Professional Documents
Culture Documents
: مالحظة
الدكتور حكى بعرف انو لما ييجيكم دكتور من برا ما بتذكرو اشي بس انا بدي تذكرولي كم.1
. معلومة وراح يكونو اسئلة باالمتحان
االسنان اهم يعرفوbleeding & infection وحكى انتو كأطباء اسنان بهمكم انو مايصير.2
. anemia اكتر منneutropenia عن ال
الدكتور كان يقرأ العنوان من الساليد ويحكي هاد مش مهم الكم انا عارف (الدكتور) فأنا كتبت.3
والدكتور حكى في, الحكي الي حكى جميعو وكتبت معلومات بتوقع أنها مهمة من الساليدات
. الي بحب يقرأ معلومات أكتر وزيادة يقرأ الساليدات, االخر انو الي شرحتو هو المهم
neutropenia cause mouth ulcer( if patient came to you and he has mouth
ulcer remember neutronpenia and request CBC).
Neutrophils count
Platlete count
Drugs like: warferin, heparin,asperin
Anemia
Reduction in the total number of RBCs, hemoglobin, and/or hematocrit.
According to age and sex female have less hemoglobin level than male bcause
of menses in female and this is normal.
Always remember anemia is not a dagnosis you should know the cause of
anemia .
Anemia could be Presentation for leukemia: patient came and he looks pale
and doctor request CBC and the result (hemoglobin =7, WBCs=50000) and he
has gingival hypertrophy ,so mostly this patient have leukemia .
1
In hematology it is important to look at CBC ,the most important thing in CBC
is :
1. White blood cells : (important for dentistry), it decrease the
incidence of infection,so we have what we call deferential
neutrophils ,if we have WBCs =10000 in CBC the deferential
neutrophils is 20% =2000.so absolute neutrophils count = 2000,if
it is less than 2000 you shouldn’t start treatment
اذا بلشتو في المريض مش رايحينleukopenic مش الزم تبلشو بالمريض اذا كان: بالعربي
. تخلصو
2. hemoglobin.(not important for dentist).
If patient came and he has hemoglobin =7 it is ok to treat him
• Macrocytic >100 fl
• Normocytic 80-100 fl
• Microcytic < 80 fl
2
vitamin B12 deficiency associated with neurological damage
(very imp)
:Hemolytic anemia
Jaundice in eye.
Reticulocyte count to see bone marrow if it is work or not.
In hemolytic anemia reticulocyte count is high.
Anemia
:Normocytic
: Microcytic :Macrocytic
MCV normal
Megaloblastic
Common in patient
Iron deficiency& anemia(B12&folic
with renal failure
thalasimia acid)
&cancer
3
If patient suspected to iron deficiency anemia you should ask female
about menses (if she has heavy menses you can explain iron deficiency
anemia)and male about bleeding ,he may have bleeding tendency and
.epistaxi
Case: 35 years female came with gingival hyper trophy she goes to
dentist then he extracted the teeth after that she has bleeding and
infection, when doctor see CBC
(WBCs=100000,platelet=20000,hemoglobin =7).she is anemic and this
anemia is secondary to bleeding because hemoglobin before extraction
=9.
4
And RBCs size is small so it is microcytic so we call it :
hypochromic microcytic anemia because most of the cause come with
. iron deficiency other cause may thalassimia
Thalassemia
We have alpha(α) & beta(B) thalassemia .
When two want to engage they should do this test and some time they
have low MCV but it doesn’t mean the patients have thalassemia , may
have iron deficiency anemia ,so they should do ferritin and if it is low
we give him iron then repeat CBC.
Megaloblastic anemia
From name mega mean large .
Patient may have pancytopenia ( allfree cell line is low ),free cell
line mean blood cell(WBCs,RBCs,platelet).
5
When we talk about megaloblastic anemia we mean folic acid &
B12.
B12 deficiency :
Anemia is macrocytic
We call it pernicious anemia
Body store B12 liver for 3 years ,so patient may have anemia after
3year .
We treat patient for two reason :
1. hematological → decrease in B12 lead to anemia.
2. neurological →decrease in B12 lead to neurological damage.
Note : you should not treat patient if he has leukemia ,so if you receive
lab report and you found blast cell this will indicate that the patient
has leukemia ( lab report you should concentrate on : blast cell,
neutrophils, platelet ).
. ألنو إذا بلشتو مش حتخلصوleukemia دائما ً حاولو ما تبلشو في مرضى ال: الدكتور
6
Mouth ulcer
Infections
:If patient came to you and he has candidiasis you should think in
1. neutropenia
2. steroids
doctor say: always remember absolute count for neutrophils is =2000 if
less ,you should not start treatment( ) ما تبلشو على قولت الدكتور.
Pernicious anemia
))بالعربي فقر الدم الخبيث
Aplastic anemia
()فقر الدم االتصنعي
Bone marrow fail to produce blood cells .
May occur with pancytopenia.
7
Low hemoglobin, platelet, RBCs, WBCs .( inthis case you should
not start treatment because if you start you will not stop and may
lose patient.
كمان مرة عاد الجملة الي ضل يكررها طول المحاضرة والي هي دائما ُ قبل ما تبلشو: الدكتور
ماتبلشوhigh or low إذا كانوCBC (platlet & WBC) بالمريض اتطلعو على ال
.بالمريض
Hemolytic anemia
Decrease RBCs survival (Normal survival for RBC IS 100-120
days).
Patient comes especially female with low hemoglobin.
Jaundice and splenomegaly most common features.
MCV may normal or high.
This patient came same as patient with hepatitis (jaundice) but
liver function test is normal.
8
When you see gingival hypertrophy always suspect acute myloid
leukemia,and you should request CBC deferential ( and remember
doctor say don’t treat patient whith high or low WBCs).
Case : patient 65years old female came to doctor complain from lesion
in here cheek and she has gingival hypertrophy, unfortunatelydoctors
doing asurgery and take biopsy without looking for CBC ,so after
surgery she has problems then doctors request CBC and they see low
WBCs, platelet and hemoglobin befor surgery but doctors don’t care
about that ,so after surgery she has poor healing ,then doctors do test
for bone marrow and they found acute myloid leukemiathen the
patient sudden die ( ( هللا يرحمهاbecause of infections .
هاي الحالة كانت بمشتشفى الملك عبدهللا وكل الناس بحطو الحق على الدكتور الي عمل العملية.
question in exam:
decrease in WBCS cause( mouth ulcer, candidiasis, infections).
Acute myloid leukemia cause gingival hyper trophy .
**************
The end