Operative Exam - We're Real Dentists Now!

lunalovegood's version from 2016-03-11 19:19

Section 1

Question Answer
Do you have any new medications? Have you been _______ ? hospitalized
Take BP every ... monthes6 months (for pt >140/90 every appt)
Moderate risk CRA is...1 to 9

Section 2

Question Answer
140-159 over 90-99Follow up with physician in 60 days
160-179 over 100-110Follow up with physician in 30 days
> 180 or >110 without signs or symptomsDefer elective treatment - refer to physician immediately
180-210 over 110-120 with signs and symptomsDefer elective treatment - refer to Emergency Room
>210 over >120 Refer to Emergency Room immediately!

Section 3

Question Answer
Non-selective Beta blocker?DO NOT USE EPINEPHRINE
Propranolol, Nadolol, Timolol Maleate, Penbutotol sulfate, Sotalol hydrocholride, PindololNon-selective Beta-blockers - NO EPI
Unstable angina?DO NOT TREAT - until stabilized
Stable angina?No change
Coronary Artery Bypass Graft <2 weeks ago?DO NOT TREAT - w/o written MD consult, premed with antibiotics
Coronary Artery Bypass Graft >2 weeks ago?No change
Coumadin?Avoid block anesthesia - INR within 1-2 weeks or 2 days for surgical procedure
INR of < ___ is generally considered OK for routine operative dentistry3.5
Artificial Heart Valve?anything that causes bleeding requires premed - if it has been <9days since round of antibiotic premedication then select another antibiotic med
Asthma pt without their inhaler?DO NOT TREAT - until they have it with them
Bisphosphonates taken for >3 years?minimize trauma to bone with prep and retraction cord
Cancer?consult with OME
Diabetes?take med & eat, blood sugar tested within a few days <400, HbA1c within last month
Bad HbA1c?6-10 is fair. >10 uncontrolled
Blood sugar > ___ = DO NOT TREAT400
Articifial Heart Valve, Endocarditis, Congenital Heart Disease Cardiac transplantation premedicate antibiotics (amoxicillin or for penicillin allergy use clindamycin)
"I have dialysis Mon, Wed, Fri"Treat on Tues or Thurs
Recent MI?No elective treatment for 6 months
Pacemaker?Battery operated curing lights, some ultrasonic scalers may interfere with pacemaker. - Use plug in light and piezo scaler
Pregnancy?cautious radiation - plan treatment during SECOND trimester unless emergency
End stage renal disease?OME evaluation
Recently diagnosed HYPOthyroidism?watch for over-treatment - if meds are making pt hyperthyroid then avoid epi or other pressor amines
HYPERthyroidisim - not well controlled?avoid epi or other pressor amines in local anesthesia
Organ transplant <6 month ago?no elective treatment
Are orthodontic bands or brackets more significant in causing bacteremic disease?bands


Question Answer
___ seconds for mandibular block; _________ seconds for an infiltration.60, 30
About ___% of block fail the first time.20%