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374 Cards in this Set
- Front
- Back
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What ____% of peak bone mass is determined by heredity?
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80%
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What are osteoclasts?
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cells that resorb bone
-do not decrease with age |
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What is still the predominant cause of tooth loss in all ages?
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Dental caries
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In 1965 ____% of older adults had graduated high school & ____% had a Bachelor's degree.
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-24%
-5% |
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What are the years of the silent generation?
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1926-1942
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What is gerontology?
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study of the aging process
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The young gain form the elders by what?
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their experience, stability & continuity
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In 2007, ___% of adults had graduated high school & ____% had at least a Bachelor's degree.
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-76%
-19% |
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What is the median age in the U.S.?
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35.3
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What tissues do not exhibit turnover?
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-dentin & cementum
-tooth enamel -specialized nerve cells |
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What is senescence?
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The process of growing old
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What is the dominant risk factor for cardiovascular disease?
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Hypertension
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People aged 65 & older are projected to represent ____% of the total population in 2030.
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20%
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What governs differentiation & maintenance of all cellular functions.
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DNA
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Fractures occur once ___% of bone mass has been lost.
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30%
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In the U.S., peak bone mass is least in what ethnicity?
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white & Asian women
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What is predictable, & not dose dependent?
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Allergy
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What is predictable & dose dependent?
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Side effect
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What is polypharmacy?
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The use of multiple medications by one person.
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What are the years for baby boomers?
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1946-1964
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What are the most vulnerable bones to fracture?
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Neck of the femur, spine, wrist bones
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What percentage of seniors live in nursing homes?
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5% to 6% (those over 65)
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One of the best ways to deal with stress is to?
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have a strong belief in yourself & your ability to deal with situations
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What two things increase self-confidence and a feeling of personal control for the elderly?
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encouragement & empathy
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Loss of function in the cardiovascular system is due to what?
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-coronary heart disease
-sedentary lifestyle |
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What type of caries are elderly more at risk of getting?
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root caries
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Define "universal"
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detectable in all members of the species provided they live long enough
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Define "intrinsic"
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proceeding independently of influences from outside the organism
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List high risk cardiovascular medications
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anti-hypertensives
Calcium channel blockers Propranolol Diuretics |
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Define "progressive"
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developing gradually & irreversibly
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Define deleterious
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harmful to the survival of the individual
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What are proteins?
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"long" polypeptide molecules
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What are peptides?
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"short" polymers formed from the linking of amino acids
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Where are root caries predominately located?
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At the CEJ
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T/F: Most physiological systems deteriorate with advancing age.
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True
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T/F: In healthy seniors resting heart rate, stroke volume & end diastolic HV are markedly influenced.
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False
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___% of older people live independently.
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80%
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About ___% of older people require daily assistance.
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15%
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What are cells that synthesize matrix proteins and regulate mineralization of the newly formed matrix.
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Osteoblasts
-they decrease as the bone surface area and volume decrease with age |
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What is the study of the biochemical and physiological effect of the body on drugs.
(what the body does to a drug) |
Pharmacokinetics
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What is the study of the biochemical & physiological effect of drugs on the body?
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Pharmacodynamics
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What is dentin sclerosis?
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-obturation of the tubules by gradual growth of the peritubular dentin
-changes refractive index making it more translucent. (decreases in sensitivity, permeablilty, and pulpal reactions) -adds more bulk to dentin |
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List psychotropic drugs
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antipsychotics
Benzodiazepines sedatives hypnotics |
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Remineralization results from the uptake of what from the saliva?
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calcium & phophate
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What are the 4 main actions of drugs?
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depress
stimulate destroy cells replace substances |
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Elders gain from interacting with the young by what?
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gaining support, care & respect
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What changes happen in the pulp chamber as we age?
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-size is reduced unevenly
-molars=more dentin on ceiling & floor of pulp chamber -max. incisors= more dentin on lingual side of pulp chamber |
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What clinical changes happen in the oral mucosa with age?
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-becomes increasingly thin, smooth & dry
-acquires a satin-like edematous appearance -loss of elasticity & stippling -tongue becomes smoother & loses filiform papilla -more sensitive in minor injury -lingual varicosities larger |
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What is aging?
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biological, psychological & social process through which an organism progresses starting at conception and continuing until death
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Coordination level determinants
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failure of control organisms (endocrine, nervous, immune) to restore homeostasis after disturbances
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What is physicological aging?
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the decreased ability to meet challenges and the reduced capacity of the system
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Details about inactive or arrested lesion
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-typically dark brown
-frequently shiny & smooth -hard upon probing -sometimes the entire root surface is darkly discolored and leathery -has this appearance whether there has been distinct loss or not (tissue) |
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What are the causes (levels) of biological aging?
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genetic level
cellular level organ/organ system level coordination level |
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The ability to dissipate heat is reduced ____% from age 25 to 70 years.
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33%
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Is the surface area wider in an active or inactive lesion?
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inactive lesion
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What is normal aging?
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aging in the absence of disease
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What years are generation Y
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1982-2000+
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What is macular degeneration?
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gradual loss of vision caused by the oxidation of the macula-small, circular membrane at the center of the retina (central vision deteriorates)
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List drugs with narrow therapeutic index
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digoxin
phenytoin warfarin theophylline lithium |
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What is a strong risk factor for health problems and early death?
