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UNIVERSITY OF LOUISIANA AT MONROE Course: DHYG 4034 Title: Clock Hours: 3 Time: 10:00 – 11:20 T Th Program: Dental Hygiene Dental Management of the Medically Compromised Patient Credits: 3 Level/Sem./Yr: Sr/Fall/16 Office Hours: M,W,F 9-11:00a.m. and by appointment I. INSTRUCTOR II. COURSE DESCRIPTION The dental assessment and management of the medically compromised patient. III. COURSE PREREQUISITES/COREQUISITES Prerequisites: DHYG: 4015, 4016, 4017 Corequisites: Registration in DHYG: 4014, 4021, 4022 IV. COURSE OBJECTIVES AND COMPETENCIES Competencies Sharon C. Chaney, R.D.H., M.P.S. Course Objectives With respect to the following list of medically compromising conditions and diseases, the student will be able to *, 6.1, 6.3, 6.4, 6.5, 6.7 *, 6.3, 6.4, 6.5, 6.7 1. Describe the characteristics, signs and symptoms that patients with each condition present. 2. Summarize medical, surgical or pharmacological treatment that is normally provided for each condition and state how those treatments would influence dental treatment. 6.2, 6.6, 6.7 3. Identify the assessment tools appropriate for the patient *, 6.3, 6.4, 6.5, 11.1, 4. Select treatment modifications and adaptations that might be 11.2, 11.3 necessary to assess and treat compromised individuals and explain the rationale for such 7.2, 8.1, 8.2 5. State the elements to be included for appropriate patient education for each condition and the rationale for inclusion 6.3, 10.2 6. State any necessary consultations, referrals, additional treatment or education that would be recommended. *, 10.1 7. State possible modifications of expectations of treatment due to the condition/disease 10.3 8. Select and justify an appropriate maintenance/recall interval for the patient. Infective endocarditis and associated conditions Hypertenstion Ischemic heart disease Cardiac arrhythmias Congestive heart failure Pulmonary Diseases: COPD; asthma; tuberculosis Diabetes mellitus Chronic renal disease; ESRD; dialysis Liver disease: Hepatitis; alcohol related disorder Gastrointestinal disease: Peptic Ulcer, Inflammatory Bowel Disease, Pseudomembranous colitis Sexually transmitted diseases HIV; AIDS and related conditions Adrenal insufficiency Thyroid disease Pregnancy and breastfeeding; relation to infant/toddler Hormonal imbalances: adolescence; menopause Allergy Bleeding disorders, Disorders of the red and white blood cells Cancer; Oral Cancer Neurological disorders: epilepsy; cerebrovascular accident Behavioral / psychiatric disorders Rheumatologic and Connective Tissue Disorders: osteoarthritis; rheumatoid; lupus Organ and Bone Marrow Transplants V. COURSE TOPICS See attached Session Topic Schedule VI. INSTRUCTIONAL METHODS AND ACTIVITIES Reading Assignments Lecture Discussion in large and small groups Group activities Specific medical/ dental equipment/ models Handouts Aids: Videos, Power point presentations, handouts, online resources/research VII EVALUATION AND GRADE ASSIGNMENT Exams There will be four examinations given during the semester. Make-up examinations will not be given unless the student has an excused absence and has notified the instructor in advance. Missed exams are calculated as “0” when computing the final course grade. A comprehensive final examination will be given on the scheduled date. There will be no exemptions from the final examination. Examinations are pencil and paper using scantrons. Questions are a variety of multiple choice types similar to those used on the national board examination. Participation is expected during class sessions and will be evaluated by the instructor and members of the peer groups. Evaluation will be based on observation, and peer evaluation according to the criteria listed on the form posted on Moodle. Reading Assignments Assigned material must be read before class in order to participate in the discussion or activities for that day. Quizzes will test for understanding of this information. Class assignments/activities (both individual and group) will be utilized regularly. Activities will be utilized to help the student organize, process, and integrate the material. This will assist the student in transferring the information to the clinical setting and utilizing it in patient treatment. Quizzes are typically given at the beginning of each session. They will evaluate understanding of previously assigned readings and/or application to patient situations. Regular quizzes will be given throughout the course covering the reading assignments. Quizzes missed during an excused absence will be made up the day of the final examination. Students may take their group grade or opt to take the quiz if they miss a quiz while at VA. Missed quizzes are calculated as a “0” when computing the final grade. Group Activities / Presentations Each group will be assigned cases or portions of a case involving a moderate periodontally involved patient with a