TTP-HUS and HIT

Question 1

Deficiency in TTP

Answer 1

ADAMTS13

Question 2

ADAMTS13 function

Answer 2

cleaves vWF multimers

Question 3

TTP can be caused by

Answer 3

Cancer
Transplant recipients
Chemotherapy
Drugs- quinine, clopidogrel, ticlopidine, cyclosporine, gemcitabine

Question 4

Infection associated with HUS

Answer 4

Ecoli O157:H7 or Shigella

Question 5

20% of people with infection-related bloody diarrhea progress to

Answer 5

HUS microangiopathic hemolytic anemia, AKI.. 6 days after onset.

Question 6

Labs in TTP-HUS

Answer 6

elevated, bilirubin and LDH, fragmented erythrocytes

Question 7

Clinical findings in TTP

Answer 7

Fever, kidney disease, neurologic abnormalities

Question 8

TTP treatment

Answer 8

remove causative drug

PLEX

Question 9

HUS treatment

Answer 9

supportive therapy

Question 10

In TTP-HUS do not order

Answer 10

Platelet transfusion

Question 11

In TTP-HUS, PT, PTT, d-dimer and fibrinogen are

Answer 11

Normal

Question 12

HIT criteria

Answer 12

Platelets decrease by >50% in a patient taking heparin
Thromboembolic event 5-10 days after starting heparin
Patient with recent exposure (last 30 days) May develop HIT for rapidly after re-exposure

Question 13

Testing for HIT

Answer 13

ELISA for heparin/PF4 antibodies

Serotonin release assay

Question 14

Treatment for HIT

Answer 14

Discontinue Heparin

Start Argatroban, Fondaparinux, bivalirudin

Question 15

For HIT, you cannot us

Answer 15

Warfarin, LMWH