Approach to bruising or easy bleeding Flashcards
What are the causes of decreased platelet production in thrombocytopenia
Aplastic anemia
Myelodysplastic syndrome
Infiltration of bone marrow
Drugs causing bone marrow suppression (e.g., AZT, MTX)
What are the immune-mediated causes of increased platelet destruction
Autoimmune disorders: SLE, ITP
Infections: HIV, EBV, CMV, viral
Allo-immune causes
Drugs: Heparin, Rifampin, Quinidine, Quinine, Sulfonamides, Sulfonylureas, Penicillins
What are the non-immune causes of increased platelet destruction
Sepsis
DIC, TTP, HUS
HELLP syndrome (hypertensive disorder of pregnancy)
What are causes of platelet sequestration
Hypersplenism:
Liver cirrhosis with portal hypertension
Myelofibrosis
Rheumatoid arthritis with Felty’s syndrome
Storage diseases
What are the common causes of platelet dysfunction
Drugs: Aspirin, NSAIDs
Von Willebrand disease
Renal failure
Multiple myeloma (Calcium, Renal impairment, Anemia, Bone lesions – CRAB)
Clotting Disorders (Congenital vs Acquired)
Congenital: Haemophilia
Acquired:
- Liver cirrhosis
- Vitamin K deficiency (associated with malabsorption syndromes, steatorrhea)
- DIC (sepsis/consumptive coagulopathy)
- Drugs: anticoagulants, warfarin, NOACs, heparin
Blood Vessel Disorder/CTD
- Hereditary Hemorrhagic Telangectesias
- Connective tissue disease:
- Marfan’s, Ehler’s Danlos,
Cushing’s, Vit C deficiency - Infections: meningococcus, gonococcus, bacterial endocarditis
- Vasculitis: HSP, SLE, polyarteritis nodosa, cryoglobulinemia
- Amyloidosis (AA/AL)
- Drugs: steroids, sulfonamides, penicillins, thiazides
CHAT GPT (PLATElets, CLOTV CTD/Vessel)
P: Production issues (e.g., aplastic anemia, myelodysplasia, marrow infiltration)
L: Lysis (immune or non-immune destruction)
A: Aspirin/NSAIDs (platelet dysfunction)
T: Toxins (uremia in renal failure)
E: Extra sequestration (hypersplenism)
C: Congenital (e.g., hemophilia)
L: Liver disease (cirrhosis)
O: Overdose on anticoagulants (e.g., warfarin, NOACs)
T: Thrombin depletion (DIC)
V: Vitamin K deficiency
