| T or F: there is an iron deficiency in thalassemia major. |
false; an iron overload, side effect of hemolysis |
| These dental findings are for what disease? Hair on end, chipmunk
face, bimaxillary protrusion, teeth spacing, rarefaction of alveolar bone,
widened marrow spaces, tooth discoloration (due to excess iron) |
thallassemia major |
| which disease? Severe, high mortality, splenomegaly hemosiderosis,
hepatomegaly, jaundice, Inc. hematopoeisis in flat bones, retarted growth,
intellectual impairment, SOB (not "son of a bitch", "shortness of breath"
chase), death due to heart failure |
thallassemia major |
| What disease? Mild symptoms, normal life expectancy, microcytic,
hypocromic, (defective HbA synthesis, lower conc. Of HbA per RBC), no tx
necessary |
Thalassemia minor |
| What is the regular name of 'mediterranean anemia" |
thalassemia |
| Which thalassemia (alpha or beta) causes more severe anemia? |
beta |
| In thalassemia minor, __ of four chains is missing, in thallassemia
major ___ of four genes are missing. |
one; two |
| What disease: defect in synthesis of HbA that reduces the rate of
globin chain synthesis. NO abnormal hemoglobin is produced (quantitative,
not qualitative). Hypochromic, microcytic anemia results, crew-cut skull.
|
Thalassemias (in general) |
| What happens when deletion of all alpha globin transcripts occurs? |
fetal demise |
| Which thalassemia is more common, alpha or beta? |
beta |
| for the defective thalassemia gene, heterozygotes are thalassemai
_________ and homozygotes are thal. ___________. |
minor, major |
| what disease? Genetically inherited, 200 + mutations, quantitative
defect of hemoglobin, decreased production of alpha chain, deficient or
absent beta chain, end result=defect in AMOUNT of globin chain synthesized |
Thalassemias (in general) |
| How do you treat sickle cell |
mainly avoid triggering factors, Ab prophy, hydroxy urea |
| What is the prognosis for sickle cell anemia? |
50% survival past age 50 |
| Dental findings of this disease include: spontaneous necrosis of
multiple teeth, enlarged marrow spaces, "hair on end" in x-ray, delayed
tooth eruption, osteomyelitis |
sickle cell anemia |
| As a long term side effect of tx for lymphomas/leukemias, lichenoid
lesions (in the mouth) suggest onset of ______________. |
Graft v. Host disease |
| What complications of leukemia/lymphoma tx are there in dentistry? |
oral mucositis, viral, bacterial, fungal infextions, |
| Dental diagnosis of a destructive bone lesion could mean presence of
________ |
a lymphoma |
| Dental diagnosis of intraoral boggy red soft tissue mass
(Localized!!!!) could mean presence of ____________ |
a lymphoma |
| Dental diagnosis of intraoral bleeding, fever, malaise, tiredness,
boggy gumms (generalized!!!!) could mean presence of __________. |
myeloid leukemias |
| Dental diagnosis of a cervical lymphadenopathy could mean presence of
__________. |
a lymphoma (or a hicky on chase's neck) |
| Tx for this disease includes: CT chest, abdomen, pelvis; bone marrow
biopsy, PET scan, Chemo/radio therapy |
Hodgkins disease |
| What is the most important in determining prognosis for hodgkins
disease? |
staging (lower stages have best prognosis) |
| What disease? Bimodal distribution (25 & 55), Reed-Sternberg Cells
(bilobed/multilobed nucleus w/ clear zones), involves a single node or
chain of nodes, possible EBV related. |
Hodgkins disease |
| Which NHL can appear as an ulcer on the hard palate? |
extranodal NK/T cell lymphoma |
| Which NHL appears to be related to EBV, associated w/ children, max.
& man. Involvement, and an endemic african variant (also curable)? |
Burkitt lymphoma |
| Follicular, Mantle Cell, Diffuse large B-cell, Burkitt's, and
Extranodal NK/T cell lymphomas are what class of lymphoma? |
Non-Hodgkin lymphomas (NHL's) |
| Which NHL is the most common and is slow-growing (indolent)? |
Follicular lymphoma |
| HIV & EBV, environmental causes, gene translocations, antigenic
stimulation, are supposed etiology factors for what disease? |
Lymphomas |
| Immunohistochemistry and Flow cytometry are methods to detect what
disease? |
lymphoma |
| T or F: lymph nodes are always involved in lymphomas |
FALSE |
| What are the 2 main categories of lymphomas? |
Hodgkins Disease & Non-Hodgkin's Lymphoma (NHL--not to be confused
with the National Hockey League--who cares about hockey anyway?) |
| When a lymphoma is spread to other organs in the body (not lymphoid
tissue) what is this spread called? |
extranodal spread of lymphoma |
| T or F: All lymphomas are malignant |
TRUE |
| What disease? Old ppl (>50 yrs), cells indistinguishable from
normal mature lymphocytes, slowly progressive, progonsis 7-10 yrs, chemo
not indicated (NO Tx) |
CLL |
| What disease? Contain gene called bcl-2 which counteracts programmed
cell death of normal lymphocytes, immortalizes these cells and eventually
achieve world domination | CLL |
| Tx for CML: |
Bone marrow translplant; Gleevec (tyrosine kinase inhibitor) |
| 50% of pts w/ CML progress to an _________ phase while the other 50%
progress straight to a ________ ________. |
accelerated(before blast crisis); blast crisis |
| What do 90% of patients with CML have in common? |
the Philadelphia Chromosome |
| What disease? Adults, slow onset, mild anemia, hypermetabolism,
fatigue, infections, splenomegaly, thrombosis, anorexia | CML |
| What is the most common leukemia in a adults? |
AML |
| What is the most common leukemia overall? |
AML |
| What disease? Massive infiltration of the bone marrow with immature
blasts (immune cells) with immature blasts that spill over into peripheral
blood, fatigue, pallor, diffuse BOGGY gingival enlargement, peak age 50
| AML |
| What type of chemo is used to prepare a patient for bone marrow
transplant? |
conditioning chemo |
| Which step of chemo is to achieve a complete remission? |
consolidation |
| What are the 3 steps of chemotherapy? |
Induction, Cosolidation, and Maintenance |
| T or F: with Tx, ALL never comes back |
false; 50-75% remission (w/out chemo, fatal 3-6 mos) |
| What lab findings in ALL? |
elev. WBC, immature WBC's (blasts) in blood and marrow |
| Symptoms of this disease: sudden onset, fatigue, fever, bleeding,
flu-like symptoms, bone pain, lymphadenopathy (generalized), splenomegaly,
hepatomegaly, child age less than 5 |
ALL |
| What disease? Bimodal peaks--first in children under age 5, then in
elderly; Most common malignant tumor in children under age 5; overall 20%
of leukemias | ALL |
