NBDHE Medical Conditions bext Study Guide, Exams of Dentistry

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NBDHE Medical Conditions bext Study Guide ASA I - ✔ Normal healthy patient ASA II - ✔ Patient with mild systemic conditions: -allergies -controlled hypertension -asthma -diabetes without systemic effects -cigarette smoking WITHOUT chronic obstructive pulmonary disease (COPD) -BMI of 30-39 -Pregnancy with NO other systemic conditions ASA III - ✔ Patient with severe systemic diseases and some functional limitation -Controlled disease of more than one body system -controlled congestive heart failure (CHF) -stable angina -poorly controlled hypertension -morbid obesity -chronic renal failure -Respiratory problems (COPD) -BMI 40+ ASA IV - ✔ Patient with severe systemic disease that is a constant threat to life -Possible risk of death -unstable angina -symptomatic COPD -symptomatic CHF -Hepatorenal failure ASA V - ✔ Moribund patient not expected to survive for more than 24 hours without surgery ASA VI - ✔ Brain-dead patient Normal BP - ✔ Systolic <120 mmHg Diastolic <80 mmHg Elevated BP - ✔ Systolic 120-129 mmHg Diastolic <80 mmHg Hypertension stage 1 - ✔ Systolic 130-139 mmHg Diastolic 80-89 mmHg Hypertension stage 2 - ✔ Systolic >140 mmHg Diastolic >/= 90 mmHg Hypertensive crisis - ✔ Systolic >/= 180 mmHg Diastolic > 120 mmHg If patient's systolic and diastolic blood pressure fall into two different categories the __________ category should be selected - ✔ Higher (more severe) HBP is known as the - ✔ Silent killer Hypertension is the most prevalent cause of - ✔ stroke and kidney failure Contributing factors to HBP are - ✔ Atherosclerosis, arteriosclerosis, coronary artery disease, congestive heart failure, and diabetes Arteriosclerosis - ✔ -Hardening of arteries -Blood vessels loose elasticity, become thick and stiff, sometimes restricting blood flow Atherosclerosis - ✔ -Type of arteriosclerosis which arteries become hardened due to plaque build up -Plaque can cause a blood clot in arteries Sodium polishers can increase - ✔ Blood pressure Common side effects of antihypertensive medications include - ✔ xerostomia and hypotension ✔ Blood clot (thrombus) forms in one of the arteries of the brain Embolic stroke - ✔ Blood clot or other debris in the body travel through the bloodstream, ends in a narrower brain artery and blocks it Hemorrhagic stroke - ✔ Blood vessel is ruptured in the brain Risk factors for stroke - ✔ Hypertension, atherosclerosis, diabetes, coronary disease, obesity Do not treat a person after stroke for how long? - ✔ 6 months Seizure - ✔ -A single occurrence where nerve cell activity in the brain becomes disrupted -Uncontrolled electrical activity in the brain -Produces convulsion, thought disturbance, abnormal behavior Epilepsy - ✔ Neurological condition characterized by two or more unprovoked seizures Petite mal seizure (generalized absence) - ✔ Sudden pause with the patient staring into space Usually lasts around 10 seconds Grand mal seizure (tonic-clonic) - ✔ Loss of consciousness accompanied by tonic convulsions (voluntary muscles continuously contract - body becomes stiff) followed by clonic movements (intermittent muscle relaxation and contraction - body shakes) Lasts 1-3 minutes Atonic - ✔ Brief loss of muscle tone Lasts less than 15 seconds Stages of epilepsy - ✔ 1. Aura stage 2. Tonic stage 3. Clonic stage 4. Postictal stage Depression - ✔ Hormone and chemical imbalance that can provoke sadness, insomnia, memory difficulty, etc Schizophrenia - ✔ Condition caused by excessive dopamine and serotonin levels Symptoms include: hallucinations and disordered thoughts Obsessive-compulsive disorder (OCD) - ✔ Unreasonable thoughts that lead to repetitive behaviors or compulsions Alcohol dependency - ✔ -Suffer from malnutrition, especially thiamine B-1 and folate B-9 deficiency -Alcohol and tobacco causes increase the risk of oral cancer -Xerostomia, taste impairment, and increased caries