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Questions and Answers
Which autoimmune disease is characterized by the pancreas not making enough insulin?
What is a sign that may indicate the presence of diabetes?
HbA1c levels below which percentage indicate well-controlled diabetes?
Shortness of breath, fatigue, and swelling of the lower extremities are symptoms of which condition?
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What should patients taking Warfarin do before most dental procedures?
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A blood pressure reading of 145/100 is classified as which stage?
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What does sudden numbness of the face, arm, or leg on one side typically indicate?
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Patients who have suffered a stroke may safely receive which treatment?
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Which platelet count in a patient with thrombocytopenia necessitates a medical consultation before treatment?
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What treatment modification should be made for patients with sickle cell anemia?
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What is the appropriate INR level for performing routine care on patients under Warfarin therapy?
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Which type of hepatitis does not currently have a vaccine available?
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Under what circumstance is antibiotic premedication necessary for an HIV patient?
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Which of the following is NOT an oral manifestation associated with cancer treatment or radiation to the head and neck?
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Why is it important to monitor blood pressure and vitals for pregnant patients during dental treatment?
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Which analgesic is considered the safest option during pregnancy?
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Myxedema coma is primarily associated with which condition?
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What is a potential cause for a patient to experience an adrenal crisis?
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Which option represents an equivalent dose of cortisone (25 mg)?
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Which situation typically does NOT warrant a medical consult for a patient with adrenal gland disorder?
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Which of the following is NOT a sign of Chronic Obstructive Pulmonary Disorder (COPD)?
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What common issue can asthma medications lead to in oral health?
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Which factor is considered a risk for developing asthma?
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COPD can increase the risk of which of the following conditions?
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Which factor does NOT influence the perception of oral dryness?
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Which examination finding is most atypical?
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Nutritional deficiencies and Candida albicans are commonly associated with which area?
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A symblepharon would be located in which area?
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Which cancer risk factor is unchangeable by lifestyle modifications?
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Patients with cancer risk factors should be screened how often?
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Which virus is notably linked to oropharyngeal cancers?
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What percentage of oropharyngeal cancers are squamous cell carcinomas?
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What is the most common site for cancer to develop on the tongue?
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Which condition is characterized by the collection of debris in affected tonsils?
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What is the best diagnosis for painful ulcers that heal in approximately 7 days and recur frequently?
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For a 67-year-old woman with persistent ulcers lined with white rough areas, what is the most likely diagnosis?
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What is likely the diagnosis for a patient with asymptomatic, irregular red and white patches on the dorsum of the tongue?
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What is the best diagnosis for a nontender, compressible lesion with a blue surface on the lower labial mucosa?
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What condition does NOT typically lead to the development of lesions on the tonsils?
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Which of the following options is unlikely to cause soreness in the mouth?
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Study Notes
### Dialysis
- Appointments should be scheduled on the same day as dialysis
- Healthcare providers should check for excessive bleeding after dialysis
- Do not use the arm with the hemodialysis shunt when taking vitals
- Patients with hemodialysis shunt may need a medical consult
### Thrombocytopenia
- A platelet count below 45,000/mm3 requires a medical consult before treatment
Sickle Cell Anemia
- Treatment modifications are needed for patients with sickle cell anemia
- Premedication is required for minor surgical procedures
- Local anesthetic with vasoconstrictor should be limited
- Patients may not receive dental treatment during a sickle cell crisis
- Nitrous oxide may be used with at least 25% oxygen
Warfarin
- An INR of 2.7 is an appropriate level for performing routine care on patients who are undergoing Warfarin therapy
Hepatitis
- Hepatitis C does not have a vaccine available
HIV
- Antibiotic premedication is necessary for an HIV patient if the patient is experiencing severe immune neutropenia
Oral Manifestations of Cancer Treatment
- Oral mucositis is a common oral manifestation of cancer treatment, however, salivary stones are not
Pregnant Patients
- Monitor for signs of preeclampsia during dental treatment in pregnant patients
- Acetaminophen is the best analgesic to use during pregnancy
Hyperthyroidism
- Controlled hyperthyroidism does not mean a patient should not be given epinephrine
- Myxedema coma is not a medical emergency associated with hyperthyroidism
Myxedema Coma
- Myxedema coma is a medical emergency associated with hypothyroidism
Adrenal Crisis
- Adrenal crisis is caused by a severe lack of cortisol
Cortisone Equivalence
- 25 mg of Cortisone is equivalent to 25 mg of Hydrocortisone
Adrenal Gland Disorder
- It is not necessary to get a medical consult for a patient with adrenal gland disorder if they require local anesthesia for a restorative procedure
COPD
- COPD is a group of diseases that cause airflow blockage resulting in breathing problems
- Signs and Symptoms: wheezing, chest tightness, shortness of breath, coughing with large amounts of mucous, frequent respiratory infections, lower extremity edema, weight loss, decreased muscle endurance, blue lips or fingernails, tachycardia, decreased alertness
- Causes: long term exposure to lung irritants, genetics, respiratory infections, allergies
- Dental considerations: Medications can reduce the amount and quality of saliva, increasing the risk of dental caries, dental erosion, periodontal disease, and oral candidiasis
- COPD increases the risk of arthritis and depression
Diabetes
- Type 1 diabetes is an autoimmune disease where the pancreas does not make enough insulin
- Signs and Symptoms: urinating often at night, smell of acetone on breath, weight loss without trying
- HbA1c levels below 7% indicate the patient's diabetes is well controlled
Heart Failure
- Shortness of breath, fatigue, and swelling of the lower extremities, stomach and veins in the neck are signs and symptoms of heart failure
Warfarin
- Patients who are taking Warfarin should discontinue or alter their dose for most dental procedures.
