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166 Cards in this Set

  • Front
  • Back
Gingival Curettage
remove soft tissue ling of perio pocket, leaving only gingival connective tissue lining (AA of Perio statement)
Does gingival curettage promote more long JE attachment than SRP alone?
no (AA of Perio statement)
What can be used for gingival curettage?
Curette
Sodium Sulfite
Phenol camphor
antiformin (can damage CT)
sodium hypochlorite
Ultrasonic
Dental Laser
What can cause an overhang?
Improper placement of matrix
Improper manipulation of restorative materials
Carving errors
lack of improper restorative finishing technique (overhang handout on BB 387)
Margination (what we are learning right now)
overhang removal (overhang handout on BB)
What be used for margination (OH removal)
Hand instruments (curet, amalgam files, knives, chisels, and finishing strips)
Conventional High Speed Handpiece (limited to accessible areas, flame tipped scaler insert available with water spray)
Ultrasonic Devices
Slow speed motor driven handpieces (wedge shaped abrasive tips)

(overhang handout on BB)
Is pre-med necessary for OH removal?
Yes (overhang handout on BB, p. 388)
Contraindications of OH removal
Open Contact
Open Margins
Extensive in Size (greater than 1/2 embrasure space)

(overhang handout on BB 388)
Type I overhang classification
Light catch with explorer, easily removed with hand instruments
(overhang handout on BB 388)
Type II overhang classification
moderate, definite catch with explorer, material extends beyond cavosurface, visible radiographically


removed by directional handpiece system
ultrasonics
handheld instruments

(overhang handout on BB 388)
Type III overhang classification
Gross overhang
Requires replacement
One half of the embrasure is filled

(overhang handout on BB 388)
What is the suggested sequence for removal of amalgam restorations?
1. Remove bulk excess in provimal area. Use shaving strokes starting at the base and exterior surface of the material. Work from the most apical portion of overhang to contact.
2. Make smooth between tooth and material
3. maintain anatomy. Watch angulation of instruments!

(overhang handout on BB 389)
OH removal: Burs
Diamond or finishing: used for large excess of amalgam where access permits without damage to surrounding structures

overhang handout on BB 389)
OH removal: Files
Working files: Removal of bulk, proximal surfaces

Finishing Files: refinement of cavosurface margin

overhang handout on BB 389)
OH removal: Gold Knives
Proximal surfaces
B and L surfaces
Gingival cavosurface margins
Moderate to slight excess of amalgam

overhang handout on BB 389)
OH removal: Curets
shave or smooth amalgam surface
area specific or univerals used

(overhang handout on BB 389)
OH removal: Cuttle Discs
accessible surfaces on F and L
refine and smooth amalgam surfaces on proximals

(overhang handout on BB 389)
OH removal: Abrasive Strips (finishing)
proximal surfaces
smooth cavosurface margin on proximal
smooth amalgam surfaces on proximal

(overhang handout on BB 389)
OH removal: Dental Tape and Pumice
proximal surgaces to check contact and smoothness. Use floss in conjunction with pumice to make smooth

(overhang handout on BB 389)
OH removal: Explorer and Dental Floss
check smoothness

(overhang handout on BB 389)
What is unique about the Burnett Power Tip?
slim diameter ultrasonic tip that withstands higher power setting and more lateral pressure than conventional.
Used for smoothing OH of amalgam
An extended shank Gracey curet has a _____ working end and a lower shank that is 3 mm ________ than the lower shank of standard area specific curet
An extended shank Gracey curet has THINNER (by 10%) working end and a lower shank that is 3 mm LONGER than the lower shank of standard area specific curet

p.485,488 NG
A miniature gracey curet has a ____, ____ working end and a _____ lower shank compared with the design of a standard Gracey curet.
A miniature gracey curet has a SHORTER (by 1/2), THINNER (by 10 %) working end and a LONGER lower shank compared with the design of a standard Gracey curet.

