CMC exam 1 with Accurate Solutions
T/F most common medical emergencies in dental practice are avoidable - ANSWER-
true! as long as you know the patient
What are the most common medical emergencies in dental practice - ANSWER--
syncope
- mild allergic reactions
- angina pectoris
- postural hypotension
- seizures
- asthma attack
- hyperventilation
- epinephrine reaction
- insulin shock
- cardiac arrest
- anaphylaxis
- MI
- stroke
What are examples of immediate adverse events? - ANSWER-MI
Stroke
Hypoglycemia
Allergic reactions
What are examples of delayed adverse events? - ANSWER-Infection
Bleeding
Adrenal crisis
Infective endocarditis
Drug reaction
delayed events are more common than immediate events
How do you identify patients at risk? - ANSWER-- med history
- physical examination (general survey, face, eyes, skin, etc)
- lab tests
- medical consultation
How do you decide to treat or not to treat? - ANSWER-treatment planned: whether its
invasive or noninvasive
level of stress involved
and risk of adverse reactions
,consider the stability, severity, and status or pts med condition, physical/emotional state
of pt
What do you need to know about a patients medications? - ANSWER-class, dose,
indication, and side effect/interaction
Medical Risk assessment determines - ANSWER-medical stability and potential for
adverse events
use medical complexity classification (MCS)
Whats an example of a pt who would be MC-1A? - ANSWER-controlled diabetes
so NO anticipated complications w/ stable condition/disease that is controlled
Whats an example of a pt who would be classified as MC-1C? -
ANSWER-controlled/stable condition with possible MAJOR complications
i.e. give patient penicillin and forgot to ask that they're allergic!! --> ANAPHYLAXIS
Define MC-0 - ANSWER-No significant medical problem
Define MC-1A - ANSWER-Controlled and stable condition/disease
no anticipated complications
Define MC-1B - ANSWER-Controlled and stable condition
Anticipated/possible *minor* complications
Define MC-1C - ANSWER-Controlled and stable condition/disease
Anticipated/possible *major* complications
Define MC-2A - ANSWER-Poorly controlled and/or unstable condition/disease
No anticipated complications
Define MC-2B - ANSWER-Poorly controlled and/or unstable condition/disease
Anticipated/possible minor complications
Define MC-2C - ANSWER-Poorly controlled and/or unstable condition/disease
Anticipation/possible *major* complications
Define MC-3 - ANSWER-Cardiac or other conditions needing continuous monitoring
What are the 4 dental modification statuses? - ANSWER-DM-0: no mod. needed for tx
,DM-1: mod. needed BEFORE tx
DM-2: mod. needed DURING tx
DM-3: mod. needed AFTER tx
For MCS classifications what cannot be easily managed chair side? - ANSWER-the
major possible complications
What is the ASA classification used for? - ANSWER-It's the american society of
anesthesiologists atstus
for pts undergoing surgery with local and general anesthesia
patients capacity to walk up a slight of stairs or walk two blocks
Where do you put side effects and interactions in axium? - ANSWER-Drug
Dosage and frequency and in the NOTES SECTION you put side effects and
interactions
Where is LexiComp on axium, what is it for? - ANSWER-Under links, can look up drugs
and directly see dental considerations
Daubert v Frye - ANSWER-Daubert = scientific evidence regarding antibiotic
prophylaxis
What is ANC?
what's normal? - ANSWER-ABSOLUTE NEUTROPHIL count
total of WBC x (*% neutrophils + % bands*)
normal is 50-80%
If WBC is 3500 and the # of neutrophils in differential is 68% what is the ANC?
can you perform surgical tx? - ANSWER-3500 x .68 = 2,380
YES this is normal
18 yr old girl in dental chair for check up and ext of wisdom teeth. In med hx she
mentions "highly allergic to penicillin, what is the issue? potential problem?
management plan? MCS and DM? - ANSWER-Issue: allergic to penicillin
Potential problem: anaphylaxis
, Management: avoid penicillin, use clindamycin (if no GI issues) or azirthromycin or
clarithromycin
MC-1C
What is the MOST COMMON cause of drug induced anaphylaxis? - ANSWER-Pencillin
substantial morbidity and mortality
most common rxns to antibiotics are maculopapular skin eruptions, urticaria, and
pruritis.
HTN increases the risk of: - ANSWER-heart disease (2x greater risk)
kidney disease
stroke
What is the "silent killer"?
How many americans have it? - ANSWER-Hypertension
1/4 of americans!!
What is stage 1 HTN? - ANSWER-130-139 or 80-89
What is stage 2 hypertension? - ANSWER->or= 140 or >or= 90
Etiology of HTN? - ANSWER-unknown
some conditions may cause it (kidney/adrenal gland disease)
Pts are prone to hypertensive crisis if BP reaches: - ANSWER-180/110 or higher
Risk of developing CVD doubles for - ANSWER-every increase of 20mmHg systolic or
10mmHg diastolic
What medications increase BP? - ANSWER-*COLD AND FLU* (decongestants,
pseudoenphedrine(sudafed), and phenilephrine(neo-synephrine)).
*ANTIDEPRESSANTS* (bupropion(wellbutrin), benlafaxine(effexor) and
desipramine(nopramin)).
