Altered Consciousness

Type II diabetes may sometimes be treated with what?

Oral hypoglycemics

a stroke in which signs & symptoms are exhibited for only a few minutes is known as what?

TIA (transient ischemic attack)

types of seizures

Tonic-clonic (grand mal) absence (petite mal) partial (focal or localized) status epilepticus

signs & symptoms of absence (petite mal)

blank stare twitching rapid blinking short duration

tonic

tension

status epilepticus causes death in 10% of cases

true

Which of the following are signs & symptoms of a CVA? (1)headache (2)paralysis (3)nausea (4)dizziness

(1) & (2)

which of the following conditions may result in a cerebral hemorrhage? (1) aneurysm (2)embolism (3)hypertensive vascular disease (4)ischemia- deficiency in blood supply

(1) aneurysm (2)embolism (3)hypertensive vascular disease

Which of the following is not appropriate in the treatment of an epileptic seizure? (1) loosen any tight clothing (2) restrain the patient from making any movements (3) remove any dental objects from the patient's mouth (4) do not remove the patient unless it is necessary

(2) restrain the patient

Which of the following is/are included in the emergency of treatment of a CVA? (1)administer a CNS relaxer (2)maintain open airway (3) administer oxygen (4)summon medical assistance

(2), (3), & (4)

Type I diabetic patients more often experience what?

Insulin shock

Syncope is a life threatening emergency

True

During what type of seizure would the patient exhibit a blank stare and twitch or blink?

Absence (petite mal) seizure

During which phase of the grand mal seizure would the tonic/clonic movements be seen?

Convulsive phase

Type II diabetic patients more often experience what?

Diabetic coma

Hypoglycemia (Insulin Shock)

abnormally low level of sugar in the blood

the correct treatment for the conscious patient suffering from insulin shock is to what?

administer a sugar source such as orange juice

Signs & symptoms associated with a cerebral hemorrhage include: (1)vertigo (2)vomiting (3)stupor (4)difficulty in movement

all of them

Which of the following may cause a person to develop a seizure disorder? injury to the brain high fever injury during birth

all of them

which of the following patient have increased chances of experiencing a CVA? (1) hypertensive (2) diabetic (3) history of heart disease (4) history of TIA

all of them

In most cases epilepsy can be controlled by administering an?

anticonvulsant

cerebral thrombosis occurs most often as a result of what?

atherosclerosis

signs & symptoms of tonic-clonic (grand mal)

aura tonic/clonic movements unconsciousness

a stroke that occurs as a result of a clot forming in some area of the body and traveling is what?

cerebral embolism

Causes of CVA

cerebral embolism-floating clot stuck in cerebral artery cerebral infarction-low blood flow to cerebral artery atherosclerosis-causes cerebral infarction cerebral hemorrhage- rupture in cerebral artery cerebral thrombosis- blockage of cerebral artery from a clot

what type of stroke is most likely to occur in the dental office?

cerebral hemorrhage

An absence or petit mal seizure is most often seen in who?

children

signs & symptoms of hypoglycemia (insulin shock)

cold sweat nervousness trembling weakness hunger personality change confusion

signs & symptoms of status epilepticus

continuous seizures life-threating

Signs & Symptoms of Syncope

death-like appearance shallow breaths dilated pupils convulsive movements loss of bladder control

an example of a microvascular disease is what?

diabetic retinopathy

Hyperglycemia (Diabetic Coma)

excessive sugar in the blood

Syncope

fainting or sudden loss of consciousness caused by lack of blood supply to the cerebrum

