WBC Disorders & Cancer

Question 1

what is the primary host defense against microbial infections?

Answer 1

WBCs

Question 2

what is the #1 fighting cell?

Answer 2

neutrophils

Question 3

neutrophils make up what percent of WBC volume?

Answer 3

5-60%

Question 4

where does WBCs arise from?

Answer 4

bone marrow

Question 5

types of WBCs

Answer 5

• lymphocytes
• monocytes
• eosinophils
• basophils
• neurophils

Question 6

WBC cancers

Answer 6

• leukemia
• lymphoma
• multiple myeloma

Question 7

leukemia

Answer 7

malignant proliferation of myeloid or lymphoid cells

Question 8

acute leukemia

Answer 8

rapid accumulation of immature, non-fxnal WBCs in marrow

Question 9

chronic leukemia

Answer 9

pts have more mature, fxnal WBCs because disease is slow to develop

Question 10

chronic leukemia is common in adults of what age?

Answer 10

> 65 yo

Question 11

med management of acute leukemia

Answer 11

• cure depends on tumor burden at diagnosis and the ability to rapidly eliminate the malignant WBCs
• chemotherapy
• bone marrow transplant if have a match

Question 12

what are the 2 phases of chemotherapy for pts with acute leukemia

Answer 12

1. induction and consolidation

2. maintenance

Question 13

induction and consolidation phase of chemotherapy for pts with acute leukemia

Answer 13

hit hard, kill tumor cells

*goal is to get rid of as many tumor cells as possible

Question 14

maintenance phase of chemotherapy for pts with acute leukemia

Answer 14

prevent expansion of remaining leukemic cells

Question 15

at what phase in chemotherapy are pts in remission?

Answer 15

maintenance phase

Question 16

can acute leukemia be cured?

Answer 16

yes!

Question 17

do pts who are cured from acute leukemia easier to induce a relapse?

Answer 17

no, more difficult

Question 18

is it possible for pts with chronic myelogenous secondary to chronic leukemia to obtain complete remission?

Answer 18

yes

Question 19

is chronic lymphocytic secondary to chronic leukemia curable?

Answer 19

no, txtment has little effect on improving quality of life

Question 20

lymphoma

Answer 20

cancer of lymphoid organs and tissues

Question 21

which type of lymphomas are more aggressive?

Answer 21

higher grades

Question 22

examples of lymphoma

Answer 22

• Hodgkin

- non-Hodgkin

Question 23

med management of lymphoma

Answer 23

• induction chemo to shrink volume

- radiation to remaining mass

Question 24

what is the cure rate of Hodgkins?

Answer 24

90%

Question 25

what is the cure rate of non-Hodgkins?

Answer 25

60-70%

Question 26

chemo and radiation can cause long-term complications in which organs?

Answer 26

- heart - lungs - thyroid

Question 27

multiple myeloma

Answer 27

- lymphoproliferative disorder - overproduction of malignant plasma cells - multiple tumorous masses through the skeletal system

Question 28

radiographic characteristic of multiple myeloma

Answer 28

punched out appearance of skull

Question 29

overproduction of malignant plasma cells can cause what?

Answer 29

soft spots in bone so sets pts up for fracture

Question 30

med management of multiple myeloma

Answer 30

- cancericidal chemotherapy | - palliative radiation

Question 31

what is the survival rate of pts diagnosed with MM

Answer 31

5 yr survival rate (28-41%)

Question 32

dental concerns of treating pts with WBC disorders

Answer 32

- infection - delayed healing - bleeding

Question 33

dental care before cancer txtment

Answer 33

- consult with oncologist - examination, radiographs as needed - eliminate disease/infection before start of chemo/radiation

Question 34

if did a full mouth ext on pt with WBC disorder, how long should pt wait before starting chemo?

Answer 34

at least 2 weeks

Question 35

platelet count needs to be minimally at what number prior to surgery?

Answer 35

>50,000 but if less then need replacement pre-op

Question 36

WBC count prior to surgery?

Answer 36

>2000 total count OR >500 neutrophils

Question 37

if WBCs count is <2000 total count OR <500 neutrophils in pts prior to surgery, should you give them antibiotic prophylaxis?

Answer 37

yes

Question 38

which antibiotic should be given to pts with low WBCs for antibiotic prophylaxis prior to surgery?

Answer 38

amoxicillin 2g 1 hour pre-op then 500mg 4x daily for 1 wk

Question 39

guidelines for extraction pts

Answer 39

- be prepared to txt bleeding - obtain primary closure if possible - minimum 10-14 days between surgery and start of chemo/radiation

Question 40

what types of dental care can be given to pts during cancer txtment?

Answer 40

- preventive care only (i.e. oral hygiene instruction, dental prophylaxis, caries control) - NO ELECTIVE DENTAL CARE

Question 41

what happens if a pt has a dental emergency during cancer txtment?

Answer 41

txt in coordination with oncologist