Sample Questions Blood Disorders Flashcards
Oral manifestations of iron deficiency anemia
angular chelitis
atrophic glossitis
mucosal pallor
Plummer-Vinson syndrome
rare condition in middle aged Scandinavian women
chronic Fe deficiency
dysphagia, atrophic mucositis of aerodigestive tracts
predisposition to oral/esophageal SCC
RBCs in iron deficiency anemia
hypochromatic and microcytic
Clinical symptoms of pernicious anemia
fatigue, headache, breath shortness
paresthesia, tingling, numbness of extremities
burning/painful tongue, lips, and buccal mucosa
atrophic, pale, erythematous oral mucosa
loss of tongue filiform papillae
RBCs in pernicious anemia
macrocytic and hyperchromatic
Clinical symptoms of sickle cell crisis
extreme pain from ischemia and infarction
Most affected areas during sickle cell crisis
long bones, lungs, abdomen
Radiographic features of sickle cell anemia
step ladder trabeculation of posterior mandible
hair on end appearance of calvarium
Cause of thalessemia
decreased synthesis of alpha or beta globulin Hb chains
Age predilection of thalessemia
children and young adults
Clinical features of thalessemia
jaundice
fever
malaise
weakness
Maxillary enlargement in thalessemia is due to
bone marrow hyperplasia
Radiographic features of thalessemia
hair on end skull films
honeycombed appearance of trabeculae in jaws
RBCs in thalessemia
hypochromatic and microcytic
What is the risk of blood transfusions in thalessemia pateints?
hemochromatosis
Leukopenia is mainly due to a decrease in what WBC type?
neutrophils
Causes of agranulocytosis
idiopathic
congenital
drug related (chemo)
Oral manifestations of agranulocytosis
punched out, necrotic ulcerations of oral mucosa and tongue
Symptoms of agranulocytosis
malaise sore throat fever chills bone pain
Treatment of agranulocytosis
antibiotic therapy
bone marrow stimulating cytokines
cessation of drug if drug related
Cause of cyclic neutropenia
idiopathic
Oral clinical features of cyclic neutropenia
oral ulcerations on tongue, buccal mucosa, gingiva
severe periodontal disease in children
Clinical features of cyclic neutropenia
fever
malaise
sore throat
URIs
Leukocytosis
increased mature circulating WBCs
normal response to infectious diseases
Mono is cause by what virus? what cell types does it infect?
EBV infects epithelial cells and B lymphocytes
Oral manifestations of mono
vesicles and ulcerations on soft palate
Life threatening risk of mono
hepatosplenomegaly
Cell type in acute leukemias
immature blast cells
Cell type in chronic leukemias
well-differentiated WBCs
Genetic mutation implicated in leukemia
Philadelphia chromosome
Lab findings (CBC) in leukemia
decreased RBCs and platelets (thrombocytopenia)
normal to elevated WBCs
Oral manifestations of leukemia
hard/soft palate and gingival hemorrhages
hypertrophic, inflamed gingiva
candida and herpetic infections
gingival infiltrates
Prognosis of acute and chronic leukemias
acute: better prognosis in kids than adults
chronic: more common in adults, more indolent course
Where does Hodgkin’s arise from?
lymph nodes
Hodgkin’s M?F
M>F
Hodgkin’s age predilcection
bimodal presentation
15-35y and after 50y
Clinical presentation of Hodgkin’s
non-tender swelling of cervical or mediastinal lymph nodes
weight loss, fever, pruritus, night sweats
Histopathology of Hodgkin’s
Reed-Sternberg cells
binucleate, owl eye giant cells with prominent nucleoli
RS cells in an inflammatory background
Prognosis of lymphocyte predominant Hodgkin’s
most favorable
Prognosis of lymphocyte depletion Hodgkin’s
most aggressive
Hodgkin’s presenting with collagen bands subdividing lymph nodes
nodular sclerosis
Most common site of oral involvement in non-Hodgkin’s
palate
Viruses implicated in non-Hodgkin’s
EBV, HTLV
linked to B cell and Burkitt lymphomas
Non-Hodgkin’s M?F
M>F
Head and neck features of non-Hodgkin’s
firm, non-tender cervical nodes
alveolar bone loss/ tooth mobility
red/purple soft tissue swellings
oral ulcerations
Non-Hodgkin’s resembles what oral lesion clinically?
pyogenic granuloma
Most common intraoral sites of non-Hodgkin’s
posterior hard palate, gingiva, buccal vestibule
What is EBV’s role in Burkitt’s lymphoma?
involved but not necessarily casual
Burkitt’s age and sex predilection
males between 3y and 8y
Which is more common in jaws, endemic or non-endemic Burkitt’s?
endemic
Radiographic features of Burkitt’s
ill-defined radiolucency
tooth displacement
root resorption
Intraoral locations of Burkitt’s lesions
gingiva and palate
Histopathology pattern of Burkitt’s
starry sky
malignant B cells
scattered macrophages with abundant cytoplasm
Recurrence rate of Burkitt’s
high
Which has a better prognosis, endemic or non-endemic Burkitt’s?
endemic
What cell type is malignant in multiple myeloma?
terminally differentiated B cells
Age predilection of multiple myeloma
50-60y
Clinical features of multple myeloma
bone pain
renal failure
recurrent infections, hypercalcemia, amyloid deposition
Protein found in the urine of multiple myeloma patients
Bence-Jones protiens
Radiographic features of multiple myeloma
punched out radiolucencies throughout maxilla, mandible, and skull
Prognosis of multiple myeloma
high survival rae
tx can be worse than the disease itself
Normal platelet count
250,000-450,000/mm3
Thrombocytopenia
dcreased platelet counts, decreased platelet survival. increased splenic platelet sequestration
Idiopathic thrombocytopenia purpura
acute childhood, chronic adult disorder
acute form follows viral infection
antigen binding on platelets
Clinical features of thrombocytopenia
small blood vessel leakage producing petechiae
larger leakage leads to ecchymoses, hematomas
spontaneous gingival hemorrhage
Thromboastenia
decreased platelet function
Factor abnormality in Von Willebrand disease
VIII
Mechanism of action of aspirin thrombastenia
decreased thromboxane A2 synthesis
Capillary fragility due to a deficiency in what vitamin?
C
Clinical presentation of vitamin C deficiency
petechial hemorrhages, ecchumoses, purpura after trauma or pressure
abnormal bone calcification and growth failure in children
Oral manifestations of vitamin C deficiency
gingival inflammation, ulceration, bleeding
secondary infection of ulcers
tooth mobility
bone loss
Hereditary hemorrhagic telangiectasia is associated with what syndrome?
Rendu-Olser-Weber syndrome
Hereditary hemorrhagic telangiectasia is a disorder affecting what?
blood vessel wall integrity
Clinical presentation of Hereditary hemorrhagic telangiectasia
small surface collections of dilated capillaries
red/violet lesions on face, oral/nasal mucosae, hands feet
lesions blanch with pressure
may be GI lesions
rupture with significant blood loss
repeated nose bleeds
Oral manifestations of Hereditary hemorrhagic telangiectasia
oral lesions on lip vermillion, tongue dorsum, buccal mucosa
Intrinsic coagulation pathway initiated by what factor?
XII
Extrinsic coagulation pathway initiated by what factor?
tissue thromboblastin
What is faster, the extrinsic or intrinsic coagulation pathway?
extrinsic
Factor VIII deficiency/dysfunction is characteristic of what bleeding disorder?
Hemophilia A
Factor IX deficiency/dysfunction is characteristic of what bleeding disorder?
Hemophilia B
Oral manifestations of hemophilia
oropharyngeal/CNS bleeding
oral ecchymoses and bleeding may follow trauma