p.485 NG
Standard area specific curets are meant to instrument in pockets ___mm or less.
4 mm or less

p.485 NG
There are no 17/18 curets in either extended shank or mini. Why?
The standard Gracey 17/18 has logner shank length and shorter, slightly thinned working end

p.487 NG
Design of After Five and Gracey 3+ pocket curets differ from standard Gracey how?
1. lower shank 3 mm +
2. Working end 10% thinner

p.488 NG
What general four places are mini gracies designed to work best?
Narrow pockets of 4mm in depth
1. root branches
2. midlines of anterior roots
3. root concavities
4. furcation areas

p.489 NG
Vision Curvette Miniature Curets have a ______ and more ________ working end. The shank design differs ____
Vision Curvette Miniature Curets have a SHORTER and more CURVED (60-70 degree) working end in comparison to standard area specific gracie. The shank design differs:
1. extended lower shank in 11/12 and 13/14
2. lower shank two bands indicate 5 and 10 mm

p.490 NG
How is a modified intraoral fulcrum different from a split fulcrum?
Middle and ring finger contact near middle knuckle region. In split, there is NO contact

p.514 NG
Cross Arch fulcrum vs. opposite arch fulcrum
Cross arch--fulcrum on opposite side of the SAME arch
Opposite arch--fulcrum on opposite ARCH (mand vs. max)
Who is at the highest risk for OSA (obstructive sleep apnea)
a. men
b. women
a. MEN (Little 129)
What is a polysomnography?
an overnight sleep study. A technician records activities during sleep.
electroencephalogram
a test done that monitors brain waves (for sleep study) (little 129)
electro-oculogram
monitors eye movements (for sleep study, Little 129)
electromyogram
monitors jaw muscular activity and leg movements (for sleep study, Little 129)
Split night study
Start the night with a polysomnography and if they are able to make a diagnosis early in the night, they try applying positive airway pressure (Little 129)
What index is used to determine severity of OSA?
Apnea Hypopnea Index (AHI)--add all apneas in the night with all hypopneas and divide total number of hours slept
or
Respiratory Disturbance Index (RDI)--same, but respiratory effort related arousals are added too.

Diagnosis made if higher than 5 per hour w/symptoms.
0-5 normal
5-15 mild
15-30 mod
30+ severe
(129-131 Little)
Apnea
cessation or near complete cessation of airflow for at least 10 seconds (Little 130)
Hypopnea
greater than 30% reduction in airflow compared with baseline with greater than 4% O2 desaturation (Little 130)
Sleep Latency Test
tests ability to fall asleep (Little 131)
Maintenance of Wakefulness Test
assess ability to stay awak (Little 131)
The American Academy of Sleep Medicine has these guidelines for the use of oral appliances in the treatment of patients with snoring and OSA
•patients with primary snoring
• mild to mod OSA who wont use CPAP, don't respond, or aren't appropriate for CPAP
• severe OSA failed an initial trial of CPAP
what is the most common surgery performed for the treatment of obstructive sleep apnea?
uvulopalatopharyngoplasty (little 134)
What is the most common cause of OSA in children?
adenotonsillary hypertrophy, so adenotonsillectomy is curative in 75-100% of cases! (little 135)
At what point is care contraindicated with clients who have obstructive sleep apnea?
patients with OSA may undergo any necessary dental treatment (little DM-13)
Oral Manifestations of obstructive sleep apnea
large tongue
long soft palate
long uvula
redundant parapharyngeal tissues
large tonsils
retrusive mandible (Little DM-12)
What does obstructive sleep apnea increase risk for ?
hypertension
stroke
arrhythmia
myocardial infarction
diabetes (little DM-12)
What is the most effective treatment for obstructive sleep apnea?
weight loss
T or F. alcohol, sedatives or muscle relaxors should be avoided before bed time in clients with obstructive sleep apnea
True
Complications of Snoring
Headaches
Hard to concentrate
Fatigue
Poor work performance
Bothering Partner (class lecture)
Side Effects of Oral Appliances
TMJ pain
Muscular Pain
Tooth Pain
Hypersalivation
Crepitus
Xerostomia
Gingival irriation
Abnormal Occlusion in the morning
T or F Adrenal glands are endocrine glands
True p. 236
T or F the adrenal medulla functions as a sympathetic ganglion and secretes catecholamines
True p. 236
T or F Glucocorticoids, mineralcorticoids and androgens are all derives from cholesterol, share a common molecular nucleus, and are manufactured by the adrenal cortex
True p. 236
What is Aldosterone
regulates physiologic levels of sodium and potassium
mineralocorticoid
The predominant hormone of the zona glomerulosa
p. 236-237
T or F Cortisol is a mineralocorticoid
False, it the primary glucocorticoid
p. 236
Cortisol is responsible for...
regulate carb, fat or protein metablolism
maintain homeostasis during physical or emotional stress
insulin antagonist increasing blood levels and peripheral use of glucose
p. 236
How is secretion of cortisol regulated?
the hypothalmuc pituitart adrenal axis p. 236

