diseases of the blood 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
2
Q
list some dental procedures which carry a risk to those with inherited bleeding disorders
A
- extraction
- minor oral surgery
- periodontal surgery
- biopsy
3
Q
inherited bleeding disorders may affect 3 things, what are these?
A
coagulation cascade
platelet number/function
combined deficiency
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
5
Q
von willebrands disease is a reduction in which 2 things?
A
factor viii
platelet aggregation
6
Q
name the most common inherited bleeding disorder
A
von willebrands
7
Q
how to you counteract the effect of factor vii and ix inhibitors produced in response to clotting factor treatment?
A
increase dose
8
Q
how do you treat moderate-severe haemophilia A?
A
recombinant factor viii
9
Q
how do you treat mild haemophilia A?
A
DDAVP
10
Q
how does DDAVP work?
A
increases the release of factor viii
11
Q
what is the function of tranxemic acid?
A
slows clot breakdown
12
Q
how is haemophilia B treated?
A
factor ix and tranxemic acid
13
Q
describe the pattern of inheritance for von willebrands disease?
A
autosomal dominence
14
Q
how is von willebrands treated?
A
tranxemic acid and DDAVP
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
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
17
Q
what is the name given to the condition which has the opposite effects of haemophilia?
A
thrombophilia
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
19
Q
reduced no. of platelets is called?
A
thrombocytopenia
20
Q
normal platelet count but abnormal function is known as?
A
qualitative disorder
21
Q
increased platelet no. is known as?
A
thrombocytheamia
22
Q
name the 4 components of blood
A
plasma proteins (albumin, globulin)
lipids
nutrients
water
23
Q
the proportion of RBCs to total blood vol is known as?
A
heamatocrit (HCT)
24
Q
define anaemia
A
low Hb
25
define leukopenia
low WBC
26
define thrombocytopenia
low platelets
27
define pancytopenia
all cells reduced (bone marrow not functioning)
28
define polycythaemia
raised Hb
29
define leukocytosis
raised WBC
30
define thrombocythaemia
raised platelets
31
compare leukaemia and lymphoma
leukaemia - disseminated (goes round circulation)
| lymphoma - solid tumour (not in circulation)
32
which blood type can receive all other types?
AB
33
which blood type can be given to anyone
O
34
name an anti-platelet drug
aspirin
35
name an anticoagulant drug
warfarin
36
an abnormality of haemoglobin metabolism is defined as
porphyria
37
give some examples of things that may cause anaemia
heavy cycles
pregnancy
heavy drinking
GI bleed
38
anaemia can be classified in 3 ways, name these
microcytic (small cells)
normocytic
macrocytic (large cells)
39
what may cause macrocytic anaemia
vit B12 or folic acid deficiency
40
what is pernicious anaemia
vit B12 deficiency due to inability to absorb it
41
list some symptoms of anaemia
```
fatigue
pale
pale mucous membranes
pale conjunctiva
breathlessness
recurrent ulceration
thrush
```
42
which medication is given to treat oral thrush
histatin
43
if a patient has a stomach ulcer and therefore GI bleed, which medications can u not prescribe to them?
ibuprofen or aspirin
44
which type of patients take warfarin
those prone to DVT
valve replacement patients
abnormal heart rhythm
45
which patients take aspirin
taken MI in past
| have angina
46
what is aplastic anaemia?
reduced normal red cell count
47
what usually causes aplastic anaemia?
marrow failure
48
what is haematinic anaemia?
normal red cell count but reduced Hb
49
what name is given to the things needed to make RBCs ?
haematinics
50
name 3 haematinics
iron
vit B12
folate
51
list some dietary sources of iron
meat
green leafy veg
iron tablets
52
iron is absorbed into cells and stored as _?
feratin
53
name 2 diseases which may decrease iron absorption
coeliac
| achlorhydria
54
name dietary sources of vit b12
```
fish
meat
eggs
dairy
fortified soy and rice beverages
```
55
name dietary sources of folic acid
```
leafy greens
seeds and nuts
beans
peas
lentils
vegetables
```
56
a group of inherited conditions that affect a substance in the blood called haemoglobin is called?
thalassaemia
57
what disease is characterised by genetic mutation go globing chains?
thalassaemai
58
an inherited disorder resulting in abnormal globing chains in which red blood cells are not able to efficiently transport O2 is known as?
sickle cell anaemia
59
what is the life span of a RBC?
120 days
60
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?
