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biological and medical sciences 2 > diseases of the blood > Flashcards

diseases of the blood Flashcards

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USMLE® Step 1 flashcards
1
Q

list some dental procedures which carry no risk to those with inherited bleeding disorders

A
  • hygiene phase therapy
  • rpd
  • restorative
  • endo
  • orthodoxy
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2
Q

list some dental procedures which carry a risk to those with inherited bleeding disorders

A
  • extraction
  • minor oral surgery
  • periodontal surgery
  • biopsy
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3
Q

inherited bleeding disorders may affect 3 things, what are these?

A

coagulation cascade
platelet number/function
combined deficiency

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4
Q

name 4 common inherited bleeding disorders

A 
haemophilia A (factor viii deficiency)
haemophilia B (christmas disease/factor ix deficiency)
von willebrands 
factor xi deficiency
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5
Q

von willebrands disease is a reduction in which 2 things?

A

factor viii

platelet aggregation

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6
Q

name the most common inherited bleeding disorder

A

von willebrands

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7
Q

how to you counteract the effect of factor vii and ix inhibitors produced in response to clotting factor treatment?

A

increase dose

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8
Q

how do you treat moderate-severe haemophilia A?

A

recombinant factor viii

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9
Q

how do you treat mild haemophilia A?

A

DDAVP

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10
Q

how does DDAVP work?

A

increases the release of factor viii

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11
Q

what is the function of tranxemic acid?

A

slows clot breakdown

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12
Q

how is haemophilia B treated?

A

factor ix and tranxemic acid

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13
Q

describe the pattern of inheritance for von willebrands disease?

A

autosomal dominence

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14
Q

how is von willebrands treated?

A

tranxemic acid and DDAVP

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15
Q

name the LA injections which are safe to carry out in those with inherited bleeding disorders

A
  • buccal infiltration
  • intraligamentary injection
  • intrapapillary injection
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16
Q

name the LA injections which are not safe to carry out in those with inherited bleeding disorders

A
  • IDB
  • lingual infiltration
  • posterior superior nerve block
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17
Q

what is the name given to the condition which has the opposite effects of haemophilia?

A

thrombophilia

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18
Q

thrombophilia can be acquired or inherited, name the 4 inherited deficiencies that cause thrombophilia?

A
  • protein c
  • protein s
  • factor V leiden
  • antithrombin iii
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19
Q

reduced no. of platelets is called?

A

thrombocytopenia

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20
Q

normal platelet count but abnormal function is known as?

A

qualitative disorder

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21
Q

increased platelet no. is known as?

A

thrombocytheamia

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22
Q

name the 4 components of blood

A

plasma proteins (albumin, globulin)
lipids
nutrients
water

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23
Q

the proportion of RBCs to total blood vol is known as?

A

heamatocrit (HCT)

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24
Q

define anaemia

A

low Hb

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25
Q

define leukopenia

A

low WBC

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26
Q

define thrombocytopenia

A

low platelets

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27
Q

define pancytopenia

A

all cells reduced (bone marrow not functioning)

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28
Q

define polycythaemia

A

raised Hb

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29
Q

define leukocytosis

A

raised WBC

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30
Q

define thrombocythaemia

A

raised platelets

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31
Q

compare leukaemia and lymphoma

A

leukaemia - disseminated (goes round circulation)

lymphoma - solid tumour (not in circulation)

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32
Q

which blood type can receive all other types?

