Module 18 Exam 3 Flashcards Preview

Dental Hygiene II > Module 18 Exam 3 > Flashcards

Flashcards in Module 18 Exam 3 Deck (75):
1

what is sickle cell disease

- hereditary form of hemolytic anemia, resulting from a defective hemoglobin molecule
-autosomal recessive trait disorder with no symptoms

2

what is the most common genetic disorder of the blood

sickle cell anemia

3

who does sickle cell disease primarily occur in a

african american populations, white populations of mediterranean origin

4

what is the blood test for sickle cell disease

hemoglobin electrophoresis

5

when do signs and symptoms start appearing for sickle cell disease

within first 6 months with anemia and vasculopathy

6

what may be impaired in sickle cell disease during the early years

growth and development, makes the susceptible to communicable diseases

7

what causes thrombosis and infarction from sickle cell anemia

cause there is an increase in fluid viscosity

8

what is severe hemolytic anemia

a hemolytic sickle cell disease where the hematocrit ranges from 18-30%

9

what is the normal lifespan RBC

-90 to 120 days

10

what is the lifespan of RBC in hemolytic anemias

10 to 15 days

11

what is a sickle cell crisis

recurrences of clinical exacerbations of the disease with periods of remission characterize childhood and adolescence

12

what are the precipitating factors of a sickle cell crisis

-can occur at any time without stimuli
-hypoxia, dehydration, sudden change in temp
-physical activity, extreme fatigue
-stress/anxiety, additional physical burden

13

what are clinical symptoms of a sickle cell crisis

-reversible, pain episodes involving extremities head, back , chest
-swelling, fever, dehydration,
-infarctions
-symptoms of seizure, stroke, coma

14

can a sickle cell crisis be fatal

yes

15

what is the major organ that is effected in a sickle cell crisis

kidney

16

what are some preventative measures that can be taken for sickle cell anemia

-stem cell transplant
-daily penicillin until 6
-promptly treat infections
-genetic counseling
-folate supplements

17

what are tx for sickle cell anemia

-supportive and palliative tx
-pain releif
-antibiotics for infectious disease
-o2 therapy and blood transfusions

18

what are the radiographic findings of sickle cell

-decreased radiodensity
-coarse trabecular pattern, step ladder
-sig. bone loss in children
-thinning of the border of the mandible

19

what are oral manifestations of sickle cell disease

-pallor of tissues
-jaundice
-perio involvment can lead to sickle cell crisis
-pockets infection and bleeding
-delayed eruption, malocclusion, dentin hypomineralization
-facial and dental pain

20

what is the objective of appointment mangagement of sickle cell disease

do precipitate a sickle cell crisis

21

Does sickle cell disease require antibiotic premed

some do

22

what kind of local anesthetic for sickle cell disease

low doses of vasoconstrictors

23

can you use n20 in sickle cells

yes oxygen must be above 50 %

24

what is a polycythemia

increase in the number and concentration of blood cells above the normal level, hemoglobin and hematocrit levels are more than 55% in males and 50% infemales

25

what is relative polycythemia

-loss of plasma with a corresponding los of red blood cells, concentration of cells increases and relative polycythemia results

26

what can be causes of fluid loss in relative polycythemia

dehydration, diarrhea, repeated vomiting, sweating or loss of fluid from burns

27

is the risk of CVA and infarction increased in relative polycythemia

yes

28

what is polycythemia vera (primary polycythemia)

actual increase in RBC count and Hg value, white cell and platelet counts elevated, blood viscosity increases

29

what is polycythemia vera caused by

its a neoplastic condition resulting from a bone disorder in which primitite red cells or stem cells proliferate cause is unknown

30

what are the oral signs and symptoms of polycythemia vera

-tongue, mucous membranes are deep redish purple
-gingiva are enlarged, bleed easily
-submucosal petichiae, ecchymosis and hematoma formation

31

what is the treatment for polycythemia vera

chemo
phlebotomy
avoid iron supplements and aspirin meds

32

what are the dental hygiene considerations for poly cythemia vera

-frequent maintenance appts
-review medical history
-eval pt blood test results

33

what is secondary polycythemia

erythrocytosis, and increase in the numbers of red blood cells

34

what can the increase in RBC production in secondary polycythemia result from

-hypoxia, neoplasms

35

what can bleeding tendencies in secondary polycythemia be partially controlled by

-control of gingival irritiants

36

why may disorders of the WBC occur

because of a decrease or an increase in cell numbers

37

what is leukopenia

-decrase in the total number of WBC results when production cant keep up with the turnover rate, or when accellerated rate of removal of cells occurs

