deck_5394274 Flashcards

1
Q

What are the main types of purpura?

A

1) Macular/non-palpable purpura (generally non-inflammatory)2) palpable purpura (sign of vasculitis)These are NON blanchable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of purpura is this?

A

Petechiae (not blanchable)- small (less than 3mm) usually found in the ‘dependent’ areas of the body (legs when standing, back/butt when lying down in a hospital bed)generally painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main causes of petechiae?

A

1) platelet related (low platelets or dysfunction)2) non-platelet related (things that increase capillary fragility or allow them to leak)- sun damage can do this!!Petechiae are usually a sign of platelet dysfunction, and not a coagulation defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are ecchymoses?

A

large (5+mm) non-palpable purpura that may or may not be painful or tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

While most petechiae are platelet related, ecchymoses are more likely to reflect what?

A

abnormalities in coagulation, rather than platelet defects (can result from hypercoag- OR hypocaguable states)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some causes of purpura?

A

-thrombocytopenia or abnormal platelet function + infection/inflammation/traumapoor dermal support + trauma (actinic damage, amyloid, Ehler’s Danlos, scurvy)Anticoagulant stage + trauma (DIC, vitamin K deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is this?

A

Solar purpura- chronic sun damage can cause bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is happening here?

A

thrombocytopenia + trauma (linear purpura (=vibex))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the main causes of petechiae?

A

ABNORMAL PLATELET FUNCTION-DIC and infection-low platlets due to idiopathic, drug-induced, or autoimmune reasons-inflammatory skin diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the main causes of ecchymoses?

A

COAGULATION DEFECTS-DIC and infection-trauma-weak skin-Waldenstrome hypergammaglobinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is happening here?

A

Hypergammaglobulinemic Purpura of Waldenstrom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is this?

A

Henoch-Schonlein purpura (these are palpable- remember, unlike bland petechiae/ecchymosis, palpable purpura is assoicated with inflammation in blood vesselsdue to IgA deposition in vascular walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are vasculites categorized?

A

Primarily based on the size of the blood vessel involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some diseases associated with small vessel vasculitis?

A

-Henoch Schonleion purpura (IgA vasculitis)-Infections, drug reactions, maligancies and autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is this?

A

Small vessel vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is this?

A

Meningococcemia (acute)

17
Q

What is this?

A

Leukocytoclastic vasculitis

18
Q

What are some mixed size (small and medium vessel) vasculites?

A

ANCA assoicated vasculites (Churg-Strauss, Microscopic polyangiitis, Wegener’s granulomatosis)-Cyroglobulinemic vasculitis

19
Q

What is this?

A

Churg-Strauss vasculitis

20
Q

What is a common medium vessel vasculitis?

A

Polyarteritis nodosa

21
Q

What are some common large vessel vasculites?

A

-giant cell arteritis-Takayasu arteritis-Behcet’s

22
Q

Skin lesions depend on the size of the blood vessel involved. How do small vessel vasculities present?

A

These present as palpable purpura or blisters and rarely hives

23
Q

How do mediumvessel vasculities present?

A

Nodules, purpura, livedo retiuclaris/racemosa orulcers, skin necrosisNOTE: large vessel vasculities are less likely to affect skin

24
Q

What is this?

A

Henoch-Schonleion purpura

25
Q

What does this show?

A

IgA deposition in blood vessel wall in HSP

26
Q

What is this?

A

Polyarteritis nodosa causing deep nodules instead of palpable purpura

27
Q

What is retiform purpura?

A

A form of eccymosis with a netlike pattern resulting from vascular ischemia, usually due to an underlying thrombotic disorder

28
Q

Widespread retiform purpura is called what?

A

purpura fulminans

29
Q

Palpable purpura =

A

vasculitis

30
Q

Retiform purpura

A

Pink spots down in the dermis are clots (caused bycutting cocaine with levamisole- a medication used to treatparasitic worminfections)Levamisole can make a subset of people extremly hypercoaguable

31
Q

What causes retiform purpura?

A

It is a pattern of purpura caused by a variety of insults that disrupt blood flow to the skin. Common causes:congential coag defects, infection, cocaine cut with levamisole (if you see retiform purpura in someone that is ILL (with fever, etc.) you have to think meningococcemia)