ODM 814 - Lecture 5

What is the primary goal of performing a medical risk assessment before dental treatment?

Which of the following is the first step in the diagnostic sequence for patient care?

According to the American Society of Anesthesiologists (ASA) Physical Status classification, a patient with severe systemic disease that is a constant threat to life would be classified as:

Which of the following is NOT typically included in a patient's medical history assessment?

An ASA PS 3 patient is defined as:

Which ASA Physical Status (PS) classification would be assigned to a brain-dead patient whose organs are being harvested for donation?

A patient presents with well-controlled hypertension and mild asthma. According to the ASA Physical Status classification, what would be the MOST appropriate assignment?

A patient is undergoing a complex reconstructive surgery following a traumatic injury. Pre-operative assessment reveals previously undiagnosed severe coronary artery disease, significantly limiting cardiac function and posing an immediate high risk of cardiac arrest during the procedure. The patient is still deemed a candidate for the surgery due to the nature of injuries. Which ASA Physical Status classification would be most appropriate?

Which of the following conditions is NOT explicitly listed as associated with worse outcomes in infective endocarditis?

Which ASA (American Society of Anesthesiologists) classification is typically assigned to a patient with an implanted pacemaker?

According to the guidelines, which dental procedure necessitates consideration for antibiotic prophylaxis in patients at high risk for infective endocarditis?

A patient on an irregular dialysis schedule would most likely be classified as which ASA category?

In the context of cardiac conditions warranting antibiotic prophylaxis, which scenario is LEAST likely to necessitate it?

A patient with a prosthetic heart valve requires a dental extraction due to severe caries. The dentist consults with the patient's cardiologist, who suggests altering the standard antibiotic prophylaxis regimen due to the patient's allergy to amoxicillin and a history of Clostridium difficile infection. Which alternative antibiotic regimen is MOST appropriate in this complex clinical scenario?

A patient presents with severe heart disease that significantly limits their daily activity and poses a major impact on anesthesia and surgery. Which ASA classification is most appropriate?

During ASA classification, what key aspects of a patient's medical condition should a healthcare provider determine?

A researcher is conducting a meta-analysis of studies investigating the efficacy of antibiotic prophylaxis in preventing infective endocarditis following dental procedures. After analyzing data from multiple trials, they observe a statistically significant reduction in bacteremia immediately following dental procedures in patients receiving antibiotics. However, they find no statistically significant difference in the incidence of infective endocarditis between the antibiotic and placebo groups at 6 months follow-up. Which conclusion is MOST justified based on these findings?

A 45-year-old patient with a BMI of 34.6, controlled back pain, depression managed with medication, and anxiety about a tooth extraction desires oral sedation. What is the MOST appropriate ASA classification?

What factor does the ASA classification system primarily rely on to determine a patient's risk category?

A 2-year-old child weighing 49 lbs presents with a sore area on their chin and takes no medications. What ASA classification is most appropriate?

A 35-year-old pregnant woman (BMI 34.6) with well-controlled asthma using Fluticasone requires a tooth extraction due to a toothache (no swelling) and expresses anxiety. What ASA classification is appropriate?

A 65-year-old female (BMI 34.6, BP 158/92) drinks 4 glasses of wine nightly, is diabetic (fasting glucose 280 mg/dL), and needs a tooth extraction. What ASA classification is most appropriate?

Which of the following patients would be classified as ASA III? Consider all factors.

Which patient factor directly influences the level of consciousness during a dental procedure?

In the context of dental safety, what does 'DLDK' typically signify regarding lab values?

Which of the following is NOT a patient-related risk factor that needs to be considered when doing a risk assessment prior to a dental procedure?

A patient presents with an ASA score of 3 or 4. According to the Patient Risk Assessment Categories, how would they be classified?

A patient who can perform activities equivalent to 4 METs falls into which functional capacity category?

How does a patient's functional capacity, specifically their MET score, influence the safety assessment for a dental procedure?

Which of the following best describes a patient in Patient Risk Assessment Category 1?

When evaluating the 'Stability of Medical Health' in a patient risk assessment, what distinguishes a patient with 'poor control' from one who is 'stable'?

A dentist is planning an invasive procedure that is expected to last over 2 hours on an elderly patient (ASA 3) with cardiovascular disease, well managed with medication. The patient is extremely anxious and can barely sit still. While the dentist is highly skilled, their assistant is relatively new. Which of the following factors poses the HIGHEST risk?

A patient with a history of controlled hypertension (ASA 2) is scheduled for a routine dental cleaning but reports experiencing recent, uncharacteristic shortness of breath and chest pain, though vital signs are now normal. They take a common ACE inhibitor. Without additional investigation, proceeding with the cleaning is:

According to the provided categories, what characterizes a risk level of '0' concerning orofacial health?

What defines a risk level '2' in the 'Drug Administration' category?

Which of the following procedures would fall into invasiveness risk level 1?

Why is medical risk assessment a critical component of the diagnostic process?

How does the stability of a patient's condition influence the risk category?

Which of the following best describes the role of the ASA-PS classification system?

What is the invasiveness, pain level, and duration associated with risk level '2'?

Why might a risk assessment require obtaining a laboratory test result or consulting with a physician?

Which of the following are NOT explicitly mentioned as risk factors with anesthesia?

Consider a patient requiring a complex surgical procedure. The patient has a history of significant drug interactions with multiple medications, responds only to painful stimuli, and the planned surgery is expected to last several hours. Based solely on the provided categories, which combination of risk levels (Orofacial Health, Drug Administration, Level of Consciousness, Invasiveness) is MOST representative of this patient's situation? Assume orofacial health is not a significant factor.

What is Risk Assessment?

What is Risk Related to?

Diagnostic Sequence

Key Components of History Taking

Why Assess Medical Risk First?

ASA Physical Status (PS) Classification

ASA (PS) 1

ASA (PS) 4

In-hospital mortality of infective endocarditis

Conditions associated with worse infective endocarditis outcomes

Cardiac conditions with high risk of infective endocarditis

Dental procedures requiring infective endocarditis prophylaxis

Dental procedures NOT requiring infective endocarditis prophylaxis

Pacemaker Implant (ASA)

Irregular Dialysis (ASA)

Severe Heart Disease (ASA)

Determining ASA

Knowing the patient's...

ASA is based on...

ASA II

ASA III

Unstable patient

Stable patient

Threshold (Lab Value)

Controlled (Medical Condition)

Poorly Controlled (Medical Condition)

Uncontrolled (Medical Condition)

"DLDK"

ASA (Medical Status)

Functional Capacity

Tolerance/Functional Reserve

Drug Interactions/ADEs

Steroids, anticoagulants and bisphosphonates

Visual Analogue Scale (VAS)

ASA Status

Minimal Anxiolysis

Deep Sedation/General Anesthesia: Level of Consciousness

Additive Risk Assessment

Patient-Related Risk Factors

Procedure-Related Risk Factors

Endocarditis

Conscious Sedation

Drug Interaction