specific disease or condition that is compromising. Groups are to develop the case or aspect of the case according to the following criteria. The group will present their portion of the case or the entire care to the class. The class will be allowed to ask questions following the presentation. Evaluation of the presentations will be based on the following criteria as per the assignment: Content: 75% Exemplified the signs and symptoms typically found in patients with the disease or condition considered. Addressed any medical treatment that might be currently utilized for this patient. Considered pharmacological considerations for the patient and any possible interactions with dental drugs or treatment. Selected and utilized appropriate assessment data Developed a treatment plan, including patient education, appropriate to the patients’ needs Included modifications for assessment, treatment, patient education and expectations Presentation: 25% The case was presented in an organized, interesting and informative manner. Mid-Term Grades will be posted on-line for students to view via Banner. Midterm grades indicate a student's status at mid-semester only and do not indicate the final performance outcome of a student. Criteria for the final grade Quizzes Examinations (4) Final Exam Attendance/Participation/Peer Evaluation 25% 40% 30% 5% 100% Grading Scale The grading scale for the Dental Hygiene Program is as follows: A 93-100 B 85-92 C 77-84 D 70-76 F Below 70 VIII. CLASS POLICIES AND PROCEDURES Required Texts: Little, et. al. Dental Management of the Medically Compromised Patient 8th ed. ULM, Dental Hygiene Clinic Manual 2015 ed. Wilkins Esther, Clinical Practice of the Dental Hygienist, 11th ed. Wynn, LexiComp Online Drug Information latest ed. References: Physician’s Desk Reference , latest ed. Mosby’s Dental Dictionary latest ed. Journal Articles Moodle Resources Attendance: Recognizing that a dental hygiene student will soon be obligated to meet the needs and demands of the profession of dental hygiene, there are stricter attendance requirements than those imposed by other academic curricula. Attendance is required at all clinical courses, laboratories, clinics, and external rotations as scheduled. Penalties for tardies and absences are as follows: 1. First tardy – no penalty, If a quiz is in progress, you must stay in the back of the room until the quiz is over. You will not be allowed to make up the quiz and a zero will be recorded. 2. Second tardy – 1 point deducted from the final course grade. Policy regarding quizzes is the same as mentioned above. 3. Subsequent tardies – two points deducted from the final course grade for each tardy. Policy regarding quizzes is the same as mentioned above. 4. First absence – no penalty if time and/or missed work in all subject areas missed is made up. The student must contact the course director the day the student returns to school to make arrangements for the missed work, assignments. If arrangements are not made, you will not be allowed to make up the work, assignment; and a zero will be recorded. In addition, 2 points will be deducted from your final course grade. See course evaluation section for make-up examination policy. 5. Second absence – 2 points will be deducted from the final course grade. Policy regarding missed work is the same as mentioned in #4. 6. Subsequent absences – for each day of absence, five points will be deducted from the final course grade in all subject areas missed. Policy regarding missed work is the same as mentioned in #4. 7. If you are ill, notify A. your patients B. dental hygiene receptionist/secretary &/or Clinic Lecture Instructor C. clinical coordinator A student may appeal the grade penalty to the Dental Hygiene Admissions and Academic Standards Committee by personal appearance or written application if the following two conditions exist and can be demonstrated: 1. there is sufficient documented evidence to support a genuine need for the absence 2. that missed course work, laboratory work or clinical work can be overcome The committee will determine the merit of the appeal and decide what action will be taken. For VA rotation – Absences resulting from VA rotation will not be counted against the student. The student is responsible for all course work missed. If a test and or quiz is missed, it must be taken the Friday at 8:00 a.m. that the student returns to school, unless prior arrangements have been made with the course director. Notes and work missed will be in the VA box in Caldwell 210. It is the student’s responsibility to pick up this information. For satellite clinic rotations: students assigned to outside satellite clinics on class days will be allowed to leave class at 11:00a.m. in order to prepare for and begin treatment at clinic site on time. Make-up exams will not be given unless it was an official university excused absence and the instructor has been notified in advance. It is