Microangiopathic Hemolytic Anemia

Question 1

treatment of TTP

Answer 1

Plasmapheresis (before this or if plasmapheresis machine is unavailable, give plasma infusion/FFP to replenish ADAMTS 13 since this gets exhausted, or can do this if no plasmapheresis machine is available)

Question 2

contraindication of TTP treatment

Answer 2

platelets (worsens DVT, get more microthrombi formation)

Question 3

for MAHA in the kidneys (HUS) - tx?

Answer 3

supportive. Do NOT give ABX as it can put pt into TTP!. HD as needed

Question 4

MAHA etiologies

Answer 4

HUS (TTP), [HELLP and acute fatty liver of pregnancy (incr PT and Dbili)], DIC (incr PT/PTT), [prosthetic valves, malignant HTN]

Question 5

Buzzword for MAHA (TTP)

Answer 5

headache + forgetfulness = AMS

Question 6

HELLP syndrome treatment (< 32 wks vs > 32 wks vs post-partum)

Answer 6

< 32 wk: steroids
> 32 wk: early delivery
post-partum: control BP

Question 7

schistocytes are seen in?

Answer 7

DIC, HUS, HELLP, TTP

Question 8

what is specific to ABO incompatibility in transfusion reaction?

Answer 8

dark RED urine

Question 9

Etiology and treatment of post-transfusion purpura

Answer 9

etio: HPA-1a antibodies, alloimmunized with prior transfusion or pregnancy
tx: IVIG

Question 10

red urine seen in?

Answer 10

ABO incompatibility

Question 11

dark urine (NOT RED) seen in?

Answer 11

late hemolytic reaction