Thrombocytopenia

Question 1

2 categories of immune thrombocytopenia

Answer 1

fetal/neonatal alloimmune thrombocytopenia

immune thrombocytopenia

Question 2

thrombocytopenia due to maternal platelet antibodies

Answer 2

alloimmune thrombocytopenia

Question 3

can alloimmune thrombocytopenia occur in first pregnancy?

Answer 3

yes

Question 4

80% of alloimmune thrombocytopenia is due to what platelet antibody?

Answer 4

HPA-1a

Question 5

most common cause of severe neonatal thrombocytopenia

Answer 5

fetal/neonatal alloimmune thrombocytopenia

Question 6

disease that affects fetus and newborn in which platelet count is decreased due to maternal antibody crossing the placenta and attaching to the antigens on the fetal platelets

Answer 6

fetal and neonatal alloimmune thrombocytopenia

Question 7

fetal and maternal platelet counts in fetal and neonatal alloimmune thrombocytopenia

Answer 7

fetus = low
maternal = normal

Question 8

what ethnicity of mothers is more likely to have platelet antibodies OTHER than anti-HPA-1a?

Answer 8

Asian

Question 9

modes of presentation for fetal and neonatal alloimmune thrombocytopenia

Answer 9

previously affected sibling
recurrent fetal loss
antenatal hydrocephalus
stillbirth
bruising/bleeding
intracranial hemorrhage
DIC
postnatal ICH

Question 10

most common mode of presentation of alloimmune thrombocytopenia in neonate

Answer 10

bruises or petechiae

Question 11

diagnostic testing for alloimmune thrombocytopenia

Answer 11

screening of maternal serum for platelet antibodies
maternal and paternal platelet antigen phenotyping
maternal and paternal platelet antigen genotyping

Question 12

alloimmune thrombocytopenia treatment in utero

Answer 12

cordocentesis (diagnosis, administration of blood products, monitoring platelet count)
IVIG (to mother during pregnancy, immediately after birth to infant)

Question 13

platelet count goals in alloimmune thrombocytopenia

Answer 13

> 50,000 for vaginal delivery

>20,000 after birth

Question 14

alloimmune thrombocytopenia treatment after birth

Answer 14

compatible platelet transfusions (antigen negative or mother’s washed platelets)
IVIG

Question 15

most rapidly effective treatment in infants with severe hemorrhage and/or severe thrombocytopenia

Answer 15

transfusion of compatible platelets

Question 16

thrombocytopenia in which mother produces autoantibody to platelets

Answer 16

immune thrombocytopenia

Question 17

fetal and maternal platelet counts in immune thrombocytopenia

Answer 17

mothers = low
fetus = low

Question 18

which type of thrombocytopenia has a lower risk of fetal intracranial hemorrhage?

Answer 18

immune

Question 19

thrombocytopenia that occurs when a person makes autoantibodies against platelets which react with patient’s own platelets as well as donor and fetal platelets

Answer 19

immune

Question 20

recommended platelet count in immune thrombocytopenia

Answer 20

> 20,000 during pregnancy

>50,000 near term