the student’s responsibility to contact the instructor within 24 hours of the absence to schedule a make-up exam. Missed exams will be recorded as a zero when computing the final grade. Academic Integrity Students and faculty must adhere to the ULM published policies on academic cheating, plagiarism and other forms of academic dishonesty. Infractions of any of these policies will result in being called before the Dental Hygiene Admissions and Academic Standards Committee. The committee will determine the seriousness of the infraction and will determine the penalty or remediation. Students may appeal any decision of this committee as allowed in the ULM Student Policy Manual. Social Media Use Policy Students who want to communicate about patients via social media must use only ULM email; wherein, specific patients may be referred to only by initials, not by either first or last name. No communication about patients, parents, clinic, or the department is allowed in any other communications via social media (except ULM warhawks email). These include Facebook, blogs, text-messaging, personal mail, etc. Official Facebook postings about departmental activities can only be made by students with approval of the Department Head or Clinical Coordinator. While faculty cannot stop students from doing so, it is not in the students’ best interest to speak negatively about him/herself, faculty, the program, college or university on Facebook or elsewhere. If a student’s public communication is interpreted in a slanderous and/or non-beneficent manner, then the student can and will be held ethically and/or legally responsible. Furthermore, students should be aware that Facebook is viewable and viewed by faculty, patients, parents of patients, students at other universities, potential students, and future employers. Before a Facebook post is made, students should ask themselves, “What will a future employer (patient, patient’s parent, etc.) think when he/she sees this post? Faculty (including off- campus supervisors) are not allowed to befriend on Facebook any current student of the program, patient or parent of a patient. Social relationships with faculty are inappropriate. IX. Student Services: The University of Louisiana at Monroe strives to serve students with special needs through compliance with Sections 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act. These laws mandate that postsecondary institutions provide equal access to programs and services for students with disabilities without creating changes to the essential elements of the curriculum. While students with special needs are expected to meet our institution's academic standards, they are given the opportunity to fulfill learner outcomes in alternative ways. Examples of accommodations may include, but are not limited to, testing accommodations (oral testing, extended time for exams), interpreters, relocation of inaccessible classrooms, permission to audiotape lectures, note-taking assistance, and course substitutions. Information about ULM student services can be found via these links: Student Success Center: http://www.ulm.edu/studentsuccess/ Counseling Center http://www.ulm.edu/counselingcenter/ Special Needs at http://www.ulm.edu/studentaffairs/ Library http://www.ulm.edu/library/reference.html Computing Center Help Desk http://www.ulm.edu/computingcenter/helpdesk Students with disabilities Current college’s policies on serving students with disabilities can be obtained on the ULM website: http://ulm.edu/counselingcenter/ If you need accommodation because of a known or suspected disability, you should contact the Director for Disabled Student Services at: Voice phone: 318-342-5220 Fax: 318-342-5228 Walk-In: ULM Counseling Center, 1140 University Avenue (this building and room are handicapped accessible). Mental Wellness on the ULM Campus: If you are having any emotional, behavioral, or social problems and would like to talk with a caring, concerned professional, please call one of the following numbers: The ULM Counseling Center: 318-342-5220 The Marriage and Family Therapy Clinic: 318- 342-9797 The Community Counseling Center: 318-342-1263 Remember that all services are offered free to students, and all are strictly confidential. If you have special needs that I need to be made aware of, you should contact me within the first two days of class. Sexual Harassment or Gender-Based Discrimination: Title IX of the Education Amendments of 1972 prohibits sex discrimination against any participant in an educational program or activity that receives federal funds, including federal loans and grants. Furthermore, Title IX prohibits sex discrimination to include sexual misconduct, sexual violence, sexual harassment and retaliation. If you encounter sexual harassment or gender-based discrimination, please contact the Title IX Coordinator at 318-342-1004; you may also file a complaint online, 24 hours a day, at: www.ulm.edu/titleix. SESSION OBJECTIVES By the end of each session, the student will be able to: Interrelationships of Medicine and Dentistry 25 min. 1. State the interrelationships of medicine and dentistry 2. Summarize the health characteristics of the general population 3. State the percentage and types of medically compromised patients in an average dental practice 4. Compare the dental treatment of medically compromised patients 40 years ago and today Infective Endocarditis and Related Conditions 25 min. 1. State the etiology of endocarditis and conditions associated with it 2. Describe the characteristics, diagnostic tests and markers, course, prognosis and sequelae of the disease 3. Describe the medical management and pharmacologic treatment of the disease 4. Describe concerns, modifications and precautions for dental and dental hygiene assessment, diagnosis and treatment of a patient who is susceptible to, at risk for or has had this disease 5. State the current AHA protocols for various dental and dental hygiene procedures for patients susceptible to IE 6. List and briefly describe the conditions placing a patient a high, and moderate risk for infective endocarditis 7. State the protocol for treating patients with high, moderate and low conditions 8. Describe congenital heart conditions, treatments and relation to dental treatment and IE Hypertension 50 min. 1. State the types and etiology of hypertension 2. Summarize the pathophysiology of hypertension 3. Describe the signs, symptoms and significant laboratory findings for patients with hypertension 4. Describe the medical and pharmacologic management of hypertension 5. Categorize and compare the various types of anti-hypertensive drugs in terms of mode of action, side effects, oral manifestations and vasoconstrictor interaction 6. Describe the dental management of hypertensive patients 7. Describe the interactions and considerations of local anesthetics with hypertensive patients and those on anti-hypertensive medications Ischemic Heart Disease 50 min. 1. State the incidence, prevalence and etiology of ischemic heart disease(IHD) 2. Summarize the pathophysiology and complications of IHD 3. Compare and contrast the signs, symptoms, laboratory findings of angina pectoris and myocardial infarction 4. Describe the medical and pharmacologic management of angina pectoris and myocardial infarction 5. Identify the drugs commonly used to treat angina pectoris and myocardial infarction and describe their actions, side effects, vasoconstrictor interactions and oral manifestations 6. Identify those patients who are at major, intermediate or low risk of a cardiac perioperative complication 7. Describe the dental management of IHD patients 8. List any oral complications or manifestations of IHD Cardiac Arrhythmias 30 min. 1. Define and describe pathophysiology and complications of the major classifications of cardiac arrhythmias 2. State the etiology of cardiac arrhythmias 3. Describe the clinical presentation, (signs, symptoms and laboratory tests), of cardiac arrhythmias 4. Describe the medical and pharmacologic management of cardiac arrhythmias 5. Identify the drugs commonly used to treat cardiac arrhythmias and list their actions, side effects, and oral manifestations 6. Describe the use of pacemakers and cardioverters for arrhythmias 7. Describe the dental management of and prevention of medical complications of patients who have cardiac arrhythmias Heart Failure 50 min. 1. Define congestive heart failure and describe its etiology, pathophysiology and complications 2. Describe the clinical presentation of CHF 3. Describe the medical and pharmacologic management of CHF 4. Identify and classify the drugs used to treat CHF and list the classifications modes of action, vasoconstrictor interactions, side effects and oral manifestations 5. Describe the dental management of CHF patients Pulmonary Disease Chronic Obstructive Pulmonary Disease 30 min. 1. Define and describe the pathophysiology and complications of the two major types of COPD 2. State the etiology of COPD 3. Compare and contrast the clinical presentation of bronchitis and emphysema 4. Describe the medical and pharmacologic management of COPD 5. Describe the dental management of patients with COPD Asthma 25 min. 1. Define and describe the etiology, pathophysiology and complications of asthma 2. Describe the clinical presentation of asthma 3. List and describe the classifications of asthma 4. Describe the medical and pharmacologic management of asthma 5. Discuss the dental management of patients with asthma 6. Describe the emergency treatment of patients experiencing an asthma attack 7. Describe the oral complications and manifestations of asthma or its medications and how these can be prevented or treated Tuberculosis 25 min. 1. Define and describe the incidence, prevalence, etiology, pathophysiology and complications of tuberculosis 2. Describe the clinical presentation