Tutorials 3

Question 1

symptoms of acute lymphoblastic leukaemia

Answer 1

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

Question 2

sarcoma

Answer 2

cancer of soft tissue, connective tissue or bone

Question 3

Wilms tumour

Answer 3

nephroblastoma
cancer of kidneys
common in children

Question 4

what are megakaryocytes precursors for

Answer 4

platelets

Question 5

discuss chemotherapy
- what is it
- how is it given
- side effects

Answer 5

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

Question 6

oral problems associated with acute lymphoblastic leukaemia

Answer 6

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

Question 7

name one potential systemic cause for unexplained gingival swelling, bleeding gums and mobility of teeth

Answer 7

diabetes
Presentation of these symptoms with cause should always be investigated further

Question 8

how might undiagnosed diabetes present in a small child

Answer 8

4 Ts
Toilet (polyuria)
thirsty
tired
thinner (weight loss)

Question 9

dental problems associated with diabetes (children and adults)

Answer 9

increased susceptibility to periodontal disease
reduced salivary flow
increased caries risk
candidosis risk (partcularly if porly controlled)
infection prone

Question 10

minimum platelet and coagulation factor levels for general practice invasive procedures

Answer 10

CF - 50%
platelets 100 for GDP, 50 for hospital

Question 11

what bleeding disorder doesnt respond to DDAVP

Answer 11

haemophilia B
VWBD and haemophilia A do

Question 12

what may the haemophilia team prescribe to aid haemostasis after invasive procedures

Answer 12

tranexamic acid

Question 13

what local anaesthetic techniques carry greatest risk in haemophiliacs

Answer 13

IDB - haematoma in medial pterygoid risks trismus
lingual infil - haemotoma in FOM risks airway

Question 14

name 3 medical issues down syndrome patients are more at risk of

Answer 14

leukemia
cardiac defects
epilepsy

Question 15

name 3 physical features of down syndrome (not dental)

Answer 15

short neck
large tongue
small ears
midface hypoplasia

Question 16

name 3 dental features seen in down syndrome patients

Answer 16

hypodontia
microdontia
class III malocclusion
increased risk of perio
maxillary hypoplasia

Question 17

type one diabetes

Answer 17

autoimmune destruction of islet of langerhans cells in pancreas meaning lack of insulin production

Question 18

what condition may type one diabetes present as in the young

Answer 18

ketoacidosis

Question 19

RPG test

Answer 19

random plasma glucose test
>11.1 mmol/L on 2 occasions indicative of diabetes

Question 20

emergency management of hypoglycaemia

Answer 20

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

Question 21

what can chronic hyperglycaemia lead to

Answer 21

microvascular complications and macrovascular disease

Question 22

type 2 diabetes

Answer 22

90% of cases, strong family history, those >40

defective and delayed insulin secretion
abnormal post prandial suppression of glucagon

Question 23

name 2 drugs capable of inducing diabetes

Answer 23

cyclosporin
corticosteroids
tacrolimus

Question 24

what is ketoacidosis

Answer 24

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

Question 25

function of insulin

Answer 25

facilitates glucose entering cells therefore decreases blood glucose levels