Medicine

Often the initial presenting signs of Wernicke’s encephalopathy include abducens palsy, horizontal diplopia, nystagmus, and strabismus; and ataxia may cause ambulation difficulties. These neuromuscular signs often antecede mental changes. The disorder is caused by deficiency of thiamine (vitamin B1); administration of which can quickly reverse ocular symptoms but often has little effect on mental changes […]

Restoration of fluids and electrolytes is the first resuscitative priority due to dehydration and sodium depletion. Initial hydration rapidly corrects plasma volume and increases the efficacy of later insulin therapy. Intracellular potassium depletion may be masked by near normal or slightly elevated serum potassium levels, especially in a volume-depleted patient. Therefore, following initial rehydration, insulin

Frey syndrome, or “gustatory sweating” is a relatively common complication of parotidectomy but uncommon following temporomandibular joint arthrotomy. It is believed to be caused by aberrant regeneration of postganglionic parasympathetic parotid secretomotor fibers with severed post-ganglionic sympathetic fibers innervating facial sweat glands.

Caused by a disruption in the sympathetic innervation to the ipsilateral maxillofacial region, is characterized by: Ptosis (by loss of sympathetic innervation to Mueller’s muscle) Anhidrosis (by interruption of sympathetic innervation to cutaneous sweat glands). Miosis or a constricted pupil (by unopposed parasympathetic constriction) Remember the pnemonic, PAM is Horny (Ptosis, Anhydrosis, Miosis is Horner’s

Glasgow Coma Scale (GCS): Interpretation, Posturing, and Airway Management The Glasgow Coma Scale (GCS) is one of the most widely used clinical tools for assessing level of consciousness in patients with head injury, neurologic trauma, or altered mental status. It provides a standardized method for evaluating neurologic function and plays a critical role in trauma

Isolated cleft palate is associated with an underlying syndrome more frequently (as much as 50%) than cleft lip and palate. Stickler syndrome has been identified as the most common diagnosis causing both cleft palate and Robin sequence. Patients with Stickler syndrome demonstrate a collagen metabolism disorder. Relevant clinical findings include early myopia and an increased

Phases of Bone Healing Inflammatory phase Soft callus formation Hard callus formation Bony maturation Distraction Osteogenesis Phase 1: Osteotomy Phase 2: Latency – unique to DO; length varies based on age, location of osteotomy, healing potential of osteotomy site Phase 3: Distraction/Activation Phase 4: Consolidation Distraction osteogenesis comprises of three sequential phases; latency, distraction and consolidation

3 phases: inflammatory, proliferative, remodeling   Inflammatory phase: 3-5 days the clot serves as a reservoir of the cytokines and growth factors that are released as activated platelets degranulate. The bolus of secreted proteins, including interleukins, transforming growth factor β (TGF-β), platelet-derived growth factor (PDGF), and vascular endothelial growth factor (VEGF) Once hemostasis is secured

In patients with prosthetic joint implants, a January 2015 ADA clinical practice guideline, based on a 2014 systematic review states, “In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection. According to the ADA Chairside Guide, for patients with a history of complications

Direct Oral Anti Coagulation Direct Thrombin Inhibitors Dabigatran – Pradaxa Argatroban, Bivalirudin: have short half-lives and typically do not need reversal other than discontinuation Aripazine: potential antidote to direct thrombin inhibitors by binding directly to them Warfarin Vitamin K can be administered in nonurgent situations FFP/Prothrombin complex concentrate: urgent reversal of warfarin DOACs Apixaban, rivaroxaban: