Sunday, February 27, 2011

Jom share experience =)

Jom share experience 1

What if this patient came to your clinic with these complications. What would you do??? alamak...alamak.... !!

1. 60yo/male/Malay
With history of ESRF (renal failure), DM (diabetes mellitus), HPT (hypertension) and have just gone through dialysis in the last one hour. Complaint of toothache on the lower right side of the mouth. Difficulty in eating. No gums swelling. Mild caries seen.

Noted : poor dental hygiene, sparse teeth, lots of attrition.

Okey, gigi yang die sakit tu pulpitis reversible cetetot, plak and calculus banyak sangat. What should you do? kenape die sakit gigi?? and most importantly... tgk complication die.

1. have ESRF (renal failure)
Bila kite ade patient with renal complication and just gone through dialysis, yang kite kene "fear" is anemia. Jadi however pun kene avoid any kind of bleeding on this patient. Apa kaitan kidney dengan anemia??

ESRF disturb :
1. filtration
2. creatinine
3. production of erythropoitin

filtration of glomerulus
- filter Natrium. phosphate, calcium ions
- hipercalmia (overflow of calcium ions), hyperphosphataemia(overflow of phosphate ions)
-fluid volume overflow
- metabolic acidosis, excess acid

2. indication of renal failure is creatinine
- if the level of creatinine is high, it will decrease the capability to descrete products and failing glomerulus filtration

Bila ade gangguan kat production of erythropoitin, erythrosit pun sikit. Jadilah anemia. and also fatique. =)

Alert** Patient with renal failure always* have hypertension and DM too.alert**

So. treatment for this patient is scalling for the problem tooth and superficial scalling for other teeth (non-gingival manipulation to avoid gums bleeding) and prophylaxis. A week after, dah baik dah sakit gigi die!! Calculus ni noty btol!! Tak payah tampal. Die sakit sebab periodontal problem. Gigi tu cume pulpitis reversible je. =)

Ok gambar hiasan je =)
Congrats sesiapa yang dah dapat gaji pertama!!

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