Thrombocytopenia Flashcards
1
Q
what are the three broad categories of causes of thrombocytopenia?
A
- reduction in platelet production
- reduction in platelet survival
- dilution of platelet numbers
2
Q
what is the average lifespan of a platelet?
A
5 days
3
Q
what are the causes of reduced platelet production?
A
- viral (e.g. HSV, CMV, VZV, EBV)
- chemotherapy
- aplastic anaemia
- malignancy (e.g. leukaemia)
- B12-/folate- deficiency
- alcoholism
- congenital (e.g. fanconi’s anaemia)
4
Q
what are the immune causes of decreased platelet survival?
A
- ITP
- SLE
- RA
- sarcoidosis
- antiphospholipid syndrome
5
Q
what are the non-immune causes of decreased platelet survival?
A
- medication (e.g. heparin, carbamazepine, ibuprofen)
- splenomegaly
- HUS
- HELLP syndrome
- TTP
6
Q
what is pseudothrombocytopenia?
A
occurs when platelets undergo a phenomenon called ‘clumping’, in which they stick together causing a false low reading when passed through an auto-analyser
7
Q
what are the symptoms of thrombocytopenia?
A
- often asymptomatic
- bruising
- bleeding gums
- epistaxis
- gastrointestinal bleeding
- genitourinary bleeding
- menorrhagia
8
Q
what are the findings on examination for thrombocytopenia?
A
- petechiae
- purpura
9
Q
what are the investigations for thrombocytopenia?
A
- lymphoreticular examination
- FBC
- blood film
- U&Es
- PT/aPTT
- b12/folate
- ? bone marrow biopsy
- ? genetic screening
10
Q
what is the management of thrombocytopenia?
A
- education (e.g. avoidance of contact sports, avoidance of NSAIDs)
- platelet transfusions
- tranexamic acid
- steroids (e.g. prednisolone)
- TPO-RA (e.g. eltrombopag)
- allogenic bone marrow transplant
