Blood Disorders Quiz (BMS Learning Outcomes)

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Questions and Answers

Which type of anaemia is characterized by a deficiency in iron?

Aplastic anaemia

Iron deficiency anaemia (correct)

Thalassaemia

Sickle Cell Disease

What is a common feature of haemolytic anaemias?

Increased hemoglobin levels

Reduced oxygen carrying capacity (correct)

Excessive blood clotting

High white blood cell count

Which of the following conditions is NOT classified as a deficiency anaemia?

Folate deficiency

Iron deficiency

Vitamin B12 deficiency

Aplastic anaemia (correct)

What level of hemoglobin indicates anaemia in adult females?

Below 11.5 g/dl Signup and view all the answers

Which disorder is classified under 'Other dyscrasias'?

Lymphoma Signup and view all the answers

What is a characteristic of aplastic anaemia?

Failure of blood cell production Signup and view all the answers

Which anemia is commonly inherited?

Sickle Cell Disease Signup and view all the answers

In which condition is there an increased breakdown of red blood cells?

Acquired haemolytic anaemia Signup and view all the answers

Which type of anaemia is most likely to overlap with chronic disease?

Anaemia of chronic disease Signup and view all the answers

What is the primary consequence of abnormal red blood cells?

Decreased capacity to carry oxygen Signup and view all the answers

What is a primary cause of iron deficiency anemia?

Dietary deficiency Signup and view all the answers

Which clinical feature is most associated with vitamin B12 deficiency?

Burning mouth syndrome Signup and view all the answers

What is the primary management strategy for vitamin B12 deficiency?

Intra-muscular injections of hydroxocobalamin Signup and view all the answers

Which of the following is a common oral manifestation of folate deficiency?

Atrophic glossitis Signup and view all the answers

What is a potential consequence of folate deficiency during pregnancy?

Neural tube defects Signup and view all the answers

What primarily characterizes acquired hemolytic anemias?

Infections and autoimmune disorders Signup and view all the answers

Which condition is characterized by bone marrow failure and leads to fewer blood cells?

Aplastic anemia Signup and view all the answers

Which of the following is NOT a common cause of vitamin B12 deficiency?

High dairy intake Signup and view all the answers

In cases of anemia of chronic disease, what is typically decreased?

Red blood cell production Signup and view all the answers

What is a distinguishing feature of hereditary hemoglobinopathies?

Genetic inheritance Signup and view all the answers

What characterizes lymphoma as a type of cancer?

Cancerous cells aggregate and form tumors in lymphatic tissues. Signup and view all the answers

Which symptom is common to all three types of blood cancer?

Bone pain Signup and view all the answers

What should be considered when treating patients on long-term bisphosphonates?

Risk of osteoradionecrosis Signup and view all the answers

How does multiple myeloma impact the body?

It creates excess plasma cells that damage bone marrow. Signup and view all the answers

What is a critical approach when dealing with dental treatment for patients with blood cancers?

Defer treatment when appropriate and consult a physician. Signup and view all the answers

What distinguishes leukaemia from the other blood cancers?

It originates in the bone marrow but is found circulating in the blood. Signup and view all the answers

Which of the following is NOT considered a dental implication for patients with blood cancers?

Increased risk of cavity formation Signup and view all the answers

Which statement is true regarding the symptoms of blood cancers?

They can include weakness and fatigue. Signup and view all the answers

Which lymphatic regions are commonly associated with the manifestation of lymphoma?

Neck, groin, and armpit Signup and view all the answers

What is a crucial aspect of prevention for patients with blood cancers?

Preventive dental care and infection control Signup and view all the answers

What is a major feature of sickle cell disease?

Occurrence of rigid and irregularly shaped red blood cells Signup and view all the answers

Which of the following is true regarding thalassaemia?

It can lead to complications such as iron overload and cardiac issues. Signup and view all the answers

What differentiates acute myeloid leukaemia from acute lymphoblastic leukaemia?

Acute myeloid leukaemia is more common in adults. Signup and view all the answers

Which treatment modality is typically avoided in patients with sickle cell disease?

General anesthesia Signup and view all the answers

What is a common symptom of chronic lymphocytic leukaemia?

Frequent infections and weight loss Signup and view all the answers

Which description best fits the clinical features of multiple myeloma?

Formation of osteolytic lesions and associated bone pain. Signup and view all the answers

What is the primary cause of clinician-related complications in thalassaemia patients?

Iron overload from multiple blood transfusions Signup and view all the answers

Which statement is accurate regarding dental management of sickle cell disease?

Stress reduction during dental treatment is highly recommended. Signup and view all the answers

Which leukaemia type is most common among older adults?

Chronic lymphocytic leukaemia Signup and view all the answers

A hallmark feature of sickle cell crisis is caused by:

Clogging of blood vessels by misshapen red blood cells. Signup and view all the answers

Study Notes

Blood Disorders Classification

Blood disorders are grouped into:
- Anemias
- Leukemias
- Other dyscrasias (e.g., multiple myeloma, lymphoma)
- Bleeding disorders (separate lecture—thrombocytopenia/coagulopathies)

