Diseases of the Blood Flashcards
What are the four main components of blood?
- Plasma (carries nutrients, hormones, proteins)
- White blood cells (immune response)
- Red blood cells (oxygen transport via haemoglobin)
- Platelets (blood clotting)
What are the primary functions of blood?
- Transportation (oxygen, nutrients, hormones)
- Clotting
- Immune defense
- Temperature regulation
What does “leuko-“ mean? →
What does “erythro-“ mean? →
What does “thrombocyto-“ mean? →
What does “-cytosis” indicate? →
What does “-penia” indicate? →
What do “microcytic,” “normocytic,” and “macrocytic” mean?→
What does “leuko-“ mean? → White blood cell
What does “erythro-“ mean? → Red blood cell
What does “thrombocyto-“ mean? → Platelet
What does “-cytosis” indicate? → Excess of a type of cell
What does “-penia” indicate? → Lack of a type of cell
What do “microcytic,” “normocytic,” and “macrocytic” mean?
Microcytic → Small RBCs
Normocytic → Normal-sized RBCs
Macrocytic → Large RBCs
What is anaemia?
Low haemoglobin in blood, leading to reduced oxygen transport
What are common symptoms of anaemia?
Tiredness
Shortness of breath
Dizziness
Palpitations
What are common signs of anaemia?
Pale skin
Conjunctival pallor
What are “classical signs” of anaemia?
Angular cheilitis
Koilonychia (spoon-shaped nails)
What is the cause of iron deficiency anaemia?
Impaired haemoglobin production due to low iron
What are common causes of iron deficiency?
- Poor dietary intake
- Malabsorption (e.g., coeliac disease)
- Increased loss (e.g., menstrual bleeding, GI bleeding)
- Increased demand (e.g., pregnancy, growth)
How is iron deficiency anaemia managed?
Oral or IV iron supplementation
What are the causes of Vitamin B12 deficiency?
- Poor intake (e.g., vegan diet)
- Malabsorption (pernicious anaemia, gastrectomy, Crohn’s disease)
- Medication side effects (e.g., metformin)
What are key symptoms of B12 deficiency?
- Anaemia symptoms
- Peripheral neuropathy
- Visual disturbances
How is Vitamin B12 deficiency managed?
Oral or intramuscular B12 supplementation
What are common causes of folic acid deficiency?
- Poor dietary intake (low leafy vegetables)
- Medication (e.g., methotrexate, phenytoin)
- Alcohol excess
- Bowel disease
What is a key risk of folic acid deficiency in pregnancy?
Increased risk of neural tube defects (e.g., spina bifida)
What is thalassaemia?
Genetic defect in haemoglobin production (autosomal recessive)
What are the two types of Thalassaemia ?
Alpha-thalassaemia
Beta-thalassaemia
What are the management options?
- Monitoring
- Blood transfusions
- Splenectomy
- Bone marrow transplant
What is sickle cell anaemia?
Genetic condition causing crescent-shaped RBCs (autosomal recessive)
What triggers sickle cell crises?
- Dehydration
- Infection
- Stress
- Cold weather
How is sickle cell anaemia managed?
- Avoid triggers
- Prophylactic antibiotics
- Specialist medications
- Blood transfusions
- Bone marrow transplant
What oral signs may indicate anaemia?
- Angular cheilitis
- Atrophic glossitis (smooth, red tongue)
- Recurrent candidiasis
What is the most commonly given blood product?
Packed red cells
What are indications for blood transfusion?
- Anaemia
- Acute blood loss
- Surgery
- Complex haematological conditions
What are key risks of blood transfusions?
- Fever
- Haemolysis (incompatible blood)
- Fluid overload (TACO – transfusion-associated circulatory overload)
- Anaphylaxis
What is leukaemia?
A group of blood cancers caused by unregulated production of immature blast cells in the bone marrow, leading to loss of marrow function.
What are the key deficiencies caused by leukaemia?
RBC deficiency → Anaemia
WBC deficiency → Impaired immunity
Platelet deficiency → Easy bleeding
What are the main types of leukaemia?
