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Oral Path II - Final > Blood disorders > Flashcards

Blood disorders Flashcards

1
Q

iron deficiency anemia

A

insufficient Fe

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2
Q

causes of iron deficiency anemia

A
  • bleeding
  • poor Fe absorption
  • increased Fe demand (i.e. pregnancy)
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3
Q

clinical features of iron deficiency anemia

A
  • may be asymptomatic - may present with fatigue & weakness
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4
Q

oral manifestations of iron deficiency anemia

A
  • angular cheilitis - atrophic glossitis - mucosal pallor
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5
Q

chronic iron deficiency anemia

A

Plummer-Vinson syndrome

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6
Q

Plummer-Vinson syndrome characteristics

A
  • rare condition of Scandinavian women - chronic iron deficiency anemia - dysphagia, atrophic mucositis of aerodigestive tracts - predisposition to oral/esophageal SCC
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7
Q

histological characteristics of iron deficiency anemia

A

hypochromatic & microcytic RBCs

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8
Q

treatment for iron deficiency anemia

A

dietary supplements of Fe (ferrous sulfate)

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9
Q

pernicious anemia

A

impaired RBC maturation due to vitamin B12 deficiency

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10
Q

clinical symptoms of pernicious anemia

A
  • fatigue, weakness, headache, shortness of breath - paresthesia, tingling, numbness of extremities**
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11
Q

oral manifestations of pernicious anemai

A
  • burning painful tongue, lips, buccal mucosa - loss of filiform papillae** - atrophic, pale, erythematous oral mucosa
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12
Q

histological characteristics of pernicious anemia

A
  • hyperchromatic & macrocytic RBCs**
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13
Q

treatment of pernicious anemia

A
  • I.M. injections vitamin B12
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14
Q

sickle cell anemia

A

inherited defect of hemoglobin, autosomal recessive, causing RBCs to be crescent “sickle” shaped

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15
Q

sickle cell anemia - demographic

A

African Americans or Mediterraneans

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16
Q

sickle cell anemia - clinical features

A
  • weakness, malaise, breath shortness - infections, delayed growth
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17
Q

sickle cell crisis

A
  • severe sickling - causes: hypoxia, infection, hypothermia, dehydration - symptoms: extreme pain from ischemia and infarction - long bones, lungs, abdomen most affected
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18
Q

radiographic features of sickle cell anemia

A
  • “Hair-on-end” appearance of calvarium** - “Step-ladder” trabeculation of posterior mandible**
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19
Q

diagnosis of sickle cell anemia

A

electrophoesis

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20
Q

treatment of sickle cell anemia

A

supportive care: O2 and blood transfusions

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21
Q

thalassemia major

A

inherited (autosomal recessive) defect which causes decreased synthesis of alpha-globin or beta-globin Hb chains

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22
Q

most common form of thalassemia

A

thalassemia major

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23
Q

thalassemia major - age

A

early life

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24
Q

clinical manifestations of thalassemia major

A

jaundice, fever, malaise, weakness

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25
Q

oral manifestations of thalassemia major

A
  • maxillary enlargement** - caused by bone marrow hyperplasia - protrusion of anterior teeth - “Chipmunk faces”
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26
Q

radiographic features of thalassemia major

A
  • “hair-on-end”** - honeycombed appearance of trabeculae
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27
Q

RBCs appearance in thalassemia

A

hypochromatic & microcytic

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28
Q

diagnosis of thalassemia

A

electrophoresis

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29
Q

treatment of thalassemia

A
  • blood transfusion - multiple transfusions can lead to hemochromatosis or increased Fe deposition**
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30
Q

leukopenia

A
  • decreased WBC count (
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31
Q

agranulocytosis

A
  • decreased granulocytes - bacterial infections common
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32
Q

agranulocytosis - clinical features

A

malaise, sore throat, fever, chills, bone pain

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33
Q

agranulocytosis - oral manifestations

A

punched-out, necrotic ulcerations of oral mucosa** and tongue

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34
Q

agranulocytosis - WBC count

A

WBC count below 1,000/mm3**

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35
Q

agranulocytosis - treatment

A

antibiotic therapy**

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36
Q

agranulocytosis - cause

A

chemotherapy** usually resolves itself if you can get rid of the cause**

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37
Q

cyclic neutropenia

A

rare idiopathic disorder, periodic decrease in neutrophils (below 3,000/mm3 for several days)

