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68wm6 p2 Dis of M&E
Disorders of the Mouth and esophagus
| Question | Answer |
|---|---|
| What percentage of americans are affected by Cold Sores, Canker Sores, Aphthous Ulcers? | 20% - 50% |
| What size do Cold Sores, Canker Sores, Aphthous Ulcers range? | 0.5cm - 3cm |
| What is the treatment of aphthous ulcers in people with normal immune systems? | amlexanox (Aphthasol) anti-inflammatory |
| Adverse effects of amlexanox (Aphthasol) | *Transient pain *Stinging and/or burning at the site of application |
| Less than 1% of PTs on amlexanox (Aphthasol) experience what adverse effects? | *Contact mucositis. *Nausea. *Diarrhea. |
| In the event that a rash or contact mucositis occurs from the use of amlexanox (Aphthasol), what should be done? | Discontinue use |
| When should amlexanox (Aphthasol) first be used? | ASAP after noticing symptoms of an aphthous ulcer. |
| amlexanox (Aphthasol) should be used how often? | four times daily, preferably following oral hygiene after breakfast, lunch, dinner, and at bedtime |
| True or False: When the symptoms of aphthous ulcers heal, amlexanox (Aphthasol) use can be discontinued. | True. |
| If significant healing or pain reduction has not occurred whithin how long, what must be done? | 10 days, consult dentist or physician. |
| The acid that causes erosion in dental carries is produced by the breakdown of what by bacteria? | Carbohydrates |
| True or False: Candida is a normal flora of the mucous membranses of the mouth, intestinal tract, vagina and skin of healthy people | True. |
| Aside from newborns, who else is candidiasis often seen in? | Patients with leukemia, DM, ABX, or on steroids |
| What is the prefered treatment of candidiasis in infants and vaginal infections? | nystatin (Mycostatin) |
| What are the treatments of candidiasis? | *nystatin (Mycostatin) *ketoconazole (Nizoral) *amphotericin B *1/2 strength hydrogen peroxide/saline rinses |
| In adults with candidiasis, what foods should be eaten and what toothbrushes used? | eat soft foods and use soft-bristled toothbrush |
| How long can amphotericin B be found in the urine AFTER discontinuation? | Up to 7 weeks after. |
| List 3 side effects of amphotericin B. | *CNS: headache. *CV: hypotension. *GI: diarrhea, nausea, vomiting. *GU: nephrotoxicity. *F&E: hypokalemia |
| What is the dosage and frequency of amphotericin B PO? | 1-4 mg q 4 hours |
| What should the PT be instructed to do while taking amphotericin B? | Instruct patient to swish medication around in mouth as long as possible before swallowing. |
| How should PTs with dentures be instructed to take Nystatin? | Presoak dentures in nystatin suspension |
| What are the side effects of Nystatin? | *GI: D/N/V. *Derm: contact dermatitis. |
| What may indicate the need to discontinue the use of Nystatin? | Increased irritation. |
| How should PO Nystatin be administered? | Suspension should be administered by placing half a dose on each side of the mouth. |
| For how long after symptoms disappear should Nystatin be taken to prevent relapse? | Continue for 48 hours after symptoms have disappeared and cultures are negative |
| What are the contraindications of ketoconazole (Nizoral)? | *Pregnancy or lactation. *Concurrent triazolam. |
| What are the adverse reactions of ketoconazole (Nizoral)? | *CNS: dizziness, drowsiness. *EENT: photophobia. *GI: drug-induced hepatitis, n/v/d. *GU: decreased male libido, menstrual irregularities. |
| How can you administer ketoconazole (Nizoral) to prevent nausea and vomiting? | administer with meals or snacks |
| What must not be administered within 2 hours of taking ketoconazole (Nizoral)? | histamine H2 antagonists or antacids |
| What are the adverse effects of topical anesthetics? | *CNS: confusion, drowsiness, dizziness, nervousness, tremor. *EENT: (mucosal) decreased or absent gag reflex. *GI: nausea and vomiting. *Local: stinging, burning, contact dermatitis, erythema. |
| What drugs when used while taking topical anesthetics can lead to increased cardiac depression and toxicity? | *phenytoin *amiodarone *quinidine *procainamide |
| What is the dosage and administration of topical anesthetics for oral surfaces? | 20 mg as 2 sprays/quadrant (not to exceed 30 mg/quadrant) |
| 60% of PTs who c/o GERD have what? | delayed gastric emptying |
| How much of the population is affected somewhat by GERD? | 45% |
| GERD pain can mimic what? | Angina |
| How long can the pain from GERD last after meals? | 20min to 2hrs |
| Define Odynophagia: | Painfull swallowing |
| What percentage of adult asthmatics may have GERD? | >80% |
| What are the diagnostic tests that can confirm GERD? | *Barium swallow *Endoscopy with biopsy *Esophageal-monitoring test |
| Test that measures how often and for how long stomach acid enters the tube that leads from the mouth to the stomach (Esophagus) | Esophageal pH monitoring |
| Simple GERD may be resolved if the PT does what? | Avoid problem foods or beverages, stop smoking, or lose weight. |
| Severe GERD can cause what? | Asthma attacks *Severe chest pain *Bleeding *Chronic irritation of the esophagus. |
| Drugs of choice in the treatment of GERD | Prilosec & Prevacid |
| What drug is given for moderate to severe GERD? | Reglan |
| What does Reglan do? | Increases peristalsis without simulating secretions |
| What is Fundoplication? | A procedure that is performed to wrap the gastric fundus around the lower esophagus and suturing it is in place |
| GERD diet instructions | *4-6 small meals per day *Thoroughly chew food *No snacks/meals 2-3h before HS *Reduce foods with caffeine *Low fat, adequate PROTEIN diet |
| How should a GERD patients bed be placed? | Head of bed elevated 6-8 inches, and dont sleep in flat position. |
| What is the primary symptom of Achalasia? | Difficulty swallowing |
| Due to absence of peristalsis of the esophagus int the PT with Achalasia, the PT may experience the sensation of what? | food sticking to the lower portion of the esophagus |
| True or False: One treatment of Achalasia is FORCEFUL dilation of the esophagus | True |
| What can a PT with Achalasia do to increase the peristalsis movement to the lower esophageal spincter? | Drink fluids with meals. The pressure exerted by the fluids will assist food into the stomach. |
Created by:
Shanejqb
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