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Questions and Answers
What is the lifespan of a red blood cell (RBC)?
What is the lifespan of a red blood cell (RBC)?
120 days
The RBC count for males is lower than females
The RBC count for males is lower than females
False
What is the normal range of hemoglobin levels in males?
What is the normal range of hemoglobin levels in males?
13-16 gm/dl
What is the primary type of hemoglobin in a normal adult?
What is the primary type of hemoglobin in a normal adult?
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What is the primary type of hemoglobin in a fetus?
What is the primary type of hemoglobin in a fetus?
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What percentage of a newborn's hemoglobin is typically HbF?
What percentage of a newborn's hemoglobin is typically HbF?
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Which of the following is NOT a type of red blood cell disorder?
Which of the following is NOT a type of red blood cell disorder?
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What are the two main categories of polycythemia?
What are the two main categories of polycythemia?
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Relative polycythemia is characterized by a decrease in the red blood cell mass.
Relative polycythemia is characterized by a decrease in the red blood cell mass.
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What is the other name for primary polycythemia?
What is the other name for primary polycythemia?
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What is the other name for secondary polycythemia?
What is the other name for secondary polycythemia?
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Which of the following is NOT a clinical feature of polycythemia?
Which of the following is NOT a clinical feature of polycythemia?
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Which of the following is NOT an extra oral feature of polycythemia?
Which of the following is NOT an extra oral feature of polycythemia?
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Which of the following is NOT an oral feature of polycythemia?
Which of the following is NOT an oral feature of polycythemia?
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Dental management for patients with polycythemia should focus on minimizing the risk of bleeding.
Dental management for patients with polycythemia should focus on minimizing the risk of bleeding.
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Anemia is defined as a reduction in the oxygen-carrying capacity of the blood.
Anemia is defined as a reduction in the oxygen-carrying capacity of the blood.
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Which of the following is NOT a classification of anemia based on red blood cell size?
Which of the following is NOT a classification of anemia based on red blood cell size?
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Which of the following is NOT a classification of anemia based on hemoglobin concentration?
Which of the following is NOT a classification of anemia based on hemoglobin concentration?
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Anemia can be caused by which of the following factors? (Select all that apply)
Anemia can be caused by which of the following factors? (Select all that apply)
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Iron deficiency anemia is a type of microcytic hypochromic anemia.
Iron deficiency anemia is a type of microcytic hypochromic anemia.
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Iron deficiency anemia is more common in men than in women.
Iron deficiency anemia is more common in men than in women.
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Which of the following is NOT a common cause of iron deficiency anemia?
Which of the following is NOT a common cause of iron deficiency anemia?
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Besides the consumption of tea with meals, state another cause of impaired iron absorption.
Besides the consumption of tea with meals, state another cause of impaired iron absorption.
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Koilonychia, a condition characterized by spoon-shaped and brittle nails, is a symptom of iron deficiency anemia.
Koilonychia, a condition characterized by spoon-shaped and brittle nails, is a symptom of iron deficiency anemia.
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Pallor of skin, nail beds, and palpebral conjunctiva is a sign of iron deficiency anemia.
Pallor of skin, nail beds, and palpebral conjunctiva is a sign of iron deficiency anemia.
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Which of the following is NOT an oral feature of iron deficiency anemia?
Which of the following is NOT an oral feature of iron deficiency anemia?
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Slow wound healing in iron deficiency anemia is due to inadequate iron supply, disrupting epithelial integrity.
Slow wound healing in iron deficiency anemia is due to inadequate iron supply, disrupting epithelial integrity.
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Which of the following is NOT a laboratory finding associated with iron deficiency anemia?
Which of the following is NOT a laboratory finding associated with iron deficiency anemia?
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The treatment of iron deficiency anemia involves eliminating the cause and supplementing with ferrous sulfate tablets.
The treatment of iron deficiency anemia involves eliminating the cause and supplementing with ferrous sulfate tablets.
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Pernicious anemia is a type of macrocytic normochromic anemia often referred to as Addisonian anemia.
Pernicious anemia is a type of macrocytic normochromic anemia often referred to as Addisonian anemia.
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Pernicious anemia is caused by an autoimmune reaction that targets parietal cells of the stomach, leading to a deficiency of intrinsic factor.
Pernicious anemia is caused by an autoimmune reaction that targets parietal cells of the stomach, leading to a deficiency of intrinsic factor.
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Vitamin B12 is crucial for the maturation of red blood cells and the metabolism of nerve tissues.
Vitamin B12 is crucial for the maturation of red blood cells and the metabolism of nerve tissues.
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A deficiency of vitamin B12 can lead to anemia and neurologic manifestations due to degeneration of the spinal cord.