of tuberculosis 3. Describe the medical and pharmacologic management of tuberculosis and the relevance of multi drug resistant strains 4. Describe the actions, side and adverse effects and dental considerations of antituberculosis drugs 5. Describe the dental management of patients with tuberculosis 6. Describe the oral and perioral manifestations of tuberculosis 7. Discuss government regulations regarding tuberculosis Diabetes and Chronic Renal Failure and Dialysis 100 min. 1. Define diabetes and state its incidence, prevalence and etiology 2. Briefly summarize the pathophysiology and complications of diabetes 3. Compare and contrast Type 1 and Type 2 diabetes in terms of clinical presentation 4. Describe the medical and pharmacologic management of diabetes 5. Describe insulin reaction or hypoglycemic reaction and describe the appropriate treatment for each stage of this reaction 6. Discuss the proper dental management of various categories of diabetic patients 7. Describe oral manifestations and complications of diabetes 8. List appropriate treatment and appointment modifications typically used for patients with diabetes 9. Define end-stage renal disease and describe its etiology and prevalence 10. Summarize the pathophysiology and complications of ESRD 11. Describe the clinical presentation or ESRD 12. Discuss the medical and pharmacologic management of ESRD 13. Describe dental management of the ESRD patient including any treatment planning modifications 14. Describe any oral manifestations of ESRD 15. Identify nephrotoxic drugs and state the adjustment of dosage for others for ESRD patients Liver Disease Hepatitis 50 min. 1. Define hepatitis and describe the five major types in terms of etiology, incubation, transmission, diagnostic markers, chronic carrier state, complications, immunizations 2. Briefly summarize the pathophysiology and complications of hepatitis 3. Describe the clinical presentation of hepatitis 4. Describe the medical management of hepatitis 5. Summarize the recommendations following exposure to hepatitis infected blood 6. Describe the dental management of patients with hepatitis 7. Identify hepatotoxic drugs and those to be used limitedly in carriers or those with compromised liver function 8. Describe oral manifestations and complications of hepatitis patients Alcoholic Liver Disease 50 min. 1. Define alcoholism, alcohol dependence and alcohol abuse 2. State the etiology and describe the pathophysiology and complications of alcoholic liver disease 3. Describe the clinical presentation of alcoholic liver disease including oral and perioral manifestations 4. Describe the dental management of alcoholic liver disease patients Gastrointestinal Diseases 50 min. 1. Define Peptic Ulcer Disease, Inflammatory Bowel Disease and Pseudomembranous Colitis 2. Summarize the etiology, pathophysiology and complications of each 3. Describe the clinical presentation of each and any oral / perioral manifestations 4. Describe the medical and pharmacologic management of each 5. Describe the dental management of patients with each disease specifying any treatment modifications Sexually Transmitted Diseases 50 min. 1. State the definition, etiology and of : gonorrhea, syphilis, genital herpes, infectious mononucleosis and human papillomavirus 2. Describe the pathophysiology of: : gonorrhea, syphilis, genital herpes, infectious mononucleosis and human papillomavirus 3. Describe the clinical (including any oral manifestations) presentation of : gonorrhea, syphilis, genital herpes, infectious mononucleosis and human papillomavirus 4. State the medical and pharmacologic management of: : gonorrhea, syphilis, genital herpes, infectious mononucleosis and human papillomavirus 5. Describe the dental management of patients with : gonorrhea, syphilis, genital herpes, infectious mononucleosis and human papillomavirus AIDS and Related Conditions 50 min. 1. Define and state the incidence, prevalence and etiology of AIDS 2. Describe the pathophysiology and complications of AIDS 3. Describe the clinical presentation of AIDS 4. Summarize the medical and pharmacologic management of AIDS 5. Describe the dental management of AIDS including any treatment modifications 6. Describe oral complications and manifestations of AIDS Adrenal Insufficiency 30 min. 1. Summarize the anatomy and physiology of the adrenal glands 2. Define categorize and describe the pathophysiology and complications of primary and secondary adrenal insufficiency 3. Describe the clinical presentation (including oral manifestations) of adrenal insufficiency 4. Summarize the medical and pharmacologic management of adrenal insufficiency 5. Describe the dental management of and treatment modifications for adrenal insufficiency Thyroid Disease 30 min. 1. Describe the thyroid gland, its location and function 2. Summarize the activity of the thyroid gland and hypothalamic-pituitarythyroid axis as it is involved in the control of thyroid secretion 3. Define, state the etiology of and describe the pathophysiology and clinical presentation of thyrotoxicosis (hyperthyroidism) 4. Summarize the medical and pharmacologic management of thyrotoxicosis 5. Define, describe and state the medical management of thyrotoxic crisis 6. Briefly define, describe and state the clinical presentation and medical and pharmacologic management of thyroiditis 7. Define, state the etiology of and describe the clinical presentation of hypothyroidism. 