theory 2 final

What is asthma?

Asthma is a chronic, potentially life-threatening, inflammatory disorder of the airways associated with airway hyperresponsiveness to stimuli resulting in bronchial edema and narrowing of airways

All of the following statements related to myocardial infarction are correct EXCEPT which one?

Atherosclerotic plaques and thrombi impair blood flow to large and medium-sized veins of the heart.

What are some simple alterations that can be done to treat vasovagal syncope?

Decrease blood pooling in the legs Eat frequent meals Carry glucose tablets ALL OF THE ABOVE

If your patient swallows something but says they are fine, what is important to do before dismissing them?

Document patient's response and take a radiograph.

The normal blood sugar range for a healthy adult is:

70-99 mg/dl

When the patient is unresponsive, as determined during the primary survey _______________.

A. place the patient in the dental chair in a supine position on a firm, flat board (e.g., EMS board) to allow for adequate compressions later B. summon the office emergency team C. activate emergency medical services (EMS) ALL OF THE ABOVE

What causes an epileptic seizure?

Abnormal electrical discharges in the brain

High blood glucose levels can make you:

Have to pee a lot

What are some clinical signs of a hypoglycemic attack?

Headache, Sweating, Irritability, Muscles weakness, Confusion, Unconsciousness, Hunger, Shaking, Tachycardia, Anxiety, Seizures, Blurry vision, Difficulty to speak, Drowsiness

All of the following statements related to hypertensive emergency are correct EXCEPT which one?

Hypertensive emergency is unlikely with the administration of sympathomimetic drugs such as high doses of epinephrine.

All of the following statements related to hyperventilation are correct EXCEPT which one?

Hyperventilation syndrome is especially common in young men.

Xylitol is _______________.

a product used to prevent caries

_______________ was originally approved by the FDA for sensitivity use.

Fluoride varnish

_______________ has shown to decrease the amount of fluoride needed in the remineralization

Tricalcium phosphate

True or False: Penicillin is an antibiotic used in dental practices that may cause an allergic reaction?

True

Is it safe to administer oxygen to a patient with a history or experiencing MI?

Yes, patients should be given supplemental oxygen to reduce risk of hypoxia and myocardial ischemia.

Which would likely NOT induce angina?

a casual walk

Are males or females more likely to have an acute MI?

males

Which of the following contributes to the pathogenesis of type 2 DM?

Insulin resistance and insufficient insulin secretion

What is the first thing you should do if your patient begins to show signs of MI?

Terminate the procedure

What is the type of experimental drug being tested for vasovagal syncope?

Beta-blockers

Sreptococcus mutans assists Lactobacillus in the caries process by _______________.

increasing an acidic environment causing demineralization allowing easier penetration

The hormone that is responsible for transporting glucose into the cells is:

insulin

Out of the two classes of CVA, which is more common?

occlusive stroke

What is not a predisposing factor of asthma?

type II diabetes

Which type of hypersensitivity reaction is the only one that involves sensitized T Lymphocytes rather than antibodies?

type IV hypersensitivity

In what position should a patient experiencing MI be placed?

upright or semi-upright position.

A ligature is _______________.

used to tie the wire to the bracket

A five-carbon sweetener that is considered a sugar alcohol is _______________.

xylitol

What are some reasons you would use the chest thrust instead of the heimlich maneuver?

Indications- Infant (<1 year of age), pregnant victim, extremely obese victim. Contraindications- elderly patient

What is the time range in which an anaphylactic shock sets in?

1-15 minutes

What are three dental treatment considerations when dealing with an asthma patient?

1.Have patient take all medications as scheduled before appointment 2.Have patient rinse mouth out after using steroid inhalers 3.Only treat when patient is asymptomatic

Approximately how many Americans experience angina annually?

10 million

In the Cochrane Study, orthodontic patients had ______% reduction of gingivitis after 3 months of power toothbrush usage as compared to manual toothbrushing.

11

What type of medication is NOT used to treat angina?

barbiturates

For each minute CPR and defibrillation is delayed, the patient‑s chances of survival is reduced by 7 to 10 percent.

true

If the patient has a hypoglycemic attack in the dental chair, what are the 2 main things we monitor?

Breathing and airway

What is the blood glucose level that is considered to be hypoglycemia?

below 70 mg/dL.