CNS > circadium rhythm in response to stress>hypothalmus>release CRH>produce ACTH (in anterior pituitary)>adrenal cortex>cortisol > inhibits CRH and ACTH
p. 236
What is the most common type of adrenocortical overproduction?
a. Cushing's Disease
b. Addison's Disease
a. Cushing's Disease, caused by glucocorticoid excess
What is primary adrenocortical insufficiency?
a. Cushing's Disease
b. Addison's Disease
addison's disease
p.238
T or F. Adrenal insufficiency occurs in 40-60 persons per 1 million aduls
True p. 238
T or F Primary adrenocortical insufficiency is about 5 times more common than secondary adrenal insufficiency
False, 2ndary is more common than primary. p.238
Primary adrenocortical insufficiency is caused by progressive destruction of the adrenal cortex and/or
a. autoimmune
b. hemorrhage
c. sepsis
d. infectious disease
e. malignancy
f. adrenalectomy
g. drugs
h. all of the above
h. all of the above could cause primary adrenocortical insufficiency p. 238
T or F Clinical evidence of adrenocortical insufficiency arises only after 50% of the adrenal cortices have been destroyed.
False, 90%!!! p. 238
Lack of cortisol causes
impaired metabbolism of glucose, fat, progtein
hypotension
increased ACTH secretion
Impaired fluid excretion
excessive pigmentation
inability to tolerate stress
Aldosterone deficiency results in
inability to conserve sodium and eliminate potassium and hydrogen ions (leading to hypovolemia, heperkalemia and acidosis)
T or F Secondary adrenocortical insufficiency is more common than primary. It results from hypothalamic or pituitary disease, administration of exogenous corticosteroids or administration of specific drugs.
Both True 239-240
T or F The production of aldosterone is NOT effected by administration of corticosteroids. Why or Why not?
True-- It is not dependant upon ACTH, which is not produced because of the increased levels of administered corticosteroids. p.240
What dose of declomethasone diproprionate or budesonide in adults is considered the cutoff point indicating that adrenal suppression is probable?
a. 100-200 mg/day
b. 500-1000mg/day
c. 1000-1500 mg/day
d. 1500-2000 mg/day
c. 1000-1500 mg/day p.240
What is the following medical emergency and what can occur if not treated rapidly?

sunken eyes, profuse sweating, hypotension, weak pulse, cyanosis, nausea, vomiting, weakness, headache, dehydration, fever, dyspnea, myalgias, arthralgia, hyponatremia, eosinophilia after being in a stressful situation
adrenal crisis

if not treated rapidly, hypothermia, severe hypotension, hypoglycemia and circulatory collapse that can result in death p. 240
Adrenal crisis is typically more serious in a client with which type of adrenal insufficiency?
a. primary
b. secondary
a. primary because in a secondary adrenal crisis, there is NOT an absense of aldosterone p. 241
T or F Androgen-related (hyperadrenalism) disorders are rare and primarily affect reproductive organs
True p.241
T or F Mineralcorticoid excess is known as Cushing Syndrome and is associated with hypertension, hyperkalemia and depedant edema
First False

Mineralcorticoid excess is primary aldosteronism. Second, however, is true.
p.241
What do these symptoms represent?

