The Light Headache Symptom

Published Date: 02 Nov 2017

Which of the following is an example of a symptom?

Light headache - symptom

High blood glucose - sign

Jaundice - sign

Lymphadenopathy - sign

Symptoms are subjective complaints or words of the patient, for example: headache, pain, or dizziness

Signs are objective findings from physician or dentist that includes such things as tenderness, swelling, warmth, heart murmur and jaundice

Reference : Oral pathology introduction-concept of disease, powerpoint 2012 by Dr. Billy Ballard

Which of the following is the most important during an initial patient evaluation?

Vital signs – patient’s blood pressure, pulse, breaths/min and temperature. It is important to collect, but not the most important during an initial patient evaluation

Establishing rapport – this is the most important during an initial patient evaluation. Patients cooperate better during procedure with trust and confidence on dentist/physician

Sexual history – this is for more physician than dentist

Chief complaint – this is important because it shows that why patient need to see physician or dentist but this is not right answer to this question.

Reference : Medically Compromised patient : Dental management powerpoint by Gerald Davis ll, D.D.S

An otherwise healthy patient who smokes half a pack of cigarettes a day has which ASA classification?

ASA 1 – healthy patient with no smoking or minor drinking

ASA 2 – mild systemic disease patient, smokers, obesity

ASA 3 – severe systemic disease but not incapacitating

ASA 4 – severe systemic disease that can be constant threat to patient’s life

Reference : http://my.clevelandclinic.org/services/anesthesia/hic_asa_physical_classification_system.aspx

After viewing your patient’s panoramic radiograph, you discover and diagnose the presence of calcified atheromas in her carotid arteries. What step should you take next?

Continue with dental treatment because there is no need to be concerned – calcified atheromas is one of the sign of ischemic heart disease and patient should be referred to physician

Refer the patient to her primary care physician

Schedule to have the atheromas removed by an oral surgeon – this is physician’s job

Ignore the discovery because it is beyond your scope of training – never ignore the discovery of patient’s condition

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg. 60-64

In which of the following categories should a patient’s chief complaint be written?

Subjective – symptoms of the patient

Objective – vital sign, finding by physician/dentist

Assessment – assessment after subjective and objective

Planned – treatment plan

Reference : Medically Compromised patient : Dental management powerpoint by Gerald Davis ll, D.D.S

Which of the following conditions do NOT require antibiotic prophylaxis?

Artificial heart valves – has risk of IE, so should have prophylaxis

Mitral valve stenosis – this is congenital heart disease and need prophylaxis

Congenital heart defects – not require antibiotic prophylaxis

Hip replacement six months ago – has risk of infection, so should have prophylaxis

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.197, 234, 327-328

Which of the following agents is used to manage a patient with an overdose of Coumadin?

Naloxone – for opiate overdose

Aqua Mephyton – vitamin K and for overdose of Coumadin

Disulfuram – for alcohol dependence

Naltrexone – for alcohol and opioid dependence

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg. 566, 569

http://en.wikipedia.org/wiki/Disulfiram

http://www.drugs.com/mtm/aquamephyton.html

Which of the following represent an ideal platelet count?

50,000 – excessive bleeding

100,000 – excessive bleeding

300,000 – ideal platelet count : 140,000-400,000

500,000 – platelet excessive

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.417

What is the INR of a normal healthy patient?

0

1 – normal 0.9 – 1.3

2 – low intensity of therapy

3 – high intensity of therapy

4

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.423-424

Which of the following drugs will result in respiratory depression during an overdose?

Benzodiazepines – central nervous system depressant and less dangerous in overdose

Barbituates – central nervous system depressant and have analgesic effect. It is replaced by benzodiazepines in medical practice

NSAIDs – anti-inflammatory drugs and increase risk of GI bleeding

Albuterol – for asthma attacks

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.621-622

http://en.wikipedia.org/wiki/Barbiturate

What is another name for rapid breathing?

Tachypnea – condition of rapid breathing

Diaphoretic – condition of rapid sweating

Tachycardia – condition of rapid heart beat

Ptyalism – condition of hypersalivation

Reference : Dental management of the medically compromised patient pg.70, 99.

http://en.wikipedia.org/wiki/Diaphoresis

http://en.wikipedia.org/wiki/Ptyalism

Which of the following represent a symptom of active tuberculosis infection?

Night sweats – due to elevating temperature

Xerostomia – condition of hyposalivation

Malena – condition of black foul-smelling stool

Atelectasis – condition of collapsed lung

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.115-118

http://en.wikipedia.org/wiki/atelectasis

http://en.wikipedia.org/wiki/xerostomia

Which of the following have a normal range which lasts between eleven and sixteen seconds?

