Haem

Question 1

What are causes of gingival hyperplasia?

Answer 1

Gingival hyperplasia: phenytoin, ciclosporin, calcium channel blockers (especially nifedipine) and AML

Question 2

TTP

Thrombotic thrombocytopenic purpura

Answer 2

Pentad:

1. Headache/altered mental state
2. Renal failure
3. Fevere
4. MAHA - Microangiopathic hemolytic anemia
5. Thrombocytopenia

Features:
- Anaemia
- Thrombocytopenia
- Neurological dysfunction – altered mental status, seizures,
hemiplegia, paresthesia, visual disturbance and aphasia
- Fever
- Dark coloured urine - haemoglobinuria

Tx:

• Steroids – no evidence
• Plasma exchange
• Rituximab – refractory or relapsing cases or even in patients with neurological and cardiac involvement
• Vincristine – refractory cases

Question 3

Elevated Homocysteine

Answer 3

Elevated homocysteine levels can lead to severe health complications. Too much homocysteine increases your risk for:

• Blood clots.
• Dementia.
• Heart attack.
• Heart disease.
• Osteoporosis.
• Stroke.

Vitamin B12, vitamin B6 and vitamin B9 (folate) break down homocysteine to generate other chemicals your body needs - high levels may indicate deficiency