A deficiency of vitamin B12 can lead to anemia and neurologic manifestations due to degeneration of the spinal cord.
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Pernicious anemia is characterized by a gradual onset with progressive signs and symptoms.
Pernicious anemia is characterized by a gradual onset with progressive signs and symptoms.
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Which of the following is NOT a clinical feature of pernicious anemia?
Which of the following is NOT a clinical feature of pernicious anemia?
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Which of the following is NOT an oral feature of pernicious anemia?
Which of the following is NOT an oral feature of pernicious anemia?
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The Schilling test is a common diagnostic procedure for pernicious anemia.
The Schilling test is a common diagnostic procedure for pernicious anemia.
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The treatment for pernicious anemia typically involves lifelong injections of hydroxycobalamin.
The treatment for pernicious anemia typically involves lifelong injections of hydroxycobalamin.
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Oral folic acid therapy for pernicious anemia can alleviate hematological symptoms but may worsen neurologic symptoms.
Oral folic acid therapy for pernicious anemia can alleviate hematological symptoms but may worsen neurologic symptoms.
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Folate deficiency anemia is a type of macrocytic normochromic anemia caused by a lack of folic acid.
Folate deficiency anemia is a type of macrocytic normochromic anemia caused by a lack of folic acid.
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The body's folate reserve can be depleted in as little as 4 months.
The body's folate reserve can be depleted in as little as 4 months.
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Which of the following is NOT a common cause of folate deficiency anemia?
Which of the following is NOT a common cause of folate deficiency anemia?
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Folate deficiency anemia can lead to neurological manifestations.
Folate deficiency anemia can lead to neurological manifestations.
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Which of the following is NOT a characteristic feature of folate deficiency anemia?
Which of the following is NOT a characteristic feature of folate deficiency anemia?
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The treatment of folate deficiency anemia involves supplementing with folic acid.
The treatment of folate deficiency anemia involves supplementing with folic acid.
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Aplastic anemia is a rare bone marrow disorder characterized by a lack of cell production, leading to pancytopenia.
Aplastic anemia is a rare bone marrow disorder characterized by a lack of cell production, leading to pancytopenia.
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Aplastic anemia is a type of normocytic normochromic anemia.
Aplastic anemia is a type of normocytic normochromic anemia.
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Aplastic anemia can be either congenital or acquired. Which of the following is NOT a common cause of acquired aplastic anemia?
Aplastic anemia can be either congenital or acquired. Which of the following is NOT a common cause of acquired aplastic anemia?
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Viral infections, particularly hepatitis and measles, can lead to acquired aplastic anemia.
Viral infections, particularly hepatitis and measles, can lead to acquired aplastic anemia.
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Which of the following is NOT a typical clinical manifestation of aplastic anemia?
Which of the following is NOT a typical clinical manifestation of aplastic anemia?
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Oral manifestations of aplastic anemia include pallor of oral mucosa, minimal gingival bleeding, petechiae, ecchymosis, and oral ulcers.
Oral manifestations of aplastic anemia include pallor of oral mucosa, minimal gingival bleeding, petechiae, ecchymosis, and oral ulcers.
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Which of the following is NOT a laboratory finding associated with aplastic anemia?
Which of the following is NOT a laboratory finding associated with aplastic anemia?
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The primary treatment for aplastic anemia is bone marrow transplant.
The primary treatment for aplastic anemia is bone marrow transplant.
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Hemoglobinopathies are genetic disorders that affect the globin portion of the hemoglobin molecule.
Hemoglobinopathies are genetic disorders that affect the globin portion of the hemoglobin molecule.
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Hemoglobinopathies increase the susceptibility of red blood cells to hemolysis.
Hemoglobinopathies increase the susceptibility of red blood cells to hemolysis.
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Sickle cell disease is a hereditary disorder of hemolytic anemia caused by a single amino acid substitution in the beta globin chain.
Sickle cell disease is a hereditary disorder of hemolytic anemia caused by a single amino acid substitution in the beta globin chain.
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In sickle cell disease, glutamic acid is replaced by valine in the beta globin chain.
In sickle cell disease, glutamic acid is replaced by valine in the beta globin chain.
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Sickle red blood cells are more prone to becoming sticky and clumping together, leading to vaso-occlusion.
Sickle red blood cells are more prone to becoming sticky and clumping together, leading to vaso-occlusion.
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Sickle cell disease can manifest in different forms. Which of the following is NOT a form of sickle cell disease?
Sickle cell disease can manifest in different forms. Which of the following is NOT a form of sickle cell disease?
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In sickle cell trait, only one beta globin chain is affected.
In sickle cell trait, only one beta globin chain is affected.
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Individuals with sickle cell trait typically experience symptoms.
