Blood Disorders 1

Question 1

cells of hematopoietic system

Answer 1

red blood cells
platelets
white blood cells
plasma

Question 2

functions of hematopoietic system

Answer 2

distribute O2 nutrients, salts and hormones to cells
removes wastes from cellular metabolism
first line of defense against infection, toxic substance, and foreign antigens

Question 3

hematopoiesis

Answer 3

produces red and white blood cells
birth to age 4
4+ red marrow replaced with yellow marrow

Question 4

signs that could indicate systemic condition

Answer 4

excessive or uncontrolled gingival bleeding
spontaneous gingival bleeding
unexplained petechiae, ecchymoses, or tendency to bruise easily
pale mucosal tissue
glossitis and/or glossodynia
nonhealing mucosal ulcers, recurrent fungal infections
exaggerate gingival response to local irritants such as dental biofilm

Question 5

3 major groups of blood diseases

Answer 5

disease of erythrocytes
diseases of leukocytes
disease of platelets

Question 6

how are erythrocytes developed

Answer 6

in red bone marrow by erythropoiesis
production regulated by the kidney by release of erythropoeitin
start as pluripotential stem cells

Question 7

jaundice

Answer 7

when there is a liver dysfunction or a condition causing excessive destruction of RBCs a buildup of yellow substances happens in skin and mucous membranes

Question 8

disease of RBCs can be broken into two categories

Answer 8

anemia
polycythemia

Question 9

anemia

Answer 9

inadequate number of erythrocytes or issues with hemoglobin (inadequate amount, defective structure, inadequate or defective function)

Question 10

anemia symptoms common to all forms

Answer 10

tachycardia and palpitations
dyspnea
dizziness
weakness
fatigue
glossitis

Question 11

hypochromic anemia

Answer 11

inadequate dietary intake of iron, chronic blood loss
formation of small pale RBCs unable to carry normal amount of O2

Question 12

hypochromic anemia extraoral characteristics

Answer 12

classic symptoms of hypoxia
skin and conjunctiva are pale
brittle hair, brittle, ridged, concave or spoon-shaped nails
low hematocrit

Question 13

hypochromic anemia perioral/intraoral characteristics

Answer 13

pale mucosal membranes
glossitis
angular cheilitis
ulcers
burning sensations
dysphagia

Question 14

hypochromic anemia dental implications

Answer 14

vital signs
review medical history for indication of cause
appointment modifications
Plummer-Vinson syndrome
refer for evaluation

Question 15

thalassemia

Answer 15

genetically determined defect in hemoglobin formation
alpha and beta defects in polypeptide chain

Question 16

a-thalassemia

Answer 16

O2 not released from hemoglobin

Question 17

B-thalassemia

Answer 17

inadequate production of hemoglobin, early destruction of RBCs

Question 18

thalassemia extraoral characteristics

Answer 18

vary according to number of genes affected

Question 19

thalassemia perioral/oral characteristics

Answer 19

B-thalassemia minor and intermedia, and lesser forms of a-thalassemia: mucosal pallor possible, usually no other abnormalities
B-thalassemia major: radiographic bone changes, bone growth abnormalities, dental abnormalities

Question 20

thalassemia radiographic bone changes

Answer 20

jaw bones: more radiolucent, honeycomb trabecular pattern
skull: hair-on-end trabecular pattern

Question 21

thalassemia bone growth abnormalities

Answer 21

prominent maxilla and zygoma
bossing of the frontal bone

Question 22

thalassemia dental abnormalities

Answer 22

abnormal spacing and flaring of maxillary incisors
lamina dura is thin or missing

Question 23

thalassemia dental implications

Answer 23

potential need for prophylactic antibiotic coverage
determine coagulation status
orthodontic evaluations during childhood: overjet, spacing, delayed eruption of both primary and permanent dentition possible

Question 24

thalassemia treatment

Answer 24

minor forms of both require little if any treatment
Beta-thalassemia major requires routine transfusions

Question 25

megaloblastic anemia and its causes

Answer 25

abnormally large RBCs two major causes 1. Vitamin B12 deficiency: lack of intrinsic factor, inadequate dietary intake, malabsorption syndromes, alcoholism, pancreatic disorders 2. folic acid deficiency: inadequate intake or increased demand, malabsorption syndromes, alcoholism, neoplastic disease

Question 26

megaloblastic anemia pathogenesis

Answer 26

defective DNA and RNA synthesis causes delayed maturation of nucleus of RBC cytoplasm matures normally producing large cells have thinner cell membranes (increased chance of rupture) cells have short life span (weeks)

Question 27

megaloblastic anemia extraoral characteristics

Answer 27

classic signs of anemia blotchy skin pigmentation (dark skin) lemon yellow or jaundice (light skin) chronic vitamin B12 deficiency can cause neurologic symptoms: paresthesia, loss of proprioception, ataxia

Question 28

megaloblastic anemia perioral/intraoral characteristics

Answer 28

pale ulcerated mucosa glossitis folic acid deficiency possible link to cleft lip and/or palate

Question 29

megaloblastic anemia dental implications

Answer 29

abnormal vital signs refer for medical evaluation discuss folic acid deficiency with female patients of childbearing age rule out burning mouth syndrome or oral candidiasis

Question 30

megaloblastic anemia treatment

Answer 30

folic acid Vitamin B12

Question 31

sickle cell disease etiology

Answer 31

genetic abnormality causing the substitution of valine for glutamic acid in the B hemoglobin chain considered hemolytic disease autosomal recessive inheritance pattern: heterozygous (sickle cell trait), homozygous (sickle cell disease)

Question 32

sickle cell disease pathogenesis

Answer 32

defective hemoglobin S molecules in RBC combine into solid mass when exposed to stress stretches into long sickle shape cells easily destroyed occlusion of blood vessels because they get trapped due to shape tissue infarcts, pain, necrosis sickle cell crisis

Question 33

extraoral characteristics sickle cell disease

Answer 33

classic symptoms of anemia jaundice from RBC hemolysis damage to multiple organs chronic pain depression complications due to organ damage

Question 34

perioral/intraoral characteristics sickle cell disease

Answer 34

bone trabecular changes: skull (hair-on-end), periapical (step-ladder) trabecular pattern between posterior teeth

Question 35

dental implications sickle cell disease

Answer 35

prevent oral infections that may trigger crisis education appointment modification plain local anesthetic prophylactic antibiotic coverage during surgical procedures supplemental oxygen may be needed

Question 36

sickle cell disease treatment

Answer 36

no cure or definitive treatment management: pain control, maintain hydration and oxygenation, manage complications of disease, avoid crisis triggers, transfusions

Question 37

aplastic anemia etiology

Answer 37

the bone marrow fails to produce any of the blood cells usually due to destruction of pluripotential stem cells 80% acquired: chemical, microbial, or environmental agents 20% congenital or inherited

Question 38

aplastic anemia pathogenesis

Answer 38

bone marrow stops producing cells bone marrow replaced with fatty tissue

Question 39

aplastic anemia extraoral characteristics

Answer 39

classic symptoms of anemia bleeding tendencies infections severe periodontal infections spontaneous gingival bleeding mucosal petechiae and ecchymoses epistaxis

Question 40

aplastic anemia treatment

Answer 40

identify and remove the cause bone marrow transplants immunosuppressive therapy untreated aplastic anemia is fatal

Question 41

polychythemia

Answer 41

excess RBCs in relationship to plasma increases viscosity of blood can impair blood flow to extremities and increase tendency for thrombi three forms: relative, primary, secondary