11/16 2.0 Flashcards
HUS is a member of a larger group of diseases known as ______________
hemolytic uremic syndrome (HUS)- thrombotic microangiopathy.
HUS shares some clinical features with TTP. Both manifest as:
Shares: microangiopathic hemolytic anemia and thrombocytopenia
HUS emphasizes renal injury
TTP instead causes neurologic dysfunction
Diarrhea is the most important historical finding in typical __________
HUS
usually bloody diarrhea with abdominal cramps
hemolytic uremic syndrome (HUS) stool sample studies
Stool sample: Screening for shiga toxin-producing E. coli should be ordered.
Hemolytic uremic syndrome (HUS) - should you use antibiotics?
the current recommendation is not to use antibiotics due to evidence that they may increase shiga toxin production or release
HUS and TTP are thrombotic microangiopathies that have very similar presentations. HUS is more common in what age group?
pediatric patients
HUS is toxin-induced, most commonly caused by ______________
Shiga toxin-producing Escherichia coli
ITP is caused by?
caused by antibodies binding to platelet antigens, leading to their destruction
Most cases are self-limited.
History/physical or ITP
- Viral illness
- Abdominal pain that is diffuse/colicky
- Hematochezia/melena
- Red/dark urine
- Palpable purpuric rash
- Nonpitting edema of face, scalp, trunk, and extremities
often self-limiting over a 4- to 6-week course.
NAC in uncertain circumstance
Detectable acetaminophen concentration
elevated AST / ALT
with history concerning for supratherapeutic ingestion should prompt administration of N-acetylcysteine.
Outcomes are best if N-acetylcysteine is started within ______ time of APAP overdose
8 hours
If ingestion occurred more than 8 hours ago, an initial dose of N-acetylcysteine can be administered while awaiting acetaminophen concentration and comparison to Rumack Matthew nomogram to determine need for continuation.
Admit all patients receiving N-acetylcysteine
