Blood disorders Flashcards
1
Q
iron deficiency anemia
A
insufficient Fe
2
Q
causes of iron deficiency anemia
A
- bleeding
- poor Fe absorption
- increased Fe demand (i.e. pregnancy)
3
Q
clinical features of iron deficiency anemia
A
- may be asymptomatic - may present with fatigue & weakness
4
Q
oral manifestations of iron deficiency anemia
A
- angular cheilitis - atrophic glossitis - mucosal pallor
5
Q
chronic iron deficiency anemia
A
Plummer-Vinson syndrome
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
7
Q
histological characteristics of iron deficiency anemia
A
hypochromatic & microcytic RBCs
8
Q
treatment for iron deficiency anemia
A
dietary supplements of Fe (ferrous sulfate)
9
Q
pernicious anemia
A
impaired RBC maturation due to vitamin B12 deficiency
10
Q
clinical symptoms of pernicious anemia
A
- fatigue, weakness, headache, shortness of breath - paresthesia, tingling, numbness of extremities**
11
Q
oral manifestations of pernicious anemai
A
- burning painful tongue, lips, buccal mucosa - loss of filiform papillae** - atrophic, pale, erythematous oral mucosa
12
Q
histological characteristics of pernicious anemia
A
- hyperchromatic & macrocytic RBCs**
13
Q
treatment of pernicious anemia
A
- I.M. injections vitamin B12
14
Q
sickle cell anemia
A
inherited defect of hemoglobin, autosomal recessive, causing RBCs to be crescent “sickle” shaped
15
Q
sickle cell anemia - demographic
A
African Americans or Mediterraneans
16
Q
sickle cell anemia - clinical features
A
- weakness, malaise, breath shortness - infections, delayed growth
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
18
Q
radiographic features of sickle cell anemia
A
- “Hair-on-end” appearance of calvarium** - “Step-ladder” trabeculation of posterior mandible**
19
Q
diagnosis of sickle cell anemia
A
electrophoesis
20
Q
treatment of sickle cell anemia
A
supportive care: O2 and blood transfusions
21
Q
thalassemia major
A
inherited (autosomal recessive) defect which causes decreased synthesis of alpha-globin or beta-globin Hb chains
22
Q
most common form of thalassemia
A
thalassemia major
23
Q
thalassemia major - age
A
early life
24
Q
clinical manifestations of thalassemia major
A
jaundice, fever, malaise, weakness
25
oral manifestations of thalassemia major
- maxillary enlargement\*\* - caused by bone marrow hyperplasia - protrusion of anterior teeth - “Chipmunk faces”
26
radiographic features of thalassemia major
- “hair-on-end”\*\* - honeycombed appearance of trabeculae
27
RBCs appearance in thalassemia
hypochromatic & microcytic
28
diagnosis of thalassemia
electrophoresis
29
treatment of thalassemia
- blood transfusion - multiple transfusions can lead to hemochromatosis or increased Fe deposition\*\*
30
leukopenia
- decreased WBC count (
31
agranulocytosis
- decreased granulocytes - bacterial infections common
32
agranulocytosis - clinical features
malaise, sore throat, fever, chills, bone pain
33
agranulocytosis - oral manifestations
punched-out, necrotic ulcerations of oral mucosa\*\* and tongue
34
agranulocytosis - WBC count
WBC count below 1,000/mm3\*\*
35
agranulocytosis - treatment
antibiotic therapy\*\*
36
agranulocytosis - cause
chemotherapy\*\* usually resolves itself if you can get rid of the cause\*\*
37
cyclic neutropenia
rare idiopathic disorder, periodic decrease in neutrophils (below 3,000/mm3 for several days)
38
oral manifestations of cyclic neutropenia
- oral ulcerations: lips, tongue, buccal mucosa, gingiva - severe periodontal disease in children
39
treatment of cyclic neutropenia
antibiotic and cytokine therapy
40
leukocytosis
increase mature circulating WBCs
41
causes of leukocytosis
- normal response to infection - malignant increase in neutrophils or lymphocytes
42
infectious mononucleosis - cause
Epstein-Barr Virus (EBV)
43
infectious mononucleosis - clinical features
high fever, sore throat, \*lymphadenopathy\*, rashes, hepatosplenomegaly occur later
44
infectious mononucleosis - diagnosis
- increased WBC count (15,000 - 20,000/mm3)\*\* - peripheral smear - monospot test
45
infectious mononucleosis - treatment
- symptomatic therapy: bed rest, analgesics, antipyretics, corticosteroids (rarely)
46
leukemia
- malignant neoplasms of transformed hematopoietic stem cells - originate in bone marrow
47
leukemia classifications
- acute leukemia - chronic leukemia
48
acute leukemia
immature "blast" cells
49
chronic leukemia
well differentiated WBCs
50
leukemia - genetic link
Philadelphia chromasome
51
clinical features of leukemia
- malignant proliferation of leukemic cells overwhelm bone marrow - thrombocytopenia (decreased platelets) --\> bleeding, bruising
52
oral manifestations of leukemia
-hard/soft palate, gingival hemorrhages - candida, herpetic infections - mucosal ulcerations - gingival infiltrates (edematous gingiva)
53
leukemia - histology
overwhelming myeloid and/or lymphoid cells
54
leukemia - lab findings
- anemia - normal or elevated WBC count (above 100,000/mm3) - decreased platlets
55
leukemia - treatment
chemotherapy, possibly radiation, bone marrow transplant may be considered, antibiotics, transfusions
56
is relapse common or uncommon?
