Haematology Flashcards
What is atrial fibrillation?
- AF happens when electrical impulses in the atria of the heart fire irregularly
- Causes an irregular/ fast heart beat.
- Can create blood clots in the heart which may lead to stroke
What is diabetes?
- Pancreas no longer able to make insulin/ body becomes insensitive to insulin causing abnormal blood glucose levels.
- Chronic high blood glucose levels associated with tissue damage and organ failure (cataracts, neuropathy)
What are the dental implications of diabetes?
- Poor wound healing
- Xerostomia
- Oral dysesthesia (burning mouth syndrome)
- Periodontal disease
What is hypertension?
- High blood pressure
- Can lead to heart attack/ stroke, kidney failure, vascular dementia.
- Arteries lose stretch and become narrow, easier for a thrombus to occlude lumen.
What is frusemide?
- loop diuretic (for hypertension)
- decreases fluid in body
What is metformin?
- Anti-hyperglycaemic drug - enhances insulin sensitivity
- Can reduce vitamin B12 levels (anaemia risk)
What is a side effect of sulfonylureas?
Reduced factor VIII and reduced platelet aggregation
How is pseudomembranous candidiasis managed?
- Assess risk factors - diabetic control, medications, anaemia, ill fitting denture
- Denture hygiene advice
- Antifungal medication - miconazole contraindicated with warfarin, nystatin safe to use for warfarin
Why is joint swelling significant in haemophilia patients?
- Swelling is likely to be a haemarthrosis - bleeding into joint space (associated with haemophilia)
- This can cause damage to articular cartilage in joint- bone resorption and cyst formation.
What is haemophilia A?
Deficiency in factor VIII (most common)
What is haemophilia B?
Deficiency in factor IX
What procedures are safe for haemophilia patients?
- Treatment which doesn’t require manipulation of mucosa
- ID block contraindication (articaine infil instead)
What is DDVAP?
- Desmopressin
- Releases factor VIII that has been bound to endothelial cells, giving a temporary boost
What is tranexamic acid?
Inhibitor of fibrinolysis (keeps clot formed)
How are patients with severe haemophilia classed and managed?
<1% of factor
Recombinant factor
Haemophilia A is a deficiency of which factor?
VIII
Apixiban inhibits which factor?
Factor Xa
A person with moderate haemophilia has what percentage of normal factor in their blood?
1-5%
Von Willibrands 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
-Moderate Haemophilia B
-Type 3 Von Willebrand’s Disease
-Mild Haemophilia A
-Type 2a Von Willebrand’s Disease
-All of the above
All of the above
Takes the medication warfarin with associated blood testing every week and requires a single tooth extraction.
What is the most appropriate management strategy?
INR required within 24 hours
Takes the medications aspirin and clopidogrel following a STEMI two weeks ago and requires the extraction of two asymptomatic teeth.
What is the most appropriate management strategy?
Delay extractions until 6 month point
Takes the medication Rivaroxaban once a day in the morning and requires the extraction of 5 teeth at 0900 in the morning.
What is the most appropriate management strategy?
Delay the morning dose and take it four hours after haemostatis has been achieved
Takes the medication Dabigatran and requires the surgical extraction of two teeth at 0900 in the morning
Most appropriate management?
Miss the morning dose of medication and take the evening dose as usual
