thrombocytopnea

Question 1

what is thrombocytopnea theoretically and clinically ?

Answer 1

theoretically platelet count of less than 150,000 ul

however clinically only relevan if less than 50,0000

Question 2

what are thesigns and symptoms of thrombocytopnea ?

Answer 2

low platlets give rise to superficial bleeding

such as of the skin
petechiae (1-2mm)
ecchymosisis (more than 3mm)
and purpura (more than 1mm)

epistaxis nose bleeds
bleeding from the gum
bleeding from superifical scratches

Question 3

what are the causes for thrombocytopnea ?

Answer 3

can be due to three reasoins due to less bone marrow broduction

due to increased destruction

and splenic sequesteration - such as in sickle cell anemia and protal hypertesnion

Question 4

what are the causes for reduced bone marrow production ?

Answer 4

aplastic pancytopnea = fanconi anemia

liver diseaes - does not secrete thrombopoetin

dehydration

vitb12 and folic acid deficicny

medication
valporic acid
chemotherapy

Question 5

whata re the causes for increased destruction

Answer 5

immunne causes
= immune thrombocytopenic purpura (antibodies againts platlets )
SLE

non immune causs
DIC
micorangipathic hemolytic anemia
HELLP syndrome

Question 6

what are the different types of microangipathic hemolytic anemia ?

Answer 6

hemolytic uremic syndrome

and thrombotic thrombocytopena

Question 7

what is the differnece between the two microangiopathic hemolytic anemia ?

Answer 7

hemolytic uremic syndrome
is caused by ecoli
giving bloody diarrhea
and acute renal failure

in thrombotic thrombocytopena 
there is no bloody diarrhea 
but it does cause acute renal failure 
fevere 
neurlogical manifestation

Question 8

what are the different types of immune thrombocytopena purpura causing thrombocytopena ?

Answer 8

acute 
affects children 2-6 years old 
after viral infection 
sponatenous remission in 2-6 weeks 
platle count at presentation is less tan 20,000/ul 

chronic 
affects females of 20-40 years olf 
can be primary 
secondary due to hep c , hiv , lupus 
duration is long term 
no spontanoeus remission 
and platet count at presentation less than 50,000/ul

Question 9

how can we diagnose thrombocytopnea ?

Answer 9

rule out other causes for thrombocytopnea such as macrocytic anemia
rule out splenomegaly
hep c serology taken

ptt and aptt is not affected because itdoes not affect the secodnary hemostaisis

do cbc

Question 10

what is the treatmnet for immunemedated thrombocytopenic purpura ?

Answer 10

20-50,000
only treatmnet if bleeding = give glucocorticoid and IVIgG

if less than 20,000
give glucoorticoids regardless
if there is bleeding give IVIgG

Question 11

what is the treatmnet for thrombocytopnea ?

Answer 11

if there is no bleeding no tretamnet
steroid and folate to boost platelet production
transfusion of fresh froxen plasma platelets if less than 10,000 /ul platlets