5- medical evaluation
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Questions and Answers

Which of the following is NOT a goal of the physical and psychological evaluation?

  • Identifying possible contraindications
  • Determining the patient's ability to tolerate physical and psychological stress
  • Evaluating the patient's chronic disease status (correct)
  • Determining the appropriate sedation technique

    • What percentage of adults have a chronic disease?

  • 20%
  • 40%
  • 30%
  • 60% (correct)

    • The main question regarding dental treatment and medical complications is whether...

  • Dental treatment has no impact on medical complications
  • Medical complications can be completely avoided during dental treatment
  • The risk of medical complications outweighs the benefit of dental treatment
  • The benefit of dental treatment outweighs the risk of medical complications (correct)

    • Which of the following is NOT included in the patient evaluation?

    <p>Laboratory tests</p> Signup and view all the answers

    What is one of the components of the overall assessment in the patient evaluation?

    <p>Physical examination</p> Signup and view all the answers

    Which information is considered the most useful for a clinician when deciding whether a patient can safely undergo dental therapy?

    <p>Medical history</p> Signup and view all the answers

    How should the medical history be tailored?

    <p>To each patient</p> Signup and view all the answers

    Which component of the medical history includes information about the patient's current symptoms?

    <p>History of present illness</p> Signup and view all the answers

    What type of information is included in the past medical history?

    <p>Previous medical condition.</p> Signup and view all the answers

    What type of information is included in the past medical history?

    <p>all of the above</p> Signup and view all the answers

    Which component of the medical history includes information about the patient's current symptoms?

    <p>Chief Complaint</p> Signup and view all the answers

    Which vital signs are typically measured during the patient evaluation?

    <p>Blood pressure, heart rate, and respiratory rate</p> Signup and view all the answers

    Which systems should be reviewed if IV sedation or GA is planned?

    <p>Cardiovascular, respiratory, and nervous systems</p> Signup and view all the answers

    Which part of the body should the dentist perform a quick review of on every patient?

    <p>Head, ears, eyes, nose, mouth, and throat</p> Signup and view all the answers

    What is the purpose of a review of systems during a patient evaluation?

    <p>To reveal undiagnosed medical conditions</p> Signup and view all the answers

    Which of the following is NOT a category included in the Review of Systems during a patient evaluation?

    <p>Musculoskeletal</p> Signup and view all the answers

    Which of the following is NOT a component of the Social History in a patient evaluation?

    <p>Family History</p> Signup and view all the answers

    Which of the following is NOT a part of the physical evaluation during a patient examination?

    <p>Olfaction</p> Signup and view all the answers

    What is the primary focus of the physical examination in the maxillofacial region?

    <p>Inspection</p> Signup and view all the answers

    Which method of physical examination involves tapping on the teeth or surrounding tissues to assess for tenderness or abnormal sounds?

    <p>Percussion</p> Signup and view all the answers

    What does Assessment refer to in the context of patient evaluation?

    <p>An appraisal of a patient's condition by a healthcare provider based on clinical and laboratory data</p> Signup and view all the answers

    What is the purpose of a differential diagnosis?

    <p>To list possible conditions that share the same symptoms</p> Signup and view all the answers

    When are laboratory tests indicated in the patient evaluation process?

    <p>When based on medical history and planned procedure</p> Signup and view all the answers

    What is the primary purpose of a consultation in the patient evaluation process?

    <p>To discuss management and evaluate new symptoms</p> Signup and view all the answers

    Which ASA classification represents a patient with mild systemic disease that does not interfere with daily activity?

    <p>ASA II</p> Signup and view all the answers

    Which ASA classification represents a patient with moderate to severe systemic disease that is not incapacitating but may alter daily activity?

    <p>ASA III</p> Signup and view all the answers

    Which ASA classification represents a patient with severe systemic disease that is a constant threat to life?

    <p>ASA IV</p> Signup and view all the answers

    When should premedication be administered for stress reduction protocol?

    <p>Night before and day of treatment</p> Signup and view all the answers

    What is the significance of a morning appointment mentioned in the text?

    <p>Reduce stress on the patient</p> Signup and view all the answers

    Which of the following is a symptom of myocardial ischemia?

    <p>Chest pain</p> Signup and view all the answers

    What is the primary purpose of having nitroglycerin available for a patient with coronary artery disease?

    <p>To relieve angina symptoms</p> Signup and view all the answers

    When should dental treatment be deferred for a patient who experienced myocardial infarction (MI)?

    <p>6 months after MI</p> Signup and view all the answers

    Which of the following is a common trigger for asthma?

    <p>all of the above</p> Signup and view all the answers

    What is a recommended management approach for an asthmatic patient using steroids chronically?

    <p>Treat as if adrenal insufficiency</p> Signup and view all the answers

    When is it recommended to defer treatment for an asthmatic patient?

    <p>Until asthma is well-controlled</p> Signup and view all the answers

    What is a recommended action for managing renal insufficiency and dialysis?

    <p>Initiate treatment the day after dialysis</p> Signup and view all the answers

    What is a crucial consideration for drug management in patients with renal insufficiency?

    <p>Avoid or modify drugs which depend on renal metabolism/excretion</p> Signup and view all the answers

    What is a key recommendation for drug management in patients undergoing dialysis?

    <p>Avoid nephrotoxic drugs such as NSAIDs</p> Signup and view all the answers

    When managing patients with liver failure, what should be considered regarding drug management?

    <p>Avoiding or modifying drugs requiring hepatic metabolism/excretion like Tylenol</p> Signup and view all the answers

    What is a recommended precaution when managing patients with liver failure?

    <p>Screening for bleeding disorders</p> Signup and view all the answers

    What is a crucial consideration when managing patients with epilepsy?

