Os731 Fall 2012

Front 1

mx/mn position, insufficient width, length/projection, loss of retroglottic & upper airway space results in ____ in theory

Back 1

this is hypothesis of sleep apnea

Front 2

sleep apnea corrected via

Back 2

correction of mx/mn position increases space & sucessfuly treats obstructive sleep apnea

Front 3

T/F

sleep apnea & obstructive sleep apnea are synonymous

Back 3

False

Front 4

poor concentration, inappropriate sleep & 10 more are symptoms of sleep apnea?

Back 4

poor memory, increased irritability, chronic fatigue, decreased libido, some depression, claustrophobia, rapid sleep onset, avoidance of social events, awakening w/ a headache, and sweating in sleep

Front 5

OSA associated with
gender?
diet?
other?

Back 5

male
Age
Obese
Alcohol/Tobacco

Front 6

Consequences of OSA?

(daily & more long term)

Back 6

daytime sleepiness

arthrosclerotic-hypoxic sequelae

Front 7

Sleep apnea is mediated from 2 different sources. what are they?

hint: one is airway obstruction

Back 7

1. airway obstruction

2. CNS mediated

Front 8

central vs. obstructive vs. mixed sleep apnea. what's the frequency %?

Back 8

1% Central

14% Mixed

84% Obstructive

perhaps understatement of CNS

Front 9

SA is multifactorial. 6 items listed, 2 include lifestyle, cardiac, list others

Back 9

primary CNS
Upper airway
cardiac
pulmonary
substances
lifestyle

Front 10

Central Sleep Apnea - conditions that contribute to chronic anoxia, such as CHF, pickwickian synd., A-V malformations (septal defects) & what?

Back 10

pulmonary fibrosis

CHF, pickwickian syndrome
A-V (heart), pulmonary fibrosis

Front 11

COPD role maybe?

Back 11

conditions that cause chronic CO2 retention such as pulmonary cemphysema may also be the cause.

Front 12

disease of CNS that depressed repiratory center effects SA. includes poliomyelitis, chronic drug/alcohol use, viral emcephalitits residual damage and ___ tumors & MS

Back 12

CNS sleep apnea
polio
drug/alcohol
viruses (encephalitis)
brainstem tumors
MS

Front 13

if someone is a blue bloater it's
a. cor pulmonale
b. cyanosis
c. OSA

Back 13

blue bloater
- cor pulmonale
- cyanosis
it's sleep apnea, but not OSA

Front 14

can tonsils cause sleep apnea?

Back 14

greatly enlarged tonsils and adenoids can cause obstructive sleep apnea

Front 15

difference between oral soft tissue Mallampati scores

Back 15

grade 1 - wide open
grade 2 - open
grade 3 - hard/soft palate
grade 4 - palate

Front 16

OSA in sleep, airway obstruction on blood levels.
arousal in sleep?

Back 16

blood co2 levels rise, o2 levels fall
breathing resumes with a gasp, briefly arousal to open airway and restore blood gases

Front 17

suggested Tx often (simple daily Tx)?

Back 17

generalized exercising and stretching

Front 18

COPD role maybe?

Back 18

conditions that cause chronic CO2 retention such as pulmonary cemphysema may also be the cause.

Front 19

disease of CNS that depressed repiratory center effects SA. includes poliomyelitis, chronic drug/alcohol use, viral emcephalitits residual damage and ___ tumors & MS

Back 19

CNS sleep apnea
polio
drug/alcohol
viruses (encephalitis)
brainstem tumors
MS

Front 20

if someone is a blue bloater it's
a. cor pulmonale
b. cyanosis
c. OSA

Back 20

blue bloater
- cor pulmonale
- cyanosis
it's sleep apnea, but not OSA

Front 21

can tonsils cause sleep apnea?

Back 21

greatly enlarged tonsils and adenoids can cause obstructive sleep apnea

Front 22

difference between oral soft tissue Mallampati scores

Back 22

grade 1 - wide open
grade 2 - open
grade 3 - hard/soft palate
grade 4 - palate

Front 23

OSA in sleep, airway obstruction on blood levels.
arousal in sleep?

Back 23

blood co2 levels rise, o2 levels fall
breathing resumes with a gasp, briefly arousal to open airway and restore blood gases

Front 24

suggested Tx often (simple daily Tx)?

Back 24

generalized exercising and stretching

Front 25

OSA cycle, p 12

Back 25

p12

Front 26

hypothyroid - 2%
mild hypothyroid - ?
hyperthyroid - ?
mild hyperthyroidism - ?

