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DSE OSCE - 2024
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DSE OSCE - 2024 ADA Recommendations for Antibiotic Prophylaxis Pre-medication is required for: - Prosthetic cardiac valves: including transcatheter-implanted prostheses and homografts. - Prosthetic material used for cardiac valve repair (e.g., annuloplasty rings, chords). - History of infective...

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  • 30 de agosto de 2024
  • 33
  • 2024/2025
  • Examen
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  • dse osce 2024

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  • DSE OSCE - 2024
  • DSE OSCE - 2024

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DSE OSCE - 2024
ADA Recommendations for Antibiotic Prophylaxis

Pre-medication is required for:

- Prosthetic cardiac valves: including transcatheter-implanted prostheses and homografts.

- Prosthetic material used for cardiac valve repair (e.g., annuloplasty rings, chords).

- History of infective endocarditis.

- Cardiac transplant with valve regurgitation due to a structurally abnormal valve.

- Congenital heart diseases, including:

- Unrepaired cyanotic congenital heart disease (including palliative shunts and conduits).

- Any repaired congenital heart defect with residual issues at the site of or adjacent to a prosthetic
patch/device.



Source: [ADA Guidelines on Antibiotic Prophylaxis](https://www.ada.org/en/member-center/oral-
health-topics/antibiotic-prophylaxis)



Clinical Cases and Scenarios



1. Pregnant Patient with History of Infective Endocarditis:

- Pre-med indicated? ✔️ Yes.

- Recommended pre-med options considering penicillin allergy: ✔️ Clarithromycin (notably,
cephalexin could also be considered, but avoid ciproflaxacin as it is contraindicated in pregnancy).



2. Dentist Procedures in Bisphosphonate Patients:

- Can a dentist perform without consulting MD? ✔️ Occlusal restoration is acceptable.

- Extraction increases risk, as does endo therapy if compromised.



3. Management of Anxiety in a Pregnant Patient:

- Position during stress (before passing out)? ✔️ Place in Trendelenburg position to help prevent
supine hypotension in the third trimester.

,4. Management of Pregnancy-Related Gum Issues:

- How to treat bleeding gums and mobile teeth in a pregnant woman? ✔️ Conservative debridement
(avoid extractions).



5. Diastema in Pregnant Patient:

- Likely Reason: ✔️ Chronic periodontitis (address periodontal health to avoid complications).



Medical Knowledge and Clinical Pharmacology



6. Tetracycline Staining Timing:

- Permanent staining occurs at age: ✔️ 0-5 years (during enamel development).



7. Drug Identification:

- Pentobarbital and Secobarbital Type: ✔️ Barbiturates.



8. Treatment of Barbiturate Allergy:

- How to treat allergic reaction? ✔️ Diphenhydramine (Benadryl) is appropriate.



9. Steroid User Information Needed Before Treatment:

- What to inquire about? ✔️ Both dose and duration of steroid use.



10. Child Medication Dosage Calculation:

- Most important factor? ✔️ Weight (preferred over age, gender, height).



Patient Conditions and Considerations



11. Trisomy 21 Concerns:

- Initial concern? ✔️ Congenital heart defects (common in patients with Down syndrome).

,12. Post-Stroke Concerns:

- First concern after stroke? ✔️ Are they on anticoagulants?



13. Anaphylaxis vs. Syncope Symptoms:

- Main symptom differentiating: ✔️ Bronchoconstriction (anaphylaxis includes difficulty breathing).



14. ELISA Test Result Interpretation:

- Negative response indicates: ✔️ The patient does not have HIV antibodies.



15. Leukemia Signs in 14-Year-Old:

- Likely diagnosis with abnormal blood cells: ✔️ Leukemia (high WBC, painful gingiva).



16. Drug-Induced Hyperplasia Agents:

- ✔️ Calcium channel blockers, Cyclosporines, Anticonvulsants.



Oral Lesions and Conditions



17. Identifying Oral Lesions:

- Characteristics:

- Mucocele: Bluish, swollen salivary gland.

- Ranula: Mucocele under the tongue.

- Fibroma: Granulation tissue response to irritation.

- Papilloma: Wart-like due to HPV.

- Thermal Injury: From hot food/drink.

- SCC: Ulcerated and persistent lesions.

- Cold Sore (Herpes): Recurrent vesicular lesions.

, 18. Ectodermal Dysplasia Symptoms:

- Presentation Includes: ✔️ Missing teeth and no hair.



19. Pernicious Anemia Explanation:

- Associated with what? ✔️ Autoimmune destruction of parietal cells leading to B12 deficiency.



20. Hemolytic Anemia Definition:

- Characterized by: ✔️ Destruction of RBCs before their normal lifespan is over.



21. Hereditary Hemorrhagic Telangiectasia:

- Associated with: ✔️ Iron deficiency anemia.



Pt presents, upset with look of with canine and premolar area; spotted (pick up stains), pits and grooves
on outer surface of teeth. Likely diagnosis

- hypoplasia

- hyperplasia

- abfraction

- erosion ✔️hypoplasia; consider that fact it is localized, likely not related to systemic disease



Several spots with yellowish concave areas in cervical 1/3rd of anterior teeth. Likely cause?

- erosion

- abfraction

- hypoplasia

- hyperplasia ✔️Facial erosion due to acidic beverages



Diagnose amelogenesis imperfecta radiographically ✔️- smaller than normal teeth

- yellow or brown discoloration

- teeth prone to damage, breakage

- sensitive teeth

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