*BIRTH CONTROL PILLS*
pain meds, migrain, anticonvulsants/tigrem neuralgia, immunosupressants, stimulants,
herbal supplements
food: salt, ethanol, licorice, tyramine containing food, MSG(can last for a week in the
body)
T/F most common medical emergencies in dental practice are avoidable - ANSWER-
true! as long as you know the patient
What are the most common medical emergencies in dental practice - ANSWER--
syncope
- mild allergic reactions
- angina pectoris
- postural hypotension
- seizures
- asthma attack
- hyperventilation
- epinephrine reaction
- insulin shock
- cardiac arrest
- anaphylaxis
- MI
- stroke
What are examples of immediate adverse events? - ANSWER-MI
Stroke
Hypoglycemia
Allergic reactions
What are examples of delayed adverse events? - ANSWER-Infection
Bleeding
Adrenal crisis
Infective endocarditis
Drug reaction
delayed events are more common than immediate events
How do you identify patients at risk? - ANSWER-- med history
- physical examination (general survey, face, eyes, skin, etc)
- lab tests
- medical consultation
How do you decide to treat or not to treat? - ANSWER-treatment planned: whether its
invasive or noninvasive
level of stress involved
and risk of adverse reactions
,consider the stability, severity, and status or pts med condition, physical/emotional state
of pt
What do you need to know about a patients medications? - ANSWER-class, dose,
indication, and side effect/interaction
Medical Risk assessment determines - ANSWER-medical stability and potential for
adverse events
use medical complexity classification (MCS)
Whats an example of a pt who would be MC-1A? - ANSWER-controlled diabetes
so NO anticipated complications w/ stable condition/disease that is controlled
Whats an example of a pt who would be classified as MC-1C? -
ANSWER-controlled/stable condition with possible MAJOR complications
i.e. give patient penicillin and forgot to ask that they're allergic!! --> ANAPHYLAXIS
Define MC-0 - ANSWER-No significant medical problem
Define MC-1A - ANSWER-Controlled and stable condition/disease
no anticipated complications
Define MC-1B - ANSWER-Controlled and stable condition
Anticipated/possible *minor* complications
Define MC-1C - ANSWER-Controlled and stable condition/disease
Anticipated/possible *major* complications
Define MC-2A - ANSWER-Poorly controlled and/or unstable condition/disease
No anticipated complications
Define MC-2B - ANSWER-Poorly controlled and/or unstable condition/disease
Anticipated/possible minor complications
Define MC-2C - ANSWER-Poorly controlled and/or unstable condition/disease
Anticipation/possible *major* complications
Define MC-3 - ANSWER-Cardiac or other conditions needing continuous monitoring
What are the 4 dental modification statuses? - ANSWER-DM-0: no mod. needed for tx
,DM-1: mod. needed BEFORE tx
DM-2: mod. needed DURING tx
DM-3: mod. needed AFTER tx
For MCS classifications what cannot be easily managed chair side? - ANSWER-the
major possible complications
What is the ASA classification used for? - ANSWER-It's the american society of
anesthesiologists atstus
for pts undergoing surgery with local and general anesthesia
patients capacity to walk up a slight of stairs or walk two blocks
Where do you put side effects and interactions in axium? - ANSWER-Drug
Dosage and frequency and in the NOTES SECTION you put side effects and
interactions
Where is LexiComp on axium, what is it for? - ANSWER-Under links, can look up drugs
and directly see dental considerations
Daubert v Frye - ANSWER-Daubert = scientific evidence regarding antibiotic
prophylaxis
What is ANC?
what's normal? - ANSWER-ABSOLUTE NEUTROPHIL count
total of WBC x (*% neutrophils + % bands*)
normal is 50-80%
If WBC is 3500 and the # of neutrophils in differential is 68% what is the ANC?
can you perform surgical tx? - ANSWER-3500 x .68 = 2,380
YES this is normal
18 yr old girl in dental chair for check up and ext of wisdom teeth. In med hx she
mentions "highly allergic to penicillin, what is the issue? potential problem?
management plan? MCS and DM? - ANSWER-Issue: allergic to penicillin
Potential problem: anaphylaxis
, Management: avoid penicillin, use clindamycin (if no GI issues) or azirthromycin or
clarithromycin
MC-1C
What is the MOST COMMON cause of drug induced anaphylaxis? - ANSWER-Pencillin
substantial morbidity and mortality
most common rxns to antibiotics are maculopapular skin eruptions, urticaria, and
pruritis.
HTN increases the risk of: - ANSWER-heart disease (2x greater risk)
kidney disease
stroke
What is the "silent killer"?
How many americans have it? - ANSWER-Hypertension
1/4 of americans!!
What is stage 1 HTN? - ANSWER-130-139 or 80-89
What is stage 2 hypertension? - ANSWER->or= 140 or >or= 90
Etiology of HTN? - ANSWER-unknown
some conditions may cause it (kidney/adrenal gland disease)
Pts are prone to hypertensive crisis if BP reaches: - ANSWER-180/110 or higher
Risk of developing CVD doubles for - ANSWER-every increase of 20mmHg systolic or
10mmHg diastolic
What medications increase BP? - ANSWER-*COLD AND FLU* (decongestants,
pseudoenphedrine(sudafed), and phenilephrine(neo-synephrine)).
*ANTIDEPRESSANTS* (bupropion(wellbutrin), benlafaxine(effexor) and
desipramine(nopramin)).
*BIRTH CONTROL PILLS*
pain meds, migrain, anticonvulsants/tigrem neuralgia, immunosupressants, stimulants,
herbal supplements
food: salt, ethanol, licorice, tyramine containing food, MSG(can last for a week in the
body)
