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ADA Recommendations for Pre-Medication - **Pre-med is required for patients with:** - Prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts - Prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords - A h...
- Prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts
- Prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords
- A history of infective endocarditis
- A cardiac transplant with valve regurgitation due to a structurally abnormal valve
- The following congenital heart diseases:
- Unrepaired cyanotic congenital heart disease, including palliative shunts and conduits
- Any repaired congenital heart defect with residual shunts or valvular regurgitation at the site of or
adjacent to the site of a prosthetic patch or a prosthetic device
Case Study: 41-year-old Pregnant Woman
- **Does she need to pre-med?** ✔️ Yes
- (REVIEW HEALTH HISTORY - Patient has previous history of infective endocarditis. Pre-med IS
indicated).
- **Pre-med options for pregnant woman with history of infective endocarditis and penicillin allergy:**
- Options:
- Amoxicillin
- Cephalexin
- Clarithromycin
- Ciprofloxacin
- **Recommended answer**: ✔️ Clarithromycin
- (However, the correct option may be cephalexin due to concerns about cross-reactivity with
cephalosporins).
Procedures and Bisphosphonates
,- **What procedure can a dentist perform without consulting MD if a patient is currently taking
bisphosphonates?** ✔️ Occlusal restoration
- (Extraction is not advised; endo therapy can increase risk if apex is compromised).
Pregnant Patient Management
- **Stress management position for pregnant person afraid of needles:** ✔️ Place her in
Trendelenburg position
- (This helps prevent supine hypotension, which can occur in the third trimester).
- **Treatment for 6-month pregnant patient with bleeding gums and mobile teeth:** ✔️ Conservative
debridement
- (It is important to perform scaling and root planing to prevent plaque growth).
- **Reason for diastema in pregnant lady with deep probing depth and class 1 mobility on 8 and 9:**
✔️ Chronic periodontitis.
Tetracycline Staining
- **Permanent staining as a result of tetracycline; did this happen?** ✔️ Age 0-5 years
- (Permanent dentition starts calcification at birth).
Medications
- **Pentobarbital (Nembutal) and Secobarbital (Seconal) are what type of drugs?** ✔️ Barbiturates.
- **How to treat a patient with an allergic reaction to a barbiturate?** ✔️ Benadryl (diphenhydramine)
- (Discontinue the drug as well).
Steroidal Medication Information
- **What information do you need to obtain before treating a patient taking steroids?** ✔️ Dose and
duration
- (Rule of twos applies here).
,Pediatric Medication Dosage
- **What is the most important factor when calculating medication dosage for a child?** ✔️ Weight.
Concerns for Trisomy 21 Patient
- **What are you initially concerned about?** ✔️ Congenital heart defect
- (Must consider cardiac status and the possibility of pre-medication).
Recent Stroke Patient Concerns
- **What is your first concern for a patient who has recently had a stroke?** ✔️ Are they on
anticoagulants?
- (Consider bleeding risk when planning treatment).
Anaphylaxis vs. Syncope
- **Main symptom that differentiates anaphylaxis from syncope:** ✔️ Bronchoconstriction
- (Anaphylaxis is accompanied by wheezing, while syncope involves anxiety and light-headedness).
ELISA Test Interpretation
- **What does a negative ELISA test result mean for a person who had a needle stick?** ✔️ The patient
has no antibodies to HIV-1 present.
- (Not definitive for infection as false negatives can occur).
Diagnosis for Teen with Inflamed Gingiva
- **Diagnosis for a 14-year-old with inflamed gingiva and abnormal bloodwork:** ✔️ Leukemia
- (High WBC, lymphadenopathy, and painful gingiva are indicators).
Stem indicates patient has recently taken medications, which one likely caused the rash present on their
arm?
- Acetamiophen
- Barbituates
, - Penicillin
- diphenhydramine
(on 2024 exam)
Penicillin allergy
- hives is a common response to penicillin allergies
Name the drugs that induce hyperplasia
(on 2024 exam)
Drugs that may have increased chance of periodontal destruction
- "-statin"
- "-olol"
- "-ipril"
- Amlodipine
(on 2024 exam)
I put Amlodipine (gingival hyperplasia,
- statins have actually been shown to improve periodontal treatment outcomes due to the osteoblastic
activity induced
Pt presents with white lesion, lateral anterior tongue. History of trauma (continuously biting it, ect).
Resembled a papillary lesion.
- papilloma
- fibroma
- squamous cell carcinoma
(on 2024 exam)
Use your best judgement. History of trauma leads to fibroma diagnosis; but medical history may lead to
papilloma. If described as "cauliflower" assume papilloma!
Pt has a history of multiple odontomas. What syndrome is suspected?
- Addison's disease
- ectodermal dysplasia
- Gardner's syndrome
- Cushing's syndrome
Gardner's Syndrome
- colorectal polyposis
What is the treatment for a mucocele?
- corticosteroids
- excision with local glands
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