Special Needs ch. 69

Uncontrolled diabetes contributes to the severity of periodontal infection. A periodontal infection can complicate the control of blood glucose levels in diabetics. A) Both statements are true. B) Both statements are false. C) The first statement is true and the second statement is false. D) The first statement is false and the second statement is true.

A) Both statements are true.

Your patient with diabetes has gone into insulin shock. What is the first step in addressing this emergency? A) Give the patient glucose. B) Give the patient insulin. C) Call 911. D) Recline the patient and monitor vital signs.

A) Give the patient glucose.

A patient is taking sulfonylureas to control type 2 diabetes. What potential diabetic emergency should you watch for during dental treatment? A) Hypoglycemia B) Hyperglycemia C) Ketoacidosis D) Hyperapnea

A) Hypoglycemia

Patients with uncontrolled glucose levels are at higher risk for periodontal disease. Routine dental procedures including deep scaling procedures can be completed when the uncontrolled diabetic has received antibiotic premedication. A) The first statement is true and the second statement is false. B) The first statement is false and the second statement is true. C) Both statements are true. D) Both statements are false.

A) The first statement is true and the second statement is false.

Type 1 diabetes usually affects ______ Type 2 diabetes usually affects _____

Type I = young Type II = adults

what is postprandial

after a meal

Insulin producing cells of the islets of Langerhans in the pancreas

beta cells

A joint that is deprived of any pain or position sense due to severe osteoarthritis or as a result of disease such as diabetic neuropathy

charcot joints

The primary assay for assessing long term glycemic control

glycated or glycosylated hemoglobin (A1c)

diabetic coma is aka..?

hyperglycemia and ketoacidosis

Abnormally low levels of insulin in the blood

hypoinsulinemia

Diabetes pts are at a ___ to ___ times greater risk for more severe periodontal disease

2-4

What are normal blood glucose levels in healthy individuals? what should A1c percentage be below?

60 to 99mg/dL; a1c below 5.6%

Case Study 1 Susan Fones is a 34-year-old teacher who comes in every 6 months for her cleaning. She was diagnosed with diabetes as a child and gives herself an insulin shot daily. She is concerned about her bleeding gums and has noticed mobility of her lower anterior teeth. She reports an extremely dry mouth and a burning tongue. She has taken her insulin today at 6:00 AM and indicates that its peak action occurs between 2 and 3 hours after the injection. Open and read the attached case to answer the following question. The patient has what type of diabetes? A) Type 1 B) Type 2 C) Juvenile diabetes D) Gestational diabetes

A) Type 1

Case Study 1 Susan Fones is a 34-year-old teacher who comes in every 6 months for her cleaning. She was diagnosed with diabetes as a child and gives herself an insulin shot daily. She is concerned about her bleeding gums and has noticed mobility of her lower anterior teeth. She reports an extremely dry mouth and a burning tongue. She has taken her insulin today at 6:00 AM and indicates that its peak action occurs between 2 and 3 hours after the injection. Open and read the attached case to answer the following question. The presence of xerostomia is most likely caused by: A) medication. B) diet. C) allergic reaction. D) renal function.

A) medication.

When treating a patient with diabetes, one should do all of the following except: A) schedule appointments before a meal. B) consult with the treating physician. C) limit the length of appointment. D) be prepared for a diabetic-related emergency.

A) schedule appointments before a meal.

Common abbreviation for glycosylated hemoglobin.

A1c

Case Study 2 Susan Fones is a 34-year-old teacher who comes in every 6 months for her cleaning. She was diagnosed with diabetes as a child and gives herself an insulin shot daily. She is concerned about her bleeding gums and has noticed mobility of her lower anterior teeth. She reports an extremely dry mouth and a burning tongue. She has taken her insulin today at 6:00 AM and indicates that its peak action occurs between 2 and 3 hours after the injection. Open and read the attached case to answer the following question. Which of the following etiologic factors is related to the development of this type of diabetes? A) Insulin resistance B) Autoimmune destruction of beta cells C) Hormone imbalance D) High carbohydrate intake

B) Autoimmune destruction of beta cells

Which one of the following viruses are associated with destruction of beta cells? A) Coxsackie B) Mumps C) Chicken pox D) Rotavirus

B) Mumps

Insulin is produced in which body organ? A) Stomach B) Pancreas C) Liver D) Intestines

B) Pancreas

Case Study 2 Susan Fones is a 34-year-old teacher who comes in every 6 months for her cleaning. She was diagnosed with diabetes as a child and gives herself an insulin shot daily. She is concerned about her bleeding gums and has noticed mobility of her lower anterior teeth. She reports an extremely dry mouth and a burning tongue. She has taken her insulin today at 6:00 AM and indicates that its peak action occurs between 2 and 3 hours after the injection. Open and read the attached case to answer the following question. The peak action of Susan's insulin is reached between 2 and 3 hours. This range of action indicates the insulin is what classification? A) Rapid acting B) Short acting C) Intermediate acting D) Long acting

B) Short acting

All of the following factors impact the need for insulin except: A) food intake. B) alcohol intake. C) infection. D) variations in exercise.

