thrombocytopenia

Question 1

what are the types of thrombocytopenia associated with bleeding ?

Answer 1

ITP
drug induced
post infection
malignant infiltration of the bone marrow
connective

Question 2

what are the types of thrombocytopenia associate with thrombosis ?

Answer 2

DIC
TTP
HIT
trousseaus syndrome ( due to malignancy)

Question 3

if we were to find thrombocytopenia plus these peripheral blood smear findings what would be the most probable diagnosis?

red cell fragmentation
hyper-segmented neutrophils
WBC/RBC abnormality
normal

Answer 3

red cell fragmentation - DIC , MAHA
c - Vit B12 deficiency
WBC/RBC abnormality - bone marrow disease
normal - ITP or gestational thrombocytopenia

Question 4

what is the presentation of acute ITP ?

Answer 4

usually happen in children
after an infection
onset is within days
lasts for 2-6 weeks
is self limiting

Question 5

what is the presentation off chronic ITP

Answer 5

happens in adults
not preceded by infection
onset is within weeks
lasts long term
treated with steroids, IV immunoglobulin and splenectomy

Question 6

when at what level do we say that the patient has thrombocytopenia ?

Answer 6

below 150

Question 7

what is the target level for platelet disorders ?

Answer 7

above 10x10 for chemo patients
above 50x10 for surgical patients

Question 8

what is the first line treatment for ITP ?

Answer 8

1- for normal splenic destruction :
corticosteroids for max 6 weeks
immunosuppressants
splenectomy

2- immune meditated splenic platelete destruction:
IVIg

Question 9

splenomegaly and ITP ?

Answer 9

splenomegaly excludes the diagnosis of ITP

Question 10

how is a lab diagnosis of DIC made ?

Answer 10

everything is elevated except platelets and fibrinogen

Question 11

what is TTP ?

Answer 11

severe deficiency of ADAMTS13 causing abnormal cleavage of vwf

Question 12

what is the management of acute TTP ?

Answer 12

1- standard treatment is daily therapeutic plasma exchange along with steroids until remission

2- in cases of exacerbation or worsening clinical manifestations, add rituximab to daily TPE

Question 13

what is the clinical presentation of TTP ?

Answer 13

FM CAT
fever
MAHA
CNS involvement
AKI
Thrombocytopaenic purpura

Question 14

what type of anemia is associated with TTP. ?

Answer 14

normocytic anemia seondary to haemolysis

Question 15

what will be seen on blood film of TTP ?

Answer 15

reticulocytes secondary to haemolysis
schistocytes

Question 16

giant platelets ?

Answer 16

ITP