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CHHD > White blood cell disorders > Flashcards

White blood cell disorders Flashcards

1
Q

What 2 cells form after the first differentiation of the multipoint haemotopoietic stem cell

A
  • Common Myeloid progenitor

- Common lymphoid progenitor

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2
Q

What are the 2 types of leukocyte

A

granular and agranular

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3
Q

Name the agranular leukocytes

A

lymphocytes

Monocytes

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4
Q

Name the granular leukocytes

A

Basophil
Neutrophil
Eosinophil

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5
Q

What is leukocytosis and what can cause it

A

Increased WBCs

  • increased production - leukaemia, myeloproliferative diseases
  • reactive leukocytosis - 2ry to infection or inflammation
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6
Q

What is Leukopenia and what can cause it

A

Decreased WBCs

  • 2ry to aplastic anaemia
  • cyclic neutropenia
  • drugs - chemotherapy
  • overwhelming bacterial/viral infections (HIV)
  • Radiation - 2ry to radiotherapy
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7
Q

What is leukaemia and describe it in its acute form

A
  • Malignant proliferation of WBCs
  • Proliferation of immature blast cells in blood and bone marrow
  • Reduction in number of normal, mature RBCs and platelets
  • Acute lymphoblastic leukaemia (lymphoblasts) = ALL
  • Acute myeloid leukaemia (myeloblasts) - AML
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8
Q

Describe the chronic form of leukaemia

A
  • Proliferation of mature cells
  • Progresses slowly allowing the bone marrow to keep producing more mature functional cells
  • Often asymptomatic
  • Chronic lymphocytic leukaemia (lymphocytes) - CLL
  • Chronic myeloid leukaemia (myelocytes) = CML
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9
Q

Who is more likely to get Acute lymphoblastic leukaemia (ALL) and who has a poor prognosis

A
  • More common in children

- Poor prognosis in adults

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10
Q

Who is more likely to get Acute myeloid leukaemia (AML) and who has a poor prognosis

A
  • More common in adults

* Poor prognosis in both adults and children

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11
Q

Who is more likely to get CLL and CML

A

Both forms more common in adults

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12
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

CML may progress to acute leukaemia

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13
Q

What are the clinical presentations of acute leukaemias

A
  • Short history of feeling unwell
  • May present with neutropenia (susceptible to infections), fever, bleeding tendencies, bruising, anaemia
  • Organ infiltration may occur: skin, gums, testes, meninges
  • Blood film: leucocytosis ~ circulating blasts and cytopenias
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14
Q

What are the clinical presentations of chronic leukaemias

A
  • Often diagnosed incidentally
  • Usually long history of non-specific symptoms
  • Splenomegaly is common
  • Lymphadenopathy is common in CLL
  • Blood film: leucocytosis ~ circulating mature lymphocytes or myeloid cells
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15
Q

What are the dental signs and symptoms of decreased RBCs

A
  • Fatigue
  • Pallor
  • Inability to perform routine daily activities
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16
Q

What are the dental signs and symptoms of decreased platelets

A
  • Mucosal bleeding
  • Petechiae
  • Easy bruising and bleeding
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17
Q

What are the dental signs and symptoms of decreased mature, normal, functioning WBCs

A
  • Increased susceptibility to infections

- Poor wound healing

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18
Q

What are the dental signs and symptoms of increased immature, abnormal, dysfunctional WBCs, infiltrating organs

A
  • lymphadenopathy
  • gingival enlargement
  • abdominal fullness due to enlarged spleen/liver
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19
Q

What are the adjunct supportive therapies that are used to compensate for lack of functioning cell lines in leukaemias

A
  • Red cell transfusion
  • Platelet transfusion
  • GCSF (granulocyte colony stimulating factor)
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20
Q

What specific treatments are there for leukaemia

A
  • chemotherapy - cytotoxic drugs
  • radiotherapy
  • targeted therapy
  • stem cell transplantation
21
Q

What are lymphomas and what types are there

A

These are solid tumours caused by malignant proliferation of the lymphocytes within nodal and extra nodal sites

  • Hodgkin’s
  • Non-Hodgkin’s
22
Q

What is hodgkin’s lymphoma caused by and what risk factors are there

A

B-cell dysfunction resulting in the accumulation of abnormal B cells
• Bimodal age distribution–early 20s and>70
• M>F
• Immunocompromised - HIV/AIDS, chemo- & radio-therapy
• Previous history of infectious mononucleosis
• Positive family history

23
Q

What are the clinical features of hodgkin’s lymphoma

A
  • Progressive, painless enlargement of lymph nodes esp in neck
  • Fatigue
  • night sweats
  • fever
  • anorexia
  • weight loss
  • bone pain
  • jaundice (when disease spreads to liver)
  • shortness of breath (when disease spreads to lungs)
  • pruritus
  • flu-like symptoms
24
Q

