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MOH DHA HAAD Dental Study Material Part 2 PDF
MOH DHA HAAD Dental Study Material Part 2 PDF
TOPICS
1.
2.
3.
4.
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6.
Bleeding problems
Infective Endocarditis
Hypertension and epinephrine use
Diabetes
Adrenal insufficiency and Steroid use
Total joint replacement
30 compressions:2 breaths
BLEEDING PROBLEMS
Warfarin or Coumadin therapy, INR, PT and PTT
| Aspirin and Plavix therapy
|
QUESTION 1
Your 60 year old female patient who is on
Warfarin needs extraction of #30. Her INR on the
day of the surgery is 4.0. What should you do?
| A. Postpone surgery and decrease Warfarin dose
until INR becomes 3.0
| B. Perform the surgery
| C. Perform the surgery with local hemostatic
measures
| D. Avoid local anesthetics and perform surgery
under general anesthesia.
|
QUESTION 2
Your 68 year old patient is on clopidogrel to
prevent blood clot formation. You need to extract
#14, 15 and 16. Would you:
| A. Discontinue the clopidogrel
| B. Obtain the bleeding time
| C. NOT discontinue clopidogrel
| D. Obtain platelet function tests
|
INFECTIVE ENDOCARDITIS
Source: ADA
Source: ADA
QUESTION 3
|
A. Yes
B. No
| QUESTION
Source: JADA
ANTIBIOTIC REGIMEN
QUESTION 5
|
D. Premedicate immediately
OTHER SITUATIONS:
Coronary artery stents?
| Antibiotic prophylaxis for dental procedures is not
recommended for patients with coronary artery
stents
| Patient is already on Penicillin?
| Select an antibitoic from another class rather than
to increase the dose of the currently administered
antibiotic.
| For example, if a patient is already taking
amoxicillin, the dentist should select clindamycin,
azithromycin, or clarithromycin for IE prophylaxis.
|
Source: JADA
QUESTION 6
Your patient is on Propranolol for hypertension.
His blood pressure today is 140/80. Can you
administer lidocaine with 1:100,000 epinephrine?
| A. Yes
| B. No
| C. 1 to 2 cartridges of lido with 1:100,000 epi can
be administered safely (try a test dose of 1 mL
first!)
| D. Refer patient to his physician to change the
Propranolol to Atenolol
|
DIABETES
QUESTION 7
Mr. Khan has a long standing history of Diabetes.
Mr. Khans Hemoglobin A1c (HgA1c) level is 7.5%
and his post prandial blood glucose on the day of
the test is 140 mg/dL. Is he:
| A. Controlled diabetic
| B. Uncontrolled diabetic
| C. Not a diabetic anymore
|
QUESTION 8
|
QUESTION 9
Mr. Padilla is on Prednisone 5mg every other day
for his asthma. He needs extraction of #1 and 16
due to severe periodontal disease. What should
you do?
| A. Inform Mr. Padilla to bring the prednisone and
take it only if he has an asthma attack during
surgery
| B. Mr. Padilla MUST take 5mg of Prednisone 2
hours before procedure
| C. Mr. Padilla MUST take 25 mg of Hydrocortisone
equivalent on day of surgery
| D. Mr. Padilla must have a ACTH or HPA axis
stimulation test
|
Prednisone 5 mg
Triamcinolone 4mg
Methylprednisolone 4 mg
QUESTION 10
Mrs. Smith is a 45 year old female with a long
standing history of Rheumatoid Arthritis. She had
a car accident and suffered multiple fractures
which were plated using metal pins and screws.
She is now seeing you for an extraction of fractured
#12 and 13. Should you premedicate Mrs. Smith
prior to the extraction?
| A. Yes, for the first 2 years
| B. Yes, any time before a invasive dental procedure
| C. No premedication
| D. Only Clindamycin premedication
|
dental extractions;
periodontal procedures, including surgery, subgingival placement of
antiobiotic fibers/strips, scaling and root planing, probing, recall
maintenance;
dental implant placement and replantation of avulsed teeth;
endodontic (root canal) instrumentation or surgery only beyond the
apex;
initial placement of orthodontic bands but not brackets;
intraligamentary and intraosseous local anesthetic injections;
prophylactic cleaning of teeth or implants where bleeding is
anticipated.
The current statement notes that "patients with pins, plates and
screws, or other [orthopedic] hardware that is not within a
synovial joint are not at increased risk for hematogenous
seeding by microorganisms."
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