What is the first thing you should do if your patient passes out?

discontinue treatment

What are three risks factors for choking and aspiration?

●Dysphagia, or difficulty swallowing ●Difficulty controlling head or neck muscles ●Mobility limitations that prevent sitting up straight ●Impaired consciousness or awareness ●GERD, or Gastroesophageal reflux disease ●Eating too quickly or putting too much food in one's mouth ●Dental problems that prevent adequate chewing ●Anatomical variation such as a small airway or a large tongue ●Individuals who have high anxiety and stress ●Individuals with Down Syndrome (high risk of aspiration) ●Individuals with neurological disorders

What is the meaning of F.A.S.T

F - face drooping A - arm weakness S - speech difficulty T - time to call 911

When we say "blood sugar" we're talking about:

glucose

What is another common name for Cerebrovascular accident?

Stroke

What is not a lifestyle that your patient can change to prevent angina?

supplement more fatty foods into their diet

What is an underlying condition that can cause a blockage in the coronary arteries and reduce oxygen flow to the heart?

atherosclerosis

hypoglycemia is a condition that occurs when:

blood glucose is too low

Which of the following is not a sign/symptom of hypoglycemia?

bradycardia

When your blood sugar gets too low, which part of your body will notice it first?

brain

Which of the following would be the best source to have on hand when seeing a diabetic patient?

cake icing

A history of asthma is reported commonly by adult dental patients and may be more prevalent among who?

children

much more likely is a smoker compared to a nonsmoker to have a stroke?

2 to 4 times more

At the OUCOD, a patient with a blood glucose level of _____ mg/dL cannot be treated but can reschedule again once their levels have lowered.

200

How much of the body's oxygen/glucose does the brain use?

25%

Cebrovascular accident is the #____ cause of death in the United States?

3

When handling an acute anginal episode in the dental office, the patient can have up to how many does of nitroglycerin?

3

Oral irrigation has shown significant reductions in plaque and bleeding in as little as ______ weeks of use.

4

Which of the following statements correctly reflect a patient's level of consciousness as determined during the primary survey?

A. An alert patient is awake and speaks. B. A disoriented patient may moan, cry, or make other sound, but responds to verbal and/or painful stimuli, i.e., moves. C. An unresponsive patient is silent and does not respond to verbal and a painful stimulus, i.e., the patient is unconscious. ALL OF THE ABOVE

Which of the following statements related to anaphylaxis is correct?

A. Anaphylaxis is a type I hypersensitivity reaction - initial exposure to an allergen results in antigen-specific antibody production dominated by the immunoglobulin E (IgE) isotype. B. Following re-exposure, IgE antibodies bind to mast cells and basophils associated with mucosal and epithelial tissues. C. The simultaneous binding of an antigen to adjacent IgE molecules fixed to Fc receptors triggers degranulation of mast cells and basophils resulting in the release of histamine, leukotrienes, prostaglandins, chemokines, enzymes and cytokines in target tissues. ALL OF THE ABOVE

Which of the following statements related to angina pectoris is correct?

A. Angina pectoris is an acute coronary syndromes associated with transient ischemia to the myocardium. B. Hypoxia (and at times anoxia) results from diseases and conditions which lead to atherosclerosis and obstruction of coronary arteries by fatty deposits that limits and/or impairs coronary blood flow. C. Precipitating factors that increase cardiac oxygen demand in the presence of decreased perfusion of the myocardium include physical exertion, emotional stress, cold, recent meal. ALL OF THE ABOVE

Which of the following statements is correct with respect to pruritus, urticaria, or angioedema?

A. Histamine, released in response to various stimuli, is one of the most significant chemical mediators associated with pruritus. B. Urticaria is the result of vasoactive substances (e.g., histamine) released by mast cells in the superficial dermis resulting in intradermal edema caused by capillary and venous vasodilation. C. Angioedema is considered anaphylaxis of the subcutaneous tissues and results from mast cell and basophil activation in the deeper dermis and subcutaneous tissues. ALL OF THE ABOVE

Which of the following statements is correct with respect to a determination of patient-specific risk factors?

A. Identification of patient-specific risk factors is predicated on data obtained from the physical evaluation, i.e., medical history and physical examination. B. The medical history should also seek to determine the patient's functional capacity. C. Critically, the physical examination must also include a determination of the patient's baseline vital signs. ALL OF THE ABOVE

Which of the following statements is correct with respect to the status of the airway and actions to be taken during the primary survey?