Individuals with sickle cell trait typically experience symptoms.
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Sickle cell crisis can be triggered by reduced oxygen tension, which can occur during general anesthesia, high altitude, or unpressurized aircraft.
Sickle cell crisis can be triggered by reduced oxygen tension, which can occur during general anesthesia, high altitude, or unpressurized aircraft.
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Individuals with sickle cell trait require regular blood transfusions.
Individuals with sickle cell trait require regular blood transfusions.
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Thalassemia is a group of hereditary disorders characterized by deficient synthesis of alpha or beta globin chains.
Thalassemia is a group of hereditary disorders characterized by deficient synthesis of alpha or beta globin chains.
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Thalassemia is named after the Mediterranean Sea, where it was first discovered.
Thalassemia is named after the Mediterranean Sea, where it was first discovered.
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Which of the following is NOT a form of thalassemia?
Which of the following is NOT a form of thalassemia?
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Thalassemia minor, also referred to as thalassemia trait, is the most severe form of thalassemia.
Thalassemia minor, also referred to as thalassemia trait, is the most severe form of thalassemia.
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Thalassemia major, also known as Cooley's anemia, is characterized by a slow growth and development in children.
Thalassemia major, also known as Cooley's anemia, is characterized by a slow growth and development in children.
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Individuals with thalassemia major often present with a characteristic ashen-gray skin color due to a combination of pallor, jaundice, and hemosiderosis.
Individuals with thalassemia major often present with a characteristic ashen-gray skin color due to a combination of pallor, jaundice, and hemosiderosis.
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Thalassemia major often leads to bone marrow hyperplasia, which can cause bimaxillary protrusion, retracted upper lip, spacing of teeth, and an open bite.
Thalassemia major often leads to bone marrow hyperplasia, which can cause bimaxillary protrusion, retracted upper lip, spacing of teeth, and an open bite.
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The radiographic features of thalassemia are similar to those observed in sickle cell anemia.
The radiographic features of thalassemia are similar to those observed in sickle cell anemia.
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The dental management of thalassemia involves avoiding extensive soft tissue surgery due to delayed wound healing, but surgical correction of facial deformities is typically not recommended.
The dental management of thalassemia involves avoiding extensive soft tissue surgery due to delayed wound healing, but surgical correction of facial deformities is typically not recommended.
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Study Notes
Oral Medicine, Diagnosis & Periodontology I
- Course covers oral medicine, diagnosis, and periodontology.
- Students are responsible for all lecture and section material, even if not in handouts.
- Textbook: Burket's Oral Medicine, 12th edition.
Red Blood Cell Disorders
- RBC lifespan: 120 days.
- RBC count: 4.5-5 million/cubic mm (males > females).
- Hemoglobin: 13-16 gm/dl (males), 13-14 gm/dl (females).
- Adult hemoglobin (Hb A): α2β2.
- Fetal hemoglobin (Hb F): α2γ2.
Classification of RBC Disorders
- Polycythemia: abnormal increase in RBC count.
- Absolute erythrocytosis: true increase in red cell mass.
- Relative erythrocytosis: red cell mass is normal, but plasma volume is reduced.
- Anemia: reduction in oxygen-carrying capacity of blood.
- Classified by cell size (normocytic, microcytic, macrocytic) and hemoglobin concentration (normochromic, hypochromic).
Polycythemia
- Definition: Abnormal increase in erythrocyte count in peripheral blood, usually accompanied by increase in hemoglobin and hematocrit.
- Causes of relative polycythemia: loss of intravascular fluid, rapid diuresis secondary to treatment for congestive heart failure.
- Hemoglobin rarely rises more than 25% in relative polycythemia.
- Absolute polycythemia: Divided into primary (idiopathic, often called "Polycythemia Rubra Vera") and secondary.
- Primary polycythemia is characterized by an increased number of RBCs (may reach 18 million/mm3) increased hemoglobin (18-24 g/dl), WBC count, platelets count, blood viscosity, serum iron and ferritin.
- Secondary polycythemia is due to conditions such as heart defects or lung disease.
Anemia
- Definition: Reduction in the oxygen-carrying capacity of blood, related to decrease in red blood cells and hemoglobin levels.
Iron Deficiency Anemia
- Type of anemia (microcytic hypochromic).
- Most common in women of childbearing age.
- Etiology: inadequate iron intake, consumption of tea with meals (tannic acid interfering with absorption), impaired iron absorption (e.g., gastrectomy), chronic blood loss (e.g., heavy menstruation), increased iron requirement (e.g., pregnancy, growing children).
- Clinical features: sparse hair, brittle nails, koilonychia (spoon-shaped nails).
