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CPH Oral Exam


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Brittani Bogdane


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[Front]


What is an Endocrine Medical Condition
[Back]


Diabetes

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CPH Oral Exam - Detalles

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What is Type 1 Diabetes Mellitus
Chronic autoimmune disease characterised by an abnormally high blood glucose- body is incapable of producing insulin. No cure, no linked to modifiable lifestyle factors
What is Type 2 Diabetes Mallitus
Adequate levels of of insulin but no longer effective at the cellular level. The insulin produced does not work effectively and /or cells of the body do not respond to insulin- insulin resistance.
Risk Factors of Type 1 Diabetes
Immediate family history of diabetes, genetics, having another autoimmune disease, age bracket (4-14)
Risk Factors of Type 2 Diabetes
Family history, genetics, diet/obesity, having other diseases, no exercise, age (older), pregnancy
Effects of Type1/2 Diabetes
High or low BP, fatigue, dehydration, frequent urination (passing glucose), heart problems (angina, CI, stroke), narrowing of arteries, kidney problems, foot damage, nerve damage, blindness/eye damage, diabetic ketoacidosis, skin/mouth conditions, pregnancy issues
Medications for Diabetes
Insulin Pump, insulin injection, glucose supplements (sugary food), oral hyperglycemic agent (stimulates pancreas to produce insulin)
Diabetes effect on daily life
Low energy levels, impact on dietary choices, exercise regime, slow healing
Diabetes effects on Oral Health
High risk of decay, high risk of gingivitis, dry mouth from increase glucose levels, high risk of perio, halitosis (increase of glucose in saliva), slower healing, prone to infection
How to Modify Treatment for Diabetics
Schedule appt for after meals (bfast/lunch), Hypo; give pt. sugar, monitor, call family and or 000), Hyper; give insulin and follow with carbs, give water, call 000
What to discuss with Diabetics
How well is your diabetes under control? What are your symptoms of hypo/hyper? What is most recent HbA1c level? What is RBG on day of appt.? What meds do you take? Can I talk to your GP?
Treatment for Diabetics
Full perio chart, xryas for bone health, bring insulin/glucose, RBG lower than 3 or higher than 12 don't treat, HbA1c above 7 don't treat, post ops/products, be careful during scale, frequent appt.
What are Skeletal System Medical Conditions?
Arthritis- Osteo and Rheumatoid, Osteoporosis
What is Osteoarthritis?
Causes cartilage between joints to break down causing pain and stiffness
Rheumatoid Arthritis
Autoimmune, immune system attacks joints, beginning with lining of joints. Causes joint pain and inflammation
Risk Factors if Arthritis
Over use of joints, previous joint injury, obesity, smoking
Effects of Arthritis
Chronic pain, poor mental health, weight loss, tiredness, xerostomia from meds
Medications Taken for Arthritis
Anti-inflammatory meds
Effects of Daily Life-Arthritis
Dexterity issues, trouble with physical tasks, trouble sleeping, soreness in knuckles, wrists, knees, ankles, hips, neck
Effects on Oral Health- Arthritis
TMJ issues, cant brush effectively, issues flossing, fragile jaw- cant stay open
What to discuss with Arthritic pt.
What meds? pain levels? how can we make you comfortable?
Modifications for Arthritic pt.
Avoid prolonged static position, slowly adjusting chair, adjust operator ergonomics for pt. comfort, meds may cause blood thinning/adjust accordingly, take frequent breaks, shorter appt, slowly move chair
What is Osteoporosis
Causes bones to become weak and lose strength, making them break more easily. "porous bones"
Risk Factors of Osteoporosis
Age, family history, hormonal imbalance, women, low calcium intake, no exercise
Effects of Osteoporosis
Back pain, loss of height over tine, stooped posture, easy breaking bones, osteonecrosis of jaw from meds
Effects on Daily life- Osteoporosis
Breaking of bones, mobility issues
Effects on Oral Health- Osteoporosis
Period/bone loss, tooth loss, jaw mobility issues and increased risk of fracture
Medications for Osteoporosis
Injections and oral meds (biphosphonates), calcium supplements
What to discuss with Osteoporotic pt.
What meds/how often/how much? can I contact gp? pain levels today?
Modifications for Osteoporotic pt.
Modify ergonomics for pt., bone density testing recording, BCTX, shorter appt. take breaks, slowly put up/down chair
What are some Special Senses Medical Conditions?
Hearing loss/deafness, Low vision/blindness
What is loss of sight/blindness?
Low vision os partial impairment of sight that can be corrected with glasses, eye meds, surgery. Blindness it total loss of vision that can not be corrected