    <p>Questioning the patient about the frequency, type, and duration of seizures</p> Signup and view all the answers

    According to the American Dental Association and the American College of Obstetricians and Gynecologists (ACOG), when is it considered safe to perform emergency dental treatments during pregnancy?

    <p>At any stage during pregnancy</p> Signup and view all the answers

    What is the recommended approach for managing a pregnant patient who seeks dental treatment?

    <p>Delay treatment until after delivery</p> Signup and view all the answers

    What is the stance of the American Dental Association and the American College of Obstetricians and Gynecologists (ACOG) regarding the use of local anesthetics and radiographs during pregnancy?

    <p>Safe at any stage during pregnancy</p> Signup and view all the answers

    Which of the following local anesthetics is considered safe for use during pregnancy?

    <p>Lidocaine (with epinephrine)</p> Signup and view all the answers

    What medication is recommended for pain relief during pregnancy?

    <p>Acetaminophen (Tylenol)</p> Signup and view all the answers

    What position should be avoided for long periods of time in the management of pregnant patients?

    <p>Supine position</p> Signup and view all the answers

    Which of the following is an effect of epinephrine?

    <p>Bronchodilation</p> Signup and view all the answers

    Which of the following conditions is NOT an absolute contraindication for the use of epinephrine?

    <p>Uncontrolled diabetes</p> Signup and view all the answers

    Which of the following conditions is considered an absolute contraindication for the use of epinephrine?

    <p>Recent coronary artery bypass graft</p> Signup and view all the answers

    Which of the following conditions is listed as an absolute contraindication for the use of epinephrine?

    <p>Pheochromocytoma</p> Signup and view all the answers

    Which class of medications is NOT listed as a relative contraindication for the use of epinephrine?

    <p>Selective B-blockers</p> Signup and view all the answers

    Which condition is listed as a relative contraindication for the use of local anesthetics?

    <p>Atypical plasma cholinesterase</p> Signup and view all the answers

    Which of the following is a relative contraindication for the use of local anesthetics?

    <p>Methemoglobinemia</p> Signup and view all the answers

    In stressful situations, how much hydrocortisone can the adrenal glands produce?

    <p>Up to 300 mg</p> Signup and view all the answers

    What may patients taking exogenous steroids develop?

    <p>Adrenal suppression</p> Signup and view all the answers

    What is a sign of adrenal crisis?

    <p>Hypotension</p> Signup and view all the answers

    When is stress response typically regained with corticosteroids?

    <p>Within 2 weeks</p> Signup and view all the answers

    Why is good pain control essential when using corticosteroids?

    <p>To prevent adrenal crisis</p> Signup and view all the answers

    What is the recommended approach for dental management of a patient currently taking steroids and requiring extensive dentistry?

    <p>Double the normal daily dose of steroids</p> Signup and view all the answers

    For routine dentistry or local anesthesia, what is the recommended approach for dental management of a patient currently taking steroids?

    <p>Normal dose of steroids</p> Signup and view all the answers

    What is the recommended dosage of hydrocortisone for a patient undergoing general anesthesia in the context of dental management?

    <p>100mg IV pre-op, intra-op, post-op</p> Signup and view all the answers

    In the context of dental management, when should hydrocortisone be administered to a patient undergoing general anesthesia?

    <p>Pre-op, intra-op, post-op</p> Signup and view all the answers

    In the context of dental management, what is the recommended approach for a patient with Type I Diabetes Insulin dependent (IDDM) who requires IV anesthesia?

    <p>Administer half the usual insulin and provide dextrose IV</p> Signup and view all the answers

    What is the recommended glucose range to keep patients with Type I Diabetes Insulin dependent (IDDM) 'on the sweet side' during dental management?

    <p>100-200</p> Signup and view all the answers

    What is the recommended action for a patient with Type I Diabetes Insulin dependent (IDDM) during early AM dental appointments?

    <p>Take usual insulin and eat regular meal</p> Signup and view all the answers

    Which type of diabetes is much less prone to hypo- or hyperglycemia?

    <p>Type II Diabetes</p> Signup and view all the answers

    For which type of diabetes is it recommended to skip insulin medication before IV anesthesia?

    <p>Type II Diabetes</p> Signup and view all the answers

    Which of the following is a chronic effect of diabetes?

    <p>Progressive renal failure</p> Signup and view all the answers

    What is a common consequence of diabetes related to the eyes?

    <p>Retinopathy</p> Signup and view all the answers

    What is the primary damage caused by diabetes?

    <p>Small blood vessels damage</p> Signup and view all the answers

    What is the primary effect of Coumadin (Warfarin) on the coagulation process?

    <p>Decreases formation of factors II, VII, IX, X</p> Signup and view all the answers

    What is the recommended method to reverse the anticoagulant effect of Coumadin (Warfarin)?

    <p>Vitamin K</p> Signup and view all the answers

    If a patient on Coumadin (Warfarin) must undergo a dental procedure, Coumadin could be...

    <p>Discontinue, adjust or not change dosage</p> Signup and view all the answers

    Study Notes

    Physical Examination

    • Begins with the assessment of vital signs
    • Emphasizes examination of the oral cavity
    • Also includes evaluation of the maxillofacial region, although to a lesser extent
    • Aims to provide an accurate description of the patient's condition, rather than making a diagnosis

    Components of Physical Evaluation

    • Inspection: visual examination of the patient
    • Palpation: examination using touch or feeling
    • Percussion: examination using tapping or percussion
    • Auscultation: examination using listening to sounds

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    Description

    This quiz explores the goals of physical and psychological evaluation in dental treatment. Test your knowledge on determining patient's ability to tolerate stress, choosing sedation techniques, identifying contraindications, and weighing the benefit of treatment against medical complications.

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