16. Hematologic disorders Flashcards
What is anemia?
When there is a decrease in volume of RBC or a decreased concentration of hemoglobin
What is a hematocrit?
It is the percentage of RBC
men: 40-54%
women: 35-45%
newborns: 44-64%
What are the causes of anemia?
1.) Excessive bleeding: acute or chronic
2.) Increased erythrocyte destruction: hemolytic anemia
3.) Decreased erythrocyte production
What are some signs & symptoms of anemia?
1.) Shortness of breath
2) Low blood pressure
3.) Heart palpitations
4.) Chest pain
5.) Increased risk of angina & heart attacks
6.) Enlargement of spleen
What is the role of the spleen?
It is the production of RBC’s
What are some of the head & neck manifestations of anemia?
1.) Mucosal pallor: when the tissue is lighter in colour
2.) When it’s smooth, burning tongue
3.) Angular cheilitis: corner commissure of lips
4.) Xerostomia: dry mouth
What is iron deficiency anemia?
When there is the presence of low iron, meaning there results of a hypochromic (pale), microcytic (small) anemia
- accounts for half of all anemias world wide
What can patients exhibit with iron deficient anemia?
1.) brittle nails
2.) Pale skin
3.) Sore muscles
What is sickle cell anemia?
When there is the presence of abnormal hemoglobin in RBC, which leads to sickling of RBCs
when there is one gene affected = 50% of RBCS sick cell trait
when there is two genes affected = 100% sickle cell disease
What are the clinical features of sickle cell anemia?
1.) Results in blood clots & pain
2.) “Hair-on-end” skull
3.) Anemia
4.) Hypoxia
5.) Sickle cell crisis
What are thrombocytopenia?
They are a decreased number of platelets:
1.) A normal count would be around 150,000 - 450, 000 per microlitre
2.) Severe form: < 10,000 per microlitre
What can thrombocytopenia cause?
1.) It may increase the destruction
2.) Decrease the production
3.) Sequestration in the spleen
What are some of the clinical features of thrombocytopenia?
1.) It has increased petechia & ecchymosis
2.) There are larger hematomas (large bruising)
3.) Gingival bleeding with little manipulation
4.) Epistaxis
What is leukemia?
It is a cancer originating in the bone marrow in which has an INCREASED NUMBER of white blood cells.
How can leukemia be classified?
1.) Myeloid or lymphoid
2.) Acute or chronic
What does acute leukemia encompass?
A build-up of immature cells
What does chronic leukemia encompass?
A slower build up of mature of cells
What does myeloid leukemia encompass?
Has the progenitor cells of granulocytes, monocytes, erythrocytes or platelets
What does the lymphoid leukemia encompass?
Has the progenitor cells of lymphocytes: B-cells, T- cells.
What variation of leukemia is more relevant to dentistry?
Acute myeloid leukemia
What are the oral manifestations of leukemia?
1.) Leukemic gingivitis: more common in acute leukemia (AML)
2.) Deep ulcers: increased infections due to a decrease in functioning WBCs
3.) Hemorrhage: Due to thrombocytopenia
What is Langerhans cell histiocytosis?
It is a proliferation of Langerhans cells (which are antigen presenting cells found in a variety of tissues)
*They can result in a wide spectrum of diseases (which can affect bone, skin, organs)
In what general population is Langerhans cell histiocytosis more prevalent?
equal in both males & females, but more prevalent in 50% of cases in patients < 15 years of age.
What are some of the clinical features in bone of the langerhans cell histiocytosis?
1.) It has well-demarcated punched out lesions & can mimic periodontal disease
What are some of the clinical features in the skin of the langerhans cell histiocytosis?
1.) It has a pruritic (itchy) erythematous lesions & has ulcerations
What are some clinical features in the viscera relative to the langerhans cells histiocytosis?
They can affect the spleen, liver, & small & large intestines.
What is multiple myeloma?
- It is a malignancy of plasma cells:
1.) Monoclonal proliferation
2.) All of the cells are either kappa or lambda cells
*Originates within the bone
Where is multiple myeloma more commonly found in ?
More common in males, in older populations & in black populations > white populations
What are the clinical features of multiple myeloma?
1.) Has severe bone pain: lower back is a common location
2.) Punched out radiolucencies on radiographs noted
3.) Increased risk of pathologic fracture
4.) Hypercalcemia due to the bone destruction
How can we differentiate multiple myeloma?
If they are younger; Langerhans Histiocytosis
If they are older; multiple myeloma
What are some of the clinical features of multiple myeloma?
1.) They are noted both equally or radiographically. There is a radioluscent appearance in the area.
What can multiple myeloma result in clinically?
1.) have these amyloidosis (deposition of amyloid) in the tongue. Can cause macroglossia
