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Medical OSCE Quiz - glucose, bisphosphonates, INR
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Questions in this quiz (36)
1You must make sure you carry out ICE for all patients. What does ICE stand for?
I - [blank_start]Introduce[blank_end]
C - [blank_start]Consent[blank_end]
E - [blank_start]Expose[blank_end]- AIntroduce
- BConsent
- CExpose
2What is blood glucose measured in on a glucometer (in the UK!)
- Ammol/L
- Bmg/dl
3What is the normal range of capillary blood glucose in mmol/L in an ADULT before a meal?
- A2.9-7.5
- B3.5-5.5
- C3.5-6.9
- D2.9-6.9
4What is the normal blood glucose level in an adult without diabetes, in mmol/L, around 2 hours after eating?
- ALess than 10
- BLess than 15
- CLess than 7
- DLess than 8
5You are gaining consent to take someone's blood glucose measurement.
1. [blank_start]introduce[blank_end] yourself
2. Explain you are going to take a [blank_start]blood glucose[blank_end] measurement
3. Explain that you do this to ensure the [blank_start]levels[blank_end] of blood glucose are [blank_start]normal[blank_end] so as to prevent [blank_start]complications[blank_end] during [blank_start]dental[blank_end] treatment
4. This will also give a better [blank_start]understanding[blank_end] of how well your blood glucose is [blank_start]controlled[blank_end]
5. Can I [blank_start]proceed[blank_end]?- Aintroduce
- Bblood glucose
- Clevels
- Dnormal
- Ecomplications
- Fdental
- Gunderstanding
- Hcontrolled
- Iproceed
6What is the normal blood glucose level of a type 1 diabetic adult ON WAKING
- A3-6 mmol/l
- B2-7 mmol/l
- C5-7 mmol/l
7What is the normal blood glucose level of a type 1 diabetic adult BEFORE MEALS
- A4-7mmol/l
- B5-8mmol/l
- C3-7mmol/l
8What is the normal blood glucose level of a type 1 diabetic adult 90 minutes AFTER meals?
- A6-9mmol/l
- B5-9mmol/l
- C4-7mmol/l
9What is the normal blood glucose level of a TYPE 2 diabetic adult BEFORE meals?
- A4-7mmol/l
- B5-8mmol/l
- C3.5-5.5mmol/l
10What is the normal blood glucose level of a TYPE 2 diabetic adult two hours AFTER meals?
- ALess than 10mmol/l
- BLess than 7.5mmol/l
- CLess than 8mmol/l
- DLess than 8.5mmol/l
11The stages of carrying out a blood glucose measurement are as follows:
1. ICE ([blank_start]Introduce[blank_end], [blank_start]consent[blank_end], [blank_start]explain[blank_end])
2. Cross infection - [blank_start]wash[blank_end] hands
3. Prepare equipment - [blank_start]pricking[blank_end] device, [blank_start]glucometer[blank_end] strip (check expiry date), and the [blank_start]glucometer[blank_end].
4. Place [blank_start]strip[blank_end] in the machine - do not touch area where [blank_start]blood[blank_end] will be placed.
5. Ask patient to [blank_start]wash[blank_end] their hands - so their finger is [blank_start]clean[blank_end]
6. Place [blank_start]pricking[blank_end] device at chosen site and click
7. Dispose of device in the [blank_start]sharps bin[blank_end]
8. [blank_start]Massage[blank_end] the finger to get a [blank_start]drop[blank_end] of blood
9. Place test strip on blood droplet. Do not [blank_start]smear[blank_end] or [blank_start]spread[blank_end] the blood
10. Glucometer will generate a reading
11. Press [blank_start]cotton wool[blank_end] on to puncture wound until bleeding has [blank_start]stopped[blank_end] - possibly place a [blank_start]plaster[blank_end]
12. [blank_start]Wash[blank_end] hands, tidy up
13. Check patient is [blank_start]comfortable[blank_end]
14. Write [blank_start]record[blank_end] of measurement in notes.- Aconsent
- Bexpose
- CIntroduce
- Dwash
- Epricking
- Fglucometer
- Gglucometer
- Hstrip
- Iblood
- Jwash
- Kclean
- Lpricking
- Msharps bin
- NMassage
- Odrop
- Psmear
- Qspread
- Rcotton wool
- Sstopped
- Tplaster
- UWash
- Vcomfortable
- Wrecord
12Label the test strip using the drop down menus
- AThis goes in the machine
- BThis goes in the blood
- CThis goes in the machine
- DThis goes in the blood
13What is the correct term for BRONJ now?
Answer: [blank_start]MRONJ[blank_end]- AMRONJ
14What does the acronym MRONJ stand for?
[blank_start]Medication[blank_end] [blank_start]related[blank_end] [blank_start]osteonecrosis[blank_end] of the [blank_start]jaw[blank_end]- AMedication
- Brelated
- Costeonecrosis
- Djaw
15Which of the following drugs are true about bisphosphonates? (select all that apply)
- ABisphosphonates decrease bone resorption
- BBisphosphonates increase bone resorption
- CThey have an effect on osteoclasts
- DThey have an effect on osteoblasts
- EThey accumulate at areas of low bone turnover
- FThey accumulate at areas of high bone turnover
16How long must necrotic bone persist in the maxilla or mandible to be classified as MRONJ?
- A5 weeks
- B3 weeks
- C10 days
- D8 weeks
17True or false? MRONJ is rare in patients taking bisphosphonates
- ATrue
- BFalse
18True or false? Bisphosphonates are used to treat some cancers
- ATrue
- BFalse
19True or false? MRONJ is only truly MRONJ if the patient has no history of radiation therapy to the jaw?
