Od - Health History Pg 17-32

Front 1

what bleeding disorder test tests the extrinsic and the common pathways?

Back 1

prothrombin time (PT)

Front 2

What is the normal value for the prothrombin time test?

Back 2

11-15 seconds

Front 3

what bleeding disorder test tests the intrinsic pathway and the common pathway?

Back 3

partial prothromboplastin time (PTT)

Front 4

what is the normal value for partial prothromboplastin time?

Back 4

25-40 seconds

Front 5

what test evaluates platelet function there the normal value is <5?

Back 5

bleeding time (BT)

Front 6

what increases bleeding time?

Back 6

NSAIDS and ASA

Front 7

what is used to standardize a PT test with the normal value being 1.0-3.0?

Back 7

international normalized ratio (INR)

Front 8

what is a well-defined break in the GI mucosa that results from chronic acid-pepsin secretions?

Back 8

peptic ulcer

Front 9

80% of ulcers are found where?

Back 9

duodenum

Front 10

20% of ulcers are found where?

Back 10

stomach

Front 11

what bacteria causes stomach ulcers?

Back 11

helicobacter pylori

Front 12

what is used to treat stomach ulcers caused by helicobacter pylori?

Back 12

tetracycline or amoxicillin

Front 13

avoid giving a stomach ulcer pt what drugs?

Back 13

aspirin, NSAIDS, or corticosteroids

Front 14

what signs would you look for in the mouth of a pt who has stomach ulcers?

Back 14

fungal overgrowth (Candidiasis) during/after antibiotic use, enamel dissolution of teeth associated w/ gastric reflux

Front 15

overgrowth of yeast found in the normal oral flora that can proliferate when the flora is changed from antibiotic use

Back 15

Canidiasis (candida albicans)

Front 16

what do you use to treat canidiasis?

Back 16

antifungal drugs i.e. Nystatin

Front 17

gingival hyperplasia due to epilepsy medication

Back 17

dilantin hyperplasia

Front 18

tx for dilantin hyperplasia

Back 18

gingivectomy or medication change or both

Front 19

what causes the loss of the ability to oxidize carbohydrates in diabetes?

Back 19

faulty pancreatic activity or no response to insulin

Front 20

Etiology of diabetes (4 things)

Back 20

1. Genetic disorder (type 1 or 2)
2. destruction of the Islet cell by inflammation, cancer or surgery
3. Endocrine condition like hyperpituitarism or hyperthyroidism
4. Iatrogenic disease from glucocorticoid steroid use

Front 21

The number of diabetic cases have increased due to increases in what?

Back 21

population, life expectancy, number of obese people

Front 22

How much of the diabetic population have type I?

Back 22

5-10%

Front 23

How much of the diabetic population has type II?

Back 23

90-95%

Front 24

signs and symptoms of diabetes

Back 24

3 P's, weight loss and strength loss, blurred vision, parathesias

Front 25

what are the 3 P's of diabetes symptoms?

Back 25

polydipsia - increased thirst
polyphagia - increased hunger
polyuria - increased urination

Front 26

diet and exercise, insulin injections, continuous infusion, and pancreatic transplant are all tx for which type of diabetes?

Back 26

type I

Front 27

diet and exercise, oral hypoglycemic meds, insulin plus oral hypoglycemic meds, insulin are treatment options for which type of diabetes?

Back 27

type II

Front 28

what are the 4 major complications from diabetes?

Back 28

blindness, kidney disease, heart disease and stroke, nerve disease and amputation

Front 29

gestational diabetes appears during pregnancy during which trimester(s)?

Back 29

2nd and 3rd

Front 30

when do you test for gestational diabetes?

Back 30

first prenatal visit then again at 24-28 weeks

Front 31

diabetes can develop secondary to what?

Back 31

pancreatic disease, hormonal disease, drugs

Front 32

gingival hyperplasia due to epilepsy medication

Back 32

dilantin hyperplasia

Front 33

tx for dilantin hyperplasia

Back 33

gingivectomy or medication change or both

Front 34

what causes the loss of the ability to oxidize carbohydrates in diabetes?

Back 34

faulty pancreatic activity or no response to insulin

Front 35

Etiology of diabetes (4 things)

Back 35

1. Genetic disorder (type 1 or 2)
2. destruction of the Islet cell by inflammation, cancer or surgery
3. Endocrine condition like hyperpituitarism or hyperthyroidism
4. Iatrogenic disease from glucocorticoid steroid use

Front 36

The number of diabetic cases have increased due to increases in what?