Prothrombin time – normal range is 11 -15 seconds

Partial thromboplastin time – normal range is 25-35 seconds

Bleeding time – this is not reliable and no longer used in test

All of the above

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.405-406

Which of the following conditions are you 3% likely to contract by a needlestick?

Hepatitis D – rare to needlestick

Hepatitis C – 3%

Hepatitis B – 30%

HIV – 0.3%

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.144-145

Which of the following values represent a normal healthy range for HbA1c?

4% - healthy range for HbA1c is less than 6%

6.5% - less than 7% of HbA1c is well controlled diabetes

7% - above 7% is not controlled diabetes

10% - above 7% is not controlled diabetes

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.192

Which of the following conditions will NOT lead to renal failure?

Systemic lupus erythematosus – lead to renal failure

Brown’s tumor of hyperparathyroidism – not lead to renal failure because it is from hyperparathyroidism

Glomerulonephritis – lead to renal failure

Hypertension – lead to renal failure

Reference : Medically Compromised patient : chronic Renal failure powerpoint by Gerald Davis ll, D.D.S

What is the term given to a graft from an identical twin?

Autograft – transplant of tissues of same patient to different areas.

Homograft – human transplant

Isograft – transplant of tissues to identical twins

Xenograft – transplant to different species

Reference : http://en.wikipedia.org/wiki/Allotransplantation

Which of the following represent a common side effect of the drug rifampin?

Addictive properties – opioid side effect

Red urine – rifampin side effect

Decreased oxygen saturation – opioid side effect

Blurred vision – opioid side effect

Reference : http://en.wikipedia.org/wiki/Opioid

http://en.wikipedia.org/wiki/Rifampin

Which of the following statements should a clinician keep in mind when using a pulse oximeter?

The use of pulse oximeters exposes patients to additional radiation – measure Hb saturation

Pulse oximeters should not be used on dialysis patients – this can cause tissue hypoxia

Pulse oximeter readings have a delayed feedback – measure Hb saturation

Never place a pulse oximeter on the patient’s index finger – placed on patient’s index finger

Reference : http://en.wikipedia.org/wiki/Pulse_oximeter#Indication

Scrofula is a condition caused by which of the following organisms?

Mycobacterium tuberculosis – scrofula is infection of lymph nodes and one of condition of TB

Staphylococcus aureus – most common pathogen of IE

Mycoplasma pneumonia – seen in oral cavity

Candida albicans – small white lesion on oral cavity

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.22, 115, 237

Which of the following is likely to occur in a patient with scrofula?

Enlarged salivary glands – symptom of mumps

Cervical lymphadenopathy – this occurs in patients with scrofula

Congenital blindness – seen in babies born to syphilis mother

Premature loss of teeth – seen in patients with TB

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.394, 589-591

What is the percent of oxygen in the atmosphere? of the following statements should a clinician keep in mind when using a pulse oximeter?

15%

18%

21% - about 21% of oxygen is in the atmosphere

24%

30%

Reference : http://en.wikipedia.org/wiki/Oxygen

How often should breaths be given when performing CPR (rescue breathing)?

As often as possible – can cause a sporadic breathing pattern

After every sixty seconds – can cause a sporadic heart beat

After thirty chest compressions – 30 chest compressions/2 ventilation

After ten chest compressions – can cause a sporadic heart beat

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.583

How should a patient having a laryngospasm be managed?

Epinephrine administration – Epinephrine is used for laryngospasm

Provide positive air pressure – patient cannot breath, so this is not helping

Provide an inhaler – it might help but in dental office, epinephrine is more useful

Stand clear until person settles down – patient cannot breath, so this is not helping

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.582

What measurements are captured when using a sphygmomanometer?

Respiratory volumes - spirometer

Temperature - thermometer

Oxygen saturation - oximeter

Blood pressure – sphygmomanometer

Reference : http://en.wikipedia.org/wiki/Sphygmomanometer

http://en.wikipedia.org/wiki/Spirometer

http://en.wikipedia.org/wiki/oximeter

Which of the following blood pressure readings represent the ideal definition of a person with stage one hypertension?

142/96mmHg – stage one hypertension

125/94mmHg – prehypertension

165/91mmHg – stage two hypertension

119/79mmHg – normal patient

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg. 14

Which of the following represent the lowest reading of a patient at risk for cardiovascular disease?

120/80mmHg – normal patient

117/76mmHg – normal patient

115/75mmHg – normal patient

125/85mmHg – prehypertension

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.14

Which of the following is NOT a symptom of hypertension?

