Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Module 7 > SPECIAL CARE bleeding disorders blood cancers MRONJ > Flashcards

SPECIAL CARE bleeding disorders blood cancers MRONJ Flashcards

1
Q

what are the 2 types of bleeding disorders?

A

platelet disorders
clotting disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe normal haemostasis?

A

blood vessel vasoconstriction
platelet plug
activation of coagulation - stable fibrin plug
activation of fibrinolysis - clot dissolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 3 types of platelet disorders?

A

failed platelet production
excessive platelet destruction
abnormal platelet function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is thrombocytopenia?

A

low platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are causes of thrombocytopenia?

A

autoimmune
alcoholism
bone marrow disease
cancer
infection - HIV, EBV
cancer treatments
liver problems - cirrhosis and hepatitis
glanzmanns disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is glanzmanns disease?

A

autosomal disease which affects platelet aggregation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

symptoms of platelet disorders?

A

epistaxis
menorrhagia
gingival haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

dental management of pt with platelet disorder?

A

liaise with haematology/ oncology
FBC prior to procedure
platelet levels above 50 for xLA
platelet levels above 70 for major surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is given to pt to increase platelet count?

A

steroids
eltrombopag
tranexamic acid
platelet transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is tranexamic acid used for?

A

treat or prevent excessive blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the action of tranexamic acid?

A

antifibrinolytic action - stops clots breaking down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

name the common clotting disorders?

A

Von Willebrand’s disease
haemophillia A (factor viii)
haemophillia B (factor IX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is von willebrand factor needed for?

A

it is a co-factor for normal platelet adhesion

also a carrier for factor VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are symptoms of VWD?

A

excessive bleeding from injury, surgery, dental xla
frequent nosebleeds
heavy periods
heavy bleeding during labour and delivery
blood in urine or stool
easy bruising or lumpy bruises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the tx for VWD?

A

often no day-to-day tx

for dental procedure:
tranexamic acid (mouthwash or tablets)
desmopressin
factor VIII (only for severe cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is desmopressin (DDAVP)?

A

synthetic version of vasopressin
stimulates the release of VWF and increase in factor VIII levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how may desmopressin be delivered?

A

IV
IM
SC
Intranasal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does the severity of haemophillia depend on?

A

depends on level of clotting factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are symptoms of haemophillia?

A

nosebleeds
prolonged bleeding from wounds
bleeding gyms
skin that bruises easy
pain and stiffness around joints
internal bleedingw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what type of haemophillia is more common?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why must dental xla be planned for pts with severe haemophillia?

A

one of the most common life threatening bleeds
they will need prophylactic factor VIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is haemostatic cover therapy required for, according to WFH guidelines?

A

xla
oral surgery
perio surgery
implant surgery
IDBs, lingual infils

23
Q

what must you do prior, during and after xla for a haemophillia pt?

A

liase with haemophillia centre to organise factor replacement therapy
use of buccal articaine
tranexamic acid mouthwash and/or tablets
topical haemostatic agents - pressure packs, sutures, oxidised cellulose

24
Q

what management is required for perio tx of haemophillia pts?

A

pre and post op tranexamic acid required

25
Q

what are the challenged of pts with bleeding disorders?

A

reluctance to brush teeth due to fear of bleeding
reluctance to access regular dental care due to fear of haemorrhage
poorer attendance
increased rate of extractions

26
Q

what are challenges with haematological cover?

A

some pt develop inhibitors to replacement clotting factors so require more expensive drugs

27
Q

name drugs which affect bleeding?

A

anti-platelet drugs - aspirin, clopidogrel
anti-coagulants - warfarin, heparin
newer anti-coagulants - dabigatran, apixaban, rivaroxaban, edoxaban

28
Q

what are the types of blood cancer?

A

myeloma
leukaemia
lymphoma
myelodysplasia

29
Q

what is multiple myeloma?

A

plasma cell neoplasm - production of abnormal serum immunoglobulins

30
Q

what is multiple myeloma sometimes related to?

A

radiotherapy or petroleum products

31
Q

how is myeloma diagnosed?

A

blood tests
CT/MRI scan
bone marrow biopsy

32
Q

what are the affects of myeloma?

A

bone pain
renal failure
anemia
neurological lesions
hyperviscosity syndrome - thick blood

33
Q

dental aspects of myeloma?

A

root resorption
loose teeth
mental anaesthesia
pathological fractures
rare cause of mandibular radiolucencies

34
Q

what are the tx for myeloma?

A

chemotherapy
steroids
bisphosphonates
biological therapies

35
Q

what are the 4 types of leukaemia?

A

acute lymphoblastic leukaemia
acute myeloid leukaemia
chronic lymphocytic leukaemia
chronic myeloid leukaemia

36
Q

who is acute lymphocytic leukaemia more common in?

A

children

37
Q

who is acute myeloid leukaemia more common in?

A

adults - poor prognosis

38
Q

who is chronic leukaemia more common in?

A

adults

39
Q

what are symptoms of chronic leukaemia that pts may present with?

A

splenomegaly
lymph node enlargement

40
Q

what is treatment for leukaemia?

A

chemo
radiation therapy
stem cell transplant
immunotherapy
tyrosine kinase inhibitors

41
Q

what are dental aspects of leukaemia?

A

crowding out of normal blood cells by the leukaemic cells
anaemia
bleeding tendencies
susceptibility to infections
septicaemia from oral infections

42
Q

how may leukaemia present in the mouth?

A

mucosal pallor
ulceration
gingival swelling
spontaneous bleeding

43
Q

what is lymphoma?

A

cancer of the lymph glands or other organs of the lymphatic system

44
Q

what are the types of lymphoma?

A

Hodgkin’s lymphoma
Non Hodgkin’s lymphoma

45
Q

what are symptoms of lymphoma?

A

non tender swollen lymph nodes, fever, night sweats and unexplained weight loss

46
Q

how does Hodgkins lymphoma arise?

A

develops from B lymphocytes
characterised by reed-sternberg cells

47
Q

how is hodgkins lymphoma treated?

A

aggressive chemotherapy and radiotherapy

48
Q

what does non-hodgkins lymphoma affect?

A

B lymphocytes or T lymphocytes

49
Q

name a monoclonal antibody therapy

A

rituximab

50
Q

what is myelodysplasia?

A

rare type of blood cancer - dont have enough healthy blood cells, bone marrow makes abnormal cells instead of healthy blood cells

51
Q

what are symptoms of myelodysplasia?

A

weakness, tiredness, breathlessness

frequent infections

bruising and easy bleeding, such as nose bleeds

52
Q

what are treatments for myelodysplasia?

A

GF injections
blood transfusion
antibiotics
biologic therapies
chemotherapy
immunosuppressants
stem cells (bone marrow) transplant

53
Q

what are the dental aspects of myelodysplasia?

A

risk of bleeding - platelets, clotting
may need platelet transfusion
may be on steroids, bisphosphonates
MRONJ risk

Module 7 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions