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Hemostasis/Coag > Platelets: Qualitative & Quantitative Part 2 > Flashcards

Platelets: Qualitative & Quantitative Part 2 Flashcards

1
Q

Discuss Thrombocytopenic purpura (TTP): Predisposing factors

A

Infectious diseases, autoimmune diseases, drugs, pregnancy, hereditary

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2
Q

Discuss Thrombocytopenic purpura (TTP): clinical presentation

A
  • Characterized by: MAHA, Thrombocytopenia, Neurologic dysfunction
  • Mostly in adults
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3
Q

Discuss Thrombocytopenic purpura (TTP): platelet count

A

Decrease

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4
Q

Discuss Thrombocytopenic purpura (TTP): RBC morphology

A
  • Decrease RBC, Hemoglobin, hematocrit
  • increase reticulocytes
  • poik-SCHISTOS!!!
  • coag tests usually normal but it helps to distinguish from DIC
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5
Q

Discuss Thrombocytopenic purpura (TTP): Type of anemia/mechanism

A

Underlying disorder that damages vascular endothelium caused by ultra high molecular weight vWF multimers present when endothelial cell secreted vWF is not properly proteolysed by its cleaving protease. promotes deposition of platelet thrombi.

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6
Q

Discuss Hemolytic uremic syndrome (HUS): predisposing factors

A

-Acquired disorder that resembles TTP characterized by MAHA and Thrombocytopenia

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7
Q

Discuss Hemolytic uremic syndrome (HUS): clinical presentation in contrast to TTP

A
  • usually no neurological manifestations
  • intravascular clotting confined to kidney leading to acute renal failure
  • associated with bacterial toxins
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8
Q

Discuss Hemolytic uremic syndrome (HUS): platelet count

A

decreased

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9
Q

Discuss Hemolytic uremic syndrome (HUS): RBC morphology

A
  • similiar to TTP

- Additionally, abnormal urinalysis results: proteinuria, hematuria, RBC casts often

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10
Q

Discuss Hemolytic uremic syndrome (HUS): Clinical findings in children

A
  • Classic HUS occurs in infants <2 yrs age

- children present after a febriile illness with: vomiting, bloody diarrhea, MAHA leads to renal failure, Hypertension

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11
Q

Discuss thrombocytopenic purpura (TTP): clinical findings.

A
  • Neurological manifestations: headache, seizures, vertigo, delirium
  • Hemorrhagic symptoms (MAHA): jaundice, pallor, Acute renal failure
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12
Q

Discuss Hemolytic uremic syndrome (HUS): clinical findings in adults

A

Link with malignancy and/or chemotherapy (and HUS) in adults

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13
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): age of oneset

A

Childhood

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14
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): Previous infections?

A

Common

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15
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): Platelet count

A

Decreased (<20,000/uL), so BM exam requested

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16
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): bleeding characteristics

A

Abrupt onset of bruising, petechiae, and sometimes mucosal bleeding in a previously healthy patient

17
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): occurrence of spontaneous remission?

A

occurs in majority of patients

18
Q

Discuss acute Idiopathic (immune) thrombocytopenic purpura (ITP): treatment

A
  • Some patients do not require treatment due to spontaneous remissions
  • Severe causes require platelet transfusions and/or splenectomy (as spleen is primary site of platelet destruction
19
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): age of oneset

A

20-50 years: females over males

20
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): Previous infections?

A

usually not associated

21
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): Platelet count

A

variable, 30,000 to 80,000/uL

22
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): bleeding characteristics

23
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): occurrence of spontaneous remission?

A

Relatively rare

24
Q

Discuss chronic Idiopathic (immune) thrombocytopenic purpura (ITP): treatment

A
  • Treat with steroids

- refractory cases may require splenectomy and/or chemotherapeutic agents

25
Q

Describe heparin-induced thrombocytopenia (HIT), type II, according to the basis for the possible thrombotic and hemorrhagic presentation.

A

-In HIT, PF4 & heparin combine to form a surface complex against which the IgG antibody is directed: platelets become activated, in vivo platelet aggregation with thrombosis is possible. So, thrombotic and hemorrhagic problems

26
Q

An adverse effect of heparin therapy is called_____

A

Heparin-induced Thrombocytopenia (HIT)

27
Q

Develops when the mother lacks a specific platelet-specific Antigen that the fetus has inherited from the father.

A

Neonatal alloimmune thrombocytopenia

28
Q

How do we get thrombocytopenia in neonatal?

A

Mother produces antibodies to the fetal antigen which cross the placenta, and attach to the Ag-bearing fetal platelets, resulting in thrombocytopenia

29
Q

This is autosomal dominant inheritance and giant dohle-like bodies in neutrophils, eos, basos, and monos are seen.

A

May-Hegglin Anomaly

30
Q

Name four clinical states in which thrombocytosis can be seen.

A

Hemorrhage or surgery
inflammation
exercise-induced
FDA

31
Q

Describe thrombocytosis according to the etiology and the platelet count values

A
  • Etiology: reactive phenomena–secondary to hemorrhage or surgery, inflammation, exercise-induced, FDA???
  • Platelet count is increased but usually <1,000,000/cumm
32
Q

Describe thrombocythemia according to the etiology and the platelet count values.

A
  • MP disorder cause is unknown

- Platelet count usually exceeds 1,000,000/cumm

Hemostasis/Coag (14 decks)

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