Diagnostic Skills Exam OSCE (DSE OSCE) - 2019
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1. Pre-Med required for? - Prosthetic heart valves, or prosthetic material
used for cardiac valve repair.
- Hx of infective endocarditis
- cyonotic heart disease
- valve regurgitation w. heart thingys (even if
has transplant or was repaired already)
[According to limited data, infective endocardi-
tis appears to be more common in heart trans-
plant recipients than in the general population;
the risk of infective endocarditis is highest in
the first 6 months after transplant because of
endothelial disruption, high-intensity immuno-
suppressive therapy, frequent central venous
catheter access, and frequent endomyocardial
biopsies]
2. 5 month old preggers with b
rheumatic fever and heart
murmer: pre med?
a. yes
b. no
(remembered)
3. Pregnant person afraid of place her in trundelburg position.
needles - stress manage-
ment by putting patient - supine hypotension in 3rd trimester usually
in what position when in occurs (bc compression Inf vena cava) => must
your chair (BEFORE they prevent this in dental chair bc it can cause
even get to the point of patient to pass out.
passing out)? - Best preventative treatment for supine hy-
potension is to turn the patient, prefera-bly to
(remembered) the left side, to displace the uterus away from
the inferior vena cava. The patient can also be
placed in a sitting position with the knees flexed.
, Diagnostic Skills Exam OSCE (DSE OSCE) - 2019
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4. 6 months pregnant had conservative debridement is what other person
bleeding gums and mobile answered.
teeth? How should they be
treated? - pregnancy gingivitis: It is SO important to do
ScRP (and stress good oral hygeine) to pre-
(remembered) vent plaque growth. The plaque can enter blood
stream and stimuate patient's immune system
to produce prostaglandins, which can trigger
uterine contraction leading to early labor, pre-
mature birth, and a small baby.
5. Pregnant lady with a di- chronic perio
astema in between #8
and #9 with deep probing - increased incidence of periodontal disease
depth and class 1 mobility during pregnancy => must emphasize good
on 8 and 9. What is the rea- oral hygiene, and remove all their plaque so it
son for diastema? doesn't lead to premature birth / small baby.
(remembered)
6. Permanent dentition with Patient ingested tetracycline when they were
tetracycline staining, between 0 and 5 years old
when did this happen?
(remembered)
7. • Pentobarbital (Nembutal) barbiturates - Both pentobarbital (Nembutal)
• Secobarbital (Seconal) and secobarbital (Seconal) are used primarily
on the evening before the dental appointment.
are what kind of drugs?
8. Barbiturates - how should Benadryl -> if its a mild-moderate allergy.
an allergic reaction be
treated?
- When a patient experiences a milder form of
anaphylactic reaction, the drug or prepara- tion
(remembered) that caused a reaction is discontinued and the
patient is given diphenhydramine (Benadryl),
25-50 mg/tablet PO q6h for 48-72 hr.
, Diagnostic Skills Exam OSCE (DSE OSCE) - 2019
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9. Steroids - whats most im- duration and dosage.
portant information you
need to get from your pa- - "The rule of twos": Ask whether the patient is
tient when you find out currently on steroids or has been on corticos-
they are on steroids.. be- teroids for 2 weeks or longer within the past 2
fore even thinking about years. You must go back 2 years in the history
treating them? because it can take 2 weeks to 2 years for
the adrenal glands to bounce back to normal
function.
(remembered)
10. Patients _____ is the most b
important thing for calcu-
lating medication dosage
for a child.
a. age
b. weight
c. gender
d. height
(remembered)
11. Biggest concern with
down syndrome?
he thought Congenital
Heart Defects.
- Trisomy 21 are at in-
creased risk of cardiac de-
fects, true.
- early onset periodon-
tal disease IS MOST SIG-
NIFICANT ORAL HEALTH
, Diagnostic Skills Exam OSCE (DSE OSCE) - 2019
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PROBLEM; they have a
lower prevalence of dental
caries though.
Consider prescribing
Chlorhexidine or other an-
timicrobial agents for daily
use.
- When treating, consid-
er patient's cardiac status
and need for premedica-
tion (medical consult may
be indicated).
(remebered)
12. Patient just had a stroke. if they are on anti-coagulants (blood thinners).
What do you need to worry
about?
- Stroke patients could be on blood thinners,
(remembered) such as aspirin, dipyradamole (Persan- tine),
clopidogrol (Plavix), or Coumadin, postrecov-
ery. Prior to major surgery, always consult with
the patient's physician to determine whether
and when the blood thinners can be stopped
and subsequently restarted.
- . Following a CVA that required significant
hospitalization, routine dental treatment must
be delayed by 6 months.
- Routine dental treatment should be delayed
by 3 months if the post-CVA recovery was un-
eventful and the patient was admitted overnight
just for observation.
- Avoid epinephrine containing LAs during the
first 6 months of dental treatment. Subsequent
use of epinephrine depends on the patient's
prognosis. Epinephrine containing LAs can be
used starting 1 year after the stroke, when the
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