General Medicine and Medical Emergencies Relevant to Dentistry
Core concepts
A candidate must know how systemic disease modifies dental treatment: cardiovascular disease (hypertension, ischaemic heart disease, anticoagulation), diabetes mellitus, asthma and COPD, epilepsy, thyroid disease, adrenal insufficiency, pregnancy, and bleeding disorders. Know the ASA physical status classification,因为它 drives referral and setting decisions, and know which conditions require antibiotic prophylaxis or medical consultation.
Emergencies
Master recognition and first-line management of syncope, hypoglycaemia, angina and myocardial infarction, anaphylaxis, asthma attack, seizure, and local anaesthetic overdose. Know the supine position with legs raised for syncope, glucose for hypoglycaemia, sublingual nitrate and aspirin for cardiac chest pain, intramuscular adrenaline for anaphylaxis, and the recovery position after seizure.
Traps
Questions often test the wrong drug or route: adrenaline is IM in the anterolateral thigh, not IV; aspirin is chewed, not swallowed whole; glucose is oral if conscious, IV only if not. Another trap is assuming a patient with a recent MI can be treated - elective care is usually deferred for about six months. Anticoagulated patients are not automatically stopped; check INR and liaise with the physician.
Rule of thumb
For any collapsed patient: check responsiveness, call for help, position, and treat the most likely cause. Syncope recovers quickly when supine; if the patient does not recover promptly, assume a more serious cause.
Worked example
A patient becomes pale and sweaty during an injection and loses consciousness briefly. Lay flat with legs elevated, loosen clothing, monitor. Recovery within a minute supports vasovagal syncope.