risk -Avoid alcohol containing mouthwashes and nitrous oxide Fetal Alcohol Syndrome - ✔ -Severity is dose dependent -Abnormally narrow eyes with epicanthal folds -Smooth philtrum -Flat face and micrognathia (small jaw) -tooth malformation, malocclusion, gingivitis, cleft palate, and lip Heroin/Morphine addiction - ✔ -Tolerance and dependence on substance will increase with use -Pinpoint pupils: all narcotics (heroin, morphine, codeine, fentanyl, methadone -Decreased blood pressure/respiration/body temperature/heartbeat -More likely to experience gum disease, oral fungus, oral viral infections, bruxism, and discoloration of tongue Cocaine addiction - ✔ -Psychostimulant and vasoconstrictor -Tolerance and dependence on substance will increase with use -Dilated pupils, increased blood pressure, respiration, body temperature, and heartbeat -Avoid epinephrine if cocaine is used within 24 hours (both vasoconstrictors) Methamphetamine (meth/crystal) addiction - ✔ -Psychostimulant -Arrhythmia, high blood pressure, and other CNS/heart conditions -Highly acidic ingredients -Softens tooth enamel -Increases anxiety levels, grind teeth -Severe dry mouth -Less likely to floss and brush -Cravings to binge on sugar Meth mouth - ✔ Term for damaged teeth and oral health Teeth are described as, "blackened, stained, rotting, crumbling or falling apart" Rampant caries Ecstasy (MDMA) - ✔ -Dry mouth -Higher the dose of the drug, the more severe the dry mouth -Cavities and gum disease -Bruxism Marijuana - ✔ -Psychoactive herb -Cavities, gum disease, oral cancer Anemia - ✔ Drop in oxygen-carrying hemoglobin in red blood cells Iron-deficiency anemia - ✔ Caused by iron deficiency Pernicious anemia - ✔ Caused by vitamin B-12 (cobalamin) deficiency triggered by lack of intrinsic factor "Bald" tongue Intrinsic factor is secreted by ___________ _____ of stomach and helps the absorption of vitamin B-12 in small intestine - ✔ parietal cells Folate deficiency anemia - ✔ Caused by B-9 (folic acid) deficiency Sickle cell anemia - ✔ -Abnormal (sickle-shaped) red blood cells -Get stuck in small blood vessels -Slow/block blood flow and oxygen to the body -Hair-on-end on radiographs due to loss of trabeculae -Weakness, pallor, impaired memory, paresthesia of hands and feet, fatigue -Paleness of oral tissues, ulcerations, glossitis (swollen, red, smooth tongue) -Loss of papillae on dorsum of tongue Hemophilia - ✔ -Disorder in blood coagulation resulting in prolonged bleeding -Plasma proteins involved in coagulation cascade for conversion of fibrinogen to fibrin are insufficient -Spontaneous gingival bleeding, hematoma, and ecchymosis Von Williebrand Disease - ✔ -Drooling, gag reflex, difficulty opening mouth -Gingival hyperplasia from seizure medications -Trauma on oral cavity from repeated falling, bruxism, attrition -Mouth breathing, tongue thrusting, TMJ issues -High risk for caries and periodontal diseases Injury site C-2, C-3 - ✔ limited head and neck movement, patient depends on ventilator Injury site C-4 - ✔ Arm and leg paralysis with possible respiratory problems Injury site C-5 - ✔ Limited shoulder control, patient can perform daily oral hygiene with assistance of adaptive aids Injury site C-7 - ✔ Hand, wrist, elbow, shoulder movement, can perform self-care Injury site T-1 to T-12 - ✔ -Normal motor function of the upper body (head, neck, shoulders, arms, hands and fingers with increased use of rib, abdominal, and trunk) -Patients may independently use wheelchairs, crutches or other aids to walk Spina bifida - ✔ -Neural tube defect caused by the failure of the spine to develop and close properly during the first month of pregnancy -Results in incomplete development of brain and spinal cord Meningocele - ✔ Protrusion of meninges and cerebrospinal fluid from an open bony defect of spinal cloumn Hydrocephalus - ✔ Buildup of fluid in the brain that puts pressure on it Etiology of spina bifida includes - ✔ Folic acid (B-9) deficiency This allergy occurs