Thrombocytopenia

Question 1

Broad causes of thrombocytopenia

Answer 1

Decreased Production
Increased Destruction
Splenic Sequestration
Dilutional
Pseudo

Question 2

Decreased Production

Answer 2

Decreased precursors on BM
- viral damage
- chemo/radiation
- B12/folate deficiency
- alcohol toxicity
- aplastic marrow
- myelodysplasia
Infiltration (evident on BM, leukoerythroblastic picture)
- myelofibrosis
- tumor
- infection (TB, Fungal, MAI)

Question 3

Increased Destruction

Answer 3

Immune
- ITP
- CTD
- Drugs (heparin, quinine, valproate)
- Virus (HIV, EBV, CMV)
- Post-transfusion
Microangiopathic (check schistocytes)
- TTP/HUS
- DIC
- HELLP

Question 4

Splenic Sequestration

Answer 4

Causes of massive splenomegaly (obvious on physical exam)

• CLL, CML
• Malaria

Question 5

Diluational

Answer 5

Massive transfusion

Massive IVF

Question 6

Pseudo

Answer 6

EDTA clumping