A

AB

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33
Q

which blood type can be given to anyone

A

O

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34
Q

name an anti-platelet drug

A

aspirin

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35
Q

name an anticoagulant drug

A

warfarin

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36
Q

an abnormality of haemoglobin metabolism is defined as

A

porphyria

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37
Q

give some examples of things that may cause anaemia

A

heavy cycles
pregnancy
heavy drinking
GI bleed

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38
Q

anaemia can be classified in 3 ways, name these

A

microcytic (small cells)
normocytic
macrocytic (large cells)

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39
Q

what may cause macrocytic anaemia

A

vit B12 or folic acid deficiency

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40
Q

what is pernicious anaemia

A

vit B12 deficiency due to inability to absorb it

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41
Q

list some symptoms of anaemia

A 
fatigue
pale
pale mucous membranes
pale conjunctiva
breathlessness
recurrent ulceration
thrush
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42
Q

which medication is given to treat oral thrush

A

histatin

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43
Q

if a patient has a stomach ulcer and therefore GI bleed, which medications can u not prescribe to them?

A

ibuprofen or aspirin

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44
Q

which type of patients take warfarin

A

those prone to DVT
valve replacement patients
abnormal heart rhythm

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45
Q

which patients take aspirin

A

taken MI in past

have angina

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46
Q

what is aplastic anaemia?

A

reduced normal red cell count

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47
Q

what usually causes aplastic anaemia?

A

marrow failure

48
Q

what is haematinic anaemia?

A

normal red cell count but reduced Hb

49
Q

what name is given to the things needed to make RBCs ?

A

haematinics

50
Q

name 3 haematinics

A

iron
vit B12
folate

51
Q

list some dietary sources of iron

A

meat
green leafy veg
iron tablets

52
Q

iron is absorbed into cells and stored as _?

A

feratin

53
Q

name 2 diseases which may decrease iron absorption

A

coeliac

achlorhydria

54
Q

name dietary sources of vit b12

A 
fish
meat
eggs
dairy
fortified soy and rice beverages
55
Q

name dietary sources of folic acid

A 
leafy greens
seeds and nuts
beans
peas
lentils
vegetables
56
Q

a group of inherited conditions that affect a substance in the blood called haemoglobin is called?

A

thalassaemia

57
Q

what disease is characterised by genetic mutation go globing chains?

A

thalassaemai

58
Q

an inherited disorder resulting in abnormal globing chains in which red blood cells are not able to efficiently transport O2 is known as?

A

sickle cell anaemia

59
Q

what is the life span of a RBC?

A

120 days

60
Q

anaemia may be due to increased loss of cells or increased demand, give an example of when there may be an increase in loss of Hb?

A

GI bleed

61
Q

anaemia may be due to increased loss of cells or increased demand, give an example of when there may be an increase in demand of Hb?

A

pregnancy

62
Q

microcytic anaemia may be due to?

A

iron deficiency

thalassaemia

63
Q

normocytic anaemia is mainly sue to what?

A

bleed

chronic renal disease

64
Q

almost mature RBCs are known as?

A

reticulocytes

65
Q

anaemia with smooth tongue is usually due to deficiency of what?

A

iron

66
Q

anaemia with beefy tongue is usually due to deficiency of what?

A

vit B12

67
Q

what does MCV stand for?

A

mean corpuscle volume

68
Q

low MCV indicates what type of anaemia?

A

microcytic - iron defficient, thalassaemia

69
Q

above average MCV indicates which type of anaemia?

A

macrocytic - folate/B12 deficiency, liver disease or hypothyroidism

70
Q

name some myeloid cells

A

monocytes, macrophages, neutrophils, basophils, eosinophils, erythrocytes, and megakaryocytes to platelets

71
Q

name some lymphoid cells

A

T cells, B cells, natural killer cells

72
Q

name an acute lymphoid leukaemia

A

acute lymphoblast leukaemia

73
Q

name 4 chronic lymphoid leukaemias/lymphomas

A

chronic lymphocytic leukaemia
hodgkins lymphoma
non-hodgkins lymphoma
multiple myeloma

74
Q

name an acute myeloid leukaemia

A

acute myeloid leukaemia

75
Q

name chronic myeloid leukaemias

A

chronic myeloid leukaemia

myeloproliferative disorder

76
Q

which type of leukaemia, acute or chronic kills soon after getting it

A

acute

77
Q

which type of lymphoma is in the lymph nodes

A

hodgkins

78
Q

cancer of the bone marrow is known as?

