Bleeding disorder - Thrombocytopenia Flashcards
What is thrombocytopenia?
When theres a low platelet count. It is not a disease in itself and can be caused by many other diseases.
What is a normal platelet count?
150-450 X 10^9/Litre.
What can cause a problem with the PRODUCTION of platelets?
Leukaemia (bone marrow or megakaryocyte problem) Sepsis Folic acid deficiency B12 deficiency Liver failure Myelodysplastic syndrome
What can cause a problem with DESTRUCTION of platelets?
Medications: Sodium valproate Methotrexate Isotretinoin PPI Anti histamines
Other: Alcohol Heparin induced Thrombocytopenia purpura Haemolytic uraemia syndrome
What is the signs of a platelet count less than 50 X10^(/Litre?
Easily bruised prolonged bleeding times nose bleeds bleeding gums menorrhagia Haematuria Malaena
What are the worries of a platelet count less than 10 X10^9/Litre?
High risk of:
Spontaneous bleeds
GI bleeds
intracranial bleeding
What are differentials of thrombocytopenia?
Haemophilia A or B
Disseminated intravascular coagulopahy
Von Willebrand disease
What is ITP?
Immune thrombocytopenic purpura:
Antibodies are created that attack platelets.
What is the management of ITP?
Steroids - prednisolone IV immunoglobulins Monoclonal antibodies - ritixumab Splenectomy Platelet count monitoring suppress periods control blood pressure
What is thrombotic thrombocytic purpura?
When tiny blood clots develop through the body. This uses platelets and causes a low platelet count.
What causes thrombotic thrombocytic purpura?
A deficiency in ADAMTS13 protein - which inhibits von willebrand factor
What is heparin induced thrombocytopenia?
Antibodies develop against platelets in response to heparin exposure.
You get thrombosis and thrombocytopenia - so patient has a low platelet count but still forms blood clots unexpectedly
What is the management for heparin induced thrombocytopenia?
Stop heparin and use another anticoagulant
