RBC Disorders Flashcards Preview

SU18: Internal med final > RBC Disorders > Flashcards

Flashcards in RBC Disorders Deck (30)
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1
Q

hemoglobin

A

oxygen-carrying molecule

2
Q

normal RBC

A

33% Hb by weight

3
Q

anemia

A

reduction in oxygen-carrying capacity of the blood

4
Q

cause of anemia

A
  1. decreased RBC prod
  2. blood loss
  3. destruction of circulating RBCs
5
Q

pts with what type of disease are also prone to becoming anemic?

A

renal disease

6
Q

why do pts with renal disease prone to becoming anemic?

A

b/c kidneys help make RBCs

7
Q

med management of anemic pts

A

eliminate underlying cause

8
Q

Hb goal of anemic pts

A

> 11 g/dL

9
Q

can you txt anemic pts?

A

all dental care appropriate unless pt is symptomatic (SOB)

10
Q

sickle cell trait

A

pt carries 1 gene for HbS (heterozygous)

11
Q

what percent of African Americans are carriers for the sickle cell trait?

A

8-10%

12
Q

sickle cell disease

A

1 gene from each parent for HbS (homozygous)

13
Q

pathophysiology of sickle cell disease

A

cellular rigidity and membrane damage cause RBCs to become IRREVERSIBLY SICKLE-SHAPED due to crystallization of HbS

14
Q

what happens in response to the physiologic changes of the sickle cell disease?

A
  • deoxygenated blood
  • decreased blood pH
  • dehydration
15
Q

T/F: pts with sickle cell disease are very sensitive to sickling stimuli?

A

true

16
Q

what percent of Hb is HbS in pts with sickle cell disease?

A

> 80%

17
Q

is sickle cell trait symptomatic?

A

no, typically asymptomatic

18
Q

are pts carrying the sickle cell trait as sensitive to the sickling stimuli?

A

no, they’re less sensitive

19
Q

what percent of Hb in pts carrying the sickle cell trait is HbS?

A

20-45%

20
Q

are pts carrying the sickle cell trait at risk for adverse effects during dental txtment?

A

no

21
Q

effects of RBC sickling

A
  • erythrostasis
  • increased blood viscosity
  • reduced blood flow
  • hypoxia
  • RBC adhesion
  • vascular occlusion
  • further sickling
22
Q

sickle cell crisis

A

periods where body is stressed out causing cells to sickle

*pts in horrible pain

23
Q

do pts who has had splenectomy need antibiotic prophylaxis?

A
  • yes, needed before any type of invasive dental txtment

- work with PCP

24
Q

can routine dental care be given to pts with sickle cell disease?

A

yes, but during non-crisis periods

25
Q

dental mods for pts with sickle cell disease

A
  • stress-reduction protocol
  • profound local anesthesia
  • nitrous oxide sedation
  • consult with physician prior to any surgical procedures
26
Q

what is the minimum percent of oxygen concentrations in nitrous oxide sedation given to pts with sickle cell disease?

A

at least 50%

*low O2 conc. can get cells more sickle

27
Q

what analgesics can be given to pts with sickle cell disease for post-op pain?

A
  • NSAIDs
  • Tylenol
  • +/- codeine
28
Q

why do we aggressively txt odontogenic infections in pts with sickle cell disease?

A

infection can trigger a crisis

*infections throws off pH balance of blood

29
Q

how do you txt odontogenic infections in pts with sickle cell disease?

A
  • remove offending source
  • incision and drainage
  • systemic antibiotics
    adequate fluid intake to avoid dehydration
30
Q

how do you txt cellulitis in pts with sickle cell disease?

A

inpatient management so send them to the ER