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HUD > Haemotlogy Pathology > Flashcards

Haemotlogy Pathology Flashcards

1
Q

What should you avoid with patients who have haem problems?

A

Trauma
Regional LA
Intramuscular injections
Drugs causing gastric bleeding, increased bleeding tendency - aspirin, warfarin, heparin

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2
Q

What is anaemia?

A

A reduction in the oxygen carrying capacity of the blood
Low value of haemoglobin: <13.5 men <11.5 women
Severe: <7
Less haemoglobin less cell volume less RBC

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3
Q

What are the 3 classifications of anaemia?

A

Red cell mean corpuscle volume (RBC size)
Microcytic- small
Normocytic
Macrocytic - large

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4
Q

What are the 3 deficiencies that cause anaemia?

A

Iron
Vitamin B12
Folate

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5
Q

What is the pathogenesis of anaemia?

A

Reduced RBC production
Increased RBC destruction
Blood loss
Increased plasma demand

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6
Q

What are the 2 causes of anaemia?

A

Disease
Secondary to drug therapy

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7
Q

What are the clinical features of anaemia?

A

Acute blood loss - collapse, breathlessness, tachycardia, reduced BP, faint
Pale skin
Heart failure

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8
Q

What are the main organ dysfunctions of sever anaemia?

A

Cardiorespiratory
Neuromuscular
Gastro - loss of appetite
Menstrual

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9
Q

What is the dental relevance of anaemia?

A

Poor wound healing
Caution with sedation and drugs
Avoid GA
Emergency - give blood with diuretic

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10
Q

What are the 2 types of microcytic anaemia?

A

Iron deficiency
Thalassaemia

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11
Q

What are the causes of iron deficiency?

A

Blood loss
Pregnancy iron demand
Vegetarian
Absorption problems coeliac

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12
Q

What is the treatment for iron anaemia?

A

Remove cause
Iron supplements -ferrous sulphate

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13
Q

What is the difference in histology between iron anaemia and normal?

A

Pale and small red blood cells

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14
Q

What is thalassaemia?

A

Inherited disorders of haemoglobin
Reduced alpha and beta chain synthesis
Increased RBC

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15
Q

What is the dental relevance of thalassaemia?

A

Bony abnormalities
Prone to recurrent infections
Wound healing problem

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16
Q

Which type of thalassaemia poses a threat with high mortality rate?

A

Beta thalassaemia major
Transfusion dependent
Bone marrow expansion

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17
Q

What defines macrocytic anaemia?

A

Vitamin B12 or folate deficiency
They are required to synthesise DNA

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18
Q

What are the 2 types of macrocytic anaemia?

A

Megaloblastic haemopoeisis - abnormal RBC development due to DNA
Normoblastic haemopoeisis - normal RBC maturation

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19
Q

What are the causes of macrocytic anaemia?

A

Vit B12 deficiency
Folate deficiency
Alcoholism
Liver disease
Chemotherapy

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20
Q

What is normocytic anaemia caused by?

A

Chronic infections - TB
Chronic diseases - RA renal failure
Cancer
Bone marrow disorders

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21
Q

What is normocytic anaemia?

A

Anaemias of chronic disease

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22
Q

What are the 2 types of haemolytic anaemias?

A

Congenital
Acquired - autoimmune

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23
Q

What os haemolytic anaemia?

A

Shortened lifespan of RBC
Increased bone marrow haemopoesis

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24
Q

What type of genetic disorder is sickle cell anaemia?

A

Autosomal recessive

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25
Q

What are the 2 problems of the sickle cell shape?

A

Shortened erythrocyte survival
Micro circulation obstruction

26
Q

What are the clinical features of sickle cell?

A

Progressive anaemia
Frontal bossing
Splenic infarction

27
Q

What are some complications of sickle cell?

28
Q

What are the 3 types of acute crisis of sickle cell?

A

Thrombotic
Organ failure
Sequestration RBC in spleen

29
Q

What is the dental relevance of sickle cell?

A

Avoid prilocaine
Sedation avoided
No GA
Avoid aspirin

30
Q

What is haemostasis?