B) alcohol intake.

Polydipsia is: A) excessive hunger. B) excessive thirst. C) excessive urination. D) none of the above.

B) excessive thirst.

The most common type of dental emergency associated with a person having diabetes is: A) hyperapnea. B) hypoglycemia. C) hyperglycemia. D) ketoacidosis.

B) hypoglycemia.

Type 2 diabetes: in children the typical age at diagnosis is >____ years of age. A) 6 B) 8 C) 10 D) 12

C) 10

Systematic reviews suggest patients with diabetes are at _____ times greater risk for more severe periodontal disease than individuals without diabetes. A) 1 to 2 B) 2 to 3 C) 2 to 4 D) 2 to 6

C) 2 to 4

Case Study 2 Susan Fones is a 34-year-old teacher who comes in every 6 months for her cleaning. She was diagnosed with diabetes as a child and gives herself an insulin shot daily. She is concerned about her bleeding gums and has noticed mobility of her lower anterior teeth. She reports an extremely dry mouth and a burning tongue. She has taken her insulin today at 6:00 AM and indicates that its peak action occurs between 2 and 3 hours after the injection. Open and read the attached case to answer the following question. Susan's dental appointment should be scheduled during early morning to ensure that she is treated soon after a full meal. The ideal time for the appointment when considering her insulin intake is during the peak time of her insulin dosage. A) The first statement is true and the second statement is false. B) The first statement is false and the second statement is true. C) Both statements are true. D) Both statements are false.

C) Both statements are true.

Which of the following oral manifestations is common in persons who are diabetic? A) Increased salivary flow B) Whitish patches on oral mucosa C) Candidiasis D) Petechia on the hard palate

C) Candidiasis

Which of the following is true concerning extra/intraoral findings associated with diabetes? A) Oral cancer B) Lichen planus C) Hypogeusia D) A and B E) B and C F) A and C G) All the above

C) Hypogeusia (or E) B and C)

Insulin directly or indirectly affects every organ in the body. Well-controlled diabetes is a contraindication to placement of a dental implant. A) Both statements are true. B) Both statements are false. C) The first statement is true and the second statement is false. D) The first statement is false and the second statement is true.

C) The first statement is true and the second statement is false.

All of the following are clinical manifestations of hyperglycemia except: A) polyuria. B) polydipsia. C) polyarthritis. D) polyphagia.

C) polyarthritis.

Which of the following is not a symptom of hypoglycemia? A) Headache B) Dizziness C) Hunger D) Dry hot skin

D) Dry hot skin

Patients with diabetes mellitus type 1: A) have increased insulin in the blood. B) have non-insulin-dependent diabetes. C) can control insulin level through proper diet. D) have decreased insulin production by the pancreas.

D) have decreased insulin production by the pancreas.

All of the following are possible complications of diabetes except: A) increased susceptibility to infection. B) increased risk for cardiovascular disease. C) increased risk for kidney dysfunction. D) increased rate of blood disorders.

D) increased rate of blood disorders.

A patient has an acetonic, fruity smelling breath. This is a classic symptom of: A) insulin shock. B) hypoglycemia. C) glucose intolerance. D) ketoacidosis.

D) ketoacidosis.

what is hypoguesia?

diminished sense of taste

what is polyphagia

excessive hunger

what is polydipsia

excessive thirst

Measurement of blood glucose taken at least 8 hours after a meal

fasting plasma glucose

Delayed gastric emptying. Occurs when the vagus nerve is damaged or stops functioning normally and movement of food is slowed or stopped

gastroparesis

A prediabetes state when the fasting blood glucose level is consistently above normal, but not in the range for a diagnosis of diabetes

impaired fasting glucose

A prediabetes state of hyperglycemia associated with insulin resistance

impaired glucose tolerance

A powerful hormone secreted by the beta cells in the islets of Langerhans of the pancreas; the major fuel regulating hormone; enters the blood in response to a rise in concentration of blood glucose and is transported immediately to bind with cell surface receptors throughout the body

insulin

Former name for type 1 diabetes mellitus that is no longer used because some people with type 2 diabetes also used insulin

insulin dependent diabetes mellitus

too little insulin is known as: diabetic ketoacidosis or insulin resistance?

ketoacidosis

Normal metabolic products of lipid within the liver; excess production leads to urinary excretion of these acidic chemicals.

ketones

A carrier of cholesterol in the body, which leads to a build up of cholesterol in the arteries causing an increased risk for cardiovascular disease

low density lipoprotein

noninsulin-dependent diabetes mellitus (NIDDM) goes with (Type I or II) insulin dependent diabetes goes with..?

noninsulin = Type II insulin = Type I

Hormonal disorder where the ovaries or adrenal glands produce more male hormones than normal

polycystic ovarian syndrome