Back 36

population, life expectancy, number of obese people

Front 37

How much of the diabetic population have type I?

Back 37

5-10%

Front 38

How much of the diabetic population has type II?

Back 38

90-95%

Front 39

signs and symptoms of diabetes

Back 39

3 P's, weight loss and strength loss, blurred vision, parathesias

Front 40

what are the 3 P's of diabetes symptoms?

Back 40

polydipsia - increased thirst
polyphagia - increased hunger
polyuria - increased urination

Front 41

diet and exercise, insulin injections, continuous infusion, and pancreatic transplant are all tx for which type of diabetes?

Back 41

type I

Front 42

diet and exercise, oral hypoglycemic meds, insulin plus oral hypoglycemic meds, insulin are treatment options for which type of diabetes?

Back 42

type II

Front 43

what are the 4 major complications from diabetes?

Back 43

blindness, kidney disease, heart disease and stroke, nerve disease and amputation

Front 44

gestational diabetes appears during pregnancy during which trimester(s)?

Back 44

2nd and 3rd

Front 45

when do you test for gestational diabetes?

Back 45

first prenatal visit then again at 24-28 weeks

Front 46

diabetes can develop secondary to what?

Back 46

pancreatic disease, hormonal disease, drugs

Front 47

what are some of the oral complications from diabetes?

Back 47

infection, poor healing, periodontal disease, caries, periapical abscess, candidiasis, burning mouth, xerostomia

Front 48

what are the 3 major complications of diabetes in healing?

Back 48

hyperglycemia, ketoacidosis, vascular wall cahnges resulting in vascular insufficiency

Front 49

normal fasting blood glucose level

Back 49

< 100 mg/dL

Front 50

pre-diabetes has a fasting blood glucose level of what?

Back 50

100-125 mg/dL

Front 51

do not treat pt if blood glucose level is what?

Back 51

>200 mg/dL

Front 52

three criteria used for diagnosis of diabetes mellitus

Back 52

1. symptoms of diabetes plus causal plasma glucose concentration > 200 mg/dl
2. FPG > 126 mg/dl
3. 2 hour postload glucose level > 200 mg/dl during an OGTT

Front 53

symptoms of mild stage insulin shock

Back 53

hunger, weakness, tachycardia, pallor, sweating, paraesthesias

Front 54

symptoms of moderate stage of insulin shock

Back 54

incoherence, uncooperativeness, belligerence, lack of judgment, poor orientation

Front 55

symptoms of severe stage of insulin shock

Back 55

unconsciousness, tonic or clonic movements, hypotension, hypothermia, rapid thready pulse

Front 56

sustained abnormal elevation of arterial pressure usually asymptomatic

Back 56

hypertension

Front 57

control target bp for hypertension

Back 57

140/90

Front 58

target bp for pts with diabetes or renal disease

Back 58

130/80

Front 59

etiology for infectious mononucleosis

Back 59

epstein-barr virus

Front 60

common types of intestinal disorders

Back 60

Crohn's disease (inlammatory bowel disease - IBD)
gastritis
GERD (gastric esophageal reflux disease)

Front 61

oral manfestations of GERD

Back 61

severe erosion due to reflux of stomach acid
sensitivity of teeth
burning tongue

Front 62

is antibiotic prophylaxis before dental tx necessary for pts with artifical heart valves?

Back 62

yes - bc they are susceptible to bacterial endocarditis

Front 63

heart murmur is caused by what?

Back 63

turbulence of blood circulating through the valves and chambers of the heart

Front 64

organic heart murmurs may be caused by what?

Back 64

stenotic valve
regurgitation of blood from endocardial fibrosis (floppy incompetent valve)
combination of the two
MVP
RHD
autoimmune disease

Front 65

are valves on the L or R side of the heart more commonly affected with murmurs?

Back 65

left

Front 66

allergies to aspirin may produce what symptoms?

Back 66

urticaria or edema

Front 67

acute atrophic candidiasis is caused from what?

Back 67

steroid asthma inhaler

Front 68

tension headaches produce pain where?

Back 68

frontal bone, occipital area, muscles of the neck

Front 69

hypertension can produce what types of headaches and pain?

Back 69

headaches in occipital area, visual disturbances, muscle aches in lower extremeties

Front 70

temporal headaches may be related to what?

Back 70

TMJ problems

Front 71

noises in the ear such as buzzing, roaring, or ringing is called what?

Back 71

tinnitus

Front 72

chronic disease of the inner ear characterized by recurrent episodes of vertigo

Back 72

Meinere's disease

Front 73

antisialogogue

Back 73

drug that reduces, slows, or prevents the flow of saliva

Front 74

frequent colds are characterized to occur how often?

