thrombocytopenia Flashcards
what
low platelet count
problems with production
sepsis B12/folate deficiency liver failure = low thrombopoietin leukaemia myelodysplastic syndrome
problems with destruction
alcohol ITP thrombotic thrombocytopenic purpura heparin-induced thrombocytopenia HUS
problems with destruction - medications
sodium valproate methotrexate isotretinoin antihistamines PPI
presentation
indicental finding nosebleeds bleeding gums heavy periods easy bruising spontaneous bleeding
diferentials of abnormal or prolonged bleeding
thrombocytopenia
Haemophilia A and B
VWB disease
DIC
immune thrombocytopenic purpura
antibodies created against platelets
platelet destruction
ITP Mx optoins
prednisolone
IVIg
rituximab
splenectomy
Thrombotic Thrombocytopenic Purpura
tiny blood clots develop throughout small vessels which use up platelets causing thrombocytopenia
blood clots break up small vessels causing hameolytic anaemia
Thrombotic Thrombocytopenic Purpura - whu do clots develop
problem with protein ADAMTS13
shortage in this protein leads to VWF overactivity and formation of clots
Thrombotic Thrombocytopenic Purpura - causes ADAMTS13 deficiency
inherited genetic mutation or autoimmne disease
Thrombotic Thrombocytopenic Purpura- Mx
plasma exchange
steroids
rituximab
Heparin Induced Thrombocytopenia
development of antibodies against platelets in response to exposure to heparin
heparin induced antibodies target protein on platelets called platelet factor 4
Heparin Induced Thrombocytopenia - what do antibodies do
bind to platelets and activate clotting mechanisms –> hypercoaguable state and thrombosis
they also break down platelts and cause thrombocytopenia
Heparin Induced Thrombocytopenia Mx
stop heparin and use alternative anticoagulant