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social isolation
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List some analgesics
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NSAIDS
narcotics muscle relaxants |
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Do memory and cognition decline with increased age in healthy people?
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yes- very modestly though
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What fraction of elderly use laxatives, even when they aren't constipated?
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1/3 to 1/2
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What is pharmacotherapeutics?
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The study of the use of drugs in the treatment of disease
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What is a condition of increased fluid pressure inside the eye that can cause loss of blood flow to the optic nerve. (can cause partial vision loss, with blindness as a possible, eventual outcome)
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Glaucoma
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What years are generation X?
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1961-1981
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What years are the G.I. generation?
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1901-1924
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When does your processing speed change?
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20 yrs old & declines steadily after that
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____% of bone may be increased by exercise and calcium supplements.
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5-8%
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What is not predictable and not dose dependent?
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Idiopathic effect
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Permanent disability can result from merely _____
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over-helping
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If medication related problems were ranked as a disease, it would be the _____leading cause of death in the U.S.
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5th
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What are cataracts?
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A clouding of the internal lense of the eye that affects vision.
-Light can no longer pass freely -By age 80 more than half of Americans have experienced cataracts |
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What changes happen in the pulp as we age?
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-more fibers & fewer cells
-blood supply decreases -does not have the same repairative capacity as younger teeth -cross-linking of collagen fibers decreases |
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What is considered "early old age"?
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65-74 yrs
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What is considered "middle old age"?
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75-84 yrs
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What is considered "old old age"?
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85 yrs and older
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What % or men are married after the age of 65?
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77%
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What % of women are married after the age of 65?
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42%
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What % of women are widowed after the age of 65?
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48%
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What % if men are are widowed after the age of 65?
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14%
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Who do most older people live with?
___% live w/ spouse ___% live alone ___% live with kids ___% live with someone other than spouse or relative |
55% w/ spouse
30% live alone 12% live with kids or other relatives 2% live with someone other than spouse or relative |
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What years are the boomer generation?
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1943-1960
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T/F: It is only in times of stress that elders may be pushed beyond their limits to cope.
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True
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Does the gross size of the brain decrease as we age?
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Yes, slightly
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Does the hypothalamus lose neurons as we age?
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no
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Dendrites show age-related growth or loss during early old age?
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growth
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Is the sensory threshold to touch, pain & temperature diminished in the elderly?
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yes
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Do olfactory sense decrease or increase with age?
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decrease
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T/F: In most seniors, taste does not decrease.
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True
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T/F: Short-term memory, NOT congealed into an idea, declines with age.
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True
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List autonomic nervous system changes as we age
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-orthostatic hypotension
-impaired thermoregulation -urinary incontinence -impaired penile erection |
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What changes in sleep occur in the elderly?
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-EEG's show reduced wave amplitude and more REM interrupted episodes.
-Increased incidence of awakening |
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T/F: Exercise increases muscle strength in the elderly and can retard changes in the neuromuscular junction.
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True
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Does total lung capacity change with age?
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Yes
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More profound disturbance of homeostasis with a longer restorative phase is due to what?
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hormonal coordinating mechanism
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T/F: The epicenter of the aging phenomenon starts in the impairment of tissue & organ function.
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False- it starts in the macromolecules which leads to alterations in cell function
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Is trabecular bone mass similiar in both sexes?
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yes
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Cortical bones comprises about ___% of our skeleton.
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80%
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What is the disease in which the bone mineral density is reduced?
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Osteoporosis
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Horizontal or vertical struts in trabecular bone disappear with age?
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horizontal
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Osteonecrosis of the jaw can be associated with use of what two meds?
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Zometa and Aredia
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T/F: People over 80 with coronal or root caries are more likely to have an arrhythmia than those without active lesions.
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True
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What are the two biological mechanisms that explain the relationship between cardiovascular disease and periodontal disease?
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Through circulation and immunoinflammatory response
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What is hypertension known as?
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The silent killer
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What percent of patients over 65 are hospitalized for heart failure?
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80%
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T/F: Elderly people with active root caries have increased risk of having irregular heartbeats.
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False
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What is the leading cause of death for people over 65?
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Heart disease
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What is atherosclerosis?
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Inflammation of the heart muscles
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T/F: Elderly women are more at risk for hyertension than males
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True
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What bacteria can cause rheumatic fever?
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streptococcus
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If a heart murmur is caused by a previous cardiac condition, then the AHA recommends....
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No prophylaxis
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The most common nutritional disorder for people over 65 is obesity. Obesity does not contribute to any chronic diseases.
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First is true, second is false
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A healthy person should drink ____glasses of water a day.
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8
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The idea behind functional foods has been approved by the FDA
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False
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What percentage of elderly households report food insecurities?
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6
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Which of the following is not a category of food related behavior and tradition?
Nonessential Beneficial Neutral Potentially harmful |
Nonessential
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Older adults need an increase in which nutrients?
Calcium Vitamin D Vitamin B12 All of the above |
All of the above
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Chocolate is a functional food. Red wine and tea reduce the risk of cardiovascular disease.
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Both are true
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Which one is not a nutrition related problem?
Obesity Malnutrition Epilepsy Inactivity |
Epilepsy
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Most people spend ____of their income on food.