A

leukaemia

79
Q

what are the 3 clinical presentations of leukaemia?

A

anaemia
neutropenia (low neutrophil levels - infection)
thrombocytopenia (bleeding)

80
Q

which leukaemia causes WBCs to be released from marrow before they are ready?

A

acute lymphoblastic leukaemia

81
Q

which leukaemia has a peak age of 4

A

acute lymphoblastic leukaemia

82
Q

which leukaemia occurs mostly in the elderly and has a low prognosis for those over 70?

A

acute myeloid leukaemia

83
Q

which leukaemia is known as B cell clonal lymphoproliferative disease?

A

chronic lyphocytic leukaemia

84
Q

which leukaemia has an increase in neutrophils and their precursors?

A

chronic myeloid leukaemia

85
Q

what are the 2 types of lymphoma?

A

hodgkins and non-hodgkins

86
Q

which lymphoma is more common, hodgkins or non hodgkins?

A

non hodgkins

87
Q

the process of working out which parts of your body are affected by a lymphoma is known as?

A

staging

88
Q

describe stage 1 lymphoma?

A

localised disease - single lymph node region or single organ

89
Q

describe stage 2 lymphoma?

A

2 or more lymph node regions on same side of diaphragm

90
Q

describe stage 3 lymphoma?

A

2 or more lymph node regions above and below the diaphragm

91
Q

describe stage 4 lymphoma?

A

wide spread disease - multiple organs with or without lymph node involvement

92
Q

what is the most common type of non hodgkins lymphoma, t cell or b cell?

A

b cell

93
Q

militant proliferation of plasma cells is known as?

A

multiple myeloma

94
Q

name 4 treatments for haematological malignancies

A

chemotherapy
radiotherapy
monoclonal antibodies
haematopoetic stem cell transplant

95
Q

what is thrombophilia?

A

increased risk of clots developing

96
Q

how may thrombophilia be a risk to the heat and lungs?

A

part of clots break off and may block chambers of heart or lungs

97
Q

what haematological changes may liver disease cause?

A

little change to haemoglobin
decreased platelets
increased prothrombin time

98
Q

name 3 types of anti-thrombotic medications

A

oral anticoagulants
herparins
anti-platelet medication

99
Q

what 3 types of oral anticoagulants can you get?

A

coumarins
direct factor Xa inhibitors
direct thrombin inhibitors

100
Q

give an example of a coumarin

A

warfarin

101
Q

give 2 examples of direct factor Xa inhibitors

A

rivaroxoban and apixaban

102
Q

patients on which medication have regular INR tests

A

warfarin

103
Q

what’s the range of daily dosage of warfarin

A

1-15mg

104
Q

INR = x/y ?

A 
x = patient prothrombin time
y = mean normal prothrombin time
105
Q

what is the target inr for warfarin patients?

A

2-4

106
Q

warfarin works against which vitamin?

A

K

107
Q

what can be given to immediately reverse the effects of warfarin?

A

vit k

108
Q

list the treatments you must check a warfarin patients INR for

A

extraction
minor oral surgery
periodontal surgery
biopsy

109
Q

what INR must a warfarin patient have for treatment to go ahead?

A

<4

110
Q

you must never extract more than _ roots in patients taking warfain?

A

3

111
Q

factor viii can be donut bound to which cell type?

A

endothelial

112
Q

there are 3 types of von willebrands, which type is the worst?

A

3rd type (recessive)

113
Q

which 3 medications are used to treat von willebrands?

A

DDAVP
factor viii
tranxemic acid

114
Q

coumarin based anticoagulants inhibit which vitamin k clotting dependant clotting factors?

A

2,7,9,10

115
Q

what is a downside of using warfarin

A

drug interactions

116
Q

what effect does liver disease have on INR?

A

increased INR due to not producing clotting factors

biological and medical sciences 2 (11 decks)

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