Term
|
Definition
| pain due to a stimulus which does not normally provoke pain |
|
|
Term
| an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves |
|
Definition
|
|
Term
| four types of clinical pain |
|
Definition
NINC
1. Nociceptive pain (acute pain)
a. Burn
b. Surgery
2. Inflammatory
a. Ankle sprain
b. OA
c. Alloydynia
d. Hyperalgesia
e. Spontaneous
3. Neuropathic pain
a. Post-herpatic neuralgia
b. due to peripheral, central, mixed nerve damage
4. Central Pain Augmentation
a. Fibromyalgia
b. Migraine
c. IBS
d. Non-cardiac chest pain |
|
|
Term
|
Definition
-lasts more than 3 months
-has no biologic function
-usually controlled but never eliminated |
|
|
Term
|
Definition
inside the joint
Internal Derangement |
|
|
Term
|
Definition
– outside TMJ
Myofascial pain syndrome
Parafunctional habits |
|
|
Term
|
Definition
typical and clinical presentation and the nerves affected
-recurrent, paroxysms of sharp, stabbing pain in one or more branches of CN V
-one side of face
-women > men
-trigger points
-over 50 yo |
|
|
Term
| Trigeminal neuralgia is usually associated with |
|
Definition
| vascular compression of the superior cerebellar artery |
|
|
Term
|
Definition
glossopharyngeal neuralgia
-sharp stabbing pain in throat, posterior tongue, and back of jaw |
|
|
Term
| Migrane headaches - two types and description |
|
Definition
migraine headaches
-vascular component – exaggerated response to noxious stimuli with vasodilation of intra-extra cranial vessels
-Fam history positive in 60%
-women > men
-may begin in childhood
-Aura “Classic Migraine” – flashing lights, sparks, spots, precede throbbing HA, may have neurological symptoms
-No Aura “Common Migraine” – recurrent, unilateral throbbing/pounding, occur in periods of stress, relieved by sleep |
|
|
Term
|
Definition
- morning stiffness, less than 30 min
- radiographic findings, asymmetric
-joint involvement, non-symmetric
-synovial fluid, non-inflammatory |
|
|
Term
|
Definition
- morning stiffness, more than 30 min
-radiographic findings, erosive/symmetric
-joint involvement, symmetric
-synovial fluid, inflammatory |
|
|
Term
| Infectious arthritis characteristics |
|
Definition
Infectious arthritis characteristics
-infection of joint
-involves TMJ by direct extension (osteomyelitis, parotid, ear/throat infections)
-systemic disease (GC, syphilis, TB, actinomycosis)
-Risk factors: RA, DM, IVDA, STD, Trauma, Steroids
-surgical manipulation
-high grade fever, severe pain, effusion, malocclusion (post open bite), usually unilateral, my progress to ankylosis or growth deformity in children
-Diagnosis confirmed by TMJ aspirate
-synovial fluid shows very high WBC (PMN’s)
-MUST TAP JOINT IMMEDIATELY |
|
|
Term
| most often grown bacteria in TMJ |
|
Definition
|
|
Term
| Degenerative osteoarthritis its presentation and characteristics |
|
Definition
-non-inflammatory
-increased mechanical stress on joints – weight bearing joints/ asymmetric
-most common disease affecting TMJ
-unilateral
-women
-TMJ pain
-tenderness in join and muscles of mastication
-may be associated with MPD
-affects articular cartilage first - no radiographic changes
-reduced joint spaces
-loss of perforation of articular disc
-primary = aging/wear and tear (>50yo)
-secondary = macrotrauma or chronic microtrauma (20-40yo)
-subchondral bone sclerosis
-flattening and lipping of condyle
-osteophyte formation late in disease
-no value lab values
-non-inflammatory (few WBCs) in synovial fluid |
|
|
Term
|
Definition
-involves joints, skin, nervous system, heart
-spirochete Borrelia burgdorferi
-transmitted by tick vector
-characteristic skin lesion: erythema chronicum migrans (ECM)
-tick bite: red macule, days to months later
-“Target lesion”
-musculoskeletal involvement may occur months to years later (60%)
-migratory polyarthritis, myalgia, joint swelling, 10% go onto chronic arthritis, deformity and disability
-TMJ findings are non-specific |
|
|
Term
|
Definition
| Ginglymoarthrodial – acts as hinge and gliding joint |
|
|
Term
| Rotation Vs Translation movements |
|
Definition
-Rotation (hinge) movement occurs in the inferior joint space (27 mm)
-Translation occurs in upper joint space as it moves out of fossa(>27 mm) |
|
|
Term
| Hypoxia-Reperfusion Injury theory: |
|
Definition
-increased hydrostatic pressure – disrupts blood flow (bruxism)
-end-capillary pressure exceeded
-transient disruption in blood flow
-unloading may produce free radicals when tissue perfusion returns
-injury occurs where there is a loss of oxygen followed by regain of oxygen momentarily |
|
|
Term
| Arthrocentesis versus arthroscopy, primary difference: |
|
Definition
Arthroscopy uses a scope