8. Describe the medical and pharmacologic management of hypothyroidism 9. Describe the clinical presentation of thyroid cancer 10. Describe the dental management, medical considerations and oral manifestations of thyrotoxicosis, thyroiditis, thyroid cancer and hypothyroidism. Pregnancy and Breastfeeding 50 min. 1. Define and describe the physiology and complications of pregnancy 2. Describe the dental management of a pregnant patient 3. Discuss the advantages and disadvantages of dental radiographs, specific drugs and classifications of drugs during pregnancy 4. Describe the implications of drugs during breastfeeding 5. Describe treatment modifications for dental and dental hygiene treatment during pregnancy 6. List any treatment modifications for a breastfeeding patient Allergy 50 min. 1. Define, categorize and describe the etiology of various types of allergies 2. Summarize the pathophysiology and complications of allergic reactions 3. Describe the clinical presentations of the different types of allergic responses 4. Describe the medical and pharmacologic management of allergic responses 5. Discuss the relevance of allergy to local anesthetics, antibiotics, analgesics and dental materials and products in the practice of dentistry 6. Describe the oral manifestations of allergic responses 7. Describe the emergency management of severe Type I hypersentsitivity reactions Bleeding Disorders 50 min. 1. Define, state the general etiology of and classify the major types of bleeding disorders 2. Summarize the pathophysiology of the vascular, platelet, coagulation and fibrinolytic phases of hemostasis 3. Describe the clinical presentation (signs, symptoms and laboratory tests) of bleeding 4. Describe the medical and pharmacologic management of bleeding disorders 5. Describe and classify specific bleeding disorders by etiology 6. Describe the dental management of and treatment modifications for patients with bleeding disorders 7. Describe the oral manifestations and complications of bleeding disorders Disorders of Red and White Blood Cells 50 min. 1. Define anemia and differentiate between iron deficiency anemia, pernicious anemia, glucose-60phosphate dehydrogenase deficiency, sickle cell anemia and renal disease anemia in terms of etiology 2. Describe the clinical presentation and pathophysiology of the major forms of anemia 3. State the medical management of the major types of anemia 4. State dental management and treatment modifications of patients with major forms of anemia 5. Define and differentiate between white blood cell disorders: leukocytosis, leucopenia, leukemia and lymphoma 6. Describe the clinical presentation and pathophysiology of and note the treatment and prognoses of the major forms of acute and chronic leukemia 7. Define and describe the etiology of lymphomas: Hodgkin’s disease, NonHodgkin’s Lymphoma, Burkitts Lymphoma; and Multiple Myeloma 8. Describe the medical considerations, dental management and treatment modifications for patients with anemias and white blood cell disorders 9. Describe the oral manifestations of anemias and white blood cell disorders Cancer 1. 2. 3. 4. 5. 6. 50 min. Define, state the etiology and prevention of and describe the pathophysiology and complications of cancer Describe the clinical presentation of cancer including staging Summarize the occurrence, types and medical treatments used for various types of cancer List and describe the major types of cancer that occur orally Describe the dental management of oral cancer patients Describe the general and oral considerations and complications of radiation and chemotherapy and describe the management of each Neurologic Disorders 50 min. 1. Define and describe the pathophysiology and complications of epilepsy 2. Describe the clinical presentation ( including oral manifestations of the disease and treatment) of epilepsy 3. Summarize the medical and pharmacologic management of epilepsy 4. Describe the dental management of an epileptic patient 5. Define, state the etiology of and describe the pathophysiology of cerebrovascular accident 6. Differentiate between a TIA, a RIND, a stroke in evolution and a completed stroke 7. Differentiate between right and left sided brain damage according to signs and symptoms 8. Summarize the medical management both immediately and long term 9. Describe the dental management of and treatment modifications for a CVA patient Behavioral and Pcychiatric Disorders 50 min. 1. Define, state the etiology of and list examples of: : anxiety disorders, mood disorders, somatoform disorders, factitious disorders, substance abuse disorders and eating disorders 2. 