Oral Surgery Midterm -Part 1
1. A medical update is performed visit: every
2. What are examples of medications that may affect treatment?: Blood thinners Immunosuppressive agents
Rank Ligand Inhibitors Bisphosphonates
3. What are examples of medical history that may affect treatment?: -
Chemotherapy Radiation
therapy COPD
Cardiac Disease
4. If your patient has kidney failure, what medication should they avoid?: -
NSAIDS
5. If your patient has liver failure, most likely to due alcoholism, they often have
disorders: bleeding
6. If your patient has a history of radiation, what are the two areas we are MOST concerned with if they have
received radiation?: Head and neck
7. Anxiety can cause..: Dental phobia Aggravation of
medication conditions Syncope
8. Anxiety can aggravate medical conditions such as...: Angina MI
Hypertension
9. If your patient has anxiety, what are things you can do BEFORE the appoint- ment?: Morning appoints and
scheduled to reception time is minimized*
Sedative to reduce anxiety
Hypnotic agent to promote sleep the night before
10. If your patient has anxiety, what are things you can do DURING the appoint- ment?: Frequent verbal
reassurances
Distracting conversation
warn patient before doing anything, no surprises
no uncessary noise
11.What are some pharmacological ways to anxiety control?: Local anesthetics with sufficient intensity and
duration
, Oral Surgery Midterm -Part 1
Nitrous Oxide
Intravenous Anxiolytics
12.Angina Pectoris population: COMMON
men over 40 and post menopausal women history of angina:
-frequency
-Duration
-Severity
13.How should you proceed if your patient has angina pectoris?: Anxiety control
Decrease O2 demand
AVOID EXCESSIVE EPINEPHRINE*
14.What is angina pectoris?: Narrowing of the coronary arteries creating a de- crease in sufficient oxygenated
blood to the myocardium
symptoms resolve when myocardium needs are reduced and/or oxygen supply has improved
15.What are the symptoms of Angina Pectoris?: Substernal pressure
radiating pain to left arm and shoulder radiating pain to
mandible
sense of difficulty breathing
Vagal stimulating resulting in nausea, sweating, and bradycardia
16.What is myocardial infarction?: Oxygen supply to the myocardium has been sufficient to cause cellular death
caused by narrowing of cardiac artery combined with clot formation
cardiac muscle does NOT regenerate, so area heals with scar that does not function properly.
, Oral Surgery Midterm -Part 1
17.How should you proceed if your patient has a history of myocardial infarc- tions?: Anxiety reduction
Consult with PMD or cardiologist
Recommended to delay elective treatment and surgical treatment for 6 MONTHS post MI
other procedures may be done if OK'd by cardiologist
18.What is asthma?: narrowing of the small airways producing wheezing and dyspnea
usually a result of chemical, infectious, immunological, emotional stimulation or combination of these
19.If your patient has asthma, you should ask them...: What are the precipitating factors?
Frequency and duration? Medications
used?
# of visits to the ER and or hospitalizations
20.T/F: You should defer elective oral surgical treatment if an active URI or wheezing is present for your
asthma patient.: True
21.If your patient has asthma, you should avoid because it may
precipitate an attack in susceptible individuals:
22.COPD is typically caused by....: long term exposure to irritants
23.Patients who have COPD are often on what medications?: Bronchodilators Possibly corticosteriods
24.If your patient has COPD, what should you avoid?: Medications that will depress respiratory drive
supplemental O2 unless advised by pulmonologist
25.Patients who have renal failure/transplant typically also have :-
hypertension
26.If your patient has renal failure, what drugs should you avoid?: Drugs that are metabolized or excreted renally
Avoid NSAIDs (renal toxicity)
, Oral Surgery Midterm -Part 1
27.If your kidney failure patient is on dialysis, when is the best time to do elective surgery?: The day after
dialysis due to heparin
28.Kidney failure patients are at an increased risk for : hepatits
29.What medication is known to cause gingival hyperplasia?: Cyclosporine A
(used for organ transplants to avoid organ rejection)
30.What are the effects of corticosteriods?: Anti-inflammatory Immunosuppression
Gluconeogeneis Altered fat
metabolism
-buffalo hump
-hyperlipidemia Fluid
retention High HP
CHF
Peptic Ulcer Adrenal
Atrophy Psychosis
Cataracts Glaucoma
31.What is considered mild-moderate hypertension?: systolic less than 200 diastolic less than 110
32.What is considered severe hypertension?: systolic greater than 200 diastolic great than 110
avoid elective surgery
emergency surgery only in controlled setting
33.What is the most common cause for adrenal insufficiency?: Corticosteroid medications
34.What are examples of hematologic problems?: inherited disorders like he- mophilia
acquired disorders like liver failure or medication induced
35.T/F an INR more than 24 hours old is useless: True
36.what is normal prothrombin time (PT) clotting time?: 11-14 seconds
test extrinsic pathways
(II, V, VII, & X-- these are just coagulation factors)
