RBC Disorders Flashcards
hemoglobin
oxygen-carrying molecule
normal RBC
33% Hb by weight
anemia
reduction in oxygen-carrying capacity of the blood
cause of anemia
- decreased RBC prod
- blood loss
- destruction of circulating RBCs
pts with what type of disease are also prone to becoming anemic?
renal disease
why do pts with renal disease prone to becoming anemic?
b/c kidneys help make RBCs
med management of anemic pts
eliminate underlying cause
Hb goal of anemic pts
> 11 g/dL
can you txt anemic pts?
all dental care appropriate unless pt is symptomatic (SOB)
sickle cell trait
pt carries 1 gene for HbS (heterozygous)
what percent of African Americans are carriers for the sickle cell trait?
8-10%
sickle cell disease
1 gene from each parent for HbS (homozygous)
pathophysiology of sickle cell disease
cellular rigidity and membrane damage cause RBCs to become IRREVERSIBLY SICKLE-SHAPED due to crystallization of HbS
what happens in response to the physiologic changes of the sickle cell disease?
- deoxygenated blood
- decreased blood pH
- dehydration
T/F: pts with sickle cell disease are very sensitive to sickling stimuli?
true
what percent of Hb is HbS in pts with sickle cell disease?
> 80%
is sickle cell trait symptomatic?
no, typically asymptomatic
are pts carrying the sickle cell trait as sensitive to the sickling stimuli?
no, they’re less sensitive
what percent of Hb in pts carrying the sickle cell trait is HbS?
20-45%
are pts carrying the sickle cell trait at risk for adverse effects during dental txtment?
no
effects of RBC sickling
- erythrostasis
- increased blood viscosity
- reduced blood flow
- hypoxia
- RBC adhesion
- vascular occlusion
- further sickling
sickle cell crisis
periods where body is stressed out causing cells to sickle
*pts in horrible pain
do pts who has had splenectomy need antibiotic prophylaxis?
- yes, needed before any type of invasive dental txtment
- work with PCP
can routine dental care be given to pts with sickle cell disease?
yes, but during non-crisis periods
dental mods for pts with sickle cell disease
- stress-reduction protocol
- profound local anesthesia
- nitrous oxide sedation
- consult with physician prior to any surgical procedures
what is the minimum percent of oxygen concentrations in nitrous oxide sedation given to pts with sickle cell disease?
at least 50%
*low O2 conc. can get cells more sickle
what analgesics can be given to pts with sickle cell disease for post-op pain?
- NSAIDs
- Tylenol
- +/- codeine
why do we aggressively txt odontogenic infections in pts with sickle cell disease?
infection can trigger a crisis
*infections throws off pH balance of blood
how do you txt odontogenic infections in pts with sickle cell disease?
- remove offending source
- incision and drainage
- systemic antibiotics
adequate fluid intake to avoid dehydration
how do you txt cellulitis in pts with sickle cell disease?
inpatient management so send them to the ER