Dizziness – symptom of hypertension

Nausea – not symptom of hypertension

Headache – symptom of hypertension

Tinnitus – symptom of hypertension

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.39-40

Which of the following may result if two carpules of 2% lidocaine 1:100,000 epinephrine were accidentally injected intravenously to a patient taking propranolol?

Elevated blood pressure and tachycardia – vasoconstrictor epinephrine cause of elevation of BP, but propranolol is beta blocker and cause vasodilation.

Elevated blood pressure and compensatory bradycardia -– vasoconstrictor epinephrine cause of elevation of BP, but propranolol cause vasodilation

Decreased blood pressure and tachycardia - – vasoconstrictor epinephrine cause of elevation of BP, but propranolol cause vasodilation

Decreased blood pressure and compensatory bradycardia - –vasoconstrictor epinephrine cause of elevation of BP, but propranolol cause vasodilation

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.48

http://en.wikipedia.org/wiki/Propranolol

What is the approximate percentage of United States citizens with high blood pressure?

15%

25%

33% - US has 1 in 3 people with hypertension

40%

50%

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg. 37

Where is lidocaine metabolized?

Kidney – lidocain metabolizes in liver and kidney because it is amide product

Bone – not to dental office

Lungs – not to dental office

Blood stream – procain because it is ester product

Reference : http://en.wikipedia.org/wiki/lidocain

During which of the following dental procedures is it recommended to provided antibiotic prophylaxis for patients with nonvalvular cardiovascular devices?

Multiple extractions - according to AHA, prophylaxis is not recommend to patients with nonvalvular cardiovascular devices

Incision and drainage – prophylaxis is recommended

Routine teeth cleaning – according to AHA, prophylaxis is not recommended to patients with nonvalvular cardiovascular devices

While measuring probing depths – according to AHA, prophylaxis is not recommended to patients with nonvalvular cardiovascular devices

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg. 34

Patients who have received a renal transplant are likely to have gingival hyperplasia due to which of the following?

Cyclosporine –patient who got renal transplant with this therapy causes gingival hyperplasia

Phenytoin – antiepileptic therapy and may cause gingival hyperplasia

Amlodipine – hypertension therapy

Dilantin – antiepileptic therapy

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.360

http://en.wikipedia.org/wiki/Phenytoin

http://en.wikipedia.org/wiki/Amlodipine

http://en.wikipedia.org/wiki/dilantin

Which of the following tooth formations has NO association with congenital syphilis?

Hutchinson’s incisors – associated with congenital syphilis

Screw-driver incisors – associated with congenital syphilis

Peg laterals – associated with amelogenesis imperfect

Mulberry molars – associated with congenital syphilis

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.203 -205

Which of the following tooth formations has NO association with congenital syphilis?

Kaposi sarcoma – associated with HHV8

Infectious mononucleosis – associated with HHV4, Epstein-barr virus

Nasopharyngeal cancer - associated with HHV4, Epstein-barr virus

Oral hairy leukoplakia - associated with HHV4, Epstein-barr virus

Reference : Medically Compromised patient : chronic Renal failure powerpoint by Gerald Davis ll, D.D.S

Shingles is a ssociated with which of the following herpes viruses?

HHV-1 – primary/secondary

HHV-2 – genital herpes

HHV-3 – varicella and zoster, chickenpox and shingles

HHV-4 – Epstein-Barr virus, Burkitt’s lymphoma

Reference : Medically Compromised patient : chronic Renal failure powerpoint by Gerald Davis ll, D.D.S

Healthcare employees are required to receive a vaccination for which of the following?

HBV – can be transmitted by oral-fecal route and 30% of transmitting rate

HCV – rare in healthcare 3%

HIV – rare in healthcare 0.3%

HPV – rare in healthcare

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.144-148

What is the best way to manage a poor historian?

Consult with the patient’s physician – this is the best way to get good medical history of patient

Have patient repeat themselves – poor response

Have patient speak slowly – poor response

Consult the patient’s spouse – poor response

Reference : Medically Compromised patient : Dental management powerpoint by Gerald Davis ll, D.D.S

Which type of medications should a dentist document?

prescribed

over the counter

multivitamins

herbal supplement

All of the above

Reference : http://en.wikipedia.org/wiki/Pharmaceutical_drug

Which of the following ASA classifications represents a person who is brain-dead?

ASA 1 – healthy patient : no sickness and not too old or young

ASA3 – patient with severe systemic diseases : controlled congestive heart failure (CHF), stable angina, old heart attack, poorly controlled hypertension, morbid obesity, chronic renal failure.

