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Pathology > Blood Disorders 2 > Flashcards

Blood Disorders 2 Flashcards

1
Q

thalassemia

A

a hemoglobin disorder that has some effect on the bones and patients present with a range of anemic symptoms

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2
Q

thalassemia pathogenesis

A

a-chain: high affinity for oxygen and will not release O2 to cells
b-chain: interferes with normal maturation of RBCs and contributes to early destruction

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3
Q

extraoral characteristics thalassemia

A

a-thalassemia: mild to moderate signs of anemia
b-thalassemia: minor, intermedia, major (bone malformations and stunted growth)

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4
Q

radiographic bone changes thalassemia

A

jaw: honeycomb trabecular pattern
skull: hair-on-end trabecular pattern

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5
Q

megaloblastic anemia is caused by

A

Vitamin B12 deficiency
folic acid deficiency

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6
Q

megaloblastic anemia pathogenesis

A

normal RBCs have a nucleus while maturing, but once the maturation process is complete the nucleus is ejected

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7
Q

perioral characteristics megaloblastic anemia

A

glossitis “beefy red,” smooth, sore appearance
pale ulcerated mucosa
possible cleft lip and/or palate

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8
Q

megaloblastic anemia dental implications

A

abnormal vital signs
refer for medical evaluation
female patients of childbearing age

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9
Q

what are the two anemias with bone changes

A

sickle cell disease and thalassemia

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10
Q

sickle cell crisis

A

episodic exacerbations brought on by cold, stress, physical exertion, dehydration, acidosis, infectious agents, hypoxia or a low level of oxygen

sickling of many RBC, occluding the microvasculature in many areas, such as the chest, abdomen and bones, causing extreme pain

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11
Q

sickle cell disease perioral/intraoral characteristics

A

bone trabecular changes: skull “hair-on-end” trabecular pattern caused by bone marrow expansion similar to the thalassemias

periapical “step-ladder” trabecular pattern between posterior teeth

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12
Q

sickle cell disease dental implications

A

use local anesthetics with little or no vasoconstrictors (avoid epi)

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13
Q

anemia associated with chronic disease or disorders

A

treatment of these conditions usually eliminates the anemia
cancer, chronic inflammatory disease, renal disease, hypertension, prosthetic heart valves, turbulent blood flow

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14
Q

aplastic anemia

A

bone marrow fails to produce any of the blood cells usually due to destruction of pluripotential stem cells

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15
Q

extraoral characteristics of aplastic anemia

A

classic symptoms of anemia
bleeding tendencies
infections
severe perio infections
spontaneous gingival bleeding

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16
Q

polycythemia

A

excess RBCs, can impair flow

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17
Q

three forms of polycythemia

A

relative polycythemia
secondary polycythemia
primary: caused by proliferative neoplastic disease, clinical manifestations

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18
Q

lymphoid stem cell

A

lymphocytes

19
Q

myeloid stem cell

A

monocytes
granulocytes
platelets
erythrocytes

20
Q

disease of WBCs can be broken into two categories

A

diseases of the leukocytes (Neutropenia, agranulocytosis, cyclic neutropenia)
lymphomas: Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Leukemia, Multiple Myeloma

21
Q

neutropenia etiology

A

adverse reaction to a drug
many types

22
Q

neutropenia pathogenesis

A

genetic of caused as reaction to infection
results in increased susceptibility to infections

23
Q

neutropenia extraoral characteristics

A

fatigue, fever, malaise, extreme weakness
vital signs
skin infections (will not have exudate or erythema present)
upper respiratory infections
genitourinary tract infection

24
Q

neutropenia perioral/intraoral characteristics

A

oral infections
oral ulcers
perio infections
rapid, progressive loss of periodontal attachment
can lead to premature loss of dentition

25
Q

neutropenia dental implications

A

focus on prevention of infections and preserving dentition
patient education

26
Q

lymphomas

A

Hodgkin lymphoma: involves an atypical form of B lymphocyte
Non-Hodgkin lymphoma involves: B lymphocytes, T lymphocytes, Natural killer cells

27
Q

hodgkin lymphoma pathogenesis

A

presence of an abnormal tumor cell
as disease progresses the individual becomes highly susceptible to infection because of the associated immune system dysfunction

28
Q

hodgkin lymphoma dental implications

A

head and neck eval
cervical and supraclavicular nodes importatn

29
Q

non-hodgkin lymphoma describes

A

various B and T cell malignant neoplasms

30
Q

non-hodgkin lymphoma perioral/intraoral characteristics

A

soft tissue mass in Waldeyer ring area
hard palate is common location
tumors within bone may present as ill-defined radiolucencies that can progress to expansion of the bone

31
Q

non-hodgkin lymphoma dental implications

A

EO/IO importnat
intraoral swelling

32
Q

burkitt lymphoma

A

aggressive form of non-hodgkin lymphoma
most rapidly growing cancer
EBV
three forms: endemic, sporadic, immune def

33
Q

leukemia

A

a group of malignant neoplasms involving leukocytes
lymphoid or myeloid

34
Q

leukemia pathogenesis acute vs chronic

A

acute form: days to several weeks, overgrowth of blastic cells
chronic form: gradual progression, production of stem cells that do not respond to body’s attempts to regulate proliferation

35
Q

both forms of leukemia

A

have extremely high numbers of the abnormal white cells
overwhelms the bone marrow, and not enough stem cells to make other blood products so other blood issue are usually present

36
Q

the symptoms of leukemia are associated with

A

the disorders produced by the decrease in the numbers of these cells, specifically anemia, neutropenia, thrombocytopenia

37
Q

extraoral characteristics leukemia

A

Acute and Chronic differ
bone pain
headache, nerve dysfunction, nausea, vomiting, seizures
Chronic Lymphoid (bone pain) and Chronic Myeloid (three phases) differ

38
Q

leukemia perioral/intraoral characteristics

A

increased periodontal infections and gingival bleeding
petechiae/purpura in oral soft tissues

39
Q

leukemia dental implications

A

determine WBC level and coagulation status
stress good oral hygiene

40
Q

multiple myeloma etiology

A

overproduction of plasma cells

41
Q

multiple myeloma pathogenesis

A

excessive production of M protein, causing immunosuppression
bone resorption
Bence Jones protein causes renal failure

42
Q

two additional forms of myeloma

A

solitary plasmacytoma: single area of bone destruction
extramedullary plasmacytoma: soft tissues, exophytic red masses

43
Q

multiple myeloma perioral/intraoral characteristics

A

increases risk of periodontal infection

44
Q

multiple myeloma dental implications

A

determine white cell levels
clotting time
patients treated with bisphosphonates must be monitored closely for osteonecrosis of the jaw

Pathology (12 decks)

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