.2%, .1-.6%, 5-17%. match

Back 26

hypothyroid - 2%
mild hypothyroid - 5-7%
hyperthyroid - .2%
mild hyperthyroidism - .1-0.6%

Front 27

p.9 thyroid

Back 27

p.9 thyroid

Front 28

these are signs of what?:
weakness, fatigue, cold intolerance, dry/cold/yellow skin, thick tongue, weight gain and Bradycardia

Back 28

thyroid hypofxn: hypothyroidism :

weakness, fatigue, cold intolerance, dry/cold/yellow skin, thick tongue, weight gain and Bradycardia

Front 29

hyperthyroid, what will you see clinically?

Back 29

exophthalmos

also: tremors, sweating, heat intolerance, warm/thin/soft skin, weight loss, tachycardia

Front 30

if out of control

hypothyroidism leads to?

hyperthyroidism leads to?

Back 30

hypo --> MYXEDEMA COMA

hyper --> THYROID STORM

Front 31

emergency management of myxedema coma or hypothyroid storm. 5 steps

Back 31

1. stop dental tx
2. position supine, elevate legs
3. BLS, airway, breathing, circulation
4. EMS, IV established, administer Oxygen
5. transport to hospital

Front 32

cardia emergencies

Back 32

part 1

age 10+, heart disease is #1 killer

Front 33

average wait from symptoms of cardiac event to help is?
__% via private transport.
X will die, X will never reach hospital alive

Back 33

average wait from symptoms of cardiac event to help is TWO HOURS
50% via private transport.
500,000 will die, 300,000 will never reach hospital alive

total: 1,500,000 individual events

Front 34

chest pain

acute coronary syndrome can be one of 2 things:

Back 34

unstable angina
or
Myocardial infarction

Front 35

difference b/w angina and MI

Back 35

angina - brief periods of occlusion would likely cause unstable angina (at rest)
MI - protracted episodes could result in nontransmural or transmural infarction

Front 36

what do i got?
subeternal squeezing/burning pain "heavy weight" "indigestion", sudden onset w/ exertion or emotion.
radiates to shoulder, face, left arm
- subsides w/ rest or nitroglycerin

Back 36

these are clinical manifistations of Angina Pectoris

Front 37

angina pectoris, has some precipitating factors; name 3

Back 37

1. physical activity, 2. hot/humid room 3. cold weather, 4. large meals, 5. emotional stress, 6. caffeine ingestion, 7. fever/anemia 8. cigarette smoking, 9. smog 10. high altitudes

Front 38

how to assess a pt with hx of angina, as about ... 1.2.3.

Back 38

stable v. unstable angina
1. exercise tolerance
2. nature of angina
3. NTG effectiveness

Front 39

what shows Consistent...
1. frequency of angina
2. type of discomfort
3. location of pain
4. precipitating factors
5. response to NTG

Back 39

these are all signs of

Stable Angina Pectoris

Front 40

if you see clinically ...
1. angina of recent onset, by minimal exertion
2. increasingly severe/prolonged/frequent angina in pt w/ relatively stable, exertional angina
3. angina both at rest & minimal exertion

Back 40

these are 3 clinical criteria of

UNSTABLE ANGINA PECTORIS

Front 41

angina in the dental chair goes from Anxiety/fear/pain -->X --> Chest Pain. what's X

Back 41

Anxiety/fear/pain - release of catecholamines (EPI) - increases BP/HR/contraction - increases myocardial oxygen demand - mycardial ischemia - chest pain

Front 42

angina pectoris management. ask, is this your typical angina?
also ask about

Back 42

this your typical angina?
location?
radiation?
severity? other?
response to NTG?

Front 43

manage\angina pectoris:
position upright, BLS/vitals, hx?, Nitroglycerine .3-0.6mg SL, oxygen, repeat q3-5'; total 3 doses, then ...
discharge or hospital? Tx? if no response?

Back 43

if hx of angina pectoris - discharge, treat - no problem
if no hx - hospital. assume cardiac in origin
if no response --> 3 doses & Tx as MI

Front 44

pt comes in & high BP, hx of angina, uses nitroglycerin, before tx do anything different?

Back 44

few minutes before injection use nitroglycerin as prophylactic

Front 45

what group careful to use nitroglycerin with?

Back 45

folks with ED drugs in system
(interaction dangerous)
people who are allergic