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2 - Diseases Of The Human System > Blood Diseases - 2 > Flashcards

Blood Diseases - 2 Flashcards

1
Q

What are the reasons for decreases in normal red cells?

A

Usually bleeding - chronic from GI

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2
Q

What are the reasons for decreases abnormal red cells?

A

autoimmune

hereditary conditions - span (<120 days)
removed by the spleen

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3
Q

Why would the spleen enlarge if cells have reduced life span?

A

due to overactivity of spleen trying to remove dead RBCs

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4
Q

What is microcytic, macrocytic, and normocytic in anaemia cell terminology ?

A

o microcytic
- small RBC - Fe def., Thalassaemia

o macrocytic
- large RBC - B12/folate def., Retics

o normocytic
- normal RBC - bleed, renal, chronic disease

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5
Q

What is hypochromic?

A
  • hypo (less) chromic (colour)

Due to there being less Haemoglobin in the red cells

most often microcytic and hypochromic

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6
Q

What is ansiocytic?

A

Red cells are always a range of sizes even in normal people. This is exaggerated in anisocytosis – very big cells and very small cells in the same sample

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7
Q

What are macrocytic cells a sign of?

A

immature RBCs that have not shrunk

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8
Q

What are reticulocytes?

A

oAlmost mature RBC
oReleased early into the circulation to replace losses
oWill raise MCV (mean cell volume)

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9
Q

When would reticulocytes be present and how would they look?

A

have residual organelles and are larger

when patient has lost blood and is rapidly trying to replace RBCs

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10
Q

What are signs?

A

things a clinican can see upon examination

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11
Q

What are symtoms?

A

symptoms are things the patient will conplain about

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12
Q

What are the signs of anemia?

A

pale (mucosa)
tachycardia
smooth tongue/ loss of papilla (iron deficiency)

Rarely
enlarged liver
enlarged spleen

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13
Q

What are the symptoms of anaemia?

A

tired and weak
dizzy
SOB (shortnessofbreath)
palpitations

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14
Q

What oral disease commonly presents with iron deficiency?

A

angular chelitis

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15
Q

What oral sign can occur with vit B12 deficiency?

A

beefy (inflammed, smooth) tongue

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16
Q

What are the investigations that are required to diagnose anaemia in order?

A
  • history

-FBC (ferritin and RC folate/ vit B12)

-GI blood loss
found in FOB (faecal occult blood)
endoscopy (upper), colonoscopy (lower)

-renal function (erythropoetin levels)

-bone marrow exam (last restort)

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17
Q

How is anaemia treated?

A

o Replace haematinics

o Transfusions - production failure

o Erythropoeitin replacement via injection due to production failure
-Renal disease

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18
Q

What are the problems that anaemia may cause dentally?

A

oGeneral Anaesthesia - O2 capacity

oDeficiency States
- Fe usually
- mucosal atrophy (thinning)
- Candidiasis
- Recurrent Oral Ulceration
- Sensory changes
- inflammation of tongue
- smoothness of tongue

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19
Q

What is a possible cause of anemia in females?

A

menstrual blood loss

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20
Q

Where does GI bleeding occur in elderly people?

A

upper/ lower GI

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21
Q

Where does GI bleeding occur in young people?

A

upper GI

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22
Q

What does a less differentiated cancer mean?

A

more aggressive

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23
Q

When can a haematological cell line turn neoplastic?

A

numer of stages
the earlier, the more potentially aggressive the malignancy

24
Q

What mutation happens to cause the malignancy?

A

DNA mutation (usually translocation)

Switches “off” a tumour suppressor gene or switches “on” an
oncogene

Clonal proliferation

25
Q

What are characteristics of cancer cells?

A

Uncontrolled proliferation

Loss of apoptosis

Loss of normal functions/products

26
Q

What do acute and chronic denote?

A

clinical behaviour and span

27
Q

What terms decribe the point in the cell line or the cell type at fault?

A

Lymphocytic, lymphoblastic or myeloid

28
Q

What is “blast”?

A

immature cell

29
Q

What leukaemia is serious and life threatening?

A

acute leukaemia

30
Q

What is leukaemia and what conditions does it result in?

A

Describes a group of cancers of the bone marrow which prevent normal manufacture of the blood and therefore result in:

Anaemia

Infection (Neutropenia)

Bleeding (Thrombocytopenia)

31
Q

What is the pathogenesis of leukaemia?

A

clonal proliferation

replacement of marrow

increasing marginalisation of productive normal marrow - marrow failure, organ infiltration

32
Q

What type of Leukaemia occurs in very young children, causing them to go into a Catabolic state?

A

acute lymphoblastic

not fatal

33
Q

What are the clinical presentations of leukaemia?

