Thombocytopenia

Question 1

What is normal platelet count and when do we say thrombocytopenia?

Answer 1

150-450, less than 150

Question 2

At what levels do we say primary hemostasis impaired, possible spontaneous bleeding, clinically significant bleeding possible, and life threatening hemorrhage possible?

Answer 2

Less than 75
Less than 50
Less than 20
Less than 10

Question 3

What are the 4 umbrella categories for causes of thrombocytopenia?

Answer 3

Decreased production
Sequestration
Increased destruction, so immune and non immune
Platelet loss or dilution.

Question 4

4 top causes of fetal thrombocytopenia?

Answer 4

Alloimmune
Congenital infection
Aneuploidy
Autoimmune

Question 5

What are the 6 common causes of thrombocytopenia is early onset neonatal, so less than 72 hours?

Answer 5

Placental insufficiency, perinatal asphyxia, perinatal infection, DIC, alloimmune thrombocytopenia, and autoimmune condition

Question 6

What is the one big time cause of thrombocytopenia in late onset neonatal periods, so greater than 72 hours?

Answer 6

Sepsis

Question 7

6 conditions that cause destructive thrombocytopenia?

Answer 7

ITP, HUS, DIC, TTP, kasabach merrit syndrome, HELLP

Question 8

5 conditions causing impaired or ineffective production thombocytopenia?

Answer 8

Tar syndrome, nutritional deficiency (iron, b12, folate), marrow infiltrate process, wiscott Aldrich syndromes, fanconi aplastic anemia.

Question 9

Young male presents with eczema and recurrent infections with small platelets what are we thinking?

Answer 9

Wiscott Aldrich syndrome

Question 10

What is the most common cause of isolated thrombocytopenia in otherwise well children and whats going on?

Answer 10

ITP
Spleen makes a plasma cell that produced antibodies against platelet antigens. Spleen and liver macros take the platelet out.
Platelets less than 20k.
Manifests as a sudden onset of petechia and bruising, half the time following a viral infection.

Question 11

What is going on with kasabach merrit syndrome?

Answer 11

Thrombocytopenia and low fibrinogen in blood secondary to giant hemangioma and associated intravascular coagulation

Question 12

What would be seen on peripheral blood smear and bone marrow for ITP?

Answer 12

Large platelets and increased Megas

Question 13

What is the key to the laboratory findings for ITP?

Answer 13

Everything is normal, RBC, WBC except the low platelet.