Blood Pressure
- A blood pressure range of 145/100 is considered High Blood Pressure - Stage 1
- Elective dental treatment should be postponed for patients who have uncontrolled high blood pressure (≥ 180/110 mm Hg)
Stroke
- Sudden numbness of the face, arm, or leg on one side of the body is a classic sign and symptom of a stroke
- Patients who have experienced a stroke can be safely given local anesthesia with epinephrine 1:100,000 or 1:200,000
TMJ
- Deviation - an altered opening pathway with its greatest distance from the midline at maximum opening
- Crepitus - a crackling or grating sound
- Derangement - Internal displacement of the disk that is not reducible
Oropharynx
- Structures that should be noted during an oropharynx exam: tonsils, adenoids, tonsillar crypt, anterior/posterior pillars, posterior pharyngeal wall
Tonsillitis
- An acute infection of the tonsils
Oral Dryness
- Oral Dryness can depend on the amount of saliva present, the amount of serous saliva, the amount of mucous saliva, the salt/calcium composition of the saliva, and the consistency of the saliva
Atypical Exam Findings
- Stippled gingiva, Fordyce granules, leukoedema, and two mms of attached gingiva are all considered normal. However, Fordyce granules and leukoedema could be considered atypical because people are typically concerned and request removal.
Oral Mucosal Lesions
- Common sites for nutritional deficiencies, Candida albicans, human herpes virus, and lesions associated with loss of dimension: tongue, hard palate, commissures, floor of the mouth, pharyngeal pillars
Symblepharon
- A symblepharon is an adhesion between the conjunctiva and the eyeball
- A symblepharon is found in the eye
Cancer Risk Factors
- Alcohol, tobacco, diet, and sunlight are all cancer risk factors that can be lowered or modified by a change in lifestyle or behavior
Screening for Cancer
- Patients with known risk factors for cancer should be screened at more frequent intervals
Oropharyngeal Cancer
- HPV is associated with a significant increase in oropharyngeal cancers
- 90% of oropharyngeal cancers are squamous cell carcinomas
- The appearance of oral cancer can be any of the following: white lesion, red and white lesion, pigmented lesion, ulcer-like lesion
- Salivary gland tumors, lymphoma, and sarcoma-related cancers comprise 30-40% of oropharyngeal cancers
- Clinicians may not suspect cancerous changes in young individuals, therefore, cancerous changes are often missed.
- Debris tends to collect in tonsils affected by cancerous conditions
- The lateral border of the tongue is the most common site for cancer to develop
Aphthous Ulcers
- Painful ulcers on the labial mucosa and buccal mucosa that have a duration of 4 days or less
Lichen Planus
- Multiple persistent ulcers adjacent to white rough thickened areas which do not rub off and are arranged in a striated pattern
Geographic Tongue
- Multiple, asymptomatic, irregular, flat patches on the dorsum of the tongue. Each patch has a red center and an irregular white periphery
Hemangioma
- A compressible, nontender, soft tissue enlargement with a blue mucosal surface that does not blanch upon palpation
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Description
Test your knowledge on critical healthcare considerations for patients undergoing dialysis and those with various blood disorders such as thrombocytopenia, sickle cell anemia, and HIV. This quiz covers treatment modifications, procedural guidelines, and key medical facts essential for healthcare providers.
