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HD 3 - dental relevance > haematology > Flashcards

haematology Flashcards

1
Q

histological presence of iron deficient anaemia?

A

RBC paler + smaller

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2
Q

what would blood test show for iron deficient anaemia?

A

low Hb
low MCV (size of RBC)
low ferritin levels

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3
Q

3 causes of iron deficient anaemia

A
  1. dietary deficiency
  2. malabsorption
  3. blood loss - GI tract, haemorrhage
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4
Q

common oral sign of iron deficient anaemia?

A

angular stomatitis

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5
Q

common oral cause of B12 deficient anaemia?

A

macroglossia + smooth tongue

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6
Q

histological presence of B12/folate deficient anaemia?

A

microcytic

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7
Q

what would blood test show for B12/folate deficient anaemia?

A

Hb low

high MCV

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8
Q

5 causes of folate deficient anaemia

A
  1. dietary deficiency
  2. increased requirement - pregnant
  3. malabsorption e.g. coeliac
  4. alcoholism
  5. drugs - septrin + methotrexate
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9
Q

4 causes of B12 deficient anaemia

A
  1. inadequate intake
  2. low gastric acid
  3. intrinsic factor/antibodies against parietal cells - pernicious aneamia
  4. abnormal terminal ileum
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10
Q

what causes petechiae?

A

reduced platelets

ITP most commonly

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11
Q

if you noticed petechiae on pts palate what would you need to be aware of?

A

pts bleed excessively

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12
Q

what is an oral manifestation of acute leukimia?

A

gingival hyperplasia

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13
Q

why is it important to be aware of myeloma pts as a dentist?

A

on bisphophonates

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14
Q

what sort of anaemia is found in myeloma patients?

A

normocytic anaemia

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15
Q

what is the WHO oral toxicity scale?

A
  1. grade 1 - soreness +/- erythema
  2. grade 2 - erythema, ulcers, can swallow solids
  3. grade 3 - ulcers, extensive erythema, cannot swallow solids
  4. can’t swallow liquids
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16
Q

4 main components of blood

A

plasma
platelets
RBC
crycoprecipitate

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17
Q

what is the role of collagen in haemostasis?

A

exposed when damage to vessel wall
binds to platelets or VWF
platelet plug forms

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18
Q

what is the role of clotting factor X?

A

prothrombin –> thrombin

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19
Q

what is the role of thrombin?

A

fibrinogen –> fibrin

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20
Q

how would you manage haemophiliacs undergoing dental surgery?

A

close liaison with haemophilia centre

  1. DDAVP infusion for mild haemophiliacs
  2. factor VIII/IX for mod/severe
  3. atraumatic as possible
  4. local haemostats measure - tranexamic acid
21
Q

what is platelet count level for safe treatment?

A

> 50x10^9 /l

22
Q

how may liver disease cause bleeding problems?

A

low platelet count - caused by portal venous hypertension which is caused by liver disease

clotting factors 2, 7, 9, 10

23
Q

what is ITP?

A

immun thrombocytopenia pupura - autoimmune disease causing low platelets

24
Q

how may local haemostasis be achieved?

A

pressure
oxidised cellulose (surgical), collagen sponges + sutures
5% tranexamic acid mouthwash

25
Q

what must not be prescribed to pts who take warfarin following extraction?

A

cox-2 or NSAIDs as analgesic

26
Q

an example of a congenital vascular bleeding disorder?

A

Ehlers dans

27
Q

an example of an acquired vascular bleeding disorder?

A

chronic prednisolone use

28
Q

difference in presentation between platelet disorders + coagulation disorders?

A

coagulation - present with bruising at deeper levels

29
Q

importance of kidney disease in bleeding?

A

renal disease = impaired platelet function

30
Q

what are thrombophillias?

A

conditions causing clotting

31
Q

what is ecchymoses?

A

bruising

bleeding into subcutaneous tissue due to trauma

32
Q

what is purpura?

A

spontaneous bleeding into skin

33
Q

2 types of purpura?

A
  1. petechiae - small

2. senil purpura

34
Q

what may spider telangiectasia be a sign of?

A

liver disease

35
Q

what is haemangioma and how would you treat a pt with it?

A

dark ref pulsatile lesion along maxilla

DONT extract

36
Q

What part of clotting pathway does APTT test?

A

intrinsic

37
Q

what part of clotting pathway does PT test?

A

extrinsic + common

38
Q

what effects APTT?

A

factor deficiencies + heparin

39
Q

what effect PT?

A

warfarin + alcoholic liver disease

40
Q

how would you measure platelet count?

A

FBC

41
Q

what does TT test?

A

common pathway

42
Q

LFT showing decreased synthesis

A

albumin down
factors down
PT up

43
Q

LFT showing decreased excretion

A

bilirubin, alkaline phosphates + GGT up

44
Q

LFT showing hepatocyte necrosis

A

AST + ALT up

45
Q

in liver disease which anaesthetic is best used?

A

prilocaine - metabolised in lung not liver

articaine - partly metabolised in blood

46
Q

what to use to stop bleeding post extraction if bleeding is from bone?

A

bone wax

47
Q

how does tranexamic acid stop bleeding?

A

anti-fibrinolytic - stops breakdown of the clot

48
Q

2 types of cautery that can be used post op?

A

chemical

electrical - bipolar or monopolar

49
Q

how to treat urgent high INR

A

vitamin k 10mg IV or PO

life threatening - beriplex used (prothrombin complex conc from human plasma)

HD 3 - dental relevance (7 decks)

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