Sickle Cell Disorders Flashcards
___ is an oxygen-carrying molecule. A normal RBC is ___% Hb by weight.
Hemoglobin; 33
___ is a reduction in the oxygen-carrying capacity of the blood. It is considered a ___ ___ not a disease.
Anemia; symptom complex
What are some causes of anemia?
- decreased RBC production
- blood loss
- destruction of circulating RBCs
In patients with the sickle cell trait, how many genes for HbS do they carry? Sickle cell disease?
trait: 1 (heterozygous)
disease: 1 gene for each parent for HbS (homozygous)
__-___% of African Americans carry the sickle cell trait and ___ African Americans have sickle cell disease
8-10%; 1/600
Define sickle cell disease
Cellular rigidity and membrane damage cause RBCs to become irreversibly sickle-shaped due to crystallization of HbS
What are three sickling stimuli?
- Deoxygenated blood
- Decreased blood pH
- Dehydration
T/F. Patients with >80% of their Hb being HbS are very sensitive to sickling stimuli.
True.
Patients with 20-45% Hb as HbS are less sensitive to sickling stimuli (usually sickle cell trait patients)
What are the net effects of RBC sickling?
- erythrostasis
- increased blood viscosity
- reduced blood flow
- hypoxia
- RBC adhesion
- vascular occlusion
- further sickling
What type of patients are typically asymptomatic, less sensitive to sickling stimuli, and not at risk for adverse events during dental treatment?
sickle cell trait
Routine dental care should be given during non-___ periods.
crisis
Sickle cell patients should be given a ___-___ protocol, ___ local anesthesia, nitrous oxide sedation with at least ___% oxygen concentration, ___ +/- ___ for pain, and physician consultation prior to any surgical procedures.
stress-reduction; profound; 50; Tylenol +/- codeine
___ can trigger a crisis. How is this handled?
infection
remove offending sourse, I&D, systemic antibiotics
If cellulitis, consider inpatient management
adequate fluid intake to avoid dehydration