Back 74

more than 3 or 4 per year

Front 75

angina pectoris suggests what?

Back 75

insufficiency of the blood supply to the heart

Front 76

increase in appetite w/ no wt gain suggests what?

Back 76

hyperthyroidism or diabetes

Front 77

decrease in appetite may suggest what?

Back 77

hepatitis, infectious mononucleosis, anorexia, depression, GI cancer, or AIDS

Front 78

most common causes of indigestion

Back 78

peptic ulcer and gall bladder disease

Front 79

what is considered frequent urination?

Back 79

> 6x a day

Front 80

how do you approach tx for a pregnant lady in 1st trimester?

Back 80

avoid elective tx, ER tx only, may perform prophy w/ visual exam
most critical time for teratogenicity
development of major organs in fetus

Front 81

which trimester is the most ideal for dentistry?

Back 81

2nd - fetus is past critical stage and mother is not too large to be uncomfortable in chair

Front 82

ASA I classification

Back 82

Normal healthy pt, no dental management alterations, no probs climbing stairs or running at least 2 min

Front 83

ASA II classification

Back 83

mild systemic disease that does not interfere w/ day-to-day activity or that has a significant health risk factor i.e. mild hypertension, type 2 diabetes, well controlled epilepsy, etc

Front 84

ASA III classification

Back 84

pt w/ moderate to severe systemic disease that is not incapacitating but may alter day-to-day activity i.e. type 1 diabetes, COPD, moderate HT, etc

Front 85

ASA IV classification

Back 85

pt w/ severe systemic disease that is constant threat to life. pt will be unable to do light activity for short period of time and may experience discomfort at rest
i.e. severe HT, liver failure, advanced AIDS, etc

Front 86

what is a manifestation of diabetes that causes a decrease in phagocytic function of granlocytes in the area of injury and facilitates growth of microorganisms?

Back 86

hyperglycemia

Front 87

what is a manifestation of diabetes that causes a delay in migration of granulocytes in the area of injury and decreases phagocytic activity?

Back 87

ketoacidosis

Front 88

what is a manifestation of diabetes that causes a decrease in blood flow, granulocytes, and oxygen tension in injury?

Back 88

vascular wall changes resulting in vascular insufficiency

Front 89

what is the leading cause of blindness in people ages 20-74?

Back 89

diabetes

Front 90

what is the leading cause of end-stage renal disease?

Back 90

kidney disease from diabetes

Front 91

60-70% of diabetes sufferers have a mild to severe form of what?

Back 91

diabetic nerve damage

Front 92

fasting is no caloric intake for at least how long?

Back 92

8 hrs

Front 93

hypertension causes long term damage to what structures?

Back 93

heart, brain, eyes, kidneys, and blood vessels

Front 94

all calcium channel blockers, especially Nifedipine can cause what oral manifestations?

Back 94

gingival hyperplasia

Front 95

what would you do while your are working on a pt who has high blood pressure to avoid postural hypotension?

Back 95

provide gradual changes of position

Front 96

how is mono transmitted?

Back 96

by oropharyngeal route

Front 97

what is the tx for mono?

Back 97

bed rest, analgesics, aantipyretics, acyclovir, gargling with wars salty water

Front 98

what are the earliest signs of oral manifestations of mono?

Back 98

multiple red petechiae

Front 99

what are the other oral manifestations from mono?

Back 99

acute ulcerative gingivitis, pharyngeal ulcerations, exudative tonsillitis

Front 100

what are 2 types of prosthetic heart valves?

Back 100

mechanical and porcine

Front 101

what does an increased flow rate of blood, change in viscosity, narrowed valves or vessels, dilated valves or vessels, or a vibration of the valve leaflets cause?

Back 101

turbulence

Front 102

ow do you diagnose a heart murmur/determine cause of turbulent flow?

Back 102

testing

Front 103

sounds caused by turbulence in the absence of a cardiac abnormality

Back 103

functional/innocent murmur

Front 104

sounds caused by a pathologic/valvular disorder in the heart

Back 104

organic murmur

Front 105

organic/pathologic murmurs are heard most often during what?

Back 105

diastole

Front 106

reduced orifice bw heart chambers

Back 106

stenotic valve

Front 107

regurgitation of blood from endocardial fibrosis results in what?

Back 107

floppy, incompetent valve

Front 108

a III/VI diastolic murmur is heard best where?

Back 108

over the fourth rib radiating to the axilla