Platelet Disorders Flashcards
What is immune thrombocytopenia Purpura?
Autoimmune destruction of platelets
What is primary ITP?
Often seen post-viral infection, self-limiting
What can cause secondary ITP?
Malignancies, HIV
What is Purpura?
Bruising and purple/red rash
How does ITP present?
Purpura, epistaxis, menorrhagia, prolonged bleeding from the gums, severe headache, vomiting, fatigue
What investigations would you do for ITP?
FBC, bone marrow biopsy, platelet autoantibodies
What would an FBC?
Thrombocytoenia
How do manage ITP?
Prednisolone, IV IgG, Platelet transfusions, Oral azathioprine
What does oral azathioprine do?
Immunosuppresses
What is thrombotic thrombocytopenic purpura?
Deficiency of vWF cleaving protein
What is TTP associated with?
HIV, cancer, SLE
How does TTP present?
Flu-like symptoms, purpura, epistaxis, easy bruising, menorrhagia, haemoptysis, headache, abdominal pain, GI bleeding, chest pain
What would you see on a blood smear in TTP?
Fragmented erythrocytes
What U&E results would you expect in TTP?
Raised creatinine
What blood results would you expect in TTP?
Raised bilirubin, raised reticulocyte count
What would you expect on urinalysis in TTP?
Proteinuria, haematuria
How do you manage TTP?
IV plasma exchange, IV methylprednisolone, rituximab, folic acid
What is DIC?
Systemic activation of blood coagulation
What is DIC associated with?
Previous sepsis, malignancies, crush syndrome, transplant rejection, drugs
How does DIC present?
Large bruises, spontaneous bleeding at venepuncture sites or after minor trauma, epistaxis, GI bleeds, confusion and shock, fever, ARDS, purpura, gangrene
What would you see on an FBC in DIC?
Severe thrombocytopenia
What blood results would you expect?
Prolonged PT time, prolonged activated partial thromboplastin time, low fibrinogen levels
How would you manage DIC?
Treat underlying cause, platelet transfusion if present with bleeding, red cell transfusion in those bleeding, FFP to replace coagulation factors
