Haematology 12 - Thrombocytopenia

Question 1

there are 10 main causes of low platelets, 5 production issues, 5 destruction issues

name them

Answer 1

sepsis 
B12/folate deficient
liver failure
leukaemia
myelodysplastic syndrome

medications (PPI, valproate, etc)
immune TP
thrombotic TP
heparin induced 
haemolytic uraemic syndrome

Question 2

presentation of thrombocytopenia

Answer 2

spontaenous bruising
prolonged bleeds

gum bleeds
blood in urine/stool
nosebleeds

Question 3

DDx x 4 for prolonged bleeds

Answer 3

low platelets
haemophilia
VWD
DIC

Question 4

immune thrombocytopaenic purpura

Answer 4

antibodies attack platelets

watch out for headaches and melaena

give pred
IVIG
rituximab
remove spleen

Question 5

thrombotic thrombocytopaenic purpura

Answer 5

ADAMTS13 protein inactive

excessive platelet adhesion

clots in small vessels + haemolysis

treat - plasma exchange, steroids, rituximab

Question 6

heparin induced low plateltes

Answer 6

can create HIT antibodies to the heparin which then attack platelet factor

so hypercoagulable even with low platelet count