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20%
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What is/are the most common pathogens responsible for food borne illnesses?
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Salmonella
E. Coli Listeria |
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T/F The tendency to over estimate the state of ones health is common within the elderly?
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True
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T/F Those who minimize the extent of their disease are at risk for more severe outcomes?
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True
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T/F They often attribute a change in feeling or function to an external occurrence rather than disease?
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True
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Studies have shown that ____ % of older individuals have experienced symptoms in previous 30 days and only ____ % reported them.
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90%, 30%
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Nearly ____% named a relative when asked who they would consult about illness?
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90%
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Less than __% of 2000 symptoms were ever reported to any health care professional.
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1%
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Major functional decline occurring abruptly should be attributed to ______.
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Disease
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T/F Slow and modest functional decline are normal?
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True
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Unidentified problems influence each other and cause ______-______ interactions.
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Disease -disease
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Chronic means?
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Any disease lasting over 3 months
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____% of people over 65 have at least one chronic disease.
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80%
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The most common chronic diseases are?
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Arthritis 53%
Hearing Impairment 41% Hypertension 39% Heart Disease 33% |
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Over ___% of health care resources are devoted to chronic conditions
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80%
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Successful chronic disease management requires a _____, ______,________evaluation of all signs and symptoms.
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sensitive, accurate, comprehensive
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Preventive efforts should be concentrated on what?
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Management
Functional Improvement Postponing Deterioration |
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Activities of daily living (ADL) include:
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Mobility
Eating Toileting Dressing Grooming |
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Instrumental Activities of Daily Living (IADL):
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House keeping
Cooking Shopping Banking Driving or UsingPublicTransportation Ability to maintain good oral hygiene |
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Initial Medical Assessment of the Geriatric Patient includes
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YOUR FIRST IMPRESSION OF:
Physical apperance Nutritional State Posture Attitude Behavior *The patient SHOULD be seen alone for the first appointment |
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What should you do with a patient taking many medications?
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Ask them to bring ALL of them with them in a bag including OTC
Ask which are taken for what At what intervals Identify potential adverse reactions that may impact dental/oral interventions |
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T/F Nearly 20% of those over 75 have some degree of clinically detectable cognitive impairment.
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True
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T/F Temporary dementia can be side effect of many diseases?
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True
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Oral Health Assessment Includes?
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Asking the patients purpose for the visit
Ask about barriers to care such as: Finance, Fear, Anxiety, Transportation, Length/time of visits |
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Ask your patients if they have experienced what in previous dental visits?
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Fainting, Allergic Reactions, Abnormal Bleeding, or any other complications
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Successful communication will:
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Provide more accurate medical history
Allow practitioner to provide the most appropriate treatment Prevent errors in comprehension of home care practices Allow clear understanding of future appointments |
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Non-Verbal communication includes:
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Facial expression
Eye contact Gaze Body posture Physical disterbance Touch Convey fear, anxiety and pain |
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A patients non verbal communication may include:
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changes in posture
clenching fists flexing, tensing, tapping feet or palms scrunched up facial features heavy sighs restlessness |
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Cultural Differences Include:
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Comfortable speaking position
Avoiding or seeking eye contact Assuming a superior or inferior position Physical distance Lower educational achievement of elderly |
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65+ grow up in an era without _____ dentistry.
Dental visits were for emergency care only. |
Preventative
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Edentulous Patients:
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See a dentist less often
Come for emergencies only *Must educate them on the importance of maintaining functional level with their prosthesis. |
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Because of elders aging and memory they need?
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quite backgrounds
don't just assume they get it have a slower reaction time so we need to slow down put things in chronological order |
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Sensory changes include:
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Hearing loss of high frequency and low volume sounds
Tinnitus-high pitched ringing *Speak slowly |
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Keys to successfully managing a medically compromised elder include:
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Thorough evaluation and assessment to see if they can safely tolerate the procedure
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Four components of risk assessment include:
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1-Severity & stability of medical condition
2-Functional capacity 3-Emotional capactiy 4-Type and magnitude of the procedure |
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Untreated or Symptomatic Heart Failure Patients are NOT candidates for what?
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NOT candidates for elective treatment
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Untreated or Symptomatic heart failure includes what?
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Myocardial infarction
arrhythmia acute heart failure sudden death syndrome |
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T/F Avoid vasoconstrictors when on digitalis?
|
True
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Symptoms of heart failure include?
|
Shortness of breath
Swelling of feet & legs Chronic lack of energy Difficulty sleeping due to breathing problems Swollen or tender abdomen with loss of appetite Cough with frothy sputum Increased night-time urination Confusion/impaired memory |
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Angina
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If it is unstable or progressive- NO elective treatment
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Things to ask your patient if they have high blood pressure include?
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Are they on medications, if so have they taken it?
|
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Symptoms of high blood pressure include?
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Visual changes
Dizziness Headaches |
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AHA recommend prophylaxis for congenital heart disease if:
|
It is complex cyanotic heart disease
Valve repair with residual leak |
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Does artificial heart valve require premedication?
|
YES
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Arrhythmias are frequently related to?
|
Heart failure
Ischemic heart disease |
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Coronary artery bypass is when?
|
They graft a bypass to bypass an occluded vessel. Balloon catheters and metallic mesh stents are also commonly used.
