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SU18: Internal med final > WBC Disorders & Cancer > Flashcards

WBC Disorders & Cancer Flashcards

1
Q

what is the primary host defense against microbial infections?

A

WBCs

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2
Q

what is the #1 fighting cell?

A

neutrophils

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3
Q

neutrophils make up what percent of WBC volume?

A

5-60%

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4
Q

where does WBCs arise from?

A

bone marrow

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5
Q

types of WBCs

A
  • lymphocytes
  • monocytes
  • eosinophils
  • basophils
  • neurophils
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6
Q

WBC cancers

A
  • leukemia
  • lymphoma
  • multiple myeloma
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7
Q

leukemia

A

malignant proliferation of myeloid or lymphoid cells

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8
Q

acute leukemia

A

rapid accumulation of immature, non-fxnal WBCs in marrow

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9
Q

chronic leukemia

A

pts have more mature, fxnal WBCs because disease is slow to develop

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10
Q

chronic leukemia is common in adults of what age?

A

> 65 yo

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11
Q

med management of acute leukemia

A
  • cure depends on tumor burden at diagnosis and the ability to rapidly eliminate the malignant WBCs
  • chemotherapy
  • bone marrow transplant if have a match
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12
Q

what are the 2 phases of chemotherapy for pts with acute leukemia

A
  1. induction and consolidation

2. maintenance

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13
Q

induction and consolidation phase of chemotherapy for pts with acute leukemia

A

hit hard, kill tumor cells

*goal is to get rid of as many tumor cells as possible

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14
Q

maintenance phase of chemotherapy for pts with acute leukemia

A

prevent expansion of remaining leukemic cells

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15
Q

at what phase in chemotherapy are pts in remission?

A

maintenance phase

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16
Q

can acute leukemia be cured?

A

yes!

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17
Q

do pts who are cured from acute leukemia easier to induce a relapse?

A

no, more difficult

18
Q

is it possible for pts with chronic myelogenous secondary to chronic leukemia to obtain complete remission?

A

yes

19
Q

is chronic lymphocytic secondary to chronic leukemia curable?

A

no, txtment has little effect on improving quality of life

20
Q

lymphoma

A

cancer of lymphoid organs and tissues

21
Q

which type of lymphomas are more aggressive?

A

higher grades

22
Q

examples of lymphoma

A
  • Hodgkin

- non-Hodgkin

23
Q

med management of lymphoma

A
  • induction chemo to shrink volume

- radiation to remaining mass

24
Q

what is the cure rate of Hodgkins?

A

90%

25
Q

what is the cure rate of non-Hodgkins?

A

60-70%

26
Q

chemo and radiation can cause long-term complications in which organs?

A
  • heart
  • lungs
  • thyroid
27
Q

multiple myeloma

A
  • lymphoproliferative disorder
  • overproduction of malignant plasma cells
  • multiple tumorous masses through the skeletal system
28
Q

radiographic characteristic of multiple myeloma

A

punched out appearance of skull

29
Q

overproduction of malignant plasma cells can cause what?

A

soft spots in bone so sets pts up for fracture

30
Q

med management of multiple myeloma

A
  • cancericidal chemotherapy

- palliative radiation

31
Q

what is the survival rate of pts diagnosed with MM

A

5 yr survival rate (28-41%)

32
Q

dental concerns of treating pts with WBC disorders

A
  • infection
  • delayed healing
  • bleeding
33
Q

dental care before cancer txtment

A
  • consult with oncologist
  • examination, radiographs as needed
  • eliminate disease/infection before start of chemo/radiation
34
Q

if did a full mouth ext on pt with WBC disorder, how long should pt wait before starting chemo?

A

at least 2 weeks

35
Q

platelet count needs to be minimally at what number prior to surgery?

A

> 50,000 but if less then need replacement pre-op

36
Q

WBC count prior to surgery?

A

> 2000 total count OR >500 neutrophils

37
Q

if WBCs count is <2000 total count OR <500 neutrophils in pts prior to surgery, should you give them antibiotic prophylaxis?

A

yes

38
Q

which antibiotic should be given to pts with low WBCs for antibiotic prophylaxis prior to surgery?

A

amoxicillin 2g 1 hour pre-op then 500mg 4x daily for 1 wk

39
Q

guidelines for extraction pts

A
  • be prepared to txt bleeding
  • obtain primary closure if possible
  • minimum 10-14 days between surgery and start of chemo/radiation
40
Q

what types of dental care can be given to pts during cancer txtment?

A
  • preventive care only (i.e. oral hygiene instruction, dental prophylaxis, caries control)
  • NO ELECTIVE DENTAL CARE
41
Q

what happens if a pt has a dental emergency during cancer txtment?

A

txt in coordination with oncologist

SU18: Internal med final (25 decks)

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