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CMS1 > Blood 2 > Flashcards

Blood 2 Flashcards

1
Q

Where are red cells derived from?

A

Bone marrow

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2
Q

What is the function of RBC?

A

Transport oxygen to tissues

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3
Q

Define Anaemia

A

Reduction of haemoglobin in the blood

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4
Q

What is the normal Hb for males and females?

A

> 13.5 g/dl males
11.5 g/dl females

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5
Q

What is MICROcytic anaemia?

A

small RBC (<80 fl)

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6
Q

What is NORMOcytic anaemia?

A

normal RBC (80 - 96 fl)

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7
Q

What is MACROcytic anaemia?

A

large RBC (>96 fl)

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8
Q

Give an example of MICROcytic anaemia

A

Iron deficiency (Ferritin)

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9
Q

Give an example of MACROcytic anaemia

A

Folate deficiency
Vit B12 deficiency

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10
Q

Give an example of NORMOcytic anaemia

A

Sickle cell disease

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11
Q

What are the 3 causes of Anaemia?

A
  1. Reduced production
  2. Increased losses
  3. Increased demand
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12
Q

Give some examples of how reduced production causes Anaemia

A

Marrow failure –> Reduced normal red cells

Abnormal globin chains
Chronic inflammatory disease –> Reduced Hb
Deficiency state

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13
Q

Give some examples of how increased losses causes Anaemia

A

Bleeding
Abnormal red cells = autoimmune or hereditary
Hereditary:
-Sickle
- G6PD
- Spherocytosis

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14
Q

Name 4 conditions that results in loss RBC

A
  • Menstrual blood loss
  • Peptic ulcer
  • Haemorrhoids
  • Bowel carcinoma
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15
Q

Name 2 examples of Increased demand

A
  • Pregnancy
  • Malignant disease
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16
Q

List some signs of Anaemia

A

-Pale conjunctiva
-smooth tongue
-beefy tongue (fissured tongue)
-oral ulceration
-candida infection
-angular cheilitis

17
Q

How big is minor oral ulceration?

A

less than 10mm diameter

18
Q

How big is major oral ulceration?

A

more than 10mm diameter

19
Q

What are the 4 symptoms of Anaemia?

A

Fatigue
Dizzy
Shortness of Breath
Palpitation

20
Q

Name ways to Investigate Anaemia

A
  • Full blood count
  • Haematinics
  • Endoscopy/Renal function/Faecal occult blood/Bone marrow examination
  • Micro swab/Smear/Rinse
21
Q

How do you treat Anaemia?

A

Treat the cause e.g.
-Ferritin deficiency = Ferrous Sulphate tablets
-Folate deficiency = Folic Acid tablets
-Vit B12 deficiency = intramuscular injections

22
Q

What is the dental relevance of Anaemia?

A
  • Diagnosis
  • Reduced O2 carrying capacity – sedation and GA risks
  • Burning mouth/glossitis
  • Candidosis
    may need to liase with General Medical Practitioner.
23
Q

Abnormal Globin chains leads to what 2 conditions?

A

Thalassaemia
Sickle Cell Disease

24
Q

How does Thalassaemia occur?

A
  • Normal haem production
  • Genetic mutation of globin chain – causing haemolysis
  • Alpha = Asians
  • Beta = Mediterranean
  • Mainly seen in those from Mediterranean area
25
Q

What is the difference between minor thalassaemia vs major thalassaemia?

A
  • Minor = ‘Trait’ heterozygotes = mild anaemia (persistent microcytic)
  • Major = homozygotes = usually beta
    = severe microcytic anaemia, enlarged liver and spleen, bone changes
    = large osteoporotic bones
    = obliterated maxillary sinuses
26
Q

What are the clinical effects of thalassaemia?

A
  • Chronic anaemia
  • Marrow hyperplasia (skeletal deformities)
  • Splenomegaly
  • Gallstones
  • Cirrhosis (liver)
27
Q

What is the dental relevance of thalassaemia?

A
  • Xerostomia (iron deposition in glands)
  • GA and sedation considerations
28
Q

What is Sickle Cell Anaemia?

A
  • Mutation in HBB gene - beta-haemoglobin
  • 13,000 Anaemia v 250,000 Trait
  • Most common in those of African descent
  • HbA = Normal
    HbS = Abnorma
29
Q

What type of inheritance pattern is Sickle cell?

A

Autosomal Recessive pattern

30
Q

What are the 3 types of Sickling crises?

A
  • Painful
  • Aplastic
  • Sequestration
31
Q

What is ‘Painful’ Sickling Crises?

A

Blockage of blood vessels and leading to bone marrow infarcts.

32
Q

What is the ‘Aplastic’ Sickling Crises?

A

Bone marrow stops producing RBC

33
Q

What is the ‘Sequestration’ Sickling Crises?

A

sickle cells pooling in spleen, liver and lung- often requires splenectomy

34
Q

what is the consequence of splenectomy?

A

reduces resistant to infection

35
Q

How does Sickling Crises occur?

A

Deoxygenated HbS
↓
Sickle Shape
↓
Haemolysis –> Anaemia
↓
Blood viscosity
↓
Tissue ischaemia

36
Q

How do you diagnose Sickle cell?

A
  • Thorough history – medical and family
  • Full blood count (Hb)
  • Haemoglobin electrophoresis
  • Bone infarcts – appears similar to osteomyelitis radiographically
37
Q

What is the dental relevance of Sickle cell?

A
  • Caution with GA and Sedation
  • Treat infection quickly
  • Prevention is key
  • No need for antimicrobial prophylaxis
  • Treat sickle cell trait patients as normal
38
Q

How do you treat sickle cell trait pts?

A

as normal

CMS1 (23 decks)

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