- Acute lymphoblastic leukaemia (ALL) – common in children
- Acute myeloid leukaemia (AML) – common in adults
- Chronic lymphocytic leukaemia (CLL) – slow progression, older adults
- Chronic myeloid leukaemia (CML) – associated with the Philadelphia chromosome
What is lymphoma?
A cancer affecting WBCs in the lymphatic system, causing painless lymph node enlargement.
What are the two main types of lymphoma?
Hodgkin’s lymphoma (20-40 years old, Reed-Sternberg cells)
Non-Hodgkin’s lymphoma (most common)
What are “B symptoms” in lymphoma?
Fever, night sweats, weight loss.
What is myeloma?
A cancer affecting plasma cells, leading to excessive production of one antibody type (paraprotein), causing tissue/organ impairment.
What are the CRAB symptoms of myeloma?
Calcium (elevated)
Renal impairment
Anaemia
Bone lesions/fractures
What oral symptoms may indicate a blood cancer?
- Easy bleeding – petechiae, gingival bleeding
- Infections – candidosis, herpes simplex
- Anaemia signs – pallor, glossitis
- Gingival swelling – associated with AML
What are common oral side effects of chemotherapy?
- Oral mucositis
- Dry mouth (xerostomia)
- Increased infection risk (fungal, viral)
- Easy bleeding (thrombocytopenia)
What are the oral side effects of radiotherapy?
Osteoradionecrosis (if jaw is affected)
Dry mouth
Fibrosis → Trismus
What is MRONJ and which medication is it associated with?
Medication-Related Osteonecrosis of the Jaw, associated with bisphosphonates.
How should dental health be managed prior to chemotherapy/radiotherapy?
- Full dental assessment (including OPT radiograph)
- Remove hopeless/infected teeth
- Stabilise caries & smooth traumatic edges
- High fluoride toothpaste & varnish
- Diet advice
Why is a dentist important in managing haematology patients?
To prevent infections, manage oral side effects, and ensure a patient’s oral health before/during/after treatment.
What should be done if uncertain about a patient’s haematological condition?
REFER to a specialist!
What are the main phases of clotting?
- Vascular phase – vasoconstriction
- Platelet phase – platelet adhesion & aggregation
- Coagulation phase – fibrin clot formation
- Clot stabilization
- Clot dissolution
What initiates the vascular phase of clotting?
Vessel injury triggers vasoconstriction and releases ADP, tissue factor, and endothelins.
What is the function of platelets in clotting?
Platelets adhere to exposed collagen, aggregate, and release ADP & thromboxane A2 to form a temporary plug.
Name four common antiplatelet medications.
Aspirin, Clopidogrel, Dipyridamole, Ticagrelor.
How does aspirin affect platelet function?
Inhibits COX enzyme, reducing thromboxane A2, preventing platelet aggregation.
What are the two pathways in the coagulation cascade?
- Intrinsic pathway – initiated within the bloodstream.
- Extrinsic pathway – triggered by vessel wall damage.
Name four common Direct Oral Anticoagulants (DOACs).
Rivaroxaban, Apixaban, Edoxaban, Dabigatran.
What is the mechanism of warfarin?
Inhibits vitamin K-dependent clotting factors (II, VII, IX, X).
What are the most common inherited bleeding disorders?
Von Willebrand Disease, Haemophilia A (Factor VIII deficiency), Haemophilia B (Factor IX deficiency).
What is the treatment for Von Willebrand Disease before dental procedures?
Tranexamic acid, DDAVP/desmopressin, or Von Willebrand factor concentrate (based on severity).
What are the symptoms of haemophilia?
Spontaneous bleeding (joints), prolonged bleeding after minor trauma, excessive post-surgical bleeding.
What are the general principles for managing patients on anticoagulants?
- Consult GP/specialist if unsure.
- Plan treatment early in the day/week.
- Use atraumatic techniques and consider suturing.
- Avoid NSAIDs for pain relief (use paracetamol instead).
What blood test is used to monitor warfarin therapy?
INR (International Normalized Ratio).
What is the recommended INR level for safe dental procedures?
INR < 4.
What are two common complications of excessive clotting?
Pulmonary Embolism (PE) & Deep Vein Thrombosis (DVT).
Name three risk factors for thrombophilia.
Prolonged immobility, cancer, pregnancy.
