Oral Manifestations of Haematological Disease Flashcards
Infections in Immunocompromised patients
Susceptible to disease and infection by fungi,
Herpes simplex
Has greater effect in
Immunocompromised
Neutropenic
Bleeding disorders
thrombocytopenia haemophilia warfarin other inherited disorders scurvy - gingival inflammation
Immune thrombocytopenic purpura
Conjunctival haematoma
indicates low platelet count
Glandular fever
PEtichiae
Swelling
Aplastic anaemia
platelets <10
spontaneous bleeding from gums
ulcer
Acute myeloid leukaemia
Bruising
Mucosal purpura
Haemophilia
Exaggerated injury
Mouth heamatoma - can occlude mouth
Oral hairy leukoplakia - white patch on side of tongue in HIV+ patients
Poor dentition
Reluctance to have procedures
Fear of bleeding out
Given pre treatment infusion of Factor VIII given
Ehlers-Danlos syndrome
Hyper extensive skin
Collagen is abnormal
Infiltration of disease
Tonsillar lymphoma
Gum hypertrophy e.g acute monocytic leukaemia - M5
macroglossia due to amyloid deposition
Other disorders
Angular stomatitis in iron or B12/iron deficiency (oral ulcers)
Smooth tongue ^^
Cyanosis
Hereditary haemorrhage telangiectasia - spots on lips and cheeks
Maxillary hypertrophy due to extramedullary haemopoiesis in thalassaemia major
Cyanosis due to congenital heart disease
Hereditary angioneurmtic oedema
History taking - presenting complaint
Most important part!!
Explore in detail
Ask relevant positive and negative questions
Presentations of complaint
Referral from haematologists
- immunocompromised patients
- patients with known bleeding disorders
- patients on oral anticoagulants
General patients seen routinely
- is there a bleeding disorder
- is there a haematological disorder
Haematology directed questions
Anaemia - tiredness - shortness of breath - chest pain Infections Bleeding problems thrombosis