Haemotlogy Pathology Flashcards by Aisha Mohammed

What should you avoid with patients who have haem problems?

Trauma
Regional LA
Intramuscular injections
Drugs causing gastric bleeding, increased bleeding tendency - aspirin, warfarin, heparin

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What is anaemia?

A reduction in the oxygen carrying capacity of the blood
Low value of haemoglobin: <13.5 men <11.5 women
Severe: <7
Less haemoglobin less cell volume less RBC

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What are the 3 classifications of anaemia?

Red cell mean corpuscle volume (RBC size)
Microcytic- small
Normocytic
Macrocytic - large

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What are the 3 deficiencies that cause anaemia?

Iron
Vitamin B12
Folate

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What is the pathogenesis of anaemia?

Reduced RBC production
Increased RBC destruction
Blood loss
Increased plasma demand

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What are the 2 causes of anaemia?

Disease
Secondary to drug therapy

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What are the clinical features of anaemia?

Acute blood loss - collapse, breathlessness, tachycardia, reduced BP, faint
Pale skin
Heart failure

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What are the main organ dysfunctions of sever anaemia?

Cardiorespiratory
Neuromuscular
Gastro - loss of appetite
Menstrual

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What is the dental relevance of anaemia?

Poor wound healing
Caution with sedation and drugs
Avoid GA
Emergency - give blood with diuretic

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What are the 2 types of microcytic anaemia?

Iron deficiency
Thalassaemia

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What are the causes of iron deficiency?

Blood loss
Pregnancy iron demand
Vegetarian
Absorption problems coeliac

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What is the treatment for iron anaemia?

Remove cause
Iron supplements -ferrous sulphate

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What is the difference in histology between iron anaemia and normal?

Pale and small red blood cells

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What is thalassaemia?

Inherited disorders of haemoglobin
Reduced alpha and beta chain synthesis
Increased RBC

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What is the dental relevance of thalassaemia?

Bony abnormalities
Prone to recurrent infections
Wound healing problem

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Which type of thalassaemia poses a threat with high mortality rate?

Beta thalassaemia major
Transfusion dependent
Bone marrow expansion

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What defines macrocytic anaemia?

Vitamin B12 or folate deficiency
They are required to synthesise DNA

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What are the 2 types of macrocytic anaemia?

Megaloblastic haemopoeisis - abnormal RBC development due to DNA
Normoblastic haemopoeisis - normal RBC maturation

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What are the causes of macrocytic anaemia?

Vit B12 deficiency
Folate deficiency
Alcoholism
Liver disease
Chemotherapy

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What is normocytic anaemia caused by?

Chronic infections - TB
Chronic diseases - RA renal failure
Cancer
Bone marrow disorders

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What is normocytic anaemia?

Anaemias of chronic disease

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What are the 2 types of haemolytic anaemias?

Congenital
Acquired - autoimmune

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What os haemolytic anaemia?

Shortened lifespan of RBC
Increased bone marrow haemopoesis

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What type of genetic disorder is sickle cell anaemia?

Autosomal recessive

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What are the 2 problems of the sickle cell shape?

Shortened erythrocyte survival Micro circulation obstruction

What are the clinical features of sickle cell?

Progressive anaemia Frontal bossing Splenic infarction

What are some complications of sickle cell?

Stroke

What are the 3 types of acute crisis of sickle cell?

Thrombotic Organ failure Sequestration RBC in spleen

What is the dental relevance of sickle cell?

Avoid prilocaine Sedation avoided No GA Avoid aspirin

What is haemostasis?

Prevents blood loss from vascular injury Blood clotting

What are the 4 events of haemostasis?

Vasoconstriction Platelet plug Firbin clot Clot dissolution

What is the dental relevance for bleeding disorders?

LA no cover with coagulation Post administration of ID block Many are HIV hep C positive

What are platelet disorders caused by?

Reduced numbers Functional abnormalities Reduced production Increased destruction

What are the clinical features of platelet disorders?

Bruising Nosebleeds Haemorrhage

Which drugs affect platelet function?

NSAIDs Clopidogrel Beta lactam antibiotics Nitrates Beta blockers Warfarin

What conditions use warfarin?

DVT Embolism Atrial fibrillation RH disease Stroke

What is the dental relevance of warfarin?

Morning appointments Avoid block injections Check INR

What are some haemostats measures?

Non traumatic surgery Pack socket with gauze Careful suturing Pressure

Where does haemopoiesis occur?

Bone marrow of axial skeleton

What are the 2 types of stem cells from pluripotent?

Myeloid Lymphoid

What is acute leukaemia?

Malignant tumours of haemopoietic precursor cells

What are the 2 causes of acute leukaemia?

Radiation Down’s syndrome (Damaged DNA)

What are the 2 classifications of acute leukaemia?

Acute myeloid - m0-m7, older Acute lymphoblastic - l1-l3, childhood

What are the clinical features of acute leukaemia?

Weight loss Bone marrow suppression lack of RBC anaemia Organomegaly

What is the treatment for acute leukaemia?

Chemotherapy Transfusions Antibiotics Bone marrow transplant

What are the causes of chronic leukaemia?

CML - radiation and chemical CLL - unknown

What are the clinical features of chronic leukaemia ?

Asymptomatic Organomegaly Anaemia Weight loss CLL - Immunosuppressed

What is the treatment for chronic leukaemia?

CML - hydroxyurea, allogenic transplant CLL - chemotherapy

What is the dental releavance of chronic leukaemia?

ALL - gingival bleeding, ulcers, candidiasis AML - gingival infiltration CLL - cervical lymph, herpes zoster Prophylactic antibiotics

What are lymphomas?

Malignant tumours of T B cells within lymphoid tissue

What is Hodgkin disease?

Tumours of cervical supraclavicular lymph nodes

What causes Hodgkin disease?

EBV

What do the lymphomas feel like for Hodgkin’s?

Painless Non tender Rubbery Fixed Asymmetrical Red itchy rash

What is non-hodgkins lymphoma?

Lymphoreticular tissue Spleen, liver, bowel Unknown cause

What is burkitts lymphoma?

High grade non-Hodgkin Abnormal B lymph Previous EBV

What is the treatment for lymphomas?

Radiotherapy for localised Chemo for generalised

What is the dental relevance of lymphomas?

Non hodgkins oropharyngeal sore throat Lesions in salivary glands Burkitts - jaw complications

What is multiple myeloma?

Malignant proliferation of single clone of bone marrow plasma cells

What are the clinical features of multiple myeloma?

Bone marrow suppression Thick blood Lytic lesions in bone Renal

What is the treatment for multiple myeloma?

Chemo Analgesia Plasma

What is the dental relevance of multiple myeloma?

Lytic lesions in jaw and skull Anaemia Renal - no NSAIDs

Haemotlogy Pathology Flashcards

(61 cards)