Deficiency Anemias

Symptoms of deficiency anemias include fatigue, lethargy, breathlessness, palpitations, pallor, headache, brittle nails, and koilonychia (spoon-shaped nails)
Dental features of deficiency anemias include pale oral mucosa, atrophic glossitis, recurrent aphthous ulcers, angular cheilitis, and burning mouth syndrome.
Iron deficiency anemia:
- Characterized by low iron in the body, reducing red blood cell numbers
- Red blood cells become smaller, paler, and carry less haemoglobin.
- Causes include dietary deficiency, chronic blood loss, malabsorption, and pregnancy.
- Management includes checking medical history, identifying the underlying cause, iron supplements, preventative dental care, and regular checkups.
Vitamin B12 deficiency:
- B12 is required for DNA/RNA synthesis.
- Absorption depends on intrinsic factor secretion from parietal cells and absorption in the terminal ileum.
- Causes include dietary deficiency (e.g., vegans) and impaired absorption (e.g., Crohn's disease, pernicious anemia).
- Red blood cells become larger, and the condition develops slowly.
- Management involves diagnosis, replacing B12 (cobalamin) via regular intramuscular injections of hydroxocobalamin, and preventive dental care.
Folate deficiency:
- Necessary for DNA/RNA synthesis and red blood cell production.
- Found in fresh leafy vegetables.
- Absorption occurs in the small intestine, and the body has virtually no stores.
- Primarily caused by dietary deficiency.
- Management includes folic acid supplements and improved diet. Fetal neural tube defects, like spina bifida, can result from folate deficiency in pregnancy.

Haemolytic Anaemias

Inherited:
- Haemoglobinopathies:
  - Sickle cell disease
  - Thalassemia
Acquired:
- Infections
- Medications (e.g., penicillin, antimalarials)
- Blood cancers
- Autoimmune disorders
- Overactive spleen
- Mechanical heart valves
- Severe blood transfusions reactions.

Inherited Haemolytic Anaemias

Sickle Cell Disease:
- Autosomal recessive, causing intermittent acute crises.
- Primarily affects people of African descent.
- Healthy red blood cells are deformable disks.
- Sickled red blood cells are rigid and irregularly shaped.
Sickle Cell Trait:
- Carriers of the sickle cell gene have minimal health issues.
- Having two trait carriers can result in a child with Sickle Cell Disease.
Sickle Cell Crisis: Reduced oxygen can trigger crises due to exercise, stress, dehydration, infections, trauma, or general anesthesia. Clogged blood vessels, reduced blood flow (anoxia), pain, clotting, and potentially death.
Thalassaemia:
- Abnormal hemoglobin production.
- Inherited from both parents (Mediterranean, Middle/Far Eastern, or Asian backgrounds).
- Red blood cells are fewer and fragile, causing early hemolysis and anemia.
- Alpha-thalassemia: Primarily in Asians, varying degrees of severity. The major type is lethal in utero or infancy.
- Beta-thalassemia: Mainly in Mediterranean and Caribbean populations. Two types are homozygous beta-thalassemia major and heterozygous beta-thalassemia minor.

Aplastic Anemia

Bone marrow depression, resulting in reduced blood cell production (all types).
Causes: idiopathic, genetic, cytotoxic drugs, radiation, chemicals, malignancy, viral infections (rarely antibiotics, anticonvulsants, and sulfonamides).
Symptoms: severe bruising, fatigue, pallor, palpitations, dyspnoea.
Management: removing the cause, immunosupressant therapy, and bone marrow transplant.

Anemia of Chronic Disease

Characterized by anemia and immune system activation.
Decreased red blood cell production, possibly with increased haemolysis.
Common in: chronic infections, autoimmune disorders, chronic diseases, malignancy, major trauma, major surgery, critical illness, and older adults.

Leukemias

Acute lymphoblastic leukaemia (ALL): Most common in children/young adults, characterised by immature white blood cells; treated with chemotherapy, antibiotics, transfusions, and stem cell transplants.
Acute myeloid leukaemia (AML): Aggressive myeloid cell cancer; abnormal myeloblasts; affects all ages, but risk increases with age; treated with chemotherapy, radiotherapy, bone marrow, or stem-cell transplants.
Chronic myeloid leukaemia (CML): Rare; mostly affects adults; slow development; increased myeloid cell growth. Treated with tyrosine kinase inhibitors and sometimes stem cell transplants, with good prognosis.
Chronic lymphocytic leukaemia (CLL): Most common adult leukemia; too many immature lymphocytes; typically affects over-60s; may not require immediate treatment but managed with tyrosine kinase therapy, BCL2 inhibitors, monoclonal antibodies, chemo, radiotherapy or immunotherapy.

Multiple Myeloma

Cancerous plasma cells in bone marrow produce faulty antibodies (paraprotein).
Multiple osteolytic lesions (holes) form in bones, resulting in bone pain, recurring infections, kidney damage, and fatigue.

Lymphoma

Lymphatic system cells grow out of control.
Tumours in lymph nodes, spleen, other lymph tissues, or neighbouring organs.
Usually characterized by enlarged lymph nodes (neck, groin, armpit).
Sometimes intraoral lesions.
Two main types: Hodgkin's and non-Hodgkin's lymphoma.

Difference between Leukaemias, Lymphomas and Multiple Myeloma

Common symptoms: weakness, fatigue, bone pain, infections, fever, weight loss
Leukaemia: starts in bone marrow, cancerous cells found in blood
Lymphoma: cancerous cells form tumours in lymphatic tissues
Multiple myeloma: bone marrow tumour, too many plasma cells, bone marrow and bone damage.

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Description

Test your knowledge on blood disorders including anemias and leukemias. This quiz covers the symptoms, causes, and management of deficiency anemias along with their dental features. Dive into the details of iron deficiency anemia and other related conditions.