Oral Manifestations of Haematological Disease Flashcards

1
Q

Infections in Immunocompromised patients

A

Susceptible to disease and infection by fungi,

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2
Q

Herpes simplex

A

Has greater effect in
Immunocompromised
Neutropenic

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3
Q

Bleeding disorders

A
thrombocytopenia 
haemophilia 
warfarin
other inherited disorders
scurvy - gingival inflammation
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4
Q

Immune thrombocytopenic purpura

A

Conjunctival haematoma

indicates low platelet count

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5
Q

Glandular fever

A

PEtichiae

Swelling

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6
Q

Aplastic anaemia

A

platelets <10
spontaneous bleeding from gums
ulcer

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7
Q

Acute myeloid leukaemia

A

Bruising

Mucosal purpura

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8
Q

Haemophilia

A

Exaggerated injury
Mouth heamatoma - can occlude mouth
Oral hairy leukoplakia - white patch on side of tongue in HIV+ patients

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9
Q

Poor dentition

A

Reluctance to have procedures
Fear of bleeding out
Given pre treatment infusion of Factor VIII given

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10
Q

Ehlers-Danlos syndrome

A

Hyper extensive skin

Collagen is abnormal

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11
Q

Infiltration of disease

A

Tonsillar lymphoma
Gum hypertrophy e.g acute monocytic leukaemia - M5
macroglossia due to amyloid deposition

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12
Q

Other disorders

A

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

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13
Q

History taking - presenting complaint

A

Most important part!!
Explore in detail
Ask relevant positive and negative questions

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14
Q

Presentations of complaint

A

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
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15
Q

Haematology directed questions

A
Anaemia
- tiredness
- shortness of breath
- chest pain 
 Infections 
Bleeding problems 
thrombosis
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16
Q

Questions for bleeding disorders?

A
Easy bruising? 
Bleeding after cuts?
Nosebleeds? Epistaxes
Bleeding post extraction 
Menorrhagia 
Bleeding after surgery
17
Q

Systems
Past MH
Family history
social history

A

Drug history
Allergies
Smoking
Alcohol