Haematology

Question 1

What are the important platelet count numbers?

Answer 1

• 100 to take out tooth in GDP
• 50 in hospital

Question 2

What is the normal INR?

Answer 2

• 1

Question 3

What does high MCH mean?

Answer 3

• Macocytic anaemia ( not enough B12/folic acid)

Question 4

What does low urea suggest?

Answer 4

• Sign of liver damage (alcohol abuse)

Question 5

What is Atrial fibrillation?

Answer 5

• Electrical impulses in atria of heart fire irregularly when they should be steady and regular
• Causes them to quiver or twitch (fibrillation)
• Can create blood clots in hearts that may lead to stroke

Question 6

Symptoms of atrial fibrillation?

Answer 6

• Irregular and sometimes fast heartbeat or pulse
• AKA palpitations

Question 7

What is Diabetes?

Answer 7

• Chronic disease that occures when pancreas no longer able to make insulin or body can’t efficiently use the insulin it does produce
• Type 1 , Type 2 and Gestational

Question 8

What are the risks of Diabetes?

Answer 8

• Risk of hypoglycaemic episode
• Increase prevalence, progression and severity of periodontal disease
• Xerostomia
• Oral dysethesia
• Impaired wound healing
• Parotid gland enlargement

Question 9

What is hypertension?

Answer 9

• High blood pressure
• Arteries lose elasticity and become stiff and narrow
• Increases risk of atheroma build up
• This can lead to heart attack or stroke depending on where the arteries lead to

Question 10

What are some causes of hypertension?

Answer 10

• Too much alcohol
• Smoking
• Being overweight
• Sedentary lifestyle
• Too much salt
• Contraceptive pills

Question 11

What is the INR?

Answer 11

• Prothrombin time of pt and dividing it by reference PT plasm value

Question 12

Haemophilia A is a deficiency in what factor?

Answer 12

• VIII

Question 13

Apixaban inhibits what factor?

Answer 13

• Factor Xa

Question 14

When assessing bleeding risk is extraction of a single tooth a high risk procedure?

Answer 14

• No

Question 15

A person with moderate Haemophilia has what percentage of normal factor in their blood?

Answer 15

• 1-5%

Question 16

Von Willebrands Type 2 is normally mamaged with which product to manage bleeding?

Answer 16

• Factor VIII concentrate

Question 17

What does Prothrombin time measure?

Answer 17

• Factors VII, X, V, Prothrombin and Fibrinogen

Question 18

What does activated partial thromboplastin time (APTT) measure?

Answer 18

• Factors VIII, IX, XI, XII and factors X, V, prothrombin and fibrinogen

Question 19

The APTT would be deranged in what pt?

Answer 19

• Haemophillia

Question 20

The prothrombin time would be deranged in what pt?

Answer 20

• Liver disease
• Warfarin therapy

Question 21

What is Haemophilia B a deficiency in?

Answer 21

• Factor IX

Question 22

How does a haemophilia diagnosis affect txt?

Answer 22

• Dental XLA, surgical procedures, subgingival scaling or anaesthesia requiring IANB then need to be seen at dental clinic ass with haemophilia centre
• Increased risk of bleeding
• May need medical prophylaxis and appropriate monitoring

Question 23

What do we want to reduce the number of times a pt is exposed to these things?

Answer 23

• Risk of blood borne virus if plasma derived factor used
• Risk of local site infection
• Risk of inhibitors/antibodies developing
• Cpst

Question 24

What are pt with mild haemophilia or Von Willebrands disease given for dental procedures of increased bleeding risk?

Answer 24

• DDAVP (desmopressin)
• Tranexamic (antifibrolytic agent)

Question 25

What are pt with moderate and severe haemophilia given for dental procedure of increased bleeding risk?

Answer 25

• Factor replacement
• Tranexamic acid

Question 26

What are some common bleeding disorders?

Answer 26

• Haemophilia A/B
• Von Willebrands