1. Diseases of the Respiratory System

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1. Diseases of the Respiratory System

M-7A2 A 12-year-old boy comes to your clinic for tooth extraction before the fitting of permanent braces. The mother tells you that he has asthma on medication and is currently having a “cold” with running nose.

(a) What questions will you ask to determine if it is safe to proceed? (6M)

(b) Name 2 medications he may be using for the long-term management of his asthma. (4m)

The child starts to have an itchy rash over his body, complains of feeling light-headedness and starts to wheeze.

(c) What do you think has happened? (2M)

(d) Briefly describe how you would manage this situation. (8M)
M06B4 A 34 year old male foreign patient sees you for routine dental work. You notice that he has a runny nose and cough. A few minutes into the dental work, he becomes increasingly breathless.

  1. Describe some aspects of the history and physical examination that will be useful to help you diagnose the cause of his symptoms.

  2. How would you manage the patient’s acute symptoms?

  3. Outline the subsequent steps in the management of this patient’s symptoms, including the need for notification.

M06B6(a) Write short notes on Aspiration (inhalational) pneumonia

J02B3 A 70-year old Chinese male presents to you with the complaint of a toothache and you determine that he requires a dental extraction. He admits to smoking 40 sticks of cigarettes daily. He complains of breathlessness even at rest and his symptoms have progressed in the last 2 years. Auscultation of his lungs reveals that the breath sounds are diminished and widespread rhonchi are heard.

(a) What are the possible differential diagnoses?

(b) How will you manage this patient?

M01B1 A 35 year old man who travels widely and frequently within Asia, presents to you for dental treatment. He has been admitted to hospital in the past 2 years for episodes of recurrent pneumonia.

(a) What additional historical points are necessary in your pre treatment assessment?

(b) What tests would you deem necessary to arrive at a diagnosis?

(c) Discuss the management approach in this case.
M01A1 An 8 year old boy has a history of chronic asthma and is on high dose inhaled steroids via a dry powder inhaler for the past several years. He presents to you for management of severe dental caries.

(a) Briefly discuss the possible relationship between his asthma therapy and the dental caries and the advice you would give to prevent this possible complication. (b) If this child has had a long course of systemic steroids and now requires dental treatment under general anaesthesia, what precautions must you take and specify the pre operative medications you will need to administer.

(c) Name 3 complications of long term systemic steroids.
M00B2b Write short notes on the general principles of drug therapy in bronchial asthma.
M00B4c Write short notes on normal and abnormal breath sounds.
M98B4a Write short notes on: aspiration pneumonia
M97A1 Discuss the defence mechanisms against infection in the upper respiratory tract. Give 3 examples to illustrate how this may be important.
M97B2 A five-year old girl with chronic bronchial asthma is seen at the dental clinic for multiple dental caries.

  1. What other history would you want to elicit before proceeding with dental treatment?

  2. What are the symptoms and signs of an acute asthmatic exacerbation?

M96A1 Discuss the etiology and clinical features of Community Acquired Pneumonia.

M94A3b Write short notes on aspiration pneumonia.
M92A2 A 20-yr old lady with bronchial asthma sees you for dental caries. She says recently she is having more episodes of wheezing. Discuss the various factors that can aggravate her asthma. How would you manage her?
M92A3a Write short notes on Defence mechanism in the upper respiratory tract.
J91A3c Write short notes on Bronchiectasis.
M90A1 A 65-yr old man was admitted for breathlessness. He had been a heavy cigarette smoker for the last 40 years. The chest z-ray revealed massive left pleural effusion.

  1. What is the most likely diagnosis and briefly outline your plan of investigations.

  2. Briefly outline the effects of smoking.

2. Diseases of Liver and Biliary System

M04B3 You are called to see a patient in the medical ward who needs tooth extraction . You notice that the patient appears jaundice and the patient volunteers a history of intravenous drug abuse.

  1. What problems might you encounter in the dental management of this case?

  2. What are the necessary precautions you need to take?

M00B1 A 45-year-old woman with liver cirrhosis is referred to you for dental clearance. You discover significant dental caries which require dental extraction.

  1. What problems do you anticipate in this patient?

  2. What precautions would you take to ensure a good outcome?

M99B1 A 45-year old man with a history of hepatitis for 20 years on follow-up by a specialist is seen at dental clinic for tooth extraction.

  1. What are the causes of chronic hepatitis?

  2. What are the complications of chronic hepatitis?

  3. What are the additional points in the history and tests that are necessary for assessment before dental treatment?

M94A3d Write short notes on modes of transmission of Hepatitis B virus.

M93A6 Write short notes on

  1. prevention of Hepatitis B infection in dental practice

  2. Hepatitis A infection in children

  3. Causes of hepatomegaly

M92A3 Write short notes on d) Hepatocellular carcinoma.

J91A3a Write short notes on Hepatitis B virus infection.
M90A1/ A 45-yr old married man was noted to a Hepatitis B carrier on routine
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