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38
Q

oral manifestations of cyclic neutropenia

A
  • oral ulcerations: lips, tongue, buccal mucosa, gingiva - severe periodontal disease in children
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39
Q

treatment of cyclic neutropenia

A

antibiotic and cytokine therapy

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40
Q

leukocytosis

A

increase mature circulating WBCs

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41
Q

causes of leukocytosis

A
  • normal response to infection - malignant increase in neutrophils or lymphocytes
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42
Q

infectious mononucleosis - cause

A

Epstein-Barr Virus (EBV)

43
Q

infectious mononucleosis - clinical features

A

high fever, sore throat, *lymphadenopathy*, rashes, hepatosplenomegaly occur later

44
Q

infectious mononucleosis - diagnosis

A
  • increased WBC count (15,000 - 20,000/mm3)** - peripheral smear - monospot test
45
Q

infectious mononucleosis - treatment

A
  • symptomatic therapy: bed rest, analgesics, antipyretics, corticosteroids (rarely)
46
Q

leukemia

A
  • malignant neoplasms of transformed hematopoietic stem cells - originate in bone marrow
47
Q

leukemia classifications

A
  • acute leukemia - chronic leukemia
48
Q

acute leukemia

A

immature “blast” cells

49
Q

chronic leukemia

A

well differentiated WBCs

50
Q

leukemia - genetic link

A

Philadelphia chromasome

51
Q

clinical features of leukemia

A
  • malignant proliferation of leukemic cells overwhelm bone marrow - thrombocytopenia (decreased platelets) –> bleeding, bruising
52
Q

oral manifestations of leukemia

A

-hard/soft palate, gingival hemorrhages - candida, herpetic infections - mucosal ulcerations - gingival infiltrates (edematous gingiva)

53
Q

leukemia - histology

A

overwhelming myeloid and/or lymphoid cells

54
Q

leukemia - lab findings

A
  • anemia - normal or elevated WBC count (above 100,000/mm3) - decreased platlets
55
Q

leukemia - treatment

A

chemotherapy, possibly radiation, bone marrow transplant may be considered, antibiotics, transfusions

56
Q

is relapse common or uncommon?

A

common due to chemotherapy causing second primary malignancy (complete remission is possible)

57
Q

prognosis of acute leukemia

A

poor prognosis (children do better if treated)

58
Q

prognosis of chronic leukemia

A

better then acute (more indolent course)

59
Q

Hodgkin’s disease

A

malignancy arising in lymph nodes

60
Q

Hodgkin’s disease - M?F

A

M > F

61
Q

Hodgkin’s disease - age of onset

A

15-35 and after 50

62
Q

Hodgkin’s disease - most common clinical finding

A

non-tender swelling

63
Q

Hodgkin’s disease - histology

A

Reed-Sternberg (RS) cells: binucleate (“owl’s eye”) giant cells

64
Q

Hodgkin’s disease - diagnosis

A

dependent upon histological identification of RS cells

65
Q

Hodgkin’s disease - treatment

A
  • depends on stage - can include chemotherapy and/or radiotherapy
66
Q

Non-Hodgkin lymphoma

A

A malignant neoplasm of lymphocytes lacking RS cells

67
Q

Non-Hodgkin lymphoma commonly occurs with what disease?

