Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
|
What is TTP etiology?
|
Sporadic caases are due to an antibody against the protease which cleaves the ultra-large molecular wt multimers of von Willebrand's factor.
The protease is called ADAMTS-13, which stands for A Disintegrin And Metalloprotease with Thrombospondin like repeats... more |
|
|
treatment for TTP?
|
plasma exchange
|
|
|
should platelet transfusion be used for ttp tx?
|
no- they fuel the fire
|
|
|
what are the unique features of TTP/HUS?
|
fever, neuro sequelae, but more renal manifestiations. usually precipitated by dirrheal illness. esp e.coli 0157:H7 or shigella . more in ped pts. respond less well to plasma exchange
|
|
|
what drugs are clinically induce thromocytomenia?
|
B-lactam antibiotics, Trimethoprim-sulfamethoxazole and other sulfa drugs, quinine/quinidine, heparin, abciximab (ReoPro)
|
|
|
what is heparin induced thrombocytopenia?
|
1-3% of pts with heparin get it 7-10 days after heparin, platelts fall by 30-50%. plattlet counts do not have to be normal. if platelets fall on heparin, stop heparin immediately. can lead, paradoxically to thrombosis in some pts.
|
|
|
ITP?
|
need to exclude splenomegaly and subclinical thyroid disease. megakaryocytes should be present inthe marrow because it is a peripheral descructive process. in adults when platelt count < 50, get tx.
|
|
|
ITP in kids?
|
in kids is is usually provoked by viral illness and no tx needed.
|
|
|
itp tx?
|
corticosteriods, take 48-72 hrs to take effect.
if platelet count <10K, or if pt bleeding, need more rapid Tx, use IVIg if pt is Rh +, cuse Anti-D in place of IVIg, acts as a decoy for splenic macrophages |
|
|
ITP Therapy?
|
2/3 of adult pts will relapse after steriod taper. in this case, splenectomy is required. 2/3 of pts respond to splenectomy. otherwise, more immunosuppresson
|
|
|
splenic sequestration?
|
normally 1/3 of total platelet mass resides in spleen. splenic enlargement from any cause can lead to displacement of platelets from peripheral circulaton into splenic pool.
|
|
|
splenimegaly causes?
|
Portal Hypertension
Malignancy Chronic Hemolytic Diseases-Hemoglobin C (not Sickle Cell Disease, they have small spleen!), Thallassemias, Hereditary Sperocytosis. |
|
|
Thrombocytosis?
|
too many platelets!
|