ASA 5 - patients who can survive only with operation : imminent risk of death

ASA 6 - declared brain-dead patient who organs are being removed for donor purposes

Reference : http://my.clevelandclinic.org/services/anesthesia/hic_asa_physical_classification_system.aspx

Which of the following ASA classifications represents a normal healthy patient?

ASA1 – healthy patient : no sickness and not too old or young

ASA3 – patient with severe systemic diseases: controlled congestive heart failure (CHF), stable angina, old heart attack, poorly controlled hypertension, morbid obesity, chronic renal failure.

ASA5 – patients who can survive only with operation : imminent risk of death

ASA6 – declared brain-dead patient who organs are being removed for donor purposes

Reference : http://my.clevelandclinic.org/services/anesthesia/hic_asa_physical_classification_system.aspx

Which of the following is an example of a symptom?

Pain

Jaundice – sign

Warmth – sign

Heart murmur - sign

Symptoms are subjective complaints or words of the patient, for example: headache, pain, or dizziness

Signs are objective findings from physician or dentist that includes such things as tenderness, swelling, warmth, heart murmur and jaundice

Reference : Oral pathology introduction-concept of disease, powerpoint 2012 by Dr. Billy Ballard

The habit of chewing beetle quid should be documented under which category?

Chief complaint – this is patient’s main reason to seek physician or dentist. Subjective statement made by a patient to describe their illness.

Social history – consists of information about smoking or drinking

Dental history – consists of information about dental works in the past

Family history – consists of information about disorders on blood relatives of the patient.

Social history – it covers variety areas such as smoking (beetle quid, tobacco) and alcohol consumption.

Reference : Medically compromised patient: dental management powerpoint by Gerald Davis ll, D.D.S

http://en.wikipedia.org/wiki/Family_history_(medicine)

http://medical-dictionary.thefreedictionary.com/chief+complaint

What is the approximate overall U.S mortality rate of infective endocarditis?

10%

20%

30%

40% - and is more common in men that in women.

Reference : Dental management of the medically compromised patient 7Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.18

What is the most common sign of infective endocarditis?

Osler’s nodes – result from the deposition of immune complexes. 10-25% of endocarditis patients will have this, but it is not most common sign of infective endocarditis

Roth spots – retinal hemorrhages. It may be observed in subacute bacterial endomarditis, pernicious anaemia, ischemic events, and rarely in HIV. Again, this is not most common sign of infective endocarditis

Fever - The classic findings of IE include fever, heart murmur, and positive blood culture

Clubbing of the digits –The most causes of clubbing are pulmonary disease, cyanotic heart disease, and cirrhosis of the liver.

Reference : http://www.turner-white.com/pdf/hp_sep03_club.pdf

http://en.wikipedia.org/wiki/Roth%27s_spot

http://en.wikipedia.org/wiki/Osler%27s_nodes

Which of the following has the higher frequency of causing bacteremia?

Rubber dam matrix with wedge placement – minor (9-32%)

Chewing food – minor (7-51%)

Root canal therapy – minor (<20%)

Toothbrushing and flossing (20-68%)

Bacteremia can result from many normal daily activities such as toothbrushing, flossing, using toothpicks, using oral water irrigation devices, and chewing.

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.28

Which of the following have the highest lifetime risk of acquiring infective endocarditis?

Rheumatic heart disease

History of previous endocarditis

Patients with mechanical valves

Mitral valve prolapsed with regurgitation – 25-30% of adult cases

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.22

The peak plasma concentration of two grams (2g) of amoxicillin is reached at approximatelyu two hours after oral administration. How long does an acceptable MIC for 2g of amoxicillin last?

Two hours

Four hours

Six hours

Eight hours

Half-life of amoxicillin is 80mintues and 2g of amoxicillin produces 6 hours of acceptable

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.27

What is the name given to a graft that is taken from a different species?

Autograft – transplant of tissues of same patient with different areas.

Alloplast – transplant of tissues to same species

Xenograft – transplant of tissues to different speicies

Isograft – transplant of tissues to identical twin.

Reference : http://en.wikipedia.org/wiki/Allotransplantation

Which of the following is NOT caused by HPV?

Heck’s Disease – HPV-13, 32

Squamous cell carcinoma – HPV-2,16,18

Oral hairy leukoplakia

Squamous papilloma – HPV- 6,11

Human papillomaviruses are viruses that infect in epithelial cells. It is one of the most common STDs in the United States and can be transmitted through sexual contact.

Reference : Dental management of the medically compromised patient 8Ed. James W. Little, Donald A.Falace, Craig S. Miller, Nelson L.Rhodus pg.211-212