Arthrocentesis does not |
|
|
Term
| Epinephrine: maximum doses |
|
Definition
Healthy pts
• .2 mg
• 200 mcg
• 11 cartridges of 1:100,000
Cardiac pts
• .04 mg
• 40 mcg
• 2 cartridges of 1:100,000 |
|
|
Term
| Vasoconstricitors: absolute contraindications: |
|
Definition
• Unstable angina
• Thyroid storm
• Most ASA IV pts will not be treated at office setting |
|
|
Term
| Pregabalin (Lyrica) adverse effect: |
|
Definition
| may decrease platelet count |
|
|
Term
| Lab values for liver function, blood count and platelets before starting and during therapy: |
|
Definition
|
|
Term
|
Definition
Gabapentin
Carbamazepine
Lyrica |
|
|
Term
| Elavil©(amitriptyline) and Cymbalta© (duloxetine) are: |
|
Definition
Tricyclic Antidepressants (TCA)
NE and serotonin reuptake inhibitors
Cardiotoxicity is a concern in the elderly |
|
|
Term
| Flexeril (cyclobenzaprine) |
|
Definition
Adverse Effects: tachycardia, contraindicated in heart disease and elderly patients
Drug Interactions: CNS depressants
Mechanism: unknown. muscle relaxant. |
|
|
Term
| Imitrex© (sumatriptan) is used to treat which chronic pain condition? |
|
Definition
|
|
Term
| Neurontin© (gabapentin) is a: |
|
Definition
|
|
Term
| Baseline liver enzyme levels before beginning and during therapy are recommended when treating chronic pain with: |
|
Definition
Zanaflex©(tizanidine). relaxant
Can lower HR and BP. Interactions with CNS depressants. |
|
|
Term
| Which drug is best used to treat chronic pain in a patient with heart disease? |
|
Definition
TCA's are contraindicated.
Skelaxin©(metaxalone) - skeletal muscle relaxation
contraindications: glaucoma, myasthenia gravis, ulcer, angina |
|
|
Term
| Epinephrine is a catecholamine that interacts: |
|
Definition
| directly on α 1, α 2, β 1 and β 2 adrenergic |
|
|
Term
| Albuterol is a direct acting adrenergic agonist that primarily interacts with: |
|
Definition
| β 2 receptors in the lungs. |
|
|
Term
| Which of the following routes of administration provides rapid d! elivery of drugs and the ability to titrate dosages? |
|
Definition
|
|
Term
| The most common perioperative medical emergency to occur in a dental setting is: |
|
Definition
|
|
Term
| When managing a patient with a history of seizures: |
|
Definition
| prolonged tonic-clonic activity should be considered an emergent situation. |
|
|
Term
| Obtaining an accurate medical history is: |
|
Definition
| is crucial in order to prevent many medical emergency situations. |
|
|
Term
| After unsuccessfully attempting to locate a potentially swallowed or aspirated a foreign object, the next step is to: |
|
Definition
| contact the emergency department to obtain radiographs in order to locate the object |
|
|
Term
| An appropriate step in the management of an unresponsive patient receiving dental trea! tment in your dental office is administration of |
|
Definition
| intramuscular glucagon secondary to severe hypoglycemia. |
|
|
Term
| Risk factors associated with coronary artery disease include: |
|
Definition
|
|
Term
| Medical management of a patient with ischemic heart disease may include all of the following EXCEPT one. Which one is the EXCEPTION? |
|
Definition
| Antiplatelet medications and catecholamines** |
|
|
Term
| when discussing acute coronary syndromes, all of the following are true EXCEPT one. Which one is the EXCEPTION? |
|
Definition
| Routine dental care is con! traindicated for at least one year following an STEMI |
|
|
Term
| Vasoconstrictors mimic the action of which nervous system? |
|
Definition
|
|
Term
| Epinephrine is what type of compound? |
|
Definition
|
|
Term
| Which adrenergic receptor produces vasoconstriction? |
|
Definition
|
|
Term
| In a patient with heart disease why could epinephrine cause chest pain? |
|
Definition
| Increases myocardial oxygen consumption |
|
|
Term
| Which of the following patients are not suitable for office dentistry? |
|
Definition
|
|
Term
| A glycated hemoglobin of 9% corresponds to what value for a fasting blood sugar? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Which of the following oral agents can cause hypoglycemia? |
|
Definition
|
|
Term
| For which patient is DDAVP the initial agent used to promote hemostasis? |
|
Definition
|
|
Term
| Pharmacologic adverse effects which are not of concern when managing patients with psychiatric disorders are: |
|
Definition
| orthostatic hypertension. |
|
|
Term
| Which of the following represents appropriate management of a patient who is scheduled for the extraction of two maxillary anterior teeth? |
|
Definition
Consider using adjunctive hemostatic agents (e.g. fibrillar collagen) for the patient taking Plavix.