A. If the patient is responsive (i.e., alert and talking, even in a whisper) the airway is open (at least partially) at this time. B. If the patient is unresponsive (i.e., does not respond to verbal and painful stimuli) evaluate airway and the airway is not open, it may be due to relaxation of the soft tissues of the oropharynx - perform head-tilt/chin-lift. C. If obstruction is caused by foreign material it must be cleared - suction thick, frothy, bloody saliva and vomitus; foreign object must be removed. ALL OF THE ABOVE

Which of the following statements related to angina pectoris is correct?

A. If the working diagnosis is angina pectoris, place patient in an upright or semi-reclining position; note the time and administer nitroglycerin, 0.4 mg, tablet or spray, SL; administer oxygen, 2 to 4 L/minute by nasal cannula; and reevaluate vital signs. B. In a conscious patient, chest pain lasting more than 10 minutes must be assumed to be due to unstable angina or myocardial infarction; activate EMS. C. Adverse reaction to nitroglycerin includes flushing, headaches, dizziness, nausea, and vomiting; syncope and paradoxical angina pectoris due to nitrate-induced vasodilation has been reported. ALL OF THE ABOVE

Which of the following statements is correct with respect to the appropriate emergency response to pruritus, urticaria, or angioedema?

A. If the working diagnosis is generalized pruritus, urticaria, or mild angioedema, stop exposure to suspected precipitating agents and administer oral diphenhydramine (an oral H1-receptor antagonist), 25 to 50 mg, four times daily. B. If the working diagnosis is severe angioedema stop exposure to suspected precipitating agents and administer prednisone 30 to 40 mg, once a day. C. If the working diagnosis is severe angioedema with oropharyngeal and/or laryngeal edema with stridor and wheezing stop exposure to suspected precipitating agents, activate EMS, and administer epinephrine (1:1000). ALL OF THE ABOVE

Which of the following statements related to the emergency response to postural hypotension is correct?

A. Immediately return patient to supine position for 5-10 minutes; administer oxygen, 4 to 6 L/min by nasal cannula; and reevaluate vital signs. B. When vital signs return to baseline values, allow patient to assume a sitting position for at least 2 minutes; reevaluate vital signs. C. If vital signs are stable, allow patient to stand for 2 minutes; reevaluate vital signs; stable vital signs and alertness are signs of recovery. ALL OF THE ABOVE

Which of the following statements related to stroke is corrects?

A. Most commonly, a stroke is secondary to an evolving blood clot associated with atherosclerosis that progressively blocks a cerebral artery. B. Stroke may be due to an embolus that lodged in a cerebral artery obstructing blood flow or result from subarachnoid or intracerebral hemorrhage into brain tissue. C. Stroke-like symptoms lasting less than 1 hour are termed transient ischemia attacks (TIA). ALL OF THE ABOVE

Which of the following statements is correct with respect to local anesthetic toxicity?

A. Nonselective voltage-gated sodium channel blockade is responsible for LAs toxic properties. B. Most commonly, toxic reactions result from (1) excessive dosage, (2) repeated doses, (3) rapid absorption, and (4) unintentional intravascular injection. C. Toxic reactions may be due to low plasma protein binding, and slow metabolism or elimination of the LA or its metabolites. ALL OF THE ABOVE

When faced with an emerging medical event, three hierarchical steps (i.e., the primary survey) must be implemented in every situation to identify which of the following problems?

A. Obstructed airway B. Respiratory arrest C. Cardiac arrest ALL OF THE ABOVE

Which of the following statements related to medical emergencies within the context to the secondary survey is correct?

A. Physical signs and symptoms are produced by physical causes and must be recognized before a physical problem can be diagnosed and treated. B. Without at least a presumptive or working diagnosis there is nothing to treat. C. Based on symptoms analysis, medical emergencies can be characterized as altered consciousness; chest pain; and ventilatory, allergic (pruritus, urticaria, angioedema), neurogenic (i.e., sensory, affective, motor), and toxic events. ALL OF THE ABOVE

Which of the following statements is correct with respect to the emergency response to local anesthetic toxicity?

