Tutorials 3 Flashcards
symptoms of acute lymphoblastic leukaemia
breathlessness
looking pale
tiredness (school may report them falling asleep in class)
unexplained bruising or bleeding (not enough platelets in circulation)
prone to infections, coughs and colds (not enough WBCs)
swollen lymph nodes
high temp not attributed to another cause
boen pain - mostly in long bones e.g legs and arms
loss of appetite
swollen testicles in boys
sarcoma
cancer of soft tissue, connective tissue or bone
Wilms tumour
nephroblastoma
cancer of kidneys
common in children
what are megakaryocytes precursors for
platelets
discuss chemotherapy
- what is it
- how is it given
- side effects
medicine used to kill cancer cells therefore preventing reproduction of cells, growth and spread
most commonly given via IV in hospitals
side effects include tiredness, vomiting, hair loss, oral mucositis, infection prone, dry/ sore/ itchy skin
oral problems associated with acute lymphoblastic leukaemia
increased infection risk
oral and pharyngeal mucositis
dry mouth (salivary gland dysfunction)
increased caries risk
ORN, MRONJ risk
oral graft vs host disease (if stem cell or bone marrow transplant)
trismus (damage to MOM)
gingival hyperplasia and bleeding gingivae
name one potential systemic cause for unexplained gingival swelling, bleeding gums and mobility of teeth
diabetes
Presentation of these symptoms with cause should always be investigated further
how might undiagnosed diabetes present in a small child
4 Ts
Toilet (polyuria)
thirsty
tired
thinner (weight loss)
dental problems associated with diabetes (children and adults)
increased susceptibility to periodontal disease
reduced salivary flow
increased caries risk
candidosis risk (partcularly if porly controlled)
infection prone
minimum platelet and coagulation factor levels for general practice invasive procedures
CF - 50%
platelets 100 for GDP, 50 for hospital
what bleeding disorder doesnt respond to DDAVP
haemophilia B
VWBD and haemophilia A do
what may the haemophilia team prescribe to aid haemostasis after invasive procedures
tranexamic acid
what local anaesthetic techniques carry greatest risk in haemophiliacs
IDB - haematoma in medial pterygoid risks trismus
lingual infil - haemotoma in FOM risks airway
name 3 medical issues down syndrome patients are more at risk of
leukemia
cardiac defects
epilepsy
name 3 physical features of down syndrome (not dental)
short neck
large tongue
small ears
midface hypoplasia
name 3 dental features seen in down syndrome patients
hypodontia
microdontia
class III malocclusion
increased risk of perio
maxillary hypoplasia
type one diabetes
autoimmune destruction of islet of langerhans cells in pancreas meaning lack of insulin production
what condition may type one diabetes present as in the young
ketoacidosis
RPG test
random plasma glucose test
>11.1 mmol/L on 2 occasions indicative of diabetes
emergency management of hypoglycaemia
if awake and responsive - 3x glucose tablets or oral glucose gel
if unresponsive 1mg glucagon IM injection using Z-track technique
always give food after treatment
what can chronic hyperglycaemia lead to
microvascular complications and macrovascular disease
type 2 diabetes
90% of cases, strong family history, those >40
defective and delayed insulin secretion
abnormal post prandial suppression of glucagon
name 2 drugs capable of inducing diabetes
cyclosporin
corticosteroids
tacrolimus
what is ketoacidosis
lack of insulin in body leads to cells using fats for energy rather than glucose, fats breakdown leads to increased ketones in blood which can lower blood pH to a dangerous level
seen in type one, rarely in type 2
function of insulin
facilitates glucose entering cells therefore decreases blood glucose levels