frequently in patients with spina bifida - ✔ Latex Bell's palsy - ✔ -Unilateral facial muscle paralysis affecting the 7th -Potential causes: viral infections, trauma, fever, tooth extractions Symptoms of Bell's palsy include: - ✔ Unilateral facial paralysis, drooling, inability to close the eye on the side affected Myasthenia gravis - ✔ -Autoimmune disease caused by the breakdown in the communication between the nerves and muscles -Weakness in voluntary muscles -Respiratory muscles can become affected causing serious breathing problems -Drooping eyelids, slurred speech, difficulty breathing, and walking Lupus Erythematosus - ✔ -Autoimmune disease-causing damage to the joints, skin, kidneys, heart, lungs, blood vessels, and brain -Triggered by ultraviolet rays, medications, viruses, stress -A butterfly-shaped rash on the nose unfolding across both cheeks Multiple sclerosis - ✔ -Immune system attacks myelin sheath covering the nerves, disrupting the communication between brain and body system -Mostly young adults -Treat patients during remission -Fatigue, slurred speech, muscle spasms, short-term memory loss -Heat sensitivity Muscular dystrophy - ✔ -Genetic disease which muscle fibers are unusually susceptible to damage -Duchenne syndrome: Affects infants and young children (ages 3-5), especially males ---Weakness starts with lower body, then spreads through whole body ---Children are unable to walk by the age of 12, and life expectancy is around 25 Osteoarthritis - ✔ -Damage to the cartilage of the joints -Enough damage results in bone grinding directly on bone -Most common type of arthritis in US Rheumatoid arthritis - ✔ -Damage to the lining of the joint capsule -Destroy cartilage and bone within the joint -Joint tenderness, swelling, and stiffness that worsens with age Marfan syndrome - ✔ -Genetic disorder that affects the body's connective tissue -Patients usually very thin, tall, and often have heart problems -High palate, narrow jaw, crowding of teeth, and malocclusion ALS (Amyotrophic lateral sclerosis) - ✔ -Lou Gehrig's disease -Progressive neurodegenerative disease that affects motor neurons from brain to spinal cord -Leads to death -Ages 40-60 -Muscle weakness, twitching, shortness of breath, etc. Crohn's disease - ✔ -Inflammation of the digestive tract -Diarrhea, weight loss, fatigue, and malnutrition -Oral conditions: angular cheilitis, fissured lips, and "cobblestone" buccal mucosa -Schedule appointments during remission Anorexia nervosa - ✔ -Weigh at least 15% less than normal healthy weight -Refuse to eat enough, exercise obsessively, induce vomiting, or use laxatives to lose weight -Adolescent girls who are self-conscious about appearance -Sensitivity to cold, absent, or irregular menstruation, and excessive fine facial/body hair (lanugo) -Oral conditions: glossitis, angular cheilitis, bleeding gingiva due to nutritional deficiency, perimolysis (erosion) Bulimia nervosa - ✔ -Binge eating and purging -Oral conditions: glossitis, angular cheilitis, bleeding gingiva due to nutritional deficiency -Perimolysis (tooth erosion) -Advise patients to rinse thoroughly after purging to get rid of acids in the oral cavity; advise not to brush immediately after purging -Xerostomia and enlarged parotid glands Celiac disease - ✔ -Sensitivity to dietary gluten -Causes injury to intestinal mucosa leading to malabsorption of nutrients -Diarrhea and paresthesia of extremities -Oral conditions: painful burning tongue (glossitis), angular cheilitis, ulcers, and atrophy of the papillae of tongue Asthma - ✔ -Chronic inflammatory respiratory disease in which the airways narrow, swell, and produce extra mucus -Triggered by stress, allergies, or exercise -Mostly diagnosed in childhood/adolescence -Symptoms: difficulty breathing, tightening of chest, wheezing, and cyanosis -Albuterol (Ventolin, Proventil) for quick relief -Oral conditions: oral candidiasis and xerostomia ✔ Thyroxine (T4) and triiodothyronine (T3) in the thyroid gland Thyroid gland is stimulated by __________ _____________ __________ in the pituitary gland - ✔ Thyroid stimulating hormone (TSH) Hypothyroidism - ✔ -Insufficient production of thyroid hormone -Pituitary gland produces more TSH to stimulate the thyroid -Extra production of TSH forms a goiter -Oral conditions: enlarged tongue, delayed tooth eruption, small jaw development, and malocclusion Cretinism - ✔ Hypothyroidism in children Myxedema - ✔ -Hypothyroidism in adults -Lethargy, fatigue, cold intolerance, and bradycardia Hyperthyroidism - ✔ -Excessive production of thyroid hormone from thyroid gland -Body's metabolism increases -Exophthalmos (bulding of the eyes), heat intolerence, fatigue, insomnia, dyspnea (shortness of breath), tachycardia, weight loss, muscle weakness Grave's disease - ✔ Autoimmune disease caused by antibodies that attach to specific sites of the thyroid gland and causes an overproduction of hormones Oral conditions of hyperthyroidism - ✔ Early loss of deciduous teeth, early eruption of permanent teeth, large mandible, osteoporosis of alveolar bone causing more progressive periodontal disease Thyroid storm (thyrotoxic crisis) - ✔ Occurs if hyperthyroidism is left untreated Hyperpituitarism - ✔ Excessive hormone production by the anterior pituitary gland Gigantism - ✔ Increase in growth hormone production during childhood Oral conditions: enlargement of maxilla and mandible causing separation of teeth and malocclusion, thickened lips and macroglossia Acromegaly - ✔ Increase in growth hormone production during adulthood Adrenal cortex - ✔ Secretes corticosteroid and aldosterone that regulates the level of sodium and potassium, maintain blood volume and pressure Adrenal medulla - ✔ Produces epinephrine (adrenaline) and norepinephrine to help body respond to a stressful situation by increasing the heart rate and force of heart contractions Hypocortisolism (Addison's disease) - ✔ Hyposecretion of cortisol and aldosterone by adrenal glands; caused by destruction of adrenal; cortex (outer layer) Symptoms of Addison's disease - ✔ Skin pigmentations, weakness and fatigue, low tolerance from stress, low blood pressure, and susceptibility to infections, rapid heart, and respiratory rates Adrenal crisis - ✔ sudden appearance of symptoms triggered by excessive stress Hypercortisolism (Cushing's syndrome) - ✔ Hypersecretion of cortisol by adrenal glands Symptoms of Cushing's syndrome - ✔ Weight gain, fatty tissue deposits in face and body creating a "moon face" and "buffalo hump" Hepatitis - ✔ -Inflammation of liver caused by hepatitis viruses, toxic substances (e.g. alcohol, certain drugs) and autoimmune diseases -Self limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer -Can live outside body for 7 days -Fatigue, dark urine, and jaundice Hepatitis B and C - ✔ Transmitted through blood or body fluids Hepatitis A and E - ✔ Transmitted indirectly through contaminated food and water Hepatitis D - ✔ Piggyback virus linked to hepatitis B Dental health care workers should be vaccinated against hepatitis - ✔ B There is no vaccine for hepatitis - ✔ C Tuberculosis (TB) - ✔ Bacterial infection of lungs caused by Mycobacterium tuberculosis TB is spread through - ✔ Airborne particles Coughing, sneezing, talking TB is NOT spread through - ✔ Sharing utensils, sharing cigarettes, saliva from kissing, sharing toothbrushes PPD (Mantoux) skin test - ✔ -Antigen used to test for tuberculosis -Read after 48-72 hours A positive PPD TB skin test does not mean that the patient has active TB but confirms _____________ to the disease at some point in patient's life - ✔ Exposure Elective non-emergency dental treatment should be ____________ for patients who have active TB or who have suspected TB - ✔ Postponed TB bacteria can be in the air for __________ - ✔ Hours Patients with active TB _________ be treated in the dental office - ✔ Cannot HIV/AIDS - ✔ -The human immunodeficiency viruses invade T lymphocyte cells (CD4 