Med Comp jeopardy

JEOPARDY JEOPARDY JEOPARDY JEOPARDY JEOPARDY JEO
RDY JEOPARDY JEOPARDY JEOPARDY JEOPARDY JEOPARDY

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HERE ARE
TODAY’S
CATEGORIES

HYPERTENSION

ANGINA
PECTORIS

ANTICOAGULANTS

DIABETES
MELLITUS

CHEMOTHERAPY

ANTIBIOTICS

$100 $100 $100 $100 $100
$200 $200 $200 $200 $200 $200
$300 $300 $300 $300 $300 $300
$400 $400 $400 $400 $400 $400
$500 $500 $500 $500 $500 $500
HYPER-
TENSION
ANGINA
PECTORIS
ANTI-
COAUGULANTS
DIABETES
MELLITUS
CHEMO-
THERAPY
ANTI-
BIOTICS
FINAL JEOPARDY
$100

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ANSWER
(question)
What are the new
ACC Guidelines
for elevated
hypertensive
patients?

120-130 Systolic
80 Diastolic
Category Systolic Diastolic
NORMAL < 120 < 80
Elevated 120-130 80
HYPERTENSION
Stage 1 130-139 80-89
Stage 2 ≥140 ≥90

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ANSWER
(question)
List ALL 8 classes of Anti-
Hypertensive Agents.

•Diuretics
•Beta blockers
•Alpha blockers
•Alpha-2 agonists
•ACE inhibitors
•ARBs
•CCBs
•Direct vasodilators

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ANSWER
(question)
How do loop Diuretics
function to reduce
Hypertension?

Act on renal cell
units, inhibits
reabsorption of
sodium.
Review:
Hypokalemia, low potassium
Hyponatremia, low sodium
Hypomagnesemia, low magnesium
Example of loop diuretics: Thiazides and
Potassium Sparing.

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ANSWER
(question)
What affects do Beta
blockers have on the
Adrenegenic system?

Vasodilation
Increase HR
Increase BP
Review:
Atenolol
Metoprolol
Bisoprolol
propranolol

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ANSWER
(question)
What are common Calcium
Channel Blockers and a
common ADR oral
manifestations?

Amlodipine, nifedipine
Diltiazem, verapamil
CCB Induce
Gingival
Hyperplasia

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ANSWER
(question)
What are follow up questions
that a Dental hygienist
should as a patient with
Angina Pectoris? (List 3)

What usually causes your angina
episode?
How often does angina occur?
How long does it last?
Do you use nitroglycerin to manage
the pain?
Have you ever needed to call for
emergency assistance because of
angina?
Have you ever had a heart attack?

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ANSWER
(question)
What is the most common
anti-anginal drug?

Nitroglycerin
(NTG)
Review:
Dental patients must bring their immediate released NTG
(sublingual) to the dental office at their appointment
Patient to be seated before taking NTG
Analgesics for HA must be available
NTG to be stored properly (far from heat or moist) at
dental office
Watch the expiration date

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(question)
What is a contraindication to
Anti-anginal drug?

Phosphodiesterase
Inhibitor
(Viagra, Vardenafil,
and Tadalafil)
Review:
Causes profound hypotension

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ANSWER
(question)
What are treatment
modifications for patients with
Angina Pectoris? (List 2)

- Stress reduction protocol and short
appointments
- Cardiac dose of LA with vasoconstrictor
- Precaution should be used when using LA with
a vasoconstrictor in clients taking nonspecific
B-blocker drugs (i.e. propranolol)
- Have vasodilator (nitroglycerin) available
check expiration date (should be less than 6
months)
- No more than 3 tablets in 10 minutes (only
administer if pt’s prescription and systolic BP
is > 100)
- If no relief from pain after 2 tablets, notify EMS

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ANSWER
(question)
List 3 symptoms of Angina
Pectoris

- Pain that may radiate to arm
and shoulder, neck or
mandible (more likely left side
but can be either)
- Sweating
- Faintness
- Anxiety
- Pallor
- Difficulty breathing

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ANSWER
(question)
What are
common uses for
anti-coagulants?

Prevent blood
clots.
Review:
Keep existing clots from getting
larger but does NOT break them.
Commonly taken by patient with
TJR, Post- MI, and ESRD
Patients.

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ANSWER
(question)
What are the 2 most
common
Anticoagulants?

Unfractionated
Heparin (UFH) &
Warfarin

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(question)
What does INR
stand for, and
what is a normal
range?

International
Normalized Ratio
Normal range 2-3
Review:
>3.5 Medical Consult Required.

