Thrombocytopenia Flashcards
DIC disseminated intravascular coagulation definition
- abnormal activation of coagulation factors leading to use of coagulation factors and generation of thrombin, consumption of clotting factors, destruction of platelets, and activation of fibrinogen
- hemolytic form of MAHA
- thrombocytopenia
- schistocytes
DIC will have a prolonged/normal PT
prolonged
DIC treatments
- treat cause - transfuse, coagulation factors
DIC will have decreased/increased fibrinogen
decreased
TTP thrombic thrombocytopenia purpura
abnormal vWF leads to abnormal platelet and endothelial cell activation
purpura
spots on the skin that do not blanch when pressure is applied
DIC will have elevated/normal D-dimer
elevated
DIC is associated with
- severe burns
- sepsis
- gram negative bacteria
- venoms
- shock
- OBGYN disasters
- leukemia
pseudothrombocytopenia
- artificially low platelet count - due to platelet clumping
thrombocytopenia can caused by three categories
- underproduction 2. peripheral destruction 3. splenic sequestration
underproduction
- bone marrow toxin- radiology, chemo therapy 2. bone marrow infiltration- tumor 3. marrow failure- myelodysplasia, aplastic anemia, vitamin deficiencies
DIC has elevated PT due to consumption of factor _____
VII
TTP clinical characterizations
- fever 2. MAHA: elevated bilirubin and LDH, schistocytes 3. decreased platelets 4. renal and neurological manifestations
What protease is abnormal in TTP and what is it normally required for?
ADAMTS 13; breaking vWF into smaller useable polypeptide fragments
TTP treatment
plasma exchange EPLEX NO PLATELET TRANSFUSION
What two manifestations are seen in TTP?
neurological and renal
abnormal ultra-large vWF multimers lead to
abnormal platelet activation and therefore thrombocytopenia
TTP can be induced with what three drugs
- cyclosporin, quinine, and tacrolimus
There is increased incidence of TTP with _________ and ________
pregnancy; HIV/AIDS
TTP CAUSE _____% FATALITY WITHOUT THERAPY
90
TTP patients have ______ survival rate with therapy
80-90 %
HUS
hemolytic uremia syndrome
- less neurolgocial and more renal
- GI diarrhea
- E coli and shiga toxin
- associated with TTP
HUS treatment
- PLEX
can transfuse if blood less present
platelet transfusion is contraindicated in
patients with TTP
shig toxin binds to ____ cells in the ____
epithelium; kidney
atypical HUS and treatment
HUS wihtout diarrhea; treated with PLEX and eculizamab
ITP
ideopathic thrombocytopenia purpura
- no diagnostic test
- diagnosis of exclusion
- can be provoked by virla infection
ITP treatment
- corticosteroids
- IVIg
- splenectomy
- rituximab
heparin induced thrmobocytopenia usually occurs _____ days after heparin therapy ; treatment
7-10 days; stop heparin
heparin can lead to ________ mediated thrombocytopin
immune
T/F aspirin can cause platelets to become hypofunctional
T
heparin induced thrombocytopenia
can happen within 5-14 dyas after heparin adminstration… cause sever thrombocytopenia…. very important to monitor aTTP and platelt levels when prescribing heparin