A

AIDS increased prevalence with immunosuppression & immunodeficiencies

68
Q

Non-Hodgkin lymphoma - classifcation

A
  • several systems - Kiel Classification (divided into low and high grade malignancies)
69
Q

Non-Hodgkin lymphoma - M?F

A

M > F

70
Q

Non-Hodgkin lymphoma - origin

A

lymph nodes (more commonly occur as extra-nodal lesions compared to Hodgkin’s lymphoma)

71
Q

Non-Hodgkin lymphoma - differential diagnosis

A

pyogenic granuloma (difficult to differentiate clinically)

72
Q

Non-Hodgkin lymphoma - radiographic features

A

multiple radiolucencies (helps differentiate from pyogenic granulomas)

73
Q

Non-Hodgkin lymphoma - histology

A
  • LACKS RS CELLS - looks like crushed artificat
74
Q

Non-Hodgkin lymphoma - prognosis

A

very lethal not nearly as effective at treating as Hodgkin’s lymphoma

75
Q

Burkitt’s lymphoma - associated virus

A

EBV

76
Q

Burkitt’s lymphoma - genetic link

A

chromosomal translocations of chromosome 8 to chromosomes 2, 14, and 22

77
Q

Burkitt’s lymphoma - classification

A
  • endemic - non-endemic - AIDS type
78
Q

Burkitt’s lymphoma - endemic demographics

A
  • children - central Africa - head and neck region (mandible)
79
Q

Burkitt’s lymphoma - non-endemic demographics

A
  • throughout the world - more common in abdomen - slightly older (teens?)
80
Q

Burkitt’s lymphoma - radiographic features

A
  • tooth displacement, root resorption - tend to arise on gingiva and palate
81
Q

Burkitt’s lymphoma - histology

A
  • sheets of monomorphic lymphocytes - scattered macrophages with abundant cytoplasm (“starry sky”)
82
Q

Burkitt’s lymphoma - treatment

A

high does of cyclophoshamide

83
Q

multiple myeloma

A

malignancy of plasma cells

84
Q

multiple myeloma - origin

A

plasma cells

85
Q

multiple myeloma - age

A

older adults (50-60 y/o) important to know

86
Q

multiple myeloma - clinical features

A
  • renal failure - recurrent infections
87
Q

multiple myeloma - oral manifestations

A

amyloid tongue depositions may cause macroglossia

88
Q

multiple myeloma - radiographic features

A

punched out radiolucencies

89
Q

multiple myeloma - histology

A

signet ring (looks like a setting in a ring)

90
Q

thrombocytopenia

A
  • decreased platelets - sequestration in spleen and liver
91
Q

thrombocytopenia - clinical features

A
  • petechiae (small blood vessel leakage) - ecchymoses, hematomas (larger vessel bleeding) - spontaneous gingival hemorrhage
92
Q

thrombasthenia

A
  • prolonged bleeding time with normal platelet counts - platelets have defective adherence or aggregate
93
Q

thrombasthenia - causes

A
  • congenital (von Willebrand’s disease) - acquired (aspirin)
94
Q

von Willebrand’s disease

A

factor VIII disorder

95
Q

vitamin C deficiency, “Scurvy”

A
  • not common in wester countries (when seen - neglected elderly, malnourished alcoholics) - causes abnormal collagen synthesis - capillary fragility
96
Q

vitamin C deficiency

A
  • gingival inflammation, ulceration, bleeding - tooth mobility, bone loss
97
Q

hereditary hemorrhagic telangiectasia

A
  • capillary fragility - Rendu-Osler-Weber syndrome - uncommon - autosomal dominant
98
Q

hereditary hemorrhagic telangiectasia - clinical features

A

telangiectasia (dilation of the capillaries, which causes them to appear as small red or purple clusters)

99
Q

hemophilia A

A
  • coagulation disorder - factor VIII deficiency/dysfunction - clinically indistinguishable from hemophilia B
100
Q

hemophilia B

A
  • Christmas disease - factor IX deficiency - clinically indistinguishable from hemophilia A
101
Q

hemophilia - clinical features

A

bleeding into soft tissues, joints, muscles

102
Q

hemophilia - laboratory findings

A

prolonged PTT

103
Q

hemophilia treatmenent

A

clotting factor replacement therapy

Oral Path II - Final (2 decks)

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