common due to chemotherapy causing second primary malignancy (complete remission is possible)
57
prognosis of acute leukemia
poor prognosis (children do better if treated)
58
prognosis of chronic leukemia
better then acute (more indolent course)
59
Hodgkin's disease
malignancy arising in lymph nodes
60
Hodgkin's disease - M?F
M \> F
61
Hodgkin's disease - age of onset
15-35 and after 50
62
Hodgkin's disease - most common clinical finding
non-tender swelling
63
Hodgkin's disease - histology
Reed-Sternberg (RS) cells: binucleate (“owl’s eye”) giant cells
64
Hodgkin's disease - diagnosis
dependent upon histological identification of RS cells
65
Hodgkin's disease - treatment
- depends on stage - can include chemotherapy and/or radiotherapy
66
Non-Hodgkin lymphoma
A malignant neoplasm of lymphocytes lacking RS cells
67
Non-Hodgkin lymphoma commonly occurs with what disease?
AIDS increased prevalence with immunosuppression & immunodeficiencies
68
Non-Hodgkin lymphoma - classifcation
- several systems - Kiel Classification (divided into low and high grade malignancies)
69
Non-Hodgkin lymphoma - M?F
M \> F
70
Non-Hodgkin lymphoma - origin
lymph nodes (more commonly occur as extra-nodal lesions compared to Hodgkin's lymphoma)
71
Non-Hodgkin lymphoma - differential diagnosis
pyogenic granuloma (difficult to differentiate clinically)
72
Non-Hodgkin lymphoma - radiographic features
multiple radiolucencies (helps differentiate from pyogenic granulomas)
73
Non-Hodgkin lymphoma - histology
- LACKS RS CELLS - looks like crushed artificat
74
Non-Hodgkin lymphoma - prognosis
very lethal not nearly as effective at treating as Hodgkin's lymphoma
75
Burkitt's lymphoma - associated virus
EBV
76
Burkitt's lymphoma - genetic link
chromosomal translocations of chromosome 8 to chromosomes 2, 14, and 22
77
Burkitt's lymphoma - classification
- endemic - non-endemic - AIDS type
78
Burkitt's lymphoma - endemic demographics
- children - central Africa - head and neck region (mandible)
79
Burkitt's lymphoma - non-endemic demographics
- throughout the world - more common in abdomen - slightly older (teens?)
80
Burkitt's lymphoma - radiographic features
- tooth displacement, root resorption - tend to arise on gingiva and palate
81
Burkitt's lymphoma - histology
- sheets of monomorphic lymphocytes - scattered macrophages with abundant cytoplasm (“starry sky”)
82
Burkitt's lymphoma - treatment
high does of cyclophoshamide
83
multiple myeloma
malignancy of plasma cells
84
multiple myeloma - origin
plasma cells
85
multiple myeloma - age
older adults (50-60 y/o) important to know
86
multiple myeloma - clinical features
- renal failure - recurrent infections
87
multiple myeloma - oral manifestations
amyloid tongue depositions may cause macroglossia
88
multiple myeloma - radiographic features
punched out radiolucencies
89
multiple myeloma - histology
signet ring (looks like a setting in a ring)
90
thrombocytopenia
- decreased platelets - sequestration in spleen and liver
91
thrombocytopenia - clinical features
- petechiae (small blood vessel leakage) - ecchymoses, hematomas (larger vessel bleeding) - spontaneous gingival hemorrhage
92
thrombasthenia
- prolonged bleeding time with normal platelet counts - platelets have defective adherence or aggregate
93
thrombasthenia - causes
- congenital (von Willebrand’s disease) - acquired (aspirin)
94
von Willebrand’s disease
factor VIII disorder
95
vitamin C deficiency, “Scurvy”
- not common in wester countries (when seen - neglected elderly, malnourished alcoholics) - causes abnormal collagen synthesis - capillary fragility
96
vitamin C deficiency
- gingival inflammation, ulceration, bleeding - tooth mobility, bone loss
97
hereditary hemorrhagic telangiectasia
- capillary fragility - Rendu-Osler-Weber syndrome - uncommon - autosomal dominant
98
hereditary hemorrhagic telangiectasia - clinical features
telangiectasia (dilation of the capillaries, which causes them to appear as small red or purple clusters)
99
hemophilia A
- coagulation disorder - factor VIII deficiency/dysfunction - clinically indistinguishable from hemophilia B
100
hemophilia B
- Christmas disease - factor IX deficiency - clinically indistinguishable from hemophilia A
101
hemophilia - clinical features
bleeding into soft tissues, joints, muscles
102
hemophilia - laboratory findings
prolonged PTT
103
hemophilia treatmenent
clotting factor replacement therapy
