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4th Yr - CMS 1 > Blood 2 > Flashcards

Blood 2 Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what are the 3 main components of rbc?

A

rbc - erythrocytes
plasma
wbc - leukocytes

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2
Q

what is plasma?

A
  • makes up 55% of blood
  • mostly water 96%
  • contains water, ions, nutrients, gases, waste, proteins (immunoglobulins, electrolytes, sugars and fat
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3
Q

what are red blood cells?

A
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4
Q

fill in the gaps

A
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5
Q

what are the myeloid stem cells responsible for?

A

rbc platelets and others

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6
Q

what are the lymphoid stem cells responsible for?

A

producing specific immune response cells:
lymphoblast to
t and b cells and natural killer cells

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7
Q

fill in the blanks

A
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8
Q

what is leukaemia ?

A

cancer of a particular type of stem cells in bone marrow causing unregulated production of certain types of blood cells

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9
Q

how is leukaemia classified ?

A

depending on how rapidly they progress and the cell line that is affected (myeloid or lymphoid)

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10
Q

what do we call a slowly progressing leukaemia ?

A

chronic leukaemia

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11
Q

what do we call a fast growing leukaemia

A

acute leukaemia

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12
Q

what are the 4 main types of leukaemia ?

A

acute myeloid
acute lymphoblastic
chronic myeloid
chronic lymphocytic

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13
Q

what does a mutation in precursor cells in the bone narrow lead to?

A

an excessive production of a slightly abnormal WBC

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14
Q

what is pancytopenia?

A

the excessive production of a single type comes at the expense of other cell types

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15
Q

what problems does pancytopenia cause?

A

combination of anemia, leukopenia and thrombocytopenia

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16
Q

what are the symptoms of an acute marrow failure (anaemia symptoms) ?

A

breathlessness - due to blood doesn’t have enough capacity to carry gases of respiration
dizziness
pallor of oral mucosa and membrane and conjunctiva of eye
apthous ulceration
oppurtinsitc infections eg. angular chelitis

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17
Q

what are some symptoms of thrombocytopenia ?

A
  • coagulation defects eg. bruise easily or bleed easily
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18
Q

what is a pneumonic to easily remember the different types of leukaemia

A
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19
Q

what is acute lymphoblastic aneamia ?

A

acute proliferation of a single type of lymphocyte usually b lymphocytes causing replacement of other cells created in bone marrow leading to pancytopenia

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20
Q

he most common type of cancer in children?

A

acute lymphoblastic leukaemia
peaks around 2-4 yrs
can also affect adults over 45ys

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21
Q

what condition is acute lymphoblastic aneamia linked to?

A

downs syndrome

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22
Q

what is chronic lymphocytic leukaemia ?

A

chronic proliferation of b lymphocytes usually
affects 55yrs+ old

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23
Q

what are the symptoms of chronic lymphocytic luekamia

A

often asymptomatic
but can present with increased susceptibility to infections, anaemia, bleeding an weight loss

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24
Q

what can chronic lymphocytic leukaemia lead to ?

A

high grade lymphoma

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25
Q

which age group tends to get chronic myeloid ?

A

65 yrs and older

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26
Q

what are the three phases of chronic myeloid leukaemia ?

A

chronic
accelerated
blast

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27
Q

describe the chronic phase of chronic myeloid leukaemia

A
  • can last 5 yrs
  • often asymptomatic
  • pts are diagnosed incidentally via a blood test with a raised white cell count
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28
Q

describe the accelerated phase of chronic myeloid leukaemia

A
  • abnormal blast cells take up a high proportion of bone marrow and blood (10-20%)
  • pts therefore suffer symptoms of anaemia, thrombocytopenia and become immunocompromised
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29
Q

describe the blast phase of chronic myeloid leukaemia

A
  • follows accelerated phase and involves even higher proportion of blast cells = 30%
  • severe symptoms stemming from pancytopenia
  • fatal
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30
Q

what is the most common acute leukamia in adults ?

A

acute myeloid leukaemia
can present at any age but usually from middle age onwards
peak after 75 yrs

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31
Q

how many types of acute myeloid leukaemia are there?

A

many types with different presentations

32
Q

what are the signs and symptoms of acute myeloid leukaemia?

A
33
Q

what are some oral signs and symptoms of AML?

A
  • compared to other leukaemia’s, oral manifestations are ordinary seen in AML
  • mucosal pallor related to anaemia
  • spontaneous bleeding and petechial haemorrhage of gingivae, palate, tongue or lips arising from thrombocytopenia
  • gingival hyperplasia caused by leukaemia infiltration

most prevalent oral signs and symptoms = gingival bleeding, oral ulceration and gingival hyperplasia, bruising or mobility = REFER

34
Q

what may we see if a pt is under chemo in their acute phase AML?

A

mucositis - swelling, ulceration, discomfort along GIT

oral mucosal ulceration after induction phase

dryness if saliva gland involved in disease or side effect of medication is xerostomia

trismus - when leukaemic cells directly invade TMJ

35
Q

label the signs of leukaemia

A

A= inappropriate bleeding and submucosa; bruising
B= gross swelling
C= oral ulceration on lip due to neutropenia
D and E= gingival swelling from gingivae packed with leukaemic infiltration also swelling bruising and bleeding

*swollen lymph nodes too (not in pics)

36
Q

what is this ?

A

chronic ulceration
- could be secondary to chemotherapy
- could be mucositis if in acute phase
- can see this ulceration due to longer lasting consequence of treatment

37
Q

how do we diagnose leukaemia

A
  • blood film = look at shape and type of blood cells
  • bone marrow biopsy = needle passed thru cortex of bone into marrow and investigate
38
Q

how do we treat leukaemia ?