Weight Gain
Round or mood-shaped face
Buffalo Hump on upper back
abdominal striae
hypertension
hirsutism
acne
cushing syndrome--glucocorticoid excess.

May also cause glucose intolerance, heart failure, osteoporosis, bone fractures, impaired healing, psychiatric disorders. p.241
Which of the following is NOT an increased risk of long-term steroid use?
a. insomnia
b. peptic ulceration
c. cataract formation
d. glaucoma
e. growth suppression
f. abnormal cuticle discoloration
g. delayed wound healing
f. abnormal cuticle discoloration

p.241
Where can cortisol be detected?
urine, plasma, saliva
most sensitive in saliva
p.241
T or F. Cortisol values may be altered by circadiuan rhythm, diet and stress.
True. p.241
A positive screening cortisol screening test should be followed by provocative tests of the HPA axis to detect hyper or hypo adrenalism. These tests include...
synthetic ACTH stimulation test---most reliable for adrenal hypofunction, directly evaluates level of adrenal reserve. + means adrenal function

CRH test-- differentiates ACTH dependant form from ACTH independant

dexamethasone suppression test-- screen for adrenal hyperfunction, specificity issues (false + and -)
p. 241
What are the two primary needs of the addison patient?
1. management of adrenal disease
2. hormonal replacement therapy
p. 241
For what therapeutic properties are steroids prescribed for (speaking of non-endrocrine disorders)
anti-inflammatory effects and immunosuppressive properties
p. 242
Hydrocortisone 20mg/day
prednisone 5mg/day
dexathasone 0.5 mg/day
yup p. 242
T or F Midazolam administration reduces stress associated with oral surgery
true 242
What is done for adrenal crisis?
IV injection of glucocorticoid (100mg bolus) and fluid and electrolyte replacement. p.243
Are clients with hyperadrenalism at an increased risk for periodontal disease?
Yes, because osteoporosis is related to bone lose and fracture. This consideration should be included in the treatment plan
Because of the increased risk of peptic ulceration in clients with hyperadrenalism should not use WHAT post op analgesics?
Aspirin or NSAIDS p. 243
T or F past or present history of TB, histoplasmosis, or HIV increases risk for adrenal disease
true 243
To determine if a client needs hormone supplementation for moderate or severe surgical procedures, what test/s should be done?
ACTH stimulation test p. 243
T or F Adrenal insufficiency is prevented with circulating levels of flucocorticoids are about 65 mg of hydrocortisone equivalent per day
FALSE, 25 mg per day. This is evuivalent to about 6mg of predisone p.244
What represents hypotension?
systolic 100 mm Hg/ diastolic 60mmHg
What is the proper patient positioning for a client that is hypotensive?
Head LOWER than feet
fluid replacement
administer vasopressors
distinguish between signs of adrenal dysfunction vs hypoglycemia
What is a common oral complication of primary adrenal insufficiency?
a. leukedema
b. diffuse or brown focal macular pigmentation of oral mucous membranes
c. large oral ulcerations
b. diffuse or brown focal macular pigmentation of oral mucous membranes
p.245
Physical signs of anoretic patient
failure to maintain normal body weight
15% below normal
fear of gaining weight
distorted body image
pale skin
bruising easily
(P&G Eating Disorders)
Medical complications with anorexia nervosa
amenorrhea
bradycardia
hypothermia
low potassium
hypotension
(P&G Eating Disorders)
Which is the most common of the eating disorders?
Bulimia nervosa
(P&G Eating Disorders)
Characterized by indulging in recurrent binges of highly caloric, sweet or high carbohydrate foods followed by purging
a. Anorexia Nervosa
b. Bulimia Nervosa
c.
b. bulimia nervosa 4-20% of college aged women may be related
T or F Purging in bulimia nervosa can be done through vigorous exercise.
TRUE Also, laxatives, diuretics, or self vomiting
(P&G Eating Disorders)
T or F An anorexic or Bulimic patient can be underweight, normal weight or overweight.
False, Anorexic patients are usually underweight while bulimic can be ANY weight
Physical signs of bulimia
darkness under the eyes
damages cuticles
scarred and or calloused knuckles
red eyes
headaches
weekly fluctuations in weight of 5 to 10 pounds
(P&G Eating Disorders)
Medical complications associated with bulimia include
dehydration
potassium imbalance
gastric distension
gastric ruptures
GI bleeding
cardiac arrythmias
constipation
