LIFECYCLE EXAM 1

RBCs (erythrocytes)

Carry oxygen; biconcave discs with no nucleus

WBCs (leukocytes)

Immune defense; larger, nucleated cells. types include neutrophils (multi-lobed nucleus), lymphocytes (large nucleus), monocytes (kidney-shaped nucleus), eosinophils (bilobed, red granules), basophils (dark blue granules)

Platelets (thrombocytes)

Cell fragments for clotting; small purple specks

Hypercoagulable state

Blood clots too easily

immobility (stasis)

greatest risk factor for hypercoagulable state

Hydration, movement/exercise, compression stockings, weight control, avoid smoking

ways to reduce hypercoagulable risks NONpharmacologically

Heparin, warfarin, DOACs (e.g., apixaban, rivaroxaban), aspirin

medications used to decrease coagulability 

Increase bleeding risk

dental considerations of anticoagulation medications

atherosclerosis

Common disease that leads to arterial clots

healthy diet, exercise, stop smoking, statins, antiplatelet meds (aspirin)

treatments to reduce arterial diseases 

atrial fibrilation

common disease treated with anticoagulation even though the patient is

NOT technically hypercoagulable throughout their entire body

Innate immunity

Immediate, nonspecific; players = neutrophils, macrophages, NK cells, complement

Adaptive immunity

Specific, slower; players = B cells (antibodies), T cells (helper & cytotoxic)

Autoimmunity

Immune system attacks self-tissues

loss of self tolerance

Most common mechanism of autoimmunity

lichen planus, pemphigus vulgaris, mucous mebrane pemphigoid

3 most common dental immunologic disease

Lichen planus

White lacy patches on mucosa; T-cell–mediated attack on basal keratinocytes

Pemphigus vulgaris

Painful oral blisters that rupture easily; autoantibodies against desmosomes

Mucous membrane pemphigoid

Blistering lesions (esp. gingiva); autoantibodies against hemidesmosomes

Neutrophil and macrophage

phagocytose pathogens

B cell

Produce antibodies to neutralize pathogens

Cytotoxic T cells (CD8⁺)

Kill infected or cancerous cells

Helper T cells (CD4⁺)

Activate B cells and other immune cells

mast cells

release histamine

Plasma cells

produce antibodies

Enlarged tender lymph nodes

properties of lymph nodes that may indicate infection

Non-tender hard/firm fixed nodes

properties of lymph nodes that may indicate malignancy

right

which side of lung has 3 LOBES

Right lower lobe (bronchus intermedius)

Which lobe of lung is most typically affected by aspiration

alveoli 

tiny air sacs in the lungs where gas exchange occurs

Pulmonary capillaries/alveolar capillaries

tiny blood vessels that surround the alveoli in the lungs for gas exchange

Hyperventilation

decreased CO2 levels due to excessive breathing

increased pH and decreased PCO2

result of HYPERVENTILATION 

respiratory alkalosis

blood becomes too alkaline (high pH) due to excessive loss of carbon dioxide

Increased Bicarbonate excretion

Response of KIDNEYS to HYPERVENTILATION (increased pH)

Avoid triggers (e.g., stress, sulfites in LA), inhaler, avoid NSAIDs in sensitive patients

important consideration for ASTHMA

Avoid N2O and long supine positioning; maintain low oxygen flow if on chronic O₂ (not to suppress respiratory drive)

important considerations for COPD

body, right heart,  lungs, left heart, body

Flow of blood through heart

pulmonary artery

Which blood vessel carries deoxygenated blood  to LUNGS

vena cava (inferior and superior)

Which blood vessel carries deoxygenated blood to HEART

Ejection fraction

The percentage of blood pumped out of the ventricle relative to how much it held before contraction (normal ≈ 55–70%)

Cardiac output

The total amount of blood pumped by the heart per minute

CO=heart rate x stroke volume

equation for CARDIAC OUTPUT

Stroke volume

The amount of blood pumped out of one ventricle with each beat (~70 mL/beat)

Preload

Stretch of the ventricle from blood filling before contraction

Afterload

Resistance the ventricle must overcome to eject blood

Atherosclerosis

leading pathological cause of cardiovascular disease

plaque rupture, clot, blocked coronary artery, MI

how does Atherosclerosis lead to myocardial infarction

Smoking, high cholesterol, hypertension, diabetes, poor diet, inactivity

behaviors that worsen MI risk 

infective endocarditis

presents as Fever, heart murmur, fatigue, petechiae, and splinter hemorrhages

Infective endocarditis

What danger can artificial heart valves put dental patient at risk for?

