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BDS2 BAMS Diseases of the blood > Disorders of the blood > Flashcards

Disorders of the blood Flashcards

1
Q

What are the functions of the blood

A
  • transport of nutrients
  • removal of waste
  • transport host defences
  • ability to carry nutrients/waste/defences
  • ability to self repair
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2
Q

what are the components of blood

A
  • cell component
  • plasma proteins (albumin, globulin)
  • lipids
  • nutrients
  • water
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3
Q

What is FBC

A

full blood count

will measure all the cells in the blood

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4
Q

What is RBC

A

red blood cells

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5
Q

What is RCC

A

red cell count

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6
Q

What is WCC

A

white cell count

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7
Q

What is PLT

A

platelets

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8
Q

What is HCT

A

hematocrit

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9
Q

What is MCV

A

mean cell volume

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10
Q

What is the hematocrit

A

what is the proportional value that is cell and liquid

usually ~0.4-0.5
if high = viscous/clotting problems

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11
Q

Define anaemia

A

low Hb

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12
Q

Define leukopenia

A

low WCC

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13
Q

Define thrombocytopenia

A

low platelets

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14
Q

Define pancytopenia

A

all cells reduced

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15
Q

If you have one of anaemia/ leukopenia/thrombocytopenia or pancytopenia what might this indicate

A

reactive change to environment

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16
Q

If you have multiple of anaemia/ leukopenia/thrombocytopenia or pancytopenia what might this indicate

A

bone marrow failure

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17
Q

Define polycythaemia

A

raised Hb

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18
Q

Define leukocytosis

A

raised WCC

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19
Q

Define thrombocythaemia

A

raised platelets

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20
Q

If you have one of polycythaemia/ leukocytosis/ thrombocythaemia what might this indicate

A

reactive or pre-neoplastic

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21
Q

If you have multiple of polycythaemia/ leukocytosis/ thrombocythaemia what might this indicate

A

pre-neoplastic (myelodysplasia)

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22
Q

Define leukaemia

A

neoplastic proliferation of white cells, usually disseminated

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23
Q

Define lymphoma

A

neoplastic proliferation of white cells, usually a solid tumour

24
Q

Why might someone have to get a blood transfusion?

A
  • where one or more components of the blood has to be replace quickly (RBCs, platelets, clotting factors)
  • where the bone marrow cannot produce blood cells (red cells, platelets)
25
Q

What are the blood antigens

A 
ABO system (A,B,O,AB)
D system (rhesus, + ro -)

n.b. there are others too

26
Q

Why if possible should we avoid blood transfusions

A

we don’t always know what is in the blood e.g. HepC didn’t used to test for as didn’t know it existed

27
Q

What is a safe way to have a blood transfusion

A

giving yourself one
e.g. a hip operation
(if you know in advance you can store blood from the patient, patient replaces blood before the operation)

28
Q

What is the process of a blood transfusion

A
  • sample taken from patient
  • tested against known blood types
    (ABO and rhesus compatability)
  • tested against donated sample
  • matched blood given to patient
29
Q

what antibodies does group AB have

A

none

30
Q

What antigens does group B have

A

B

31
Q

what antibodies does group O have

A

Anti A and B

32
Q

what antibodies does group A have

A

Anti -B

33
Q

what antigens does group O have

A

none

34
Q

what antigens does group AB have

A

A and B

35
Q

what antibodies does group B have

A

Anti -A

36
Q

what is cross matching

A

when you mix blood from groups with different antibodies to see if they react

37
Q

what happens when blood reacts with the antibodies it is cross matched with

A

coagulation

38
Q

What are some possible transfusion complications

A
  • incompatible blood (RBC lysis)
  • fluid overload (Heart failure)
  • transmission of infection (blood borne viruses, prions, bacterial infections)
39
Q

As dentists what do we need to know about haemostatic disorders

A
  • that coagulation is a continuous process
  • understand principles of investigating a patient with a bleeding disorder
  • know what investigations to ask for
40
Q

What are the 3 components that can be abnormal in someone with a haemostatic disorder

A
  • vascular component (retraction of vessel-collagen disorder)
  • cellular component (platelets number and function)
  • coagulation component (adequate clotting, adequate lysis)
41
Q

How does aspirin/ NSAIDs affect platelets

A

reduces clotting ability for the lifetime of platelets present when dose taken (7-10 days)

42
Q

what can be abnormal about the coagulation component of blood

A
  • amount of clotting factors
  • range of clotting factors
  • balance between thrombotic and thrombolytic systems

(X linked condition)

43
Q

What happens in disseminated intravascular coagulation (DIC)

A

a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding.

44
Q

What clinical signs might someone with a clotting disorder present with

A

history of prolonged bleeding

  • after extractions
  • after minor cuts

visual signs

  • pupura (purple blotches on skin)
  • ecchymosis
  • petechniae
45
Q

What investigations can you do on someone with a suspected clotting disorder

A
  • FBC (platelet numbers)
  • Bleeding time (platelet function)
  • INR and APPT
  • LFT (clotting factor synthesis

(FBC and INR are main ones)

46
Q

What does an INR test

A

how well you can produce a clot, testing how well the system works and can you make clotting factors, do they have enough clotting factors

1 = normal
the higher the number the thinner the blood

47
Q

Characteristics of haemophilia?

A
  • inherited deficiency of VIII or IX
  • males affected, females carriers
  • can be mild, moderate, severe
  • treatment led to HBV, HCV and HIV (now treated using e.coli with genetic enginerring to make more factor VIII)
48
Q

What is thrombophilia

A

excessive tendency to clot - usually DVT

49
Q

what can exacerbate thrombophilia

A 
smoking
immobiliity
surgery
pregnancy
medicines (OCP)
50
Q

what is therapeutic coagulopathy

A

where the coagulation system is manipulated by medicine to make clotting less likely

51
Q

how is therapeutic coagulopathy achieved

A

reduce platelet adhesion and function
(usuallly prevent arterial thrombosis)

reduce activity in the coagulation cascade (usually prevent venous thrombosis)

52
Q

where do I look if i have a patient with a bleeding disorder

A

SDCEP (anticoagulant/antiplatelet)

53
Q

What is the standard anticoagulant drug

A

warfarin

54
Q

what drugs are coming to replace warfarin

A
  • apixaban
  • dabigatran
  • rivaroxaban
55
Q

As a dentist what’s important to think/ do about bleeding problems

A
  • always ask about bleeding problems
  • always look for bleeding problems
  • if in doubt test first (INR)
  • if known haemostatic problem ask advice
  • follow avaliable SDCEP guidance for dental care delivery
  • remember local haemostatic measures
56
Q

what do i need to know about porphyria

A

that it’s bad

(abnormality or haem metabolism, 1:10000 population, 2 main groups, most people don’t know they have them until they have an acute episode)

(photosensitive rash, neuropsychiatric disturbance in acute attacks, hypertension and tachycardia, may be fatal)

triggers are poorly understood (drugs including LA, pregnancy, acute infections, alcohol, fasting)

BDS2 BAMS Diseases of the blood (3 decks)

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