A. Place patient in a supine position; administer oxygen, 4 to 6 L/min by nasal cannula; activate EMS; monitor vital signs. B. Signs of recovery: mental state improves, vital signs return to baseline values. C. Signs of deterioration: altered consciousness progressing to coma; progressive respiratory and/or cardiac depression. ALL OF THE ABOVE

Which of the following statements related to the emergency response to grand mal seizure is correct?

A. Place patient in a supine position; protect patient from injury, i.e., guide the extremities during seizure, but do not restrain. B. After the seizure is complete suction oral cavity if needed; position patient on his/her side (recovery position); administer oxygen, 4 to 6 L/min by nasal cannula. C. Monitor vital signs; if at any time the patient becomes unresponsive, no normal breathing, and/or no palpable pulse activate EMS. ALL OF THE ABOVE

Which of the following statements related to seizures is correct?

A. Seizures are a group of neurological disorders caused by excessive discharge of cerebral neurons. B. Seizures may lead to focal (motor, sensory (somatic, visual, auditory, olfactory), or psychomotor (automatisms, psychical); or generalized myoclonic, absence (petit mal), and tonic-clonic or grand mal seizures. C. The cause of seizure may be genetic; or head trauma, hypoxia, infection (fever) pregnancy, drug or alcohol overdose or withdrawal, sensory input (e.g., sound, light, touch, and smell), hypoglycemia, circulatory disturbances, degenerative disorders, and tumors. ALL OF THE ABOVE

Which of the following statements associated with syncope is correct?

A. Signs and symptoms associated with the cholinergic component of syncope include diaphoresis (perspiration), nausea, salivation, bradycardia, hypotension, and loss of consciousness. B. When the working diagnosis is syncope, place patient in Trendelenburg position, i.e., head and chest slightly below a line parallel to the floor and feet slightly elevated. C. Emergency responses to syncope include the administration of oxygen, 4 to 6 L/min by nasal cannula, and stimulation of cutaneous reflexes. ALL OF THE ABOVE

Which of the following statement related to syncope is correct?

A. Syncope is defined as sudden brief loss of consciousness due to cerebral ischemia. B. In the young adult it is usually precipitated by a generalized, progressive autonomic discharge secondary to anxiety, pain, heat, or humidity. C. Syncope in patients over 50 years of age may likely be secondary to cardiovascular disorders (e.g., dysrhythmia, postural hypotension), hypoglycemia or cerebrovascular insufficiency. ALL OF THE ABOVE

Which of the following statements related to Type IV delayed hypersensitivity reactions is correct?

A. Type IV, delayed hypersensitivity reactions are closely related to cellular immunity in that specifically sensitized CD4+ T-lymphocytes initiate the reaction. B. Once sensitized, upon reexposure immunologically committed lymphocytes react with the allergen (antigen) and release cytokines (i.e., lymphokines). C. Lymphokines activate macrophages resulting in the release of histamine, leukotrienes, prostaglandins, chemokines, enzymes and cytokines in target tissues. ALL OF THE ABOVE

A(n) _______________ appliance is one that utilizes the orofacial muscles of eating, speaking, and swallowing to produce additional forces.

A. functional B. orthopedic C. Herbst ALL OF THE ABOVE

Which of the following statement related to the ASA PS classification system is correct? The ASA PS classification system _______________.

A. is predicated on patient-specific risk factors identified during the physical evaluation B. provides a practical method to quantify perioperative risk for patients undergoing surgical (and by extension dental) procedures C. defines ASA PS II as a patient with well-controlled mild systemic disease affecting one organ system and no substantive functional limitations, i.e., good functional capacity ALL OF THE ABOVE

Being prepared to respond to a major medical event in oral healthcare settings includes developing a medical emergency team and _______________.

A. knowing what to look for, i.e., familiarity with predisposing factors and signs and symptoms of medical emergencies B. being alert, i.e., looking for evidence of distress or adverse reactions, particularly when drugs are being administered to the patient C. regularly checking the status of emergency drugs and other equipment ALL OF THE ABOVE

Fixed orthodontic appliances _______________.

A. make plaque removal difficult B. can be used to prevent relapse C. create compliance of wear time D. may be functional in nature through using orofacial muscles to add force for movement ALL OF THE ABOVE

During the primary survey, _______________.

