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Sep 26, 2014
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Dental Student
Hi everyone, I am a dental student in Australia and I am studying for my exams.

I am stuck on a physiology question from a past paper and I am wondering if anyone can help me.

The question is:

An anxious 22 year old patient enters your consulting room for a dental examination and treatment. Her face is pale, there are beads of sweat on her forehead and upper lip and she has cold clammy hands. You attempt to calm her when she is seated in the dental chair, but she continues to show signs of anxiety and is not hyperventilating. Subsequently her breathing slows and becomes shallow; her lips turn blue.

a) What is the explanation for the pallor, the sweating and the cold clammy hands? Your explanation should contain appropriate detail of the physiological mechanisms involved.

b) What is the explanation for the respiratory changes subsequent to hyperventilation, and why are her lips blue? Your explanation should contain appropriate detail of the physiological mechanisms involved.

c) How would you manage her condition before proceeding with her dental examination.

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For a), I know the symptoms are due to the effects of adrenaline. And c), I would assume the standard treatment for acute asthma.

I am assuming that the condition is anxiety-induced asthma attack, resulting in hyperventilation and hypoxic hypoxia.

However, I don't really understand why her breathing would slow and become shallow after hyperventilation. Is it because she has fainted and thus her breathing reflexes kicks in or something? Please help!
 
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