haematology Flashcards
2 symptoms of AF
palpitations
flutter
hyperglycaemia meaning
raised glucose levels in blood
describe type 1diabetes
more frequent in children
little or no insulin produced
need daily injections of insulin
describe T2 diabetes
more common in adults
body does not make good use of insulin produced
linked to unhealthy lifestyle
require oral drugs
HbA1c is 5.7-6.4%
prediabetes
target HbA1c for type 2 diabetic
less than 6.5%
HbA1c is greater than 6.5%
diabetes
below 5.7% HbA1c
healthy
risk factors of hypertension
smoking
obesity
genetics
what is furosemide and what is it used for
loop diuretic
hypertension
INR in healthy individual
1
what condition has target INR of 2.5
AF
DVT
pulmonary embolism
what condition has target INR of 3.5
recurrent DVT
mechanical prosthetic heart valves
how to calculate INR
PT /reference PT plasma
(prothrombin time is PT)
treatment plan structure
Acute
Prevention
Stabilisation
Restorative/Definite
Maintenance
patient has unstable INR
what causes change in INR
poor warfarin control
what treatment are you willing to do on INR 4
BPE
OHI
supragingival scaling
haemophilia A is deficiency in which factor
8
abixaban inhibits which factor
factor Xa
The extraction of a single tooth is a high risk procedure when assessing bleeding risk : true or false
false
management of pt who takes the medications aspirin and clopidogrel following a STEMI two weeks ago and requires the extraction of two asymptomatic teeth
delay extractions until 6 months
management of pt who Takes the medication Apixaban and requires a single extraction
do not change drug regime
management of pt who Takes the medication Dabigatran and requires the surgical extraction of two teeth at 0900 in the morning
miss morning dose and take evening dose
management of pt who Takes the medication Rivaroxaban once a day in the morning and requires the extraction of 5 teeth at 0900 in the morning
delay morning dose and take evening dose 4 hrs after haemostasis achieved
A person with Moderate Haemophilia has what percentage of normal factor in their blood?
1-5%
Von Willebrand’s Type 2 is normally managed with which product to manage bleeding?
Factor VIII Concentrate
Augmentation of factor levels is required for which of the inherited bleeding conditions:
Select one:
a.
Mild Haemophilia A
b.
Type 2a Von Willebrand’s Disease
c.
All of the above
d.
Type 3 Von Willebrand’s Disease
e.
Moderate Haemophilia B
all of above
The activated partial thromboplastin time (APTT) would be deranged in
haemophilia
The prothrobin time (PT) would be deranged in
liver disease of warfarin therapy
Protrhombin time (PT) measures:
Factors 5 7 10 prothrombin and fibrinogen
(three factors prothrombin and fibrinogen)
Activated partial thromoboplastin time (APTT) measures:
Factors 5 8 9 10 11 12 and prothrombin and fibrinogen
(seven factors prothrombin and fibrinogen)
A patient with moderate Haemophilia A requires factor cover for supra-gingival scaling - true or false
false
Topical miconazole for the management of oral candidosis presents a risk for patients prescribed Warfarin by potentiating bleeding? true or false
true
management of pseudomembranous candidiosis in patient taking warfarin
toothbrush or gauze to clean palate
OHI denture hygiene
remove denture at night
nystatin
why might you consider making a new acrylic denture for pt with pseudomembranous candidiosis
candidate species have ability to penetrate acrylic
2 drug contraindications of miconazole and why
warfarin as increases potentiates effect
statin as risk of myopathy
A person with severe Haemophilia has what percentage of normal factor in their blood?
<1%
A person with mild Haemophilia has what percentage of normal factor in their blood?
6-40%
how long before appointment should you check INR
ideally 24 hrs before but 72 if stable
local heamostatic measures
LA with vasoconstrictor by infiltration
pack sockets Wirth oxidised cellulose (surgicel)
sutures
pressure to socket after closure for 20 mins
post op instruction
avoid smoking and alcohol
avoid rinsing the mouth for 24 hours,
do not disturb the socket
avoid hot liquids and hard foods for the day
to avoid chewing on the affected side
Care should then be taken to avoid dislodging the clot
if bleeding apply pressure using damp gauze for 20 minutes. If bleeding persists, the dentist should be contacted
Give contact details
Analgesia advice
