Thrombocytopenia

Question 1

DIC disseminated intravascular coagulation definition

Answer 1

• 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

Question 2

DIC will have a prolonged/normal PT

Answer 2

prolonged

Question 3

DIC treatments

Answer 3

• treat cause - transfuse, coagulation factors

Question 4

DIC will have decreased/increased fibrinogen

Answer 4

decreased

Question 5

TTP thrombic thrombocytopenia purpura

Answer 5

abnormal vWF leads to abnormal platelet and endothelial cell activation

Question 6

purpura

Answer 6

spots on the skin that do not blanch when pressure is applied

Question 7

DIC will have elevated/normal D-dimer

Answer 7

elevated

Question 8

DIC is associated with

Answer 8

1. 1. severe burns
2. sepsis
3. gram negative bacteria
4. venoms
5. shock
6. OBGYN disasters
7. leukemia

Question 9

pseudothrombocytopenia

Answer 9

• artificially low platelet count - due to platelet clumping

Question 10

thrombocytopenia can caused by three categories

Answer 10

1. underproduction 2. peripheral destruction 3. splenic sequestration

Question 11

underproduction

Answer 11

1. bone marrow toxin- radiology, chemo therapy 2. bone marrow infiltration- tumor 3. marrow failure- myelodysplasia, aplastic anemia, vitamin deficiencies

Question 12

DIC has elevated PT due to consumption of factor _____

Answer 12

VII

Question 13

TTP clinical characterizations

Answer 13

1. fever 2. MAHA: elevated bilirubin and LDH, schistocytes 3. decreased platelets 4. renal and neurological manifestations

Question 14

What protease is abnormal in TTP and what is it normally required for?

Answer 14

ADAMTS 13; breaking vWF into smaller useable polypeptide fragments

Question 15

TTP treatment

Answer 15

plasma exchange EPLEX NO PLATELET TRANSFUSION

Question 16

What two manifestations are seen in TTP?

Answer 16

neurological and renal

Question 17

abnormal ultra-large vWF multimers lead to

Answer 17

abnormal platelet activation and therefore thrombocytopenia

Question 18

TTP can be induced with what three drugs

Answer 18

• cyclosporin, quinine, and tacrolimus

Question 19

There is increased incidence of TTP with _________ and ________

Answer 19

pregnancy; HIV/AIDS

Question 20

TTP CAUSE _____% FATALITY WITHOUT THERAPY

Answer 20

90

Question 21

TTP patients have ______ survival rate with therapy

Answer 21

80-90 %

Question 22

HUS

hemolytic uremia syndrome

Answer 22

• less neurolgocial and more renal
• GI diarrhea
• E coli and shiga toxin
• associated with TTP

Question 23

HUS treatment

Answer 23

1. PLEX

can transfuse if blood less present

Question 24

platelet transfusion is contraindicated in

Answer 24

patients with TTP

Question 25

shig toxin binds to ____ cells in the ____

Answer 25

epithelium; kidney

Question 26

atypical HUS and treatment

Answer 26

HUS wihtout diarrhea; treated with PLEX and eculizamab

Question 27

ITP

ideopathic thrombocytopenia purpura

Answer 27

• no diagnostic test
• diagnosis of exclusion
• can be provoked by virla infection

Question 28

ITP treatment

Answer 28

1. corticosteroids
2. IVIg
3. splenectomy
4. rituximab

Question 29

heparin induced thrmobocytopenia usually occurs _____ days after heparin therapy ; treatment

Answer 29

7-10 days; stop heparin

Question 30

heparin can lead to ________ mediated thrombocytopin

Answer 30

immune

Question 31

T/F aspirin can cause platelets to become hypofunctional

Answer 31

T

Question 32

heparin induced thrombocytopenia

Answer 32

can happen within 5-14 dyas after heparin adminstration… cause sever thrombocytopenia…. very important to monitor aTTP and platelt levels when prescribing heparin