- ATrue
- BFalse
20True or false? Bisphosphonates are never prescribed as a preventative measure
- ATrue
- BFalse
21True or false? MRONJ patients should never be treated in primary care.
- ATrue
- BFalse
22During a medical history, you should ensure you ask about [blank_start]past[blank_end], current, or possible [blank_start]future[blank_end] use of bisphosphonates.
Bisphosphonates are often prescribed for non-malignant conditions such as:
- O[blank_start]steoporosis[blank_end]
- P[blank_start]aget's[blank_end] disease
- O[blank_start]steogenesis[blank_end] imperfect
- F[blank_start]ibrous[blank_end] d[blank_start]ysplasia[blank_end]
and some malignant conditions such as:
- [blank_start]Multiple[blank_end] myeloma
- B[blank_start]reast[blank_end] cancer
- P[blank_start]rostate[blank_end] cancer
- Metastatis bony lesions- Apast
- Bfuture
- Csteoporosis
- Daget's
- Esteogenesis
- Fibrous
- Gysplasia
- HMultiple
- Ireast
- Jrostate
23Symptoms of MRONJ often include:
- [blank_start]Delayed[blank_end] healing following extraction or oral surgery
- P[blank_start]ain[blank_end]
- Soft tissue [blank_start]infection[blank_end]
- Sw[blank_start]elling[blank_end]
- P[blank_start]araesthesia[blank_end]
- [blank_start]Exposed[blank_end] bone
- N[blank_start]umbness[blank_end]- ADelayed
- Bain
- Cinfection
- Delling
- Earaesthesia
- FExposed
- Gumbness
24Check all things you must advise a patient taking bisphosphonates during, and before, dental treatment
- ABisphosphonate use should be discouraged during active dental treatment courses
- BGood oral hygiene must be maintained
- CHealthy diet and stopping smoking is important
- DReduce bisphosphonate intake
- EReduce alcohol intake
- FRegular dental check ups
- GAvoid visiting the dentist often
- HReport symptoms as soon as possible
- IAllow time for symptoms to resolve as they may be transient
- JRoutine treatments such as scale and polish should be avoided
25True or false? Carrying out dental treatment prior to a course of bisphosphonate therapy is contraindicated and will increase risk of MRONJ
- ATrue
- BFalse
26How might bisphosphonates improve a patient's medical state?
- AIncrease bone turnover
- BDelaying onset of disease
- CReduce chance of treatment complications
- DReduce chance of bone pain
- EReduce chance of necrosis
- FIncrease blood supply to bone
27Which of these is the correct term for death of bone?
- AOsteoporosis
- BOsteoradionecrosis
- COsteonecrosis
- DOsteomyelitis
28True or false? A patient on bisphosphonate therapy for management of osteoporosis is at high risk of MRONJ
- ATrue
- BFalse
29Are patients on IV bisphosphonates at a higher or lower risk of developing MRONJ?
- AHigher
- BLower
30Patients at high risk of developing MRONJ have one or more of the following factors
− previous [blank_start]diagnosis[blank_end] of BONJ;
− taking a bisphosphonate as part of the management of a [blank_start]malignant[blank_end] condition;
− other non-[blank_start]malignant[blank_end] systemic condition affecting [blank_start]bone[blank_end] (e.g. Paget’s disease);
− under the care of a [blank_start]specialist[blank_end] for a [blank_start]rare[blank_end] medical condition (e.g. [blank_start]osteogenesis[blank_end] imperfecta); − concurrent use of systemic [blank_start]corticosteroids[blank_end] or other [blank_start]immunosuppressants[blank_end];
− coagulopathy, chemotherapy or radiotherapy.- Adiagnosis
- Bmalignant
- Cmalignant
- Dbone
- Especialist
- Frare
- Gosteogenesis
- Hcorticosteroids
- Iimmunosuppressants
31True or false: MRONJ risk is temporarily reduced by the patient ceasing their bisphosphonate therapy prior to dental treatment.
- ATrue
- BFalse
32True or false? bisphosphonate drugs can remain in the skeletal tissues for years.
- ATrue
- BFalse
33The anticoagulant treatment record is more commonly known as the...?
- ABlue book
- BYellow book
- CGreen book
- DRed book
34True or false: Patients on warfarin therapy should be advised against taking ibuprofen and aspirin
- ATrue
- BFalse
35What should a patient's INR be prior to commencing dental treatment with a bleeding risk?
- AMore than 4
- BLess than 4
- CMore than 2
- DLess than 2
36You are seeing a lady who is about to have dental treatment. She is on warfarin therapy.
- You should ask [blank_start]why[blank_end] she was [blank_start]prescribed[blank_end] warfarin
- You should look at their anticoagulant therapy record ([blank_start]yellow[blank_end] book)
- You need to ensure her [blank_start]INR[blank_end] has been measured [blank_start]recently[blank_end] and that measurements are under control with no [blank_start]fluctuations[blank_end]
- [blank_start]Paracetamol[blank_end] can be taken for pain relief
- You can place [blank_start]sutures[blank_end] to control bleeding if necessary
- She should [blank_start]not[blank_end] stop taking her warfarin before treatment
- Risk of [blank_start]thrombosis[blank_end] is greater than the risk of [blank_start]bleeding[blank_end]- Awhy
- Bprescribed
- Cyellow
- DINR
- Erecently
- Ffluctuations
- GParacetamol
- Hsutures
- Inot
- Jthrombosis
- Kbleeding
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- Description
- Dentistry 4th year osce
- Language
- English
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