- Proceed with surgery in the patient with A. Fibrillation is INR is therapeutic between 2.5 – 3. |
|
|
Term
A 28 year old female presents for a dental appointment with a chief
complaint of pain radiating to her neck, jaws and ears. She reports that she
takes no medications and has no history of hospitalization except for
childbirth 7 months ago. Upon palpation of the patient’s neck you note an enlargement. These findings suggest which of the following? |
|
Definition
|
|
Term
| The primary concern of a dental provider for patients with thyroid disease is which of the following? |
|
Definition
|
|
Term
| Drug interactions of concern during dental treatment for patients with Graves' disease include |
|
Definition
| anticoagulants and beta blockers |
|
|
Term
A 20 year old male patient presents for his 6 month dental appointment with complaint of bleeding gums for approximately 3 week. Upon review of systems, medical history, medications the patient reports that he has not been feeling well, has a sore throat and he has recently developed a rash on his legs. He is obviously sweating and has a fever. Oral examination reveals
generalized, enlarged, bleeding gingival tissues, lymphadenopathy, enlarged tonsils, and palatal petechiae. Your immediate plan for this patient should be
to: |
|
Definition
| order a complete blood count including differential and platelets. |
|
|
Term
|
Definition
| demonstrate wheezing during auscultation. |
|
|
Term
| Which of the following characterizes iron deficiency anemia? |
|
Definition
| Microcytosis and hypochromia demonstrated on peripheral blood smear |
|
|
Term
| Treatment of gastroesophageal disease includes: |
|
Definition
| prescribing medication including proton pump inhibitors, H2 Blockers and prokinetic agents. |
|
|
Term
| When comparing Vitamin B12 deficiency with folic acid deficiency, besides differences in B12 and folate levels, which of the following findings is a distinguishing factor? |
|
Definition
|
|
Term
| What is the ASA classification where a patient has a single systemic disease which is mild or well controlled? |
|
Definition
|
|
Term
The elderly or medically compromised patient functional status should
always be evaluated, when initially obtaining their history or prior to
considering performing a procedure. Using the METS (metabolic equivalents)
the ability to climb a flight of stairs is associated with what value? |
|
Definition
|
|
Term
| Amides are metabolized in the: |
|
Definition
|
|
Term
| Esters are metabolized in the |
|
Definition
|
|
Term
| Number of nodes and length that must be blocked to prevent impulse: |
|
Definition
| A minimum of 2-3 Nodes of Ranvier (8 to 10 mm of nerve) must be covered by anesthetic solution to prevent progression of the impulse |
|
|
Term
| Zip" perforations on the mesial root of the mandibular first molar occur: |
|
Definition
| on the mesial of the apical third of the root |
|
|
Term
| Which of the following are true about Gates Glidden burs? |
|
Definition
| Available in 15 and 19 mm lengths |
|
|
Term
| Underfilling is caused by |
|
Definition
|
|
Term
| Walton indicates the main cause of vertical root fracture in endo treated teeth is: |
|
Definition
| post preparation and cementation. |
|
|
Term
| The usual cause of separated instruments is: |
|
Definition
|
|
Term
| The most common cause of failed apexogenesis and apexification is: |
|
Definition
|
|
Term
|
Definition
| can be a permanent procedure |
|
|
Term
| What value measures the effect of coumadin? |
|
Definition
|
|
Term
| The INR should be below what value in order to perform extractions? |
|
Definition
| most of the literature is going to tell you an INR below 3 |
|
|
Term
| aPTT we use to monitor the anti coagulation on a patient that is on: |
|
Definition
|
|
