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BDS2 BAMS Diseases of Human Systems > Malignant haematology > Flashcards

Malignant haematology Flashcards

have a basic understanding of leukaemia, lymphoma, myeloma and be able to identify features of blood cancer and oral implications of cancer management

1
Q

what is leukaemia?

A

a group of blood cancers from myeloid and lymphoid lineage

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2
Q

what does leukaemia cause in the body?

4

A

loss of bone marrow function due to the production of abnormal white blood cells
* RBC deficiency (anaemia)
* WBC deficiency (impaired immunity)
* platelet deficiency (easy bleeding)

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3
Q

what are the subtypes of leukaemia and describe them

A

acute lymphoblastic - often in kids
acute myeloid - in adults
chronic lymphocytic - older adults, slow proliferation
chronic myeloid leukaemia - philadelphia chromosome
acute is more dangerous as faster onset and affects younger people

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4
Q

what are the clinical features of leukaemia?

7

A

fatigue
fever
weight loss
easy bruising
easy bleeding
abnormal infections
lymphadectomy

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5
Q

how is leukaemia diagnosed?

3

A

blood tests - FBC, RBC, WBC, platelets
bone marrow biopsy
scans

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6
Q

how do you manage leukaemia?

3

A

chemotherapy
targerted therapies (monoclonal antibodies)
bone marrow transplant

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7
Q

what is chemotherapy?

A

medication (usually IV) used to kill cancer cells or slow/halt their growth

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8
Q

what kinds of cells does chemoherapy target?

3

A

oral mucosa cells
gut mucosa cells
hair cells

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9
Q

what are the general side effects of chemotherapy?

8

A

hair loss
nausea, vomiting, diarrhoea
infertility
bone marrow suppression
cardiac toxicity
oral mucositis
immunosuppression
depression/anxiety

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10
Q

what is lymphoma?

1

A

cancer affecting the white blood cells in the lymphatic system

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11
Q

what is the classical presenting symptom of lymphoma?

A

swollen lymphnodes

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12
Q

what are the two types of lymphoma?

A

Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma

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13
Q

what are the B symptoms of lymphoma?

3

A

fever
night sweats
weight loss

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14
Q

what are general symptoms of lymphoma?

6

A

fatigue
itching
cough
shortness of breath
abdominal pain
recurrent infections

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15
Q

how is lymphoma diagnosed?

2

A

lymph node biopsy
PET scan - shows cells with fast turn over

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16
Q

what are the key histological cell type in Hodgkin’s lymphoma?

A

Reed-Sternberg (owl eyes)

17
Q

how do you manage lymphoma?

4

A

chemotherapy
radiotherapy
targeted therapy - monoclonal antibodies
stem cell transplant

18
Q

what is staging and how is lymphoma staged?

1,4

A

staging determines the size and spread of cancer
stage 1 - one lymph node affected
stage 2 - more than one affected on one side of diaphragm
stage 3 - more than one affected on both sides of diaphragm
stage 4 - organ/s have been affected

19
Q

what is a myeloma?

2

A

cancer that affects the plasma cells (make antibodies)
results in overproduction of paraprotein which deposits in organs/tissues and causes impairment

20
Q

how do you diagnose myeloma?

A

Bence-Jones protein is present in urine

21
Q

what are the key features of myeloma?

4

A

Calcium increased - bone becomes soft and Ca enters blood
Renal impairment
Anaemia
Bone lesions - pathological fractures

22
Q

what does myeloma present as?

8

A

unexplained fever
weightloss
fatigue
anaemia
renal impairment
bone pain
pathological fractures
rarely presents in mout

23
Q

how do you manage myeloma?

4

A

no cure
disease control
* chemotherapy
* stem cell transplant
* bisphosphonates (bone related diseases)

24
Q

what are the dental manifestations of haematological malignancy?

A

easy bleeding
* petechiae (bruising)
* haemorrhage
* spopntaneous bleeding
low immunity
* candidosis
* herpes simplex virus
anaemia
* pallor
gingival swelling

25
Q

what are the oral side effects of chemotherapy?

4

A

oral mucositis
dry mouth (xerostomia) - caries, dysphagia
infection - fungal, viral
easy bleeding - thrombocytopenia

26
Q

what are the oral side effects of radiotherapy?

3

A

dry mouth (xerostomia)
osteoradionecrosis of jaw
fibrosis = trismus (restricted jaw movement)

27
Q

what are the side effects of the adjuncts used to treat cancer?

2

A

bisphosphonates - MRONJ (medication related ostenecrosis of the jaw)
bone marrow transplant - significant immunosuppression

28
Q

how can you optimise dental health prior to chemo/radiotherapy?

7

A

remove teeth/caries 10 days before
oral hygiene instruction
dietary advice
fluoride toothpaste/varnish
mouthguard so teeth dont irritate inflammed mucosa
remove traumatic edges
prepare pt for unexpected side effects

29
Q

how can you optimise dental health during chemo/radiotherapy?

A

hygienist support
maintenance of oral hygiene
ongoing caries prevention
assess and manage mucositis
provision of saliva substitutes
avoid elective dental treatment e.g. veneers, whitening

BDS2 BAMS Diseases of Human Systems (12 decks)

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