helper cells) -CD4 cell count falls below 200 cells/mm3 of blood (normal CD4 is 500-1,600 cells/mm3) -Body becomes weak, HIV infection leads to AIDS -Flu-like symptoms and chronic infection People diagnosed with AIDS typically survive for - ✔ Approximately 3 years Death from AIDS usually occurs due to - ✔ Opportunistic infections Antiretroviral therapy (ART) - ✔ Increased bleeding Oral conditions related to end-stage renal disease - ✔ Candidiasis, metallic taste from urea in saliva, xerostomia, stomatitis, bleeding gingiva Autism Spectrum Disorder (ASD) - ✔ -Does not cause oral health changes -Avoid direct eye contact with patient -Higher risk for caries if caregiver reinforces behavior with cariogenic foods Down Syndrome (Trisomy 21) - ✔ -Has 47 chromosomes instead of 46 -Prognathic mandible with class III malocclusion -Open bite due to tongue thrusting -Fissured tongue and cracked lips due to mouth breathing -Small airways -Macroglossia -Delayed exfoliation and tooth development -Microdontia with malformed teeth -Anomalies in eruption and congenitally missing teeth -Higher risk for periodontal disease -Bruxism, conical shaped roots, PMN dysfunction -Early onset, severe periodontal disease -Lower risk for dental caries in children and young adults -Cleft lip and palate, as well as bifid uvula occasionally -open mouth posture and protruding tongue and drooling -Hypotonia (low muscle tone) -Content and well natured, but can become aggressive if disorientated or confused Patients with down syndrome have lower risk for dental caries because - ✔ Delayed primary/permanent tooth eruption, missing permanent teeth, small-sized teeth, wider interproximal space What function is accomplished in the loop of henle? - ✔ Filtration and regulation of electrolytes in the kidney Recently it has been established that the presence of periodontal infection may be a contributing factor to all of the following systemic conditions EXCEPT one. Which is the exception? - ✔ Multiple sclerosis Contraction of the right atrium as blood flows from the right atrium to the right ventricle is called: - ✔ Atrial systole Asthma is characterized by constriction of the airways secondary to inflammation. Each of the following is descriptive of symptoms of asthma except one. Which is the EXCEPTION? - ✔ Symptoms are lesser in the early morning Skin, lips, and mucosal tingling followed by ulcerative and eruptive lesions are associated with which forms of human herpes virus? - ✔ Herpes simplex virus Characterized by slanted eyes, shorter than normal stature, heart abnormalizes, fissured tongue, and premature loss of teeth, this chromosomal abnormality is called - ✔ Down's Syndrome Secretion of excess growth hormone which causes some bones to continue growing after normal growth has completed can result in a disease/syndrome called - ✔ Acromegaly Type I diabetes typically has an abrupt onset is associated with the three Ps. Each of the following is included in this list EXCEPT one. Which is the EXCEPTION? - ✔ Polycythemia Each of the following is an endocrine gland or organ except one. Which one is the EXCEPTION? - ✔ The parotid gland Infectious mononucleosis is caused by the: - ✔ Epstein-Barr virus Which condition is most closely associated with type 2 diabetes? - ✔ Increased insulin resistance Cholesterol, an essential structural component of cells and membranes, includes high- density and low-density lipoproteins. Each of the following is true of high-density lipoproteins HDLs except one. Which is the EXCEPTION? - ✔ High blood levels of HDL are linked to arterial damage and cardiovascular disease Hepatitis is primarily an infection of which organ? - ✔ Liver In a review of the client's health history, the client indicated that she uses more than two pillows to sleep at night, becomes out of breath walking short distances, and has constant swelling in her feet and ankles. What condition is MOST likely causing these symptoms? - ✔ Congestive heart failure