RDA (Other exams) cheat sheet

Standard precautions are applied to every patient regardless of known or presumed infectious status; diagnosis never determines the level of protection used.

Spaulding classification: critical items (enter sterile tissue or vasculature) require sterilization; semicritical items (contact mucous membranes) require high-level disinfection at minimum; noncritical items (intact skin contact only) require low-level disinfection.

Gravity steam autoclave cycle: 121 C (250 F) at 15 psi for 15-30 minutes; flash cycle: 132 C (270 F) at approximately 27-30 psi for 3-4 minutes.

Biological monitoring is run at least weekly: Geobacillus stearothermophilus spores for steam and chemical vapor sterilizers; Bacillus atrophaeus spores for dry heat and ethylene oxide.

Each pack carries an internal chemical indicator plus an external process indicator, and every load is logged with cycle type, temperature, pressure, time, and operator.

Soap and water is required when hands are visibly soiled and after contact with spore-formers such as Clostridioides difficile or norovirus; alcohol-based rub is used in all other routine situations.

PPE doffing order is gloves first, then eyewear or face shield, then gown, then mask or respirator last, followed immediately by hand hygiene.

Dental unit water used for irrigation must contain no more than 500 CFU/mL of heterotrophic bacteria; lines are flushed at the start of the day and between patients.

Post-exposure management: wash the site, report immediately, and begin HIV post-exposure prophylaxis as soon as possible, ideally within 2 hours of exposure.

ALARA: all exposures are kept as low as reasonably achievable, using the shortest acceptable exposure time, fastest receptor, and tightest collimation.

Occupational effective dose limit is 50 mSv (5 rem) per year; cumulative lifetime allowance is 10 mSv multiplied by age in years; the public limit is 1 mSv per year.

Total filtration must be at least 1.5 mm aluminum equivalent for machines operating at or below 70 kVp and at least 2.5 mm Al equivalent above 70 kVp.

Rectangular collimation restricts the beam to the receptor outline, cutting the irradiated tissue area by roughly 60 percent and reducing patient dose compared with round collimation.

A 16-inch (long) position indicating device lowers skin dose by about 50 percent compared with an 8-inch (short) PID because it reduces beam divergence at the skin surface.

F-speed intraoral film requires roughly 60 percent less exposure than D-speed film and about 20 percent less than E-speed film.

Direct digital sensors require only about one-fifth to one-tenth of the exposure needed for D-speed film, an 80-90 percent dose reduction.

During exposure the operator stands at least 6 feet from the tube head at a 90- to 135-degree angle to the primary beam, behind a barrier when one is available.

The central ray must be perpendicular to the receptor and the PID aligned within 20 degrees of the receptor plane; a 0.25 mm lead-equivalent apron is the minimum patient shield.

Four-handed clock positions for a right-handed clinician: dentist 8-10 o'clock, assistant 2-4 o'clock, and the instrument transfer zone over the patient's chest at 4-7 o'clock.

Instruments are transferred single-handed and handle-first in a pen grasp, with the assistant holding the instrument parallel to and slightly above the clinician's fingers.

A high-volume evacuator placed near the working area removes roughly 90 percent or more of oral fluids and aerosols; a saliva ejector removes only small pooled volumes.

Rubber dam stock is 5 x 5 inches for anterior teeth and 6 x 6 inches for posterior teeth; a floss ligature on the clamp prevents aspiration if the clamp is dropped.

Paralleling technique places the receptor parallel to the tooth long axis with the central ray perpendicular; bisecting technique aims the ray perpendicular to the plane bisecting the angle between tooth and receptor.

A standard local anesthetic cartridge holds 1.8 mL in the United States; 2 percent lidocaine with 1:100,000 epinephrine delivers 36 mg lidocaine and 0.018 mg epinephrine per cartridge.

Aspiration for several seconds precedes deposition; a positive blood draw indicates intravascular placement and requires needle repositioning before continuing.

A matrix band restores proximal contour while a wedge separates teeth, adapts the band cervically, and prevents gingival excess of restorative material.

Retraction cord is packed into the sulcus before impressioning to displace tissue, control crevicular fluid, and expose the finish line; it is removed before the final impression.

Alginate is an irreversible hydrocolloid that is dimensionally unstable; the impression is poured within about 12 minutes because the gel both imbibes and loses water.

Vinyl polysiloxane and polyether impressions are far more stable than alginate; polyether is hydrophilic and rigid but has a bitter taste and short working time.

Typical water-to-powder ratios: dental plaster 0.45-0.50, dental stone 0.28-0.30, high-strength die stone 0.22-0.24.

For gypsum products, raising the water-to-powder ratio increases setting time and setting expansion while reducing compressive strength and density; potassium sulfate accelerates set and borax retards it.

Zinc phosphate cement is mixed on a cool, dry slab by adding powder to liquid in small increments over 60-90 seconds; the mix is used while it still has a glossy surface.

Light-cured composite is placed in increments no thicker than 2 mm because curing-light penetration is limited; darker and more opaque shades cure shallower.

Curing lights emit blue light at roughly 400-500 nm, with camphorquinone-based composites activated near 470 nm.

Etching uses 37 percent phosphoric acid for about 15 seconds on enamel and 10-15 seconds on dentin, followed by thorough rinsing and controlled drying.

Glass ionomer bonds chemically to enamel and dentin and releases fluoride over time, but it is moisture sensitive and needs a protective coating during initial set.

HIPAA requires that protected health information be used or disclosed only under treatment, payment, or operations, limited to the minimum necessary for the purpose.

Records are kept for the period required by state law and at least until the malpractice statute of limitations expires, commonly 7 years after the last treatment; minors' records are held until majority plus the statutory period.

Informed consent requires disclosure of the diagnosis, the nature and purpose of the proposed treatment, material risks and benefits, alternatives including no treatment, and the consequences of declining.

Chart errors are corrected with a single line through the entry plus the correction, initials, and date; erasures, correction fluid, and backdating are never acceptable.

SOAP notes organize documentation into subjective patient reports, objective clinical findings, assessment or diagnosis, and the plan of care.

The five ADA Code of Ethics principles are patient autonomy, nonmaleficence, beneficence, justice, and veracity.

Confidentiality may be breached without consent when legally required, such as reportable communicable diseases, suspected child or elder abuse, and court-ordered disclosures.

HIPAA breach notification to affected individuals is made without unreasonable delay and no later than 60 days after discovery of the breach.

Minors generally cannot consent to treatment; a parent or legal guardian signs unless state law grants emancipated minor or mature minor status.