1. A medical update is performed visit: every
2. What are examples of medications that may affect treatment?: Blood thinners Immunosuppressive agents
Rank Ligand Inhibitors Bisphosphonates
3. What are examples of medical history that may affect treatment?: -
Chemotherapy Radiation
therapy COPD
Cardiac Disease
4. If your patient has kidney failure, what medication should they avoid?: -
NSAIDS
5. If your patient has liver failure, most likely to due alcoholism, they often have
disorders: bleeding
6. If your patient has a history of radiation, what are the two areas we are MOST concerned with if they have
received radiation?: Head and neck
7. Anxiety can cause..: Dental phobia Aggravation of
medication conditions Syncope
8. Anxiety can aggravate medical conditions such as...: Angina MI
Hypertension
9. If your patient has anxiety, what are things you can do BEFORE the appoint- ment?: Morning appoints and
scheduled to reception time is minimized*
Sedative to reduce anxiety
Hypnotic agent to promote sleep the night before
10. If your patient has anxiety, what are things you can do DURING the appoint- ment?: Frequent verbal
reassurances
Distracting conversation
warn patient before doing anything, no surprises
no uncessary noise
11.What are some pharmacological ways to anxiety control?: Local anesthetics with sufficient intensity and
duration
, Oral Surgery Midterm -Part 1
Nitrous Oxide
Intravenous Anxiolytics
12.Angina Pectoris population: COMMON
men over 40 and post menopausal women history of angina:
-frequency
-Duration
-Severity
13.How should you proceed if your patient has angina pectoris?: Anxiety control
Decrease O2 demand
AVOID EXCESSIVE EPINEPHRINE*
14.What is angina pectoris?: Narrowing of the coronary arteries creating a de- crease in sufficient oxygenated
blood to the myocardium
symptoms resolve when myocardium needs are reduced and/or oxygen supply has improved
15.What are the symptoms of Angina Pectoris?: Substernal pressure
radiating pain to left arm and shoulder radiating pain to
mandible
sense of difficulty breathing
Vagal stimulating resulting in nausea, sweating, and bradycardia
16.What is myocardial infarction?: Oxygen supply to the myocardium has been sufficient to cause cellular death
caused by narrowing of cardiac artery combined with clot formation
cardiac muscle does NOT regenerate, so area heals with scar that does not function properly.
, Oral Surgery Midterm -Part 1
17.How should you proceed if your patient has a history of myocardial infarc- tions?: Anxiety reduction
Consult with PMD or cardiologist
Recommended to delay elective treatment and surgical treatment for 6 MONTHS post MI
other procedures may be done if OK'd by cardiologist
18.What is asthma?: narrowing of the small airways producing wheezing and dyspnea
usually a result of chemical, infectious, immunological, emotional stimulation or combination of these
19.If your patient has asthma, you should ask them...: What are the precipitating factors?
Frequency and duration? Medications
used?
# of visits to the ER and or hospitalizations
20.T/F: You should defer elective oral surgical treatment if an active URI or wheezing is present for your
asthma patient.: True
21.If your patient has asthma, you should avoid because it may
precipitate an attack in susceptible individuals:
22.COPD is typically caused by....: long term exposure to irritants
23.Patients who have COPD are often on what medications?: Bronchodilators Possibly corticosteriods
24.If your patient has COPD, what should you avoid?: Medications that will depress respiratory drive
supplemental O2 unless advised by pulmonologist
25.Patients who have renal failure/transplant typically also have :-
hypertension
26.If your patient has renal failure, what drugs should you avoid?: Drugs that are metabolized or excreted renally
Avoid NSAIDs (renal toxicity)
, Oral Surgery Midterm -Part 1
27.If your kidney failure patient is on dialysis, when is the best time to do elective surgery?: The day after
dialysis due to heparin
28.Kidney failure patients are at an increased risk for : hepatits
29.What medication is known to cause gingival hyperplasia?: Cyclosporine A
(used for organ transplants to avoid organ rejection)
30.What are the effects of corticosteriods?: Anti-inflammatory Immunosuppression
Gluconeogeneis Altered fat
metabolism
-buffalo hump
-hyperlipidemia Fluid
retention High HP
CHF
Peptic Ulcer Adrenal
Atrophy Psychosis
Cataracts Glaucoma
31.What is considered mild-moderate hypertension?: systolic less than 200 diastolic less than 110
32.What is considered severe hypertension?: systolic greater than 200 diastolic great than 110
avoid elective surgery
emergency surgery only in controlled setting
33.What is the most common cause for adrenal insufficiency?: Corticosteroid medications
34.What are examples of hematologic problems?: inherited disorders like he- mophilia
acquired disorders like liver failure or medication induced
35.T/F an INR more than 24 hours old is useless: True
36.what is normal prothrombin time (PT) clotting time?: 11-14 seconds
test extrinsic pathways
(II, V, VII, & X-- these are just coagulation factors)