(P&G Eating Disorders)
T or F The ultimate medical complication with anorexia or bulimia is death.
true
(P&G Eating Disorders)
Lanugo
downy hair growth may that may appear on the vermillion border of the lips, lower border of the mandible and extremities seen in anorexia nervosa
(P&G Eating Disorders)
Perimolysis
enamel erosion
(P&G Eating Disorders)
Oral signs of anorexia
Lanugo
Skin dry and flaky and appear orange
Petechia may also be present
enlarged parotid gland
angular cheilitis
lymphadenopathy
(P&G Eating Disorders)
Oral signs of bulimia
Perimolysis, facial erosion smooth and dished out present in person has been purging for a long time, linguals, increased dental caries,
dehydration
oralpharyngeal area may be red or bleed
enlarged parotid gland
angular cheilitis
lymphadenopathy
Why is a bulimic client at an increased risk for caries?
a. a diet that included large amounts of sugars and carbs
b. from the stomach acid in the mouth
c. decreased salivary flow
d. all of the above
d. all of the above
(P&G Eating Disorders)
A few signs of ______ that may be seen in a health history include:
heart disorders
dehydration
bruising easily
blood chemistry problems
eating disorders
(P&G Eating Disorders)
T or F A bulimic individual should be told NOT to brush immediately after purging but can rinse with tap water.
First is true
Second is false, rinsing with tap water could decrease the buffering capacity of the saliva
(P&G Eating Disorders)
Peptic Ulcer
well defined break in the GI mucosa greater than 3 mm in diameter resulting from host response to HElicobacter pylori.
(little chp 12)
T or F Peptic ulcers develop principally in regions of the GI tract that are proximal to the acid/pepsin secretions.
TRUE (little chp 12) The first portion of duodenum most common in western pop and gastric ulcers more frequenct in asia. Upper ujunum rarely involved
T or F Peptic ulcer disease usually is chronic and focal
True (little chp 12)
The incidence of peptic ulceration has declined since 1950. What did the book discuss as possible reasons why?
• decreased cigarette and aspirin use
• increased use of veggie oils
• better sanitation
(little chp 12)
Who is at a higher risk than the general population for getting peptic ulcers?
• first degree relatives of those who have them
• Smoke and heavily drinke
• Type O blood
• hyperparathyroidism and conditions with increased gastrin levels (renal dialysis, Zollinger-Ellison syndrome, mastocytosis)
• NSAID for more than 1 month
(little chp 12)
T or F Peptic ulcers are rarely seen in children. When they are, it is usually due to poor sanitation in third world countries.
First is true, second is FALSE
Its most often associated with an underlying systemic illness like severe burn or major trauma
(little chp 12)
Etiological factors for peptic ulcers
• H pylori
• NSAID use
• acid hypersecretion
• cigarette smoking
• distress (psychological or physical)
• Cytomegalovirus (rare, in HIV + patients)
T or F Helicobacter pylori is microaerophilic, gram-negative, sprial shaped bacillus
TRUE (little p.163)
Why are NSAIDS associated with peptic ulcers?
directly damage mucosa
reduce mucosal prostaglandin production
inhibit mucous secretion
(little p.163)
In relation to peptic ulcers...
In a properly functioning body, what normally provides protection against acid breakdown?
Mucosal resistance
Mucous and prostoglandin production
blood flow
bicarbonate secretion
ion-carrier exchange
Antibacterial proteins like lysozyme, lactoferrin, interferon, defensin/cryptdin (little p. 163)
T or F Alcohol and NSAIDS are directly injurious to gastric mucosa
TRUE little p. 165
T or F H. pylori is a known cause of acid hypersecretion.
FALSE, no correlation exists (little p. 165)
T or F. H. Pylori is able to injure the stomach mucosa alone.
FALSE, it has the ability to cause inflammation but it is most likely the host response that causes the mucosal breakdown (little p. 165)
When does discomfort of duodenal ulcer typically happen? Gastric?
duodenal: on an empty stomach 90 min to 3 hours after eating (can awake someone from sleep) p.165
Gastric: unpredicatable, may get it from eating
What is a BAD sign that an ulcer has penetrated deeper?
Changes in character of pain..
loss of antacid relief
pain radiating to the back
p. 165
Test used to diagnose a peptic ulcer
fiberoptic endoscopy
Urea breath tests --measure presence of bug before and after treatment