3. 4. 5. 6. 7. Describe the clinical presentation and medical and pharmacologic management of : anxiety disorders, mood disorders, somatoform disorders, factitious disorders, substance abuse disorders and eating disorders Define, state the etiology , clinical presentation and medical and pharmacologic management of schizophrenia Define, state the etiology of, describe the clinical presentation of and medical and pharmacologic management of cognitive disorders List and describe the medical action, side effects and interactions with other drugs of the major classifications of psychiatric drugs Describe the dental management and treatment modifications of patients with psychiatric, drug abuse, eating and cognitive disorders List and describe any oral manifestations or complications of psychiatric, drug abuse, eating and cognitive disorders Rheumatologic and Connective Tissue Disorders 50 min. 1. Define and describe the etiology and pathophysiology and complications of arthritis 2. Describe the clinical presentation of arthritis 3. Summarize the medical and pharmacologic management of arthritis 4. Describe the oral manifestations and considerations of arthritic patients 5. Describe the dental management of and treatment modifications for arthritic patients 6. Define, state etiology and describe the pathophysiology, complications, medical and pharmacologic management and dental management of lime disease 7. Define, state etiology and describe the pathophysiology, complications, medical and pharmacologic management and dental management of Sjogren’s Syndrome. Organ and Bone Marrow Transplantation 50 min. 1. Define and differentiate between the types of transplants in terms of histocompatibility 2. List the typical indications for transplantations 3. Summarize the medical management of pre, surgical and post transplantation 4. List and describe the effects and symptoms of overdose of drugs used for transplant patients and note which drugs should be avoided or minimized in post-transplant patients of specific organs 5. List and describe complications of pre and post transplant patients and their management 6. Describe oral manifestations and complications found in transplant patients and how best to prevent or manage them Case Studies 4 - 60 min. sessions 1. Develop a patient profile for a scenario of a patient with an assigned condition or disease. The profile will include clinical presentation, medical and pharmacologic management, oral manifestations, and medical considerations. 2. Develop a dental hygiene treatment plan for this patient based on moderate periodontal disease including any necessary modifications. 3. Present a summary of the case to the class. DHYG 4034 Dental Management of the Medically Compromised Patient Fall 2016 Schedule Date Assignment/Topic 8/25 Th Introduction, L: Ch.1 Interrelationships of Medicine and Dentistry W: pp. 739-741 L:Ch.2 Infective Endocarditis and Related Conditions W: Ch. 66; pp 1007-1012 9/1 Th L:Ch. 3 Hypertension W: Ch. 66; pp. 1012-1014 L:Ch. 4 Ischemic Heart Disease W: Ch. 66; pp. 1014-1017 L:Ch. 5 Cardiac Arrhythmias W: Ch. 66; pp.1045-1048 9/8 Th L:Ch. 6 Heart Failure W: Ch. 66; pp. 1017-1023 L:Ch.7 Pulmonary Disease W: Ch. 65 p.1016-1030 Review 9/15 Th Exam I L:Ch. 14 Diabetes W: Ch. 68 The Patient with Diabetes Mellitus L:Ch. 12 Chronic Kidney Disease and Dialysis 9/22 Th Ch. 10 Liver Disease W: The Patient with a Substance-Related Disorder p.971 L:Ch. 11 Gastrointestinal Disease L:Ch. 17 Pregnancy and Breast-Feeding W: Ch. 48 The Pregnant Patient 9/29 Th L:Ch. 15 Adrenal Insufficiency L:Ch. 16 Thyroid Disease W: pp 785-787 10/6 Th Exam II L:Ch. 13 Sexually Transmitted Diseases L:Ch. 18 AIDS and Related Conditions Date 10/13 Th Assignment/Topic L:Ch. 19 Allergy L: Ch 22 Disorders of Red Blood Cells L: Ch. 23 Disorders of White Blood Cells W: Ch. 67 The Patient with a Blood Disorder 10/20 Th Fall Holiday 10/27 Th L: Ch. 24 Acquired Bleeding and Hypercoagulable Disorders L: Ch. 25 Congenital Bleeding and Hypercoagulable Disorders W: pp. 1036-1039 11/3 Th Exam III L:Ch. 20 Rheumatologic and Connective Tissue Disorders W: Arthritis & Scleroderma p. 902-906 L:Ch 21 Organ and Bone Marrow Transplantation W: pp.840-842, 844 11/10 Th L:Ch. 26 Cancer W: Ch. 55 The Patient with Cancer L: Ch. 27 Neurologic Disorders W: Ch. 62 The Patient with a Seizure Disorder Ch. 58 CVA 886-892 11/17 Th L:Ch. 28, 29, 30 Behavioral and Psychiatric Disorders W: Ch 60, 63, 64 The Patient with a Psychiatric Disorder 11/24 Th THANKSGIVING HOLIDAY 12/1 Th Exam IV Review for Final Friday Dec. 9 10:00 11:50a.m. Final Examination The class schedule may be changed during the semester due to unexpected situations. Students will be notified as soon as possible of any changes.