Every epileptic experiences the same type of aura

false

TIAs usually last at least 48 hours

false

a good treatment for syncope is to have the patient place the head between the knees

false

all causes of epilepsy are unknown

false

it is imperative that the dental team know what caused the CVA before it can provide proper treatment

false

it is uncommon for a patient to experience a TIA prior to experiencing a severe stroke

false

nonpsychogenic factors are the most common cause of syncope in the dental office

false

people who survive a CVA experience a low risk of recurrence

false

since the patient is unconscious, is it not important for the dental team to remain calm while treating syncope

false

syncope is a loss of consciousness due to an increase in the flow of blood to the brain

false

the most common type of seizure in children is partial

false

the patient may leave the office immediately after recovering from syncope

false

most medical problems are associated with type II diabetes

false; Type I because the patient has such problems for a longer time

Type II diabetes was once called juvenile diabetes

false; adult-onset

Tonic/clonic movements are usually seen in absence seizures

false; grand mal

hypoglycemia results when there is too much sugar in the bloodstream

false; hyperglycemia

anticonvulsants are not successful in treating most cases of epilepsy

false; it treats about 75%

diabetes is a disease that originated in the early 1900s

false; since Roman times BUT the cause was discovered in the 1900s

the primary goal in treating an epileptic seizure is to maintain an open airway

false; to prevent injury to patient

Psychogenic factors of syncope

fear pain emotional upset anxiety

the only fuel for the brain is what?

glucose

Type II Diabetes Mellitus

glucose dependent; adult-onset

Signs & symptoms of CVA

headache unconsciousness paralysis confusion impaired speech unequal pupils respiration difficulties

Signs & symptoms of Diabetic Coma (Hyperglycemia)

increased thirst increased urination loss of appetite nausea vomiting fatigue abdominal pains generalized aches Kussmaul breathing

Diabetic coma is treated with what?

insulin

Type I diabetes is most often treated with daily injections of what?

insulin

Type I Diabetes Mellitus

insulin dependent; juvenile onset

clonic

jerking

signs & symptoms of partial (focal or localized)

jerking movements of one body part trance-like state fidgeting

Signs & Symptoms of Pre-syncope

pallor cold sweat dizziness nausea warm feeling

a dental patient with diabetes may be more prone to what?

periodontal disease

If a person experiences an aura, it usually occurs during what phase?

prodromal phase

medical assistance should be summoned if what happens?

status epileptics is suspected the patient is injured the patient stops breathing

If a person experiences several epileptic seizures occurring one after another, the person is experiencing what?

status epilepticus

Main cause of syncope

stress

Seizure

sudden, transient disturbances in brain function resulting from an abnormal firing of nerve impulses; may or may not be associated with convulsion

Purpose of ammonia capsule during syncope treatment

to stimulate breathing

Dilantin gingival hyperplasia occurs in some epileptics as a result of taking Dilantin

true

Once a patient experiences syncope they are likely candidate for it to recur

true

Type II diabetes accounts for the majority of the diagnosed cases of diabetes

true

a cerebral hemorrhage is usually preceded by a headache

true

a cerebral thrombosis occurs as a result of an obstruction of the cerebral artery by a clot that forms within the artery

true

a patient should not be restrained during a seizure

true

anxiety and pain associated with a dental appointment have the potential to trigger a CVA

true

cerebral embolisms usually occur while the patient is awake

true

diabetic coma was the leading cause of death among patients with diabetes before the discovery of insulin

true

during pre-syncope there is a decrease in the BP and an increase in the Pulse rate

true

fear is an example of a psychogenic factor causing syncope

true

hereditary plays an important part in the cause of diabetes

true

if pre-syncope is recognized and treated properly, most instances of syncope can be prevented

true

insulin is produced in the body by the pancreas

true

it is best to used fixed dental appliances, if possible, when dealing with an epileptic

true

paralysis associated with a CVA is usually unilateral

true

signs & symptoms of a CVA vary according to the area of the brain affected as well as the type of CVA

true

Type I diabetes can usually be controlled with diet

true; along with exercise and drugs

Insulin may not be taken orally because it is digested in the stomach

true; since it is a protein

a patient suffering from a stroke should be positioned in what?

with head slightly elevated

An adverse dental condition that sometimes occurs as a result of taking Dilantin is what?

Dilantin gingival hyperplasia

The unconscious patient suffering from insulin shock should be treated how?

By being given glucagon injection