A. simultaneously, see if the patient's chest rises and falls, listen for escaping air, feel the airflow against the side of your cheek; and palpate the carotid artery B. if the breathing is not normal, but the patient has definite pulse initiate rescue breathing (1 breath every 5-6 seconds (10 to 12 breaths/min.) C. check pulse every 2 minutes - if no pulse, begin cardiopulmonary resuscitation (CPR) and prepare for automated external defibrillation (AED) ALL OF THE ABOVE

During the primary survey, if there is no breathing or only agonal breaths (i.e., isolated or infrequent gasping) and no pulse begin CPR (cycles of 30 compressions and 2 breaths) and _______________.

A. while continuing with CPR, turn on AED and apply AED pads - when the AED is ready to analyze the heart rhythm, ensure that everyone, including the rescuer performing CPR, is clear of the patient B. if the AED advises that a shock is not indicated resume CPR immediately until prompted by AED to allow rhythm check (about 2 minutes) C. if the AED advises that a shock is indicated press the shock button and resume CPR immediately until prompted by AED to allow rhythm check (about 2 minutes) ALL OF THE ABOVE

All of the following statements related to medical emergencies in oral healthcare settings are correct EXCEPT which one?

Available data on the types and incidence of medical emergencies in oral healthcare indicate that the rate of medical emergencies per dentist per year is quite high.

All of the following statements related to the secondary survey are correct EXCEPT which one?

Before determining the patient's the blood pressure, reassess the pulse rate and character and the rate and character of respiration.

What should you do first if you think your conscious patient is having an acute anginal episode?

Call 911/ Activate EMS while monitoring vital signs This is a correct answer

If a patient is unconscious for more than 15 minutes you should...

Call EMS while giving patient definitive care.

What would warrant surgery for vasovagal syncope?

Cardiac is involved/ No other Tx works

What is the difference between choking and aspiration?

Choking occurs when the airway is blocked by food, drink, or foreign objects. Aspiration occurs when food, drink, or foreign objects are breathed into the lungs (going down the wrong tube).

All of the following are ways to manage hyperventilation EXCEPT:

Continue breathing abnormally until you faint

What is the most common cause of the reduced blood flow associated with angina?

Coronary Artery Disease

All of the following statements related to airway obstruction due to a foreign object are correct EXCEPT which one?

Each time the airway is opened to give ventilations, look for any visible objects in the oropharynx - if a foreign object is not visible, perform a blind finger sweep.

All of the following statements are correct with respect to functional capacity EXCEPT which one?

For a patient with a history of CAD who is asymptomatic and runs 30 minutes daily the risk of a medical emergency is predictable high.

What is the most common type of epileptic seizure?

Generalized tonic-clonic seizures

What might you see clinically in a patient who is taking antiepileptic medication such as Dilantin?

Gingival hyperplasia and gingival bleeding

_______________ is used as an orthodontic cement having the ability to release fluoride.

Glass ionomer

All of the following statements related to hypoglycemia are correct EXCEPT which one?

Glucagon promotes hepatic glycogenolysis and gluconeogenesis and is a hypoglycemic agent.

What are the 3 conditions mentioned that can provoke an epileptic seizure?

Hyponatremia, drug and alcohol withdrawal, hypoglycemia

All of the following statements related to the emergency response to anaphylaxis are correct EXCEPT which one?

If a patient with anaphylaxis does not respond to an initial dose of epinephrine and the arrival of EMS will exceed 30 minutes, a repeat dose may be administered.

All of the following statements related to the emergency response to a case of suspected stoke are correct EXCEPT which one?

If the patient shows all three of the above abnormal symptoms, activate EM

All of the following statements related to hyperventilation are correct EXCEPT which one?

If the working diagnosis is hyperventilation, place patient in an upright or semi-reclining position and administer oxygen, 4 to 6 L/min by nasal cannula.

All of the following statements related to hypertensive emergency or urgency are correct EXCEPT which one?

In a hypertensive emergency in the oral health care setting, the BP should be promptly lowered to decrease the mean arterial pressure (MAP) to prevent cerebral ischemia.

Which of the following is the biochemical definition of Diabetic Ketoacidosis?

Increase in serum ketone concentration > 5 mEq/L, blood glucose level > 250 mg/dL, and blood pH < 7.3

All of the following statements are correct with respect to delayed hypersensitivity reaction EXCEPT which one?

