34.1 Neutrophil and Platelet Disorders

Question 1

how long does it take for neutrophils to mature?

Answer 1

5-7 days

Question 2

how long do neutrophils survive in circulation?

Answer 2

12 hours

Question 3

who has lower neutrophil counts ethnicity wise?

Answer 3

african/middle eastern

Question 4

what level do you see problems from neutropenia?

Answer 4

<0.5

don’t investigate 1.0-1.5

Question 5

caused for neutropenia?

Answer 5

• decreased production
• increased destruction
• sequestration
• dilution

Question 6

transient neutropenia is?

Answer 6

usually with a viral infection, febrile, neutropenic, no other cause, likely benign

Question 7

5 causes of chronic neutropenia?

Answer 7

• neonatal alloimmune (self resolves)
• autoimmune neutropenia: most common
• benign granulocytopenia
• hypersplenism
• congenital neutropenia

Question 8

what is postman’s syndrome?

Answer 8

consistent neutropenia <0.2

Question 9

treatment of choice for neutropenia?

Answer 9

steroids/GCSF

Question 10

immediate cause of acute neutrophils?

Answer 10

mobilize marginated cells: eg. blood tests

Question 11

causes of neutrophilia? 7 causes

Answer 11

infection
inflammation (eg. arthritis)
Blood loss
Diabetic Keto
burns
steroids
constipation

Question 12

when eosinophilia high?

Answer 12

> 3.0

Question 13

what kind of allergies trigger eosinophils?

Answer 13

skin
URTI
Parasites

Question 14

what kind of bleeding in platelet problems?

Answer 14

mucocutaneous usually

-petechiae, bruising, purpura

Question 15

most common reason for low platelets?

Answer 15

clotted sample

Question 16

approach to low platelets?

Answer 16

• review hx.clinical findings
• repeat bloods?
• blood film

Question 17

low platelets basic mechanisms?

Answer 17

• poor production
• increased destruction
• abnormal distribution/sequestration

Question 18

most common childhood cause of thrombocytopenia?

Answer 18

immune thrombocytopenia purpura

Question 19

what is immune thrombocytopenia purpura?

Answer 19

• autoimmune
• short hx, abrupt onset
• film reviewed by haematologist
• dx of exclusion
• usu. no dysmorphism

Question 20

immune thrombocytopenia purpura blood film looks like?

Answer 20

large platelets on film

NORMAL MCV

Question 21

mx of immune thrombocytopenia purpura?

Answer 21

• controversial
• options
• conservative
• steroids
• IVIG
• new therapies - rituximab

Question 22

immune thrombocytopenia purpura why do ppl treat instead of monitor?

Answer 22

worried about ICH, though rare

Question 23

immune thrombocytopenia purpura recommended management?

Answer 23

avoid strenuous activity

• unecessary traumatizing
• no NSAIDS
• if symptoms of ICH, call 000
• avoid HERBAL medications

Question 24

approach to life threatening bleeding?

Answer 24

-methylpred 10mg/kg
-platelet transfusion
-rFVIIa
IVIG 1g/kg/dayx2
urgent splenectomy