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Surgery Handbook Dent10 (2)

Surgery Handbook Dent10 (2)

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Published by Prince Ahmed

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Published by: Prince Ahmed on Nov 24, 2013
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03/26/2014

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MALAYSIAN DENTAL STUDENT | JORDAN UNI OF SCIENCE TECHNOLOGY
[2013]
 
SURGERY 
 
HANDBOOK
 
[
MEDICAL COMPROMISED
]
 
m
 
 
INDEX 1. Angina Pectoris 2. Myocardial Infarction 3. Congestive Heart Failure 4. Hypertensive 5. Rheumatic Fever 6. Infective Endocarditis 7. Resp - Asthma 8. COPD 9. Endocrine
 – 
 Diabetes 10. Corticosteroid Theraphy 11. Liver
 – 
 Hepatitis 12. Chirrosis 13. Anemia Overview &Classification 14 Macro : Vit B12, Folate 15. Micro : IDA 16. Normo : Aplastic 17. Vascular- Hereditary Haemorrhagic Telangiectasia 18. Platelet
 – 
 Itp 19. Coagulation : Haemophilia A, Haemophilia B, Vwb 20. Haemolytic
 – 
 Sickling, Thalassemia (211-215) 21. Steroid (149-152) 22. Endocrine- Thyroid Please note that this is a brief summary of Medical problems in Dentistry lectures discussed.  based from the book Crispian Scully, Medical Problems in Dentistry 6
th
 edition. Kindly refer the book for further details.
 
 
1.
 
ANGINA PECTORIS
-
 
Episodes of chest pain caused by myocardial ischaemia secondary to CAD
-
 
Severity and prognosis : degree of coronary artery narrowing Causes : Artherosclerotic plaque > rupture > platelet activation, adhesion and : thrombosis impeding coronary artery blood flow : arterial spasm Types
 
Stable angina : pain only on exertion and relieved in a few minutes by rest and sublingual GTN
 
Unstable angina (acute coronary syndrome) : angina at rest or sudden onset with ra
 
 pid increase in severity
 
Cardiac syndrome X (microvascular angina) : clinical features of angina but normal coronary arteries on angiogram
 
Decubitus angina : pain on lying down
 
Vasospastic (prinzmetal) angina : caused by coronary artery spasm Clinical features
 
Chest pain described as a pressure sensation. Fullness or squeezing in the mid-portion of thorax
 
Radiation of chest pain into jaw/teeth, shoulder, arm, back
 
Occasionally associated dyspnoea (shortness of breath), epigastric discomfort or sweating General management
 
Investigations : resting ECG
 – 
 ST segment depression with flat/inverted T wave : myocardial perfusion scan (ischaemic myocardium) : coronary angiography (assess coronary blood flow)
 
Identify and correct the risk factor : diabetes, cigarette smoking, hypercholestrol,  physical inactivity, obesity
 
Medication :
 
Percutaneous transluminal coronary angioplasty (PTCA) : open up coronary blood flow, inserting ballon-tipped catheter Acute angina -oxygen -GTN (sublingual/ in buccal sulcus) -reducing anxiety -CCB, K-channel activator Frequent angina -long-acting nitrates (isosorbide mononitrate) -beta-adrenergic blocking drugs (atenolol) -Ca antagonist (amlodipine)

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