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Predisposing conditions to a stroke include?
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Hypertension and Diabetes
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T/F Calcified atheromatous plaques may be seen in the carotid arteries on panoramic films
|
True
|
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Seizure triggers include?
|
Bright Lights & Odors
|
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True Allergy Symptoms Include?
|
Itching
Urticaria (hives) Rash Swelling Wheezing Angioedema Runny nose Tearing eyes |
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Not generally of allergenic origin include?
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Nausea
Vomiting Palpitation Fainting |
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What to know with asthma?
|
Type
Drugs taken Precipitating factors |
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If you have a prosthetic joint with these conditions you need an antibiotic prophylaxis:
|
Rheumatoid arthritis
Type 1 diabetes Recent joint placement Hemophilia Immunosuppressed |
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Kidney failure increased potential for:
|
Abnormal Drug metabolism
Immunosuppresive drug therapy Bleeding problems Hepatitis Infection HBP Heart failure |
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T/F Sexually transmitted disease can be transmitted to a hygienist through direct contact with oral lesions or infectious blood.
|
True
|
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If your patient has been previously hospitalized or had a surgery you should ask?
|
Diagnosis
Treatment Complications |
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Disability means?
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A person with physical or mental impairment that limits one or more major life activities
|
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What is called when you have a deficit in insulin secretion and or action?
|
hyperglycemia
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What is a group of metabolic diseases characterized by hyperglycemia?
|
diabetes mellitus
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____ of those with diabetes have not yet been diagnosed.
|
1/3
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Diabetes affects ___% -____% of the population.
|
6%-8%
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In some older populations the prevalence of diabetes 2 may be as high as ____%.
|
20-25%
|
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What are the greatest risk factors for diabetes?
|
-age (45 and older)
-obesity -smoking -sedentary lifestyle -hispanic or african american -hypertension -dyslipidemia -previously identified impaired glucose intolerance |
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What are the cardinal symptoms of hyperglycemia?
|
-polyuria (excessive urination)
-polydipsia (excessive thirst) -polyphagia (excessive hunger) -weight loss -blurred vision -increased susceptibility to infections -impaired growth |
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Is insulin shock from hypoglycemia or hyperglycemia?
|
hypoglycemia
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What emergency is most likely to occur when treating a diabetic?
|
insulin shock: occurs because too much insulin and not enough food. GIVE SUGAR!
|
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Is a diabetic coma from hypoglycemia or hyperglycemia?
|
hyperglycemia
|
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What causes a diabetic coma?
|
Too little insulin and too much food. Inject insulin, EMS.
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Is absolute insulin deficiency Type 1 or Type 2 diabetes?
|
Type 1
|
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Absolute insulin deficiency accounts for __to___% of those with diabetes.
|
5-10%
|
|
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Is insulin resistance with a relative, not absolute, insulin deficiency Type 1 or Type 2 diabetes?
|
Type 2
|
|
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What are Type 2 diabetes risk factors?
|
-obesity
-habitual physical inactivity -had baby weighing more than 9 Ibs -hypertension -age 45 or greater -blood relative with diabetes -low HDL cholesterol level |
|
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What is gestational diabetes mellitus?
|
Any degree of glucose intolerance with onset or first recognition during pregnancy.
|
|
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T/F: Women that experience gestational diabetes mellitus do not have a tendency to develop type 2 diabetes later in life.
|
False
|
|
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What is the primary cause of Type 1 diabetes?
|
the inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells. Progressive destruction of the B cells produces hyperglycemia that leads to ketosis and eventually ketoacidosis.
|
|
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T/F: Type 1 diabetes begins with genetic susceptibility to the disease.
|
True
|
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What is the drug of choice for treatment of Type 1 diabetics?
|
Insulin
|
|
|
Developmental disability is?
|
A substantial handicap of indefinate duration before the age of 18
|
|
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Impairment means?
|
an abnormality of structure or function of a limb or organ, whereas the disability is the inability to preform a task or activity as a result.
|
|
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Handicap means?
|
The disadvantage or limitation that an individual has when compaired with others of the same age, sex or background.
|
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Information to obtained about a disabled patient includes:
|
1-Who is responsible for informed consent
2-Do you have permission to discuss their care with someone else? 3-Will the caregiver accompany the patient? 4-Degree of independence, self care and way to communicate |
|
|
Dental history of a disabled patient should include?
|
1-Difficulties with appointments
2-Most recent care 3-History of oral infections and habits 4- Current home care methods 5-Precieved needs and attitudes 6-Mobility 7-Sitting tolerance 8-Ability to cooperate |
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|
Neuromuscular Problems may have:
|
high gag reflex or rigid/loos masticatory muscles.
