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    The Symptoms:

    • This is a case report series based on real patients, built around a graphic backbone.
    • Much of the communication is visual. The graphic forms an image of the teaching points.
    • The characters are based on needs and more than one case will unfold with each episode.
    • The teaching points are folded into the graphics, the images, references, reports and the quiz.
    • The episodes allow you, as the narrative progresses, to reflect , consult the references and if you wish to form a self study project.
    • The series is intended to promote reflection and the sharing of ideas in a community linked by the forum. (you need a password for this)
    • The graphics are by Jesse Bochner, the author of the series is Michael Rosengarten

    How to use the Symptoms:

    • Follow the evolution of the cases (Enjoy Jesse Bochner's great graphics)
    • Reflect on the narrative, the differential diagnosis, the tests , and the actions you would take.
    • Visit the references and explore the online resources to reflect on and deepen your knowledge.
    • Take the quiz (you will need a password for this)
    • Reflect on your answers.
    • Share your ideas on the forum (don't be a lurker!), stimulate others to reflect, and be stimulated in turn.
    • Give us feedback and fill out the evaluation form at least once.

    N.B:

    The teaching points are in the Quiz, so it is important to take the Quiz.

    Disclaimer:

    By viewing the material on this site you understand and accept that:


    · The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of McGill.
    · The hosting of material on the McGill CME site does not signify endorsement of this material by McGill.
    · The material is solely for educational purposes for qualified health care professionals.
    · McGill University is not liable for any decision made or action taken based on the information contained in the material on this site.
    · The information cannot be used as a substitute for professional care.
    · The information does not represent a standard of care.
    · No physician-patient relationship is being established.
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    Teaching objective:

    The learner reflects on minor surgical procedures such as tooth extraction and managing concurrent anticoagulation.


    In this episode:

    • George has found out from his dentist that he has a deep cavity that will require a root canal and crown.
    • This is complicated by the need to lower the gum line around the tooth to enable a successful placement of the crown.
    • The solution is to remove the last molar which is just behind the diseased tooth and so allow the gum line to lower itself.
    • The issue this raises is what to do with the oral anticoagulant the George is on for his pulmonary emboli.

     

    How to learn from this module:

    • Read the graphic novel strip
    • Take the quiz ***
    • Checkout the references
    • Join the forum***

    ***you need to have a password for this
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The quiz

 

Note: a password is required.

 

 

 

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  1. Kamien Max. Remove the tooth, but don't stop the warfarin. Australian Family Physician 233- 235 Vol. 35 No 6 Arpil 2006.
  2. Yolanda Jiménez , Rafael Poveda , Carmen Gavaldá , María Margaix , Gracia Sarrión. An update on the management of anticoagulated patients programmed for dental extractions and surgery. Med Oral Patol Oral Cir Bucal. 2008 Mar1;13(3):E176-9.
  3. Branislav V. Bajkin MD, Stevan L. Popovic PhD and Srecko D.J. Selakovic PhD. Randomized, Prospective Trial Comparing Bridging Therapy Using Low-Molecular-Weight Heparin With Maintenance of Oral Anticoagulation During Extraction of Teeth. Journal of Oral and Maxillofacial Surgery Pages 990-995Volume 67, Issue 5, May 2009

More references are available on PubMed

 

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Join the forum

 

Note: you need a password for this.

 

 
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