A

Anaemia
Neutropenia (infections, latent or aquired)
Lymphadenopathy - neck lumps
Bone pain- especially in children
Hepatomegaly/ Splenomegaly - swollen abdomen

34
Q

What is the difference between lymphocytic and lymphoblastic?

A
  • Lymphocytic - mature lymphocytes (healthy immune system cells)
  • Lymphoblastic - immature lymphocytes (not fully functional)
35
Q

What type of leukaemia results in an increase of neutrophils?

philidelphia chromosome

A

chronic myeloid

36
Q

What type of Leukaemia occurs in the Elderly (over 70) and is usually Asymptomatic?

b-cell clonal lymphoproliferative disease

A

chronic lymphocytic

37
Q

What forms of Leukaemia affects elderly individuals more?

A

chronic lymphocytic
acute myeloid

38
Q

What is lymphoma?

A

Clonal proliferation of lymphocytes arising in a lymph node or associated tissue
solid tumour but some cells in blood

39
Q

What are the two types of lymphoma?

A
  1. Hodgkin Lymphoma (Hodgkin’s disease)
  2. Non-Hodgkin Lymphoma
40
Q

What is the most common lymphoma?

A

non-hodgkin lymphoma

41
Q

What are symtoms of lymphoma?

A

fever
swelling of face/neck
lump in neck, armpits or groin
excessive sweating
unexpected weight loss
loss of appetie
breathlessness

42
Q

Where does cancer proliferation occur in lymphoma?

A

tissue proliferation occurs in the lymphoid tissues rather than the bone marrow in leukaemia

lymph nodes

43
Q

What does staging require?

A

imaging
-CT, PET or MRI

44
Q

What does staging depend on?

A

no of nodes involved and sites

extra-nodal involvement

systemic symptoms

45
Q

What are characteristics of hodgkin lymphoma?

A
  • Peak incidence age 15-40 years males
  • Painless lymphadenopathy, fever, night sweats, weight loss, itching
  • High survival
46
Q

What are the characteristics of non-hodgkin lymphoma?

A
  • B-cell (85%) or T-cell (15%) types
  • Any age (more indolent in elderly)
  • Aetiology: microbial factors, autoimmune disease associated, immunosuppression
  • lymphadenopathy, oral swelling, oropharyngeal diseases
  • marrow failure symptoms common (normal lymphoma symptoms not common)
  • Fatal (relapse after treatment)
47
Q

What is multiple myeloma?

A

Malignant proliferation of plasma cells derived from b cells

48
Q

What are the features of multiple myeloma?

A
  1. Monoclonal paraprotein in blood and urine
  2. Lytic bone lesions > pain and fracture
  3. Excess plasma cells in bone marrow > marrow failure
49
Q

What does multiple myeloma cause?

A

infections
bone pain and fractures
renal failure
amyloidosis

50
Q

What is treatment for multiple myeloma?

A

mostly monoclonal antibody drugs and turnover suppression medicine

51
Q

What is the types of treatment of haematological malignancies?

A
  • Chemotherapy
  • Radiotherapy
  • Monoclonal antibodies – increasingly important * ‘Biologic’ medication that targets specific cell types
  • Haemopoietic stem cell transplantation
52
Q

What concepts must be understood before treating haematological malignancy?

A
  • Induction
  • Remission
  • Maintenance & consolidation
  • Relapse
53
Q

What is supportive therapy that is important?

A
  • Nutrition
  • Psychological and social support
  • Prevention and treatment of infection
  • Managing symptoms of therapy side effects
  • Correcting marked blood component deficits
  • Pain control
54
Q

What is chemotherapy?

A
  • Cells with high turnover rate targeted
  • Side effects well known but newer agents are improving: hair loss, nausea and vomiting, tiredness
  • Long-term risk of oncogenesis in surviving patients
55
Q

Whatis radiotherapy?

A
  • Cytotoxic effect of ionizing radiation
  • Beam directed form outside body
  • Adjacent healthy tissue will also be irradiated
  • Effect of this minimised using complex spatial positioning, targeting and dosing techniques

arranged by computers to minimise harm

56
Q

What is monoclonal treatment?

A

Monoclonal antibody therapy in cancer utilizes antibodies designed to bind to specific antigens on cancer cells to

  • Directly induce cancer cell death (cytotoxic effect).
  • Deliver cytotoxic drugs or radioactive payloads to cancer cells.
  • Stimulate the immune system to attack cancer cells (immunotherapy).
57
Q

What is haemopoietic stem cell transplant?

A

replaces damaged bone marrow with healthy stem cells (from donor - allogenic or patient - autologous) to restore blood cell production. Used for treating blood cancers and disorders.

very high risk

2 - Diseases Of The Human System (19 decks)

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