*keep chin down, and head slightly to the side, use short acting anesthetic |
|
|
Paraplegia
|
an impairment of motor and/or sensory functions of the lower extremities due to spinal cord injury BELOW the first thoracic vertebra or congenital condition such as spina bifida
|
|
|
Quadriplegia/Tetraplegia
|
an impairment of motor and/or sensory functions resulting in complete or partial paralysis of ALL four limbs due to a spinal cord injury ABOVE the first thoracic vertebra
|
|
|
Steps of a wheel chair transfer:
|
1: Prepair the Op:Move everything out of the way, position chair at same height or slightly lower than the wheelchair
2:Determine the patients needs: Patients ability to help, preferred method, Reduce the patients anxiety by announcing each step before you do it. 3:Wheelchair preparation: Position it close to and parallel to the dental chair, lock wheels, remove foot/arm rests, check for special padding or equipment |
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Paraplegic Self Transfer
|
1:Patient removed impediments and confirms that dental chair is at the same level
2: Removes arm rests, puts board under butt and on dental chair |
|
|
What does the duration of insulin depend on?
|
-if its short or long acting
-route of administration -patient-dependent factors |
|
|
What is the treatment of choice for type 2 diabetics?
|
oral hypoglycemic agents used in conjunction with diet, exercise, and possibly injection of insulin
|
|
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Patients taking insulin are at risk for what 2 things?
|
hypoglycemia and insulin shock
|
|
|
Examples of oral medications for type 2 diabetes
|
Metformin
Avendon Januvia |
|
|
Pancreas transplantation has eliminated need for exogenous insulin in many type 1 or type 2 patients?
|
Type 1
|
|
|
Do patients that have a pancreas transplantation require pre-med?
|
yes
|
|
|
What is the healthy, well controlled blood glucose levels for fasting and postprandial testing?
|
fasting: <126 mg/dL
Postprandial: <160 mg/dL |
|
|
What is the moderate control blood glucose levels for fasting and postprandial testing?
|
fasting: <160 mg/dL
Postprandial: 160-200mg/dL |
|
|
What is the uncontrolled blood glucose levels for fasting and prosprandial testing?
|
fasting: >160 mg/dL
Postprandial: >200mg/dL |
|
|
What test measures the amount of glucose irreversibly bound to a hemoglobin molecule?
|
HbA1c
|
|
|
The HbA1c indicates gylcemic control over how many months?
|
2-3 month period
|
|
|
What is the healthy, well controlled HbA1c percentage?
|
<6%
|
|
|
What is the moderate control HbA1c percentage?
|
6-7%
|
|
|
What is the uncontrolled HbA1c percentage?
|
>8%
|
|
|
T/F: An uncontrolled diabetic patient may require antibiotic premedication.
|
True
|
|
|
T/F: With increasing blood glucose levels may also decrease glucose levels in saliva and gingival sulcus.
|
False; increase glucose leves
|
|
|
T/F; most people are aware of the correlation between diabetes and periodontal disease.
|
False
|
|
|
Of the 20.8 million of diabetics, there is an estimate of ________ people who have not yet been diagnosed.
|
6 million
|
|
|
T/F: Their is already focus on the effects of diabetes and oral health being taught on diabetic clinics.
|
False
|
|
|
What is the most common form of dementia?
|
Alzheimer's disease
|
|
|
One Person Transfer
|
1: Can use arm pits, with patient arms clasped in front,
2: movers knees and feet on the outside of the patients 3: Pivot patient over top of dental chair, seat patient 4: Move patients legs on to chair |
|
|
Multidisiplinary Model
|
Separate from other sources, no outside input
MD makes all decisions unilaterally |
|
|
Interdisciplinary Model
|
Team leadership rotates
Decision making is shared Encourages equality Challenges team members to increase their knowledge |
|
|
Role of the dentist/hygienist in an interdisciplinary team
|
become knowledgeable about each members discipline and how it relates to oral health
Participate as a team member |
|
|
The patients role as a team member in an interdisciplinary team
|
Most important member
autonomy/cooperation is vital to success Make decisions If incompetent a family member is responsible for decisions |
|
|
Nursing Staffs role as a team member in an interdisciplinary team
|
provide most current information on overall health, medications, functional status, cognitive impairment
consult with home care regimens |
|
|
Occupational Therapists role as a team member in an interdisciplinary team
|
helps patient maximize their functional skills and skills of daily living
consult regarding functional status work with to devise aids that enable home care |
|
|
Speech/Language Pathologist role as a team member in an interdisciplinary team
|
consult for help with swallowing
can assist DDS in developing intra oral divices to enhance speech and swallowing |
|
|
Social Workers role as a team member in an interdisciplinary team
|
Determine social service needs
Financial status, living conditions councils family in making decisions |
|
|
Pharmacist role as a team member in an interdisciplinary team
|
Can advise DDS in making alternate RX choices in minimize interactions
Consult regarding unfamiliar meds |
|
|
T/F: Alzheimer's disease develops rapidly.
|
False; it develops slowly over time
|
|
|
Alzheimer's disease affects ___% of the population between the ages of 65 and 74.
|
3%
|
|
|
What is the etiology of Alzheimer's disease?
|
-nerve cells die in areas of the brain that are vital to memory and other mental abilities
-connections between nerve cells are disrupted -lower levels of chemicals in the brain that carry messages between nerve cells -affects memory, judgment and thinking |
|
|
What are the 2 types of Alzheimer's disease?
|
Early onset: patients in their 30's & 40's
Late onset: people over 65 |
|
|
What type of Alzheimer's disease is most common?
|
Late onset
|
|
|
Which type of Alzheimer's disease involves
-memory loss and poor memory of recent events -trouble naming common items -ask the same thing over & over -get lost easily -lose interest in things -lose things more often than normal |
Mild Alzheimer's disease
|
|
|
Which type of Alzheimer's disease have personality changes and they tend to be worried of depressed?
