Haematology Flashcards
where is the cellular component of blood produced?
marrow
what does a full blood count measure?
number and size of cells
what is the condition associated with lack of haemoglobin?
anaemia
cells that are too big are?
too small?
macrocytic
microcytic
what is WCC?
quantity of white blood cells
too many white blood cells?
too few?
leucocytosis
leukopenia
too few platelets?
too many?
thrombocytopenia
thrombocythaemia
what is a blood film test?
smear of red blood cells examined under a microscope
what is neutrophilia?
increase in neutrophil production caused by an acute infection
what is malaria?
red blood cells deteriorate because of parasites
how are bone marrow samples done?
taken from iliac crest/sternum
what are tests to measure coagulation?
activated prothrombin time APTT
INR
what pathway causes APTT?
what is a normal prothrombin time?
intrinsic pathway
12-13 secs
reasons for lack of haemoglobin in anaemia?
lack of raw materials
production problems
longevity problems
what raw materials are needed for haemoglobin to form?
iron, vit B12, folate
erythropoietin
why might there be a lack of iron and folic acid?
usually dietary, rarely malabsorption
increase in lack of when pregnant
lack of vit b12 caused by?
what kind of anaemia does it cause?
autoimmune diseases affect absorption of B12
pernicious anaemia
what do you see on a blood film of someone with anaemia?
very pale cells = hypochromic
micocytic smaller cells
why might there be production problems to do with erythropoiten?
renal failure
reasons for production problems do to with bone marrow ?
aplastic anaemia - no cells
chemotherapy/immunosuppressants
haematological malignancy
anaemia of chronic disease - any chronic inflam process
what are reasons for blood loss causing lack of haemoglobin?
bowel - majority
menstruation
trauma/post op
other organs - unusual
wjhat is haemolysis?
destruction of cells in circulation
e.g autoimmunity, sickle cell anaemia, thalassemia
lack of what raw materials cause macorcytic cells?
B12, folate deficiency
what are some symptoms of anaemia?
tired, weak, breathless, dizzy, palpitations
signs of anaemia?
pale, rapid pulse, oral feautres
management of anaemia?
history and exam
establish type - fbc, blood film, levels of iron, folate, b12
treatment of anaemia?
iron sulphate folic acid, B12
erythropoietin
severe/symptomatic - blood transfusion
dental - oral abnormalities caused by?
why be careful with GA?
what should you verify in an anaemic pt?
iron, b12, folate
o2 capacity reduced,
sickle cell status
what is a neutropenia? caused by?
an inadequate number of neutrophils
bone marrow failure, auntoimmune disease
what infections can occur in the mouth?
candida, viral herpes simplex, commensal bacteria
dentally be aware of what? do to with white blood cell disorders
chemo pts - bone marrow affected
be aware of who is at risk
avoid invasive tx
what is leukemia?
proliferation of immature cells in blood/bone marrow
what is lymphoma?
proliferation of lymphocytes
confined to nodes, liver, spleen, bone marrow
acute leukaemia, acute - common in who? what is seen on a blood film?
kids
full of lymphocytes
chronic leukaemia, common in who?
adults
can transform to acute
increased risk of what with leukaemia?
risk of infection, anaemia, bleeding
types of lymphoma?
hodgkins, non hodgkins
hodgkins lymphoma systemic factors?
lymphadenopathy
fever, weight loss, night sweats
non hodgkins common in?
prognosis?
older pt’s
poorer
tx of lymphoma?
transfusions, infection management chemo radio bone marrow transplant - autologous, allogenic novel therapies
dental relevance of lymphomas?
atypical infections, bleeding, lymphadenopathy, gum infiltration
what does rate of coagulation depend on?
number and functioning ability of platelets
3 stages of a clot formation?
vasoconstriction, platelet aggregation, coagulation cascade
problems with platelets forming?
deficiencys of raw materials
production - bone marrow failure
destruction - immune mediated
immune mediated conditions causing platelet destruction?
portal hypertension - spleen sequestrian
auntoimmune thrombocytopenic purpura
aggregation problems - reason? tx?
platelet function impaired/ medical therapy - aspririn or copidogrel
tx of underlying cause
platelet transfusion maybe necessary
coagulation cascade problems?
gen deficiency ?
specific deficiency?
gen - protein - liver disease/malnutrition
spec. - coagulation - haemophilia, von wilebrands disease
drugs - warfarin/heparin
what is haemophilia A? B?
A - x lined genetic disorder - absence of VIII clotting factor
B - “ , IX clotting factor
what is von wilebrands disease?
autosomal dominant - platelet factor VIII function problem
tx of lack of clotting factors?
factor replacement, prophylactic
what does DDAVP do?
increases factor VIII levels
what does tranexamic acid do?
inhibits clot breakdown
dentally, what to be aware of with pt’s with coagulation problems?
risk management, trauma avoidance, prep for suspected bleeding
associated conditions - HIV, hepatitis
what is warfarin used for?
atrial fib, heart valves, PE, DVT
interferes with clotting factor activity
INR checked
what is heparin used for?
DVT, PE
injectable
what is - petechiae, purpura, ecchymoses?
cutaneous bleeding
larger bleeds
brusing bc bleeding
what is menhagva? haemoturina?
excess menstrual bleeding
urinary tract bleeding
