Haematology

Question 1

where is the cellular component of blood produced?

Answer 1

marrow

Question 2

what does a full blood count measure?

Answer 2

number and size of cells

Question 3

what is the condition associated with lack of haemoglobin?

Answer 3

anaemia

Question 4

cells that are too big are?

too small?

Answer 4

macrocytic

microcytic

Question 5

what is WCC?

Answer 5

quantity of white blood cells

Question 6

too many white blood cells?

too few?

Answer 6

leucocytosis

leukopenia

Question 7

too few platelets?

too many?

Answer 7

thrombocytopenia

thrombocythaemia

Question 8

what is a blood film test?

Answer 8

smear of red blood cells examined under a microscope

Question 9

what is neutrophilia?

Answer 9

increase in neutrophil production caused by an acute infection

Question 10

what is malaria?

Answer 10

red blood cells deteriorate because of parasites

Question 11

how are bone marrow samples done?

Answer 11

taken from iliac crest/sternum

Question 12

what are tests to measure coagulation?

Answer 12

activated prothrombin time APTT

INR

Question 13

what pathway causes APTT?

what is a normal prothrombin time?

Answer 13

intrinsic pathway

12-13 secs

Question 14

reasons for lack of haemoglobin in anaemia?

Answer 14

lack of raw materials
production problems
longevity problems

Question 15

what raw materials are needed for haemoglobin to form?

Answer 15

iron, vit B12, folate

erythropoietin

Question 16

why might there be a lack of iron and folic acid?

Answer 16

usually dietary, rarely malabsorption

increase in lack of when pregnant

Question 17

lack of vit b12 caused by?

what kind of anaemia does it cause?

Answer 17

autoimmune diseases affect absorption of B12

pernicious anaemia

Question 18

what do you see on a blood film of someone with anaemia?

Answer 18

very pale cells = hypochromic

micocytic smaller cells

Question 19

why might there be production problems to do with erythropoiten?

Answer 19

renal failure

Question 20

reasons for production problems do to with bone marrow ?

Answer 20

aplastic anaemia - no cells
chemotherapy/immunosuppressants
haematological malignancy
anaemia of chronic disease - any chronic inflam process

Question 21

what are reasons for blood loss causing lack of haemoglobin?

Answer 21

bowel - majority
menstruation
trauma/post op
other organs - unusual

Question 22

wjhat is haemolysis?

Answer 22

destruction of cells in circulation

e.g autoimmunity, sickle cell anaemia, thalassemia

Question 23

lack of what raw materials cause macorcytic cells?

Answer 23

B12, folate deficiency

Question 24

what are some symptoms of anaemia?

Answer 24

tired, weak, breathless, dizzy, palpitations

Question 25

signs of anaemia?

Answer 25

pale, rapid pulse, oral feautres

Question 26

management of anaemia?

Answer 26

history and exam | establish type - fbc, blood film, levels of iron, folate, b12

Question 27

treatment of anaemia?

Answer 27

iron sulphate folic acid, B12 erythropoietin severe/symptomatic - blood transfusion

Question 28

dental - oral abnormalities caused by? why be careful with GA? what should you verify in an anaemic pt?

Answer 28

iron, b12, folate o2 capacity reduced, sickle cell status

Question 29

what is a neutropenia? caused by?

Answer 29

an inadequate number of neutrophils | bone marrow failure, auntoimmune disease

Question 30

what infections can occur in the mouth?

Answer 30

candida, viral herpes simplex, commensal bacteria

Question 31

dentally be aware of what? do to with white blood cell disorders

Answer 31

chemo pts - bone marrow affected be aware of who is at risk avoid invasive tx

Question 32

what is leukemia?

Answer 32

proliferation of immature cells in blood/bone marrow

Question 33

what is lymphoma?

Answer 33

proliferation of lymphocytes | confined to nodes, liver, spleen, bone marrow

Question 34

acute leukaemia, acute - common in who? what is seen on a blood film?

Answer 34

kids | full of lymphocytes

Question 35

chronic leukaemia, common in who?

Answer 35

adults | can transform to acute

Question 36

increased risk of what with leukaemia?

Answer 36

risk of infection, anaemia, bleeding

Question 37

types of lymphoma?

Answer 37

hodgkins, non hodgkins

Question 38

hodgkins lymphoma systemic factors?

Answer 38

lymphadenopathy | fever, weight loss, night sweats

Question 39

non hodgkins common in? | prognosis?

Answer 39

older pt's | poorer

Question 40

tx of lymphoma?

Answer 40

``` transfusions, infection management chemo radio bone marrow transplant - autologous, allogenic novel therapies ```

Question 41

dental relevance of lymphomas?

Answer 41

atypical infections, bleeding, lymphadenopathy, gum infiltration

Question 42

what does rate of coagulation depend on?

Answer 42

number and functioning ability of platelets

Question 43

3 stages of a clot formation?

Answer 43

vasoconstriction, platelet aggregation, coagulation cascade

Question 44

problems with platelets forming?

Answer 44

deficiencys of raw materials production - bone marrow failure destruction - immune mediated

Question 45

immune mediated conditions causing platelet destruction?

Answer 45

portal hypertension - spleen sequestrian | auntoimmune thrombocytopenic purpura

Question 46

aggregation problems - reason? tx?

Answer 46

platelet function impaired/ medical therapy - aspririn or copidogrel tx of underlying cause platelet transfusion maybe necessary

Question 47

coagulation cascade problems? gen deficiency ? specific deficiency?

Answer 47

gen - protein - liver disease/malnutrition spec. - coagulation - haemophilia, von wilebrands disease drugs - warfarin/heparin

Question 48

what is haemophilia A? B?

Answer 48

A - x lined genetic disorder - absence of VIII clotting factor B - " , IX clotting factor

Question 49

what is von wilebrands disease?

Answer 49

autosomal dominant - platelet factor VIII function problem

Question 50

tx of lack of clotting factors?

Answer 50

factor replacement, prophylactic

Question 51

what does DDAVP do?

Answer 51

increases factor VIII levels

Question 52

what does tranexamic acid do?

Answer 52

inhibits clot breakdown

Question 53

dentally, what to be aware of with pt's with coagulation problems?

Answer 53

risk management, trauma avoidance, prep for suspected bleeding associated conditions - HIV, hepatitis

Question 54

what is warfarin used for?

Answer 54

atrial fib, heart valves, PE, DVT interferes with clotting factor activity INR checked

Question 55

what is heparin used for?

Answer 55

DVT, PE | injectable

Question 56

what is - petechiae, purpura, ecchymoses?

Answer 56

cutaneous bleeding larger bleeds brusing bc bleeding

Question 57

what is menhagva? haemoturina?

Answer 57

excess menstrual bleeding | urinary tract bleeding