|
Mild Alzheimer's disease
|
|
|
Which type of Alzheimer's disease have a hard time dressing for the weather, forget to shave or shower, argue more often, and believe things are real when they are not?
|
Moderate Alzheimer's disease
|
|
|
Which type of Alzheimer's disease do people have that wander, often at night, need close supervision, and trouble with tasks such as washing dishes or setting a table?
|
Moderate Alzheimer's disease.
|
|
|
Which type of Alzheimer's disease do people have problems with eating, problems with speech or cannot speak at all, not able to recognize family member and problems with walking?
|
Severe Alzheimer's disease
|
|
|
Which type of Alzheimer's disease do people have that are not able to control bowels or bladder?
|
Severe Alzheimer's disease
|
|
|
Which medication do patients receive with mild or moderate symptoms of Alzheimer's disease?
|
Cholinesterase inhibitors
|
|
|
How does Alzheimer's disease affect your patients' oral health?
|
-impaired cognition
-impaired apathy -impaired apraxia -medications leading to xerostomia |
|
|
What is a chronic and disabling disorder with cognitive impairment?
|
dementia
|
|
|
T/F: Dementia occurs only in the elderly.
|
False: it can occur in ANY stage of adulthood.
|
|
|
T/F: Non-disabling memory impairment in old age (age association memory impairment) is not considered dementia.
|
True
|
|
|
Roles of a team leader
|
Skilled communicator: delegation, conflict resolution, gate keeping
Ensure productive use of time Restating goals Clarifying roles Making sure each member has adequate input |
|
|
Effective team members
|
Remain focused
Contribute Trust Frequent communication Improves with practice |
|
|
Team Recorder
|
Documents team proceedings
Facilitating progress towards goals Initiates team maintanance discussions |
|
|
SOAP
|
Subjective, Objective, Assessment, Plan
Ex: Subjective: patient has had a head ache for two weeks Objective: BP: 175/100, P: 75 Resp: 20 Assessment: Headache, cause unknown Plan: Plan of action includes xrays, drugs, pt education |
|
|
Four stages in group development & communication facilitate productivity they are:
|
Forming : groups or teams initially test the establishment of dependent relationships and establish interpersonal boundaries
Storming: Conflict of interpersonal issues Norming:Team building and start to function as a group. Intimate and personal opinions are expressed Preforming:The interpersonal structure becomes the tool of task activities. Structural issues are resolved |
|
|
Conflict can be identified by types they are:
|
Goal conflict
Role conflict Power/Status conflict Interpersonal conflict |
|
|
Styles of Conflict Management:
|
Competitive
Avoidance Accommodation Compromise Collaborates |
|
|
dementia divided into?
|
-idiopathic dementia (primary degenerative dementia)
-vascular dementia -secondary dementia |
|
|
T/F: the final stage of Alzheimer's disease and senile dementia are similiar in that they both involve sever disorentation of all mental functions.
|
True
|
|
|
Symptoms for dementia include:
|
-sensory, motor and perceptual capacities reduced
-visuo-spacial recognition decreased -Aphasia, agnosia, and disorientation to space, time, and person -Emotional state -Interest in social life reduced -Patients may suffer from weight loss |
|
|
___% of the population 65 yrs of age or older have organic dementia, and that ____% of the dementia cases are considered, to be Alzheimer's.
|
-5-6%
-50-60% |
|
|
T/F: Dementia DOES NOT necessarily imply impairment of only intellectual.
|
True
|
|
|
T/F: Today vasodialators are used for treatment of dementia.
|
False: the use of vasodialators has almost been abandoned.
|
|
|
Stroke is the ____leading cause of death.
|
3rd
|
|
|
Dementia usually gets worse and often decrease quality of life and lifespan. T/F
|
True
|
|
|
Neglect or abandonment by caregivers
|
*Failure to fulfill a caretaking obligation
*Two types: Active (intentional) Passive (unintentional) |
|
|
What causes depression?
|
*Chronic pain and illness
*Changes in the family *Difficulty getting around *Frustration with memory loss *Trouble adapting to life change *Medical problem *Side effect of drugs *Lack of social network |
|
|
Is Depression a normal part of aging?
|
NO
|
|
|
Successful transplantation has eliminated the need for exogenous insulin in many type 1 patients. Lifelong immunosuppression therapy is not needed because every transplant surgery is successful.
|
First statement true, second statement false
|
|
|
The primary cause of type 1 diabetes comes from the inability of the ___________ to secrete __________ because of autoimmune destruction of the _______ cells.
|
Pancreas, Insulin, Beta
|
|
|
Which of the following is NOT a risk factor for Type 2 Diabetes?
|
Normal/thin body weight
|
|
|
4. In Type 2 diabetes, the B cells are destroyed and no insulin is produced. Type 1 Diabetes has periodic reduction in insulin secretion, resulting in a receptor defect.
|
both statements are false
|
|
|
Ketoacidosis is a complication of type I diabetes
|
false
|
|
|
Which complication is not associated with diabetes mellitus?
|
gall stones
|
|
|
The following are cardinal symptoms of Diabetes EXCEPT?