What special investigations are used for hodgkin’s lymphoma

A
  • lymph node biopsy - reed-sternberg cells

- FBC radiographs, CT/MRI and PET scans

25
Q

What are the treatment options for hodgkin’s lymphoma

A
  • Radiation therapy: Stage 1/2
  • Combined chemotherapy: stage 3/4
  • Stem cell transplant: recurrent hodgkin’s lymphoma
  • Targeted therapy
26
Q

What are the main dental problems that come from hodgkin’s lymphoma

A
  • Oral infections – esp. with viruses and fungi
  • Mucositis or oral ulceration caused by cytotoxic drugs
  • Hyposalivation – from salivary gland irradiation damage
  • Anaemia
  • Bleeding tendencies
  • Painless enlarged cervical lymph nodes
  • Impaired respiratory function (pulmonary fibrosis due to irradiation)
27
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

LA regional blocks should be avoided if there is any bleeding tendencies

28
Q

Describe all the features of non-hodgkin’s lymphoma

A
  • More common than hodgkin’s lymphoma
  • B or T cell associated subtypes
  • Most NHLs are of B cell origin
  • Greater propensity for extranodal sites
  • Any age
  • Poor prognosis
29
Q

What are the risk factors for Non Hodgkin’s lymphomas

A
  • Increasingage
  • Immunosuppression
  • Certain infections
  • Exposure to certain chemicals, including benzene, herbicides and pesticides
  • Strong family history of NHL
30
Q

What are the signs, symptoms, staging, treatments and dental aspects of NHLs

A

All the same as hodgkin’s lymphoma

31
Q

What is Burkitt’s lymphoma associated with

A

Previous epstein-barr virus infection

32
Q

What 3 subtypes are there for burkitt’s lymphoma

A

Endemic
Sporadic
Immunodeficiency

33
Q

Who is most susceptible to endemic burkitt’s lymphoma and what is a characteristic feature of it

A
  • African children and young adults
  • Boys > Girls
  • Jaw Swelling
34
Q

Who is most susceptible to sporadic burkitt’s lymphoma and what is a characteristic feature of it

A
  • Western world
  • Males > Females
  • Linked to EBV
35
Q

Who is most susceptible to immunodeficiency burkitt’s lymphoma and what is a characteristic feature of it

A
  • Increased incidence in HIV/AIDs

- Organ transplant

36
Q

What are the signs/symptoms/dental aspects/treatments etc of burkitt’s lymphoma

A

Same as hodgkin’s lymphoma

37
Q

What is multiple myeloma and what causes it

A

• Proliferation of malignant plasma cells
• Malignant plasma cells produce defective immunoglobulins - overabundance of monoclonal
paraproteins or M-proteins
• Malignant plasma cells release osteoclast-activating factors which cause bone resorption and pain

38
Q

What are the risk factors for multiple myeloma

A
  • Increasing age: more common around age 60
  • Gender: M > F
  • More prevalent in Africans
  • Immunosuppression
  • Past exposure to radiation
  • Strong Family history
39
Q

What are the classic signs and symptoms

A

CRAB

  • Calcium elevation (hyperCalcaemia)
  • Renal failure
  • Anaemia
  • Bone pain (esp. spinal)
40
Q

Name some other features of multiple myeloma

A
  • Blood hyperviscosity - thrombosis
  • weakness
  • visual disturbance
  • bleeding/ bruising tendencies
  • susceptibility to infections
  • osteoporosis
  • amyloidosis
41
Q

What are some of the special investigations for multiple myeloma

A
  • Serum protein electrophoresis - M proteins
  • Urine - pence-jones protein
  • bone marrow aspiration
  • FBC - anaemia, thrombocytopenia, leukopenia
  • renal function
  • bone profile - hypercalcaemia
  • Radiographies, CTs/MRIs
42
Q

What are the treatment options for multiple myeloma

A
  • Chemotherapy + steroids
  • Immunomodulatory drugs – inhibits the growth and survival of myeloma cells
  • Bone marrow transplant
43
Q

What can be done to treat the symptoms/complications of multiple myelomas

A
  • Analgesic
  • Blood transfusion
  • Dialysis
  • Bisphosphonates – help prevent pathological fractures
  • Radiotherapy
  • Surgery
44
Q

What is the prognosis for multiple myelomas

A
  • Variable

* Median survival is about 3 years

45
Q

What are some of the dental aspects for multiple myelomas

A
  • Jaw osteolytic lesions (involving posterior mandible)
  • Root resorption, loosening of teeth and pathological fractures
  • Risk of osteonecrosis (MRONJ) – due to IV bisphosphonates
46
Q

What are some of the rare complications of multiple myelomas

A

• Gingival bleeding
• Oral petechiae
- Cranial nerve palsies
- Herpes simplex and zoster infections

47
Q

What are the causes of reactive leukocytosis

A
  • Infections
  • Inflammation
  • Disease
  • Neoplastic conditions
48
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

idfk what’s going on with this evaluate WBC differential count

CHHD (27 decks)

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