Hubbard Platelets

Question 1

palpable purpura is in what

Answer 1

leukocytoclastic vasculitis

Question 2

most common place you get nose bleed

Answer 2

kesselbach’s plexus

Question 3

-Vasomotro changes that occur in patients with essential thrombocythemia
-Burning pain
-looks like Raynaud
Responds to what?

Answer 3

Erythromelgia

-baby ASA

Question 4

explain pseudothrombocytopenia

Answer 4

• seen in CBC drawn in EDTA tube . . clumping not in patient

- Repeat CBC in heparin or citrate tube

Question 5

in hospitalized patients, if you point out that these can lower platelet count, you will look like a rockstar

Answer 5

• Loop diuretics
• H2 blockers
• digoxin
• antibiotics

Question 6

at what level do you need to start treating ITP

Answer 6

platelets below 35k

Question 7

upfront drug for treatment of ITP?
if persists?
If still persists? . . give what vaccines?

Answer 7

prednisone or dexamethasone

• rituximab or IVIG or Romiplostim (SQ) or Eltrombopag (PO)
• splenectomy (Pneumococcal, H. flu type b, and meningococcal)

Question 8

diabetic or immunocompromised and ITP treatment

Answer 8

IVIG

Question 9

Describe HELLP

Answer 9

• hemolytic uremic syndrome, elevated liver enzymes, low platelets
• obstetrical situations . . treatment if delivery of baby

Question 10

19 yr old

• arthralgias and myalgias
• leukopenia
• anemia
• HIGH platlets

Answer 10

acute viral illness . . EBV . . mono

Question 11

patient has mono . . what do you do to manage the thrombocytosis

Answer 11

observe. . the platelets are not causing an issue . .treat the patient

Question 12

Mild thrombocytopenia with ENLARGED PLATELETS

Answer 12

Bernard-Soulier

Question 13

Fragmented RBCs and diminished numbers of normal appearing platelets

Answer 13

TTP

Question 14

Agranular platelets

Answer 14

Gray platelet syndrome . . would have normal count

Question 15

what 2 things have absent aggregation to ristocetin and normal aggregation to everything else

Answer 15

• Bernard Soulier

- von Willebrand

Question 16

Normal aggregation to ristocetin and abnormal to everything else

Answer 16

Glanzmann

Question 17

Aspirin like defect . . . impaired second wave aggregation

Answer 17

Gray platelet syndrome

Question 18

Treatment of choice to control thrombocytosis

Answer 18

oral hydroxyurea

• if not well tolerated because of anemia . . anagrelid
• try to keep platelets under 500k