|
polycythemia
|
|
|
Type II diabetes shows normal, increased or decreased insulin by the pancreas. Type I Diabetes shows no insulin produced by the pancreas and a defective receptor
|
First statment true, second statement false
|
|
|
Your Diabetic patient presents with a HbA1c greater than 8 percent. Which route of treatment do you proceed with?
|
Postpone elective care, and consult thier physician.
|
|
|
Uncontrolled postprandial blood glucose scores are greater than?
|
200
|
|
|
Who is effected most by depression?
|
Woman
|
|
|
The elderly account for what percentage of all suicides?
|
20%
|
|
|
What percent of elderly experience symptoms of depression?
|
10%
|
|
|
What percent of elderly experience major depression?
|
1-2%
|
|
|
What medications are most commonly prescribed for elderly?
|
SSRI's
|
|
|
How many deaths occur annually in the US because of stroke?
|
275,000
|
|
|
What is the leading cause of serious, long-term disablility in the U.S.?
|
Stroke
|
|
|
T/F: Recurrent stroke is rare.
|
F: recurrent stroke is frequent
|
|
|
___% of people who have had a stroke will have another in 5 years.
|
5%
|
|
|
Death rates are higher for whites or African Americans involving strokes?
|
African Americans
|
|
|
Nearly ____ of all strokes occur in people over the age of 65.
|
3/4
|
|
|
T/F: the risk of having a stroke more than doubles each decade after the age of 55.
|
True
|
|
|
What are the signs of a stroke?
|
-sudden numbness of face, arm, or leg
-sudden confusion, touble speaking or understanding speech -sudden trouble seeing, walking, dizziness |
|
|
What are the risks of stroke?
|
-radiographic manifestation of calcified atherosclerotic
-severe perio bone loss is associated with carotid artery plaques and increased risk of stroke |
|
|
What type of stroke is the most common of all strokes?
|
Ischemic stroke
|
|
|
What type or stroke is caused by a clot or other blockage within an artery leading to the brain?
|
Ischemic stroke
|
|
|
What type of stroke is caused by a sudden rupture of an artery within the brain; blood is then released into the brain, compressing the brain structures?
|
Intracerebral Hemorrhage
|
|
|
What type of stroke is caused by the sudden rupture fo an artery, location of the rupture leads to blood fills the space surrounding the brain rather than inside it?
|
Subarachnoid Hemorrhage
|
|
|
What are some risk factors for stroke?
|
-chronic hypertension
-gender -atherosclerosis -tobacco use -heart disease -elevated cholesterol and lipid levels -obesity -inactivity -family history of stroke -endocarditis -sleep apnea -sickle cell anemia -cocaine use |
|
|
What is hemiplegia?
|
complete paralysis on one side of the body
|
|
|
What is hemiparesis?
|
one sided weakness
|
|
|
What is dysarthria?
|
difficulty speaking
|
|
|
What is dysphagia?
|
difficulty swallowing
|
|
|
What are the oral effects after a stroke?
|
-loss or difficulty in speech
-unilateral paralysis of opralfacial musculature -loss of sensory stimuli of oral tissues -tongue may be flaccid with multple folds (may deviate on extrusion) -food, debris, etc. may accumulate around the teeth, under tongue or in alveolar folds |
|
|
When someone has a stroke how long do you defer treatment?
|
6 months
|
|
|
What is the most common nutritional disorder for people over 65?
|
obesity
|
|
|
What percentage of ppl are considered overweight?
|
34% of woman
44% of men aged 65-74 |
|
|
What percentage of ppl are considered obese?
|
27% of woman
25% of men aged 65-74 |
|
|
What percentage of americans have one chronic disease?
|
80%
|
|
|
What percentage of americans have two or more chronic diseases?
|
50%
|
|
|
Why do nutrient amounts need to be changed in older adults?
|
because their lack of absorbtion, utilization, and excretion.
|
|
|
How much calcium should older adults have?
|
1,200 milligrams
|
|
|
How much Vitamin D should older adults have?
|
10 micrograms for adults 51-70
15 micrograms for adults over 70 |
|
|
How much Vitamin B12 should older adults have?
|
2.4 micrograms
|
|
|
How much water should you have a day?
|
8 glasses
|
|
|
Dental management for people that have had a stroke
|
-contraindication for elective treatment
-identify risk factors -encourage control of risk factors -obtain thourough health history -short stress free, midmorning appointments -recognized signs and symptoms -actaivate EMS if necessary |
|
|
During treatment for people that have had a stroke
|
-may require help getting into chair
-losts of suction; keep airway clear -monitor blood pressure and oxygen saturation -limit vasoconstrictors -more aggressive treatment planning; more frequent recalls |
|
|
Appoximately what percentage of dopamine in the nigrostriatal pathway of the brain must be depleted before symptoms of Parkinson's disease arise?
|
80%
|
|
|
Is Parkinson's disease acute or chronic?
|
chronic and progressive
|
|
|
What is the most common sign for Parkinson's disease?
|
tremors
|
|
|
What complications come from Parkinson's disease?
|
-depression
-sleep problems -difficulty chewing -difficulty swallowing -urinary problems -constipation -sexual dysfunction |
|
|
When people have Parkinson's disease, some medicine induced problems include:
|
-involuntary twitching or jerking movements
-hallucinations -sleepiness -drop in BP when standing |
|
|
With people that have Parkinson's disease is the jerking and involuntary movements from the disease or from the medication?