GI bleed
61
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?
pregnancy
62
microcytic anaemia may be due to?
iron deficiency
| thalassaemia
63
normocytic anaemia is mainly sue to what?
bleed
| chronic renal disease
64
almost mature RBCs are known as?
reticulocytes
65
anaemia with smooth tongue is usually due to deficiency of what?
iron
66
anaemia with beefy tongue is usually due to deficiency of what?
vit B12
67
what does MCV stand for?
mean corpuscle volume
68
low MCV indicates what type of anaemia?
microcytic - iron defficient, thalassaemia
69
above average MCV indicates which type of anaemia?
macrocytic - folate/B12 deficiency, liver disease or hypothyroidism
70
name some myeloid cells
monocytes, macrophages, neutrophils, basophils, eosinophils, erythrocytes, and megakaryocytes to platelets
71
name some lymphoid cells
T cells, B cells, natural killer cells
72
name an acute lymphoid leukaemia
acute lymphoblast leukaemia
73
name 4 chronic lymphoid leukaemias/lymphomas
chronic lymphocytic leukaemia
hodgkins lymphoma
non-hodgkins lymphoma
multiple myeloma
74
name an acute myeloid leukaemia
acute myeloid leukaemia
75
name chronic myeloid leukaemias
chronic myeloid leukaemia
| myeloproliferative disorder
76
which type of leukaemia, acute or chronic kills soon after getting it
acute
77
which type of lymphoma is in the lymph nodes
hodgkins
78
cancer of the bone marrow is known as?
leukaemia
79
what are the 3 clinical presentations of leukaemia?
anaemia
neutropenia (low neutrophil levels - infection)
thrombocytopenia (bleeding)
80
which leukaemia causes WBCs to be released from marrow before they are ready?
acute lymphoblastic leukaemia
81
which leukaemia has a peak age of 4
acute lymphoblastic leukaemia
82
which leukaemia occurs mostly in the elderly and has a low prognosis for those over 70?
acute myeloid leukaemia
83
which leukaemia is known as B cell clonal lymphoproliferative disease?
chronic lyphocytic leukaemia
84
which leukaemia has an increase in neutrophils and their precursors?
chronic myeloid leukaemia
85
what are the 2 types of lymphoma?
hodgkins and non-hodgkins
86
which lymphoma is more common, hodgkins or non hodgkins?
non hodgkins
87
the process of working out which parts of your body are affected by a lymphoma is known as?
staging
88
describe stage 1 lymphoma?
localised disease - single lymph node region or single organ
89
describe stage 2 lymphoma?
2 or more lymph node regions on same side of diaphragm
90
describe stage 3 lymphoma?
2 or more lymph node regions above and below the diaphragm
91
describe stage 4 lymphoma?
wide spread disease - multiple organs with or without lymph node involvement
92
what is the most common type of non hodgkins lymphoma, t cell or b cell?
b cell
93
militant proliferation of plasma cells is known as?
multiple myeloma
94
name 4 treatments for haematological malignancies
chemotherapy
radiotherapy
monoclonal antibodies
haematopoetic stem cell transplant
95
what is thrombophilia?
increased risk of clots developing
96
how may thrombophilia be a risk to the heat and lungs?
part of clots break off and may block chambers of heart or lungs
97
what haematological changes may liver disease cause?
little change to haemoglobin
decreased platelets
increased prothrombin time
98
name 3 types of anti-thrombotic medications
oral anticoagulants
herparins
anti-platelet medication
99
what 3 types of oral anticoagulants can you get?
coumarins
direct factor Xa inhibitors
direct thrombin inhibitors
100
give an example of a coumarin
warfarin
101
give 2 examples of direct factor Xa inhibitors
rivaroxoban and apixaban
102
patients on which medication have regular INR tests
warfarin
103
what's the range of daily dosage of warfarin
1-15mg
104
INR = x/y ?
```
x = patient prothrombin time
y = mean normal prothrombin time
```
105
what is the target inr for warfarin patients?
2-4
106
warfarin works against which vitamin?
K
107
what can be given to immediately reverse the effects of warfarin?
vit k
108
list the treatments you must check a warfarin patients INR for
extraction
minor oral surgery
periodontal surgery
biopsy
109
what INR must a warfarin patient have for treatment to go ahead?
<4
110
you must never extract more than _ roots in patients taking warfain?
3
111
factor viii can be donut bound to which cell type?
endothelial
112
there are 3 types of von willebrands, which type is the worst?
3rd type (recessive)
113
which 3 medications are used to treat von willebrands?
DDAVP
factor viii
tranxemic acid
114
coumarin based anticoagulants inhibit which vitamin k clotting dependant clotting factors?
2,7,9,10
115
what is a downside of using warfarin
drug interactions
116
what effect does liver disease have on INR?
increased INR due to not producing clotting factors