prostate, lung, colorectal, bladder

4 most common cancers in MEN in US

 breast, lung, colorectal, uterine

4 most common cancers in WOMEN in US

 lung, prostate, colorectal, pancreatic

4 most  DEADLY  cancers in MEN in US

lung, breast, colorectal, pancreatic

4 most DEADLy  cancer in WOMEN in US

Tumor

mass or lump formed by that neoplastic growth

Neoplasm

abnormal and uncontrolled growth of cells(can be benign or malignant)

Benign

Non-cancerous; does not invade or spread

Malignant

Cancerous; invades nearby tissue and can spread

Leukemia, Lymphoma, Myeloma

3 main types of blood cancers

Autologous

transplant with Patient’s own stem cells

Allogenic transplant

transplant with Donor stem cells

Weakens immune system, dental infection may be life threatening

Why is it important to treat dental disease prior to bone marrow transplant or intensive chemotherapy?

Xerostomia, tooth decay, mucositis, and MRONJ

Dental impacts of radiation

Oral mucositis

Painful inflammation and ulceration of the mouth lining from chemo or radiation

saltwater, , good oral hygiene, topical anesthtics, pain killers

Treatment for oral mucositis

MRONJ

exposed bone that doesn’t heal after dental work due to bisphosphonate use

bisphosphonates

Drugs that pose risk for MRONJ

Glomerulus

part of nephrron where blood is FILTERED

Bowman’s capsule

Collects filtrate

Proximal convoluted tubule (PCT)

Reabsorbs water, glucose, ions

Loop of Henle

Concentrates urine (descending = water out; ascending = salt out)

Distal convoluted tubule (DCT)

Selective secretion/reabsorption; regulated by hormones

Collecting duct

Final water reabsorption under control of ADH

Filtration

Blood pressure forces water and small molecules (like ions, glucose, urea) out of the blood and into the nephron

Reabsorption

Useful substances (like water, glucose, amino acids, and ions) are taken back from the filtrate into the bloodstream

Secretion

Extra wastes, toxins, or drugs (like hydrogen ions, potassium, creatinine, and some medications) are actively transported from the blood to nephron to be excreted

GFR (Glomerular Filtration Rate)

Measures how well kidneys filter blood

Low GFR/ poor kidney function

what does High serum creatinine indicate

avoid drugs cleared by kidneys (NSAIDs or antibiotics)

Special considerations for patients with poor kidney function/ high serum  creatinin

Aldosterone

Increases sodium and water reabsorption and potassium excretion in the kidneys → raises blood volume and pressure

Antidiuretic hormone (ADH)

Causes kidneys to reabsorb water → concentrates urine and prevents dehydration INCREASES BP

Vasopressin

another name for antidiuretic hormone

manage bleeding in hemophilia pts

When should vasopressin/antidiuretic hormone be used on dentistry

Hyponatremia

Low sodium in blood → cells swell → confusion, headache, weakness

Hypernatremia

 High sodium in blood → dehydration of cells → thirst, confusion

Edema

Fluid buildup in tissues → swelling (often from heart, kidney, or liver problems)

Hypotension/elevated heart rate/volume depletion

dehydration or blood loss → body compensates with faster heart rate to maintain blood flow

Storage, mix, meter, intrinsic factor production, Fe reduction

functions of the stomach

digestive enzymes, bicarb, autodigestion prevention, hormone release

pancreas function 

secrete digestive enzymes and bicarb to  small intestine

Exocrine function of pancreas

release insulin and glucagon to regulate blood sugar

Endocrine function of pancreas

small intestine

Main site of digestion and nutrient absorption

colon

Absorbs water and electrolytes, Forms and stores feces

colon

Where are bacteria located that help  produce vitamins (vitamin K) 

liver

Bile production, Storage (glycogen, vit, min) , metabolization (nutrients, drugs, toxins)

Bile

Fluid made by the liver to aid fat digestion (contains bile salts, bilirubin, cholesterol, etc.)

Bile salts

The active components of bile that emulsify fats for digestion

Bilirubin

A waste product from the breakdown of red blood cells; gives bile and stool their color

Haptocorrin

relased in saliva binds vitamin B-12 and protects from stomach acid so it can reach small intestine