38

what are specific infections in which leukopenia occurs

-HIV/AIDS, typhoid fever, infulenza, malaria, measles, German measles

39

what are diseases or intoxifications of the bone marrow in which leukopenia occurs

-chronic drug poisioning, ionizing radiation, autoimmune or drug induced immune reactions

40

what is agranulocytosis (malignant neutropenia)

-rare, serious disease involving the destruction of the bone marrow, a reduction in circulating neutrophils

41

what is the cause of the primary form of agranulocytosis? secondary

unknown
by drugs and chemicals

42

what is the oral characteristic of agranulocytosis

presence of infection

43

what is leukocytosis

increase in the number of circulating WBC, caused by inflammatory and infectious states, trauma, exhertion, and other condititons

44

what is the most extreme abnormal cause of leukocytosis

leukemia

45

what is a leukemia

malignant neoplasm of immature WBC that muliply uncontrollably and become cancerous

46

what is leukemia characterized by

abnormally large numbers of immature WBC, located within circulating blood and bone marrow

47

what is lymphocytopenia

-abnormally low number of lymphocytes in the blood

48

what is the treatment of lymphocytopenia

-gamma globulin, antivirals if pt has AIDS

49

what does a hereditary deficency in lymphocytopenia require

bone marrow transplantation

50

what are the general types of bleeding disorders caused by

-pathology of the blood vessel wall
-platelet deficiency or dysfunction
-disorders of coagulation

51

what is the pathology of the vessel wall in bleeding disorders

-vascular fragility increased, petechial and purpuric hemorrhages

52

what are the 2 platelet deficiencys or dysfunctions in bleeding disorders

-throbocytopenia (lowered number of platelets)
-Platelet dysfunction (interferece with clotting mechanism)

53

what are the two types of coagulation disorgders in bleeding disorders

aquired disorders- (vitamin K deficiency, essentail for factors VII, IX and X, liver disease, anticoagulation drugs)
Hereditary disorders (deficiency or abnormality of a plasma protien, Hemophilia A and B, von willebrands factor)

54

what is Hemophilia A (classic)

cause by reduced amount of activity of factor VIII, 85% of people with hemophilia have this form

55

what is hemophilia B (christmas disease)

deficiency of a blood plasma protien called factor IX that effects the clotting properties of blood

56

both hemophilia A and B are _____ linked rescessive genetic diseases

x-linked, occurs primarily in males

57

what can the severity of hemophilia be related directly to

the level of the clotting factor in the circulating blood

58

what von willebrands disease

prolonged bleeding time in the presence of a normal platelet count, most common hereditary disorder of platelet function.

59

who does von willebrands occur in

males and females

60

what are extra oral signs of vonwillebrands

petechiae of skin

61

what are the effect of minor trauma in hemophilias

bleeding and bruising depends on the extent of the disease

62

what is hemarthroses in long term complications of hemophilia

bleeding into soft tissues of the joints, swelling, pain, incapacitation

63

what is the joing deformity in complicaitons of hemophilia

-permanent joint damage, can result and the patient may need splints, braces or orthopedic surgery

64

what is the intramuscular hemorrage in hemophilia

hemorrhage into muscles is accompanied by pain and limitation of motion

65

what is oral bleeding in the complications of hemophilia

-gingival bleeding common, even more when perio infeciton
-b/c of fear of bleeding patients may neglect brushing and flossing

66

how do you manage uncontrolled bleeding i

-stop tx
-if clotting doesnt occur with in a couple mins, apply gauze
-medical attention if bleeding doesnt stop

67

what needs to be included in the medical history of a bleeding disorder

-type, severity, tx, meds, and family history

68

does someone with a bleeding disorder require premed,

consult physician

69

do many dental procedures require factor replacement therapy before dental appointments

yes

70

what test are needed on the same day as dental tx

PT-within 24 hrs or INR

71

what is the most common side effect of warfin and coumadin

hemorrhage

72

what does a PT measure

status of extrinsic and common pathways of coagulation

73

what does an INR measure

standard method of measuring PT independent of thromboplastin reagent, more accurate thatn PT

74

what is an aPTT

mesures the status of the intrisic and common pathways of coagulation

75

What should we teach with OH in a blood disorder pt

-careful flossing, age appropriate preventative measures, nutritional counseling
-encourage to improve and maintain good oral heath
-meticulous biofilm removal, soft toothbrush