Serology (past or current infection, cant document eradication of bug) or H.pylori stool antigen tests less commonly used
p.165
What three types of drugs are considered first line therapy ("triple") for peptic ulcers
at least two antibiotics and one antisecretory drug
Specifically, what is the first line therapy for peptic ulcers?
Propton pump inhibitor (or ranitidine bismuth citrate) twice daily PLUS
Clarithromycin 500 mg twice daily PLUS
Amoxicillin 1000 mg twice daily or metronidazole 500 mg twice daily
P.167
How long does therapy (meds) last for peptic ulcers?
10 days to 2 weeks
What is the second line therapy for peptic ulcers?
Quadruple therapy subsalicylate proton pump inhibitor twice daily, bismuth subsalicylate/subcitrate 120 mg 4x daily plus metronidazole 500 mg twice daily, tetracycline 500 mg 4 times daily
p. 167
When should a med consult be done with a client who has circled peptic ulcers on the health history?
when there are symptoms of active disease (p. 167)
Which of the following should be prescribed to a client with peptic ulcers (or history of peptic ulcers) for pain?
a. acetaminophen
b. aspirin
c. NSAIDS
a. Acetaminophen only, the others should be avoided because they can irritated the GI epithelium
p. 167
T or F. A client with peptic ulcers should be instructed to take antibiotics or dietary supplements 2 hours before or after antacids are ingested.
TRUE, because the antacid impair absorption of those things p.167
T or F H. Pylori is found in dental plaque. Good oral hygiene and periodic scaling should be discussed with clients with peptic ulcers
TRUE p. 168
Inflammatory Bowel Disease
subcategories are ulcerative colitis and Crohns disease. Distinguished by site and extent of tissue involvment. p.169
T or F. Crohns disease is a mucosal disease that is limited to the large intenstine and rectum. In contast, ulcerative colitis is transmural process (affectes entire wall of bowel) and may produce patchy ulcerations on any point from mouth to anus.
FALSE, they are opposite p.169
Inflammatory Bowel Disease most commonly found in
Jew and whites
US and Europe
Young adulthood (20-40 yrs)
Crohns: female
ulcerative colitis: m=f
Ulerative colitis and Crohns disease are inflammatory diseases of unknown cause thought to be associated with.....
a. immune disfunction in response to environmental factors
b. infection and destruction of tissue from bacterial infection
a. (little chp. 12)
The three main symptoms of ulcerative colitis
1. attacks of diarrhea
2. rectal bleeding or bloody diarrhea
3. abdominal crams
T or F Patients with Crohns disease do not typically require operation but long standing colonic crohns disease increases risk for colorectal cancer.
First false
Second true
p. 170
Extraintestinal manifestations of Ulcerative Colitis
Dehyrdation
Fatigue
weight Loss
Fever
arthritis
erythem nodosum
growth failure
eye disorders

(little chp. 12)
Crohns disease initial manifestations
Persistent diarrhea
abdominal cramps
anorexia
weight loss

