid heartbeat

        1. creates quivering of the atria rather than a true contraction

        2. blood can remain trapped and become stagnate in the atria of the heart

    4. list a few risk factors for the development of AFIB

      1. history of a heart attack, dehydration, hyperthyroidism

      2. drinking excessively for long periods of time

      3. lack of physical activity

      4. tobacco

      5. changes to heart

      6. electrolyte imbalances

      7. other conditions associated with AFIB

        1. muscular dystrophy (heart is a muscle), eating disorders, hyperthyroidism, stress or anxiety

    5. list common symptoms of AFIB

      1. syncope, palpitations, fatigue, heart palpitations, irregular heartbeat, difficulty breathing

    6. commonly used medications for treatment of arrhythmias

      1. Warfarin, Plavix, Digoxin

      2. Beta-blockers (-olol)

      3. calcium channel blockers (-dipine)

      4. cardiac glycosides (digoxin, digitalis)

      5. anticoagulants (warfarin/coumadin, eliquis, plavix, xarelto, aspirin)

    7. what precaution should be taken when treating a patient with a pacemaker using an ultrasonic scaler

      1. use a piezoelectric ultrasonic scaler

        1. Cannor use any magnetostrictive devices (ultrasonic scaler, sterilizer)

        2. piezo is always safe

        3. if pacemaker is shielded you can use either

    8. what is the primary complication of untreated AFIB

      1. Stroke

        1. blood pools and clots (thrombi) = stroke

    9. what is the first step in managing a suspected stroke in the dental office

      1. position the patient semisupine and call 911

        1. stroke management

          1. F - facial drooping

          2. A - arm weakness, asymmetry

          3. S - slurred speech/changes

          4. T - time to call 911

            1. sit patient semisupine

            2. initiate basic life support

            3. administer oxygen if dyspnea present

            4. check glucose

    10. what is a common medication used to present stroke in AFIB patient

      1. warfarin (anticoagulants)

    11. modifications for a patient with AFIB needing scaling and root planing

      1. use cardiac dose of epi (0.04mg epi, 0.2mg levo)

      2. postpone treatment for uncontrolled afib

      3. get recent INR

    12. what is the primary dental risk for patients with atrial fibrillation on anticoagulation

      1. excessive bleeding

    13. what is the role of INR testing in dental management for patients with afib

      1. to assess the bleeding risk

        1. non-selective beta blockers (propanolol) may have drug interactions with epinephrine

        2. patient not taking warfarin INR = 1.1 or less

        3. INR range for someone taking wafarin - 1.5-3.5

        4. no SRP if INR over 4

        5. antibiotics and coumadin (wafarin) = increased coumadin effect

        6. aspirin and coumadin = increased bleeding