Risk Factors of low vision/blindness
Genetic condition, damage to eyes, isolated incidents, diabetic retinopathy, macular degeneration, cataracts, glaucoma (pressure from fluid causing nerve damage), smoking, intense light exposure, age
Effects of low vision/blindness
Field of vision altered, perception of distance, focus on objects, shade and colour perception, balance
Effects on daily life- low vision/blindness
Difficulty with physical activity, accident prone, mental health issues, discrimination, dropping things
Effects of Oral Health- low vision/blindness
Struggle to clean interproximally, not seeing where they are brushing (missing spots), not seeing stain, plaque, calculus, decay ect.
Medications for low vision/blindness
Glasses, surgery, eye drops, eye patches
Discussions/Modifications for pt with low vision/blindness
Be with patient to help walk and sit, remove obstacles, communicate ALL steps (simple or complex), provide sunglasses
What are some Cardiovascular Health Conditions
High/Low BP, Heart attack (clot in heart), Stroke (clot in brain), Heart failure (stent/pacemaker), Chest Pain (angina)
What is angina?
Is a type of chest pain caused by reduced blood flow to the heart. Angina is a symptom of coronary artery disease. Angina pain is often described as squeezing, pressure, heaviness, tightness or pain in the chest. It may feel like a heavy weight lying on the chest. Angina may be a new pain that needs to be checked by a health care provider, or recurring pain that goes away with treatment.
What is Coronary Artery Disease?
CAD happens when coronary arteries struggle to supply the heart with enough blood, oxygen and nutrients. Cholesterol deposits, or plaques, are almost always to blame- can cause Angina
What is an MI?
A heart attack. A heart attack occurs when the flow of blood to the heart is severely reduced or blocked. The blockage is usually due to a buildup of fat, cholesterol and other substances in the heart (coronary) arteries. The fatty, cholesterol-containing deposits are called plaques. The process of plaque buildup is called atherosclerosis.
What is a Stroke?
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die. A stroke is a medical emergency and immediate medical treatment is crucial.
What is heart failure?
Heart failure occurs when the heart muscle doesn't pump blood as well as it should. When this happens, blood often backs up and fluid can build up in the lungs, causing shortness of breath. Certain heart conditions gradually leave the heart too weak or stiff to fill and pump blood properly. These conditions include narrowed arteries in the heart and high blood pressure. Stents and pacemakers usually have to be placed
What is Blood Pressure?
The measurement of pressure the blood exerts against the inner walls of blood vessels (arteries), and is the force that keeps blood flowing around body between heartbeats. Measured in mmHg, S/D
What is systolic pressure
Pressure in arteries at peak of ventricular contraction
What is Diastolic Pressure?
Pressure when ventricles relax
What is normal BP levels
110-140/ 70-80 mmHg
Whats is High BP levels
Systolic higher than 140, disatolic higher than 90 or both
What is low BP levels
Below 100 / 60 mmHg
Risk Factors for Cardiovascular Health Conditions?
Obesity, diet, genetics, family history, smoking, alcohol, lack of exercise, chronic autoimmune disease (diabetes), stress, medications, High/low BP
Effects of Cardiovascular Heart Conditions
Fatigue, fainting, stroke, heart attack, heart failure, kidney damage, vision problems, aneurysm, muscle problems
Medication for Cardiovascular Health Conditions
Blood thinners (warafin), anticoagulants, stent, pacemaker
Effects on Daily life- Cardiovascular Health Conditions
Lethergic (laziness or lack of energy), shortness of breath, diet and drug considerations
Effects on Oral Health- Cardiovascular Health Conditions
Uncontrolled bleeding in oral cavity from meds, difficulty numbing
Discussion to have with Cardiovascular Related pt.
What meds? what dose? when do you take it? what is your bp? do you have stent/pacemaker? can I contact GP? do you need antibiotic cover? what is your INR level- The international normalised ratio (INR) blood test tells you how long it takes for your blood to clot. It is used to test clotting times in people taking warfarin (a medicine used to treat and prevent blood clots). Your doctor will use your INR result to work out what dose of warfarin you should take.
Modifications for Cardiovascular pt.
No administering local anaesthetic with adrenaline (epi) for high BP pt., consult with GP, try not to make pt. anxious, talk about diet changes, DON'T treat unstable BP, make sure hydrated and eaten, treat in morning, don't treat if pale/faint, move pt. slowly in chair, only do treatments that are safe with thei pacemaker