|
medication
|
|
|
T/F: Antiparkinsonian drugs can be CNS depressants.
|
True
|
|
|
When should people with Parkinson's disease recieve dental care during the day?
|
During the time of day at which their medication has the max effect which is 2 to 3 hours after taking it
|
|
|
What happens if you have Vit D defieciency?
|
bone mineralization
|
|
|
benefits of phytochemicals and antioxidants?
|
reduce the risk of cancer
|
|
|
benefits of enhanced fortified foods?
|
enhances the level of specific food component
|
|
|
benefits of dietary fibers?
|
produce lower serum cholesterol reducing the risk of coronary heart disease
|
|
|
benetits of red wine and tea?
|
reduce the risk of cardiovascular disease
|
|
|
benefits of chocolate?
|
boost the immune system, reduces blood clots, arrests DNA damage
|
|
|
the elderly have an overall better diet
|
TRUE
|
|
|
what contributes to poor diet among older people?
|
lack of taste and smell, and depression
|
|
|
What percent of households report food insecurities?
|
6%
|
|
|
Food insecurity leads to what?
|
compromised immune function, and development of chronic disease
|
|
|
Decline of organ functions can begin as early as what age?
|
30
|
|
|
Hypogeusia
|
loss of taste
|
|
|
Anosmia
|
loss of sense of smell
|
|
|
dysphagia
|
difficulty swallowing
|
|
|
where would one go to get nutritional information?
|
county health department
|
|
|
Food Borne Illnesses
|
76 million illnesses
325,000 hospitalizations 5,000 deaths ` |
|
|
what are the 3 most common pathogens responsible for food borne illnesses?
|
1. Salmonella
2. E.Coli 3. Listeria |
|
|
USDA label of organic food requirements
|
animals are fed organic foods that dont contian part of other animals, have not been given growth hormones or antibiotics, have been allowed outdoors.
|
|
|
Healthy Eating Index (HEI)
|
*64-74: 13% good, 70% needs improvement, 18% poor
*75-84: 21% good, 67% needs improvement, 13% poor *85+: 20% good, 65% needs improvement, 15% poor |
|
|
Oral complications from drugs used for people with Parkinsons disease include:
|
xerostomia
nausea tardive dyskinesia |
|
|
T/F: People with Parkinson's disease should have more frequent dental visits.
|
True
|
|
|
What are colon polys?
|
Extra tissue that grows inside your large intestine.
-most are benign but as you age they can turn into cancer |
|
|
What are the causes of colon polyps?
|
-eating fatty foods, not exercising, smoking, alcohol
|
|
|
T/F: If you are over 50 your chance of getting polyps decreases.
|
False: increases
|
|
|
What are the symptoms of colon polyps?
|
Not many symptoms but some may occur including:
-anal bleeding and constipation that lasts more than a week |
|
|
What is a peptic ulcer?
|
A sore on the lining of the stomach or duodenum
|
|
|
How often do peptic ulcers occur?
|
1 in every 10 Americans
|
|
|
T/F: Peptic ulcers are caused by spicy foods and stress.
|
False
|
|
|
What bacteria causes peptic ulcers?
|
H. pylori
|
|
|
What are the symptoms of peptic ulcers?
|
dull aching occuring 2-3 hours after meal which can be relieved by eating again
|
|
|
How are peptic ulcers treated?
|
with drugs that kill the bacteria which include H2 blockers and proton pump inhibitors
|
|
|
What is Crohn's Disease?
|
-inflammation in the small intestine
-can cause pain and makes the intestine empty frequently which causes lots of diarrhea |
|
|
T/F: Crohn's disease is hereditary.
|
True
|
|
|
Symptoms for Crohn's disease include:
|
Abdominal pain
Gas and bloating Change in bowel habits |
|
|
IBS treatment include:
|
-avoid caffeine
-monitoring foods -increasing fiber intake -minimizing stress |
|
|
What is incontinence?
|
is uncontrolled leaking of urine from the bladder
|
|
|
What are the different types of urinary incontinence?
|
-stress incontinence
-urge incontinence -overflow incontinence -total incontinence -functional incontinence |
|
|
What disease do almost half of all elderly people have?
|
arthritis
|
|
|
What is arthritis?
|
Stiffness, pain, and tenderness around the joints
|
|
|
Arthritis most commonly affects what body parts?
|
hands, feet, knees, and hips
|
|
|
What is a chronic inflammatory disease characterized by pain, swelling, and stiffness in joints?
|
Rheumatoid Arthritis
|
|
|
Rheumatoid arthritis affects __% of the population in allraces and ethnic backgrounds?
|
1%
|
|
|
Does rheumatoid arthritis affect more often in women or men?
|
women
|
|
|
What is the most common oral manifestation in Rhematoid Arthritis?
|
TMJ involvement
|
|
|
___% of people with Rhematoid Arthritis experience TMJ problems.
|
75%
|
|
|
What are the 2 types of sleep apnea?
|
-Obstuctive sleep apnea (OSA)
-Central Sleep Apnea (CSA) |
|
|
On average, it is estimated that about ___%-___% of the adult population are affected by Obstructive Sleep Apnea.
|
2%-5%
|
|
|
Are males or females affected more with sleep apnea?
|
Males
|