A
  • m. team = oncologist, dietician, haematologist
  • chronic forms of leukaemia arent treated but monitored
  • acute forms (2 forms) : induction phase (aggressive) = pt suffers from severe side effects of chemo eg. mucocitis, suppressed immune system, once primary stage suppressed this stage is called consolidation phase = chemo used long term
  • bone marrow transplant = young and fit pts
39
Q

what is lymphoma ?

A

umbrella term encompassing a broad range of cancers derived from lymphocytes

40
Q

how does lymphoma differ from leukaemia ?

A

abnormal cells develop in lymph nodes and not bone marrow

41
Q

what are the 2 subtypes of lymphoma?

A

non Hodgkin and Hodgkin

42
Q

what do both of these lymphomas have in common?

A

both of these types are more common in men than women

43
Q

what is non Hodgkin lymphoma

A
  • 85% of lymphomas
  • onset = 65-75 yrs
  • 5th highest cause of cancer in young adults
44
Q

what is Hodgkin lymphoma?

A
  • 15% of lymphomas
  • has bimodal incidence = first as a young adult and then again later in life
  • occurs in cervical lymph nodes
45
Q

what are the risk factors for Hodgkin lymphoma?

A

EBV, family history, HIV/AIDS
half cases are due to EBV

46
Q

what is the prognosis of Hodgkin lymphoma?

A

good = 5 yr survival up to 98% (85% unfavourable feautres

47
Q

how do we treat Hodgkin

A

localised radiotherapy

48
Q

what do a third of Hodgkin pts have?

A

B symptoms - fever, night sweats and weight loss which is greater than 10% of Their body weight in a 6 month period

49
Q

what is the main difference between Hodgkin an non Hodgkin ?

A

in hodgkin there are reed Sternberg cells (multinucleate cells in lymph nodes)

50
Q

what are the risk factors for non hodgkin lymphoma ?

A

poor immune system function, autoimmune diseases, H pylori infection, Hep C, obesity, EBV

51
Q

what is the percentage of lymphomas that appear in the oropharynx ?

A

10%
- may see a persistent painless ulcer or enlargement in mouth usually in palate

52
Q

what symptoms relating to dentistry do ppl with non Hodgkins show?

A

facial asymmetry
visible swelling in neck
mobility in teeth
change in fit of denture
longer down the line - pain or paraesthsia in nerve = perinural invasion
ulceration of overlying mucosa

53
Q

what are some signs and symptoms of lymphoma

A
  • lymphademopathy= WBC proliferate in nodes
54
Q

what does a lymph node biopsy look like?

A

abnormal lymphocytes

55
Q

what does a reed Sternberg cell look like under a microscope ?

A

multinucealted (Hodgkin)

56
Q

how do we treat lymphoma

A
  • surgical
  • mix of chemo and localised radio
57
Q

what is myeloma?

A

blood cancer that arises from plasma cells (b lymphocytes that produce specific antibodies )
15% of blood cancers and 2% of all cancer
mainly affects over 65yrs
M:F 2:1

58
Q

how does myeloma develop?

A

when dna is damaged during the development of a plasma cell.
this abnormal cell then starts to multiply and spread within the bone marrow. the aboral cell realises a large amount of a single type of antibody = paraprotein - which is has no useful function

59
Q

what is the survival rate of myeloma?

A

5 yrs survival is 52%
treatable but incurable

60
Q

what are the risk factors for myeloma ?

A

obesity
family hx
EBV
certain chemical exposures
radiation

61
Q

what are paraproteins ?

A

plasma cell proteins that produce cytokines which cause damage

62
Q

what damage can paraproteins cause?

A

osteoporosis
lytic lesions in bone
antibodies that are produced by the plasma clones are deposited in various organs eg. nephrons in kidney can cause kidney failure or polyneuropathy = weakness numbness and pain all around body

63
Q

what are some signs and symptoms of myeloma ?

A

amyloidosis= deposition of para proteins in tissue around the body eg. in mouth = red purple swelling sides of tongues

64
Q

what pneumonic can help us remember the key features of myeloma ?

A
65
Q

how do we diagnose myeloma?

A
66
Q

multiple myeloma x rays

A
67
Q

what does an oral plasmacytoma look like ?

A

packed full of plasma cells can move to jaw (30% of cases)

68
Q

what are some dental implications of myeloma

A
  • impaired kidney func= may affect certain LA usage or drug interactions
69
Q

what is graft vs host disease ?

A
  • results from a bone marrow transplant which is a common treatment for many haematological malignancies
  • occurs if there is an allergenic bone marrow transplant (transplanting the bone marrow of one person into the person to the disease) and GVHD is the immune response to this foreign bone marrow
70
Q

what are the 2 types of GVHD?

A

acute or chronic

71
Q

what is acute GVHD ?

A
  • potentially fatal
  • affects GIT skin and liver
72
Q

what is chronic GVHD ?

A

number of organs are affected including oral cavity

73
Q

what are the oral manifestation of GVHD?

A

head neck salivary glands = lichenoid lesions, persistent recurrent facial infections , xerostomia , ulceration, fibrous bands in mucosa of cheek= trismus, altered taste sensation, white striae around tongue (immunosuppressed pts), pts with bone marrow or stem cells or GVHD = increased risk of dysplasia of oral tissues and oral cancer= meed to be vigilant

74
Q

the determinate effects on oral health and how these are managed

A
75
Q

what is our role ?

A

4th Yr - CMS 1 (27 decks)

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