6. Haematology Flashcards
Blood and disorders
Function of blood (3)
Types of blood disorders with reduced cell levels (4)
Causes (2)
Types of blood disorders with raised cell levels (3)
Causes (2)
Components of haemostatic disorders (3)
Action of therapeutic coagulopathy (3)
Transport host defences, transport nutrients, remove waste
Anaemia (low Hb), leukopenia (low WCC), thrombocytopenia (low PLT), pancytopenia (all cells reduced)
One due to reactive change to environment; more than one due to bone marrow failure
Polycythaemia (high Hb), leucocytosis (high WCC), thrombocythaemia (high PLT)
One due to reactive change to environment; more than one due to pre-neoplastic change
Vascular, cellular and coagulation components
Reduce PLT adhesion, reduce PLT function, reduce coagulation cascade activity
Porphyria
Definition Types (2) Effects (4) Triggers (4) Dental relevance - possible cause of
Haem metabolism abnormality
Hepatic, erythropoietic
Photosensitive rash, neuropsychiatric disturbances, hypertension, increased HR
Drugs, alcohol, pregnancy, fasting
LA allergy
Leukaemia
Definition Presentation (5) Signs and symptoms (4) Types (4) Features of ALL (2) Features of AML (2) Features of CLL (2) Features of CML (3)
Treatment (4)
Neoplastic differentiation of white cells, usually a disseminated malignancy
Anaemia, neutropenia (infection associated with portals of entry), thrombocytopenia, lymphadenopathy, abnormal FBC
Easy bruising, minor cuts don’t clot, petechiae, nose bleeds
Acute lymphoblastic, acute myeloid, chronic lymphocytic, chronic myeloid
ALL - catabolic state, affects mainly younger patients
AML - similar to ALL but affects mainly elderly patients
CLL - B-cell lymphoproliferative disease, elderly
CML - in neutrophils (Philadelphia chromosome), older adults - fatigue, weight loss, sweating, anaemia
Chemotherapy, radiotherapy, stem cell transplant, monoclonal antibodies
Lymphoma
Definition Staging involves (3) Types (2) Features of HL (5) Features of NHL (5) Features of multiple myeloma (6)
Blood cancer development stages (4)
Treatment (4)
Neoplastic differentiation of white cells, usually a solid tumour
Number of nodes involved, extra-nodal involvement, systemic symptoms
Hodgkin’s and Non-Hodgkin’s lymphoma
Younger adults, weight loss, night sweats, painless lymphadenopathy. High cure rate
Due to microbial factors/autoimmune disease - lymphadenopathy, extra-nodal disease, marrow failure. Difficult to treat
Malignant proliferation of plasma cells. Lytic bone lesions, marrow failure, renal failure, bone pain. Affects elderly
Induction, remission, maintenance and consolidation, relapse
Chemotherapy, radiotherapy, stem cell transplant, monoclonal antibodies
Progressive anaemia signs and symptoms (4)
Anaemia
Definition Causes (3) Types (3) and causes (3) Investigations (3) Diagnosis (4) Signs and symptoms (4) Treatment (3)
Sickle cell anaemia features (2)
SoB, pallor, tired, chest pain
Reduced haemoglobin (Hb) in blood
Decreased production, increased loss, increased demand
Microcytic (due to reduced Fe), microcytic (due to reduced B12), normocytic (same size but less number - due to bleeding)
MH, FBC, endoscopy
From FBC - Hb, RCC, HCT, MCV
Pale, raised HR, SoB, palpitations
Replace haematinics, transfusion, EPO injection
Abnormal global chains, curved RBCs due to reduced Hb and O2 environment
Thalassemia
Definition
Effects (3)
Management
Common causes of blood loss (2)
Warfarin Dangers Function of INR test Normal INR Mechanical heart valve INR Max INR for dental treatment
Action of anti platelets (2)
Genetic globin mutation
Chronic anaemia, cirrhosis, gallstones
Transfusion
Gastritis (alcohol), NSAIDs
Determine clotting tendency of blood by warfarin, liver damage and vitamin K status Haemorrhage 1.0 3.0-4.0 <3.5/4.0
Inhibit platelet aggregation and inhibit thrombus formation
Inherited bleeding disorders
Definition
Types of haemophilia and deficiency that causes them (2)
Type of disease - genetic
Treatment (2)
Definition of von Willebrand disease
Type of disease - genetic
Types (3)
Treatment
Definition of thrombophilia Why can thrombophilia be life threatening Type of disease - genetic Exacerbating factors (4) Cause
Acquired defects which affect clotting
Type A (FVIII), type B (FIX)
Sex-linked recessive - males affected, females carriers
A - recombinant FVIII, DDAVP, oral tanexamic acid
B - recombinant FIX
FVIII deficiency and reduced PLT aggregation
Autosomal dominant
Types 1, 2 (both dominant and mild) and 3 (recessive and severe)
DDAVP, oral tanexamic acid
Excessive tendency to clot (DVT)
DVT can lead to pulmonary embolism
Acquired superimposed on genetic condition
Smoking, immobility, pregnancy, surgery
Due to FV leiden (protein C/S deficiency)
Types of inherited syndromes (4)
Type of acquired syndrome and cause
Types of platelet abnormalities
Stages in clotting (3)
Why do haemophiliacs bleed (2)
Action of antithrombin III
Action of protein C
Action of protein S
Lack of protein C/S can increase the risk of
Types of bleeding tests (2)
Types of clotting tests (2)
FV leiden, antithrombin III deficiency, protein C deficiency, protein S deficiency Antiphospholipid syndrome (oral contraceptives)
Thrombocytopenia, thrombocythaemia, qualitative (altered function - inherited or acquired - cirrhosis)
Bleeding and vasoconstriction, platelet plug formation (vWF) which activates clotting factors, coagulation
Haemophiliacs form platelet plug but plug cannot stabilise - plug is broken down –> delayed bleed
Inactivates coagulation enzymes
Regulates anticoagulation and inactivates FVa and FVIIIa
Regulates anticoagulation and inactivates FVa and FVIIIa
Thrombosis
PLT, FBC
INR, APPT