- Clinical features due to hypoxia: fatigue, headache, palpitation, dyspnea on exertion.
- Oral features: pallor of oral mucosa, angular cheilitis, glossitis, sore mouth, slow wound healing.
- Diagnosis: history, clinical exam, lab investigations (e.g., decreased RBCs count, hemoglobin concentration).
- Treatment: eliminate the cause, iron supplements (e.g., ferrous sulfate tablets).
Pernicious Anemia
- Autoimmune disease destroying gastric fundic glands.
- Leads to atrophic gastritis and loss of intrinsic factor and vitamin B12 malabsorption.
- Etiology: Circulating autoantibodies against parietal cells (stomach cells) & defect in intrinsic factor secretion, and defect in vitamin B12 absorption.
- Results in anemia and nerve tissue defects.
- Clinical features: insidious onset, progressive signs & symptoms, severe pallor, jaundice (premature breakdown of RBC), neurological symptoms (symmetrical numbness, weakness), gastrointestinal symptoms (constipation/diarrhea, vague pain).
- Oral features: glossitis, glossodynia , pale oral mucosa, aphthous-like ulceration.
- Diagnosis: history, clinical exam, lab investigations (decreased RBC, low Hb, MCV, MCH & serum B12 level).
Folate Deficiency Anemia
- Macrocytic normochromic anemia from folate deficiency.
- Body's folate reserve can deplete within 4 months.
- Main causes: poor intake, malabsorption (e.g., inflammatory bowel disease), increased demand (e.g., pregnancy), drugs (alcohol, barbiturates, phenytoin).
- Unlike pernicious anemia, folate deficiency doesn't typically cause neurological symptoms.
- Diagnosis: history, clinical signs, lab tests (low serum folate, normal B12 level, normal Schilling test).
- Treatment: folic acid supplements (5mg/daily).
Aplastic Anemia
- Rare bone marrow failure.
- Causes can be congenital (e.g., Fanconi's anemia) or acquired (e.g., immune suppression, drugs, radiation, viral infections).
- Clinical features include general anemia symptoms and features of thrombocytopenia (minimal blood clotting) and leukopenia.
- Oral features: pallor, minimal but persistent gingival bleeding, petechiae, and ecchymosis.
- Diagnosis: case history, clinical exam, laboratory investigations (pancytopenia, normal MCV, MCH, MCHC).
- Treatment: Remove cause if possible, bone marrow transplant.
Hemoglobinopathies
- Definition: defects in the globin portion of hemoglobin molecules rendering RBCs susceptible to hemolysis.
- Examples: sickle cell disease, thalassemia.
Sickle Cell Disease
- Genetic disorder of hemolytic anemia.
- Glutamic acid on beta chain replaced by valine in hemoglobin.
- Disease may be present as sickle cell trait (heterozygous).
- Heterozygous: 20%-45% of total HbS, rest is HbA : No signs/symptomatic.
- Homozygous: 75%-100% of total HbS, rest is HbF : Marked clinical manifestations.
- Pathogenesis: Hypoxia, cold, acidosis, dehydration, infection cause red blood cells to become rigid & sickle-shaped.
- Clinical features: anemia, jaundice, painful crises (abdominal/bone), aplastic crisis (decreased RBC production).
- Oral manifestations: pale oral mucosa, yellowish tinge of soft palate (some).
- Lab findings: normochromic normocytic anemia.
Thalassemia
- Genetic disorder of absent or reduced synthesis of alpha or beta globin chains in hemoglobin.
- Disease may be present as thalassemia major ("Cooley's anemia") or thalassemia minor ("thalassemia trait").
- Major (homozygous): severe clinical manifestations start within 4-6 months of life.
- Minor (heterozygous): mild manifestations.
- Clinical features: slow growth, ashen-gray skin, recurrent bacterial infection, severe anemia, hepatosplenomegaly, skeletal growth retardation.
- Oral manifestations: pale oral mucosa/yellowish tinge, delayed eruption, enamel hypoplasia.
- Lab findings: normochromic/normocytic anemia, low or absent beta globin chain.
Dental Management
- General recommendations and guidelines for patients with blood disorders during dental procedures.
- For patients with anemia a CBC with differential should be ordered and if necessary, avoid general anesthesia if Hb < 10 mg/dl
- Avoid extensive soft tissue surgery due to delayed healing in most patients with blood disorders.
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Description
This quiz covers essential topics in Oral Medicine, Diagnosis, and Periodontology I, alongside key concepts in Red Blood Cell Disorders. Students will be tested on their understanding of RBC lifespan, counts, classification of disorders, and definitions of conditions like polycythemia and anemia. Prepare thoroughly, as the material is drawn from lectures and the specified textbook.