THEN comes... fever, malaise, arthritis, uveitis, malabsorption features
(little chp. 12)
First line drugs for IBD
Anti inflammatory (sulfasalazine, corticosteroids...etc) (little chp. 12)
Second line drugs for IBD
Immunosuppressive and antibiotics (little chp. 12)
Third line drugs for IBD
monoclonal antibody against TNF ad surgery. (little chp. 12)
Sulfasalazine
Anti-inflammatory, administered 4g/day for active mild to moderate IBD at 1g/day during remission.
(may cause nausea head ache fever arthralgia, rash anemia agranulocytosis cholestatic hepatitis in 1/3 of patients)

(little chp. 12)
What supplements are usually recommended during sulfasalazine use?
Folic acid or iron (little chp. 12)
T or F Corticosteroids and sulfasalazine is used to induce remission in patients moderately to severely ill with IBD
TRUE
(steroids not for maintenance)
Corticosteroid use is typically for ______ in IBD
a. maintenance in moderate to severe IBD
b. mild disease
c. short term use to induce remission
d. long term use
c. short term use to induce remission
p.171
What is Methotrexate? Adverse Effects?
immunomodulator used for severe disease in IBD (specificially Crohns disease) when it is refractory to all other treatments and for maintaining remission.

Prolonged use causes hepatotoxicity and pneaumonitis (also very expensive)
In a med consult what should be asked if your client has IBD and is taking Methotrexate?
• ask about the patients breathing capacity.
• Ask for review of liver enzymes
• Blood studies and coagulation studies need to be done too
T or F Development of a fever in a client taking immunosuppressants with IBD should be cause for referal to physician
TRUE only if the cause of the fever is unexplainable or unknown. p. 172
T or F Routine care is not contraindicated for clients in any stage of IBD
FALSE, only urgent care during acute exacerbations p. 172
How can you assess the severity of IBD?
temperatue
number of diarrheal bowl movements per day
if stool is bloody p.172
T or F Oral ulcerations may manifest in clients with IBD and Pyostomatitis vegetans can also be seen specifically in clients with Crohns disease.
TRUE p. 172
T or F Oral lesions in ulcerative colitis and crohns disease resolve when the GI state is medically controlled
TRUE p. 173
What distinguishes between apthous ulcers and ulcers seen as manifestations of IBD?
IBD ulcers are granular and may have irregular margins p. 172
Pseudomembranous colitis
severe and fatal resulting from overgrowth of Clostridium difficile due to loss of competative anaerobic gut bacteria p.173
Most common nosocomial infection of the GI tract
Pseudomembranous colitis p.173
Pseudomembranous colitis most common in
elderly, hospitalized patients, tube fed, infected with HIV p.173
(no gender distinction, young children rare)
C difficile is
a. aerobic
b. gram-negative
c. anaerobic
d. gram positive
e. sporeforming rod
a. gram-positive
c. anaerobic
e. rod
Overgrowth causes pseudomembranous colitis p. 173
What might be suspected:

After initiating clindamycin (ampicillin or amoxicillin), the client developed diarrhea(watery, loose or even bloody), dehydration, abdominal cramps and tenderness and fever.
refer this client IMMEDIATELY, they could have Pseudomembranous colitis. These symptoms typically show 4-10 days after initiation of oral antibiotic but could show in 1-8 p. 174
Oral complications in Pseudomembranous colitis
systemic antibiotics could cause candidiasis p. 175
Diagnostic Triad for Anorexia Nervosa
body weight 85% less than expected
intense fear of weighht gain
disturbance in body image
T or F An enlarged parotid gland may be seen in clients with eating disorders
TRUE p. 499
T or F the prognosis is better for bulimia nervosa than anorexia nervosa.
False, opposite p.500
Which bug is associated with Peptic Ulcers?
a. h. pylori
b. p. gingivallis
c. c. difficile
c. h. pylori
a. h. pylori
(chp 12)
How often should blood pressure be taken on a client with hyperadrenalism?
It should be monitored throughout the appointment (243)
Which bug is associated with Pseudomembranous colitis?
a. h. pylori
b. p. gingivallis
c. c. difficile
c. c. difficile
(chp 12)