A

Prevents blood loss from vascular injury
Blood clotting

31
Q

What are the 4 events of haemostasis?

A

Vasoconstriction
Platelet plug
Firbin clot
Clot dissolution

32
Q

What is the dental relevance for bleeding disorders?

A

LA no cover with coagulation
Post administration of ID block
Many are HIV hep C positive

33
Q

What are platelet disorders caused by?

A

Reduced numbers
Functional abnormalities
Reduced production
Increased destruction

34
Q

What are the clinical features of platelet disorders?

A

Bruising
Nosebleeds
Haemorrhage

35
Q

Which drugs affect platelet function?

A

NSAIDs
Clopidogrel
Beta lactam antibiotics
Nitrates
Beta blockers
Warfarin

36
Q

What conditions use warfarin?

A

DVT
Embolism
Atrial fibrillation
RH disease
Stroke

37
Q

What is the dental relevance of warfarin?

A

Morning appointments
Avoid block injections
Check INR

38
Q

What are some haemostats measures?

A

Non traumatic surgery
Pack socket with gauze
Careful suturing
Pressure

39
Q

Where does haemopoiesis occur?

A

Bone marrow of axial skeleton

40
Q

What are the 2 types of stem cells from pluripotent?

A

Myeloid
Lymphoid

41
Q

What is acute leukaemia?

A

Malignant tumours of haemopoietic precursor cells

42
Q

What are the 2 causes of acute leukaemia?

A

Radiation
Down’s syndrome
(Damaged DNA)

43
Q

What are the 2 classifications of acute leukaemia?

A

Acute myeloid - m0-m7, older
Acute lymphoblastic - l1-l3, childhood

44
Q

What are the clinical features of acute leukaemia?

A

Weight loss
Bone marrow suppression lack of RBC anaemia
Organomegaly

45
Q

What is the treatment for acute leukaemia?

A

Chemotherapy
Transfusions
Antibiotics
Bone marrow transplant

46
Q

What are the causes of chronic leukaemia?

A

CML - radiation and chemical
CLL - unknown

47
Q

What are the clinical features of chronic leukaemia ?

A

Asymptomatic
Organomegaly
Anaemia
Weight loss
CLL - Immunosuppressed

48
Q

What is the treatment for chronic leukaemia?

A

CML - hydroxyurea, allogenic transplant
CLL - chemotherapy

49
Q

What is the dental releavance of chronic leukaemia?

A

ALL - gingival bleeding, ulcers, candidiasis
AML - gingival infiltration
CLL - cervical lymph, herpes zoster
Prophylactic antibiotics

50
Q

What are lymphomas?

A

Malignant tumours of T B cells within lymphoid tissue

51
Q

What is Hodgkin disease?

A

Tumours of cervical supraclavicular lymph nodes

52
Q

What causes Hodgkin disease?

53
Q

What do the lymphomas feel like for Hodgkin’s?

A

Painless
Non tender
Rubbery
Fixed
Asymmetrical
Red itchy rash

54
Q

What is non-hodgkins lymphoma?

A

Lymphoreticular tissue
Spleen, liver, bowel
Unknown cause

55
Q

What is burkitts lymphoma?

A

High grade non-Hodgkin
Abnormal B lymph
Previous EBV

56
Q

What is the treatment for lymphomas?

A

Radiotherapy for localised
Chemo for generalised

57
Q

What is the dental relevance of lymphomas?

A

Non hodgkins oropharyngeal sore throat
Lesions in salivary glands
Burkitts - jaw complications

58
Q

What is multiple myeloma?

A

Malignant proliferation of single clone of bone marrow plasma cells

59
Q

What are the clinical features of multiple myeloma?

A

Bone marrow suppression
Thick blood
Lytic lesions in bone
Renal

60
Q

What is the treatment for multiple myeloma?

A

Chemo
Analgesia
Plasma

61
Q

What is the dental relevance of multiple myeloma?

A

Lytic lesions in jaw and skull
Anaemia
Renal - no NSAIDs

HUD (16 decks)

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