ITP

Question 1

What are the 2 types of ITP?

Answer 1

Primary

Secondary

Question 2

Primary causes?

Answer 2

Idiopathic

Girls two peak ages <10 and >65

Question 3

Secondary causes?

Answer 3

Infection

Syndromes

Question 4

What are infective causes?

Answer 4

HCV

H. Pylori

Question 5

Syndromes that cause it?

Answer 5

SLE

Evan’s syndrome

Question 6

What do symptoms of ITP depend on?

Answer 6

Platelet count

Question 7

What are the main symptoms?

Answer 7

Purpura

Ecchymosis

Question 8

What are purpura and ecchymosis?

Answer 8

Purpura = non-blanching spots
Ecchymosis = bruising

Question 9

Typical presentation

Answer 9

” 50 y/o woman presents with easy bruising and bleeding from the gums. O/e she has petechiae and bruising all over. Her liver and spleen are not palpable. FBC reveals thrombocytopenia with a count of 12 but all other cell lines are normal. “

Question 10

Investigation?

Answer 10

FBC
- Only thrombocytopenia

Coombs test
- +ve

Bone marrow biopsy

Question 11

What is seen on bone marrow biopsy?

Answer 11

Increased megakaryocytes

Mostly done to rule out malignancy

Question 12

Initial treatment?

Answer 12

IVIG
Steroids

Can give platelet transfusion in severe thrombocytopenia but will just be broken down by immune cells

Question 13

Surgical treatment?

Answer 13

Splenectomy

Question 14

Non-severe bleed?

Answer 14

Observation

Steroids