Instruct patient or caretaker that if wheezing develops to call you immediately.

All of the following statements are correct with respect to myocardial infarction EXCEPT which one?

More than 6 months should elapse after a MI before elective noncardiac procedures, e.g., elective dental care is considered.

All of the following statements related to hypoglycemia are correct EXCEPT which one?

Neuroglycopenic manifestations of hypoglycemia include twitching and tremor; anxiety and nervousness; sweating, cold, clammy skin; pallor; and mydriasis.

What are the two classes of CVA?

Occlusive and Hemorrhagic

Which of the following patient populations is at increased risk for developing type 2 DM?

Patients older than age 40 years, obese patients, and patients with a genetic risk for type 2 DM

All of the following statements are correct with respect to ventilation failure EXCEPT which one?

Patients with COPD must not be given O2 supplementation, as higher levels of O2 may worsen respiratory failure.

What are the two major factors associated with an anaphylaxis?

route of exposure and time between exposures

What are you to do if someone in your dental chair is having a severe allergic reaction?

Seek medical care, inject epinephrine, perform CPR if the patient stops breathing, and always follow up with your patients

Patients prone to syncope should be treated in ____ position or ____ position.

Semi-supine or supine

What are some clinical signs and symptoms of asthma?

Severe shortness of breath Chest tightness or pain Coughing or wheezing

What are the three other conditions that can be a result of acute MI?

Shock, heart failure, and cardiac arrest can be results of MI.

All of the following statements related to postural hypotension are correct EXCEPT which one?

Signs and symptoms of postural hypotension include a distinctive prodrome.

the process of hyperventilating includes all of the following EXCEPT:

Slow breathing during exercise

The presence of _______________ demonstrates good periodontal health.

Streptococcus oralis

To prevent a hyperventilation crisis in the dental chair you should NOT:

Surprise the patient by saying they are going to get a crown put on that day

What is the best way to find out if your patient experiences syncope?

Take a thorough medical and dental history

In the dental chair or on the floor, what position should the patient be in during a seizure?

supine position

All of the following statements related to procedure-specific risk factors are correct EXCEPT which one?

The magnitude of surgical stress is unrelated to the severity of tissue trauma, duration of the procedure, volume of blood loss, fluid shifts, and changes in core body temperature.

All of the following statements are correct with respect to ventilation failure EXCEPT which one?

Ventilation failure is defined as a rise in CO2 concentration when alveolar ventilation either falls or fails to respond adequately to increased oxygen.

What is another name for syncope?

fainting

If a patient has heart disease or angina, you'll always be able to see oral changes associated with that condition.

false

The risk of angina increases after the age of 50 for men and 65 for women

false

When using a local anesthetic, do not use one with a vasoconstrictor, such as epinephrine, on patients with angina

false

Which of these is not a clinical sign of MI?

fever

What is the most common oral adverse reaction to antiplatelet drugs used to treat angina?

gingival hyperplasia

What is the main source of energy for the body?

glucose

Acute myocardial infarction is AKA what?

heart stroke

What type of animal experiences vasovagal syncope?

humans

Too much sugar in your blood is called:

hyperglycemia

Do remember the name of the position you would put your patient when they are aspirating?

lateral decubitus

Which of these will raise your blood sugar level the fastest?

mashed potatoes

Biofilm is _______________.

matrix of microbial societies, which communicate with one another

Fluorapatite is considered _______________ as compared to hydroxyapatite.

more structurally and chemically sound

What time of day is ideal for a diabetic patient to come in for a dental appointment?

morning appointment after breakfast and medications

There are two stages of angina: stable and unstable (2) Stable is unexpected, short in duration, controlled and unstable

only the first (1) statement is true

Which of the following statements is correct with respect to the risk of major medical events associated with ASA FS IV?

possible risk

What is the first line of treatment for vasovagal syncope?

preventive therapy

_______________ are living microorganisms used in dentistry to help decrease incidences of dental caries and periodontal disease.

probiotics

Angina is not a disease in itself, but it is a symptom of a disease.

true

Having a family history of MI puts you at a higher risk.

true

Pain in the left jaw could be an indicator of angina pectoris.

true

True or False, MI (heart attack) is the leading cause of death in the US?

true