Module 17 Exam 3 Flashcards
where do early signs of systemic conditions manifest themselves
in the oral soft tissues
What are findings that may suggest a blood disorder
- gingival bleeding
- history of difficulty of controlling bleeding
- history of bruising
- numerous petichiae
- pallor of mucous membrane
- atrophy of papillae of tongue
- sore painful tongue
- infections, dont respond to normal tx
- server ulcerations
- exaggerated gingival response to local irritants
what is normal blood comprised of
55% plasma and 45% formed elements
what do the formed elements consist of?
44% erythrocytes
1% leukocytes
what does hematocrit show
- percentage packed volume of blood cells
- normal values are males 39-39% females 33-43%
Where do blood cells originate
bone marrow
what is a hemocytoblast
stem cell of origin
what cells leave the bone marrow and go to lymphoid tissue for maturing
agranulocytes (lymphocytes, monocytes)
What are the plasma proteins
albumin, gamma globulins, beta globulins, fibrinogen, prothrombin
what is albumin
maintains tissue fluid balance within the vascular system
what are gamma globulins
circulating antibodies essential to the immune system
what are beta globulins
aid in transport of hormones, metallic ions and lipids
what is fibrinogen and prothrombin essential for
blood clotting
if plasma is allowed to clot what is it called
serum
what is plasma composed of
90% water
10% plasma proteins, inorganic salts, gases substances being transported
What are erythrocytes
- RBC/corpuscles
- biconcave discs
- CO2 transported from cells
what are the functions of RBC
transport hemoglobin, carry 02 to the body, C02 transported from the cells
what is hemoglobin measured in
g/ml
normal values 12 to 17.2
what are the two kinds of WBC (leukocytes)
granulocytes, agranulocytes
what are the granulocytes
neutrophils, eosinophils, basophils
what are the agranulocytes
lymphocytes, monocytes
what cells arrive first of the WBC
neutrophils
what functions as a transport medium for WBC
blood
what are lymphocytes
-round cells with round nucleus
capable of reverting to blast-like cells of origin and then multiplying as the immunologic need arises
what are monocytes
- bean shaped
- phagocytic
- in conn tissue differentiate into macrophages
what are neutrophils
PMN
- most numerous of WBC
- ameoboid in the tissues and function in phagocytosis, first line of defense
what are eosinophils
-increase during allergic reactions
what are basophis
-increases vascular permeability during inflammation so that the phagocytic cells can pass into the area
what are plateles
- formed element, no nucleus
- active in blood clotting mechanism
what is anemia
-reduction of the hemoglobin concentration, the hematocrit or the number of RBC to a level that is below normal
as a result of anemia what is diminished
oxygen carrying capacity to the cells-
anemias are classified by what
cause
what is anemia caused by blood loss
- acute- blood loss from trauma or disease
- chronic- internal leison with constant slow bleeding usually of GI or gyne origin
what is anemeia cause by increased hemolysis
- hereditary hemolytic disorders
- acquired hemolytic disorder
what is an example of a hereditary hemolytic disorders s
sickle cell disease
what are examples of aquired hemolytic disorders
from drugs infections, and certain physical and chemical agents
what is antibody mediated anemia, erythroblastosis fetalis
occurs when a mother is Rh- negative
what is erythroblastalis fetalis also known as
hemolytic disease of the newborn
what are 2 types of anemia cause by diminished production of RBC
nutritional deficency, bone marrow failure
what is nutritional defeciency in anemia
- inadequate intake or dietary choices
- ex:pernicious anemia- vit B12 absorbtion deficiency
- iron deficency anemia
what is an example of bone marrow failure in anemia
-aplastic anemia
what is aplastic anemia
-combination of anemia, neutropenia, thrombocytopenia occurs which leads to a decrease in all cells formed in the bone marrow
what is the most prevalent anemia? second most?
iron deficency
anemia of chronic dieseases
when does anemia of chronic diseases occur
in pts with acute or chronic immune activation, pts. have low reticulocyte count, underprod of RBC
what is an example of an anemia caused by genetic blood disorders
thalassemia
What is thalassemia characterized by
absent or decreased production of hemoglobin
Is thalassemia inheritied? who does it effect the most?
-yes, mediterranean, african, middle eastern, south east asian descent
what is the most severe form of thalassema
thalassemia major (cooley’s anemia)
what is tx for thalassemia
- transfusions
- folic acid
- bone marrow trans is cure during childhood
- steme cell transplant
what are the general signs and symptoms of anemia
-pale thin skin weakness, fatigue, easy fatigability dyspna on slight exertion, faintness dimness of vision, headache, vertigo, tinnitus brittle nails
what is iron deficiency anemia
hypochromic microcytic anemia, hemoglobin deficient, blood corpuslces are smaller than normal
what can develop as a result of chronic iron deficency
plummer-vision syndrome
what are the causes of iron deficency anemia
- malnutrition/adsorbtion
- chronic infection
- increased demand
- chronic alcoholism
- chronic blood loss
- internal bleeding
- excessive menstrual flow
- frequent blood donations
what are the signs and symptoms of iron deficency anemia
- general weakness, headache, pallor
- fatigue on slight exertion
what are oral signs and symptoms of iron deficency anemia
- pallor of mucosa
- tongue changes- atrophic glossitis
- secondary irritations to thinned mucosa, may result from smoking, trauma, hot spicy foods
- angular chelitis
- increased risk of angular chelitis
What is tx for iron deficiency anemia
- oral ferrous iron
- folic acid
- nutritional counseling
- liquid preps for children may stain teeth
what are megablastic anemias
- abnormally large RBC
- result from deficiency of B12, folate or both
what are the principle types of megoblastic anemai
- pernicious anemia
- folate deficency anemia
what are B12 and folate essential for
RBC prod in bone marrow
what is pernicious anemia caused by
-decreased intake, increased requirement, impaired absorbtion of B12
what is pernicous anemia due to deficiency of intrinsic factor
failure of production of intrinsic factor, necessary for B12 adsorbtion
what age do you see pernicious anemia in
over 40 years of age
Is the childhood form a of pernicious anemia is there a gastric abnormality
no
what are the general clinical findings of pernicious anemia
- fatiuge, weakness, tingling, numbness of fingers and toes
what are CNS system involvement clinical findings of pernicious anemia
- dizziness, confusion, hypotension
- sever parathesia
- dimmed vision, abdominal pain, weight loss
what are the oral clinical findings of pernicious anemia
- tongue- atrophic glossitis, pain, inflammed, flabby, red, smooth, shiny
- sensitivity to hot or spicy food
- painful swallowing
- gingiva and mucosa pale, atrophic
what is the tx of pernicous anemia
-B12 injections 2x week then monthly
what is folate deficiency anemia-
like pernicous anemia, no CNS involvement
what are the etiologic factors of folate deficiency anemia
- decreased intake- inadequeate diet or adsorbtion
- increased requirement- pregnancy, cancer, tobacco, pts who take alot of asprin or antacids, drugs that impair utilization of folate
what are dietary sources of folate
-fresh fruits, green leafy veggies
-liver, kidney
-dairy products, whole grain cereal
-
what is folate deficiency most frequently related to
-malabsorbtion rather than inadequate intake