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ANSWER
(question)
What type of patients
receive Heparin (UFH)
as an Anticoagulant?

End Stage Renal
Disease patients
that are receiving
Hemodialysis

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ANSWER
(question)
What Warfarin- Food
Interactions occur?

Interaction with
Cranberries & Green
vegetables. Also foods
with that are rich in
Vitamin K.
Review:
Vitamin K can is an Antidote for
Warfarin.

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ANSWER
(question)
How many types of
diabetes are there?
(List ALL)

5 types
- Type 1 (Genetic)
- Type 2 (Obesity and
genetically induced)
- Gestational (Pregnancy)
- Drug-Induced
- Disease Induced

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ANSWER
(question)
What is the 1st
line of
pharmaceutical
treatment in type
2 diabetes?

Metformin
Review:
- Decrease hepatic glucose
production
- Decreases intestinal glucose
absorption
- Improves insulin sensitivity

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ANSWER
(question)
What is an emergency
that the dental
hygienist should be
ready for when treating
patient with Diabetes?

The patient may
become
hypoglycemic.
Review:
A sugar source should be within
reach when treating a diabetic
patient due to this emergency.

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ANSWER
(question)
What are the most
commone cardinal
signs of diabetes?
(List 3)

Polydipsia
Polyuria
Polyphagia
Loss of strength

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ANSWER
(question)
What are the A1C levels for
normal, well controlled
diabetes, moderately
controlled diabetes, and
poorly controlled and prone
to complications?

NORMAL range: 4-6%
Well controlled diabetic: <7%
Moderately controlled diabetic:
7.5-8.5%
Poorly controlled and prone to
complications: >8.5%

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(question)
What type of
treatments are
provided for
hematologic
malignancies?

Induction treatment
– Eradicates cancer cells
Consolidation treatment
– Given post remission to eradicate
any remaining cancer cells
Maintenance treatment
– Prevent from recurrence

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ANSWER
(question)
What are some
common oral
complication for
patient receiving
Chemotherapy or
Radiation?

Oral Mucositis
Fungal infection
(Candidiasis)
Xerostomia
Osteonecrosis of the jaw
Osteoradionecrosis of the
jaw

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(question)
List 3 follow up
question for
chemotherapy
patients?

•Does your oncologist know you are here today?
•Did you have lab work done before this
appointment? What is your ANC?
•What type of cancer do you have and what area of
the body is affected?
•May I have permission to contact your oncologist
about your treatment?
•When did/will your oncology treatment start?
•What type of treatments are you receiving?
•Has your MD given you any instructions related to
having oral health treatment?

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(question)
Why is fluoride
recommended for
patient going
through radiation
therapy?

To treat radiation
caries and
erosion.

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(question)
When should
dental treatment
be postponed?

platelet count < 50,000
platelets/mm3 or
abnormal clotting factors are
present
neutrophil count < 1,000
cells/mm3

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ANSWER
(question)
What conditions
require antibiotic
pre-medication?
(List 3)

Prosthetic Cardiac Valve
Prosthetic material
Previous history of IE
Cardiac Transplant with
valve
Congenital heart disease

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(question)
Patient must take
antibiotic _____
minutes before dental
treatment.

30-60 minutes
Ideally 60
minutes.

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(question)
What class of antibiotics
should not be used if the
patient has a history of
anaphylaxis, angioedema,
or urticaria with penicillin
or ampicillin?

Cephalosporins

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ANSWER
(question)
Patient A is taking
Azithromycin for an sinus
infection, and has previous
history of prosthetic cardiac
valve. The patient is coming
in for a surgical extraction of
#19. Is antibiotic pre-
medication required? If yes,
what antibiotic and dosage?

Yes, Amoxicillin 2g
because the
patient shows no
indication of
penicillin allergy.

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(question)
Patient B had an appointment for
2 quadrants of scaling and root
planning and will have all lower
teeth extracted later the same
day. Patient B is antibiotic Pre-
medicated prior the scaling
appointment. At which point will
the patient need to take a full
dose of antibiotic again?

6 hours of having
administered
amoxillin

What are general
questions that you
should ask ALL
patients? (List ALL)
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ANSWER
(question)

•Question the patient regarding ANY changes in
their HHx--even if the patient was recently in the
office:
1.)Have you seen a physician since the last visit
(record date!)?
New illness or been seen in the ED?
Been hospitalized or recent surgery?
2.) Question regarding medication and OTC
drugs/supplement changes
What are you taking? Why are you taking them? How
much (dosage)?
Question when they took their meds: do they take
them regularly AND did they take them today?

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